Science.gov

Sample records for overcoming organizational barriers

  1. Overcoming the organization-practice barrier in sports injury prevention: A nonhierarchical organizational model.

    PubMed

    Dahlström, Ö; Jacobsson, J; Timpka, T

    2015-08-01

    The organization of sports at the national level has seldom been included in scientific discussions of sports injury prevention. The aim of this study was to develop a model for organization of sports that supports prevention of overuse injuries. The quality function deployment technique was applied in seminars over a two-season period to develop a national organizational structure for athletics in Sweden that facilitates prevention of overuse injuries. Three central features of the resulting model for organization of sports at the national level are (a) diminishment of the organizational hierarchy: participatory safety policy design is introduced through annual meetings where actors from different sectors of the sporting community discuss training, injury prevention, and sports safety policy; (b) introduction of a safety surveillance system: a ubiquitous system for routine collection of injury and illness data; and (c) an open forum for discussion of safety issues: maintenance of a safety forum for participants from different sectors of the sport. A nonhierarchical model for organization of sports at the national level - facilitated by modern information technology - adapted for the prevention of overuse injuries has been developed. Further research is warranted to evaluate the new organizational model in prospective effectiveness studies.

  2. Transforming Education: Overcoming Barriers.

    ERIC Educational Resources Information Center

    David, Jane L.; Goren, Paul D.

    Barriers to progress in educational reform exist inside and outside the education system. Some arise where new practices encounter traditional expectations and boundaries, but others go much deeper than education, such as poverty, racism, local political conflicts, and human resistance to change. The following five categories of barriers are…

  3. OVERCOMING CULTURAL BARRIERS.

    ERIC Educational Resources Information Center

    BARRUTIA, RICHARD

    THE RELATIONSHIP OF LANGUAGE DEVELOPMENT TO CULTURAL BARRIERS AND THE TEACHING OF FOREIGN LANGUAGES IS DISCUSSED IN THIS ARTICLE. VARIOUS VIEWS OF THE MEANING OF CULTURE ARE MENTIONED IN ORDER TO SINGLE OUT ANTHROPOLOGICAL CULTURE AS A MAIN FOCAL POINT. INTERCULTURAL DIFFERENCES ARE SPELLED OUT WITH EXAMPLES OF LINGUISTIC BARRIERS, AND…

  4. Overcoming Language Barriers

    PubMed Central

    De Buda, Yvonne

    1976-01-01

    Many family physicians in Canada experience language and cultural barriers between themselves and their patients. Several aspects of the ensuing problems are described and some practical suggestions for solutions are made. The importance of health education for new Canadians in the family physician's office as well as through the media and community projects is stressed. Imagesp68-ap68-bp70-a PMID:21308059

  5. Overcoming Blocks and Barriers to Creativity.

    ERIC Educational Resources Information Center

    Raudsepp, Eugene

    1982-01-01

    Organizational barriers to creativity are examined. It is noted that resistance to change is a major impediment to creative problem solving in most organizations. Understanding the barriers to change that exist is viewed to help people exercise and develop their creativity more fully and effectively. (MP)

  6. Overcoming Barriers: Women in Superintendency

    ERIC Educational Resources Information Center

    Miller, Claire M.

    2009-01-01

    Women currently represent the largest number of teachers in the United States but remain underrepresented in the superintendent position. This suggests that the superintendency has been influenced by patriarchy. If women are to break through the barriers that prevent them from attaining a superintendency, we will need to understand the social…

  7. Overcome barriers to career success

    SciTech Connect

    Raudsepp, E.

    1983-04-01

    A test is given to determine if an engineer suffers from one of the three barriers to technical success: fear of success, fear of failure, or perfectionism. As in most such tests, the middle way is best. Successful engineers know that perfection cannot be attained, that they don't have time to worry about failure or success, and that by aiming and perservering in doing things well, success can be achieved.

  8. Overcoming Barriers in the Media Center

    ERIC Educational Resources Information Center

    Winter, Clint

    2011-01-01

    Web 2.0 has revolutionized one's ability to teach students in new and exciting ways. Students with disabilities can now overcome many barriers that once kept them from being successful in the regular education classroom. Media specialists can effectively advocate for students with disabilities. School library media specialists have the ability to…

  9. Overcoming Barriers to Engaging in College Academics

    ERIC Educational Resources Information Center

    Hensley, Lauren; Shaulskiy, Stephanie; Zircher, Andrew; Sanders, Megan

    2015-01-01

    Underprepared college students face transition issues that prevent full academic engagement. The written responses of 176 students in a learning-strategies course were used to develop a grounded model of overcoming barriers to academic engagement. Findings revealed contexts in which academic engagement involved high costs (i.e., effort, trade-off,…

  10. Overcoming Barriers to Palliative Care Consultation.

    PubMed

    Perrin, Kathleen Ouimet; Kazanowski, Mary

    2015-10-01

    Palliative care consultations for patients with life-threatening illnesses provide benefits for the patients and their families as well as for the health care team. Patients have better quality of life and live longer but cost the health care system less. Still, many patients are not offered the opportunity to receive a palliative care consultation. Barriers to palliative care consultation for patients in critical care units include misunderstandings about palliative care and not having agreed upon criteria for referral. Critical care nurses can assist in overcoming these barriers.

  11. Weather in Mountainous Terrain (Overcoming Scientific Barriers to Weather Support)

    DTIC Science & Technology

    2011-02-15

    Weather in Mountainous Terrain (Overcoming Scientific Barriers to Weather Support) Fiesta Resort & Conference Center Tempe, AZ February 1...Meteorology Overcoming Scientific Barriers to Weather Support Fiesta Resort & Conference Center Tempe, AZ February 1 & 2, 2010 Hosted by University

  12. Fortification: overcoming technical and practical barriers.

    PubMed

    Hurrell, Richard F

    2002-04-01

    The main barriers to successful iron fortification are the following: 1) finding an iron compound that is adequately absorbed but causes no sensory changes to the food vehicle; and 2) overcoming the inhibitory effect on iron absorption of dietary components such as phytic acid, phenolic compounds and calcium. These barriers have been successfully overcome with some food vehicles but not with others. Iron-fortified fish sauce, soy sauce, curry powder, sugar, dried milk, infant formula and cereal based complementary foods have been demonstrated to improve iron status in targeted populations. The reasons for this success include the use of soluble iron such as ferrous sulfate, the addition of ascorbic acid as an absorption enhancer or the use of NaFeEDTA to overcome the negative effect of phytic acid. In contrast, at the present time, it is not possible to guarantee a similar successful fortification of cereal flours or salt. There is considerable doubt that the elemental iron powders currently used to fortify cereal flours are adequately absorbed, and there is an urgent need to investigate their potential for improving iron status. Better absorbed alternative compounds for cereal fortification include encapsulated ferrous sulfate and NaFeEDTA, which, unlike ferrous sulfate, do not provoke fat oxidation of cereals during storage. Encapsulated compounds also offer a possibility to fortify low grade salt without causing off-colors or iodine loss. Finally, a new and useful additional approach to ensuring adequate iron absorption from cereal based complementary foods is the complete degradation of phytic acid with added phytases or by activating native cereal phytases.

  13. Overcoming Organizational Fixation: Creating and Sustaining an Innovation Culture

    ERIC Educational Resources Information Center

    Stempfle, Joachim

    2011-01-01

    Fixation on established paradigms and practices can severely limit the capability of organizations to change, thereby jeopardizing the ability of organizations to keep up with changes in their environment and new technological developments. Overcoming organizational fixation is therefore a requirement for any organization that strives to achieve…

  14. Overcoming a nucleosomal barrier to replication

    PubMed Central

    Chang, Han-Wen; Pandey, Manjula; Kulaeva, Olga I.; Patel, Smita S.; Studitsky, Vasily M.

    2016-01-01

    Efficient overcoming and accurate maintenance of chromatin structure and associated histone marks during DNA replication are essential for normal functioning of the daughter cells. However, the molecular mechanisms of replication through chromatin are unknown. We have studied traversal of uniquely positioned mononucleosomes by T7 replisome in vitro. Nucleosomes present a strong, sequence-dependent barrier for replication, with particularly strong pausing of DNA polymerase at the +(31–40) and +(41–65) regions of the nucleosomal DNA. The exonuclease activity of T7 DNA polymerase increases the overall rate of progression of the replisome through a nucleosome, likely by resolving nonproductive complexes. The presence of nucleosome-free DNA upstream of the replication fork facilitates the progression of DNA polymerase through the nucleosome. After replication, at least 50% of the nucleosomes assume an alternative conformation, maintaining their original positions on the DNA. Our data suggest a previously unpublished mechanism for nucleosome maintenance during replication, likely involving transient formation of an intranucleosomal DNA loop. PMID:27847876

  15. Consumer and Employer Strategies for Overcoming Employment Barriers. Technical Report.

    ERIC Educational Resources Information Center

    Crudden, Adele; Williams, Wendy; McBroom, Lynn W.; Moore, J. Elton

    This report on strategies for overcoming employment barriers for persons with visual impairments summarizes comments and suggestions of 7 focus groups comprised of either consumers (n=49) or employers (n=19). The report first reviews the literature concerning employment barriers and how consumers in previous studies suggested these barriers be…

  16. Explaining and overcoming barriers to climate change adaptation

    NASA Astrophysics Data System (ADS)

    Eisenack, Klaus; Moser, Susanne C.; Hoffmann, Esther; Klein, Richard J. T.; Oberlack, Christoph; Pechan, Anna; Rotter, Maja; Termeer, Catrien J. A. M.

    2014-10-01

    The concept of barriers is increasingly used to describe the obstacles that hinder the planning and implementation of climate change adaptation. The growing literature on barriers to adaptation reveals not only commonly reported barriers, but also conflicting evidence, and few explanations of why barriers exist and change. There is thus a need for research that focuses on the interdependencies between barriers and considers the dynamic ways in which barriers develop and persist. Such research, which would be actor-centred and comparative, would help to explain barriers to adaptation and provide insights into how to overcome them.

  17. Overcoming cellular barriers for RNA therapeutics.

    PubMed

    Dowdy, Steven F

    2017-03-01

    RNA-based therapeutics, such as small-interfering (siRNAs), microRNAs (miRNAs), antisense oligonucleotides (ASOs), aptamers, synthetic mRNAs and CRISPR-Cas9, have great potential to target a large part of the currently undruggable genes and gene products and to generate entirely new therapeutic paradigms in disease, ranging from cancer to pandemic influenza to Alzheimer's disease. However, for these RNA modalities to reach their full potential, they first need to overcome a billion years of evolutionary defenses that have kept RNAs on the outside of cells from invading the inside of cells. Overcoming the lipid bilayer to deliver RNA into cells has remained the major problem to solve for widespread development of RNA therapeutics, but recent chemistry advances have begun to penetrate this evolutionary armor.

  18. Overcoming the English-language barrier

    NASA Astrophysics Data System (ADS)

    Mahoney, Terry J.

    Astronomers from non-English-speaking countries, who form a sizeable proportion of the astronomical research community, are obliged to communicate the results of their investigations in a language that is not their own. Consequently, good science is frequently masked by poor command of English, which can create an unnecessary barrier to the communication of scientific results. A suggested method of surmounting the language barrier is the setting up of scientific editorial services in at least the major astronomical centres. It is further argued that journal editors, rather than scientific referees, should be responsible for judging the linguistic and stylistic quality of articles presented for publication. The peer-review system would then be restricted exclusively to the scientific rather than linguistic content of papers presented. The scientific Editorial Service of the Instituto de Astrofisica de Canarias, in operation since 1996, is briefly described in this context.

  19. Desensitization: Overcoming the Immunologic Barriers to Transplantation

    PubMed Central

    Choi, Jua; Vo, Ashley; Peng, Alice; Jordan, Stanley C.

    2017-01-01

    HLA (Human Leucocyte Antigen) sensitization is a significant barrier to successful kidney transplantation. It often translates into difficult crossmatch before transplant and increased risk of acute and chronic antibody mediated rejection after transplant. Over the last decade, several immunomodulatory therapies have emerged allowing for increased access to kidney transplantation for the immunologically disadvantaged group of HLA sensitized end stage kidney disease patients. These include IgG inactivating agents, anti-cytokine antibodies, costimulatory molecule blockers, complement inhibitors, and agents targeting plasma cells. In this review, we discuss currently available agents for desensitization and provide a brief analysis of data on novel biologics, which will likely improve desensitization outcomes, and have potential implications in treatment of antibody mediated rejection. PMID:28127571

  20. Organizational Barriers to Cultural Competence in Hospice.

    PubMed

    Reese, Dona J; Beckwith, Samira K

    2015-11-01

    This national mixed method study with directors of 207 hospices identified major barriers to cultural competence, including (1) lack of funding for additional staff for community outreach or development of culturally competent programs, (2) lack of applications from diverse professionals, and (3) lack of knowledge about diverse cultures and what cultural groups in the community are not being served. Qualitative results indicated that elements of an organizational culture, which create barriers to access included (1) failure to prioritize cultural competence, (2) failure to budget for culturally competent services, and (3) a staff that does not value awareness of cultural differences, is uncomfortable with diversity, and stereotypes diverse individuals. In phase 2, an interactive session with a 100-symposium audience provided strategies to address the barriers.

  1. Overcoming Nonviral Gene Delivery Barriers: Perspective and Future

    PubMed Central

    Jones, Charles H.; Chen, Chih-Kaung; Ravikrishnan, Anitha; Rane, Snehal; Pfeifer, Blaine A.

    2013-01-01

    A key end goal of gene delivery research is to develop clinically-relevant vectors that can be used to combat elusive diseases such as AIDS. Despite promising engineering strategies, efficiency and ultimately gene modulation efficacy of nonviral vectors have been hindered by numerous in vitro and in vivo barriers that have resulted in sub-viral performance. In this perspective, we concentrate on the gene delivery barriers associated with the two most common classes of nonviral vectors, cationic-based lipids and polymers. We present the existing delivery barriers and summarize current vector-specific strategies to overcome said barriers. PMID:24093932

  2. Overcoming Barriers to School Based Research: A Local School Perspective.

    ERIC Educational Resources Information Center

    Epps, Jean M.

    The importance of collaboration between professional research and professional personnel in the classroom and school office is described, and suggestions are made for overcoming barriers to effective collaboration. Crandall's conditions for effective collaboration are: that the participants possess substantive competency; that both organizations…

  3. Overcoming barriers to Baby-Friendly status: one hospital's experience.

    PubMed

    McKeever, Joyce; Fleur, Rose St

    2012-08-01

    The journey toward Baby-Friendly status at Jersey Shore University Medical Center in Neptune, NJ began with a desire to improve overall breastfeeding rates at the hospital. Although evidence showed that hospitals that incorporated some or all of the Ten Steps to Successful Breastfeeding had improved breastfeeding rates, it was difficult to overcome barriers that prevented the hospital physicians and nursing staff from seeing the value in adopting this quality initiative. Long-standing practices combined with misinformation compounded the problem. That situation changed when several factors nationally and statewide came together to create a prime environment for implementation of the Baby-Friendly Hospital Initiative. This article will discuss the barriers that one hospital encountered and the strategies used to overcome these common barriers to achieving Baby-Friendly status. This hospital is not yet designated as Baby-Friendly but is awaiting the outcome of a site visit in 2012.

  4. Overcoming of energy barrier for irreversible magnetization in nanocomposite magnets

    NASA Astrophysics Data System (ADS)

    Li, Zhu-bai; Zhang, Ying; Shen, Bao-gen; Zhang, Ming; Hu, Feng-xia; Sun, Ji-rong

    2017-01-01

    The irreversible magnetization occurs mainly in hard grains in nanocomposite magnets, and the domain wall involves a little part of defect region in irreversible magnetization due to the self-interaction. The investigation on thermal activation shows that the defect region involved in domain wall becomes narrower due to the TiNb addition in Pr2Fe14B/α-Fe magnets. The defect region augments the energy density in the negative direction of domain wall to overcome the energy barrier of perfect hard region. The soft phase, exchange-coupled with defect region at hard grain outer-layer, promotes magnetization reversal in defect region by exchange coupling. While the defect region plays a role as a ladder to overcome the energy barrier, resulting in the decrease of coecivity more or less depending upon the width and anisotropy of defect region.

  5. Overcoming barriers to health service access: influencing the demand side.

    PubMed

    Ensor, Tim; Cooper, Stephanie

    2004-03-01

    Evidence suggests that demand-side barriers may be as important as supply factors in deterring patients from obtaining treatment. Yet relatively little attention is given, either by policy makers or researchers, to ways of minimizing their effect. These barriers are likely to be more important for the poor and other vulnerable groups, where the costs of access, lack of information and cultural barriers impede them from benefiting from public spending. Demand barriers present in low- and middle-income countries and evidence on the effectiveness of interventions to overcome these obstacles are reviewed. Demand barriers are also shown to be important in richer countries, particularly among vulnerable groups. This suggests that while barriers are plentiful, there is a dearth of evidence on ways to reduce them. Where evidence does exist, the data and methodology for evaluating effectiveness and cost-effectiveness is insufficient. An increased focus on obtaining robust evidence on effective interventions could yield high returns. The likely nature of the interventions means that pragmatic policy routes that go beyond the traditional boundaries of the public health sector are required for implementing the findings.

  6. Overcoming translational barriers impeding development of Alzheimer's disease modifying therapies.

    PubMed

    Golde, Todd E

    2016-10-01

    It has now been ~ 30 years since the Alzheimer's disease (AD) research entered what may be termed the 'molecular era' that began with the identification of the amyloid β protein (Aβ) as the primary component of amyloid within senile plaques and cerebrovascular amyloid and the microtubule-associated protein tau as the primary component of neurofibrillary tangles in the AD brain. These pivotal discoveries and the subsequent genetic, pathological, and modeling studies supporting pivotal roles for tau and Aβ aggregation and accumulation have provided firm rationale for a new generation of AD therapies designed not to just provide symptomatic benefit, but as disease modifying agents that would slow or even reverse the disease course. Indeed, over the last 20 years numerous therapeutic strategies for disease modification have emerged, been preclinically validated, and advanced through various stages of clinical testing. Unfortunately, no therapy has yet to show significant clinical disease modification. In this review, I describe 10 translational barriers to successful disease modification, highlight current efforts addressing some of these barriers, and discuss how the field could focus future efforts to overcome barriers that are not major foci of current research efforts. Seminal discoveries made over the past 25 years have provided firm rationale for a new generation of Alzheimer's disease (AD) therapies designed as disease modifying agents that would slow or even reverse the disease course. Unfortunately, no therapy has yet to show significant clinical disease modification. In this review, I describe 10 translational barriers to successful AD disease modification, highlight current efforts addressing some of these barriers, and discuss how the field could focus future efforts to overcome these barriers. This article is part of the 60th Anniversary special issue.

  7. Evolving Drug Delivery Strategies to Overcome the Blood Brain Barrier

    PubMed Central

    Hersh, David S.; Wadajkar, Aniket S.; Roberts, Nathan B.; Perez, Jimena G.; Connolly, Nina P.; Frenkel, Victor; Winkles, Jeffrey A.; Woodworth, Graeme F.; Kim, Anthony J.

    2016-01-01

    The blood-brain barrier (BBB) poses a unique challenge for drug delivery to the central nervous system (CNS). The BBB consists of a continuous layer of specialized endothelial cells linked together by tight junctions, pericytes, nonfenestrated basal lamina, and astrocytic foot processes. This complex barrier controls and limits the systemic delivery of therapeutics to the CNS. Several innovative strategies have been explored to enhance the transport of therapeutics across the BBB, each with individual advantages and disadvantages. Ongoing advances in delivery approaches that overcome the BBB are enabling more effective therapies for CNS diseases. In this review, we discuss: (1) the physiological properties of the BBB, (2) conventional strategies to enhance paracellular and transcellular transport through the BBB, (3) emerging concepts to overcome the BBB, and (4) alternative CNS drug delivery strategies that bypass the BBB entirely. Based on these exciting advances, we anticipate that in the near future, drug delivery research efforts will lead to more effective therapeutic interventions for diseases of the CNS.

  8. Barriers to women engaging in collective action to overcome sexism.

    PubMed

    Radke, Helena R M; Hornsey, Matthew J; Barlow, Fiona Kate

    2016-12-01

    Over centuries women have fought hard to obtain increasing gender equality, but despite these successes absolute equality remains an elusive goal. Theoretically, women's numerical strength makes them well-placed to take effective collective action, and millions of women engage in feminist collective action every day. In this article, however, we argue that women also face barriers to engaging in feminist collective action; barriers that are associated with the social construction and experience of what it means to be a woman. Our review synthesizes sexism research under a contemporary collective action framework to clarify our current understanding of the literature and to offer novel theoretical explanations for why women might be discouraged from engaging in feminist collective action. Using the antecedents of collective action identified by van Zomeren, Postmes, and Spears' (2008) meta-analysis, we critically review the sexism literature to argue that women face challenges when it comes to (a) identifying with other women and feminists, (b) perceiving sexism and expressing group-based anger, and (c) recognizing the efficacy of collective action. We then outline a research agenda with a view to investigating ways of overcoming these barriers. (PsycINFO Database Record

  9. Overcoming barriers to pain relief in the Caribbean.

    PubMed

    Macpherson, Cheryl; Aarons, Derrick

    2009-12-01

    This paper examines pain and pain relief in the Caribbean, where pain is widely perceived as an unavoidable part of life, and where unnecessary suffering results from untreated and under treated pain. Barriers to pain relief in the Caribbean include patient and family attitudes, inadequate knowledge among health professionals and unduly restrictive regulations on the medical use of opioids. Similar barriers exist all over the world. This paper urges medical, nursing and public health professionals, and educators to examine attitudes towards pain and pain relief and to work towards making effective pain relief and palliation more accessible. It recommends that i) health professionals and officials be better educated about pain, palliation and opioids, ii) regulatory restrictions be updated in light of clinical and scientific evidence, iii) opioid procurement policies be adjusted to facilitate increased medical use, iv) medical charts and records be modified to routinely elicit and document patients levels of pain, and v) educational campaigns be developed to inform the public that moderate and severe pain can be safely relieved at the end of life and other stages of life. The professional, respectful, and beneficent response to patients in pain is to provide rapid and aggressive pain relief or to urgently consult a pain or palliative specialist. When a health system hinders such efforts the ethical response is to identify, facilitate and advocate for overcoming barriers to improvement.

  10. Self-induced dust traps: overcoming planet formation barriers

    NASA Astrophysics Data System (ADS)

    Gonzalez, J.-F.; Laibe, G.; Maddison, S. T.

    2017-01-01

    Planet formation is thought to occur in discs around young stars by the aggregation of small dust grains into much larger objects. The growth from grains to pebbles and from planetesimals to planets is now fairly well understood. The intermediate stage has however been found to be hindered by the radial-drift and fragmentation barriers. We identify a powerful mechanism in which dust overcomes both barriers. Its key ingredients are i) backreaction from the dust onto the gas, ii) grain growth and fragmentation, and iii) large-scale gradients. The pile-up of growing and fragmenting grains modifies the gas structure on large scales and triggers the formation of pressure maxima, in which particles are trapped. We show that these self-induced dust traps are robust: they develop for a wide range of disc structures, fragmentation thresholds and initial dust-to-gas ratios. They are favored locations for pebbles to grow into planetesimals, thus opening new paths towards the formation of planets.

  11. Polymeric nanoparticles of different sizes overcome the cell membrane barrier.

    PubMed

    Lerch, Simone; Dass, Martin; Musyanovych, Anna; Landfester, Katharina; Mailänder, Volker

    2013-06-01

    Polymeric nanoparticles have tremendous potential either as carriers or markers in treatment for diseases or as diagnostics in biomedical applications. Finding the optimal conditions for effective intracellular delivery of the payload to the location of interest is still a big challenge. The particles have to overcome the barrier of the cell membrane. Here, we investigated the uptake in HeLa cells of fluorescent polystyrene particles with different size and surface charge. Particles stabilized with the nonionic surfactant Lutensol AT50® (132 nm, 180 nm, 242 nm, 816 nm, 846 nm diameter) were synthesized via dispersion polymerization. Cationic particles (120 nm, 208 nm, 267 nm, 603 nm diameter) were obtained by a combination of miniemulsion and seed dispersion polymerization using cationic surfactant (cetyltrimethylammonium chloride (CTMA-Cl). The particle uptake into HeLa cells was studied by confocal laser scanning microscopy and flow cytometry. Nonionic particles were - independent of their size - taken up by cells only at a barely detectable level, thus aggravating a quantitative comparison. The uptake of positively charged particles was substantially higher and therefore enabling further investigation keeping constant one of these parameters: either material amount or particles number or total interaction surface area. It was found that the uptake rather depends on the total amount of polymeric material present in the media than on the number of particles. The total particle's surface area does not correlate linearly with the uptake, thus indicating that there is no direct dependency between the total surface area and the cellular endocytotic process to overcome the biobarrier "cell membrane." A potentially novel uptake mechanism is found which can be described as an excavator shovel like mechanism. It is a kind of macropinocytosis dependent on actin filaments as well as dynamin, but is clathrin-independent.

  12. Overcoming barriers to integrating economic analysis into risk assessment.

    PubMed

    Hoffmann, Sandra

    2011-09-01

    Regulatory risk analysis is designed to provide decisionmakers with a clearer understanding of how policies are likely to affect risk. The systems that produce risk are biological, physical, and social and economic. As a result, risk analysis is an inherently interdisciplinary task. Yet in practice, risk analysis has been interdisciplinary in only limited ways. Risk analysis could provide more accurate assessments of risk if there were better integration of economics and other social sciences into risk assessment itself. This essay examines how discussions about risk analysis policy have influenced the roles of various disciplines in risk analysis. It explores ways in which integrated bio/physical-economic modeling could contribute to more accurate assessments of risk. It reviews examples of the kind of integrated economics-bio/physical modeling that could be used to enhance risk assessment. The essay ends with a discussion of institutional barriers to greater integration of economic modeling into risk assessment and provides suggestions on how these might be overcome.

  13. Overcoming Barriers to Wind Development in Appalachian Coal Country

    SciTech Connect

    Brent Bailey; Evan Hansen

    2012-10-09

    This research project synthesizes existing data and communication from experts to assess barriers to wind development in Pennsylvania, Maryland, West Virginia, Virginia, and Kentucky, and makes recommendations where feasible to reduce or eliminate those barriers.

  14. 75 FR 58347 - Information Collection; Overcoming Barriers to Wildland Fire Defensible Space Behaviors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ...; ] DEPARTMENT OF AGRICULTURE Forest Service Information Collection; Overcoming Barriers to Wildland Fire... Fire Defensible Space Behaviors. DATES: Comments must be received in writing on or before November 23...: Overcoming Barriers to Wildland Fire Defensible Space Behaviors. OMB Number: 0596-New. Type of Request:...

  15. Overcoming Barriers to Total Quality Management in Colleges and Universities.

    ERIC Educational Resources Information Center

    Winter, Robert S.

    1991-01-01

    To implement Total Quality Management concepts successfully, colleges and universities must change their cultures significantly. In higher education, with its organizational characteristics and traditions, authority relationships between faculty and administrators must be recognized, and some changes in the role and attention of leaders must…

  16. SOLUTIONS TO OVERCOME BARRIERS TO IMPLEMENTATION OF TREATMENT TECHNOLOGIES

    EPA Science Inventory

    To make treatment a viable option for remediation you must first identify the barriers to implementing treatment. The primary barrier is economics. Treatment options are relatively expensive and there is a lack of funds for treatment. The cost of technologies can be lowered by 1)...

  17. Teaching English Language Learners: Strategies for Overcoming Barriers

    ERIC Educational Resources Information Center

    Helfrich, Sara R.; Bosh, Amy J.

    2011-01-01

    The number of English language learners (ELLs) in today's classrooms is increasing. In this article, the authors identify four perceived barriers beginning and veteran teachers face in teaching literacy to ELLs: the lack of understanding of the role of literacy in other cultures, the teacher's inability to differentiate instruction to meet the…

  18. Automation U.S.A.: Overcoming Barriers to Automation.

    ERIC Educational Resources Information Center

    Brody, Herb

    1985-01-01

    Although labor unions and inadequate technology play minor roles, the principal barrier to factory automation is "fear of change." Related problems include long-term benefits, nontechnical executives, and uncertainty of factory cost accounting. Industry support for university programs is helping to educate engineers to design, implement, and…

  19. Adolescents' Self-Efficacy to Overcome Barriers to Physical Activity Scale

    ERIC Educational Resources Information Center

    Dwyer, John J. M.; Chulak, Tala; Maitland, Scott; Allison, Kenneth R.; Lysy, Daria C.; Faulkner, Guy E. J.; Sheeshka, Judy

    2012-01-01

    This paper describes a revised measure of self-efficacy to overcome barriers to moderate and vigorous physical activity in a sample of 484 high school students in Toronto, Ontario. The students had a mean age of 15.3 years. Principal axis factoring with oblique rotation yielded five factors: self-efficacy to overcome internal, harassment, physical…

  20. Overcoming barriers in online workshop development: an ELITE experience.

    PubMed

    Talcott, Kimberly S; O'Donnell, John M; Burns, Helen K

    2013-06-01

    The Emerging Learning and Integrated Technologies Education (ELITE) Faculty Development Program created eight online workshops to assist nurse educators in using technology within their organization's nurse education program. Continuing education units were provided for completion of the individual online workshops. The ELITE program worked through several barriers to transform content that was previously presented during face-to-face workshops into standalone online offerings. Barriers and implementation strategies for the on-site to online transition included restructuring workshop objectives, keeping current with rapid technology changes, altering a course management system to meet the needs of the program and the learner, and crafting independent practice opportunities for the online learner. The online workshop development experience of the ELITE program may assist other continuing education and staff development professionals who are updating their program offerings or pursuing online education for the first time.

  1. Implementing District Energy Systems: Municipal Approaches To Overcoming Barriers

    NASA Astrophysics Data System (ADS)

    Simpson, Kevin George

    Climate change and energy security are issues facing municipalities throughout the world. Efficient, resilient, sustainable, community-based energy systems, such as district energy systems (DES), fuelled mostly by renewables, are an important tool for addressing both climate change and energy security at the municipal level. In spite of their benefits, DES are not widely adopted in Canada (CDEA, 2011). This is due to the complex nature of the barriers which project proponents face. This thesis examines the experience of the City of Prince George in adopting and implementing the Downtown DES. Using a case study methodology, data was collected through a review of relevant municipal documents and a series of semi-structured, open-ended interviews. A thematic analysis revealed unexpected barriers related to lack of adequate public consultation and negative perceptions regarding biomass as a fuel for the DES. These `lessons learned' were then developed into recommendations for other municipalities considering DES.

  2. No One Is Unemployable: Creative Solutions for Overcoming Barriers to Employment.

    ERIC Educational Resources Information Center

    Harney, Elisabeth E.

    The goal of the WorkNet Model Career Development & Job Placement for people with barriers is to help even the most challenged job seekers begin and advance in careers they enjoy. This paper presents one key component of the WorkNet Model, a practical process for creatively overcoming any barrier a candidate faces. The chapter includes: the…

  3. Overcoming barriers to public understanding of climate change

    NASA Astrophysics Data System (ADS)

    Hayhoe, K.

    2012-12-01

    Humans are interfering with global climate, increasing the risk of serious consequences for human society and the natural environment. As the scientific evidence builds, however, so does the public controversy surrounding this issue. Why is climate change so contentious? What makes it so hard to comprehend? I argue that there is no single reason for this, but rather a perfect storm of multiple confounding factors; scientific, historical, ideological, psychological and even physiological in nature. Education—of both the messengers and the audience—can play a critical role in surmounting many of the common barriers to understanding, accepting, and acting this important issue.

  4. Overcoming the barriers to using kangaroo care in neonatal settings.

    PubMed

    Penn, Sarah

    2015-06-01

    Skin-to-skin contact, or kangaroo care (KC), has benefits for babies and parents, improving clinical outcomes, temperature control, breastfeeding rates and child-parent bonding; it reduces morbidity and mortality. Barriers to KC for neonates may include a lack of training for nurses, lack of time, maternal or child physical or mental ill health, and inappropriate settings. With education and helpful management, neonatal nurses can advocate for KC for all babies. Parents may need information and encouragement to begin with. Therefore, nurses can improve the experiences of their patients and, in the long run, free time to perform clinical procedures.

  5. Kidney Exchange to Overcome Financial Barriers to Kidney Transplantation.

    PubMed

    Rees, M A; Dunn, T B; Kuhr, C S; Marsh, C L; Rogers, J; Rees, S E; Cicero, A; Reece, L J; Roth, A E; Ekwenna, O; Fumo, D E; Krawiec, K D; Kopke, J E; Jain, S; Tan, M; Paloyo, S R

    2017-03-01

    Organ shortage is the major limitation to kidney transplantation in the developed world. Conversely, millions of patients in the developing world with end-stage renal disease die because they cannot afford renal replacement therapy-even when willing living kidney donors exist. This juxtaposition between countries with funds but no available kidneys and those with available kidneys but no funds prompts us to propose an exchange program using each nation's unique assets. Our proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers. By making developed-world health care available to impoverished patients in the developing world, we replace unethical transplant tourism with global kidney exchange-a modality equally benefitting rich and poor. We report the 1-year experience of an initial Filipino pair, whose recipient was transplanted in the United states with an American donor's kidney at no cost to him. The Filipino donor donated to an American in the United States through a kidney exchange chain. Follow-up care and medications in the Philippines were supported by funds from the United States. We show that the logistical obstacles in this approach, although considerable, are surmountable.

  6. Physical activity and exercise after stoma surgery: overcoming the barriers.

    PubMed

    Russell, Sarah

    2017-03-09

    This article presents the results from a large nationwide survey completed in 2016 that investigated the physical health and wellbeing of people living with stomas in the UK. In particular, the survey looked at physical activity and exercise, general attitudes and opinions about exercise, whether or not advice about physical activity had been received and other general questions about parastomal hernia and quality of life. There were 2631 respondents making it one of the largest known surveys to date. The findings were concerning yet unsurprising, highlighting a trend toward inactivity after stoma surgery and a fear of exercise in general. People also seem to have poor knowledge about appropriate activities, with many suggesting that the fear of developing a parastomal hernia is a major barrier to activity. Unsurprisingly, those who have a stoma owing to cancer seem to fare worse, reporting even lower levels of physical activity and worse quality of life compared to those with other conditions. This indicates that people who have a combination of a cancer diagnosis and also a stoma may need more specific or additional support in the longer term. The most concerning finding, however, was that the majority of patients could not recall being given any advice about exercise or physical activity by their nurse or surgeon. While this survey presents some initial findings, it raises questions for further research and work. It also highlights a significantly neglected area in both research and support for stoma patients and the health professionals caring for them.

  7. Mentoring women in academic surgery: overcoming institutional barriers to success.

    PubMed

    Hoover, Eddie L

    2006-09-01

    Women now comprise 50% of Caucasian matriculants to medical school; 66.6% of African Americans, 48% of Hispanics and 51.3% of Asians beginning medical school are also women. This trend is likely to continue since women now earn 57% of all undergraduate degrees, and they earn more degrees in the health professions and biological sciences than men. Black and Hispanic women now earn 66% and 60% of bachelor's degrees in their respective ethnic groups. Overall, women are concentrated at the lowest faculty ranks at medical schools, with 70% holding the rank of instructor or assistant professor. Women continue to experience difficulty with recruitment, retention, promotion and pay issues compared to men. They also experience additional gender-specific issues, including primary responsibility for rearing families and quality-of-life issues in some specialties, including most of the surgical disciplines. Clearly, there is an evolving population shift at work here; the pool of candidates for medical school faculty positions is likely to be evenly split between men and women for Caucasians, Hispanics and Asians, while the African-American pool is likely heavily weighted in favor of the women. Women are beginning to garner more Latin honors recognition at graduation as well and the definition of the "best and the brightest" is being redefined. Therefore, institutions must continue to identify the barriers that deter women from entering surgery, to develop research tools to understand how to improve the process of developing leadership skills among women and to insure a "buy-in" of their male counterparts when components of the plan are being implemented.

  8. Coherent anti-Stokes Raman scattering microscopy: overcoming technical barriers for clinical translation.

    PubMed

    Tu, Haohua; Boppart, Stephen A

    2014-01-01

    Clinical translation of coherent anti-Stokes Raman scattering microscopy is of great interest because of the advantages of noninvasive label-free imaging, high sensitivity, and chemical specificity. For this to happen, we have identified and review the technical barriers that must be overcome. Prior investigations have developed advanced techniques (features), each of which can be used to effectively overcome one particular technical barrier. However, the implementation of one or a small number of these advanced features in previous attempts for clinical translation has often introduced more tradeoffs than benefits. In this review, we outline a strategy that would integrate multiple advanced features to overcome all the technical barriers simultaneously, effectively reduce tradeoffs, and synergistically optimize CARS microscopy for clinical translation. The operation of the envisioned system incorporates coherent Raman micro-spectroscopy for identifying vibrational biomolecular markers of disease and single-frequency (or hyperspectral) Raman imaging of these specific biomarkers for real-time in vivo diagnostics and monitoring.

  9. Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study.

    PubMed

    Barnicot, Kirsten; Couldrey, Laura; Sandhu, Sima; Priebe, Stefan

    2015-01-01

    Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients' experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants' reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research.

  10. Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study

    PubMed Central

    Barnicot, Kirsten; Couldrey, Laura; Sandhu, Sima; Priebe, Stefan

    2015-01-01

    Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients’ experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants’ reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research. PMID:26465757

  11. Measuring women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso

    PubMed Central

    2012-01-01

    Background In sub-Saharan Africa, women must overcome numerous barriers when they need modern healthcare. Respect of gender norms within the household and the community may still influence women's ability to obtain care. A lack of gender-sensitive instruments for measuring women's ability to overcome barriers compromises attempts to adequately quantify the burden and risk of exclusion they face when seeking modern healthcare. The aim of this study was to create and validate a synthetic measure of women's access to healthcare from a publicly available and possibly internationally comparable population-based survey. Method Seven questionnaire items from the Burkina Faso 2003 DHS were combined to create the index. Cronbach's alpha coefficient was used to test the reliability of the index. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were applied to evaluate the factorial structure and construct validity of the index while taking into account the hierarchical structure of the data. Results The index has a Cronbach's alpha of 0.75, suggesting adequate reliability. In EFA, three correlated factors fitted the data best. In CFA, the construct of perceived ability to overcome barriers to healthcare seeking emerged as a second-order latent variable with three domains: socioeconomic barriers, geographical barriers and psychosocial barriers. Model fit indices support the index's global validity for women of reproductive age in Burkina Faso. Evidence for construct validity comes from the finding that women's index scores increase with household living standard. Conclusion The DHS items can be combined into a reliable and valid, gender-sensitive index quantifying reproductive-age women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso. The index complies conceptually with the sector-cross-cutting capability approach and enables measuring directly the perceived access to healthcare. Therefore it can help to improve the

  12. Strategies for Overcoming Key Barriers to Development of a National Security Workforce

    SciTech Connect

    2008-06-30

    This report documents the strategies for overcoming identified key barriers to development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP) being performed under a Department of Energy (DOE) National Nuclear Security Administration (NNSA) grant. Many barriers currently exist that prevent the development of an adequate number of properly trained national security personnel. The identified strategies to address the barriers will focus on both short-term and long-term efforts, as well as strategies to capture legacy knowledge of retiring national security workforce personnel.

  13. Building America Guidance for Identifying and Overcoming Code, Standard, and Rating Method Barriers

    SciTech Connect

    Cole, P. C.; Halverson, M. A.

    2013-09-01

    This guidance document was prepared using the input from the meeting summarized in the draft CSI Roadmap to provide Building America research teams and partners with specific information and approaches to identifying and overcoming potential barriers to Building America innovations arising in and/or stemming from codes, standards, and rating methods.

  14. Using Appropriate Digital Tools to Overcome Barriers to Collaborative Learning in Classrooms

    ERIC Educational Resources Information Center

    Wardlow, Liane; Harm, Eian

    2015-01-01

    Collaborative learning provides students with vital opportunities to create and build knowledge. Existing technologies can facilitate collaborative learning. However, barriers exist to enacting collaborative practices related to the coverage of material for assessments and classroom management concerns, among others. Teachers can overcome these…

  15. Autism and Overcoming Job Barriers: Comparing Job-Related Barriers and Possible Solutions in and outside of Autism-Specific Employment

    PubMed Central

    Lorenz, Timo; Frischling, Cora; Cuadros, Raphael; Heinitz, Kathrin

    2016-01-01

    The aim of this study was to discover how individuals with autism succeed in entering the job market. We therefore sought to identify expected and occurred barriers, keeping them from taking up and staying in employment as well as to identify the solutions used to overcome these barriers. Sixty-six employed individuals with autism–17 of them with autism-specific employment–participated in an online survey. Results showed a variety of possible barriers. Individuals in autism-specific employment named formality problems–problems with organizational and practical process-related aspects of the job entry–most frequently while individuals in non-autism-specific employment mentioned social problems–obstacles concerning communication and human interaction–most. In terms of solutions, both groups used their own resources as much as external help, but differed in their specific strategies. In addition, correlations of an autism-specific employment with general and occupational self-efficacy as well as life and job satisfaction were examined. Possible implications of the results are discussed with regard to problem solving behavior and the use of strengths. PMID:26766183

  16. Critical elements for eco-retrofitting a conventional industrial park: Social barriers to be overcome.

    PubMed

    Ceglia, Domenico; Abreu, Mônica Cavalcanti Sá de; Da Silva Filho, José Carlos Lázaro

    2017-02-01

    This paper aims to explore critical elements for eco-retrofitting a conventional industrial park, based on a survey of companies and institutions located in Brazil. The study investigates social barriers to be overcome in promotion of opportunities for waste exchange. Our results indicate that values, trust behaviour, waste cognitive domain and environment engagement are necessary for the creation of an eco-industrial park. Similar values of benevolence and universalism are essential for company engagement to eco-retrofit. Low levels of trust behaviour combining with limited waste cognitive domain prevent firms from establishing agreement on waste exchange initiatives. The findings lend support to the view that social barriers are pre-requisites to engagement among firms in establishing technological and logistical solutions. Serious attention needs to be given to these social barriers because they are not easily overcome in the social and economic context of developing countries.

  17. Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study

    DTIC Science & Technology

    2010-06-01

    research period, we have nearly completed recruitment of patients over age 70 with diabetes and poor glycemic control as defined by A1c>8%, and have...older adults even with poor glycemic control. 2) Self-management interventions to overcome barriers to diabetes improved self-care frequency and...continuous glucose monitoring. 15. SUBJECT TERMS Diabetes, elderly, glycemic control, Cerebral perfusion, Care management 16. SECURITY

  18. "Closing the Loop": Overcoming barriers to locally sourcing food in Fort Collins, Colorado

    NASA Astrophysics Data System (ADS)

    DeMets, C. M.

    2012-12-01

    Environmental sustainability has become a focal point for many communities in recent years, and restaurants are seeking creative ways to become more sustainable. As many chefs realize, sourcing food locally is an important step towards sustainability and towards building a healthy, resilient community. Review of literature on sustainability in restaurants and the local food movement revealed that chefs face many barriers to sourcing their food locally, but that there are also many solutions for overcoming these barriers that chefs are in the early stages of exploring. Therefore, the purpose of this research is to identify barriers to local sourcing and investigate how some restaurants are working to overcome those barriers in the city of Fort Collins, Colorado. To do this, interviews were conducted with four subjects who guide purchasing decisions for restaurants in Fort Collins. Two of these restaurants have created successful solutions and are able to source most of their food locally. The other two are interested in and working towards sourcing locally but have not yet been able to overcome barriers, and therefore only source a few local items. Findings show that there are four barriers and nine solutions commonly identified by each of the subjects. The research found differences between those who source most of their food locally and those who have not made as much progress in local sourcing. Based on these results, two solution flowcharts were created, one for primary barriers and one for secondary barriers, for restaurants to assess where they are in the local food chain and how they can more successfully source food locally. As there are few explicit connections between this research question and climate change, it is important to consider the implicit connections that motivate and justify this research. The question of whether or not greenhouse gas emissions are lower for locally sourced food is a topic of much debate, and while there are major developments

  19. Designing Caregiver-Implemented Shared-Reading Interventions to Overcome Implementation Barriers

    PubMed Central

    Logan, Jessica R.; Damschroder, Laura

    2015-01-01

    Purpose This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. Methods A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Results Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. Conclusions A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders. PMID:26262941

  20. Geothermal(Ground-Source)Heat Pumps: Market Status, Barriers to Adoption, and Actions to Overcome Barriers

    SciTech Connect

    Hughes, Patrick

    2008-12-01

    More effective stewardship of our resources contributes to the security, environmental sustainability, and economic well-being of the nation. Buildings present one of the best opportunities to economically reduce energy consumption and limit greenhouse gas emissions. Geothermal heat pumps (GHPs), sometimes called ground-source heat pumps, have been proven capable of producing large reductions in energy use and peak demand in buildings. However, GHPs have received little attention at the policy level as an important component of a national strategy. Have policymakers mistakenly overlooked GHPs, or are GHPs simply unable to make a major contribution to the national goals for various reasons? This brief study was undertaken at DOE's request to address this conundrum. The scope of the study includes determining the status of global GHP markets and the status of the GHP industry and technology in the United States, assembling previous estimates of GHP energy savings potential, identifying key barriers to application of GHPs, and identifying actions that could accelerate market adoption of GHPs. The findings are documented in this report along with conclusions and recommendations.

  1. Hedgehog Signaling Overcomes an EZH2-Dependent Epigenetic Barrier to Promote Cholangiocyte Expansion

    PubMed Central

    Lu, Jie; Almada, Luciana L.; Lomberk, Gwen; Fernandez-Zapico, Martin E.; Urrutia, Raul; Huebert, Robert C.

    2016-01-01

    Background & Aims Developmental morphogens play an important role in coordinating the ductular reaction and portal fibrosis occurring in the setting of cholangiopathies. However, little is known about how membrane signaling events in ductular reactive cells (DRCs) are transduced into nuclear transcriptional changes to drive cholangiocyte maturation and matrix deposition. Therefore, the aim of this study was to investigate potential mechanistic links between cell signaling events and epigenetic regulators in DRCs. Methods Using directed differentiation of induced pluripotent stem cells (iPSC), isolated DRCs, and in vivo models, we examine the mechanisms whereby sonic hedgehog (Shh) overcomes an epigenetic barrier in biliary precursors and promotes both cholangiocyte maturation and deposition of fibronectin (FN). Results We demonstrate, for the first time, that Gli1 influences the differentiation state and fibrogenic capacity of iPSC-derived hepatic progenitors and isolated DRCs. We outline a novel pathway wherein Shh-mediated Gli1 binding in key cholangiocyte gene promoters overcomes an epigenetic barrier conferred by the polycomb protein, enhancer of zeste homolog 2 (EZH2) and initiates the transcriptional program of cholangiocyte maturation. We also define previously unknown functional Gli1 binding sites in the promoters of cytokeratin (CK)7, CK19, and FN. Our in vivo results show that EZH2 KO mice fed the choline-deficient, ethanolamine supplemented (CDE) diet have an exaggerated cholangiocyte expansion associated with more robust ductular reaction and increased peri-portal fibrosis. Conclusion We conclude that Shh/Gli1 signaling plays an integral role in cholangiocyte maturation in vitro by overcoming an EZH2-dependent epigenetic barrier and this mechanism also promotes biliary expansion in vivo. PMID:27936185

  2. Overcoming barriers in topical administration of gold nanoparticles for optical coherence tomography using multimodal delivery

    NASA Astrophysics Data System (ADS)

    Kim, Chang Soo; Wilder-Smith, Petra; Ahn, Yeh-Chan; Liaw, Lih-Huei L.; Chen, Zhongping; Kwon, Young Jik

    2010-02-01

    Optical coherence tomography (OCT) is a non-invasive and promising imaging modality with high resolution that is an order of magnitude higher than current diagnostic techniques. However, its use in detecting early-stage cancer is limited due to insufficient contrast level in biological tissue, which can be enhanced by harnessing contrast agents [e.g., gold nanoparticles (Au NPs)]. Enhanced penetration by creating micropassages and distribution by ultrasonic force (multimodal topical delivery) was proven to overcome two major barriers (stratum corneum and epithelial barriers) in topically administering Au NPs using an in vivo oral dysplasia hamster model (overall 150% enhanced OCT contrast). Expanded progress on a highly efficient and versatile Au NP-releasing polymer microneedle platform showed a promising next generation multi-modal delivery of Au NPs.

  3. Overcoming barriers to high performance seismic design using lessons learned from the green building industry

    NASA Astrophysics Data System (ADS)

    Glezil, Dorothy

    NEHRP's Provisions today currently governing conventional seismic resistant design. These provisions, though they ensure the life-safety of building occupants, extensive damage and economic losses may still occur in the structures. This minimum performance can be enhanced using the Performance-Based Earthquake Engineering methodology and passive control systems like base isolation and energy dissipation systems. Even though these technologies and the PBEE methodology are effective reducing economic losses and fatalities during earthquakes, getting them implemented into seismic resistant design has been challenging. One of the many barriers to their implementation has been their upfront costs. The green building community has faced some of the same challenges that the high performance seismic design community currently faces. The goal of this thesis is to draw on the success of the green building industry to provide recommendations that may be used overcome the barriers that high performance seismic design (HPSD) is currently facing.

  4. Smart nanoparticles improve therapy for drug-resistant tumors by overcoming pathophysiological barriers

    PubMed Central

    Liu, Jian-ping; Wang, Ting-ting; Wang, Dang-ge; Dong, An-jie; Li, Ya-ping; Yu, Hai-jun

    2017-01-01

    The therapeutic outcome of chemotherapy is severely limited by intrinsic or acquired drug resistance, the most common causes of chemotherapy failure. In the past few decades, advancements in nanotechnology have provided alternative strategies for combating tumor drug resistance. Drug-loaded nanoparticles (NPs) have several advantages over the free drug forms, including reduced cytotoxicity, prolonged circulation in the blood and increased accumulation in tumors. Currently, however, nanoparticulate drugs have only marginally improved the overall survival rate in clinical trials because of the various pathophysiological barriers that exist in the tumor microenvironment, such as intratumoral distribution, penetration and intracellular trafficking, etc. Smart NPs with stimulus-adaptable physico-chemical properties have been extensively developed to improve the therapeutic efficacy of nanomedicine. In this review, we summarize the recent advances of employing smart NPs to treat the drug-resistant tumors by overcoming the pathophysiological barriers in the tumor microenvironment. PMID:27569390

  5. Overcoming Codes and Standards Barriers to Innovations in Building Energy Efficiency

    SciTech Connect

    Cole, Pamala C.; Gilbride, Theresa L.

    2015-02-15

    In this journal article, the authors discuss approaches to overcoming building code barriers to energy-efficiency innovations in home construction. Building codes have been a highly motivational force for increasing the energy efficiency of new homes in the United States in recent years. But as quickly as the codes seem to be changing, new products are coming to the market at an even more rapid pace, sometimes offering approaches and construction techniques unthought of when the current code was first proposed, which might have been several years before its adoption by various jurisdictions. Due to this delay, the codes themselves can become barriers to innovations that might otherwise be helping to further increase the efficiency, comfort, health or durability of new homes. . The U.S. Department of Energy’s Building America, a program dedicated to improving the energy efficiency of America’s housing stock through research and education, is working with the U.S. housing industry through its research teams to help builders identify and remove code barriers to innovation in the home construction industry. The article addresses several approaches that builders use to achieve approval for innovative building techniques when code barriers appear to exist.

  6. Adaptation of avian influenza A virus polymerase in mammals to overcome the host species barrier.

    PubMed

    Mänz, Benjamin; Schwemmle, Martin; Brunotte, Linda

    2013-07-01

    Avian influenza A viruses, such as the highly pathogenic avian H5N1 viruses, sporadically enter the human population but often do not transmit between individuals. In rare cases, however, they establish a new lineage in humans. In addition to well-characterized barriers to cell entry, one major hurdle which avian viruses must overcome is their poor polymerase activity in human cells. There is compelling evidence that these viruses overcome this obstacle by acquiring adaptive mutations in the polymerase subunits PB1, PB2, and PA and the nucleoprotein (NP) as well as in the novel polymerase cofactor nuclear export protein (NEP). Recent findings suggest that synthesis of the viral genome may represent the major defect of avian polymerases in human cells. While the precise mechanisms remain to be unveiled, it appears that a broad spectrum of polymerase adaptive mutations can act collectively to overcome this defect. Thus, identification and monitoring of emerging adaptive mutations that further increase polymerase activity in human cells are critical to estimate the pandemic potential of avian viruses.

  7. Overcoming the Barriers to Pharmacist Intervention in Problems Associated with the Use of Drugs--Institutional Pharmacy.

    ERIC Educational Resources Information Center

    Baumgartner, R. Paul, Jr.

    1979-01-01

    Barriers to role expansion for pharmacists working in institutional settings are discussed, such as competency, interdisciplinary responsibilities, and financial reimbursement. Underlying principles that may be applied to overcome the traditional barriers to pharmacist intervention in drug use problems are examined. (SF)

  8. Nanocomplexes for gene therapy of respiratory diseases: Targeting and overcoming the mucus barrier.

    PubMed

    Di Gioia, Sante; Trapani, Adriana; Castellani, Stefano; Carbone, Annalucia; Belgiovine, Giuliana; Craparo, Emanuela Fabiola; Puglisi, Giovanni; Cavallaro, Gennara; Trapani, Giuseppe; Conese, Massimo

    2015-10-01

    Gene therapy, i.e. the delivery and expression of therapeutic genes, holds great promise for congenital and acquired respiratory diseases. Non-viral vectors are less toxic and immunogenic than viral vectors, although they are characterized by lower efficiency. However, they have to overcome many barriers, including inflammatory and immune mediators and cells. The respiratory and airway epithelial cells, the main target of these vectors, are coated with a layer of mucus, which hampers the effective reaching of gene therapy vectors carrying either plasmid DNA or small interfering RNA. This barrier is thicker in many lung diseases, such as cystic fibrosis. This review summarizes the most important advancements in the field of non-viral vectors that have been achieved with the use of nanoparticulate (NP) systems, composed either of polymers or lipids, in the lung gene delivery. In particular, different strategies of targeting of respiratory and airway lung cells will be described. Then, we will focus on the two approaches that attempt to overcome the mucus barrier: coating of the nanoparticulate system with poly(ethylene glycol) and treatment with mucolytics. Our conclusions are: 1) Ligand and physical targeting can direct therapeutic gene expression in specific cell types in the respiratory tract; 2) Mucopenetrating NPs are endowed with promising features to be useful in treating respiratory diseases and should be now advanced in pre-clinical trials. Finally, we discuss the development of such polymer- and lipid-based NPs in the context of in vitro and in vivo disease models, such as lung cancer, as well as in clinical trials.

  9. Overcoming Barriers: Adolescents’ Experiences Using a Mobile Phone Dietary Assessment App

    PubMed Central

    Svensson, Åsa; Magnusson, Maria

    2016-01-01

    Background The use of new technology has the potential to increase participation rates in dietary studies and improve the validity of collected dietary data. However, to evaluate the usability of developed dietary methods, qualitative studies of participants’ experiences and perceptions are needed. Objective To explore adolescents’ experiences using a newly developed mobile phone dietary assessment app, with a focus on factors that could affect their recording of dietary intake. Methods Focus group interviews were conducted with 75 participants who had used a newly developed mobile phone dietary assessment app in a quantitative evaluation study. The interviews were analyzed using qualitative content analysis and the theoretical framework of Self Determination Theory was applied. Results The adolescents’ use of the mobile phone dietary assessment app was characterized by their struggle to overcome several perceived barriers. Facilitators that helped adolescents complete the method were also identified. Motivation was found to be an important facilitator, and intrinsically motivated participants completed the method because they found it fun to use. The autonomous extrinsically motivated participants completed the method for the greater good, in order to contribute to the study. The controlled extrinsically motivated participants completed the method to get a reward or avoid punishment. Amotivated participants did not complete the method. More motivated participants were assumed to be more able to overcome barriers and needed less facilitators. Conclusions Future studies that examine the recording of food intake should include systematic efforts that aim to minimize identified barriers and promote identified facilitators. Further research should specifically aim at studying methods for (and effects of) increasing intrinsic motivation by supporting autonomy, competence, and relatedness among adolescents asked to participate in dietary studies. PMID:27473462

  10. Barriers to Differentiation: Applying Organizational Studies to Ontario Higher Education

    ERIC Educational Resources Information Center

    Milian, Roger Pizarro; Davies, Scott; Zarifa, David

    2016-01-01

    Ontario's Ministry of Training, Colleges and Universities is currently attempting to increase institutional differentiation within that province's postsecondary education system. We contend that such policies aimed to trigger organizational change are likely to generate unanticipated responses. Using insights from the field of organizational…

  11. Preparing Dental Students and Residents to Overcome Internal and External Barriers to Evidence-Based Practice.

    PubMed

    Coleman, Brandon G; Johnson, Thomas M; Erley, Kenneth J; Topolski, Richard; Rethman, Michael; Lancaster, Douglas D

    2016-10-01

    In recent years, evidence-based dentistry has become the ideal for research, academia, and clinical practice. However, barriers to implementation are many, including the complexity of interpreting conflicting evidence as well as difficulties in accessing it. Furthermore, many proponents of evidence-based care seem to assume that good evidence consistently exists and that clinicians can and will objectively evaluate data so as to apply the best evidence to individual patients' needs. The authors argue that these shortcomings may mislead many clinicians and that students should be adequately prepared to cope with some of the more complex issues surrounding evidence-based practice. Cognitive biases and heuristics shape every aspect of our lives, including our professional behavior. This article reviews literature from medicine, psychology, and behavioral economics to explore the barriers to implementing evidence-based dentistry. Internal factors include biases that affect clinical decision making: hindsight bias, optimism bias, survivor bias, and blind-spot bias. External factors include publication bias, corporate bias, and lack of transparency that may skew the available evidence in the peer-reviewed literature. Raising awareness of how these biases exert subtle influence on decision making and patient care can lead to a more nuanced discussion of addressing and overcoming barriers to evidence-based practice.

  12. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare.

    PubMed

    Weller, Jennifer; Boyd, Matt; Cumin, David

    2014-03-01

    Modern healthcare is delivered by multidisciplinary, distributed healthcare teams who rely on effective teamwork and communication to ensure effective and safe patient care. However, we know that there is an unacceptable rate of unintended patient harm, and much of this is attributed to failures in communication between health professionals. The extensive literature on teams has identified shared mental models, mutual respect and trust and closed-loop communication as the underpinning conditions required for effective teams. However, a number of challenges exist in the healthcare environment. We explore these in a framework of educational, psychological and organisational challenges to the development of effective healthcare teams. Educational interventions can promote a better understanding of the principles of teamwork, help staff understand each other's roles and perspectives, and help develop specific communication strategies, but may not be sufficient on their own. Psychological barriers, such as professional silos and hierarchies, and organisational barriers such as geographically distributed teams, can increase the chance of communication failures with the potential for patient harm. We propose a seven-step plan to overcome the barriers to effective team communication that incorporates education, psychological and organisational strategies. Recent evidence suggests that improvement in teamwork in healthcare can lead to significant gains in patient safety, measured against efficiency of care, complication rate and mortality. Interventions to improve teamwork in healthcare may be the next major advance in patient outcomes.

  13. Peptide modules for overcoming barriers of nucleic acids transport to cells.

    PubMed

    Egorova, Anna A; Kiselev, Anton V

    2016-01-01

    Absence of safe and efficient methods of nucleic acids delivery is one of the major issues which limits the development of human gene therapy. Highly efficient viral vectors raise questions due to safety reasons. Among non-viral vectors peptide-based carriers can be considered as good candidates for the development of "artificial viruses"--multifunctional polyplexes that mimic viruses. Suggested strategy to obtain multifunctionality is to combine several peptide modules into one modular carrier. Different kinds of peptide modules are needed for successful overcoming barriers of nucleic acids transport into the cells. Design of such modules and establishment of structure-function relationships are issues of importance to researchers working in the field of nucleic acids delivery.

  14. Building America Guidance for Identifying and Overcoming Code, Standard, and Rating Method Barriers

    SciTech Connect

    Cole, Pamala C.; Halverson, Mark A.

    2013-09-01

    The U.S. Department of Energy’s (DOE) Building America program implemented a new Codes and Standards Innovation (CSI) Team in 2013. The Team’s mission is to assist Building America (BA) research teams and partners in identifying and resolving conflicts between Building America innovations and the various codes and standards that govern the construction of residences. A CSI Roadmap was completed in September, 2013. This guidance document was prepared using the information in the CSI Roadmap to provide BA research teams and partners with specific information and approaches to identifying and overcoming potential barriers to Building America (BA) innovations arising in and/or stemming from codes, standards, and rating methods. For more information on the BA CSI team, please email: CSITeam@pnnl.gov

  15. N-trimethyl chitosan chloride-coated PLGA nanoparticles overcoming multiple barriers to oral insulin absorption.

    PubMed

    Sheng, Jianyong; Han, Limei; Qin, Jing; Ru, Ge; Li, Ruixiang; Wu, Lihong; Cui, Dongqi; Yang, Pei; He, Yuwei; Wang, Jianxin

    2015-07-22

    Although several strategies have been applied for oral insulin delivery to improve insulin bioavailability, little success has been achieved. To overcome multiple barriers to oral insulin absorption simultaneously, insulin-loaded N-trimethyl chitosan chloride (TMC)-coated polylactide-co-glycoside (PLGA) nanoparticles (Ins TMC-PLGA NPs) were formulated in our study. The Ins TMC-PLGA NPs were prepared using the double-emulsion solvent evaporation method and were characterized to determine their size (247.6 ± 7.2 nm), ζ-potential (45.2 ± 4.6 mV), insulin-loading capacity (7.8 ± 0.5%) and encapsulation efficiency (47.0 ± 2.9%). The stability and insulin release of the nanoparticles in enzyme-containing simulated gastrointestinal fluids suggested that the TMC-PLGA NPs could partially protect insulin from enzymatic degradation. Compared with unmodified PLGA NPs, the positively charged TMC-PLGA NPs could improve the mucus penetration of insulin in mucus-secreting HT29-MTX cells, the cellular uptake of insulin via clathrin- or adsorption-mediated endocytosis in Caco-2 cells and the permeation of insulin across a Caco-2 cell monolayer through tight junction opening. After oral administration in mice, the TMC-PLGA NPs moved more slowly through the gastrointestinal tract compared with unmodified PLGA NPs, indicating the mucoadhesive property of the nanoparticles after TMC coating. Additionally, in pharmacological studies in diabetic rats, orally administered Ins TMC-PLGA NPs produced a stronger hypoglycemic effect, with 2-fold higher relative pharmacological availability compared with unmodified NPs. In conclusion, oral insulin absorption is improved by TMC-PLGA NPs with the multiple absorption barriers overcome simultaneously. TMC-PLGA NPs may be a promising drug delivery system for oral administration of macromolecular therapeutics.

  16. Cronobacter sakazakii clinical isolates overcome host barriers and evade the immune response.

    PubMed

    Almajed, Faisal S; Forsythe, Stephen J

    2016-01-01

    Cronobacter sakazakii is the most frequently clinically isolated species of the Cronobacter genus. However the virulence factors of C. sakazakii including their ability to overcome host barriers remains poorly studied. In this study, ten clinical isolates of C. sakazakii were assessed for their ability to invade and translocate through human colonic carcinoma epithelial cells (Caco-2) and human brain microvascular endothelial cells (HBMEC). Their ability to avoid phagocytosis in human macrophages U937 and human brain microglial cells was investigated. Additionally, they were tested for serum sensitivity and the presence of the Cronobacter plasminogen activation gene (cpa) gene, which is reported to confer serum resistance. Our data showed that the clinical C. sakazakii strains invaded and translocated through Caco-2 and HBMEC cell lines and some strains showed significantly higher levels of invasion and translocation. Moreover, C. sakazakii was able to persist and even multiply in phagocytic macrophage and microglial cells. All strains, except one, were able to withstand human serum exposure, the single serum sensitive strain was also the only one which did not encode for the cpa gene. These results demonstrate that C. sakazakii clinical isolates are able to overcome host barriers and evade the host immune response indicating their capacity to cause diseases such as necrotizing enterocolitis (NEC) and meningitis. Our data showed for the first time the ability of C. sakazakii clinical isolates to survive and multiply within human microglial cells. Additionally, it was shown that C. sakazakii clinical strains have the capacity to translocate through the Caco-2 and HBMEC cell lines paracellularly.

  17. Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report

    PubMed Central

    Listhaus, Alyson; Covarrubias, Constanza M; Schmidt, Siegfried OF; Mackey, Sean; Carek, Peter J; Fillingim, Roger B; Hurley, Robert W

    2016-01-01

    In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden. PMID:26159464

  18. Highly compacted biodegradable DNA nanoparticles capable of overcoming the mucus barrier for inhaled lung gene therapy.

    PubMed

    Mastorakos, Panagiotis; da Silva, Adriana L; Chisholm, Jane; Song, Eric; Choi, Won Kyu; Boyle, Michael P; Morales, Marcelo M; Hanes, Justin; Suk, Jung Soo

    2015-07-14

    Gene therapy has emerged as an alternative for the treatment of diseases refractory to conventional therapeutics. Synthetic nanoparticle-based gene delivery systems offer highly tunable platforms for the delivery of therapeutic genes. However, the inability to achieve sustained, high-level transgene expression in vivo presents a significant hurdle. The respiratory system, although readily accessible, remains a challenging target, as effective gene therapy mandates colloidal stability in physiological fluids and the ability to overcome biological barriers found in the lung. We formulated highly stable DNA nanoparticles based on state-of-the-art biodegradable polymers, poly(β-amino esters) (PBAEs), possessing a dense corona of polyethylene glycol. We found that these nanoparticles efficiently penetrated the nanoporous and highly adhesive human mucus gel layer that constitutes a primary barrier to reaching the underlying epithelium. We also discovered that these PBAE-based mucus-penetrating DNA nanoparticles (PBAE-MPPs) provided uniform and high-level transgene expression throughout the mouse lungs, superior to several gold standard gene delivery systems. PBAE-MPPs achieved robust transgene expression over at least 4 mo following a single administration, and their transfection efficiency was not attenuated by repeated administrations, underscoring their clinical relevance. Importantly, PBAE-MPPs demonstrated a favorable safety profile with no signs of toxicity following intratracheal administration.

  19. Creating sustainable local health information exchanges: can barriers to stakeholder participation be overcome?

    PubMed

    Grossman, Joy M; Kushner, Kathryn L; November, Elizabeth A

    2008-02-01

    Local health information exchanges (HIEs) hold the promise of collecting patient clinical data across sites of care to provide more complete and timely information for treatment, as well as supporting quality improvement and reporting, public health activities, and clinical research. Findings from a study of stakeholder perspectives on participation in four HIEs by the Center for Studying Health System Change (HSC) and the National Institute for Health Care Management (NIHCM) Foundation suggest, however, that barriers to achieving data exchange remain high. Concerns about loss of competitive advantage and data misuse impede provider and health plan willingness to contribute patient data. Additionally, uncertainty about who benefits from HIEs is affecting stakeholder willingness to fund the exchanges. The more mature exchanges--Cincinnati-based HealthBridge and the Indiana Health Information Exchange (IHIE)--have achieved some viability by meeting a specific business need--more efficient delivery of hospital test results to physicians. The newer exchanges--CareSpark, serving northeast Tennessee and southwest Virginia, and the Tampa Bay Regional Health Information Organization (RHIO)--have struggled to identify and finance initial services without a similar critical mass of hospital participation. While narrow data exchange efforts that improve transaction efficiency may be a pragmatic first step to overcome barriers to stakeholder participation, expanding HIEs to achieve the broad-based data exchange necessary for quality reporting and pay-for-performance (P4P) activities raises more challenges.

  20. Electrical, magnetic, photomechanical and cavitational waves to overcome skin barrier for transdermal drug delivery.

    PubMed

    Wong, Tin Wui

    2014-11-10

    Transdermal drug delivery is hindered by the barrier property of the stratum corneum. It limits the route to transport of drugs with a log octanol-water partition coefficient of 1 to 3, molecular weight of less than 500Da and melting point of less than 200°C. Active methods such as iontophoresis, electroporation, sonophoresis, magnetophoresis and laser techniques have been investigated for the past decades on their ability, mechanisms and limitations in modifying the skin microenvironment to promote drug diffusion and partition. Microwave, an electromagnetic wave characterized by frequencies range between 300MHz and 300GHz, has recently been reported as the potential skin permeation enhancer. Microwave has received a widespread application in food, engineering and medical sectors. Its potential use to facilitate transdermal drug transport is still in its infancy stage of evaluation. This review provides an overview and update on active methods utilizing electrical, magnetic, photomechanical and cavitational waves to overcome the skin barrier for transdermal drug administration with insights into mechanisms and future perspectives of the latest microwave technique described.

  1. Overcoming Barriers in Kidney Health-Forging a Platform for Innovation.

    PubMed

    Linde, Peter G; Archdeacon, Patrick; Breyer, Matthew D; Ibrahim, Tod; Inrig, Jula K; Kewalramani, Reshma; Lee, Celeste Castillo; Neuland, Carolyn Y; Roy-Chaudhury, Prabir; Sloand, James A; Meyer, Rachel; Smith, Kimberly A; Snook, Jennifer; West, Melissa; Falk, Ronald J

    2016-07-01

    Innovation in kidney diseases is not commensurate with the effect of these diseases on human health and mortality or innovation in other key therapeutic areas. A primary cause of the dearth in innovation is that kidney diseases disproportionately affect a demographic that is largely disenfranchised, lacking sufficient advocacy, public attention, and funding. A secondary and likely consequent cause is that the existing infrastructure supporting nephrology research pales in comparison with those for other internal medicine specialties, especially cardiology and oncology. Citing such inequities, however, is not enough. Changing the status quo will require a coordinated effort to identify and redress the existing deficits. Specifically, these deficits relate to the need to further develop and improve the following: understanding of the disease mechanisms and pathophysiology, patient engagement and activism, clinical trial infrastructure, and investigational clinical trial designs as well as coordinated efforts among critical stakeholders. This paper identifies potential solutions to these barriers, some of which are already underway through the Kidney Health Initiative. The Kidney Health Initiative is unique and will serve as a current and future platform from which to overcome these barriers to innovation in nephrology.

  2. Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report.

    PubMed

    Harle, Christopher A; Listhaus, Alyson; Covarrubias, Constanza M; Schmidt, Siegfried Of; Mackey, Sean; Carek, Peter J; Fillingim, Roger B; Hurley, Robert W

    2016-01-01

    In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden.

  3. Understanding and Overcoming Barriers to Upper Limb Surgical Reconstruction After Tetraplegia: The Need for Interdisciplinary Collaboration.

    PubMed

    Punj, Vandana; Curtin, Catherine

    2016-06-01

    There are approximately 300,000 persons with spinal cord injury living in the United States, and nearly 60% of these persons have suffered tetraplegia with resultant alterations in body function, activity, and therefore participation. Restoring hand function can improve independence, and various studies have shown that persons with tetraplegia rate restoration of arm and hand function higher than bowel and bladder control, walking, or sexuality. There are conservative options to improve upper limb function in this population (eg, orthoses, neuroprostheses). Surgical interventions are also available, and 70% of surgical patients report satisfaction and improvement in various activities of daily living after surgery to restore arm and hand function. Despite these positive surgical outcomes, <10% of the eligible population of 60% to 70% undergo tendon transfer surgery to restore function. Underutilization of surgical interventions can be explained by population-, provider-, and health care systems-specific barriers. With further education of providers and patients and team building across disciplines these barriers can be overcome, ultimately leading to reduced disability and improved quality of life for persons with tetraplegia.

  4. Evidence for Health II: Overcoming barriers to using evidence in policy and practice.

    PubMed

    Andermann, Anne; Pang, Tikki; Newton, John N; Davis, Adrian; Panisset, Ulysses

    2016-03-14

    Even the highest quality evidence will have little impact unless it is incorporated into decision-making for health. It is therefore critical to overcome the many barriers to using evidence in decision-making, including (1) missing the window of opportunity, (2) knowledge gaps and uncertainty, (3) controversy, irrelevant and conflicting evidence, as well as (4) vested interests and conflicts of interest. While this is certainly not a comprehensive list, it covers a number of main themes discussed in the knowledge translation literature on this topic, and better understanding these barriers can help readers of the evidence to be more savvy knowledge users and help researchers overcome challenges to getting their evidence into practice. Thus, the first step in being able to use research evidence for improving population health is ensuring that the evidence is available at the right time and in the right format and language so that knowledge users can take the evidence into consideration alongside a multitude of other factors that also influence decision-making. The sheer volume of scientific publications makes it difficult to find the evidence that can actually help inform decisions for health. Policymakers, especially in low- and middle-income countries, require context-specific evidence to ensure local relevance. Knowledge synthesis and dissemination of policy-relevant local evidence is important, but it is still not enough. There are times when the interpretation of the evidence leads to various controversies and disagreements, which act as barriers to the uptake of evidence. Research evidence can also be influenced and misused for various aims and agendas. It is therefore important to ensure that any new evidence comes from reliable sources and is interpreted in light of the overall body of scientific literature. It is not enough to simply produce evidence, nor even to synthesize and package evidence into a more user-friendly format. Particularly at the policy

  5. Overcoming Access Barriers for Facility-based Delivery in Low-income Settings: Insights from Bangladesh and Uganda

    PubMed Central

    Rahman, Syed Azizur; Ssengooba, Freddie

    2006-01-01

    Women in both Bangladesh and Uganda face a number of barriers to delivery in professional health facilities, including costs, transportation problems, and sociocultural norms to deliver at home. Some women in both the countries manage to overcome these barriers. This paper reports on a comparative qualitative study investigating how some women and their families were able to use professional delivery services. The study provides insights into the decision-making processes and overcoming access barriers. Husbands were found to be particularly important in Uganda, while, in Bangladesh, a number of individuals could influence care-seeking, including unqualified local healers or traditional birth attendants. In both the settings, cost and transport barriers were often overcome through social networks. Social prohibitions on birth in the health facility did not feature strongly in women's accounts, with several Ugandan women explaining that friends or peers also used facilities, while, in Bangladesh, perceived complications apparently justified the use of professional medical care. Investigating the ways in which some women can overcome common barriers can help inform policy and planning to increase the use of health facilities for child delivery. PMID:17591340

  6. Let's not contribute to disparities: the best methods for teaching clinicians how to overcome language barriers to health care.

    PubMed

    Diamond, Lisa C; Jacobs, Elizabeth A

    2010-05-01

    Clinicians should be educated about how language barriers contribute to disparities for patients with limited English proficiency (LEP). However, educators must avoid developing educational interventions that increase health disparities for LEP patients. For example, studies suggest that teaching "Medical Spanish" or related courses may actually contribute to health care disparities if clinicians begin using these non-English language skills inappropriately with patients. We discuss the risks and benefits of teaching specific cultural competence skills and make evidence-based recommendations for the teaching content and methods for educational interventions focused on overcoming language barriers in health care. At minimum, we suggest such interventions include: (1) the role of language barriers in health disparities, (2) means of overcoming language barriers, (3) how to work with interpreters, (4) identifying and fixing problems in interpreted encounters, and (5) appropriate and safe use of one's own limited non-English language skills.

  7. Reassortment and mutation of the avian influenza virus polymerase PA subunit overcome species barriers.

    PubMed

    Mehle, Andrew; Dugan, Vivien G; Taubenberger, Jeffery K; Doudna, Jennifer A

    2012-02-01

    The emergence of new pandemic influenza A viruses requires overcoming barriers to cross-species transmission as viruses move from animal reservoirs into humans. This complicated process is driven by both individual gene mutations and genome reassortments. The viral polymerase complex, composed of the proteins PB1, PB2, and PA, is a major factor controlling host adaptation, and reassortment events involving polymerase gene segments occurred with past pandemic viruses. Here we investigate the ability of polymerase reassortment to restore the activity of an avian influenza virus polymerase that is normally impaired in human cells. Our data show that the substitution of human-origin PA subunits into an avian influenza virus polymerase alleviates restriction in human cells and increases polymerase activity in vitro. Reassortants with 2009 pandemic H1N1 PA proteins were the most active. Mutational analyses demonstrated that the majority of the enhancing activity in human PA results from a threonine-to-serine change at residue 552. Reassortant viruses with avian polymerases and human PA subunits, or simply the T552S mutation, displayed faster replication kinetics in culture and increased pathogenicity in mice compared to those containing a wholly avian polymerase complex. Thus, the acquisition of a human PA subunit, or the signature T552S mutation, is a potential mechanism to overcome the species-specific restriction of avian polymerases and increase virus replication. Our data suggest that the human, avian, swine, and 2009 H1N1-like viruses that are currently cocirculating in pig populations set the stage for PA reassortments with the potential to generate novel viruses that could possess expanded tropism and enhanced pathogenicity.

  8. Overcoming barriers to hepatitis B immunisation by a dedicated hepatitis B immunisation service

    PubMed Central

    Larcher, V; Bourne, J; Aitken, C; Jeffries, D; Hodes, D; SLOAN, D.; RAMSAY, M.; GOLDBERG, D.; BRAMLEY, C.

    2001-01-01

    AIMS—To determine the effectiveness of a selective hospital based hepatitis B immunisation programme and the barriers to be overcome in obtaining a successful outcome.
METHODS—Retrospective case note review of 265 infants born over a five year period to hepatitis B carrier mothers at a university affiliated hospital in Hackney, London.
RESULTS—A total of 242 infants (91%) were fully vaccinated; 217 (82%) had serology; 31 required booster doses. Percentages failing to reach second, third vaccinations, and serology on schedule rose exponentially (7%, 18%, 33% respectively). Mobility was high (25%) and significantly affected outcome. A total of 95% Hackney resident babies were fully vaccinated compared with 78% non-residents. Uptake of routine immunisations was higher in Hackney residents than non-residents and greater in those who were eligible for hepatitis B vaccine. Name changes occurred in 35%. Translation requirements were high (85% for Turkish, Vietnamese, and Asian families). Requirements for specific postnatal counselling of mothers and hepatology referral fell significantly during the course of the study. Only seven of 22 babies born in 1995 in Tower Hamlets compared with 53 of 58 Hackney babies received a full vaccination course in non-hospital based primary care.
CONCLUSION—In inner city areas with high prevalence of hepatitis B carriage, mobility, and diverse ethnicity, a dedicated centralised immunisation service can be highly effective, provided that adequate support services (translation, counselling, and parental referral) are available.
 PMID:11159283

  9. Lung Gene Therapy with Highly Compacted DNA Nanoparticles that Overcome the Mucus Barrier

    PubMed Central

    Suk, Jung Soo; Kim, Anthony J.; Trehan, Kanika; Schneider, Craig S.; Cebotaru, Liudmila; Woodward, Owen M.; Boylan, Nicholas J.; Boyle, Michael P.; Lai, Samuel K.; Guggino, William B.; Hanes, Justin

    2014-01-01

    Inhaled gene carriers must penetrate the highly viscoelastic and adhesive mucus barrier in the airway in order to overcome rapid mucociliary clearance and reach the underlying epithelium; however, even the most widely used viral gene carriers are unable to efficiently do so. We developed two polymeric gene carriers that compact plasmid DNA into small and highly stable nanoparticles with dense polyethylene glycol (PEG) surface coatings. These highly compacted, densely PEG-coated DNA nanoparticles rapidly penetrate human cystic fibrosis (CF) mucus ex vivo and mouse airway mucus ex situ. Intranasal administration of the mucus penetrating DNA nanoparticles greatly enhanced particle distribution, retention and gene transfer in the mouse lung airways compared to conventional gene carriers. Successful delivery of a full-length plasmid encoding the cystic fibrosis transmembrane conductance regulator protein was achieved in mouse lungs and airway cells, including a primary culture of mucus-covered human airway epithelium grown at air-liquid interface, without causing acute inflammation or toxicity. Highly compacted mucus penetrating DNA nanoparticles hold promise for lung gene therapy. PMID:24440664

  10. Overcoming Barriers; Enabling Learners: Planning, Designing and Delivering the Full-Time FE Curriculum in Scotland's Colleges

    ERIC Educational Resources Information Center

    Her Majesty's Inspectorate of Education, 2006

    2006-01-01

    The further education (FE) curriculum in Scotland's colleges aims to enable people to develop skills and capacities which will improve the quality of their working, personal, family and community life. To achieve this aim people need assistance to overcome barriers constraining their confidence and ability to take part in learning situations and…

  11. Helping Our Most Vulnerable Families Overcome Barriers to Work and Achieve Financial Success. KIDS COUNT 2005 Essay

    ERIC Educational Resources Information Center

    Annie E. Casey Foundation, 2005

    2005-01-01

    This essay, taken from the 2005 KIDS COUNT Data Book, examines four employment barriers that policymakers and others consider among the most difficult to overcome: substance abuse, domestic violence, a history of incarceration, and depression. These burdens can diminish a person's motivation and ability to find work. Furthermore, they can make it…

  12. All Health Plans Need CLAMS: Culturally and Linguistically Appropriate Materials for Diverse Populations Can Overcome Language Barriers to Effective Treatment.

    ERIC Educational Resources Information Center

    Smith, Sandra; Gonzales, Virginia

    2000-01-01

    CLAMs are "Culturally and Linguistically Appropriate Materials" designed for diverse populations to help them overcome language barriers to effective treatment. The demographic shift underway in the United States is making the country more linguistically diverse. Health plans need to accommodate this shift, because without information patients…

  13. Overcoming Relationship-Initiation Barriers: The Impact of a Computer-Dating System on Sex Role, Shyness, and Appearance Inhibitions.

    ERIC Educational Resources Information Center

    Scharlott, Bradford W.; Christ, William G.

    1995-01-01

    A survey of the users of an online computer-mediated matchmaking service showed that their communication patterns and objectives varied by their sex, shyness level, and appearance. Intrinsic aspects of this system helped some users overcome relationship-initiation barriers rooted in sex role, shyness, and appearance inhibitions. (Author)

  14. Translating Research to Practice: Overcoming Barriers to Implementing Effective Off-Campus Party Intervention. Issues in Prevention

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    This issue of "Issues in Prevention" focuses on overcoming barriers in implementing effective off-campus party intervention. This issue contains the following articles: (1) Confronting the Problems Associated With Off-Campus Parties With Evidence-Based Strategies (John D. Clapp); (2) Overview of Research on Effective Off-Campus Party…

  15. Re-thinking barriers to organizational change in public hospitals.

    PubMed

    Edwards, Nigel; Saltman, Richard B

    2017-01-01

    Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations. While the problems in each of these three dimensions of public hospital organization are well-known, and the first two dimensions clearly affect private as well as publicly run hospitals, insufficient attention has been paid to the combined impact of all three factors in making public hospitals particularly difficult to manage and steer. Further, these three structural dimensions interact in an institutional environment defined by three restrictive context limitations, again two of which also affect private hospitals but all three of which compound the management dilemmas in public hospitals. The first contextual limitation is the inherent complexity of delivering high quality, safe, and affordable modern inpatient care in a hospital setting. The second contextual limitation is a set of specific market failures in public hospitals, which limit the scope of the standard financial incentives and reform measures. The third and last contextual limitation is the unique problem of generalized and localized anxiety, which accompanies the delivery of medical services, and which suffuses decision-making on the part of patients, medical staff, hospital management, and political actors alike. This combination of six institutional characteristics - three structural dimensions and three contextual dimensions - can help explain why

  16. Lipid nanoparticles (SLN, NLC): Overcoming the anatomical and physiological barriers of the eye - Part I - Barriers and determining factors in ocular delivery.

    PubMed

    Sánchez-López, E; Espina, M; Doktorovova, S; Souto, E B; García, M L

    2017-01-01

    Ocular drug delivery is still a challenge for researchers in the field of pharmaceutical technology due to anatomical and physiological eye characteristics. The tissue barriers (such as cornea, conjunctiva, blood aqueous barrier, and blood-retinal barrier) limit the access of drugs to their targets. Taking into account the short retention time in the precorneal area of classical ocular dosage forms (e.g. solutions, suspensions or ointments) which are rapidly eliminated by tears and eyelid movement, only less than five percent of the administered drug attains intraocular structures. With the aim to overcome ocular barriers, drug delivery systems, able to increase ocular bioavailability reducing side effects, are recognized as promising alternative. In this review, the main barriers and strategies to increase drug transport in ocular delivery are comprehensively discussed, highlighting the factors involved in ocular transport of SLN and NLC.

  17. Nanoparticles decorated with proteolytic enzymes, a promising strategy to overcome the mucus barrier.

    PubMed

    Pereira de Sousa, Irene; Cattoz, Beatrice; Wilcox, Matthew D; Griffiths, Peter C; Dalgliesh, Robert; Rogers, Sarah; Bernkop-Schnürch, Andreas

    2015-11-01

    The intestinal mucus gel layer represents a stumbling block for drug adsorption. This study is aimed to formulate a nanoparticulate system able to overcome this barrier by cleaving locally the glycoprotein substructures of the mucus. Mucolytic enzymes such as papain (PAP) and bromelain (BRO) were covalently conjugated to poly(acrylic acid) (PAA). Nanoparticles (NPs) were then formulated via ionic gelation method and characterized by particle size, zeta potential, enzyme content and enzymatic activity. The NPs permeation quantified by rotating tube studies was correlated with changes in the mucus gel layer structure determined by pulsed-gradient-spin-echo NMR (PGSE-NMR), small-angle neutron scattering (SANS) and spin-echo SANS (SESANS). PAP and BRO functionalized NPs had an average size in the range of 250 and 285 nm and a zeta potential that ranged between -6 and -5 mV. The enzyme content was 242 μg enzyme/mg for PAP modified NPs and 253 μg enzyme/mg for BRO modified NPs. The maintained enzymatic activity was 43% for PAP decorated NPs and 76% for BRO decorated NPs. The rotating tube technique revealed a better performance of BRO decorated NPs compared to PAA decorated NPs, with a 4.8-fold higher concentration of NPs in the inner slice of mucus. Addition of 0.5 wt% of enzyme functionalized NPs to 5 wt% intestinal mucin led to c.a. 2-fold increase in the mobility of the mucin as measured by PGSE-NMR indicative of a significant break-up of the structure of the mucin. SANS and SESANS measurements further revealed a change in structure of the intestinal mucus induced by the incorporation of the functionalized NPs mostly occurring at a length scale longer than 0.5 μm. Accordingly, BRO decorated NPs show higher potential than PAP functionalized NPs as mucus permeating drug delivery systems.

  18. Overcoming the blood-brain tumor barrier for effective glioblastoma treatment.

    PubMed

    van Tellingen, O; Yetkin-Arik, B; de Gooijer, M C; Wesseling, P; Wurdinger, T; de Vries, H E

    2015-03-01

    demonstrate 'within-organ-metastasis' away from the core part to brain areas displaying a more organized and less leaky BBTB. Hence, drug delivery in glioblastoma deserves explicit attention as otherwise new experimental therapies will continue to fail. In the current review we highlight different aspects of the BBTB in glioma patients and preclinical models and discuss the advantages and drawbacks of drug delivery approaches for the treatment of glioma patients. We provide an overview on methods to overcome the BBTB, including osmotic blood-brain barrier disruption (BBBD), bradykinin receptor-mediated BBTB opening, inhibition of multidrug efflux transporters, receptor-mediated transport systems and physiological circumvention of the BBTB. While our knowledge about the molecular biology of glioma cells is rapidly expanding and is, to some extent, already assisting us in the design of tumor-tailored therapeutics, we are still struggling to develop modalities to expose the entire tumor to such therapeutics at pharmacologically meaningful quantities. Therefore, we must expand our knowledge about the fundamentals of the BBTB as a step toward the design of practical and safe devices and approaches for enhanced drug delivery into the diseased brain area.

  19. Overcoming hybridization barriers by the secretion of the maize pollen tube attractant ZmEA1 from Arabidopsis ovules.

    PubMed

    Márton, Mihaela L; Fastner, Astrid; Uebler, Susanne; Dresselhaus, Thomas

    2012-07-10

    A major goal of plant reproduction research is to understand and overcome hybridization barriers so that the gene pool of crop plants can be increased and improved upon. After successful pollen germination on a receptive stigma, the nonmotile sperm cells of flowering plants are transported via the pollen tube (PT) to the egg apparatus for the achievement of double fertilization. The PT path is controlled by various hybridization mechanisms probably involving a larger number of species-specific molecular interactions. The egg-apparatus-secreted polymorphic peptides ZmEA1 in maize and LURE1 and LURE2 in Torenia fournieri as well as TcCRP1 in T. concolor were shown to be required for micropylar PT guidance, the last step of the PT journey. We report here that ZmEA1 attracts maize PTs in vitro and arrests their growth at higher concentrations. Furthermore, it binds to the subapical region of maize PT tips in a species-preferential manner. To overcome hybridization barriers at the level of gametophytic PT guidance, we expressed ZmEA1 in Arabidopsis synergid cells. Secreted ZmEA1 enabled Arabidopsis ovules to guide maize PT in vitro in a species-preferential manner to the micropylar opening of the ovule. These results demonstrate that the egg-apparatus-controlled reproductive-isolation barrier of PT guidance can be overcome even between unrelated plant families.

  20. Simulations and Games: Overcoming the Barriers to Their Use in Higher Education

    ERIC Educational Resources Information Center

    Moizer, Jonathan; Lean, Jonathan; Towler, Michael; Abbey, Caroline

    2009-01-01

    Based on a categorization of simulation and gaming barriers developed in a previous study, this work seeks to explore in greater depth the composition and nature of these obstacles. It examines the interrelationships between the barriers and the impact of other contextual factors in the pedagogic environment. A series of in-depth interviews were…

  1. Energy management action plan: Developing a strategy for overcoming institutional barriers to municipal energy conservation

    SciTech Connect

    Not Available

    1992-12-31

    Energy offices working to improve efficiency of local government facilities face not only technical tasks, but institutional barriers, such as budget structures that do not reward efficiency, a low awareness of energy issues, and purchasing procedures based only on minimizing initial cost. The bureau, in working to remove such barriers in San Francisco, has identified 37 institutional barriers in areas such as operations & maintenance, purchasing, and facility design; these barriers were then reorganized into three groupings-- policy & attitudes, budget & incentives, and awareness & information-- and mapped. This map shows that the barriers mutually reinforce each other, and that a holistic approach is required for permanent change. The city`s recreation & parks department was used as a model department, and information about facility energy use was compiled into a departmental energy review. Staff interviews showed how barriers affect conservation. The bureau then generated ideas for projects to remove specific barriers and rated them according to potential impact and the resources required to implement them. Four of the six projects selected focused on maintenance staff: a cost- sharing lighting retrofit program, a boiler efficiency program, a departmental energy tracking system, and a budgetary incentive program for conservation. The other two projects are city-wide: promotion of a new term contract supplying energy-efficient light materials, and publication/distribution of ENERGY NEWS newsletter. A general methodology, the EMAP Strategy Guide, has been created to assist other energy offices in developing EMAPs.

  2. A review of multifunctional nanoemulsion systems to overcome oral and CNS drug delivery barriers.

    PubMed

    Ganta, Srinivas; Deshpande, Dipti; Korde, Anisha; Amiji, Mansoor

    2010-10-01

    The oral and central nervous systems (CNS) present a unique set of barriers to the delivery of important diagnostic and therapeutic agents. Extensive research over the past few years has enabled a better understanding of these physical and biological barriers based on tight cellular junctions and expression of active transporters and metabolizing enzymes at the luminal surfaces of the gastrointestinal (GI) tract and the blood-brain barrier (BBB). This review focuses on the recent understanding of transport across the GI tract and BBB and the development of nanotechnology-based delivery strategies that can enhance bioavailability of drugs. Multifunctional lipid nanosystems, such as oil-in-water nanoemulsions, that integrate enhancement in permeability, tissue and cell targeting, imaging, and therapeutic functions are especially promising. Based on strategic choice of edible oils, surfactants and additional surface modifiers, and different types of payloads, rationale design of multifunctional nanoemulsions can serve as a safe and effective delivery vehicle across oral and CNS barriers.

  3. Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes

    PubMed Central

    Baker, Richard; Camosso-Stefinovic, Janette; Gillies, Clare; Shaw, Elizabeth J; Cheater, Francine; Flottorp, Signe; Robertson, Noelle

    2014-01-01

    Background In the previous version of this review, the effectiveness of interventions tailored to barriers to change was found to be uncertain. Objectives To assess the effectiveness of interventions tailored to address identified barriers to change on professional practice or patient outcomes. Search methods For this update, in addition to the EPOC Register and pending files, we searched the following databases without language restrictions, from inception until August 2007: MEDLINE, EMBASE, CINAHL, BNI and HMIC. We searched the National Research Register to November 2007. We undertook further searches to October 2009 to identify potentially eligible published or ongoing trials. Selection criteria Randomised controlled trials (RCTs) of interventions tailored to address prospectively identified barriers to change that reported objectively measured professional practice or healthcare outcomes in which at least one group received an intervention designed to address prospectively identified barriers to change. Data collection and analysis Two reviewers independently assessed quality and extracted data. We undertook quantitative and qualitative analyses. The quantitative analyses had two elements. We carried out a meta-regression to compare interventions tailored to address identified barriers to change with either no interventions or an intervention(s) not tailored to the barriers.We carried out heterogeneity analyses to investigate sources of differences in the effectiveness of interventions. These included the effects of: risk of bias, concealment of allocation, rigour of barrier analysis, use of theory, complexity of interventions, and the reported presence of administrative constraints. Main results We included 26 studies comparing an intervention tailored to address identified barriers to change to no intervention or an intervention(s) not tailored to the barriers. The effect sizes of these studies varied both across and within studies. Twelve studies provided

  4. Department of Defense transformation: Organizational barriers to commercial product use in aerospace projects

    NASA Astrophysics Data System (ADS)

    Fellenzer, Sally Jean

    Over the past decade, the benefits of using commercial products in Department of Defense (DOD) projects have become evident. As a result, the DOD has been mandated to incorporate technology from the private sector by the increased use of commercially available products when feasible. This significant organizational transformation not only includes the adoption of new technologies, but also a new business philosophy. These changes have come slowly and have been problematic. This inductive study seeks to determine the organizational barriers that have prevented this new business concept from being incorporated to a greater extent than it has been to date. Based on the comparison of two Earth orbiting satellite ground control facilities; each with identical operational requirements, but built using different technologies, contract and management types, analysis on commercial product incorporation has been performed. Additionally, qualitative interview data from government procurement personnel and commercial vendors as well as data from DOD documents was collected and analyzed. Findings suggest that a misaligned reward system, entrenched networks, and historical precedent are the primary organizational impediments to adopting this significant change in business philosophy.

  5. Ground-Source Heat Pumps. Overview of Market Status, Barriers to Adoption, and Options for Overcoming Barriers

    SciTech Connect

    Goetzler, William; Zogg, Robert; Lisle, Heather; Burgos, Javier

    2009-02-03

    February 2009 final report submitted to DOE by Navigant Consulting, Inc. This report summarizes the status of ground-source heat pump (GSHP) technology and market penetration globally, estimates the energy saving potential of GSHPs in the U.S., identifies key market barriers that are inhibiting wider market adoption of GSHPs, and recommends initiatives that can be implemented or facilitated by the DOE to accelerate market adoption.

  6. Barriers that practitioners face when initiating insulin therapy in general practice settings and how they can be overcome

    PubMed Central

    Bin rsheed, Abdulaziz; Chenoweth, Ian

    2017-01-01

    AIM To explore primary care physicians’ perspectives on possible barriers to the use of insulin. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eight electronic databases were searched (between January 1, 1994 and August 31, 2014) for relevant studies. A search for grey literature and a review of the references in the retrieved studies were also conducted. Studies that focused on healthcare providers’ perspectives on possible barriers to insulin initiation with type 2 diabetic patients were included, as well as articles suggesting solutions for these barriers. Review articles and studies that only considered patients’ perspectives were excluded. RESULTS A total of 19 studies met the inclusion criteria and were therefore included in this study: 10 of these studies used qualitative methods, 8 used quantitative methods and 1 used mixed methods. Studies included a range of different health care settings. The findings are reported under four broad categories: The perceptions of primary care physicians about the barriers to initiate insulin therapy for type 2 diabetes patients, how primary care physicians assess patients prior to initiating insulin, professional roles and possible solutions to overcome these barriers. The barriers described were many and covered doctor, patient, system and technological aspects. Interventions that focused on doctor training and support, or IT-based decision support were few, and did not result in significant improvement. CONCLUSION Primary care physicians’ known delay in insulin initiation is multifactorial. Published reports of attempts to find solutions for these barriers were limited in number. PMID:28138362

  7. Overcoming the barrier of narrative adherence in conflicts through awareness of the psychological bias of naïve realism.

    PubMed

    Nasie, Meytal; Bar-Tal, Daniel; Pliskin, Ruthie; Nahhas, Eman; Halperin, Eran

    2014-11-01

    One significant socio-psychological barrier for peaceful resolution of conflicts is each party's adherence to its own collective narrative. We hypothesized that raising awareness to the psychological bias of naïve realism and its identification in oneself would provide a path to overcoming this barrier, thus increasing openness to the adversary's narrative. We conducted three experimental studies in the context of the Israeli-Palestinian conflict. Studies 1 and 2, conducted among Jewish Israelis and Palestinian Israelis, respectively, revealed that participants with hawkish political ideology reported greater openness to the adversary's narrative when they were made aware of naïve realism bias. Study 3 revealed that hawkish participants at the baseline adhered to the ingroup narrative and resisted the adversary's narrative more than dovish participants. They were also more able to identify the bias in themselves upon learning about it. This identification may explain why the manipulation led to bias correction only among hawkish participants.

  8. Strategies for Overcoming Barriers to Training and Education for Canadians with Disabilities. Lessons in Learning

    ERIC Educational Resources Information Center

    Canadian Council on Learning, 2009

    2009-01-01

    If stronger skills and more education are key to greater labour force participation, then it is important to identify critical barriers to education and training for Canadians with disabilities. In 2008, the Canadian Council on Learning's Adult Learning Knowledge Centre funded a "Community Outreach Initiative for Learner's with…

  9. Supporting Instructors in Overcoming Self-Efficacy and Background Barriers to Adoption

    ERIC Educational Resources Information Center

    Reid, Pat

    2017-01-01

    Most academic technology areas of higher education institutes do not feel faculty technology adoption is adequate (Hartman (EDUCAUSE Rev 43(6), 2008)). Among the barriers to instructional technology adoption are faculty self-efficacy and background. Self-efficacy encompasses the faculty member's belief or confidence in his ability to succeed.…

  10. Designing Caregiver-Implemented Shared-Reading Interventions to Overcome Implementation Barriers

    ERIC Educational Resources Information Center

    Justice, Laura M.; Logan, Jessica R.; Damschroder, Laura

    2015-01-01

    Purpose: This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. Methods: A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their…

  11. At-Risk Students Defy the Odds: Overcoming Barriers to Educational Success.

    ERIC Educational Resources Information Center

    Aronson, Rosa

    The phenomenon of educational resilience in at-risk students involves complex questions and answers. Seven people were interviewed whose lives are chronicled in the context of surviving and achieving despite significant barriers to success in life. They encountered common hindrances arising from poverty, racial and ethnic identity, isolation,…

  12. Overcoming Barriers to the Sexual Expression of Women with Developmental Disabilities.

    ERIC Educational Resources Information Center

    Stinson, Jennifer; Christian, LeeAnn; Dotson, Lori Ann

    2002-01-01

    This article discusses barriers to sexual fulfillment faced by women with developmental disabilities, including: access to gynecological healthcare, limited choices regarding reproductive issues, lack of sex education, and prevailing negative stereotypes that affect the way women are viewed by others and the way they view themselves.…

  13. Understanding and overcoming barriers to substance abuse treatment access for people with mental retardation.

    PubMed

    Slayter, Elspeth M

    2008-01-01

    People with mental retardation have experienced increasing levels of freedom and access to community living over the past 40 years. This has included access to alcohol, illicit drugs and the potential for developing substance abuse and related problems. The manner in which people with mental retardation have handled this access has been recognized since the de institutionalization era began. Despite this recognition, documented barriers to accessing substance abuse treatment for people with mental retardation exist and there is an overarching lack of knowledge about accessible treatment approaches for this population. Policy and practice recommendations are presented for disability and rehabilitation social workers in order to better understand and combat barriers to substance abuse treatment.

  14. Overcoming Barriers to the Market Access of Biosimilars in the European Union: The Case of Biosimilar Monoclonal Antibodies

    PubMed Central

    Moorkens, Evelien; Jonker-Exler, Clara; Huys, Isabelle; Declerck, Paul; Simoens, Steven; Vulto, Arnold G.

    2016-01-01

    Background: In 2014, six of the top ten blockbuster medicines were monoclonal antibodies. This multibillion-dollar market with expiring patents is the main driver for the development of biosimilar mAbs. With the ever-increasing cost of healthcare and the economic pressure to reduce or sustain healthcare expenses, biosimilars could be instrumental in reducing costs for medication and increasing patient access to treatment. Objectives: The aim of this study is to identify and describe the barriers to market access of biosimilar mAbs in the European Union and to analyze how these barriers could be overcome. Methods: A narrative literature review was carried out using the databases PubMed, Embase, and EconLit. Studies were published in English or Dutch. Additionally, the reference list of the articles was checked for relevant studies. Articles and conference papers known to the authors were included as well. Articles were also identified by searching on the website of the Generics and Biosimilars Initiative (GaBI) journal. Results: Six barriers were identified based on available literature: The manufacturing process, the regulatory process, intellectual property rights, lack of incentive, the impossibility of substitution, and the innovator's reach. These six barriers are presented as a possible framework to study the market access of biosimilar mAbs. Based on the literature search, recommendations can be made to overcome these barriers: (i) invest initially in advanced production processes with the help of single-use technology, experience or outsourcing (ii) gain experience with the regulatory process and establish alignment between stakeholders (iii) limit patent litigation, eliminate evergreening benefits, build out further the unitary patent and unified patent litigation system within the EU (iv) create demand-side policies, disseminate objective information (v) change attitude toward biosimilar switching/substitution, starting with physician, and patient

  15. Overcoming barriers to the mobilisation of patients in an intensive care unit.

    PubMed

    Dafoe, S; Chapman, M J; Edwards, S; Stiller, K

    2015-11-01

    We conducted a quality improvement project aimed at increasing the frequency of mobilisation in our ICU. We designed a four-part quality improvement project comprising: an audit documenting the baseline frequency of mobilisation; a staff survey evaluating perceptions of the barriers to mobilisation; identification of barriers that were amenable to change and implementation of strategies to address these; and a follow-up audit to determine their effectiveness. The setting was a tertiary care, urban, public hospital ICU in South Australia. All patients admitted to the ICU during the two audit periods were included in the audits, while all permanent/semi-permanent ICU staff were eligible for inclusion in the staff survey. We found that patient- and institution-related factors had the greatest impact on the mobilisation of patients in our ICU. Barriers identified as being amenable to change included insufficient staff education about the benefits of mobilisation, poor interdisciplinary communication and lack of leadership regarding mobilisation. Various strategies were implemented to address these barriers over a three-month period. Multivariable analyses showed that three out of four mobility outcomes did not significantly change between the baseline and follow-up audits, with a significant difference in favour of the baseline audit found for the fourth mobility outcome (maximum level of mobility). We concluded that implementing relatively simple measures to improve staff education, interdisciplinary communication and leadership regarding early progressive mobilisation was ineffective at improving mobility outcomes for patients in a large tertiary-level Australian ICU. Other strategies, such as changing sedation practices and/or increasing staffing, may be required to improve mobility outcomes of these patients.

  16. Pathogen population bottlenecks and adaptive landscapes: overcoming the barriers to disease emergence.

    PubMed

    Geoghegan, Jemma L; Senior, Alistair M; Holmes, Edward C

    2016-08-31

    Emerging diseases are a major challenge to public health. Revealing the evolutionary processes that allow novel pathogens to adapt to new hosts, also the potential barriers to host adaptation, is central to understanding the drivers of disease emergence. In particular, it is unclear how the genetics and ecology of pathogens interact to shape the likelihood of successful cross-species transmission. To better understand the determinants of host adaptation and emergence, we modelled key aspects of pathogen evolutionary dynamics at both intra- and inter-host scales, using parameter values similar to those observed in influenza virus. We considered the possibility of acquiring the necessary host adaptive mutations both before ('off-the-shelf' emergence) and after ('tailor-made' emergence) a virus is transmitted from a donor to a new recipient species. Under both scenarios, population bottlenecks at inter-host transmission act as a major barrier to host adaptation, greatly limiting the number of adaptive mutations that are able to cross the species barrier. In addition, virus emergence is hindered if the fitness valley between the donor and recipient hosts is either too steep or too shallow. Overall, our results reveal where in evolutionary parameter space a virus could adapt to and become transmissible in a new species.

  17. Coping with structural disadvantage: Overcoming negative effects of perceived barriers through bonding identities.

    PubMed

    Bakouri, Mouna; Staerklé, Christian

    2015-12-01

    Members of socially disadvantaged groups often experience societal devaluation, material hardship, and restricted opportunities, especially during critical life-course transitions. In this study, we investigate whether what we term 'bonding identities', that is identities connecting the self to significant persons whether in terms of social relationships (e.g., family relations) or in terms of categorical collective identities, help individuals negotiate structural constraints on life-course opportunities. We develop and test a model according to which greater perceived barriers to one's life projects are psychologically harmful. We then test whether bonding identities function as a buffer against these stressors' negative psychological effects. Data were collected with a standardized questionnaire from pre-apprentices, apprentices, and young employees in two institutions (N = 365). Results confirm that perceiving barriers to one's life project was harmful for self-esteem. However, for participants who defined themselves in terms of bonding identities, greater perceived barriers did not decrease their perceived coping efficacy and were less harmful for their self-esteem. These findings point to the empowering role of bonding identities (and the social relationships that they imply) for disadvantaged group members.

  18. Zelda overcomes the high intrinsic nucleosome barrier at enhancers during Drosophila zygotic genome activation

    PubMed Central

    Sun, Yujia; Nien, Chung-Yi; Chen, Kai; Liu, Hsiao-Yun; Johnston, Jeff; Zeitlinger, Julia; Rushlow, Christine

    2015-01-01

    The Drosophila genome activator Vielfaltig (Vfl), also known as Zelda (Zld), is thought to prime enhancers for activation by patterning transcription factors (TFs). Such priming is accompanied by increased chromatin accessibility, but the mechanisms by which this occurs are poorly understood. Here, we analyze the effect of Zld on genome-wide nucleosome occupancy and binding of the patterning TF Dorsal (Dl). Our results show that early enhancers are characterized by an intrinsically high nucleosome barrier. Zld tackles this nucleosome barrier through local depletion of nucleosomes with the effect being dependent on the number and position of Zld motifs. Without Zld, Dl binding decreases at enhancers and redistributes to open regions devoid of enhancer activity. We propose that Zld primes enhancers by lowering the high nucleosome barrier just enough to assist TFs in accessing their binding motifs and promoting spatially controlled enhancer activation if the right patterning TFs are present. We envision that genome activators in general will utilize this mechanism to activate the zygotic genome in a robust and precise manner. PMID:26335633

  19. Oculocutaneous albinism: identifying and overcoming barriers to vision care in a Nigerian population.

    PubMed

    Udeh, N N; Eze, B I; Onwubiko, S N; Arinze, O C; Onwasigwe, E N; Umeh, R E

    2014-06-01

    To assess eye care service utilization, and identify access barriers in a south-eastern Nigerian albino population. The study was a population-based, cross-sectional survey conducted in Enugu state between August, 2011 and January, 2012. Using the data base of the state's Albino Foundation and tailored awareness creation, persons living with albinism were identified and recruited at two study centres. Data on participants' socio-demographics, perception of vision, visual needs, previous eye examination and or low vision assessment, use of glasses or low vision devices were collected. Reasons for non-utilisation of available vision care services were also obtained. Descriptive and comparative statistics were performed. A p < 0.05 was considered statistically significant. The participants (n = 153; males 70; females 83; sex ratio: 1:1.1) were aged 23.46 + 10.44 SD years (range 6-60 years). Most--95.4 % of the participants had no previous low vision assessment and none--0.0% had used low vision device. Of the participants, 82.4% reported previous eye examination, 33.3% had not used spectacles previously, despite the existing need. Ignorance--88.9% and poor access--8.5% were the main barriers to uptake of vision care services. In Enugu, Nigeria, there is poor awareness and low utilization of vision care services among people with albinism. The identified barriers to vision care access are amenable to awareness creation and logistic change in the provision of appropriate vision care services.

  20. Work–life initiatives and organizational change: Overcoming mixed messages to move from the margin to the mainstream

    PubMed Central

    Kossek, Ellen Ernst; Lewis, Suzan; Hammer, Leslie B

    2011-01-01

    This article examines perspectives on employer work–life initiatives as potential organizational change phenomena. Work–life initiatives address two main organizational challenges: structural (flexible job design, human resource policies) and cultural (supportive supervisors, climate) factors. While work–life initiatives serve a purpose in highlighting the need for organizational adaptation to changing relationships between work, family, and personal life, we argue they usually are marginalized rather than mainstreamed into organizational systems. We note mixed consequences of work–life initiatives for individuals and organizations.While they may enable employees to manage work and caregiving, they can increase work intensification and perpetuate stereotypes of ideal workers. In order to advance the field, organizations and scholars need to frame both structural and cultural work–life changes as part of the core employment systems to enhance organizational effectiveness and not just as strategies to support disadvantaged, non-ideal workers. We conclude with an overview of the articles in this special issue. PMID:22021934

  1. AccessAbility: Overcoming Information Barriers. Proceedings from the 1987 Spring Meeting of the Nebraska Library Association, College and University Section (Omaha, Nebraska, May 29, 1987).

    ERIC Educational Resources Information Center

    Kacena, Barbara J., Ed.

    Various aspects of the theme, "AccessAbility: Overcoming Information Barriers," are considered in the conference papers collected in this document. They include: (1) "The Library Image: A Barrier to Accessibility" (Janice S. Boyer); (2) "The Educationally Disadvantaged Student: How Can the Library Help?" (Michael Poma…

  2. OVERCOMING THE METER BARRIER AND THE FORMATION OF SYSTEMS WITH TIGHTLY PACKED INNER PLANETS (STIPs)

    SciTech Connect

    Boley, A. C.; Morris, M. A.; Ford, E. B.

    2014-09-10

    We present a solution to the long outstanding meter barrier problem in planet formation theory. As solids spiral inward due to aerodynamic drag, they will enter disk regions that are characterized by high temperatures, densities, and pressures. High partial pressures of rock vapor can suppress solid evaporation, and promote collisions between partially molten solids, allowing rapid growth. This process should be ubiquitous in planet-forming disks, which may be evidenced by the abundant class of Systems with Tightly packed Inner Planets discovered by the NASA Kepler Mission.

  3. [Overcoming language barriers with telephone interpreters: first experiences at a German children's hospital].

    PubMed

    Langer, Thorsten; Wirth, Stefan

    2014-01-01

    Language barriers in the care for patients with limited German language proficiency contribute to impaired quality of care, more frequent medical errors and decreased patient satisfaction. However, professional interpreters are not systematically used in Germany. We conducted a pilot study in a German paediatric hospital to explore the demand for an interpreter by conducting a survey among parents and to test the use of telephone interpreters. Eight percent of the respondents said they were interested in interpreter support. All physicians and parents using a telephone interpreter were very satisfied with the quality and the organisation of the service.

  4. Overcoming barriers to addressing education problems with research design: a panel discussion.

    PubMed

    Yarris, Lalena M; Gruppen, Larry D; Hamstra, Stanley J; Anders Ericsson, K; Cook, David A

    2012-12-01

    A plenary panel session at the 2012 Academic Emergency Medicine consensus conference "Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success" discussed barriers educators face in imagining, designing, and implementing studies to address educational challenges. This proceedings article presents a general approach to getting started in education research. Four examples of studies from the medical education literature that illustrate a distinct way to approach specific research questions are discussed. The study designs used are applicable to a variety of education research problems in emergency medicine (EM). Potential applications of studies are discussed, as well as effects and lessons learned.

  5. Overcoming Workplace Barriers: A Focus Group Study Exploring African American Mothers' Needs for Workplace Breastfeeding Support

    PubMed Central

    Johnson, Angela Marie; Kirk, Rosalind; Muzik, Maria

    2015-01-01

    Background Persistent racial disparities in breastfeeding show that African American women breastfeed at the lowest rates. Return to work is a critical breastfeeding barrier for African American women who return to work sooner than other ethnic groups and more often encounter unsupportive work environments. They also face psychosocial burdens that make breastfeeding at work uniquely challenging. Participants share personal struggles with combining paid employment and breastfeeding and suggest workplace and personal support strategies that they believe will help continue breastfeeding after a return to work. Objective To explore current perspectives on ways to support African American mothers' workplace breastfeeding behavior. Methods Pregnant African American women (n = 8), African American mothers of infants (n = 21), and lactation support providers (n = 9) participated in 1 of 6 focus groups in the Greater Detroit area. Each focus group audiotape was transcribed verbatim. Thematic analysis was used to inductively analyze focus group transcripts and field notes. Focus groups explored thoughts, perceptions, and behavior on interventions to support African American women's breastfeeding. Results Participants indicate that they generally believed breastfeeding was a healthy option for the baby; however, paid employment is a critical barrier to successful breastfeeding for which mothers receive little help. Participants felt breastfeeding interventions that support working African American mothers should include education and training for health care professionals, regulation and enforcement of workplace breastfeeding support policies, and support from peers who act as breastfeeding role models. Conclusion Culturally appropriate interventions are needed to support breastfeeding among working African American women. PMID:25714345

  6. Overcoming research barriers in Chagas disease-designing effective implementation science.

    PubMed

    Henao-Martínez, Andrés F; Colborn, Kathryn; Parra-Henao, Gabriel

    2017-01-01

    Chagas disease is a complex tropical parasitic infection. It affects a significant portion of the population in Latin America, especially in areas of poverty and poor access to health care. It also affects immigrants in high-income countries who lack access to health care due to their legal status. Millions of people are at risk of contracting the disease, and approximately 30 % of chronically infected patients will develop cardiomyopathy. The cost of caring for patients that have been infected is substantial. Basic science research has introduced new concepts and knowledge for the parasite and vector biology as well as better understanding of the pathophysiology of the disease. These research findings nevertheless require effective and timely translation into clinical practice. Likewise, the design of new research projects should account for the multiple system-based barriers. Implementation science facilitates the applicability of research findings and identifies barriers to its execution. Creation of implementation science measures to reach and sustain research programs with greater potential to impact Chagas disease are lacking. This point of view proposes opportunities for implementation science in Chagas disease and strategies for researching effective interventions for preventing and treating the disease.

  7. Overcoming the Cystic Fibrosis Sputum Barrier to Leading Adeno-associated Virus Gene Therapy Vectors

    PubMed Central

    Schuster, Benjamin S; Kim, Anthony J; Kays, Joshua C; Kanzawa, Mia M; Guggino, William B; Boyle, Michael P; Rowe, Steven M; Muzyczka, Nicholas; Suk, Jung Soo; Hanes, Justin

    2014-01-01

    Gene therapy has not yet improved cystic fibrosis (CF) patient lung function in human trials, despite promising preclinical studies. In the human CF lung, inhaled gene vectors must penetrate the viscoelastic secretions coating the airways to reach target cells in the underlying epithelium. We investigated whether CF sputum acts as a barrier to leading adeno-associated virus (AAV) gene vectors, including AAV2, the only serotype tested in CF clinical trials, and AAV1, a leading candidate for future trials. Using multiple particle tracking, we found that sputum strongly impeded diffusion of AAV, regardless of serotype, by adhesive interactions and steric obstruction. Approximately 50% of AAV vectors diffused >1,000-fold more slowly in sputum than in water, with large patient-to-patient variation. We thus tested two strategies to improve AAV diffusion in sputum. We showed that an AAV2 mutant engineered to have reduced heparin binding diffused twice as fast as AAV2 on average, presumably because of reduced adhesion to sputum. We also discovered that the mucolytic N-acetylcysteine could markedly enhance AAV diffusion by altering the sputum microstructure. These studies underscore that sputum is a major barrier to CF gene delivery, and offer strategies for increasing AAV penetration through sputum to improve clinical outcomes. PMID:24869933

  8. Microneedles and other physical methods for overcoming the stratum corneum barrier for cutaneous gene therapy.

    PubMed

    Coulman, Sion; Allender, Chris; Birchall, James

    2006-01-01

    The outermost layer of skin, the epidermis, has developed formidable physical and immunological barrier properties that prevent infiltration of deleterious chemicals and pathogens. Consequently, transdermal delivery of medicaments is currently restricted to a limited number of low molecular weight drugs. As a corollary, there has been significant recent interest in providing strategies that disrupt or circumvent the principal physical barrier, the stratum corneum, for the efficient cutaneous delivery of macromolecular and nucleic acid based therapeutics. These strategies include: electrical methods, intradermal injection, follicular delivery, particle acceleration, laser ablation, radiofrequency ablation, microscission, and microneedles. The application of microfabricated microneedle arrays to skin creates transient pathways to enable transcutaneous delivery of drugs and macromolecules. Microneedle use is simple, pain-free, and causes no bleeding, with further advantages of convenient manufacture, distribution, and disposal. To date, microneedles have been shown to deliver drug, peptide, antigen, and DNA efficiently through skin. Robust and efficient microneedle designs and compositions can be inserted into the skin without fracture. Further progress in microneedle array design, microneedle application apparatus, and integrated formulation will confirm this methodology as a realistic clinical strategy for delivering a range of medicaments, including DNA, to and through skin.

  9. Overcoming barriers to glycemic control in African Americans with type-2 diabetes: benefits of insulin therapy.

    PubMed Central

    Marshall, Merville C.

    2007-01-01

    A disproportionate number of African-American men and women are affected by obesity and diabetes. The documented rate of poor glycemic control in the African-American population may contribute to the high rate of morbidity and mortality due to diabetes observed in these patients. Since the benefits of strict glycemic control have been demonstrated in multiple large trials, the aim of treatment should be to achieve the goals set forth by the American Diabetes Association. Insulin remains an essential therapeutic agent for helping patients achieve glycemic control and preventing long-term comorbidities. However, barriers to insulin therapy exist for both the physician and patient. Strategies to counter this resistance include identifying barriers to treatment, restoring the patient's sense of control, utilizing simple regimens, and reviewing the benefits of insulin and the risk of hypoglycemia. In treating African-American patients with diabetes, providers of various racial and ethnic backgrounds may maximize treatment efficacy by attempting to understand and practice culturally competent care. PMID:17722663

  10. Rural Veteran Access to Healthcare Services: Investigating the Role of Information and Communication Technologies in Overcoming Spatial Barriers

    PubMed Central

    Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

    2010-01-01

    This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients. PMID:20697468

  11. Enhanced intranasal delivery of mRNA vaccine by overcoming the nasal epithelial barrier via intra- and paracellular pathways.

    PubMed

    Li, Man; Zhao, Mengnan; Fu, Yao; Li, You; Gong, Tao; Zhang, Zhirong; Sun, Xun

    2016-04-28

    Facing the threat of highly variable virus infection, versatile vaccination systems are urgently needed. Intranasal mRNA vaccination provides a flexible and convenient approach. However, the nasal epithelium remains a major biological barrier to deliver antigens to nasal associated lymphoid tissue (NALT). To address this issue, a potent polymer-based intranasal mRNA vaccination system for HIV-1 treatment was synthesized using cationic cyclodextrin-polyethylenimine 2k conjugate (CP 2k) complexed with anionic mRNA encoding HIV gp120. The delivery vehicle containing CP 2k and mRNA overcame the epithelial barrier by reversibly opening the tight junctions, enhanced the paracellular delivery of mRNA and consequently minimized absorption of toxins in the nasal cavity. Together with the excellent intracellular delivery and prolonged nasal residence time, strong system and mucosal anti-HIV immune responses as well as cytokine productions were achieved with a balanced Th1/Th2/Th17 type. Our study provided the first proof of evidence that cationic polymers can be used as safe and potent intranasal mRNA vaccine carriers to overcome the nasal epithelial barrier. The safe and versatile polymeric delivery system represents a promising vaccination platform for infectious diseases.

  12. Rural veteran access to healthcare services: investigating the role of information and communication technologies in overcoming spatial barriers.

    PubMed

    Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

    2010-04-01

    This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients.

  13. Overcoming restriction as a barrier to DNA transformation in Caldicellulosiruptor species results in efficient marker replacement

    PubMed Central

    2013-01-01

    Background Thermophilic microorganisms have special advantages for the conversion of plant biomass to fuels and chemicals. Members of the genus Caldicellulosiruptor are the most thermophilic cellulolytic bacteria known. They have the ability to grow on a variety of non-pretreated biomass substrates at or near ~80°C and hold promise for converting biomass to bioproducts in a single step. As for all such relatively uncharacterized organisms with desirable traits, the ability to genetically manipulate them is a prerequisite for making them useful. Metabolic engineering of pathways for product synthesis is relatively simple compared to engineering the ability to utilize non-pretreated biomass. Results Here we report the construction of a deletion of cbeI (Cbes2438), which encodes a restriction endonuclease that is as a major barrier to DNA transformation of C. bescii. This is the first example of a targeted chromosomal deletion generated by homologous recombination in this genus and the resulting mutant, JWCB018 (ΔpyrFA ΔcbeI), is readily transformed by DNA isolated from E. coli without in vitro methylation. PCR amplification and sequencing suggested that this deletion left the adjacent methyltransferase (Cbes2437) intact. This was confirmed by the fact that DNA isolated from JWCB018 was protected from digestion by CbeI and HaeIII. Plasmid DNA isolated from C. hydrothermalis transformants were readily transformed into C. bescii. Digestion analysis of chromosomal DNA isolated from seven Caldicellulosiruptor species by using nine different restriction endonucleases was also performed to identify the functional restriction-modification activities in this genus. Conclusion Deletion of the cbeI gene removes a substantial barrier to routine DNA transformation and chromosomal modification of C. bescii. This will facilitate the functional analyses of genes as well as metabolic engineering for the production of biofuels and bioproducts from biomass. An analysis of

  14. Sustainable fuel, food, fertilizer and ecosystems through a global artificial photosynthetic system: overcoming anticompetitive barriers

    PubMed Central

    Bruce, Alex; Faunce, Thomas

    2015-01-01

    This article discusses challenges that artificial photosynthetic (AP) systems will face when entering and competing in a global market characterized by established fossil fuel technology. It provides a perspective on the neoliberal principles underpinning much policy entrenching such environmentally destructive technology and outlines how competition law could aid overcoming these hurdles for AP development. In particular, it critiques the potential for competition law to promote a global AP initiative with greater emphasis on atmospheric carbon dioxide and nitrogen fixation (as well as solar-driven water splitting) to produce an equitable, globally distributed source of human food, fertilizer and biosphere sustainability, as well as hydrogen-based fuel. Some relevant strategies of competition law evaluated in this context include greater citizen–consumer involvement in shaping market values, legal requirements to factor services from the natural environment (i.e. provision of clean air, water, soil pollution degradation) into corporate costs, reform of corporate taxation and requirements to balance maximization of shareholder profit with contribution to a nominated public good, a global financial transactions tax, as well as prohibiting horizontal cartels, vertical agreements and unilateral misuse of market power. PMID:26052427

  15. Mucosal Vaccination Overcomes the Barrier to Recombinant Vaccinia Immunization Caused by Preexisting Poxvirus Immunity

    NASA Astrophysics Data System (ADS)

    Belyakov, Igor M.; Moss, Bernard; Strober, Warren; Berzofsky, Jay A.

    1999-04-01

    Overcoming preexisting immunity to vaccinia virus in the adult population is a key requirement for development of otherwise potent recombinant vaccinia vaccines. Based on our observation that s.c. immunization with vaccinia induces cellular and antibody immunity to vaccinia only in systemic lymphoid tissue and not in mucosal sites, we hypothesized that the mucosal immune system remains naive to vaccinia and therefore amenable to immunization with recombinant vaccinia vectors despite earlier vaccinia exposure. We show that mucosal immunization of vaccinia-immune BALB/c mice with recombinant vaccinia expressing HIV gp160 induced specific serum antibody and strong HIV-specific cytotoxic T lymphocyte responses. These responses occurred not only in mucosal but also in systemic lymphoid tissue, whereas systemic immunization was ineffective under these circumstances. In this context, intrarectal immunization was more effective than intranasal immunization. Boosting with a second dose of recombinant vaccinia was also more effective via the mucosal route. The systemic HIV-specific cytotoxic T lymphocyte response was enhanced by coadministration of IL-12 at the mucosal site. These results also demonstrate the independent compartmentalization of the mucosal versus systemic immune systems and the asymmetric trafficking of lymphocytes between them. This approach to circumvent previous vaccinia immunity may be useful for induction of protective immunity against infectious diseases and cancer in the sizable populations with preexisting immunity to vaccinia from smallpox vaccination.

  16. Sustainable fuel, food, fertilizer and ecosystems through a global artificial photosynthetic system: overcoming anticompetitive barriers.

    PubMed

    Bruce, Alex; Faunce, Thomas

    2015-06-06

    This article discusses challenges that artificial photosynthetic (AP) systems will face when entering and competing in a global market characterized by established fossil fuel technology. It provides a perspective on the neoliberal principles underpinning much policy entrenching such environmentally destructive technology and outlines how competition law could aid overcoming these hurdles for AP development. In particular, it critiques the potential for competition law to promote a global AP initiative with greater emphasis on atmospheric carbon dioxide and nitrogen fixation (as well as solar-driven water splitting) to produce an equitable, globally distributed source of human food, fertilizer and biosphere sustainability, as well as hydrogen-based fuel. Some relevant strategies of competition law evaluated in this context include greater citizen-consumer involvement in shaping market values, legal requirements to factor services from the natural environment (i.e. provision of clean air, water, soil pollution degradation) into corporate costs, reform of corporate taxation and requirements to balance maximization of shareholder profit with contribution to a nominated public good, a global financial transactions tax, as well as prohibiting horizontal cartels, vertical agreements and unilateral misuse of market power.

  17. Obtaining family consent for participation in Alzheimer's research in a Cuban-American population: strategies to overcome the barriers.

    PubMed

    Williams, C L; Tappen, R; Buscemi, C; Rivera, R; Lezcano, J

    2001-01-01

    Cultural values and beliefs affect family attitudes toward participation in research. Significant resistance to allowing their elders with dementia to participate in clinical research was encountered in Cuban-American families. These families expressed concern about disturbing the elder's comfort (tranquilidad) and solitude (soledad). Furthermore, most believed that intervention would be futile. Feelings of guilt associated with nursing home placement may have been exacerbated by the suggestion that active intervention could be effective. Strategies to overcome these barriers included reduced emphasis on the potential superiority of the intervention to be tested, reassurance that contact with research staff was usually appreciated by participants, arrangements to talk with the family as a group about the study, and increased use of Spanish-language consent forms.

  18. Pregnancy options counseling for adolescents: overcoming barriers to care and preserving preference.

    PubMed

    Dobkin, Loren M; Perrucci, Alissa C; Dehlendorf, Christine

    2013-04-01

    Current clinical guidelines for counseling adolescent patients about their pregnancy options fail to give concrete suggestions for how to begin and hold conversations that support patient autonomy, provide accurate and unbiased information, and address barriers to care. Recent research suggests that relative to adult women, adolescents are at increased risk of being denied abortion because they present beyond facilities' gestational age limits. Counseling that neglects to address the structural and developmental challenges that adolescents face when seeking care may contribute to the risk of abortion denial as well as subsequent delays in prenatal care. The task of providing non-directive, patient-centered, evidence-based pregnancy options counseling to an adolescent while ensuring that she receives her chosen course of care in a timely manner is challenging. This article presents a shared decision-making framework and specific suggestions for healthcare providers to support adolescent patients in coming to their decision about whether to continue or terminate an unplanned pregnancy and access follow-up care within the current sociopolitical environment.

  19. OVERCOMING BARRIERS To DIVERSITY IN CHIROPRACTIC PATIENT AND PRACTITIONER POPULATIONS: A COMMENTARY.

    PubMed

    Young, Kenneth J

    2015-01-01

    Increasing the diversity of practitioner and patient populations has been identified as a worthy goal in the chiropractic profession, which has predominantly white male practitioners and white female patients in the USA. Toward that end, 'diversity' has been the topic of several papers and was the theme of a 2012 conference of chiropractic educators. However, generally just the microcosm of the interactions of practitioners with patients or teachers with students has been discussed. The macrocosm of larger societal issues and government policies has not been broached. Examples of issues and policies that affect diversity within a profession include portrayals of, and value judgements on diversity by the media and politicians, as well as public funding for healthcare and education. Diversity was defined in this paper to mean differences in race, sex, sexual orientation, economic status, ethnicity, religion and other life circumstances in a population. The purpose of this paper is to raise awareness of evidence that social issues and government policy affect the diversity of practitioners and patients, and to suggest that the barriers to diversity present in these realms be addressed with a cogent, profession-wide effort in order to help increase the diversity of people involved with chiropractic.

  20. Nanoparticle-mediated brain drug delivery: Overcoming blood-brain barrier to treat neurodegenerative diseases.

    PubMed

    Saraiva, Cláudia; Praça, Catarina; Ferreira, Raquel; Santos, Tiago; Ferreira, Lino; Bernardino, Liliana

    2016-08-10

    The blood-brain barrier (BBB) is a vital boundary between neural tissue and circulating blood. The BBB's unique and protective features control brain homeostasis as well as ion and molecule movement. Failure in maintaining any of these components results in the breakdown of this specialized multicellular structure and consequently promotes neuroinflammation and neurodegeneration. In several high incidence pathologies such as stroke, Alzheimer's (AD) and Parkinson's disease (PD) the BBB is impaired. However, even a damaged and more permeable BBB can pose serious challenges to drug delivery into the brain. The use of nanoparticle (NP) formulations able to encapsulate molecules with therapeutic value, while targeting specific transport processes in the brain vasculature, may enhance drug transport through the BBB in neurodegenerative/ischemic disorders and target relevant regions in the brain for regenerative processes. In this review, we will discuss BBB composition and characteristics and how these features are altered in pathology, namely in stroke, AD and PD. Additionally, factors influencing an efficient intravenous delivery of polymeric and inorganic NPs into the brain as well as NP-related delivery systems with the most promising functional outcomes will also be discussed.

  1. Overcoming barriers and thresholds – signaling of oligomeric Aβ through the prion protein to Fyn

    PubMed Central

    2013-01-01

    Evidence has been mounting for an involvement of the prion protein (PrP) in a molecular pathway assumed to play a critical role in the etiology of Alzheimer disease. A currently popular model sees oligomeric amyloid β (oAβ) peptides bind directly to PrP to emanate a signal that causes activation of the cytoplasmic tyrosine kinase Fyn, an essential player in a cascade of events that ultimately leads to NMDA receptor-mediated excitotoxicity and hyper-phosphorylation of tau. The model does not reveal, however, how extracellular binding of oAβ to PrP is communicated across the plasma membrane barrier to affect activation of Fyn. A scenario whereby PrP may adapt a transmembrane topology to affect Fyn activation in the absence of additional partners is currently not supported by evidence. A survey of known candidate PrP interactors leads to a small number of molecules that are known to acquire a transmembrane topology and understood to contribute to Fyn activation. Because multiple signaling pathways converge onto Fyn, a realistic model needs to take into account a reality of Fyn acting as a hub that integrates signals from multiple inhibitory and activating effectors. To clarify the role of PrP in oAβ-dependent excitotoxicity, future studies may need to incorporate experimental designs that can probe the contributions of Fyn modulator pathways and rely on analogous readouts, rather than threshold effects, known to underlie excitotoxic signaling. PMID:23856335

  2. [Google translate is not sufficient to overcome language barriers in neonatal medicine].

    PubMed

    Börner, N; Sponholz, S; König, K; Brodkorb, S; Bührer, C; Roehr, C C

    2013-12-01

    Language barriers hinder the interaction with patients and relatives. The use of language services increases knowledge, satisfaction and the use of medical care and thus improves patient's clinical outcome. The recommended use of professional interpreters (PI) is not always feasible. We tested an online translation tool as an alternative for PI for the transla-tion of standardized sentences from a neonatal doctor-/nurse-relative-interview.Translation of 20 sentences from a German neonatal intensive care unit parent information brochure to English, Portuguese and Arabic, using Google Translate (GT). Assessment of accuracy concerning grammar and content, in a second step simplification of all incorrect sentences, translation by GT and critical re-assessment and evaluation.An average of 42% of the sentences was correctly translated concerning grammar and content. The proportion of incorrectly translated sentences varied between 45-70%. By simpli-fication another 23% were translated correctly.Translations by GT were often incorrect in content and grammar. We suppose that the design of GT, which is a statistical translation engine, might be an explanation for this phenomenon. Presently, GT cannot guarantee unambiguous translations and cannot substitute PIs, only in particular circumstances, the use of GT or similar engines may be justified. For future use of electronic translation services, we suggest to compile a catalogue of sentences containing central information, which can be translated into defined foreign languages without misinterpretation or loss of information.

  3. Drug delivery in overcoming the blood–brain barrier: role of nasal mucosal grafting

    PubMed Central

    Marianecci, Carlotta; Rinaldi, Federica; Hanieh, Patrizia Nadia; Di Marzio, Luisa; Paolino, Donatella; Carafa, Maria

    2017-01-01

    The blood–brain barrier (BBB) plays a fundamental role in protecting and maintaining the homeostasis of the brain. For this reason, drug delivery to the brain is much more difficult than that to other compartments of the body. In order to bypass or cross the BBB, many strategies have been developed: invasive techniques, such as temporary disruption of the BBB or direct intraventricular and intracerebral administration of the drug, as well as noninvasive techniques. Preliminary results, reported in the large number of studies on the potential strategies for brain delivery, are encouraging, but it is far too early to draw any conclusion about the actual use of these therapeutic approaches. Among the most recent, but still pioneering, approaches related to the nasal mucosa properties, the permeabilization of the BBB via nasal mucosal engrafting can offer new potential opportunities. It should be emphasized that this surgical procedure is quite invasive, but the implication for patient outcome needs to be compared to the gold standard of direct intracranial injection, and evaluated whilst keeping in mind that central nervous system diseases and lysosomal storage diseases are chronic and severely debilitating and that up to now no therapy seems to be completely successful. PMID:28184152

  4. Identifying and Overcoming Critical Barriers to Widespread Second Use of PEV Batteries

    SciTech Connect

    Neubauer, J.; Smith, K.; Wood, E.; Pesaran, A.

    2015-02-01

    Both the market penetration of plug-in electric vehicles (PEVs) and deployment of grid-connected energy storage systems are presently restricted by the high cost of batteries. Battery second use (B2U) strategies--in which a single battery first serves an automotive application, then is redeployed into a secondary market--could help address both issues by reducing battery costs to the primary (automotive) and secondary (electricity grid) users. This study investigates the feasibility of and major barriers to the second use of lithium-ion PEV batteries by posing and answering the following critical B2U questions: 1. When will used automotive batteries become available, and how healthy will they be? 2. What is required to repurpose used automotive batteries, and how much will it cost? 3. How will repurposed automotive batteries be used, how long will they last, and what is their value? Advanced analysis techniques are employed that consider the electrical, thermal, and degradation response of batteries in both the primary (automotive) and secondary service periods. Second use applications are treated in detail, addressing operational requirements, economic value, and market potential. The study concludes that B2U is viable and could provide considerable societal benefits due to the large possible supply of repurposed automotive batteries and substantial remaining battery life following automotive service. However, the only identified secondary market large enough to consume the supply of these batteries (utility peaker plant replacement) is expected to be a low margin market, and thus B2U is not expected to affect the upfront cost of PEVs.

  5. Bryozoan diversity around the Falkland and South Georgia Islands: Overcoming Antarctic barriers.

    PubMed

    Figuerola, Blanca; Barnes, David K A; Brickle, Paul; Brewin, Paul E

    2017-05-01

    There are a number of remote archipelagos distributed between 45 and 60 °S. The biota of these islands provide useful information to describe and understand patterns in biodiversity and biogeography as well as potential impacts of climate change on marine ecosystems. They are in key locations either side of the Polar Front but also have limited influence from human activities. Here we investigate one taxon, bryozoans, on South Atlantic shelf habitats of the Falkland (FI) and the sub-Antarctic island of South Georgia (SG). We present new data on spatial distribution in these islands, as well as an analysis of the bryozoological similarities between these and neighbouring regions. A total of 85 species of cheilostome bryozoans (351 samples) were found, belonging to 33 genera, including 18 potentially new genera and 23 new species. Remarkably 65% and 41% of species were reported for the first time at FI and SG, respectively. The highest and the lowest value of species richness and species/genus ratio were found at East (EFI) and West Falkland (WFI), respectively, likely showing a tendency for stronger intrageneric competition. New data from this study were jointly analysed with data from the literature and existing databases, revealing new bathymetric ranges in 32 species. The biogeographic affinities of the bryozoans found give further evidence of the hypothesis of sequential separation of Gondwana and support the changing concept that although the Polar Front acts as a circumpolar biogeographic barrier it is not as impermeable as originally thought. Potential dispersal mechanisms are also discussed.

  6. Applying Risk Science and Stakeholder Engagement to Overcome Environmental Barriers to Marine and Hydrokinetic Energy Projects

    SciTech Connect

    Copping, Andrea E.; Anderson, Richard M.; Van Cleve, Frances B.

    2010-09-20

    The production of electricity from the moving waters of the ocean has the potential to be a viable addition to the portfolio of renewable energy sources worldwide. The marine and hydrokinetic (MHK) industry faces many hurdles, including technology development, challenges of offshore deployments, and financing; however, the barrier most commonly identified by industry, regulators, and stakeholders is the uncertainty surrounding potential environmental effects of devices placed in the water and the permitting processes associated with real or potential impacts. Regulatory processes are not well positioned to judge the severity of harm due to turbines or wave generators. Risks from MHK devices to endangered or protected animals in coastal waters and rivers, as well as the habitats that support them, are poorly understood. This uncertainty raises concerns about catastrophic interactions between spinning turbine blades or slack mooring lines and marine mammals, birds and fish. In order to accelerate the deployment of tidal and wave devices, there is a need to sort through the extensive list of potential interactions that may cause harm to marine organisms and ecosystems, to set priorities for regulatory triggers, and to direct future research. Identifying the risk of MHK technology components on specific marine organisms and ecosystem components can separate perceived from real risk-relevant interactions. Scientists from Pacific Northwest National Laboratory (PNNL) are developing an Environmental Risk Evaluation System (ERES) to assess environmental effects associated with MHK technologies and projects through a systematic analytical process, with specific input from key stakeholder groups. The array of stakeholders interested in the development of MHK is broad, segmenting into those whose involvement is essential for the success of the MHK project, those that are influential, and those that are interested. PNNL and their partners have engaged these groups, gaining

  7. Performance of some new Niño3.4 predictors at overcoming the spring predictability barrier.

    NASA Astrophysics Data System (ADS)

    Miguel, Tasambay-Salazar; Jose, Ortizbevia Maria; Francisco Jose, Alvarez-Garcia; Antonio, Ruizdeelvira

    2016-04-01

    The El Niño-Southern Oscillation (ENSO) phenomenon is the main source of predictability skill in many regions of the world, at seasonal and interannual timescales. Improving ENSO understanding and forecast skill is still one of the main goals of the international seasonal forecast programs. A common feature found in ENSO forecast is the skill predictability barrier, that is the skill drop for forecast across the spring season. In this study ENSO variability is represented by the Niño3.4 Index. Here we will use different seasonal linear stochastic models to test the performance of some new ENSO predictors at overcoming the spring predictability barrier. The benchmarkt is the performance scored by the same predictive scheme when the variables are those of a basic equatorial model representing the 'recharge-discharge' oscillator paradigm. Some of the new predictors, like the Tropical South Atlantic Index, the Tropical North Atlantic Index, the Indian Ocean Dipole Mode or the Pacific Meridional Model have been pointed at by recent studies. Additionally, we propose two new predictors, that take into account the zonal sea surface temperature gradients across the tropical Pacific, the North Tropical Pacific Zonal Gradient and the South Tropical Pacific Zonal Gradient Indexes. We intercompare the performance of the new predictors, by introducing them, one at a time, in a simple, three variables, stochastic predictive scheme. For some seasons and lags, the differences between the skill scored by some of the models that include one of these predictors are important. However, these are diminished when a Full Stochastic Mode set-up is adopted. References. Tasambay Salazar, M.; Ortiz Beviá, M. J.; Alvarez García, F. J.; Ruiz de Elvira Serra, A. The Niño3.4 region predictability beyond the persistence barrier. Tellus A. 2015, 67. doi: 10.3402/tellusa.v67.27457,

  8. Dialogue as an Organizational Learning Intervention: Taking a Closer Look at Psychological Barriers

    ERIC Educational Resources Information Center

    Maurer, Martin

    2008-01-01

    This paper synthesizes conceptual and empirical literature on organizational learning interventions based on dialogue. First, I attempt to delineate the concept of dialogue and to explain its relevance to organizational learning. Examples and arguments in support of dialogic learning initiatives are presented. Organizational realities and…

  9. Organizational Barriers to Adopting an Alcohol Screening and Brief Intervention in Community-Based Mental Health Organizations.

    PubMed

    Patterson, David A; Wolf Adelv Unegv Waya, Silver; Dulmus, Catherine N

    2012-06-01

    This paper examines two factors related to successfully implementing a brief alcohol screening throughout all community-based mental health organizations. The first issue is related to an organization's internal structures, such as culture and climate that can impede evidenced-based practice implementation. There is literature suggesting that organizational culture and climate affect decisions about whether evidence-based practices are adopted and implemented within health care agencies. Following this literature review on organizational barriers, the history and successes of adopting an alcohol screening and brief intervention are reviewed. Studying, identifying, and understanding the organizational factors associated with the successful dissemination and implementation of best practices throughout community-based mental health organizations would contribute to increasing the likelihood that an alcohol screening and brief intervention are implemented throughout mental health organizations.

  10. Let’s Not Contribute to Disparities: The Best Methods for Teaching Clinicians How to Overcome Language Barriers to Health Care

    PubMed Central

    Jacobs, Elizabeth A.

    2010-01-01

    Clinicians should be educated about how language barriers contribute to disparities for patients with limited English proficiency (LEP). However, educators must avoid developing educational interventions that increase health disparities for LEP patients. For example, studies suggest that teaching “Medical Spanish” or related courses may actually contribute to health care disparities if clinicians begin using these non-English language skills inappropriately with patients. We discuss the risks and benefits of teaching specific cultural competence skills and make evidence-based recommendations for the teaching content and methods for educational interventions focused on overcoming language barriers in health care. At minimum, we suggest such interventions include: (1) the role of language barriers in health disparities, (2) means of overcoming language barriers, (3) how to work with interpreters, (4) identifying and fixing problems in interpreted encounters, and (5) appropriate and safe use of one’s own limited non-English language skills. PMID:20352518

  11. The GEOFAR Project - Geothermal Finance and Awareness in Europeans Regions - Development of new schemes to overcome non-technical barriers, focusing particularly on financial barriers

    NASA Astrophysics Data System (ADS)

    Poux, Adeline; Wendel, Marco; Jaudin, Florence; Hiegl, Mathias

    2010-05-01

    Numerous advantages of geothermal energy like its widespread distribution, a base-load power and availability higher than 90%, a small footprint and low carbon emissions, and the growing concerns about climate changes strongly promote the development of geothermal projects. Geothermal energy as a local energy source implies needs on surface to be located close to the geothermal resource. Many European regions dispose of a good geothermal potential but it is mostly not sufficiently developed due to non-technical barriers occurring at the very early stages of the project. The GEOFAR Project carried out within the framework of EU's "Intelligent Energy Europe" (IEE) program, gathers a consortium of European partners from Germany, France, Greece, Spain and Portugal. Launched in September 2008, the aim of this research project is to analyze the mentioned non-technical barriers, focusing most particularly on economic and financial aspects. Based on this analysis GEOFAR aims at developing new financial and administrative schemes to overcome the main financial barriers for deep geothermal projects (for electricity and direct use, without heat pumps). The analysis of the current situation and the future development of geothermal energy in GEOFAR target countries (Germany, France, Greece, Spain, Portugal, Slovakia, Bulgaria and Hungary) was necessary to understand and expose the diverging status of the geothermal sector and the more and less complicated situation for geothermal projects in different Europeans Regions. A deeper analysis of 40 cases studies (operating, planned and failed projects) of deep geothermal projects also contributed to this detailed view. An exhaustive analysis and description of financial mechanisms already existing in different European countries and at European level to support investors completed the research on non-technical barriers. Based on this profound analysis, the GEOFAR project has made an overview of the difficulties met by project

  12. The Analysis of the Relationship between Organizational Structure and Information Technology (IT): And the Barriers to Its Establishment at the University of Isfahan from the Faculty Member's Viewpoints

    ERIC Educational Resources Information Center

    Peyman, Yarmohammadzadeh; Mohsen, Allammeh Sayyed; Hassan, Ghalavandi; Aboulghassim, Farhang; Zaman, Ajdari

    2011-01-01

    The purpose of the present study is to investigate the relationship between organizational structure between IT and the barriers to its establishment in University of Isfahan from faculty member's viewpoints in 2007-2008. The questionnaires were prepared and examined based on the organization dimensions of organizational structures (formality,…

  13. miR-155 Deletion in Mice Overcomes Neuron-Intrinsic and Neuron-Extrinsic Barriers to Spinal Cord Repair

    PubMed Central

    Mandrekar-Colucci, Shweta; Hall, Jodie C.E.; Sweet, David R.; Schmitt, Philipp J.; Xu, Xinyang; Guan, Zhen; Mo, Xiaokui; Guerau-de-Arellano, Mireia

    2016-01-01

    Axon regeneration after spinal cord injury (SCI) fails due to neuron-intrinsic mechanisms and extracellular barriers including inflammation. microRNA (miR)-155–5p is a small, noncoding RNA that negatively regulates mRNA translation. In macrophages, miR-155-5p is induced by inflammatory stimuli and elicits a response that could be toxic after SCI. miR-155 may also independently alter expression of genes that regulate axon growth in neurons. Here, we hypothesized that miR-155 deletion would simultaneously improve axon growth and reduce neuroinflammation after SCI by acting on both neurons and macrophages. New data show that miR-155 deletion attenuates inflammatory signaling in macrophages, reduces macrophage-mediated neuron toxicity, and increases macrophage-elicited axon growth by ∼40% relative to control conditions. In addition, miR-155 deletion increases spontaneous axon growth from neurons; adult miR-155 KO dorsal root ganglion (DRG) neurons extend 44% longer neurites than WT neurons. In vivo, miR-155 deletion augments conditioning lesion-induced intraneuronal expression of SPRR1A, a regeneration-associated gene; ∼50% more injured KO DRG neurons expressed SPRR1A versus WT neurons. After dorsal column SCI, miR-155 KO mouse spinal cord has reduced neuroinflammation and increased peripheral conditioning-lesion-enhanced axon regeneration beyond the epicenter. Finally, in a model of spinal contusion injury, miR-155 deletion improves locomotor function at postinjury times corresponding with the arrival and maximal appearance of activated intraspinal macrophages. In miR-155 KO mice, improved locomotor function is associated with smaller contusion lesions and decreased accumulation of inflammatory macrophages. Collectively, these data indicate that miR-155 is a novel therapeutic target capable of simultaneously overcoming neuron-intrinsic and neuron-extrinsic barriers to repair after SCI. SIGNIFICANCE STATEMENT Axon regeneration after spinal cord injury (SCI) fails

  14. Overcoming access barriers to health services through membership-based microfinance organizations: a review of evidence from South Asia.

    PubMed

    Saha, Somen; Annear, Peter Leslie

    2014-06-30

    It is a challenge for the poor to overcome the barriers to accessing health services. Membership-based microfinance with associated health programmes can improve health outcomes for the poor. This study reviewed the evidence published between 1993 and 2013 on the role of membership-based microfinance with associated health programmes in improving health outcomes for the poor in South Asia. A total of 661 papers were identified and 26 selected for inclusion, based on the relevance and rigour of the research methods. Of these 26, five were evidence reviews. Of the remaining 21 papers, 12 were from India, seven from Bangladesh, and one each from Sri Lanka and Indonesia. Three papers addressed more than one theme. Five key themes emerged from the review: (i) the impact of microfinance programmes on the social and economic situation of the poor; (ii) the impact of microfinance programmes on community health; (iii) the impact of integrated microfinance health programmes on raising client awareness; (iv) the impact of integrated microfinance health programmes on financing health care; and (v) the impact of integrated microfinance health programmes on affordable health-care products and services. The review provides new evidence on the pathways through which microfinance helps to improve population health and value for money for such programmes. Among countries with large populations in the informal sector, there is a strong case for policy-makers to support these groups in providing access to life-saving health care among the poor.

  15. Overcoming access barriers to health services through membership-based microfinance organizations: a review of evidence from South Asia

    PubMed Central

    Saha, Somen; Annear, Peter Leslie

    2015-01-01

    It is a challenge for the poor to overcome the barriers to accessing health services. Membership-based microfinance with associated health programmes can improve health outcomes for the poor. This study reviewed the evidence published between 1993 and 2013 on the role of membership-based microfinance with associated health programmes in improving health outcomes for the poor in South Asia. A total of 661 papers were identified and 26 selected for inclusion, based on the relevance and rigour of the research methods. Of these 26, five were evidence reviews. Of the remaining 21 papers, 12 were from India, seven from Bangladesh, and one each from Sri Lanka and Indonesia. Three papers addressed more than one theme. Five key themes emerged from the review: (i) the impact of microfinance programmes on the social and economic situation of the poor; (ii) the impact of microfinance programmes on community health; (iii) the impact of integrated microfinance health programmes on raising client awareness; (iv) the impact of integrated microfinance health programmes on financing health care; and (v) the impact of integrated microfinance health programmes on affordable health-care products and services. The review provides new evidence on the pathways through which microfinance helps to improve population health and value for money for such programmes. Among countries with large populations in the informal sector, there is a strong case for policy-makers to support these groups in providing access to life-saving health care among the poor. PMID:25685728

  16. The role of "blebbing" in overcoming the hydrophobic barrier during biooxidation of elemental sulfur by Thiobacillus thiooxidans

    USGS Publications Warehouse

    Knickerbocker, C.; Nordstrom, D.K.; Southam, G.

    2000-01-01

    Brimstone Basin, in southeastern Yellowstone National Park, Wyoming is an ancient hydrothermal area containing solfataric alteration. Drainage waters flowing from Brimstone Basin had pH values as low as 1.23 and contained up to 1.7×106 MPN/ml acidophilic sulfur-oxidizing bacteria. Thiobacillus thiooxidans was the dominant sulfur-oxidizing bacterium recovered from an enrichment culture and was used in a structural examination of bacterial sulfur oxidation. Growth in these sulfur cultures occurred in two phases with cells in association with the macroscopic sulfur grains and in suspension above these grains. Colonization of sulfur grains by individual cells and microcolonies was facilitated by organic material that appeared to be responsible for bacterial adhesion. Transmission electron microscopy of negatively stained (2% [wt./vol.] uranyl acetate), sulfur-grown T. thiooxidans revealed extensive membrane blebbing (sloughing of outer membrane vesicles) and the presence of approximately 100 nm sized sulfur particles adsorbed to membrane material surrounding individual bacteria. Sulfite-grown bacteria did not possess membrane blebs. The amphipathic nature of these outer membrane vesicles appear to be responsible for overcoming the hydrophobic barrier necessary for the growth of T. thiooxidans on elemental sulfur.

  17. Exploring facilitators and barriers to individual and organizational level capacity building: outcomes of participation in a community priority setting workshop.

    PubMed

    Flaman, Laura M; Nykiforuk, Candace I J; Plotnikoff, Ronald C; Raine, Kim

    2010-06-01

    This article explores facilitators and barriers to individual and organizational capacity to address priority strategies for community-level chronic disease prevention. Interviews were conducted with a group of participants who previously participated in a community priority-setting workshop held in two Alberta communities. The goal of the workshop was to bring together key community stakeholders to collaboratively identify action strategies for preventing chronic diseases in their communities. While capacity building was not the specific aim of the workshop, it could be considered an unintended byproduct of bringing together community representatives around a specific issue. One purpose of this study was to examine the participants' capacity to take action on the priority strategies identified at the workshop. Eleven one-on-one semi-structured interviews were conducted with workshop participants to examine facilitators and barriers to individual and organizational level capacity building. Findings suggest that there were several barriers identified by participants that limited their capacity to take action on the workshop strategies, specifically: (i) organizations' lack of priorities or competing priorities; (ii) priorities secondary to the organizational mandate; (iii) disconnect between organizational and community priorities; (iv) disconnect between community organization priorities; (v) disconnect between organizations and government/funder priorities; (vi) limited resources (i.e. time, money and personnel); and, (vii) bigger community issues. The primary facilitator of individual capacity to take action or priority strategies was supportive organizations. Recognition of these elements will allow practitioners, organizations, governments/funders, and communities to focus on seeking ways to improve capacity for chronic disease prevention.

  18. "My hair or my health:" Overcoming barriers to physical activity in African American women with a focus on hairstyle-related factors.

    PubMed

    Huebschmann, Amy G; Campbell, Lucille Johnson; Brown, Candace S; Dunn, Andrea L

    2016-01-01

    Physical activity disparities among African American (AA) women may be related to sociocultural barriers, including difficulties with restyling hair after exercise. We sought to identify physical activity barriers and facilitators in AA women with a focus on sociocultural factors related to hairstyle maintenance. Participants (n = 51) were AA women aged 19-73 years who completed valid surveys and participated in structured focus groups, stratified by age and physical activity levels, from November 2012 to February 2013. The Constant Comparison method was used to develop qualitative themes for barriers and facilitators. The most frequently reported general physical activity barrier among exercisers was "lack of money" (27%) and among non-exercisers was "lack of self-discipline" (57%). A hairstyle-related barrier of "sweating out my hairstyle" was reported by 7% of exercisers and 29% of non-exercisers. This hairstyle-related barrier included the need for extra time and money to restyle hair due to perspiration. Hairstyle-related facilitators included: prioritizing health over hairstyle and high self-efficacy to restyle hair after perspiration. Participants were interested in resources to simplify hairstyle maintenance. AA women whose hairstyle is affected by perspiration may avoid physical activity due to time and financial burdens. Increasing self-efficacy to restyle hair after perspiration may help to overcome this barrier.

  19. What Are the Barriers Which Discourage 15-16 Year-Old Girls from Participating in Team Sports and How Can We Overcome Them?

    PubMed Central

    Wetton, Abigail R.; Jones, Angela R.; Pearce, Mark S.

    2013-01-01

    Given the clear benefits of regular physical activity (such as reduced risks of cardiovascular disease and obesity, as well as other benefits including those related to mental health), exploration of the reasons that adolescent girls give for not taking part in team sports may be particularly valuable for enhancing later rates of participation. We combined questionnaires (n = 60) and semistructured interviews (n = 6) to assess the barriers that prevent 15-16-year-old girls from participating in extracurricular team games and what can be done to overcome these barriers and improve physical activity levels. Four barriers became prominent as to why girls in this sample do not participate: Internal Factors, Existing Stereotypes, Other Hobbies and Teachers. Methods to overcome these barriers were identified; changing teachers' attitudes and shifting the media's focus away from male sport. Following the successful summer Olympics and Paralympics in the UK, and the resulting positive focus on some of the nation's female athletes, a shift in focus may be possible. However, this needs to be maintained to allow girls more opportunities, role models and motivation to participate in sport. PMID:24073416

  20. What are the barriers which discourage 15-16 year-old girls from participating in team sports and how can we overcome them?

    PubMed

    Wetton, Abigail R; Radley, Rebecca; Jones, Angela R; Pearce, Mark S

    2013-01-01

    Given the clear benefits of regular physical activity (such as reduced risks of cardiovascular disease and obesity, as well as other benefits including those related to mental health), exploration of the reasons that adolescent girls give for not taking part in team sports may be particularly valuable for enhancing later rates of participation. We combined questionnaires (n = 60) and semistructured interviews (n = 6) to assess the barriers that prevent 15-16-year-old girls from participating in extracurricular team games and what can be done to overcome these barriers and improve physical activity levels. Four barriers became prominent as to why girls in this sample do not participate: Internal Factors, Existing Stereotypes, Other Hobbies and Teachers. Methods to overcome these barriers were identified; changing teachers' attitudes and shifting the media's focus away from male sport. Following the successful summer Olympics and Paralympics in the UK, and the resulting positive focus on some of the nation's female athletes, a shift in focus may be possible. However, this needs to be maintained to allow girls more opportunities, role models and motivation to participate in sport.

  1. Advocating for responsible oil and natural gas extraction policies; FracTracker as a mechanism for overcoming the barriers to scientific advocacy for academics and communities

    NASA Astrophysics Data System (ADS)

    Ferrar, K. J.; Malone, S.; Kelso, M.; Lenker, B.

    2013-12-01

    The inability to translate data to scientific information that can readily be incorporated by citizens into the public arena is an obstacle for science-based advocacy. This issue is particularly poignant for shale oil and natural gas development via hydraulic fracturing, as the issue has become highly politicized. Barriers to engaging in policy debate are different but highly related for community members and scientists. For citizens and interest groups, barriers including accessibility, public awareness and data presentation limit the motivation for community involvement in political interactions. To overcome such barriers, social researchers call for public engagement to move upstream and many call for a broad engagement of scientists in science-based advocacy. Furthermore surveys have shown that citizens, interest groups, and decision-makers share a broad desire for scientists to engage in environmental policy development. Regardless, scientists face a number of perceived barriers, with academics expressing the most resistance to overcoming the tension created by adherence to the scientific method and the need to engage with the broader society, described by Schneider (1990) as the 'double ethical bind'. For the scientific community the appeal of public dissemination of information beyond the scope of academic journals is limited for a number of reasons. Barriers include preservation of credibility, peer attitudes, training, and career trajectory. The result is a lack of translated information available to the public. This systematic analysis of the FracTracker platform provides an evaluation of where the features of the public engagement, GIS platform has been successful at overcoming these barriers to public dissemination, where the platform needs further development or is ill-suited to address these issues, and the development of FracTracker as an outlet for scientific researchers to engage with citizens. The analysis will also provide insight into what

  2. [How are Pediatric Hospitals in North-Rhine Westfalia Prepared to Overcome Language Barriers? A Pilot Study Exploring The Structural Quality of Inpatient Care].

    PubMed

    Langer, T; Zapf, T; Wirth, S; Meyer, B; Wiegand, A; Timmen, H; Gupta, S J; Schuster, S; Geraedts, M

    2016-05-04

    Background: In Germany, 35% of all children are considered to have a "migration background", and in the state of North-Rhine-Westfalia 43%. Frequently, one or both parents of a patient with a migration background have limited German language proficiency. Communication barriers due to a language difference can have a negative impact on quality of care, patient safety and costs of care. In this study, we investigate how children's hospitals are prepared to meet the challenges associated with language barriers. Methods: We surveyed all children's hospitals in the state of North-Rhine-Westfalia, Germany. The questionnaire was based on the "Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS)" and was adapted to circumstances in Germany. Results: Thirty-eight hospitals participated (51%) in this survey. Language barriers occurred frequently (75% of respondents mentioned language difficulties in more than 10% of the patient population). 82% of respondents rated their hospital to be "less than well prepared" to overcome language barriers. In the majority of hospitals (62%), the need for an interpreter was determined on a case-to-case basis and not according to any set protocol. In most cases bilingual staff was used for interpreting. However, only 38% of respondents found a list of available bilingual staff to be a sufficient resource. 42% of respondents did not know the monthly costs for professional interpreting services. In the remaining cases, costs were less than € 500/month. Conclusion: To overcome language barriers, hospitals rely on local resources. The majority of respondents did not find them to be appropriate and sufficient. The development of quality standards and the provision of financial resources are necessary to mobilize this potential for improvement. Therefore, other disciplines and sectors of healthcare need to be analyzed in order to provide the evidence for a constructive discussion with decision

  3. Strategies to Overcome Barriers to Implementation of Alcohol Screening and Brief Intervention in General Practice: a Delphi Study Among Healthcare Professionals and Addiction Prevention Experts.

    PubMed

    Abidi, L; Oenema, A; Nilsen, P; Anderson, P; van de Mheen, D

    2016-08-01

    Despite the evidence base, alcohol screening and brief intervention (ASBI) have rarely been integrated into routine clinical practice. The aim of this study is to identify strategies that could tackle barriers to ASBI implementation in general practice by involving primary healthcare professionals and addiction prevention experts. A three-round online Delphi study was carried out in the Netherlands. The first-round questionnaire consisted of open-ended questions to generate ideas about strategies to overcome barriers. In the second round, participants were asked to indicate how applicable they found each strategy. Items without consensus were systematically fed back with group median ratings and interquartile range (IQR) scores in the third-round questionnaire. In total, 39 out of 69 (57 %) invited participants enrolled in the first round, 214 participants completed the second round, and 144 of these (67 %) completed the third-round questionnaire. Results show that participants reached consensus on 59 of 81 strategies, such as the following: (1) use of E-learning technology, (2) symptom-specific screening by general practitioners (GPs) and/or universal screening by practice nurses, (3) reimbursement incentives, (4) supportive materials, (5) clear guidelines, (6) service provision of addiction care centers, and (7) more publicity in the media. This exploratory study identified a broad set of strategies that could potentially be used for overcoming barriers to ASBI implementation in general practice and paves the way for future research to experimentally test the identified implementation strategies using multifaceted approaches.

  4. Selected Annotated Bibliography: "Schools as Learning Communities." The Creation of High-Performance Schools through Organizational and Individual Learning.

    ERIC Educational Resources Information Center

    Cibulka, James; Nakayama, Michelle

    This annotated bibliography is part of a three-part report on creating high performing schools through organizational and individual learning. It includes such topics as: teachers supporting teachers; educational improvement via total quality management; overcoming barriers to organizational change; the institutionalization of public schools;…

  5. Are the Walls Really Down? Behavioral and Organizational Barriers to Faculty and Staff Diversity. ASHE Higher Education Report, Volume 33, Number 1

    ERIC Educational Resources Information Center

    Evans, Alvin, Ed.; Chun, Edna Breinig, Ed.

    2007-01-01

    This monograph focuses on the subtle behavioral and organizational barriers that hinder the recruitment, retention, and advancement of women and minority faculty and administrators in higher education today. Specifically the monograph explores the obstacles that face women and minorities who serve as full-time, tenure-track faculty and…

  6. Overcoming language barriers in the informed consent process: regulatory and compliance issues with the use of the "short form".

    PubMed

    Lad, Pramod M; Dahl, Rebecca

    2014-01-01

    Language barriers in the informed consent process can be a significant impediment when recruiting non-English speaking subjects into clinical research studies. Regulatory guidelines indicate that the short form procedure be utilized in such circumstances. In this paper, we examine some of the ambiguities in the regulatory framework, the resulting need for institutional policy guidelines, and compliance issues with the short form process.

  7. "We Don't Want to Talk about That": Overcoming Barriers to Rural Aging Research and Interventions on Sensitive Topics

    ERIC Educational Resources Information Center

    Zanjani, Faika; Rowles, Graham D.

    2012-01-01

    Geographical, economic, social and cultural barriers to accessing services in rural areas are widely reported. Less widely discussed are dilemmas posed by individual and community reluctance to address sensitive health issues. This article, focusing on the highly sensitive area of mental health, and employing a participatory action approach,…

  8. Overcoming barriers to effectiveness in a health care operational environment: building on the lessons of American industry.

    PubMed

    Zimmerer, L W; Zimmerer, T W; Yasin, M M

    1999-01-01

    Several of the manufacturing-based philosophies, techniques and tools, such as Total Quality Management (TQM), Continuous Improvement (CI), Business Process Reengineering (BPR) and Time-based Competition (TBC) have been successfully adapted for use within the service sector. Diverse service industries including airlines, insurance, food services and hospitality have increased customer satisfaction and performance through the use of the quality driven, manufacturing-based philosophies. This article explores the reasons for the limited success of TQM/CI, BPR, TBC and benchmarking within the health care industry. Sixteen barriers to change are identified, possible counter-measures to these barriers are outlined and two conceptual frameworks are offered as possible facilitators of change for the health care industry.

  9. Social Barriers to Successful Re-entry into Mainstream Organizational Culture: Perceptions of People with Disabilities.

    ERIC Educational Resources Information Center

    Boyle, Mike A.

    1997-01-01

    Case studies of seven workers with physical impairments identified four categories of barriers: negative social image, a rehabilitation system that controlled career options, job completion methods that denied access to occupations, and image campaigns making organizations appear to be responsive to disabilities. The Americans with Disabilities…

  10. Structural Barriers and Organizational Mechanisms for Training and Deploying ICT Champions in a School

    ERIC Educational Resources Information Center

    Woo, David James

    2016-01-01

    The misalignment or contradiction between material and abstract resources within a school are structural barriers to systemic pedagogic innovation and effective teacher professional development. This article contributes a case study to the success stories of information and communication technology (ICT) integration in schools through alternative…

  11. Being "chill" with teachers and "frozen" by peers in science: overcoming social and educational barriers in a learning community

    NASA Astrophysics Data System (ADS)

    Kim, Hannah; Scantlebury, Kathryn

    2013-09-01

    This forum discusses the issue of `othering' and how intersectionality is a useful analytical framework for understanding the students' immigrant experiences in, and out of, the science classroom. We use a feminist perspective to discuss Minjung's study because gender is a key aspect of one's identity other aspects such as race, religion, socio-economic status, and age have assumed a significant status in gender studies. Lastly we examine the supports and barriers that cliques can produce and propose the importance of building a learning community in the science classroom to engage all students.

  12. Using community-based participatory research to identify potential interventions to overcome barriers to adolescents’ healthy eating and physical activity

    PubMed Central

    Goh, Ying-Ying; Sipple-Asher, Bessie Ko; Uyeda, Kimberly; Hawes-Dawson, Jennifer; Olarita-Dhungana, Josephina; Ryan, Gery W.; Schuster, Mark A.

    2010-01-01

    Using a community-based participatory research approach, we explored adolescent, parent, and community stakeholder perspectives on barriers to healthy eating and physical activity, and intervention ideas to address adolescent obesity. We conducted 14 adolescent focus groups (n = 119), 8 parent focus groups (n = 63), and 28 interviews with community members (i.e., local experts knowledgeable about youth nutrition and physical activity). Participants described ecological and psychosocial barriers in neighborhoods (e.g., lack of accessible nutritious food), in schools (e.g., poor quality of physical education), at home (e.g., sedentary lifestyle), and at the individual level (e.g., lack of nutrition knowledge). Participants proposed interventions such as nutrition classes for families, addition of healthy school food options that appeal to students, and non-competitive physical education activities. Participants supported health education delivered by students. Findings demonstrate that community-based participatory research is useful for revealing potentially feasible interventions that are acceptable to community members. PMID:19544091

  13. Do we need to overcome barriers to learning in the workplace for foundation trainees rotating in neurosurgery in order to improve training satisfaction?

    PubMed

    Phan, Pho Nh; Patel, Keyur; Bhavsar, Amar; Acharya, Vikas

    2016-01-01

    Junior doctors go through a challenging transition upon qualification; this repeats every time they start a rotation in a new department. Foundation level doctors (first 2 years postqualification) in neurosurgery are often new to the specialty and face various challenges that may result in significant workplace dissatisfaction. The neurosurgical environment is a clinically demanding area with a high volume of unwell patients and frequent emergencies - this poses various barriers to learning in the workplace for junior doctors. We identify a number of key barriers and review ideas that can be trialed in the department to overcome them. Through an evaluation of current suggestions in the literature, we propose that learning opportunities need to be made explicit to junior doctors in order to encourage them to participate as a member of the team. We consider ideas for adjustments to the induction program and the postgraduate medical curriculum to shift the focus from medical knowledge to improving confidence and clinical skills in newly qualified doctors. Despite being a powerful window for opportunistic learning, the daily ward round is unfortunately not maximized and needs to be more learner focused while maintaining efficiency and time consumption. Finally, we put forward the idea of an open forum where trainees can talk about their learning experiences, identify subjective barriers, and suggest solutions to senior doctors. This would be achieved through departmental faculty development. These interventions are presented within the context of the neurosurgical ward; however, they are transferable and can be adapted in other specialties and departments.

  14. The Value of Companion Diagnostics: Overcoming Access Barriers to Transform Personalised Health Care into an Affordable Reality in Europe.

    PubMed

    Wurcel, Victoria; Perche, Olivier; Lesteven, Daniel; Williams, Doris-Ann; Schäfer, Birgit; Hopley, Colin; Jungwirth, Rebecca; Postulka, Anne; Pasmans, Raf; Hermansson, Lisse-Lotte; Ott, Markus; Glorioso, Valeria

    2016-01-01

    Personalised health care is an evolution, moving away from a disease-focused model of care, translating scientific and technological advances into benefits for patients, and placing them at the centre of the patients' health and care. Companion diagnostics emerge as a very specific and special group of in vitro diagnostics among the different technologies shaping the personalised health care spectrum. Companion diagnostics provide highly valuable information, allowing patients, health practitioners and payers to decide with a higher level of certainty on the potential benefits of a treatment or care pathway. Decreasing uncertainty may result in a more efficient selection of treatments and care, targeted at subpopulations that are most likely to benefit. Companion diagnostics account for a minimal portion of the already small expenditure on in vitro diagnostics (far less than 1% of total health care expenditure), and yet they provide the means to limit inefficient use of health care resources while optimising patient outcomes. It is clear that equal access to personalised health care is still an issue across the EU. One of the most common perceived barriers is affordability. The investment in companion diagnostics can provide long-term value for patients and health care systems, shifting resources to areas of need. Health systems do not fully recognise yet the value that companion diagnostics bring to make personalised health care more affordable across the EU. This inhibits patient access to personalised treatments and care, preventing improved outcomes. In many countries, market access frameworks for diagnostic tests are fragmented and not aligned with specific funding and reimbursement mechanisms, discouraging the use of these tests. Emerging evidence shows that patients are missing out on the appropriate tests and treatments while a reduction in the inefficient use of health care resources is not realised. This article outlines some of these market access

  15. Overcoming language and cultural barriers: a graphical communication tool to perform a parasitological screening in two vulnerable populations from Argentina.

    PubMed

    Buyayisqui, María Pía; Bordoni, Noemí; Garbossa, Graciela

    2013-01-01

    This is an exploratory study of the application of a support tool for the detection of asymptomatic subjects carrying enteric parasites in two vulnerable populations in Argentina: a shantytown in the city of Buenos Aires and a rural Wichí indigenous community in the province of Chaco. The ethnic and cultural diversity, high illiteracy rate, and language barriers called for the development of an auxiliary resource to explain stool sample collection procedures. In individual interviews with each family, the authors used two instructional guidance leaflets in comic strip format depicting the procedures. They evaluated the acceptance of the graphical communication tool on the basis of the number of retrieved samples. Percentages of respondent families were 72.2% and 66.7%, respectively. Definitive validation of these instruments would allow their use in community studies, community service learning experiences, and research on aboriginal communities that would otherwise be excluded from studies on health status.

  16. A collaborative care telemedicine intervention to overcome treatment barriers for Latina women with depression during the perinatal period.

    PubMed

    Baker-Ericzén, Mary J; Connelly, Cynthia D; Hazen, Andrea L; Dueñas, Cecilia; Landsverk, John A; Horwitz, Sarah McCue

    2012-09-01

    Maternal depression is highly prevalent (10-20%) during the perinatal period, with rates as high as 35% to 40% for Latinas. However, few Latinas are either identified or treated during the perinatal period. The Perinatal Mental Health (PMH) model was designed to ameliorate the barriers that prevent adequate diagnoses and intervention. The PMH is a culturally sensitive, short-term telemedicine, collaborative care intervention for addressing depression among Mexican American mothers. It attends to sociocultural and socioeconomic dimensions and is delivered by trained mental health advisors in obstetric care settings. This article describes the feasibility and acceptability of using the PMH. Participants (N = 79) were selected from a 1st-year ongoing randomized trial in community obstetric clinics. The intervention seems feasible and acceptable; low-income Latinas, identified as depressed during the perinatal period, reported having access to a range of appropriate community services and high satisfaction.

  17. A Collaborative Care Telemedicine Intervention to Overcome Treatment Barriers for Latina Women with Depression during the Perinatal Period

    PubMed Central

    Baker-Ericzén, Mary J.; Connelly, Cynthia D.; Hazen, Andrea L.; Dueñas, Cecilia; Landsverk, John A.; Horwitz, Sarah McCue

    2013-01-01

    Maternal depression is highly prevalent (10 to 20%) during the perinatal period with rates as high as 35 to 40% for Latinas. However, few Latinas are either identified or treated during the perinatal period. To address these disparities, the Perinatal Mental Health Model (PMH) was designed to ameliorate the barriers that prevent adequate diagnoses and intervention. The PMH is a culturally sensitive, short-term telemedicine, and collaborative care intervention for addressing depression among Mexican American mothers. It attends to sociocultural and socioeconomic dimensions and is delivered by trained mental health advisors within obstetric care settings. This article describes the feasibility and acceptability of utilizing the PMH. Participants (n=79) were selected from a first year ongoing randomized trial in community obstetric clinics. The intervention seems feasible and acceptable; low-income Latinas, identified as depressed during the perinatal period, reported having access to a range of appropriate community services and high satisfaction. PMID:22709321

  18. PLANET FORMATION IN STELLAR BINARIES. II. OVERCOMING THE FRAGMENTATION BARRIER IN α CENTAURI AND γ CEPHEI-LIKE SYSTEMS

    SciTech Connect

    Rafikov, Roman R.; Silsbee, Kedron

    2015-01-10

    Planet formation in small-separation (∼20 AU) eccentric binaries such as γ Cephei or α Centauri is believed to be adversely affected by the presence of the stellar companion. Strong dynamical excitation of planetesimals by the eccentric companion can result in collisional destruction (rather than growth) of 1-100 km objects, giving rise to the ''fragmentation barrier'' for planet formation. We revise this issue using a novel description of secular dynamics of planetesimals in binaries, which accounts for the gravity of the eccentric, coplanar protoplanetary disk, as well as gas drag. By studying planetesimal collision outcomes, we show, in contrast to many previous studies, that planetesimal growth and subsequent formation of planets (including gas giants) in AU-scale orbits within ∼20 AU separation binaries may be possible, provided that the protoplanetary disks are massive (≳ 10{sup –2} M {sub ☉}) and only weakly eccentric (disk eccentricity ≲ 0.01). These requirements are compatible with both the existence of massive (several M{sub J} ) planets in γ Cep-like systems and the results of recent simulations of gaseous disks in eccentric binaries. Terrestrial and Neptune-like planets can also form in lower-mass disks at small (sub-AU) radii. We find that the fragmentation barrier is less of a problem in eccentric disks that are apsidally aligned with the binary orbit. Alignment gives rise to special locations, where (1) relative planetesimal velocities are low and (2) the timescale of their drag-induced radial drift is long. This causes planetesimal pileup at such locations in the disk and promotes their growth locally, helping to alleviate the timescale problem for core formation.

  19. Overcoming barriers to seedling regeneration during forest restoration on tropical pasture land and the potential value of woody weeds

    PubMed Central

    Elgar, Amelia T.; Freebody, Kylie; Pohlman, Catherine L.; Shoo, Luke P.; Catterall, Carla P.

    2014-01-01

    Combating the legacy of deforestation on tropical biodiversity requires the conversion to forest of large areas of established pasture, where barriers to native plant regeneration include competition with pasture grasses and poor propagule supply (seed availability). In addition, initial woody plants that colonise pasture are often invasive, non-native species whose ecological roles and management in the context of forest regeneration are contested. In a restoration experiment at two 0.64 ha sites we quantified the response of native woody vegetation recruitment to (1) release from competition with introduced pasture grasses, and (2) local facilitation of frugivore-assisted seed dispersal provided by scattered woody plants and artificial bird perches. Herbicide pasture grass suppression during 20 months caused a significant but modest increase in density of native woody seedlings, together with abundant co-recruitment of the prominent non-native pioneer wild tobacco (Solanum mauritianum). Recruitment of native species was further enhanced by local structure in herbicide-treated areas, being consistently greater under live trees and dead non-native shrubs (herbicide-treated) than in open areas, and intermediate under bird perches. Native seedling recruitment comprised 28 species across 0.25 ha sampled but was dominated by two rainforest pioneers (Homalanthus novoguineensis, Polyscias murrayi). These early results are consistent with the expected increase in woody vegetation recruitment in response to release from competitive and dispersive barriers to rainforest regeneration. The findings highlight the need for a pragmatic consideration of the ecological roles of woody weeds and the potential roles of “new forests” more broadly in accelerating succession of humid tropical forest across large areas of retired agricultural land. PMID:24904602

  20. Obtaining family consent for participation in Alzheimer’s research in a Cuban-American population: Strategies to overcome the barriers

    PubMed Central

    Williams, Christine L.; Tappen, Ruth; Buscemi, Charles; Rivera, Richard; Lezcano, Jennifer

    2007-01-01

    Cultural values and beliefs affect family attitudes toward participation in research. Significant resistance to allowing their elders with dementia to participate in clinical research was encountered in Cuban-American families. These families expressed concern about disturbing the elder’s comfort (tranquilidad) and solitude (soledad) Furthermore, most believed that intervention would be futile. Feelings of guilt associated with nursing home placement may have been exacerbated by the suggestion that active intervention could be effective. Strategies to overcome these barriers included reduced emphasis on the potential superiority of the intervention to be tested, reassurance that contact with research staff was usually appreciated by participants, arrangements to talk with the family as a group about the study, and increased use of Spanish-language consent forms. PMID:11398568

  1. The Long Way From Government Open Data to Mobile Health Apps: Overcoming Institutional Barriers in the US Federal Government

    PubMed Central

    2014-01-01

    Background Government agencies in the United States are creating mobile health (mHealth) apps as part of recent policy changes initiated by the White House’s Digital Government Strategy. Objective The objective of the study was to understand the institutional and managerial barriers for the implementation of mHealth, as well as the resulting adoption pathways of mHealth. Methods This article is based on insights derived from qualitative interview data with 35 public managers in charge of promoting the reuse of open data through Challenge.gov, the platform created to run prizes, challenges, and the vetting and implementation of the winning and vendor-created apps. Results The process of designing apps follows three different pathways: (1) entrepreneurs start to see opportunities for mobile apps, and develop either in-house or contract out to already vetted Web design vendors; (2) a top-down policy mandates agencies to adopt at least two customer-facing mobile apps; and (3) the federal government uses a policy instrument called “Prizes and Challenges”, encouraging civic hackers to design health-related mobile apps using open government data from HealthData.gov, in combination with citizen needs. All pathways of the development process incur a set of major obstacles that have to be actively managed before agencies can promote mobile apps on their websites and app stores. Conclusions Beyond the cultural paradigm shift to design interactive apps and to open health-related data to the public, the managerial challenges include accessibility, interoperability, security, privacy, and legal concerns using interactive apps tracking citizen. PMID:25537314

  2. Socio-ecological Model as a Framework for Overcoming Barriers and Challenges in Randomized Control Trials in Minority and Underserved Communities

    PubMed Central

    Salihu, Hamisu M.; Wilson, Ronee E.; King, Lindsey M.; Marty, Phillip J.; Whiteman, Valerie E.

    2015-01-01

    Background: Numerous barriers and challenges can hinder the successful enrollment and retention of study participants in clinical trials targeting minority populations. To conduct quality research, it is important to investigate these challenges, determine appropriate strategies that are evidence-based and continue seeking methods of improvement. Methods: In this paper, we report such experiences in a registered clinical trial in an underserved minority population in the Southern part of United States. This research study is a randomized double-blind controlled clinical trial that tests the efficacy of higher-strength as compared to low-strength/standard of care folic acid to prevent fetal body and brain size reduction in pregnant women who smoke. A unique approach in this socio-behavioral, genetic-epigenetic clinical trial is that we have adopted the socio-ecological model as a functional platform to effectively achieve and maintain high participant recruitment and retention rates. Results: We highlight the barriers we have encountered in our trial and describe how we have successfully applied the socio-ecological model to overcome these obstacles. Conclusions and Global Health Implications: Our positive experience will be of utility to other researchers globally. Our fi ndings have far-reaching implications as the socio-ecological model approach is adaptable to developed and developing regions and has the potential to increase recruitment and retention of hard-to-reach populations who are typically under-represented in clinical trials. PMID:27621990

  3. Collective epithelial cell invasion overcomes mechanical barriers of collagenous extracellular matrix by a narrow tube-like geometry and MMP14-dependent local softening†

    PubMed Central

    Alcaraz, Jordi; Mori, Hidetoshi; Ghajar, Cyrus M.; Brownfield, Doug; Galgoczy, Roland; Bissell, Mina J.

    2013-01-01

    Collective cell invasion (CCI) through interstitial collagenous extracellular matrix (ECM) is crucial to the initial stages of branching morphogenesis, and a hallmark of tissue repair and dissemination of certain tumors. The collagenous ECM acts as a mechanical barrier against CCI. However, the physical nature of this barrier and how it is overcome by cells remains incompletely understood. To address these questions, we performed theoretical and experimental analysis of mammary epithelial branching morphogenesis in 3D type I collagen (collagen-I) gels. We found that the mechanical resistance of collagen-I is largely due to its elastic rather than its viscous properties. We also identified two strategies utilized by mammary epithelial cells that can independently minimize ECM mechanical resistance during CCI. First, cells adopt a narrow tube-like geometry during invasion, which minimizes the elastic opposition from the ECM as revealed by theoretical modeling of the most frequent invasive shapes and sizes. Second, the stiffness of the collagenous ECM is reduced at invasive fronts due to its degradation by matrix metalloproteinases (MMPs), as indicated by direct measurements of collagen-I microelasticity by atomic force microscopy. Molecular techniques further specified that the membrane-bound MMP14 mediates degradation of collagen-I at invasive fronts. Thus, our findings reveal that MMP14 is necessary to efficiently reduce the physical restraints imposed by collagen-I during branching morphogenesis, and help our overall understanding of how forces are balanced between cells and their surrounding ECM to maintain collective geometry and mechanical stability during CCI. PMID:21993836

  4. Do “trainee-centered ward rounds” help overcome barriers to learning and improve the learning satisfaction of junior doctors in the workplace?

    PubMed Central

    Acharya, Vikas; Reyahi, Amir; Amis, Samuel M; Mansour, Sami

    2015-01-01

    Ward rounds are widely considered an underutilized resource with regard to medical education, and therefore, a project was undertaken to assess if the initiation of “trainee-centered ward rounds” would help improve the confidence, knowledge acquisition, and workplace satisfaction of junior doctors in the clinical environment. Data were collated from junior doctors, registrar grade doctors, and consultants working in the delivery suite at Luton and Dunstable University Hospital in Luton over a 4-week period in March–April 2013. A review of the relevant literature was also undertaken. This pilot study found that despite the reservations around time constraints held by both junior and senior clinicians alike, feedback following the intervention was largely positive. The junior doctors enjoyed having a defined role and responsibility during the ward round and felt they benefited from their senior colleagues’ feedback. Both seniors and junior colleagues agreed that discussing learning objectives prior to commencing the round was beneficial and made the round more learner-orientated; this enabled maximal learner-focused outcomes to be addressed and met. The juniors were generally encouraged to participate more during the round and the consultants endeavored to narrate their decision-making, both were measures that led to greater satisfaction of both parties. This was in keeping with the concept of “Legitimate peripheral participation” as described by Lave and Wenger. Overall, trainee-centered ward rounds did appear to be effective in overcoming some of the traditional barriers to teaching in the ward environment, although further work to formalize and quantify these findings, as well as using greater sample sizes from different hospital departments and the inclusion of a control group, is needed. PMID:26508899

  5. Overcoming psychosocial and developmental barriers to blood and marrow transplantation (BMT) in an adolescent/young adult (AYA) transgender patient with chronic myelogenous leukemia.

    PubMed

    Khazal, Sajad; Abdel-Azim, Hisham; Kapoor, Neena; Mahadeo, Kris M

    2014-11-01

    Adolescents/young adults (AYAs) afflicted with cancer face unique barriers to potentially standard curative therapies, such as blood and marrow transplantation (BMT). Transgender AYAs face additional barriers and there is a dearth of published literature regarding their oncology-related experience. We present the case of an AYA male-to-female (MTF) transgender patient on cross-sex hormone therapy, with a history of Chronic Myelogenous Leukemia (CML) and significant psychosocial barriers, which initially served as a barrier to BMT at two different centers; we modified our standard consent and education process and was able to successfully proceed with BMT and subsequently cure her CML. Despite unique challenges, AYA and transgender patients with significant psychosocial barriers may achieve successful outcomes with BMT. Research is needed regarding guidelines for cross-sex hormone therapy administration for patients undergoing BMT and other issues, which may be unique to the transgender experience.

  6. The Effect of Initiatives to Overcome Language Barriers and Improve Attendance: A Cross-Sectional Analysis of Adherence in an Inner City Chronic Pain Clinic.

    PubMed

    Andreae, Michael H; White, Robert S; Chen, Kelly Yan; Nair, Singh; Hall, Charles; Shaparin, Naum

    2016-07-14

    Language barriers can prevent pain physicians and patients from forming meaningful rapport and drive health care disparities. Non-adherence with scheduled pain clinic appointments deprives patients with chronic pain of needed specialist care.

  7. E-Learning Barriers and Solutions to Knowledge Management and Transfer

    ERIC Educational Resources Information Center

    Oye, Nathaniel David; Salleh, Mazleena

    2013-01-01

    This paper present a systematic overview of barriers and solutions of e-learning in knowledge management (KM) and knowledge transfer (KT) with more focus on organizations. The paper also discusses KT in organizational settings and KT in the field of e-learning. Here, an e-learning initiative shows adaptive solutions to overcome knowledge transfer…

  8. Overcoming recruitment barriers revealed high readiness to participate and low dropout rate among people with schizophrenia in a randomized controlled trial testing the effect of a Guided Self-Determination intervention

    PubMed Central

    2014-01-01

    Background Recruitment is one of the most serious challenges in performing randomized controlled trials. Often clinical trials with participants diagnosed with schizophrenia are terminated prematurely because of recruitment challenges resulting in a considerable waste of resources in the form of time, funding, and the participants’ efforts. Dropout rates in schizophrenia trials are also high. Recruitment challenges are often due to patients not wanting to participate in research but can also be due to clinicians’ concerns regarding individuals diagnosed with schizophrenia as participants in research. This paper reports how overcoming recruitment challenges not related to patients revealed high readiness to take part and low dropout rates in a one year long randomized controlled trial testing Guided Self-Determination (GSD) among outpatients with schizophrenia receiving treatment in Assertive Outreach Teams in the northern part of Denmark. Methods GSD is a shared decision-making and mutual problem-solving method using reflection sheets, which was developed in diabetes care and adjusted for this study and utilized by patients with schizophrenia. Descriptive data on strategies to overcome recruitment challenges were derived from notes and observations made during the randomized controlled trial testing of GSD in six outpatient teams. Results Three types of recruitment challenges not related to patients were identified and met during the trial: 1) organizational challenges, 2) challenges with finding eligible participants and 3) challenges with having professionals invite patients to participate. These challenges were overcome through: 1) extension of time, 2) expansion of the clinical recruitment area and 3) encouragement of professionals to invite patients to the study. Through overcoming these challenges, we identified a remarkably high patient-readiness to take part (101 of 120 asked accepted) and a low dropout rate (8%). Conclusion Distinction between

  9. A Change Agent's Facilitation Process for Overcoming the Barriers of ICT Adoption for Educational Administration--The Case of a Rural-Bangladesh Vocational Institution

    ERIC Educational Resources Information Center

    Khalid, Md. Saifuddin; Nyvang, Tom

    2014-01-01

    The factors influencing the use of information and communication technologies (ICT) as a professional and management tool outside the classroom have received little research attention. The two objectives of this research were: how do stakeholders of educational administration experience the barriers of ICT adoption, and how can they facilitate the…

  10. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China.

    PubMed

    Yang, Lianping; Liu, Chaojie; Ferrier, J Adamm; Zhang, Xinping

    2015-11-01

    This study identifies potential organizational barriers associated with the implementation of the Chinese National Essential Medicines Policy (NEMP) in rural primary health care institutions. We used a multistage sampling strategy to select 90 township hospitals from six provinces, two from each of eastern, middle, and western China. Data relating to eight core NEMP indicators and institutional characteristics were collected from January to September 2011, using a questionnaire. Prescription-associated indicators were calculated from 9000 outpatient prescriptions selected at random. We categorized the eight NEMP indicators using an exploratory factor analysis, and performed linear regressions to determine the association between the factor scores and institution-level characteristics. The results identified three main factors. Overall, low levels of expenditure of medicines (F1) and poor performance in rational use of medicines (F2) were evident. The availability of medicines (F3) varied significantly across both hospitals and regions. Factor scores had no significant relationship with hospital size (in terms of number of beds and health workers); however, they were associated with revenue and structure of the hospital, patient service load, and support for health workers. Regression analyses showed that public finance per health worker was negatively associated with the availability of medicines (p < 0.05), remuneration of prescribers was positively associated with higher performance in the rational use of medicines (p < 0.05), and drug sales were negatively associated with higher levels of drug expenditure (p < 0.01). In conclusion, irrational use of medicines remains a serious issue, although the financial barriers for gaining access to essential medicines may be less for prescribers and consumers. Limited public finance from local governments may reduce medicine stock lines of township hospitals and lead them to seek alternative sources of income

  11. Tri-membrane nanoparticles produced by combining liposome fusion and a novel patchwork of bicelles to overcome endosomal and nuclear membrane barriers to cargo delivery.

    PubMed

    Yamada, Asako; Mitsueda, Asako; Hasan, Mahadi; Ueda, Miho; Hama, Susumu; Warashina, Shota; Nakamura, Takashi; Harashima, Hideyoshi; Kogure, Kentaro

    2016-03-01

    Membrane fusion is a rational strategy for crossing intracellular membranes that present barriers to liposomal nanocarrier-mediated delivery of plasmid DNA into the nucleus of non-dividing cells, such as dendritic cells. Based on this strategy, we previously developed nanocarriers consisting of a nucleic acid core particle coated with four lipid membranes [Akita, et al., Biomaterials, 2009, 30, 2940-2949]. However, including the endosomal membrane and two nuclear membranes, cells possess three intracellular membranous barriers. Thus, after entering the nucleus, nanoparticles coated with four membranes would still have one lipid membrane remaining, and could impede cargo delivery. Until now, coating a core particle with an odd number of lipid membranes was challenging. To produce nanocarriers with an odd number of lipid membranes, we developed a novel coating method involving lipid nano-discs, also known as bicelles, as a material for packaging DNA in a carrier with an odd number of lipid membranes. In this procedure, bicelles fuse to form an outer coating that resembles a patchwork quilt, which allows the preparation of nanoparticles coated with only three lipid membranes. Moreover, the transfection activity of dendritic cells with these three-membrane nanoparticles was higher than that for nanoparticles coated with four lipid membranes. In summary, we developed novel nanoparticles coated with an odd number of lipid membranes using the novel "patchwork-packaging method" to deliver plasmid DNA into the nucleus via membrane fusion.

  12. Part I: Minicircle vector technology limits DNA size restrictions on ex vivo gene delivery using nanoparticle vectors: Overcoming a translational barrier in neural stem cell therapy.

    PubMed

    Fernandes, Alinda R; Chari, Divya M

    2016-09-28

    Genetically engineered neural stem cell (NSC) transplant populations offer key benefits in regenerative neurology, for release of therapeutic biomolecules in ex vivo gene therapy. NSCs are 'hard-to-transfect' but amenable to 'magnetofection'. Despite the high clinical potential of this approach, the low and transient transfection associated with the large size of therapeutic DNA constructs is a critical barrier to translation. We demonstrate for the first time that DNA minicircles (small DNA vectors encoding essential gene expression components but devoid of a bacterial backbone, thereby reducing construct size versus conventional plasmids) deployed with magnetofection achieve the highest, safe non-viral DNA transfection levels (up to 54%) reported so far for primary NSCs. Minicircle-functionalized magnetic nanoparticle (MNP)-mediated gene delivery also resulted in sustained gene expression for up to four weeks. All daughter cell types of engineered NSCs (neurons, astrocytes and oligodendrocytes) were transfected (in contrast to conventional plasmids which usually yield transfected astrocytes only), offering advantages for targeted cell engineering. In addition to enhancing MNP functionality as gene delivery vectors, minicircle technology provides key benefits from safety/scale up perspectives. Therefore, we consider the proof-of-concept of fusion of technologies used here offers high potential as a clinically translatable genetic modification strategy for cell therapy.

  13. Adaptation to Ephemeral Habitat May Overcome Natural Barriers and Severe Habitat Fragmentation in a Fire-Dependent Species, the Bachman's Sparrow (Peucaea aestivalis)

    PubMed Central

    Cerame, Blain; Cox, James A.; Brumfield, Robb T.; Tucker, James W.; Taylor, Sabrina S.

    2014-01-01

    Bachman's Sparrow (Peucaea aestivalis) is a fire-dependent species that has undergone range-wide population declines in recent decades. We examined genetic diversity in Bachman's Sparrows to determine whether natural barriers have led to distinct population units and to assess the effect of anthropogenic habitat loss and fragmentation. Genetic diversity was examined across the geographic range by genotyping 226 individuals at 18 microsatellite loci and sequencing 48 individuals at mitochondrial and nuclear genes. Multiple analyses consistently demonstrated little genetic structure and high levels of genetic variation, suggesting that populations are panmictic. Based on these genetic data, separate management units/subspecies designations or translocations to promote gene flow among fragmented populations do not appear to be necessary. Panmixia in Bachman's Sparrow may be a consequence of an historical range expansion and retraction. Alternatively, high vagility in Bachman's Sparrow may be an adaptation to the ephemeral, fire-mediated habitat that this species prefers. In recent times, high vagility also appears to have offset inbreeding and loss of genetic diversity in highly fragmented habitat. PMID:25180939

  14. Adaptation to ephemeral habitat may overcome natural barriers and severe habitat fragmentation in a fire-dependent species, the Bachman's Sparrow (Peucaea aestivalis).

    PubMed

    Cerame, Blain; Cox, James A; Brumfield, Robb T; Tucker, James W; Taylor, Sabrina S

    2014-01-01

    Bachman's Sparrow (Peucaea aestivalis) is a fire-dependent species that has undergone range-wide population declines in recent decades. We examined genetic diversity in Bachman's Sparrows to determine whether natural barriers have led to distinct population units and to assess the effect of anthropogenic habitat loss and fragmentation. Genetic diversity was examined across the geographic range by genotyping 226 individuals at 18 microsatellite loci and sequencing 48 individuals at mitochondrial and nuclear genes. Multiple analyses consistently demonstrated little genetic structure and high levels of genetic variation, suggesting that populations are panmictic. Based on these genetic data, separate management units/subspecies designations or translocations to promote gene flow among fragmented populations do not appear to be necessary. Panmixia in Bachman's Sparrow may be a consequence of an historical range expansion and retraction. Alternatively, high vagility in Bachman's Sparrow may be an adaptation to the ephemeral, fire-mediated habitat that this species prefers. In recent times, high vagility also appears to have offset inbreeding and loss of genetic diversity in highly fragmented habitat.

  15. To Grab and To Hold: Cultivating communal goals to overcome cultural and structural barriers in first generation college students' science interest

    PubMed Central

    Allen, Jill M.; Muragishi, Gregg A.; Smith, Jessi L.; Thoman, Dustin B.; Brown, Elizabeth R.

    2015-01-01

    Homogeneity within science limits creativity and discovery, and can feed into a perpetuating cycle of underrepresentation. From enhancing social justice to alleviating health and economic disadvantages, broadening participation in science is imperative. We focus here on first-generation students (FGS) and identify factors which grab and hold science interest among this underrepresented group. Might the culture and norms within science unintentionally limit FGS' participation? We argue that two distinct aspects of communal goals contribute to FGS' underrepresentation at different stages of the STEM pipeline: cultural perceptions of science as uncommunal (little emphasis on prosocial behavior and collaboration) and the uncommunal structure of STEM graduate education and training. Across 2 studies we investigated factors that catch (Study 1) and hold (Study 2) FGS' science interest. In Study 1, we find only when FGS believe that working in science will allow them to fulfill prosocial communal purpose goals are they more intrinsically interested in science. Yet, later in the pipeline science education devalues prosocial communal goals creating a structural mobility barrier among FGS. Study 2 found that FGS generally want to stay close to home instead of relocating to pursue a graduate education. For FGS (versus continuing-generation students), higher prosocial communal goal orientation significantly predicted lower residential mobility. We discuss implications for interventions to counteract the uncommunal science education and training culture to help improve access to FGS and other similarly situated underrepresented populations. PMID:26807431

  16. Interagency Cooperation through Organizational Advocacy.

    ERIC Educational Resources Information Center

    And Others; Tesolowski, Dennis G.

    1980-01-01

    Outlines the need for interagency cooperation in the vocational development of the handicapped and disadvantaged and develops a futuristic model to be implemented. Discusses advocacy and its role in professional associations, potential barriers to organizational advocacy, and the role of professional associations in organizational advocacy. (CT)

  17. Overcoming language barriers when teaching interprofessional groups.

    PubMed

    Welsh, Jeanette

    2012-10-01

    The author of this article undertook a small qualitative study of the best way to prepare unscheduled care staff for team-based delivery of patient care. The study was intended to highlight problems in interprofessional training courses so that guidelines for the delivery of such courses can be developed. The findings show that trainers cannot assume that all participants in training courses understand the terminology used. This article discusses this finding further.

  18. Photon localization barrier can be overcome

    NASA Astrophysics Data System (ADS)

    Saari, P.; Menert, M.; Valtna, H.

    2005-02-01

    In contradistinction to a widespread belief that the spatial localization of photons is restricted by a power-law falloff of the photon energy density, Bialynicki-Birula [Phys. Rev. Lett. 80 (1998) 5247] has proved that any stronger - up to an almost exponential - falloff is allowed. We are showing that for certain specifically designed cylindrical one-photon states the localization is even better in lateral directions. If the photon state is built from the so-called focus wave mode, the falloff in the waist cross-section plane turns out to be quadratically exponential (Gaussian) and such strong localization persists in the course of propagation.

  19. Childhood lymphoedema and 'Lymphaletics': overcoming barriers.

    PubMed

    Todd, Marie

    2016-07-14

    Primary lymphoedema is a complex condition that causes tissue swelling, usually in one or more of the limbs, but lymphatic drainage of the head, trunk or deeper organs may also be affected. It can manifest in swelling at any time from birth meaning there are a number of children affected by this condition. While it is rare in childhood there are too few professionals experienced in diagnosis and treatment, which results in delays in identification and referral to appropriate services for diagnosis and treatment. The Children's Lymphoedema Special Interest Group (CLSIG) was formed in 2010 by a group of lymphoedema specialists in a bid to raise awareness, improve service provision, and enhance practitioner knowledge. One of the aims of the group was to deliver a 'fun day' (Lymphaletics) for children with lymphoedema and their families to encourage physical activity and social interaction with children who have similar problems, and to provide a source of parent-to-parent support. This article discusses the issues for children and their families, and the aims and format of the event.

  20. Overcoming Barriers to Classroom Technology Integration

    ERIC Educational Resources Information Center

    Kelly, Daniel P.

    2015-01-01

    Technology-savvy teachers are often the "go to" staff members in schools for their colleagues' technology issues. These teachers are seen as leaders within their schools with respect to technology and often do not understand their peers' difficulties when bringing technology into the classroom. Understanding both the reasons teachers may…

  1. Overcoming the Adoption Barrier to Electric Flight

    NASA Technical Reports Server (NTRS)

    Borer, Nicholas K.; Nickol, Craig L.; Jones, Frank P.; Yasky, Richard J.; Woodham, Kurt; Fell, Jared S.; Litherland, Brandon L.; Loyselle, Patricia L.; Provenza, Andrew J.; Kohlman, Lee W.; Samuel, Aamod G.

    2016-01-01

    Electrically-powered aircraft can enable dramatic increases in efficiency and reliability, reduced emissions, and reduced noise as compared to today's combustion-powered aircraft. This paper describes a novel flight demonstration concept that will enable the benefits of electric propulsion, while keeping the extraordinary convenience and utility of common fuels available at today's airports. A critical gap in airborne electric propulsion research is addressed by accommodating adoption at the integrated aircraft-airport systems level, using a confluence of innovative but proven concepts and technologies in power generation and electricity storage that need to reside only on the airframe. Technical discriminators of this demonstrator concept include (1) a novel, high-efficiency power system that utilizes advanced solid oxide fuel cells originally developed for ultra-long-endurance aircraft, coupled with (2) a high-efficiency, high-power electric propulsion system selected from mature products to reduce technical risk, assembled into (3) a modern, high-performance demonstration platform to provide useful and compelling data, both for the targeted early adopters and the eventual commercial market.

  2. Overcoming Barriers to Shared Decision Making

    MedlinePlus

    ... second opinion . Learn more: About Advanced Heart Failure Recognition and Knowing Your Options Planning Ahead Communicating With ... Healthcare Team Help for Caregivers Advanced Heart Failure Recognition and Knowing Your Options Planning Ahead Communicating with ...

  3. Overcoming Learning Barriers through Knowledge Management

    ERIC Educational Resources Information Center

    Dror, Itiel E.; Makany, Tamas; Kemp, Jonathan

    2011-01-01

    The ability to learn highly depends on how knowledge is managed. Specifically, different techniques for note-taking utilize different cognitive processes and strategies. In this paper, we compared dyslexic and control participants when using linear and non-linear note-taking. All our participants were professionals working in the banking and…

  4. Overcoming the Cutaneous Barrier with Microemulsions

    PubMed Central

    Lopes, Luciana B.

    2014-01-01

    Microemulsions are fluid and isotropic formulations that have been widely studied as delivery systems for a variety of routes, including the skin. In spite of what the name suggests, microemulsions are nanocarriers, and their use as topical delivery systems derives from their multiple advantages compared to other dermatological formulations, such as ease of preparation, thermodynamic stability and penetration-enhancing properties. Composition, charge and internal structure have been reported as determinant factors for the modulation of drug release and cutaneous and transdermal transport. This manuscript aims at reviewing how these and other characteristics affect delivery and make microemulsions appealing for topical and transdermal administration, as well as how they can be modulated during the formulation design to improve the potential and efficacy of the final system. PMID:24590260

  5. Overcoming the Uncertainty Barrier to Adaptation

    EPA Pesticide Factsheets

    The second in a three-part webinar series about climate change adaptation for state and local governments, this webinar addressed the challenge of planning for climate change in the face of uncertainty.

  6. Understanding barriers to implementation of an adaptive land management program

    USGS Publications Warehouse

    Jacobson, S.K.; Morris, J.K.; Sanders, J.S.; Wiley, E.N.; Brooks, M.; Bennetts, R.E.; Percival, H.F.; Marynowski, S.

    2006-01-01

    The Florida Fish and Wildlife Conservation Commission manages over 650,000 ha, including 26 wildlife management and environmental areas. To improve management, they developed an objective-based vegetation management (OBVM) process that focuses on desired conditions of plant communities through an adaptive management framework. Our goals were to understand potential barriers to implementing OBVM and to recommend strategies to overcome barriers. A literature review identified 47 potential barriers in six categories to implementation of adaptive and ecosystem management: logistical, communication, attitudinal, institutional, conceptual, and educational. We explored these barriers through a bureau-wide survey of 90 staff involved in OBVM and personal interviews with area managers, scientists, and administrators. The survey incorporated an organizational culture assessment instrument to gauge how institutional factors might influence OBVM implementation. The survey response rate was 69%. Logistics and communications were the greatest barriers to implementing OBVM. Respondents perceived that the agency had inadequate resources for implementing OBVM and provided inadequate information. About one-third of the respondents believed OBVM would decrease their job flexibility and perceived greater institutional barriers to the approach. The 43% of respondents who believed they would have more responsibility under OBVM also had greater attitudinal barriers. A similar percentage of respondents reported OBVM would not give enough priority to wildlife. Staff believed that current agency culture was hierarchical but preferred a culture that would provide more flexibility for adaptive management and would foster learning from land management activities. In light of the barriers to OBVM, we recommend the following: (1) mitigation of logistical barriers by addressing real and perceived constraints of staff, funds, and other resources in a participatory manner; (2) mitigation of

  7. Organizational Justice

    ERIC Educational Resources Information Center

    Burns, Travis

    2013-01-01

    Helping principals understand the importance of organizational justice is the first step in enhancing learning outcomes for all learners, regardless of their social class, race, abilities, sex, or gender. In schools, organizational justice may be defined as teachers' perceptions of fairness, respect, and equity that relate to their interactions…

  8. Organizational Science

    ERIC Educational Resources Information Center

    Beriwal, Madhu; Clegg, Stewart; Collopy, Fred; McDaniel, Reuben, Jr.; Morgan, Gareth; Sutcliffe, Kathleen; Kaufman, Roger; Marker, Anthony; Selwyn, Neil

    2013-01-01

    Scholars representing the field of organizational science, broadly defined as including many fields--organizational behavior and development, management, workplace performance, and so on--were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might…

  9. [Organizational learning].

    PubMed

    Ruiz Moreno, J

    2001-06-01

    This article presents the reader with conceptual close-up view about the attractive topic organizational apprenticeship and includes and extensive bibliographical file. Therefore, due to the author's effort, we chronologically trace those authors who have contributed to conceptualizing the aforementioned apprenticeship, with particular emphasis on the writings by Paul Senge, the so-called father of the "fifth discipline. This theoretical close-up helps apply organizational apprenticeship to nursing.

  10. Overcoming breastfeeding problems

    MedlinePlus

    Plugged milk ducts; Nipple soreness when breastfeeding; Breastfeeding - overcoming problems; Let-down reflex ... Breastfeeding (nursing) your baby can be a good experience for both the mother and the baby. It ...

  11. How to Overcome Defensive Communications

    ERIC Educational Resources Information Center

    Cross, Gary P.

    1978-01-01

    After discussing the defensive response in interpersonal communications in organizations, the article presents eight communication techniques for improving organizational communication skills and thereby creating a more supportive organizational climate. (MF)

  12. Overcoming the Polyester Image.

    ERIC Educational Resources Information Center

    Regan, Dorothy

    1988-01-01

    Urges community colleges to overcome their image problem by documenting the colleges' impact on their communities. Suggests ways to determine what data should be collected, how to collect the information, and how it can be used to empower faculty, staff, and alumni to change the institution's image. (DMM)

  13. Typologizing Organizational Amnesia

    ERIC Educational Resources Information Center

    Othman, Rozhan; Hashim, Noor Azuan

    2004-01-01

    This article proposes that a major problem limiting an organization's ability to develop organizational learning capacity is of organizational amnesia. To understand organizational amnesia, it is necessary to look at the various ways that organizational learning is defined. Organizational learning is not merely the process of acquiring knowledge.…

  14. Organizational Commitment through Organizational Socialization Tactics

    ERIC Educational Resources Information Center

    Filstad, Cathrine

    2011-01-01

    Purpose: The aim of this paper is to investigate how organizational socialization tactics affect newcomers' organizational commitment and learning processes. Design/methodology/approach: A survey was conducted using a measurement tool based on Van Maanen and Schein's theory on organizational socialization tactics and Kuvaas' measurement tools of…

  15. Institutional Narcissism, Arrogant Organization Disorder and Interruptions in Organizational Learning

    ERIC Educational Resources Information Center

    Godkin, Lynn; Allcorn, Seth

    2009-01-01

    Purpose: This article aims to present an alternative approach to diagnosing behavioral barriers to organizational learning. Design/methodology/approach: The paper juxtaposes interruptions in organizational learning with characteristics of narcissism and arrogant organization disorder. Psychoanalytically informed theory and DSM-IV criteria are…

  16. Barriers to improvements in energy efficiency

    SciTech Connect

    Reddy, A.K.N.

    1991-10-01

    To promote energy-efficiency improvements, actions may be required at one or more levels -- from the lowest level of the consumer (residential, commercial, industrial, etc.) through the highest level of the global agencies. But barriers to the implementation of energy-efficiency improvements exist or can arise at all these levels. Taking up each one of these barriers in turn, the paper discusses specific measures that can contribute to overcoming the barriers. However, a one-barrier-one-measure approach must be avoided. Single barriers may in fact involve several sub-barriers. Also, combinations of measures are much more effective in overcoming barriers. In particular, combinations of measures that simultaneously overcome several barriers are most successful. The paper discusses the typology of barriers, explores their origin and suggests measures that by themselves or in combination with other measures, will overcome these barriers. Since most of the barriers dealt with can be found in the ``barriers`` literature, any originality in the paper lies in its systematic organization, synoptic view and holistic treatment of this issue. This paper is intended to initiate a comprehensive treatment of barriers, their origins and the measures that contribute to overcoming them. Hopefully, such a treatment will facilitate the implementation of energy-efficiency improvements involving a wide diversity of ever-changing energy end uses and consumer preferences.

  17. Barriers to improvements in energy efficiency

    SciTech Connect

    Reddy, A.K.N.

    1991-10-01

    To promote energy-efficiency improvements, actions may be required at one or more levels -- from the lowest level of the consumer (residential, commercial, industrial, etc.) through the highest level of the global agencies. But barriers to the implementation of energy-efficiency improvements exist or can arise at all these levels. Taking up each one of these barriers in turn, the paper discusses specific measures that can contribute to overcoming the barriers. However, a one-barrier-one-measure approach must be avoided. Single barriers may in fact involve several sub-barriers. Also, combinations of measures are much more effective in overcoming barriers. In particular, combinations of measures that simultaneously overcome several barriers are most successful. The paper discusses the typology of barriers, explores their origin and suggests measures that by themselves or in combination with other measures, will overcome these barriers. Since most of the barriers dealt with can be found in the barriers'' literature, any originality in the paper lies in its systematic organization, synoptic view and holistic treatment of this issue. This paper is intended to initiate a comprehensive treatment of barriers, their origins and the measures that contribute to overcoming them. Hopefully, such a treatment will facilitate the implementation of energy-efficiency improvements involving a wide diversity of ever-changing energy end uses and consumer preferences.

  18. Psychological Barriers to Behavior Change

    PubMed Central

    Olson, James M.

    1992-01-01

    Adopting a healthy lifestyle often requires changing patterns of behavior. This article describes three categories of psychological barriers to behavior change: those that prevent the admission of a problem, those that interfere with initial attempts to change behavior, and those that make long-term change difficult. Strategies are identified that family physicians can use to overcome the barriers. PMID:21221258

  19. Barriers to the implementation of green chemistry in the United States.

    PubMed

    Matus, Kira J M; Clark, William C; Anastas, Paul T; Zimmerman, Julie B

    2012-10-16

    This paper investigates the conditions under which firms are able to develop and implement innovations with sustainable development benefits. In particular, we examine "green chemistry" innovations in the United States. Via interviews with green chemistry leaders from industry, academia, nongovernmental institutions (NGOs), and government, we identified six major categories of challenges commonly confronted by innovators: (1) economic and financial, (2) regulatory, (3) technical, (4) organizational, (5) cultural, and (6) definition and metrics. Further analysis of these barriers shows that in the United States, two elements of these that are particular to the implementation of green chemistry innovations are the absence of clear definitions and metrics for use by researchers and decision makers, as well as the interdisciplinary demands of these innovations on researchers and management. Finally, we conclude with some of the strategies that have been successful thus far in overcoming these barriers, and the types of policies which could have positive impacts moving forward.

  20. Mid-Atlantic Wind - Overcoming the Challenges

    SciTech Connect

    Daniel F. Ancona III; Kathryn E. George; Richard P. Bowers; Dr. Lynn Sparling; Bruce Buckheit; Daniel LoBue

    2012-05-31

    This study, supported by the US Department of Energy, Wind Powering America Program, Maryland Department of Natural Resources and Chesapeake Bay Foundation, analyzed barriers to wind energy development in the Mid-Atlantic region along with options for overcoming or mitigating them. The Mid-Atlantic States including Delaware, Maryland, North Carolina and Virginia, have excellent wind energy potential and growing demand for electricity, but only two utility-scale projects have been installed to date. Reasons for this apathetic development of wind resources were analyzed and quantified for four markets. Specific applications are: 1) Appalachian mountain ridgeline sites, 2) on coastal plains and peninsulas, 3) at shallow water sites in Delaware and Chesapeake Bays, Albemarle and Pamlico Sounds, and 4) at deeper water sites off the Atlantic coast. Each market has distinctly different opportunities and barriers. The primary barriers to wind development described in this report can be grouped into four categories; state policy and regulatory issues, wind resource technical uncertainty, economic viability, and public interest in environmental issues. The properties of these typologies are not mutually independent and do interact. The report concluded that there are no insurmountable barriers to land-based wind energy projects and they could be economically viable today. Likewise potential sites in sheltered shallow waters in regional bay and sounds have been largely overlooked but could be viable currently. Offshore ocean-based applications face higher costs and technical and wind resource uncertainties. The ongoing research and development program, revision of state incentive policies, additional wind measurement efforts, transmission system expansion, environmental baseline studies and outreach to private developers and stakeholders are needed to reduce barriers to wind energy development.

  1. Mid-Atlantic Wind - Overcoming the Challenges

    SciTech Connect

    Daniel F. Ancona III; Kathryn E. George; Lynn Sparling; Bruce C. Buckheit; Daniel LoBue; and Richard P. Bowers

    2012-06-29

    This study, supported by the US Department of Energy, Wind Powering America Program, Maryland Department of Natural Resources and Chesapeake Bay Foundation, analyzed barriers to wind energy development in the Mid-Atlantic region along with options for overcoming or mitigating them. The Mid-Atlantic States including Delaware, Maryland, North Carolina and Virginia, have excellent wind energy potential and growing demand for electricity, but only two utility-scale projects have been installed to date. Reasons for this apathetic development of wind resources were analyzed and quantified for four markets. Specific applications are: 1) Appalachian mountain ridgeline sites, 2) on coastal plains and peninsulas, 3) at shallow water sites in Delaware and Chesapeake Bays, Albemarle and Pamlico Sounds, and 4) at deeper water sites off the Atlantic coast. Each market has distinctly different opportunities and barriers. The primary barriers to wind development described in this report can be grouped into four categories; state policy and regulatory issues, wind resource technical uncertainty, economic viability, and public interest in environmental issues. The properties of these typologies are not mutually independent and do interact. The report concluded that there are no insurmountable barriers to land-based wind energy projects and they could be economically viable today. Likewise potential sites in sheltered shallow waters in regional bay and sounds have been largely overlooked but could be viable currently. Offshore ocean-based applications face higher costs and technical and wind resource uncertainties. The ongoing research and development program, revision of state incentive policies, additional wind measurement efforts, transmission system expansion, environmental baseline studies and outreach to private developers and stakeholders are needed to reduce barriers to wind energy development.

  2. Patterns of Organizational Conflict

    ERIC Educational Resources Information Center

    Corwin, Ronald G.

    1969-01-01

    Patterns of relationships were identified between indices of organizational conflict and several measures of each of five organizational variables. The measures were adapted from 1500 questionnaires and 600 interviews in 28 public high schools. (Author)

  3. Overcoming Barriers: Engaging Younger Students in an Online Intercultural Exchange

    ERIC Educational Resources Information Center

    Peiser, Gillian

    2015-01-01

    This paper reports on a small-scale project involving an online school exchange between two classes of 12-/13-year olds located in the North of England and the Ruhr area of Germany. The overarching aim of the project was to develop intercultural understanding in foreign language learning through communication in an online environment. Analysing…

  4. Overcoming cellular and tissue barriers to improve liposomal drug delivery

    NASA Astrophysics Data System (ADS)

    Kohli, Aditya G.

    Forty years of liposome research have demonstrated that the anti-tumor efficacy of liposomal therapies is, in part, driven by three parameters: 1) liposome formulation and lipid biophysics, 2) accumulation and distribution in the tumor, and 3) release of the payload at the site of interest. This thesis outlines three studies that improve on each of these delivery steps. In the first study, we engineer a novel class of zwitterlipids with an inverted headgroup architecture that have remarkable biophysical properties and may be useful for drug delivery applications. After intravenous administration, liposomes accumulate in the tumor by the enhanced permeability and retention effect. However, the tumor stroma often limits liposome efficacy by preventing distribution into the tumor. In the second study, we demonstrate that depletion of hyaluronan in the tumor stroma improves the distribution and efficacy of DoxilRTM in murine 4T1 tumors. Once a liposome has distributed to the therapeutic site, it must release its payload over the correct timescale. Few facile methods exist to quantify the release of liposome therapeutics in vivo. In the third study, we outline and validate a simple, robust, and quantitative method for tracking the rate and extent of release of liposome contents in vivo. This tool should facilitate a better understanding of the pharmacodynamics of liposome-encapsulated drugs in animals. This work highlights aspects of liposome behavior that have prevented successful clinical translation and proposes alternative approaches to improve liposome drug delivery.

  5. Retaining Talent for Army 2020: Overcoming Institutional Barriers

    DTIC Science & Technology

    2012-03-19

    Assignments for Leaders, RETAL, 8. 18 Casey Wardynski, David S. Lyle, and Michael J. Colarusso , Towards a U.S. Army Officer Corps Strategy for...Opportunities (Boston: Harvard University, 2011), 17. 22 32 Wardynski, Lyle, and Colarusso , Towards a U.S. Army Officer Corps Strategy for...www.hrc.army.mil/milper/11-282 (accessed March 14, 2012). 34 Wardynski, Lyle, and Colarusso , Towards a U.S. Army Officer Corps Strategy for

  6. What Changes Education? An Action Research to Overcome Barriers

    ERIC Educational Resources Information Center

    Eskicioglu, Yeser Eroglu

    2016-01-01

    According to the National Disabled People Data Base within Ministry of Family and Social Policies (Özveri), there are 1.559.222 disabled people in Turkey. If this rate would be linked to the families of the disabled people, the number of people who spend time with disabled individuals would increase to 10 million. This number corresponds to 12.5%…

  7. Using mobile technology to overcome language barriers in medicine

    PubMed Central

    Thyer, IA; Hayne, D; Katz, DJ

    2014-01-01

    Australia has a large migrant population with variable fluency in English. Interpreting services help ensure that healthcare services are delivered appropriately to these populations. However, the use of professional interpreters in hospitals is expensive. There are also issues with service availability and convenience. Mobile devices containing software with translating abilities have promising potential to improve communication between patients and hospital staff as an adjunct to professional interpreters. It is highly convenient and inexpensive. There are concerns about the accuracy of the interpretation done with such software and more research needs to be carried out to support or allay these concerns. For now, clinically important and medicolegal related interpretation should be undertaken by professional interpreters whereas less crucial tasks may be performed with the help of interpreting software on mobile devices. PMID:25198966

  8. Bicycle helmets: overcoming barriers to use and increasing effectiveness.

    PubMed

    Rezendes, Jennifer L

    2006-02-01

    Bicycle riding is a popular recreational activity among children, yet it is not without potential severe consequences such as traumatic brain injury and death. Despite available information attesting to the benefits of the use of bicycle safety helmets, many children still do not wear them. There are several promoting and discouraging factors that influence wearing bicycle helmets. The purposes of this article are to (1) explore current research and discuss these promoting and obstructing factors to child bicycle helmet use and to (2) provide recommendations for improving the compliance of bicycle helmet use among children. Results of the literature review have significant implications for improving the safety of children.

  9. Postsecondary Correctional Education: Recognizing and Overcoming Barriers to Success

    ERIC Educational Resources Information Center

    Palmer, Shelby M.

    2012-01-01

    Postsecondary programs offering vocational training and college credit to eligible inmates have had difficulty finding a place in the U.S. correctional system. Politically motivated restrictions preventing inmates from receiving federal funds for college resulted in drastic program closures. Although new laws restored funding to select inmates,…

  10. Overcoming language barriers for non-English speaking patients.

    PubMed

    Duffy, M M; Alexander, A

    1999-10-01

    Although some of the resources or services listed may seem expensive, it is cheaper to use these than to face a malpractice suit for failure to provide patients with limited English access to services equal to those provided to English speakers. The University of California at San Francisco (UCSF), one of the top three ranking research hospitals in the U.S., had a suit filed against it by the American Civil Liberties Union (ACLU) claiming failure to provide adequate translation services for the patient population. The university is now a participant in a statewide effort to provide access to well-trained translator services to the patient population. This effort and the development of an in-house interpreter services department has contributed to a competitive edge for UCSF in the area of patient services and satisfaction as well as attracting more Medicaid patients, which increases their revenues.

  11. Using mobile technology to overcome language barriers in medicine.

    PubMed

    Chang, D T S; Thyer, I A; Hayne, D; Katz, D J

    2014-09-01

    Australia has a large migrant population with variable fluency in English. Interpreting services help ensure that healthcare services are delivered appropriately to these populations. However, the use of professional interpreters in hospitals is expensive. There are also issues with service availability and convenience. Mobile devices containing software with translating abilities have promising potential to improve communication between patients and hospital staff as an adjunct to professional interpreters. It is highly convenient and inexpensive. There are concerns about the accuracy of the interpretation done with such software and more research needs to be carried out to support or allay these concerns. For now, clinically important and medicolegal related interpretation should be undertaken by professional interpreters whereas less crucial tasks may be performed with the help of interpreting software on mobile devices.

  12. Overcoming Barriers for "Niche" Learners Through Distance Education.

    ERIC Educational Resources Information Center

    Miller, Lawrence G.; Hyatt, Sue Y.; Brennan, Joyce; Bertani, Raymond; Trevor, Thomas

    1999-01-01

    Focuses on students who fit into "niches," and discusses how the Chattanooga State Technical Community College's distance-learning program accommodates these learners. Describes five "niche" learner categories: students with disabilities, power-line maintenance technicians, emergency-service personnel, truckers, and industrial…

  13. Overcoming Barriers to Educational Restructuring: A Call for System Literacy.

    ERIC Educational Resources Information Center

    McGonagill, Grady

    The drive for systemic reform in education reflects a widespread hunger in all sectors of society to make sense of the whole, as is shown in the increasing recognition of people in organizations of the interrelatedness of the organizations' parts. However, many attempts at systemic reform are hampered by the lack of a common view of what an…

  14. Wind Power in Australia: Overcoming Technological and Institutional Barriers

    ERIC Educational Resources Information Center

    Healey, Gerard; Bunting, Andrea

    2008-01-01

    Until recently, Australia had little installed wind capacity, although there had been many investigations into its potential during the preceding decades. Formerly, state-owned monopoly utilities showed only token interest in wind power and could dictate the terms of energy debates. This situation changed in the late 1990s: Installed wind capacity…

  15. Autophagy core machinery: overcoming spatial barriers in neurons.

    PubMed

    Ariosa, Aileen R; Klionsky, Daniel J

    2016-11-01

    Autophagy is a major degradation pathway that engulfs, removes, and recycles unwanted cytoplasmic material including damaged organelles and toxic protein aggregates. One type of autophagy, macroautophagy, is a tightly regulated process facilitated by autophagy-related (Atg) proteins that must communicate effectively and act in concert to enable the de novo formation of the phagophore, its maturation into an autophagosome, and its subsequent targeting and fusion with the lysosome or the vacuole. Autophagy plays a significant role in physiology, and its dysregulation has been linked to several diseases, which include certain cancers, cardiomyopathies, and neurodegenerative diseases. Here, we summarize the key processes and the proteins that make up the macroautophagy machinery. We also briefly highlight recently uncovered molecular mechanisms specific to neurons allowing them to uniquely regulate this catabolic process to accommodate their complicated architecture and non-dividing state. Overall, these distinct mechanisms establish a conceptual framework addressing how macroautophagic dysfunction could result in maladies of the nervous system, providing possible therapeutic avenues to explore with a goal of preventing or curing such diseases.

  16. Improving The Perfect Storm: Overcoming Barriers To Climate Literacy

    NASA Astrophysics Data System (ADS)

    Tillinger, D.

    2015-12-01

    Students and scientists are trained to speak different languages. Climate science, and the geosciences more broadly, are strictly classroom topics, not subjects appropriate for casual conversation, social media, or creative projects. When students are aware of climate change through the mainstream media, it is nearly always in a political or technological context rather than a scientific one. However, given the opportunity, students are perfectly capable of not only understanding the science behind climate change, but communicating it to their peers. At the American Museum of Natural History, a group of underprivileged high school students visited Nature's Fury: The Science of Natural Disasters to learn about volcanoes, earthquakes, and climate change impacts. They were then able to write pitches and develop trailers for scientifically accurate, but still compelling, disaster movies. Arts in Parts, a creative outreach group formed as a response to Hurricane Sandy, facilitated a workshop in which younger children made mobiles from beach debris they collected while learning about the the threat of sea level rise locally and globally. Participants in an undergraduate natural disasters class wrote guides to understanding climate change that remained factual while showing great creativity and reflecting the personality of each student. Art, humor, and popular culture are the languages that society chooses to use; scientific literacy might benefit from their inclusion.

  17. Overcoming Barriers to Technology Use in Teacher Preparation Programs

    ERIC Educational Resources Information Center

    Brzycki, Dolores; Dudt, Kurt

    2005-01-01

    Indiana, Clarion, and Edinboro Universities of Pennsylvania are completing a PT3 grant, funded by the U.S. Department of Education, entitled "Preparing Teachers for the Digital Age." The grant made great progress in infusing technology into the teacher preparation curriculum possible, and participating faculty know how far they have…

  18. Overcoming Barriers to Technology Adoption in Small Manufacturing Enterprises (SMEs)

    DTIC Science & Technology

    2003-06-01

    7 3.4 Adopting a Control-System-Modeling Tool.................................................8 3.5 Adapting Ecommerce and Manufacturing Execution...production of platform systems, components, and munitions is constrained not only by the surge capacity of the prime contractor, but also by the...Electronic Design Automation (EDA) tools that simplified implementing the design in hardware and software. 3.5 Adapting Ecommerce and Manufacturing

  19. Overcoming barriers to priority setting using interdisciplinary methods.

    PubMed

    Peacock, Stuart; Mitton, Craig; Bate, Angela; McCoy, Bonnie; Donaldson, Cam

    2009-10-01

    Ten years ago, Holm's highly influential paper "Goodbye to the simple solutions: the second phase of priority setting" was published [Holm S. Goodbye to the simple solutions: the second phase of priority setting in health care. British Medical Journal 1998;317:1000-7]. Whilst attending the 2nd International Conference on Priorities in Health Care in London, Holm argued that the search for a rational set of decision-making rules was no longer adequate. Instead, the priority setting process itself was now thought to be more complex. Ten years later, the Conference returns to the UK for the first time, and it is timely to describe some new tools intended to assist both researchers and decision-makers seeking to develop both rational and fair and legitimate priority setting processes. In this paper we argue that to do so, researchers and decision-makers need to adopt an interdisciplinary and collaborative approach to priority setting. We focus on program budgeting and marginal analysis (PBMA) and bring together three hitherto separate interdisciplinary strands of the PBMA literature. Our aim is to assist researchers and decision-makers seeking to effectively develop and implement PBMA in practice. Specifically, we focus on the use of multi-criteria decision analysis, participatory action research, and accountability for reasonableness, drawn from the disciplines of decision analysis, sociology, and ethics respectively.

  20. Overcoming barriers to residential conservation: do energy audits help

    SciTech Connect

    Hoffman, W.L.

    1982-12-01

    A study on the effects of energy audits on the pace and choice of household investment in energy-saving improvements in the home is reported. An evaluation based on the household's assessment of the usefulness of the audit which was provided for their home was performed. The number and types of recent conservation actions among audited and unaudited samples of households are compared. The audit's effect on household knowledge about the economically attractive options for their home and on the choice of recent improvements is assessed. Possible reasons are suggested for the weak effect of audits in stimulating activity and reorienting investment choices. (LEW)

  1. Group Qigong for Adolescent Inpatients with Anorexia Nervosa: Incentives and Barriers

    PubMed Central

    Gueguen, Juliette; Piot, Marie-Aude; Orri, Massimiliano; Gutierre, Andrea; Le Moan, Jocelyne; Berthoz, Sylvie; Falissard, Bruno; Godart, Nathalie

    2017-01-01

    Background Qigong is a mind-body intervention focusing on interoceptive awareness that appears to be a promising approach in anorexia nervosa (AN). In 2008, as part of our multidimensional treatment program for adolescent inpatients with AN, we began a weekly qigong workshop that turned out to be popular among our adolescent patients. Moreover psychiatrists perceived clinical benefits that deserved further exploration. Methods and findings A qualitative study therefore sought to obtain a deeper understanding of how young patients with severe AN experience qigong and to determine the incentives and barriers to adherence to qigong, to understanding its meaning, and to applying it in other contexts. Data were collected through 16 individual semi-structured face-to-face interviews and analyzed with the interpretative phenomenological analysis method. Eleven themes emerged from the analysis, categorized in 3 superordinate themes describing the incentives and barriers related to the patients themselves (individual dimension), to others (relational dimension), and to the setting (organizational dimension). Individual dimensions associated with AN (such as excessive exercise and mind-body cleavage) may curb adherence, whereas relational and organizational dimensions appear to provide incentives to join the activity in the first place but may also limit its post-discharge continuation. Once barriers are overcome, patients reported positive effects: satisfaction associated with relaxation and with the experience of mind-body integration. Conclusions Qigong appears to be an interesting therapeutic tool that may potentiate psychotherapy and contribute to the recovery process of patients with AN. Further analysis of the best time window for initiating qigong and of its place in overall management might help to overcome some of the barriers, limit the risks, and maximize its benefits. PMID:28152083

  2. Dimensionality of Organizational Trust

    ERIC Educational Resources Information Center

    Adams, Samuel H.; Wiswell, Albert K.

    2007-01-01

    Trust facilitates individual and organizational learning, and is often misunderstood by organizations although they must continuously learn in order to attain organizational goals and survive. Leaders of organizations often view trust defensively and their reactions may impede organizational learning This paper builds on prior research concerning…

  3. Emerging Organizational Structures.

    ERIC Educational Resources Information Center

    Carchidi, Daniel M.; Peterson, Marvin W.

    2000-01-01

    Discussion of emerging higher educational organizational structures focuses on the increasing importance of distance education. Considers the emerging organizational landscape, three types of network organizations, six organization archetypes, organizational forms that support distance education, and implications for higher education planners. (DB)

  4. The Organizational Learning Audit.

    ERIC Educational Resources Information Center

    Pace, R. Wayne

    2002-01-01

    Notes that organizational communication and organizational learning share a common focus on how message processing occurs in institutional settings and how they affect and are affected by people and relationships. Proposes that the assessment of organizational learning represents an assessment of a subset of communication processes in an…

  5. Comprehensive Examination of Barriers to Employment among Persons Who Are Blind or Visually Impaired.

    ERIC Educational Resources Information Center

    Crudden, Adele; McBroom, Lynn W.; Skinner, Amy L.; Moore, J. Elton

    A survey of 166 employed persons with visual impairments investigated major barriers to employment, how these barriers were overcome, and their perceptions on why they were successful in overcoming barriers when many individuals are not successful. Results of the survey indicate that the primary barriers to employment were employer attitudes,…

  6. Predicting Organizational Commitment from Organizational Culture in Turkish Primary Schools

    ERIC Educational Resources Information Center

    Ipek, Cemalettin

    2010-01-01

    This study aims to describe organizational culture and commitment and to predict organizational commitment from organizational culture in Turkish primary schools. Organizational Culture Scale (Ipek "1999") and Organizational Commitment Scale (Balay "2000") were used in the data gathering process. The data were collected from…

  7. Investigation of the Relationship between Organizational Trust and Organizational Commitment

    ERIC Educational Resources Information Center

    Bastug, Gülsüm; Pala, Adem; Kumartasli, Mehmet; Günel, Ilker; Duyan, Mehdi

    2016-01-01

    Organizational trust and organizational commitment are considered as the most important entraining factors for organizational success. The most important factor in the formation of organizational commitment is trust that employees have in their organizations. In this study, the relationship between organizational trust and organizational…

  8. Improving organizational climate for excellence in patient care.

    PubMed

    Arnold, Edwin

    2013-01-01

    Managers in health care organizations today are expected to achieve higher-quality patient care at a lower cost. Developing and maintaining a positive organizational climate can help improve motivation and foster higher employee performance. In turn, this will help the organization deliver better patient care at a lower cost. This article offers metrics for assessing organizational climate, analyzes barriers to a positive climate, and explores strategies that managers can use to build the type of climate that fosters high performance.

  9. Change in higher education: understanding and responding to individual and organizational resistance.

    PubMed

    Lane, India F

    2007-01-01

    In many fields, the ability of educators and practitioners to cope with rapid change is essential to sustained success. In veterinary medical education, as in other scientific disciplines, meaningful change is challenging to achieve and subject to resistance from many individual and organizational norms. Individual concerns often relate to fears of instability or uncertainty, loss of current status, or effects on individual time and workload. Sources of organizational resistance may include a conservative culture, fierce protection of current practices, and prevalence of disciplinary or territorial viewpoints. In academia, especially in scientific or medical fields, individuals appear to be strongly independent and conservative in nature, and generally skeptical of educational change. In this environment, a highly participatory process, with regular communication strategies and demonstrations or evidence that supports proposed changes, can be useful in facilitating change. An understanding of the nature of complex change, as well as of the reasons underlying resistance to change, and some methods to overcome these barriers are highly valuable tools for educational leaders.

  10. Facilitators and Barriers of Smokers’ Compliance with Smoking Bans in Public Places: A Systematic Review of Quantitative and Qualitative Literature

    PubMed Central

    Zhou, Li; Niu, Lu; Jiang, Hui; Jiang, Caixiao; Xiao, Shuiyuan

    2016-01-01

    Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim: To identify facilitators and barriers that influenced smokers’ compliance with smoking bans in public places. Methods: Using PubMed, MEDLINE, and the Web of Science database, we conducted a systematic search of English articles published before June 2015 on factors of smokers’ compliance with the smoking bans in public places. Results: A total of 390 references were identified, among which seventeen articles (twelve quantitative studies, two qualitative studies, three mixed-method studies) were included in this review. These studies focused on four types of public places including recreational venues (n = 7), hospital (n = 5), school (n = 4), and workplace (n = 1). Factors at the  individual-, interpersonal-, and organizational-level were identified: at the individual level, nicotine dependence, insufficiency of tobacco-related knowledge, and the negative attitudes towards smoking bans were the most commonly identified barriers; at the interpersonal level, the smoking behaviors of people around, close relatives, and friends’ approval were the main barriers; and at the organizational level, the main barriers were inefficient implementation of the bans and the inconvenience of the designative smoking areas. Conclusions: This synthesis of the literature provided evidence of the identified barriers and facilitators of smokers’ compliance with the smoking bans. It will be beneficial for the policy-maker to consider interventions on multiple levels of factors to overcome the barriers and enhance smokers’ compliance with the smoking bans in public places. PMID:27973436

  11. Organizational Paradigm Shifts.

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers, Washington, DC.

    This collection of essays explores a new paradigm of higher education. The first essay, "Beyond Re-engineering: Changing the Organizational Paradigm" (L. Edwin Coate), suggests a model of quality process management and a structure for managing organizational change. "Thinking About Consortia" (Mary Jo Maydew) discusses…

  12. Managing Organizational Priorities.

    ERIC Educational Resources Information Center

    Brightman, Baird K.; Moran, John W.

    2001-01-01

    Suggests that individuals can compile an action plan for professional and organizational change that aligns personal and organizational priorities by considering leadership, coaching, corporate citizenship, change management, efficiency, teamwork, customer focus, and decision making. Presents models and assessment instruments for personal…

  13. Identifying Organizational Identification.

    ERIC Educational Resources Information Center

    Mael, Fred A.; Tetrick, Lois E.

    1992-01-01

    A study of attitudes toward the job of 263 daytime-employed college students demonstrates that identification with a psychological group or organization (IDPG) is conceptually and empirically distinct from organizational commitment. IDPG also has less overlap than commitment with job satisfaction, organizational satisfaction, and job involvement.…

  14. Organizational Learning? Look Again

    ERIC Educational Resources Information Center

    Belle, Stuart

    2016-01-01

    Purpose: Despite the growth in research on conditions for successful learning by organizations and the introduction of expanding practices and approaches, a progressive and shared understanding of the link between organizational learning and governance is currently missing. This paper aims to take a closer look at organizational learning from a…

  15. Managing Organizational Change.

    ERIC Educational Resources Information Center

    Watwood, Britt; And Others

    Based on studies comparing leadership in two rural community colleges undergoing change and examining the management of change at Maryland's Allegany College, this paper presents a conceptual framework and model for managing organizational change. First, a framework for understanding the community college chair's role in organizational change is…

  16. Diffusion barriers

    NASA Technical Reports Server (NTRS)

    Nicolet, M. A.

    1983-01-01

    The choice of the metallic film for the contact to a semiconductor device is discussed. One way to try to stabilize a contact is by interposing a thin film of a material that has low diffusivity for the atoms in question. This thin film application is known as a diffusion barrier. Three types of barriers can be distinguished. The stuffed barrier derives its low atomic diffusivity to impurities that concentrate along the extended defects of a polycrystalline layer. Sacrificial barriers exploit the fact that some (elemental) thin films react in a laterally uniform and reproducible fashion. Sacrificial barriers have the advantage that the point of their failure is predictable. Passive barriers are those most closely approximating an ideal barrier. The most-studied case is that of sputtered TiN films. Stuffed barriers may be viewed as passive barriers whose low diffusivity material extends along the defects of the polycrystalline host.

  17. Overcoming Stereotypes, Discovering Hidden Capitals

    ERIC Educational Resources Information Center

    Beckett, Lori; Wrigley, Terry

    2014-01-01

    This article presents a model of teacher research supported by academic partners to develop a better understanding of the barriers to education faced by young people growing up in poverty. It critiques politicians' demands for teachers to "close the gap" for ignoring the cumulative intergenerational effects of deprivation. The authors…

  18. Organizational climate and culture.

    PubMed

    Schneider, Benjamin; Ehrhart, Mark G; Macey, William H

    2013-01-01

    Organizational climate and organizational culture theory and research are reviewed. The article is first framed with definitions of the constructs, and preliminary thoughts on their interrelationships are noted. Organizational climate is briefly defined as the meanings people attach to interrelated bundles of experiences they have at work. Organizational culture is briefly defined as the basic assumptions about the world and the values that guide life in organizations. A brief history of climate research is presented, followed by the major accomplishments in research on the topic with regard to levels issues, the foci of climate research, and studies of climate strength. A brief overview of the more recent study of organizational culture is then introduced, followed by samples of important thinking and research on the roles of leadership and national culture in understanding organizational culture and performance and culture as a moderator variable in research in organizational behavior. The final section of the article proposes an integration of climate and culture thinking and research and concludes with practical implications for the management of effective contemporary organizations. Throughout, recommendations are made for additional thinking and research.

  19. Overcoming the Problem of Embedding Change in Educational Organizations: A Perspective from Normalization Process Theory

    ERIC Educational Resources Information Center

    Wood, Phil

    2017-01-01

    In this article, I begin by outlining some of the barriers which constrain sustainable organizational change in schools and universities. I then go on to introduce a theory which has already started to help explain complex change and innovation processes in health and care contexts, Normalization Process Theory. Finally, I consider what this…

  20. Epistemological barriers to radical behaviorism.

    PubMed

    O'Donohue, W T; Callaghan, G M; Ruckstuhl, L E

    1998-01-01

    The historian and philosopher of science Gaston Bachelard proposed the concept of epistemological barriers to describe the intellectual challenges encountered by scientists in their work. In order to embrace novel ways of approaching a problem in science, scientists must overcome barriers or obstacles posed by their prior views. For example, Einsteinian physics presents scientists with claims that space is curved and that time and space are on the same continuum. We utilize Bachelard's concept of epistemological barriers to describe the differences between the intellectual journeys students pursuing advanced studies face when attempting to accept cognitive psychology or radical behaviorism. We contend that the folk psychological beliefs that students typically hold when entering these studies pose less challenge to cognitive psychology than to radical behaviorism. We also suggest that these barriers may also partly be involved in the problematic exegesis that has plagued radical behaviorism. In close, we offer some suggestions for dealing with these epistemological barriers.

  1. Epistemological barriers to radical behaviorism

    PubMed Central

    O'Donohue, William T.; Callaghan, Glenn M.; Ruckstuhl, L. E.

    1998-01-01

    The historian and philosopher of science Gaston Bachelard proposed the concept of epistemological barriers to describe the intellectual challenges encountered by scientists in their work. In order to embrace novel ways of approaching a problem in science, scientists must overcome barriers or obstacles posed by their prior views. For example, Einsteinian physics presents scientists with claims that space is curved and that time and space are on the same continuum. We utilize Bachelard's concept of epistemological barriers to describe the differences between the intellectual journeys students pursuing advanced studies face when attempting to accept cognitive psychology or radical behaviorism. We contend that the folk psychological beliefs that students typically hold when entering these studies pose less challenge to cognitive psychology than to radical behaviorism. We also suggest that these barriers may also partly be involved in the problematic exegesis that has plagued radical behaviorism. In close, we offer some suggestions for dealing with these epistemological barriers. PMID:22478314

  2. Varieties of Organizational Conflict

    ERIC Educational Resources Information Center

    Pondy, Louis R.

    1969-01-01

    The viewpoints and findings of the seven empirical studies of organizational conflict contained in this issue are compared and contrasted. A distinction is made between conflict within a stable organization structure and conflict aimed at changing the organization structure. (Author)

  3. Organizational Development and Evaluation.

    ERIC Educational Resources Information Center

    Patton, Michael Quinn

    1999-01-01

    Explores some opportunities open to evaluators as practitioners of organizational development and the advantages and competencies evaluators can bring to such initiatives. Presents eight examples of such opportunities. (SLD)

  4. Evolving to organizational learning.

    PubMed

    Bechtold, B L

    2000-02-01

    To transform in stride with the business changes, organizations need to think of development as "organizational learning" rather than "training." Companies need to manage learning as a strategic competitive advantage for current and future business rather than as a perk for individuals. To position themselves for success in a dynamic business environment, companies need to reframe their concept of learning and development to a mindset of organizational learning.

  5. Organizational Support of Technology Integration in One School in Lebanon

    ERIC Educational Resources Information Center

    Zgheib, Rosine S.

    2013-01-01

    Technology has been at the center of heated debates in educational settings driving schools to compete for the best technological equipments. However, in Lebanon there is a lag in technology integration matching twenty first century advances. Several barriers related to teacher attitudes, lack of technical skills and organizational constraints to…

  6. Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

    ERIC Educational Resources Information Center

    Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

    2011-01-01

    Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

  7. Managing US-Mexico "border health": an organizational field approach.

    PubMed

    Collins-Dogrul, Julie

    2006-12-01

    During World War II Mexican and US health professionals and organizations constructed a transnational organizational field to manage the border's public health problems. Despite barriers to inter-organizational cooperation, including disparate administrative structures and North-South stratification, the field's transnational approach to health on the border has continued for 60 years. Using archival data to track changes in the number and types of organizations, this article argues that the field practitioners call "border health" reconfigured during the North American Free Trade Association (NAFTA) decade from an era of loosely organized professionals to a specialized bureaucracies era. This change brought new vitality to border health, with transnational ties increasing and diversifying, but has not weakened entrenched cross-border inequalities. The organizational history of the US-Mexico border health field demonstrates how macro-politics and inter-organizational stratification shape transnational public health problems.

  8. Organizational commitment of military physicians.

    PubMed

    Demir, Cesim; Sahin, Bayram; Teke, Kadir; Ucar, Muharrem; Kursun, Olcay

    2009-09-01

    An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report, cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics.

  9. Overcoming "the Valley of Death".

    PubMed

    McIntyre, Robin A

    2014-01-01

    On a global level there are major challenges arising from climate change, resource use and changing age demographics. These issues have created a global marketplace for novel innovative products and solutions which can help to combat and overcome these challenges which have created significant commercial opportunities for companies, particularly for small and medium size enterprises or SMEs. Companies most likely to take advantage of these opportunities will be those which can innovate in a timely manner. Innovation significantly contributes to higher productivity and economic growth, and is core to a company's competitiveness within often challenging marketplaces. However, many factors can stifle innovation. Companies can struggle to identify finance for early-stage development, the returns can be difficult to predict, and the innovation 'landscape' is often complex and unclear. This brief review describes some of the main issues with commercialising innovative ideas and provides guidance with respect to the often complicated funding landscape both on a National and European level.

  10. Barriers to Asthma Management as Identified by School Nurses

    ERIC Educational Resources Information Center

    Quaranta, Judith E.; Spencer, Gale A.

    2016-01-01

    Asthma rates are increasing in children. School nurses have opportunities to care for children with asthma but need to overcome barriers impacting their ability to manage asthma in the school setting. This study (a) assessed barriers present in the school setting, (b) determined the impact of barriers on performance of asthma management behaviors,…

  11. Vehicle barrier

    DOEpatents

    Hirsh, Robert A.

    1991-01-01

    A vehicle security barrier which can be conveniently placed across a gate opening as well as readily removed from the gate opening to allow for easy passage. The security barrier includes a barrier gate in the form of a cable/gate member in combination with laterally attached pipe sections fixed by way of the cable to the gate member and lateral, security fixed vertical pipe posts. The security barrier of the present invention provides for the use of cable restraints across gate openings to provide necessary security while at the same time allowing for quick opening and closing of the gate areas without compromising security.

  12. Facilitators and barriers to doing workplace mental health research: Case study of acute psychological trauma in a public transit system.

    PubMed

    Links, Paul S; Bender, Ash; Eynan, Rahel; O'Grady, John; Shah, Ravi

    2016-03-10

    The Acute Psychological Trauma (APT) Study was a collaboration between an acute care hospital, a specialized multidisciplinary program designed to meet the mental health needs of injured workers, and a large urban public transit system. The overall purpose was to evaluate a Best Practices Intervention (BPI) for employees affected by acute psychological trauma compared to a Treatment as Usual (TAU) group. The specific purpose is to discuss facilitators and barriers that were recognized in implementing and carrying out mental health research in a workplace setting. Over the course of the APT study, a joint implementation committee was responsible for day-to-day study operations and made regular observations on the facilitators and barriers that arose throughout the study. The facilitators to this study included the longstanding relationships among the partners, increased recognition for the need of mental health research in the workplace, and the existence of a community advisory committee. The significant barriers to doing this study of mental health research in the workplace included differences in organizational culture, inconsistent union support, co-interventions, and stigma. Researchers and funding agencies need to be flexible and provide additional resources in order to overcome the barriers that can exist doing workplace mental health research.

  13. Organizational Justice As a Predictor of Organizational Silence

    ERIC Educational Resources Information Center

    Tan, Çetin

    2014-01-01

    In this study, relation between teachers' perception for organizational justice and their organizational silence was examined. Sample of this study consists of 300 teachers who work at elementary schools in Siirt. Relational Scanning model was utilized in performance of this study. In this study, Organizational Justice Scale and Organizational…

  14. Organizational Citizenship and Organizational Justice in Turkish Primary Schools

    ERIC Educational Resources Information Center

    Yilmaz, Kursad; Tasdan, Murat

    2009-01-01

    Purpose: The purpose of this study is to determine primary school teachers' perceptions regarding organizational citizenship and organizational justice. The study also aims to determine whether such perceptions vary depending on the variables of gender, field of study and seniority, and whether organizational citizenship behaviors and…

  15. Does Organizational Forgetting Matter? Organizational Survival for Life Coaching Companies

    ERIC Educational Resources Information Center

    Aydin, Erhan; Gormus, Alparslan Sahin

    2015-01-01

    Purpose: The purposes of this paper are to determine the role of organizational forgetting in different type of coaching companies and to determine organizational survival based on both knowledge structure of coaching companies and organizational forgetting with core features of organizations. Design/methodology/approach: Within the context of…

  16. Organizational Adaptation and Higher Education.

    ERIC Educational Resources Information Center

    Cameron, Kim S.

    1984-01-01

    Organizational adaptation and types of adaptation needed in academe in the future are reviewed and major conceptual approaches to organizational adaptation are presented. The probable environment that institutions will face in the future that will require adaptation is discussed. (MLW)

  17. Bound Rationality and Organizational Learning.

    DTIC Science & Technology

    1989-09-23

    8217 . 90 0 8 0.. O 4 BOUNDED RATIONALITY AND ORGANIZATIONAL LEARNING Technical Report AlP - 107 Herbert A. Simon Department of Psychology Carnegie Mellon...ACCESSION No N/A N/A N/A N/A 1 1 TITLE (include Security Classificarnon) Bounded rationality and organizational learning 12 PERSONAL AUTHOR(S) HretA io 13a...organizations organizational psychology organizational learning bounded rationality cognitive psychology 𔄃 ABSTRACT (Continue on reverse if necessary

  18. Organizational Learning and Crisis Management

    ERIC Educational Resources Information Center

    Wang, Jia

    2007-01-01

    The impact of crises on organizations has been stronger than ever. This article explores the role of organizational learning in crisis management, an area that has received little attention from HRD community. Recognizing the dynamics and interconnectedness of crisis management, organizational learning, and organizational change, the article…

  19. Organizational Learning Theory in Schools

    ERIC Educational Resources Information Center

    Fauske, Janice R.; Raybould, Rebecca

    2005-01-01

    Purpose: The paper's purposes are to establish organizational learning theory as evolving from the theoretical and empirical study of organizations and to build grounded theory explaining organizational learning in schools. Design/methodology/approach: Implementation of instructional technology as a process of organizational learning was explored…

  20. Simulation Gaming for Organizational Development

    ERIC Educational Resources Information Center

    Ruohomaki, Virpi

    2003-01-01

    This article introduces development and design approaches to organizational change (DIL). Simulation games can be used for promoting organizational development. They offer an arena for organization members to analyze the present state of an organization and create new organizational solutions. The bridge between the present and future mode of…

  1. Organizational Performance and Customer Value

    ERIC Educational Resources Information Center

    Tosti, Donald; Herbst, Scott A.

    2009-01-01

    While behavior systems analysts have recognized the importance of the consumer of organizational products (i.e., receiving system) in developing models of organizational change, few have offered a systematic assessment of the relationship between consumer and organizational practices. In this article we will discuss how a behavior systems approach…

  2. Organizational Theory and Leadership Navigation

    ERIC Educational Resources Information Center

    Brazer, S. David; Kruse, Sharon D.; Conley, Sharon

    2014-01-01

    Teaching organizational theory in a way that bridges to leadership practice is vital to preparing deft educational leaders who understand the organizational behavior of schools and districts. Organizational theory guides understanding of the complexities of schools and districts and can be a basis for collaborative and effective decision making.…

  3. Bioenergetic Progress and Heat Barriers

    NASA Astrophysics Data System (ADS)

    Zotin, A. A.; Lamprecht, I.; Zotin, A. I.

    2001-07-01

    Progressing biological evolution is discussed in the framework of nonequilibrium thermodynamics. It is connected with an increase of the mass specific standard metabolism given by coefficient a in the allometric relation (1) between oxygen consumption rate and body mass of an animal. Three “heat barriers” are found in the course of such a bioenergetic evolution. The first heat barrier concerns an animal's overheating during active movement and is overcome by the development of thermoregulation and the appearance of homeothermic animals. A second barrier arises when the coefficient a reaches values connected with lethal body temperatures. The transition across this second heat barrier occurs as result of reasonable activities and the appearance of civilization. The third heat barrier will arise during the further development of human civilization, connected with a highly increased energy production and a fatal warming of the Earth atmosphere. The manner to overcome this barrier will probably depend on the assimilation of space and the establishment of energy consuming industries outside the Earth. The bioenergetic evolution discussed in this paper does not exclude other trends of evolution, e.g. increase of size, and does not mean to be the only aspect of biological evolution.

  4. Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity.

    PubMed

    Williams, Nathaniel J; Glisson, Charles; Hemmelgarn, Anthony; Green, Philip

    2017-03-01

    The development of efficient and scalable implementation strategies in mental health is restricted by poor understanding of the change mechanisms that increase clinicians' evidence-based practice (EBP) adoption. This study tests the cross-level change mechanisms that link an empirically-supported organizational strategy for supporting implementation (labeled ARC for Availability, Responsiveness, and Continuity) to mental health clinicians' EBP adoption and use. Four hundred seventy-five mental health clinicians in 14 children's mental health agencies were randomly assigned to the ARC intervention or a control condition. Measures of organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers were collected before, during, and upon completion of the three-year ARC intervention. EBP adoption and use were assessed at 12-month follow-up. Multilevel mediation analyses tested changes in organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers as linking mechanisms explaining the effects of ARC on clinicians' EBP adoption and use. ARC increased clinicians' EBP adoption (OR = 3.19, p = .003) and use (81 vs. 56 %, d = .79, p = .003) at 12-month follow-up. These effects were mediated by improvement in organizational proficiency culture leading to increased clinician intentions to adopt EBPs and by reduced job-related EBP barriers. A combined mediation analysis indicated the organizational culture-EBP intentions mechanism was the primary carrier of ARC's effects on clinicians' EBP adoption and use. ARC increases clinicians' EBP adoption and use by creating proficient organizational cultures that increase clinicians' intentions to adopt EBPs.

  5. Rating healthy organizational performance.

    PubMed

    Berger, Ken; Penna, Robert

    2010-01-01

    Across the spectrum of philanthropy, donors are asking what evidence exists that an organization is actually creating positive, meaningful and sustainable change. Just as patient outcomes were adopted to demonstrate the efficacy of treatment, so too should organizational outcomes be adopted by health care facilities and the development organizations that support them to demonstrate the tangible and lasting benefits to the communities they serve.

  6. Internships in Organizational Communication

    ERIC Educational Resources Information Center

    Downs, Cal W.

    1975-01-01

    Considers the present status of intern programs for students of organizational communication and suggests possible future developments. (JW) Published by the Association for Communication Administration Bulletin, Staff Coordinator, ACA 5202 Leesburg Pike, Falls Church, VA 22041, $25.00 annual dues.

  7. Education and Organizational Democracy.

    ERIC Educational Resources Information Center

    Levin, Henry M.

    Because a main educational function is to prepare children for workplace roles, education's organizational forms and functions tend to correspond to those of the workplace. For instance, as the U.S. economy moved from agricultural through industrial to service bases, U.S. education moved from nonpublic schools to public schools to mass higher…

  8. ORGANIZATIONAL RISK COMMUNICATION

    EPA Science Inventory

    Ris communication tools in organizations differs in several ways from many of tools and techniques developed for public meetings. The traditional view of risk communication seeks to manage the public outrage ssociated with site-based issues. Organizational risk communication seek...

  9. Understanding Organizational Culture.

    ERIC Educational Resources Information Center

    Burkhart, Jennifer

    This guide, which is intended for workplace education providers, defines organizational culture, reviews selected techniques for reading a company's culture, and presents examples of ways in which organizations' culture can affect workplace education programs. An organization's culture is determined by: recognizing the company's philosophy…

  10. Organizational Effectiveness of Schools.

    ERIC Educational Resources Information Center

    Miskel, Cecil

    1982-01-01

    Because organizational effectiveness of schools is difficult to define, a model is needed to explain the complexities of the concept. Two models offer some promise. One is the goal model, which defines effectiveness as the degree to which organizations meet or surpass their goals (either official or operational). The other is the system resource…

  11. Organizational Learning and Unlearning

    ERIC Educational Resources Information Center

    Starbuck, William H.

    2017-01-01

    Purpose: This paper aims to summarize four decades of research into organizational adaptation, learning and unlearning. Design/methodology/approach: The most important contributions to this stream of research have been case studies of organizations struggling to survive serious crises. Findings: Very diverse kinds of organizations run into serious…

  12. Organizational Learning: Leading Innovations

    ERIC Educational Resources Information Center

    Collinson, Vivienne; Cook, Tanya Fedoruk

    2013-01-01

    This article examines the interplay among the environment, learning, leaders, and innovations in school systems. Six conditions that, together, have potential to shape an environment that supports organizational learning are illustrated with data from two leaders of innovation: one in an environment that resisted change; the other in a supportive…

  13. Organizational Communication Abstracts--1975.

    ERIC Educational Resources Information Center

    Falcione, Raymond L.; And Others

    This document includes nearly 700 brief abstracts of works published in 1975 that are relevant to the field of organizational communication. The introduction presents a rationale for the project, a review of research methods developed by the authors for the preparation of abstracts, a statement of limitations as to the completeness of the coverage…

  14. Barriers to cancer screening.

    PubMed

    Womeodu, R J; Bailey, J E

    1996-01-01

    Many barriers to cancer screening have been summarized and discussed. Barriers have been documented in all patient populations, but some groups such as ethnic minorities and the elderly face unique barriers. The barriers to cancer screening, are multifactorial, but much of the responsibility for change must lie with health care providers and the health care delivery industry. This is not to free the patient of all responsibility, but some significant barriers are beyond their direct control. Take, for example, socioeconomic status, disease knowledge, and culturally related perceptions and myths about cancer detection and treatment. The health care industry must do a better job identifying and overcoming these barriers. The significant effects of provider counseling and advice must not be underestimated. Patients must first be advised, and then further actions must be taken if they reject the screening advice. Did they refuse adherence to recommendations because they do not view themselves as susceptible, because of overwhelming personal barriers, or because of a fatalistic attitude toward cancer detection and treatment? If that is the case, physicians and health care institutions must attempt to change perceptions, educate, and personalize the message so that patients accept their disease susceptibility [table: see text]. Multiple patient and provider risk factors have been identified that can be used to target patients particularly at high risk for inadequate cancer screening and providers at high risk for performing inadequate screening. Research has clearly demonstrated the effectiveness of interventions to improve tracking of patient and physician compliance with screening recommendations. Further research is needed to show the impact of managed-care penetration and payer status on screening efforts, and incentive schemes need to be tested that reward institutions and third-party payers who develop uniform standards and procedures for cancer screening. The

  15. Math Is Like a Scary Movie? Helping Young People Overcome Math Anxiety

    ERIC Educational Resources Information Center

    Kulkin, Margaret

    2016-01-01

    Afterschool teachers who tutor students or provide homework help have a unique opportunity to help students overcome the social or emotional barriers that so often block learning. They can embrace a creative and investigative approach to math learning. Margaret Kulkin's interest in being a math attitude "myth-buster" led her to apply to…

  16. Organizational Culture and Safety

    NASA Technical Reports Server (NTRS)

    Adams, Catherine A.

    2003-01-01

    '..only a fool perseveres in error.' Cicero. Humans will break the most advanced technological devices and override safety and security systems if they are given the latitude. Within the workplace, the operator may be just one of several factors in causing accidents or making risky decisions. Other variables considered for their involvement in the negative and often catastrophic outcomes include the organizational context and culture. Many organizations have constructed and implemented safety programs to be assimilated into their culture to assure employee commitment and understanding of the importance of everyday safety. The purpose of this paper is to examine literature on organizational safety cultures and programs that attempt to combat vulnerability, risk taking behavior and decisions and identify the role of training in attempting to mitigate unsafe acts.

  17. Energy Organizational Planning

    SciTech Connect

    Gina C. Paradis; James Yockey; Tracey LeBeau

    2009-04-17

    As the Seneca Nation of Indians (SNI) continues to refine and finalize its Strategic Energy Plan, it became necessary to insure that a sustainable organization structure was developed through which the energy program and its initiatives could be nurtured and managed. To that end, SNI undertook a study to thoroughly evaluate the existing organizational structures and assess the requisite changes and/or additions to that framework that would complement the mission of the Strategic Plan. The goal of this study was to analyze, work with staff and leadership and recommend the most effective plan for the development of an organizational framework within which the Seneca could more effectively exercise energy sovereignty – control and manage their natural resource assets – i.e. develop its own energy resources, meet the current and projected energy needs of their community, and “sit at the table” with other regional energy providers to deal with issues on a peer-to-peer basis.

  18. Organizational Socialization to Innovativeness,

    DTIC Science & Technology

    1983-12-01

    Education , Fall, 1983. May, 1983. TR-i8 Barley, Stephen R. "Semiotics and the Study of Occupational and Organizational Cultures." Administrative Science...constrained and is thus -- to Innovite. Rebellion and conformity each tend toward .-’=at’.L spocs -,e, because the individual is either accepting the .’- ’ r...the spread in each age group on the basis of education (no degree, associate, Bachelors, Masters), years at LINC, years as a supervisor, gender

  19. Applying Organizational Change to Promote Lesbian, Gay, Bisexual, and Transgender Inclusion and Reduce Health Disparities.

    PubMed

    Eckstrand, Kristen L; Lunn, Mitchell R; Yehia, Baligh R

    2017-03-15

    Lesbian, gay, bisexual, and transgender (LGBT) populations face numerous barriers when accessing and receiving healthcare, which amplify specific LGBT health disparities. An effective strategic approach is necessary for academic health centers to meet the growing needs of LGBT populations. Although effective organizational change models have been proposed for other minority populations, the authors are not aware of any organizational change models that specifically promote LGBT inclusion and mitigate access barriers to reduce LGBT health disparities. With decades of combined experience, we identify elements and processes necessary to accelerate LGBT organizational change and reduce LGBT health disparities. This framework may assist health organizations in initiating and sustaining meaningful organizational change to improve the health and healthcare of the LGBT communities.

  20. Organizational Data Mining

    NASA Astrophysics Data System (ADS)

    Nemati, Hamid R.; Barko, Christopher D.

    Many organizations today possess substantial quantities of business information but have very little real business knowledge. A recent survey of 450 business executives reported that managerial intuition and instinct are more prevalent than hard facts in driving organizational decisions. To reverse this trend, businesses of all sizes would be well advised to adopt Organizational Data Mining (ODM). ODM is defined as leveraging Data Mining tools and technologies to enhance the decision-making process by transforming data into valuable and actionable knowledge to gain a competitive advantage. ODM has helped many organizations optimize internal resource allocations while better understanding and responding to the needs of their customers. The fundamental aspects of ODM can be categorized into Artificial Intelligence (AI), Information Technology (IT), and Organizational Theory (OT), with OT being the key distinction between ODM and Data Mining. In this chapter, we introduce ODM, explain its unique characteristics, and report on the current status of ODM research. Next we illustrate how several leading organizations have adopted ODM and are benefiting from it. Then we examine the evolution of ODM to the present day and conclude our chapter by contemplating ODM's challenging yet opportunistic future.

  1. Organisational Learning Barriers in Distributed Product Development: Observations from a Multinational Corporation.

    ERIC Educational Resources Information Center

    Gieskes, Jose F. B.; Hyland, Paul W.; Magnusson, Mats G.

    2002-01-01

    Using the Continuous Improvement for Global Innovation Management model, organizational learning in a multinational corporation was investigated. Barriers included time pressures, cultural differences, and inflexible hierarchy. Units with different operational foci emphasized different types of learning. Participants represented different…

  2. Organizational cynicism: bases and consequences.

    PubMed

    Abraham, R

    2000-08-01

    Organizational cynicism is the belief that an organization lacks integrity, which, when coupled with a powerful negative emotional reaction, leads to disparaging and critical behavior. In this article, the author attempts to theoretically clarify the process by which five forms of cynicism develop in the workplace and to empirically relate them to affective outcomes. Societal, employee, and organizational change cynicisms may be attributed to psychological contract violations; work cynicism may be related to burnout; and person-role conflict and personality cynicism may be related to innate hostility. Empirically, personality cynicism emerged as the strongest predictor of organizational cynicism, adversely affecting all of the criteria. Other forms of cynicism had more selective effects. Organizational change cynicism induced job dissatisfaction and alienation, and employee cynicism affected organizational commitment. Societal cynicism actually increased both job satisfaction and commitment. Both personality and work cynicisms were related to organizational citizenship indirectly, through alienation. Theoretical and practical implications are discussed.

  3. Error analysis using organizational simulation.

    PubMed Central

    Fridsma, D. B.

    2000-01-01

    Organizational simulations have been used by project organizations in civil and aerospace industries to identify work processes and organizational structures that are likely to fail under certain conditions. Using a simulation system based on Galbraith's information-processing theory and Simon's notion of bounded-rationality, we retrospectively modeled a chemotherapy administration error that occurred in a hospital setting. Our simulation suggested that when there is a high rate of unexpected events, the oncology fellow was differentially backlogged with work when compared with other organizational members. Alternative scenarios suggested that providing more knowledge resources to the oncology fellow improved her performance more effectively than adding additional staff to the organization. Although it is not possible to know whether this might have prevented the error, organizational simulation may be an effective tool to prospectively evaluate organizational "weak links", and explore alternative scenarios to correct potential organizational problems before they generate errors. PMID:11079885

  4. Drivers and Barriers in Health IT Adoption

    PubMed Central

    Avgar, A.C.; Litwin, A.S.; Pronovost, P.J.

    2012-01-01

    Despite near (and rare) consensus that the adoption and diffusion of health information technology (health IT) will bolster outcomes for organizations, individuals, and the healthcare system as a whole, there has been surprisingly little consideration of the structures and processes within organizations that might drive the adoption and effective use of the technology. Management research provides a useful lens through which to analyze both the determinants of investment and the benefits that can ultimately be derived from these investments. This paper provides a conceptual framework for understanding health IT adoption. In doing so, this paper highlights specific organizational barriers or enablers at different stages of the adoption process – investment, implementation, and use – and at different levels of organizational decision-making – strategic, operational, and frontline. This framework will aid both policymakers and organizational actors as they make sense of the transition from paper-based to electronic systems. PMID:23646093

  5. Interactional Psychology and Organizational Behavior.

    DTIC Science & Technology

    1982-02-01

    7 A0-A113 1132 MI1CHIGAN STATE UNIV EAST LANSING DEPT OF PSYCHOLOGY F/6 5/10 INTERACTIONAL PSYCHOLOGY AND ORGANIZATIONAL BEHA VIOR. (U) FEB 82 8...j INTERACTIONAL PSYCHOLOGY AND ORGANIZATIONAL BEHAVIOR Benjamin Schneider Research Report No. 82.1 February 1982 The writing of this paper was...supported in part by the Organizational Effectiveness Research Programs, Psychological Sciences Division, Office of Naval Research under Contract No. N00014

  6. One School's Approach to Overcoming Resistance and Improving Appraisal: Organizational Learning in Action

    ERIC Educational Resources Information Center

    Piggot-Irvine, Eileen

    2010-01-01

    This article reports on the action research (AR) approach adopted by one New Zealand (NZ) primary school to review and improve its appraisal system. Historically the staff had demonstrated considerable negativity towards appraisal. The classic reconnaissance, implementation and evaluation phases of AR were adopted by the case study school as a…

  7. Language barriers

    PubMed Central

    Ngwakongnwi, Emmanuel; Hemmelgarn, Brenda R.; Musto, Richard; King-Shier, Kathryn M.; Quan, Hude

    2012-01-01

    Abstract Objective To assess use of regular medical doctors (RMDs), as well as awareness and use of telephone health lines or telehealth services, by official language minorities (OLMs) in Canada. Design Analysis of data from the 2006 postcensal survey on the vitality of OLMs. Setting Canada. Participants In total, 7691 English speakers in Quebec and 12 376 French speakers outside Quebec, grouped into those who experienced language barriers and those with no language barriers. Main outcome measures Health services utilization (HSU) by the presence of language barriers; HSU measures included having an RMD, use of an RMD’s services, and awareness of and use of telephone health lines or telehealth services. Multivariable models examined the associations between HSU and language barriers. Results After adjusting for age and sex, English speakers residing in Quebec with limited proficiency in French were less likely to have RMDs (adjusted odds ratio [AOR] 0.66, 95% CI 0.50 to 0.87) and to use the services of their RMDs (AOR 0.65, 95% CI 0.50 to 0.86), but were more likely to be aware of the existence of (AOR 1.50, 95% CI 1.16 to 1.93) and to use (AOR 1.43, 95% CI 0.97 to 2.11) telephone health lines or telehealth services. This pattern of having and using RMDs and telehealth services was not observed for French speakers residing outside of Quebec. Conclusion Overall we found variation in HSU among the language barrier populations, with lower use observed in Quebec. Age older than 45 years, male sex, being married or in common-law relationships, and higher income were associated with having RMDs for OLMs. PMID:23242902

  8. Strategic Factors and Barriers for Promoting Educational Organizational Learning

    ERIC Educational Resources Information Center

    Garcia-Morales, V. J.; Lopez-Martin, F. J.; Llamas-Sanchez, R.

    2006-01-01

    This article uses a global model to analyse empirically how the personal and professional development of educators (personal mastery) facilitates the creation of a series of basic shared values (shared vision) and of team learning by the members of the educational centre, these inter-related strategic factors favouring, in turn, educational…

  9. The Relationship between Perceived Organizational Support and Teachers' Organizational Commitment

    ERIC Educational Resources Information Center

    Nayir, Funda

    2012-01-01

    Problem Statement: It can be said that one of the key factors ensuring teachers adaptation to developments is teachers' level of commitment to their schools. In this commitment, the teacher is expected to internalize the organizational objectives. The teacher's perception of organizational support is important for him to internalize the…

  10. The Relationship between Organizational Commitment and Organizational Climate in Manufacturing

    ERIC Educational Resources Information Center

    McMurray, Adela J.; Scott, D. R.; Pace, R. Wayne

    2004-01-01

    The purpose of this study was to explore the relationship between organizational commitment and organizational climate. Subjects were chosen from three large Australian automotive component manufacturing companies. A questionnaire was administered to 1,413 employees from forty-two countries of origin. A 97.8 percent response rate yielded 1,382…

  11. The Effects of Organizational Training on Organizational Commitment

    ERIC Educational Resources Information Center

    Bulut, Cagri; Culha, Osman

    2010-01-01

    This empirical study investigated the impact of organizational training on employee commitment focusing on employees' emotional and affective responses towards their organization. Organizational training is conceptualized within a multidimensional framework consisting of motivation for training, access to training, benefits from training and…

  12. The Importance of Organizational Learning for Organizational Sustainability

    ERIC Educational Resources Information Center

    Smith, Peter A. C.

    2012-01-01

    Purpose: This Special Issue is intended to heighten awareness of the importance of organizational learning in addressing the demands of organizational sustainability, and in particular triple bottom line (TBL) sustainability. A definition of TBL sustainability is provided, together with an exploration of the practical issues relevant to adopting…

  13. Barriers vs Creativity in Translator Training

    ERIC Educational Resources Information Center

    Yazici, Mine

    2016-01-01

    This paper discusses translation problems awaiting Turkish students as well as the creative solutions they develop in overcoming them. It consists of two parts; The first part studies the barriers concerning translation procedures from the perspective of translation theory and Turkish translation history; The second parts analyses the impact of…

  14. Challenges of organizational learning: perpetuation of discrimination against employees with disabilities.

    PubMed

    Wooten, Lynn Perry; James, Erika Hayes

    2005-01-01

    This article examines why organizations struggle with learning how to prevent discrimination against their employees with disabilities. To explore this issue, qualitative archival data were collected and analyzed from 53 Americans with Disabilities Act (ADA) lawsuits filed against 44 organizations. Theoretical analysis of the qualitative data suggests that several organizationally based learning theories explain the difficulty organizations have with creating a disability-friendly work environment. These barriers to learning are embedded in complex defense mechanisms and discriminatory organizational routines. Furthermore, organizations have difficulties engaging in higher-order and vicarious learning. We conclude the article with examples of successful learning practices as they relate to barriers identified in the qualitative analysis.

  15. Barriers to Liposomal Gene Delivery: from Application Site to the Target

    PubMed Central

    Saffari, Mostafa; Moghimi, Hamid Reza; Dass, Crispin R

    2016-01-01

    Gene therapy is a therapeutic approach to deliver genetic material into cells to alter their function in entire organism. One promising form of gene delivery system (DDS) is liposomes. The success of liposome-mediated gene delivery is a multifactorial issue and well-designed liposomal systems might lead to optimized gene transfection particularly in vivo. Liposomal gene delivery systems face different barriers from their site of application to their target, which is inside the cells. These barriers include presystemic obstacles (epithelial barriers), systemic barriers in blood circulation and cellular barriers. Epithelial barriers differ depending on the route of administration. Systemic barriers include enzymatic degradation, binding and opsonisation. Both of these barriers can act as limiting hurdles that genetic material and their vector should overcome before reaching the cells. Finally liposomes should overcome cellular barriers that include cell entrance, endosomal escape and nuclear uptake. These barriers and their impact on liposomal gene delivery will be discussed in this review. PMID:28228799

  16. The Influence of Organizational Leadership on "Minority" Student Success in Inner City Schools

    ERIC Educational Resources Information Center

    Peay, Yolanda S.

    2016-01-01

    The purpose of the study was to explore, discover, and understand organizational leadership processes in successful inner city schools. In order to understand the phenomenon taking place in inner city schools that were able to overcome the many challenges present in urban school settings and increase the likelihood of success in ethnic student…

  17. Promoting Physical Activity: Addressing Barriers and Moving Forward

    ERIC Educational Resources Information Center

    Beighle, Aaron; Morrow, James R.

    2014-01-01

    The barriers that keep individuals from adopting and maintaining active lifestyles are very complex. Strategies for overcoming these barriers and to incentivize and assist inactive individuals to benefit from physical activity are necessary. In addition, it is important to examine the impact of public policy on active living. As youth physical…

  18. Continuing Professional Development in Australia: Barriers and Support.

    PubMed

    Summers, Anthony

    2015-08-01

    Mandatory continuing professional development (CPD) requirements for nurses are common throughout the world, with CPD being required in Australia since 2010. Many barriers to CPD have been identified. In Australia, state and territory governments have implemented supports to help nurses overcome these barriers.

  19. The Gendered International School: Barriers to Women Managers' Progression

    ERIC Educational Resources Information Center

    Sanderson, Ruth Elizabeth; Whitehead, Stephen

    2016-01-01

    Purpose: The purpose of this paper is to examine the barriers women identify to their promotion in international schools and also the ways in which women can overcome these barriers. Design/methodology/approach: The field of enquiry is international schools, with the study drawing on qualitative research. The researchers interviewed 11 women from…

  20. Sex Bias Barriers to Vocational Education Enrollment. Final Report.

    ERIC Educational Resources Information Center

    Brown, Judy Palmer; And Others

    A study was conducted to identify barriers and develop programatic strategies necessary to overcome those barriers that deter both male and female students from enrolling in vocational education programs of their choice. The study utilized a modified delphi technique to collect the perceptions of the sample groups wanting to enroll in…

  1. Identifying and Clarifying Organizational Values.

    ERIC Educational Resources Information Center

    Seevers, Brenda S.

    2000-01-01

    Of the 14 organizational values ranked by a majority of 146 New Mexico Cooperative Extension educators as extremely valued, 9 were extremely evident in organizational policies and procedures. A values audit such as this forms an important initial step in strategic planning. (SK)

  2. Permeable Boundaries in Organizational Learning

    NASA Astrophysics Data System (ADS)

    Hazy, James K.; Tivnan, Brian F.; Schwandt, David R.

    The nature of the organizational boundary is investigated in the context of organizational learning. Boundary permeability is defined and hypotheses relating it to performance are tested computationally using data from 5,500 artificial organizations. We find that matching boundary permeability to the environment predicts both agent and organization survival.

  3. Organizational Silence in Sports Employees

    ERIC Educational Resources Information Center

    Bastug, Gulsum; Pala, Adem; Yilmaz, Taner; Duyan, Mehdi; Gunel, Ilker

    2016-01-01

    Organizational silence can be defined as a way of behaviour belonging to men and women employees in the organization exhibited without reflecting their feelings, ideas, concerns and suggestions related with their workplaces, works for which they are responsible or other activities of the organization. In the period of organizational silence,…

  4. The Effect of Organizational Justice and Perceived Organizational Support on Organizational Citizenship Behaviors: The Mediating Role of Organizational Identification

    ERIC Educational Resources Information Center

    Demir, Kamile

    2015-01-01

    Problem of Study: Research on social exchange relationships does not take into account another vital component of organizational life--namely an individual's sense of belonging and identity. Organizational identification is one of the most crucial factors holding employees together and keeping them committed to the organization. Many studies…

  5. Organizational Climate and Teacher Commitment

    ERIC Educational Resources Information Center

    Douglas, Stephen Michael

    2010-01-01

    This study examined the relationship of school climate and teacher commitment in elementary schools in Alabama. A total of 67 elementary schools were surveyed and 1353 teachers voluntarily participated in the study. The instruments used in this study were the Organizational Climate Index (OCI) and the Organizational Commitment Questionnaire (OCQ).…

  6. Organizational Learning through Transformational Leadership

    ERIC Educational Resources Information Center

    Imran, Muhammad Kashif; Ilyas, Muhammad; Aslam, Usman; Ubaid-Ur-Rahman

    2016-01-01

    Purpose: The transformation of firms from resource-based-view to knowledge-based-view has extended the importance of organizational learning. Thus, this study aims to develop an organizational learning model through transformational leadership with indirect effect of knowledge management process capability and interactive role of…

  7. Organizational Conflict: Causes and Manifestations.

    ERIC Educational Resources Information Center

    Sacks, Eugene

    1979-01-01

    No group (within an organization) can be entirely harmonious, but conflict is not an altogether disruptive factor. A delicate balance is required to obtain the advantages and restrict the disadvantages of organizational conflict. The causes and forms of organizational conflict are examined. (JMD)

  8. Evaluating Inter-Organizational Relationships.

    ERIC Educational Resources Information Center

    Intriligator, Barbara A.

    This paper presents a paradigm for evaluating an inter-organizational relationship (IOR) wherein two or more independent organizations agree to pool their authority, resources, and energies in order to achieve the goals they desire. Indicators of IOR effectiveness are clustered into four major categories: organizational situations, structural…

  9. Nurse scientists overcoming challenges to lead transdisciplinary research teams.

    PubMed

    Kneipp, Shawn M; Gilleskie, Donna; Sheely, Amanda; Schwartz, Todd; Gilmore, Robert M; Atkinson, Daryl

    2014-01-01

    Increasingly, scientific funding agencies are requiring that researchers move toward an integrated, transdisciplinary team science paradigm. Although the barriers to and rewards of conducting this type of research have been discussed in the literature, examples of how nurse investigators have led these teams to reconcile the differences in theoretical, methodological, and/or analytic perspectives that inevitably exist are lacking. In this article, we describe these developmental trajectory challenges through a case study of one transdisciplinary team, focusing on team member characteristics and the leadership tasks associated with successful transdisciplinary science teams in the literature. Specifically, we describe how overcoming these challenges has been essential to examining the complex and potentially cumulative effects that key intersections between legal, social welfare, and labor market systems may have on the health of disadvantaged women. Finally, we discuss this difficult but rewarding work within the context of lessons learned and transdisciplinary team research in relation to the future of nursing science.

  10. Organizational Climate for Successful Aging.

    PubMed

    Zacher, Hannes; Yang, Jie

    2016-01-01

    Research on successful aging at work has neglected contextual resources such as organizational climate, which refers to employees' shared perceptions of their work environment. We introduce the construct of organizational climate for successful aging (OCSA) and examine it as a buffer of the negative relationship between employee age and focus on opportunities (i.e., beliefs about future goals and possibilities at work). Moreover, we expected that focus on opportunities, in turn, positively predicts job satisfaction, organizational commitment, and motivation to continue working after official retirement age. Data came from 649 employees working in 120 companies (M age = 44 years, SD = 13). We controlled for organizational tenure, psychological climate for successful aging (i.e., individuals' perceptions), and psychological and organizational age discrimination climate. Results of multilevel analyses supported our hypotheses. Overall, our findings suggest that OCSA is an important contextual resource for successful aging at work.

  11. Organizational Climate for Successful Aging

    PubMed Central

    Zacher, Hannes; Yang, Jie

    2016-01-01

    Research on successful aging at work has neglected contextual resources such as organizational climate, which refers to employees’ shared perceptions of their work environment. We introduce the construct of organizational climate for successful aging (OCSA) and examine it as a buffer of the negative relationship between employee age and focus on opportunities (i.e., beliefs about future goals and possibilities at work). Moreover, we expected that focus on opportunities, in turn, positively predicts job satisfaction, organizational commitment, and motivation to continue working after official retirement age. Data came from 649 employees working in 120 companies (Mage = 44 years, SD = 13). We controlled for organizational tenure, psychological climate for successful aging (i.e., individuals’ perceptions), and psychological and organizational age discrimination climate. Results of multilevel analyses supported our hypotheses. Overall, our findings suggest that OCSA is an important contextual resource for successful aging at work. PMID:27458405

  12. Work reengineering: the benefits and the barriers, an analytical review.

    PubMed

    Murphy, R

    1995-01-01

    Hospital executives who are considering patient centered care (PCC) delivery models are undertaking a fascinating and sometimes frightening journey. Although the benefits are many, several barriers are often encountered on the way to achieving successful results. Many hospitals begin this initiative with enthusiasm and optimism because it makes so much sense. However, fear of change can set in when barriers overcome the motivation to proceed. This paper explores both the benefits and strategies for successfully overcoming the barriers. In the final analysis, each hospital's executive team must answer the call to this challenge. Their decisions hold the future of their hospital in the balance.

  13. Organizational Communication Inc.: Designing the Organizational Communication Theory Class as an Organizational Simulation.

    ERIC Educational Resources Information Center

    Marlier, John

    A college course in Organizational Communication typically involves the study of how people act within organizations, and why. Instructors should design a course which provides a realistically complex and extensive experiential simulation of organizational social dynamics over time, while still providing adequate theoretical input to facilitate a…

  14. A stapled BIM peptide overcomes apoptotic resistance in hematologic cancers.

    PubMed

    LaBelle, James L; Katz, Samuel G; Bird, Gregory H; Gavathiotis, Evripidis; Stewart, Michelle L; Lawrence, Chelsea; Fisher, Jill K; Godes, Marina; Pitter, Kenneth; Kung, Andrew L; Walensky, Loren D

    2012-06-01

    Cancer cells subvert the natural balance between cellular life and death, achieving immortality through pathologic enforcement of survival pathways and blockade of cell death mechanisms. Pro-apoptotic BCL-2 family proteins are frequently disarmed in relapsed and refractory cancer through genetic deletion or interaction-based neutralization by overexpressed antiapoptotic proteins, resulting in resistance to chemotherapy and radiation treatments. New pharmacologic strategies are urgently needed to overcome these formidable apoptotic blockades. We harnessed the natural killing activity of BCL-2-interacting mediator of cell death (BIM), which contains one of the most potent BH3 death domains of the BCL-2 protein family, to restore BH3-dependent cell death in resistant hematologic cancers. A hydrocarbon-stapled peptide modeled after the BIM BH3 helix broadly targeted BCL-2 family proteins with high affinity, blocked inhibitory antiapoptotic interactions, directly triggered proapoptotic activity, and induced dose-responsive and BH3 sequence-specific cell death of hematologic cancer cells. The therapeutic potential of stapled BIM BH3 was highlighted by the selective activation of cell death in the aberrant lymphoid infiltrates of mice reconstituted with BIM-deficient bone marrow and in a human AML xenograft model. Thus, we found that broad and multimodal targeting of the BCL-2 family pathway can overcome pathologic barriers to cell death.

  15. An Exploration of Two Mid-Level Faculty Developers' Influence on Organizational Learning as Transformational Leaders in Two California Community Colleges

    ERIC Educational Resources Information Center

    Hodgson, Devon Rachelle

    2009-01-01

    Researchers argue that a California Community College's capacity for improvement and reform, given the multitude of concerns and organizational barriers associated with education institutions will require transformation of current practices to influence organizational learning (O'Banion, 1997; Cohen, 1996). Extant literature has demonstrated the…

  16. Barriers to Health Care for Transgender Individuals

    PubMed Central

    Safer, Joshua D.; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae

    2016-01-01

    Purpose of Review Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to health care for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them. Recent Findings Current research emphasizes sexual minorities’ self report of barriers, rather than using direct methods. The biggest barrier to health care reported by transgender individuals is lack of access due to lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers and socioeconomic barriers. Summary National research priorities should include rigorous determination of the capacity of the United States health care system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical work force across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care required, larger social structural barriers and status of a framework to pay for appropriate care. As well, studies should propose and validate potential solutions to address identified gaps. PMID:26910276

  17. Barrier Formation

    PubMed Central

    Lyaruu, D.M.; Medina, J.F.; Sarvide, S.; Bervoets, T.J.M.; Everts, V.; DenBesten, P.; Smith, C.E.; Bronckers, A.L.J.J.

    2014-01-01

    Enamel fluorosis is an irreversible structural enamel defect following exposure to supraoptimal levels of fluoride during amelogenesis. We hypothesized that fluorosis is associated with excess release of protons during formation of hypermineralized lines in the mineralizing enamel matrix. We tested this concept by analyzing fluorotic enamel defects in wild-type mice and mice deficient in anion exchanger-2a,b (Ae2a,b), a transmembrane protein in maturation ameloblasts that exchanges extracellular Cl− for bicarbonate. Defects were more pronounced in fluorotic Ae2a,b−/− mice than in fluorotic heterozygous or wild-type mice. Phenotypes included a hypermineralized surface, extensive subsurface hypomineralization, and multiple hypermineralized lines in deeper enamel. Mineral content decreased in all fluoride-exposed and Ae2a,b−/− mice and was strongly correlated with Cl−. Exposure of enamel surfaces underlying maturation-stage ameloblasts to pH indicator dyes suggested the presence of diffusion barriers in fluorotic enamel. These results support the concept that fluoride stimulates hypermineralization at the mineralization front. This causes increased release of protons, which ameloblasts respond to by secreting more bicarbonates at the expense of Cl− levels in enamel. The fluoride-induced hypermineralized lines may form barriers that impede diffusion of proteins and mineral ions into the subsurface layers, thereby delaying biomineralization and causing retention of enamel matrix proteins. PMID:24170372

  18. Addressing language barriers to healthcare in India.

    PubMed

    Narayan, Lalit

    2013-01-01

    In spite of a growing recognition of the importance of doctor-patient communication, the issue of language barriers to healthcare has received very little attention in India. The Indian population speaks over 22 major languages with English used as the lingua franca for biomedicine. Large-scale internal migration has meant that health workers are encountering increasing instances of language discordance within clinical settings. Research done predominantly in the West has shown language discordance to significantly affect access to care, cause problems of comprehension and adherence, and decrease the satisfaction and quality of care. Addressing language barriers to healthcare in India requires a stronger political commitment to providing non-discriminatory health services, especially to vulnerable groups such as illiterate migrant workers. Research will have to address three broad areas: the ways in which language barriers affect health and healthcare, the efficacy of interventions to overcome language barriers, and the costs of language barriers and efforts to overcome them. There is a need to address such barriers in health worker education and clinical practice. Proven strategies such as hiring multilingual healthcare workers, providing language training to health providers, employing in situ translators or using telephone interpretation services will have to be evaluated for their appropriateness to the Indian context. Internet-based initiatives, the proliferation of mobile phones and recent advances in machine translation promise to contribute to the solution.

  19. Overcoming Recruitment Challenges in Palliative Care Clinical Trials

    PubMed Central

    LeBlanc, Thomas W.; Lodato, Jordan E.; Currow, David C.; Abernethy, Amy P.

    2013-01-01

    Purpose: Palliative care is increasingly viewed as a necessary component of cancer care, especially for patients with advanced disease. Rigorous clinical trials are thus needed to build the palliative care evidence base, but clinical research—especially participant recruitment—is difficult. Major barriers include (1) patient factors, (2) “gatekeeping,” and (3) ethical concerns. Here we discuss an approach to overcoming these barriers, using the Palliative Care Trial (PCT) as a case study. Patients and Methods: The PCT was a 2 × 2 × 2 factorial randomized controlled trial (RCT) of different service delivery models to improve pain control in the palliative setting. It used a recruitment protocol that fused evidence-based strategies with principles of “social marketing,” an approach involving the systematic application of marketing techniques. Main components included (1) an inclusive triage algorithm, (2) information booklets targeting particular stakeholders, (3) a specialized recruitment nurse, and (4) standardization of wording across all study communications. Results: From an eligible pool of 607 patients, the PCT enrolled 461 patients over 26 months. Twenty percent of patients referred to the palliative care service were enrolled (76% of those eligible after screening). Several common barriers were minimized; among those who declined participation, family disinterest was uncommon (5%), as was the perception of burden imposed (4%). Conclusion: Challenges to clinical trial recruitment in palliative care are significant but not insurmountable. A carefully crafted recruitment and retention protocol can be effective. Our experience with designing and deploying a social-marketing–based protocol shows the benefits of such an approach. PMID:24130254

  20. African American Female College and University Presidents: Experiences and Perceptions of Barriers to the Presidency

    ERIC Educational Resources Information Center

    Jackson, Sandra; Harris, Sandra

    2007-01-01

    This study was an investigation of the experiences and perceptions of barriers to the presidency of 43 African American female college and university presidents. Findings suggested that exclusion from informal networks, lack of preparation and lack of career goals were primary barriers. Strategies to overcome these barriers included exceeding job…

  1. Exploring Effective Communication for Organizational Change

    ERIC Educational Resources Information Center

    Nordin, Eric John

    2013-01-01

    The purpose of this case study was to explore experiences and perceptions of organizational leaders regarding organizational change communication to improve change results in an organizational setting. Building on a conceptual framework of organizational theory, 25 full-time online faculty at an institution of higher learning in the southwestern…

  2. First Davis Strait discovery overcomes offshore hazards

    SciTech Connect

    Munro, R.G.

    1982-04-01

    In spite of icebergs umpredictable currents and brief drilling seasons, the first discovery well was completed recently in the Davis Strait. The success of this well, known as Hekja 0-71, has opened the waters off the northeastern coast of Canada to more exploration. A discussion is presented of how the well was drilled, the problems encountered and how they were overcome.

  3. Overcoming the Mechanism of Radioresistance in Neuroblastoma

    DTIC Science & Technology

    2014-06-01

    of Radioresistance in Neuroblastoma PRINCIPAL INVESTIGATOR: Brian Marples PhD CONTRACTING ORGANIZATION: William Beaumont Hospital Inc...COVERED 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Overcoming the Mechanism of Radioresistance in Neuroblastoma 5b. GRANT NUMBER 5c. PROGRAM...for highly aggressive advanced-stage neuroblastoma remains poor despite a multidisciplinary approach involving aggressive surgery, chemotherapy and

  4. Successful Writing: Five Roadblocks to Overcome

    ERIC Educational Resources Information Center

    King, Kathleen P.

    2013-01-01

    This article provides essential strategies to be more successful in one of the major roles in academia: writing. Most academics struggle with roadblocks in their writing process. We are forever battling to complete research articles, manuscripts, grant proposals or other documents. The strategies and perspective shared here help overcome several…

  5. In My View. Overcoming Math Anxiety.

    ERIC Educational Resources Information Center

    Fotoples, Robert M.

    2000-01-01

    Describes math anxiety, explaining roadblocks to mathematics success; discussing strategies for overcoming anxiety (e.g., parent involvement, teacher sensitivity, and peer tutoring); and examining the influence of learning styles on mathematics achievement and attitudes. Mathematics teachers must identify students' problems in mathematics, work…

  6. Helping Developmental Students Overcome Communication Apprehension.

    ERIC Educational Resources Information Center

    Watson, Arden K.

    Since 20% of all college students experience communication apprehension (CA), the developmental student, distinguished by lower than average academic scores, may also experience this inhibiting fear of communication. Characteristics of the developmental communication apprehensive student indicate that a program for overcoming communication…

  7. Ideas for Creating and Overcoming Student Silences

    ERIC Educational Resources Information Center

    Woods, Donald R.; Sheardown, Heather

    2009-01-01

    The key idea is that 50 minutes of teacher talk with passive student listening is relatively ineffective in developing student learning. Teachers can create silences for productive active student learning. Students can also change from passive listeners to active talker-discussers of their learning. Ideas are given about how to overcome silences…

  8. Learn to Avoid or Overcome Leadership Obstacles

    ERIC Educational Resources Information Center

    D'Auria, John

    2015-01-01

    Leadership is increasingly recognized as an important factor in moving schools forward, yet we have been relatively random in how we prepare and support them. Four obstacles often block or diminish their effectiveness. Avoiding or overcoming each of these requires an underlying set of skills and knowledge that we believe can be learned and…

  9. The BARRIERS scale -- the barriers to research utilization scale: A systematic review

    PubMed Central

    2010-01-01

    Background A commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization. Aim and objectives The aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use. Methods Medline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest® digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used. Results Sixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization. Conclusions The BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal

  10. Overcoming Resistance to Culture Change: Nursing Home Administrators’ Use of Education, Training and Communication

    PubMed Central

    Tyler, Denise A.; Lepore, Michael; Shield, Renee R.; Looze, Jessica; Miller, Susan C.

    2014-01-01

    Nursing home culture change is becoming more prevalent and research has demonstrated its benefits for nursing home residents and staff, but little is known about the role of nursing home administrators in culture change implementation. The purpose of this study was to determine what barriers nursing home administrators faced in implementing culture change practices and to identify the strategies used to overcome these. We conducted in-depth individual interviews with 64 administrators identified through a nationally representative survey. Results showed that a key barrier to culture change implementation reported by administrators was staff, resident and family member resistance to change. Most nursing home administrators stressed the importance of using communication, education and training to overcome this resistance. Themes emerging around the concepts of communication and education indicate that these efforts should be ongoing, communication should be reciprocal, and that all stakeholders should be included. PMID:24266678

  11. Building blocks for organizational change.

    PubMed

    Daly, Rich

    2014-05-01

    To understand the types of organizational change that will best help them meet strategic goals, hospitals and health systems are: Projecting their quality and savings goals for the coming years and weighing their ability to meet them. Looking for partner organizations that share their culture, goals, and capabilities. Assessing the types of organizational arrangements that will provide the desired benefits. Determining the key components needed to make the arrangement fit their goals and culture.

  12. Urban FFA Members' Sense of the Organizational Culture of the FFA

    ERIC Educational Resources Information Center

    Martin, Michael J.; Kitchel, Tracy

    2014-01-01

    Organizational culture shapes how members of a group act. The culture has the power to exclude potential new members who do not fit into the culture of the organization. Research on urban school-based agriculture programs has indicated that urban agriculture students face barriers to their participation in the National FFA Organization (FFA).…

  13. Overcoming Constraints in Healthcare with Cloud Technology.

    PubMed

    Hucíková, Anežka; Babic, Ankica

    2016-01-01

    Transitioning enterprise operations to the cloud brings a variety of opportunities and challenges. Such step requires a deep and complex understanding of all elements related to the technology as well as defining the manner in which specific cloud challenges can be dealt with. To provide a better understanding of these opportunities and challenges within healthcare, systematic literature overview and industrial cases review is used. Results of the two methods show interconnection between cloud deployment advantages and constrains. However, healthcare case studies provide interesting insights emphasizing cloud complexity and superposition which seems to balance organizational limitations.

  14. The Effects of Organizational Culture on Mental Health Service Engagement of Transition Age Youth.

    PubMed

    Kim, HyunSoo; Tracy, Elizabeth M; Biegel, David E; Min, Meeyoung O; Munson, Michelle R

    2015-10-01

    Nationwide, there is a growing concern in understanding mental health service engagement among transition age youth. The ecological perspective suggests that there are multiple barriers to service engagement which exist on varying levels of the ecosystem. Based on the socio-technical theory and organizational culture theory, this study examined the impact of organization-level characteristics on perceived service engagement and the moderating role of organizational culture on practitioner-level characteristics affecting youth service engagement. A cross-sectional survey research design was used to address the research questions. The data were collected from 279 practitioners from 27 mental health service organizations representing three major metropolitan areas in Ohio. Hierarchical linear modeling was used to address a nested structure. Findings revealed that location of organization, service setting, and organizational culture had significant effects on the continuation of services. In addition, the relationship between service coordination and resource knowledge and service engagement was moderated by organizational culture.

  15. Organizational Learning and the Marine Corps: The Counterinsurgency Campaign in Iraq (CIWAG Case Study on Irregular Warfare and Armed Groups)

    DTIC Science & Technology

    2012-01-01

    the Navy Senior Research Fellow at the U.S. Naval War College, and Brigadier General H. L. Oppenheimer Chair of War-fighting Strategy, U.S. Marine...that large organizations do things. Those processes often serve as barriers to change. They throw up Chinese walls that constitute acute...discussion of the tenets of organizational learning is necessary. The Learning Process Many definitions of organizational learning can be found in

  16. Overcoming drug resistance through in silico prediction.

    PubMed

    Carbonell, Pablo; Trosset, Jean-Yves

    2014-03-01

    Prediction tools are commonly used in pre-clinical research to assist target selection, to optimize drug potency or to predict the pharmacological profile of drug candidates. In silico prediction and overcoming drug resistance is a new opportunity that creates a high interest in pharmaceutical research. This review presents two main in silico strategies to meet this challenge: a structure-based approach to study the influence of mutations on the drug-target interaction and a system-biology approach to identify resistance pathways for a given drug. In silico screening of synergies between therapeutic and resistant pathways through biological network analysis is an example of technique to escape drug resistance. Structure-based drug design and in silico system biology are complementary approaches to reach few objectives at once: increase efficiency, reduce toxicity and overcoming drug resistance.

  17. [Overcoming mandatory vaccination policy: first steps].

    PubMed

    Ferro, A; Cinquetti, S; Menegon, T; Napoletano, G; Bertoncello, L; Valsecchi, M

    2008-01-01

    Steps toward overcoming mandatory vaccination policy follow two main tracks: scientific and administrative. Scientific course checks starting conditions of the project in Veneto Region and monitors the effects of policy. Thanks to sensibilization regional programs and partecipation to national campaigns of vaccination, Veneto Region has achieved high coverage for all actively promoted vaccinations. Specific projects has been implemented in order to improve vaccination system quality, particularly with regard to infectious diseases and vaccine adverse events surveillance, training workers and informatization. On 23rd March 2007 Veneto Region passed the regional law number 7 called "Sospensione dell'obbligo vaccinale per l'età evolutiva" becoming in force for children born since January 1st 2008. The law provides for the institution of a scientific committee having the task of monitoring both vaccination coverage and preventable infectious diseases incidence after overcoming mandatory vaccination policy.

  18. [Cancer immunotherapy. Importance of overcoming immune suppression].

    PubMed

    Malvicini, Mariana; Puchulo, Guillermo; Matar, Pablo; Mazzolini, Guillermo

    2010-01-01

    Increasing evidence indicates that the immune system is involved in the control of tumor progression. Effective antitumor immune response depends on the interaction between several components of the immune system, including antigen-presenting cells and different T cell subsets. However, tumor cells develop a number of mechanisms to escape recognition and elimination by the immune system. In this review we discuss these mechanisms and address possible therapeutic approaches to overcome the immune suppression generated by tumors.

  19. Certain Organizational Characteristics Affect ACO Preventive Care Quality Performance.

    PubMed

    Ticse, Caroline

    2016-06-01

    Key findings. (1) ACOs at provider workforce extremes--few primary care providers or many specialists--performed worse on measures of preventive care quality relative to those with more PCPs and fewer specialists. (2) Upfront investment in ACO formation is associated with higher performance in preventive care quality. (3) ACOs with a higher proportion of minority beneficiaries performed worse on disease prevention measures than did ACOs with a lower proportion of minority beneficiaries. (4) ACOs facing barriers to quality performance may benefit from organizational characteristics such as electronic health record capabilities and hospital inclusion in the ACO.

  20. Applying Organizational Learning Research to Accountable Care Organizations.

    PubMed

    Nembhard, Ingrid M; Tucker, Anita L

    2016-12-01

    To accomplish the goal of improving quality of care while simultaneously reducing cost, Accountable Care Organizations (ACOs) need to find new and better ways of providing health care to populations of patients. This requires implementing best practices and improving collaboration across the multiple entities involved in care delivery, including patients. In this article, we discuss seven lessons from the organizational learning literature that can help ACOs overcome the inherent challenges of learning how to work together in radically new ways. The lessons involve setting expectations, creating a supportive culture, and structuring the improvement efforts. For example, with regard to setting expectations, framing the changes as learning experiences rather than as implementation projects encourages the teams to utilize helpful activities, such as dry runs and pilot tests. It is also important to create an organizational culture where employees feel safe pointing out improvement opportunities and experimenting with new ways of working. With regard to structure, stable, cross-functional teams provide a powerful building block for effective improvement efforts. The article concludes by outlining opportunities for future research on organizational learning in ACOs.

  1. The Relationship between Organizational Trust and Organizational Silence with Job Satisfaction and Organizational Commitment of the Employees of University

    ERIC Educational Resources Information Center

    Fard, Parastoo Gashtasebi; Karimi, Fariba

    2015-01-01

    This study aimed to investigate the structural model between organizational trust and organizational silence with job satisfaction and organizational commitment of the employees of Islamic Azad University of Isfahan, (Khorasgan) branch. The study method is descriptive-correlation. The study population is the employees of Islamic Azad University of…

  2. Strategies to Overcome Heparins’ Low Oral Bioavailability

    PubMed Central

    Neves, Ana Rita; Correia-da-Silva, Marta; Sousa, Emília; Pinto, Madalena

    2016-01-01

    Even after a century, heparin is still the most effective anticoagulant available with few side effects. The poor oral absorption of heparins triggered the search for strategies to achieve oral bioavailability since this route has evident advantages over parenteral administration. Several approaches emerged, such as conjugation of heparins with bile acids and lipids, formulation with penetration enhancers, and encapsulation of heparins in micro and nanoparticles. Some of these strategies appear to have potential as good delivery systems to overcome heparin’s low oral bioavailability. Nevertheless, none have reached the market yet. Overall, this review aims to provide insights regarding the oral bioavailability of heparin. PMID:27367704

  3. Overcoming semantic heterogeneity in spatial data infrastructures

    NASA Astrophysics Data System (ADS)

    Lutz, M.; Sprado, J.; Klien, E.; Schubert, C.; Christ, I.

    2009-04-01

    In current spatial data infrastructures (SDIs), it is still often difficult to effectively exchange or re-use geographic data sets. A main reason for this is semantic heterogeneity, which occurs at different levels: at the metadata, the schema and the data content level. It is the goal of the work presented in this paper to overcome the problems caused by semantic heterogeneity on all three levels. We present a method based on ontologies and logical reasoning, which enhances the discovery, retrieval, interpretation and integration of geographic data in SDIs. Its benefits and practical use are illustrated with examples from the domains of geology and hydrology.

  4. Management Systems and Organizational Analysis: Part II

    ERIC Educational Resources Information Center

    Levine, Donald M.

    1976-01-01

    Briefly reviews the contributions of several psychological researchers whose work represents four major approaches to organizational research, focusing primarily on the organizational theories of Bion, Miller and Rice, and Levinson. (JG)

  5. Reporters and Their Professional and Organizational Commitment.

    ERIC Educational Resources Information Center

    Becker, Lee B.; And Others

    1979-01-01

    Secondary analyses of data gathered in a national study of United States journalists yielded information about variables that predict professional and organizational commitment. The factors selected for analysis were found to explain organizational commitment better than professional commitment. (GT)

  6. The complexity of organizational change: describing communication during organizational turbulence.

    PubMed

    Salem, Philip

    2013-01-01

    Organizational researchers and practitioners have been interested in organizational change for some time. Historically, they have directed most of their efforts at improving the efficiency of planned top-down change. These efforts were strategic attempts at altering parameters leading to transformational change. Most efforts failed to meet their intended purposes. Transformational organizational change has not been likely. The legitimate systems have been robust. There has been little systematic investigation of the communication occurring during these efforts. The purpose of this essay is to describe results of a mixed methods research project answering two research questions. (a) How do organizational members communicate during a time of turbulence? (b) What features of this communication suggest the potential for or resistance to transformative change? Comparing the results at the beginning of the period to other periods, gives insight into how social actors communicate and enact the organization during a threshold period where transformational change was possible. Results reveal identifiable patterns of communication as communication strategies, parameters, or basins of attraction. The overall pattern explains how micro communication patterns intersect and how the accumulation of these patterns may resist or accomplish change at a macro level.

  7. Linking Calling Orientations to Organizational Attachment via Organizational Instrumentality

    ERIC Educational Resources Information Center

    Cardador, M. Teresa; Dane, Erik; Pratt, Michael G.

    2011-01-01

    Despite an emerging interest in callings, researchers know little about whether calling orientations matter in the workplace. We explore the under-examined relationship between a calling orientation and employees' attachment to their organizations. Although some theory suggests that callings may be negatively related to organizational attachment,…

  8. The Relationship between Work Engagement Behavior and Perceived Organizational Support and Organizational Climate

    ERIC Educational Resources Information Center

    Köse, Akif

    2016-01-01

    The purpose of this study is to examine the relationship between work engagement and perceived organizational support and organizational climate. The present study, in which quantitative methods have been used, is carried out in the relational screening model. Perceived organizational support scale, organizational climate scale, and work…

  9. Influence of Organizational Culture on the Relationship Between Psychological Contracts and Organizational Citizenship Behavior

    DTIC Science & Technology

    2006-03-01

    INFLUENCE OF ORGANIZATIONAL CULTURE ON THE RELATIONSHIP BETWEEN PSYCHOLOGICAL ...AFIT/GRD/ENV/06M-01 INFLUENCE OF ORGANIZATIONAL CULTURE ON THE RELATIONSHIP BETWEEN PSYCHOLOGICAL CONTRACTS AND ORGANIZATIONAL...RELATIONSHIP BETWEEN PSYCHOLOGICAL CONTRACTS AND ORGANIZATIONAL CITIZENSHIP BEHAVIOR Jennifer M. Carbajal, B.A. 2Lt, USAF

  10. The Relationship between Perceived Organizational Support and Organizational Cynicism of Research Assistants

    ERIC Educational Resources Information Center

    Kasalak, Gamze; Bilgin Aksu, Mualla

    2014-01-01

    The purpose of this study is to ascertain to what extent organizational cynicism may be predicted based on the level of perceived organizational support by determining the relationship between research assistants' perceived organizational support and organizational cynicism. The population of the study consists of 214 research assistants working…

  11. Overcoming social segregation in health care in Latin America.

    PubMed

    Cotlear, Daniel; Gómez-Dantés, Octavio; Knaul, Felicia; Atun, Rifat; Barreto, Ivana C H C; Cetrángolo, Oscar; Cueto, Marcos; Francke, Pedro; Frenz, Patricia; Guerrero, Ramiro; Lozano, Rafael; Marten, Robert; Sáenz, Rocío

    2015-03-28

    Latin America continues to segregate different social groups into separate health-system segments, including two separate public sector blocks: a well resourced social security for salaried workers and their families and a Ministry of Health serving poor and vulnerable people with low standards of quality and needing a frequently impoverishing payment at point of service. This segregation shows Latin America's longstanding economic and social inequality, cemented by an economic framework that predicted that economic growth would lead to rapid formalisation of the economy. Today, the institutional setup that organises the social segregation in health care is perceived, despite improved life expectancy and other advances, as a barrier to fulfilling the right to health, embodied in the legislation of many Latin American countries. This Series paper outlines four phases in the history of Latin American countries that explain the roots of segmentation in health care and describe three paths taken by countries seeking to overcome it: unification of the funds used to finance both social security and Ministry of Health services (one public payer); free choice of provider or insurer; and expansion of services to poor people and the non-salaried population by making explicit the health-care benefits to which all citizens are entitled.

  12. Barriers to women's cardiovascular risk knowledge.

    PubMed

    Liewer, Linda; Mains, Douglas A; Lykens, Kristine; René, Antonio A

    2008-01-01

    Cardiovascular disease (CVD) is the leading cause of death for women in the United States, resulting in a greater emphasis on research and methods for addressing issues relating to this health problem both nationally and worldwide. The authors' purpose was to identify barriers to women's cardiovascular risk knowledge, both personal and organizational, through key informant interviews of health leaders at 10 community health organizations. Analysis showed an overall lack of awareness of CVD risk for women. Culture, finance, and lack of awareness and easily accessible programs implicated the importance of physicians as health care providers and educators for women patients.

  13. Moderating effects of nurses' organizational support on the relationship between job satisfaction and organizational commitment.

    PubMed

    Chang, Ching-Sheng

    2015-06-01

    The aim was to investigate whether job satisfaction enhances organizational commitment among nursing personnel while exploring whether organizational support perception has a moderating effect on the relationship between their job satisfaction and organizational commitment. A cross-sectional survey was sent to 400 nurses; 386 valid questionnaires were collected, with a valid response rate of 96.5%. According to the research findings, nurses' job satisfaction has a positive and significant influence on organizational commitment. Results also indicated that the moderating effect of nurses' organizational support perception on the relationship between their job satisfaction and organizational commitment was stronger for high organizational support perception than it was for low organizational support perception. This study suggests that organizational support perception will develop a sense of belonging, and this will help improve nurses' job satisfaction and organizational commitment. This kind of relationship is rarely discussed in the research literature, and it can be applied for human resources management of nursing staff.

  14. Conditioning Factors of an Organizational Learning Culture

    ERIC Educational Resources Information Center

    Rebelo, Teresa Manuela; Gomes, Adelino Duarte

    2011-01-01

    Purpose: The aim of this study is to assess the relationship between some variables (organizational structure, organizational dimension and age, human resource characteristics, the external environment, strategy and quality) and organizational learning culture and evaluate the way they interact with this kind of culture.…

  15. Measuring Organizational Learning: A Preliminary Progress Report

    DTIC Science & Technology

    2010-08-01

    Contractor Report 2010-01 Measuring Organizational Learning : A Preliminary Progress Report Chris Winkler and Charles T...TITLE AND SUBTITLE Measuring Organizational Learning : A Preliminary Progress Report 5a. CONTRACT OR GRANT NUMBER W91WAW-07-C-0074 5b...Technical Publications Specialist (703) 602-8049 ii iii MEASURING ORGANIZATIONAL LEARNING : A PRELIMINARY

  16. The Organizational Values of "Gimnazija" in Slovenia

    ERIC Educational Resources Information Center

    Pang, Nicholas Sun-Keung

    2006-01-01

    This article assesses the organizational values of "gimnazija" in Slovenia and examines the factors that contribute to the building of quality management. The theoretical framework is built on Schein's model of levels of culture, Sathe's interpretation of organizational culture and Getzels and Guba's model of organizational behaviour.…

  17. A Synergistic Model of Organizational Career Development.

    ERIC Educational Resources Information Center

    Bernes, K. B.; Magnusson, K. C.

    The Synergistic Model of Organizational Career Development is a new model of organizational career development that combines the best of career development practice and organizational development into a unified, coherent model. The model has three levels of organization: philosophical, strategic, and practical. Expanding circles are used to…

  18. Tying Individual Dreams to Organizational Goals.

    ERIC Educational Resources Information Center

    Mossop, Catherine

    Most people want to learn, grow and achieve their career dreams. Linking individuals' career aspirations to organizational goals can be challenging, yet it is the foundation for personal and organizational success. This chapter discusses how to use learning objectives to link career learning or development to organizational strategy. Using a…

  19. Organizational Learning, Change and Socialization. Symposium.

    ERIC Educational Resources Information Center

    2002

    This symposium is comprised of three papers on organizational learning, change, and socialization. "A Study of the Organizational Learning Profile (OLP)" (Rae Dorai, Adela J. McMurray) reports findings that show the OLP (Pace et al. 1998) is a reliable instrument for measuring organizational learning and its content validity is high.…

  20. 28 CFR 0.1 - Organizational units.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Organizational units. 0.1 Section 0.1 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Organizational Structure of the Department of Justice § 0.1 Organizational units. The Department of Justice shall...

  1. 28 CFR 0.1 - Organizational units.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Organizational units. 0.1 Section 0.1 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Organizational Structure of the Department of Justice § 0.1 Organizational units. The Department of Justice shall...

  2. Faculty Perceptions of Organizational Politics

    ERIC Educational Resources Information Center

    Lawrence, Janet; Ott, Molly

    2013-01-01

    This study focuses on a contested area of shared governance, intercollegiate athletics. The researchers consider how faculty perceptions of organizational politics shape their orientations toward collaborative decision-making in this domain. The results provide insights into ways social cognitions about campus-level decision-making affect faculty…

  3. Creating a Healthy Organizational Climate.

    ERIC Educational Resources Information Center

    Bolding, James T.; Van Patten, James J.

    1982-01-01

    Four areas of college management responsibility are reviewed: the mission of the organization; administrator/faculty relationship; individual stress; and measuring organizational health. According to Argyris (1980) an organization updates its goals (1) as a consequence of detecting and solving routine problems, and (2) through periodical…

  4. The Organizational Configurations of Schools

    ERIC Educational Resources Information Center

    Lee, Linda C.

    2010-01-01

    The goal of this dissertation is twofold: 1) To develop a framework and method for simultaneously examining many different school organizations and their relation to patterns of school change and 2) To utilize that framework to obtain a district-wide understanding of the organizational functioning and change patterns of Chicago Public School (CPS)…

  5. Organizational Context of Human Factors

    DTIC Science & Technology

    1982-11-01

    There are other varieties in what has come to be called "contingency theory" (after the seminal work of Paul Lawrence and Jay Lorsch , 1967) reflecting...contingencies theory of intra-organizational power." ADMINISTRATIVE SCIENCE QUARTERLY, 16:2 (June. 1971). 216-229. Lawrence, Paul, and Jay Lorsch . ORGANIZATIONS

  6. The Measurement of Organizational Commitment.

    ERIC Educational Resources Information Center

    Mowday, Richard T.; And Others

    1979-01-01

    This paper summarizes a stream of research aimed at developing and validating a measure of employee commitment to work organizations. The instrument, developed by Porter and his colleagues, is called the Organizational Commitment Questionnaire. Satisfactory test-retest reliabilities and internal consistency reliabilities were found. (Author)

  7. Keeping Score for Organizational Performance.

    ERIC Educational Resources Information Center

    Prewitt, Vana

    2001-01-01

    Discussion of the balanced scorecard (BSC) as a performance management tool focuses on common mistakes and problems with implementing it. Topics include the need for intraorganizational communication and collaboration; strategic thinking; organizational goals; purposes of measurements; individual accountability; and setting priorities. (LRW)

  8. Organizational change: Incentives and resistance

    NASA Technical Reports Server (NTRS)

    Bishop, Peter C.

    1992-01-01

    Topics concerning Space Exploration Initiative technical interchange are presented in viewgraph form and include the following: models of change, elements of the current period, the signs of change, leaders' contribution, paradigms - our worldview, paradigm change, the effects of revealing paradigms, a checklist for change, and organizational control.

  9. Physical Education Teachers' Organizational Commitment

    ERIC Educational Resources Information Center

    Demir, Hayri

    2013-01-01

    The aim of this study was to determine physical education teachers' organizational commitment levels. The sample consisted of 204 physical education teachers working in the city center of Konya in the 2011 to 2012 academic year. The respondents were randomly selected in this research. Data collected for this research by using the Scale for…

  10. The Virtues of Organizational Integrity

    ERIC Educational Resources Information Center

    Young, Robert B.

    2011-01-01

    In this chapter, the author begins by describing the organizational virtues that are associated with structural and ethical integrity. Virtues are the focus instead of behaviors, traits, or values, because virtues contain all these components: the stable characteristics of traits, the behaviors that are evidence of traits, and the values that…

  11. Organizational change: Incentives and resistance

    NASA Astrophysics Data System (ADS)

    Bishop, Peter C.

    Topics concerning Space Exploration Initiative technical interchange are presented in viewgraph form and include the following: models of change, elements of the current period, the signs of change, leaders' contribution, paradigms - our worldview, paradigm change, the effects of revealing paradigms, a checklist for change, and organizational control.

  12. Understanding and Shaping Organizational Culture.

    ERIC Educational Resources Information Center

    Cherrey, Cynthia

    1990-01-01

    Organizational culture is difficult to change, but the norms that exist are the easiest elements to identify and change. Even if changing the norms is not desirable, it is essential to understand and articulate them. A change in cultural norms is communicated through new expectations, different language, and new behaviors. (MSE)

  13. Ghosts: Gateway to Organizational Transformation.

    ERIC Educational Resources Information Center

    Weitzel, Tim; Had, Gary

    2001-01-01

    "Ghosts" are elements that influence an organization's view of itself, its ways of working, and its culturally specific attitudes; they exert an indirect influence over everything that happens within an organization. Successful organizational change requires identifying and integrating these ghosts. (JOW)

  14. Learning Resources in Organizational Communication.

    ERIC Educational Resources Information Center

    Hickson, Mark, III

    1974-01-01

    Organizational communication, because of its interdisciplinary nature and diversity of interest (sociology, psychology, speech communication, and business administration), requries reading in several different disciplines. Among the available resources listed in this document are six specific books which may prove useful for understanding the…

  15. Communicating Change in Organizational Chaos.

    ERIC Educational Resources Information Center

    Payne, Kay E.

    A study examined the reactions of organizational members to ownership change. Participant observation during a 2-week stay in each of two national corporations, American Broadcasting Company (ABC) and Union Underwear, provided data in the study. Results showed different reactions to change illustrated through corporate differences in structure,…

  16. Expectation Effects in Organizational Change

    ERIC Educational Resources Information Center

    King, Albert S.

    1974-01-01

    The experiment reported here was conducted during a 12-month period at four plants owned by the same company. Managers were given artificial reports about previous findings obtained in implementing job enlargement and job rotation programs. Led to expect higher productivity as a result of these organizational innovations, the managers increased…

  17. The Enigma of Organizational Effectiveness.

    ERIC Educational Resources Information Center

    Cameron, Kim

    1981-01-01

    Organizational effectiveness is not a clearly defined concept. The author illustrates how the four most widely used models are not uniformly applicable. He states the evaluator must make explicit certain critical choices when measuring effectiveness. These criteria reveal the definition of effectiveness and what is being measured. (DWH)

  18. Idiosyncratic Deals and Organizational Commitment

    ERIC Educational Resources Information Center

    Ng, Thomas W. H.; Feldman, Daniel C.

    2010-01-01

    This article examines the relationship between idiosyncratic deals and organizational commitment. In particular, it examines how two individual differences which reflect self-worth (core self-evaluations and age) moderate that relationship. We predicted that employees with feelings of high self-worth will expect and will feel entitled to these…

  19. Faculty Organizational Commitment and Citizenship

    ERIC Educational Resources Information Center

    Lawrence, Janet; Ott, Molly; Bell, Alli

    2012-01-01

    Building on a theoretical framework that links characteristics of individuals and their work settings to organizational commitment (OC) and citizenship behavior, this study considers why faculty may be disengaging from institutional service. Analyses of survey data collected from a state system of higher education suggest that job characteristics,…

  20. Linking Outcomes to Organizational Planning.

    ERIC Educational Resources Information Center

    Ligon, Glynn; Jackson, Elaine

    Linking Outcomes to Organizational Planning (LOOP) was initiated during the 1984-85 school year in the Austin (Texas) Independent School District. LOOP was designed to ensure that evaluation, research, and informal findings became part of the instructional planning loop; to provide information to the Superintendent on progress toward priorities…

  1. Barriers, Successes and Enabling Practices of Education for Sustainability in Far North Queensland Schools: A Case Study

    ERIC Educational Resources Information Center

    Evans, Neus; Whitehouse, Hilary; Gooch, Margaret

    2012-01-01

    There are many documented barriers to implementing school-based sustainability. This article examines a) the barriers faced by principals and staff in two regional primary schools in Far North Queensland, Australia, well known for their exemplary practice, and b) ways the barriers were overcome. Through interviews conducted with principals and key…

  2. Disease management in Canada: surmounting barriers to adoption.

    PubMed

    Gallant, Christopher R; MacKinnon, Neil J; Sprague, Denise A

    2007-01-01

    Disease Management (DM) programs are used to optimize economic outcomes and improve patient outcomes. Despite this, relative to the United States, Canadian health care organizations have been slow to adopt them. The objective of this article is to examine the concept of DM programs, the existing evidence to support their use and the barriers to their adoption in Canada. Several solutions aimed at overcoming the barriers to DM in Canada are proposed.

  3. Barriers to Industrial Energy Efficiency - Study (Appendix A), June 2015

    SciTech Connect

    2015-06-01

    This study examines barriers that impede the adoption of energy efficient technologies and practices in the industrial sector, and identifies successful examples and opportunities to overcome these barriers. Three groups of energy efficiency technologies and measures were examined: industrial end-use energy efficiency, industrial demand response, and industrial combined heat and power. This study also includes the estimated economic benefits from hypothetical Federal energy efficiency matching grants, as directed by the Act.

  4. Barriers to Industrial Energy Efficiency - Report to Congress, June 2015

    SciTech Connect

    2015-06-01

    This report examines barriers that impede the adoption of energy efficient technologies and practices in the industrial sector, and identifies successful examples and opportunities to overcome these barriers. Three groups of energy efficiency technologies and measures were examined: industrial end-use energy efficiency, industrial demand response, and industrial combined heat and power. This report also includes the estimated economic benefits from hypothetical Federal energy efficiency matching grants, as directed by the Act.

  5. Barriers Preventing the Reporting of Child Abuse and Neglect: A Comparison of School Social Workers in Public and Private Settings

    ERIC Educational Resources Information Center

    Girgus, Janet S.

    2010-01-01

    Timely and accurate reporting of suspected child abuse and neglect is essential to protect victimized children; however, there are barriers to such reporting. The importance of barriers may be based on organizational theories that suggest structure has an impact on behavior independent of individual factors and on identity theory which suggests…

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

    PubMed

    Maria, R; Chagas, T; Silva, V

    2012-01-01

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

  7. Systems approach-based mitigation of postharvest diseases to overcome trade barriers for Washington apples

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Speck rot caused by Phacidiopycnis washingtonensis and Sphaeropsis rot caused by S. pyriputrescens were reported as new postharvest fruit rot diseases in Washington State in the mid-2000s. Both diseases can cause significant postharvest losses of fruit if left uncontrolled, and the two fungi have be...

  8. Overcoming the Barriers to Uptake: A Study of 6 Danish Health-Based Serious Games Projects

    ERIC Educational Resources Information Center

    Brown, Damian

    2013-01-01

    Serious gaming for health benefits is moving out of the realm of being potentially interesting, and the authors are starting to see a growing maturity in the field. This study of six serious gaming projects based either wholly or partly in Denmark investigates the changes taking place in the healthcare area based on experiences with serious gaming…

  9. Hematopoiesis from human embryonic stem cells: overcoming the immune barrier in stem cell therapies.

    PubMed

    Priddle, Helen; Jones, D Rhodri E; Burridge, Paul W; Patient, Roger

    2006-04-01

    The multipotency and proliferative capacity of human embryonic stem cells (hESCs) make them a promising source of stem cells for transplant therapies and of vital importance given the shortage in organ donation. Recent studies suggest some immune privilege associated with hESC-derived tissues. However, the adaptability of the immune system makes it unlikely that fully differentiated tissues will permanently evade immune rejection. One promising solution is to induce a state of immune tolerance to a hESC line using tolerogenic hematopoietic cells derived from it. This could provide acceptance of other differentiated tissues from the same line. However, this approach will require efficient multilineage hematopoiesis from hESCs. This review proposes that more efficient differentiation of hESCs to the tolerogenic cell types required is most likely to occur through applying knowledge gained of the ontogeny of complex regulatory signals used by the embryo for definitive hematopoietic development in vivo. Stepwise formation of mesoderm, induction of definitive hematopoietic stem cells, and the application of factors key to their self-renewal may improve in vitro production both quantitatively and qualitatively.

  10. Overcoming perceptions of financial barriers to rotavirus vaccine introduction in Asia.

    PubMed

    Nelson, E Anthony S; de Quadros, Ciro A; Santosham, Mathuram; Parashar, Umesh D; Steele, Duncan

    2013-11-01

    Despite a WHO recommendation in 2009, reaffirmed in 2013, that all countries should consider introducing rotavirus vaccines into their National Immunization Programs, as of June 2013 only 45 have done so. One major consideration appears to have been the costs of the vaccine to countries. Of concern, is that Asian countries have been slow to introduce rotavirus vaccines despite having robust data that could inform the decision-making process. Although decisions on new vaccine introduction are very complex and vary by country and region, economic evaluations are often pivotal once vaccine efficacy and safety has been established, and disease burden documented and communicated. Unfortunately, with private sector list prices of vaccines often used in economic evaluations, rather than a potential public health sector pricing structure, policy-makers may defer decisions on rotavirus vaccine introduction based on the belief that "the vaccine price is too high," even though this might be based on erroneous data. The Pan American Health Organization's Revolving Fund provides one example of how vaccine price can be made more competitive and transparent through a regional tendering process. Other mechanisms, such as tiered pricing and UNICEF procurement, also exist that could help Asian and other countries move forward more quickly with rotavirus vaccine introduction.

  11. Overcoming Barriers to the Remediation of Carbon Tetrachloride Through Manipulation of Competing Reaction Mechanisms

    SciTech Connect

    Tratnyek, Paul G.; Amonette, James E.; Bylaska, Eric J.

    2004-03-29

    Most approaches that have been proposed for the remediation of groundwater contaminated with carbon tetrachloride produce chloroform as the major product and methylene chloride as a minor product. Both of these products are nearly as persistent and problematic as the parent compound, but competing reaction pathways produce the more desirable products carbon monoxide and/or formate. Branching between these reaction pathways is highly variable, but the controlling factors have not been identified. To improve the applicability of reductive remediation technologies to the large plumes of carbon tetrachloride at several DOE sites, we are pursuing the complete characterization of the mechanisms and kinetics of competing degradation reactions of carbon tetrachloride through laboratory experiments closely coordinated with theoretical modeling studies. The results are beginning to suggest strategies for maximizing the yield of desirable products from carbon tetrachloride degradation, which will be tested in column model systems using real site waters and matrix materials.

  12. Mobile "Comfort" Zones: Overcoming Barriers to Enable Facilitated Learning in the Workplace

    ERIC Educational Resources Information Center

    Holley, Debbie; Sentance, Sue

    2015-01-01

    The affordances of mobile technologies are well documented (Vavoula (2004); Wali (2008); Pachler et al (2010); Cook (2011); Sharples (2013). Linked with the rapid expansion of the "SMART" phones, where users access fast/high quality information, new opportunities are offered to engage students at a time/place of their own choosing. Our…

  13. Overcoming Barriers in Oncolytic Virotherapy with HDAC Inhibitors and Immune Checkpoint Blockade.

    PubMed

    Marchini, Antonio; Scott, Eleanor M; Rommelaere, Jean

    2016-01-06

    Oncolytic viruses (OVs) target and destroy cancer cells while sparing their normal counterparts. These viruses have been evaluated in numerous studies at both pre-clinical and clinical levels and the recent Food and Drug Administration (FDA) approval of an oncolytic herpesvirus-based treatment raises optimism that OVs will become a therapeutic option for cancer patients. However, to improve clinical outcome, there is a need to increase OV efficacy. In addition to killing cancer cells directly through lysis, OVs can stimulate the induction of anti-tumour immune responses. The host immune system thus represents a "double-edged sword" for oncolytic virotherapy: on the one hand, a robust anti-viral response will limit OV replication and spread; on the other hand, the immune-mediated component of OV therapy may be its most important anti-cancer mechanism. Although the relative contribution of direct viral oncolysis and indirect, immune-mediated oncosuppression to overall OV efficacy is unclear, it is likely that an initial period of vigorous OV multiplication and lytic activity will most optimally set the stage for subsequent adaptive anti-tumour immunity. In this review, we consider the use of histone deacetylase (HDAC) inhibitors as a means of boosting virus replication and lessening the negative impact of innate immunity on the direct oncolytic effect. We also discuss an alternative approach, aimed at potentiating OV-elicited anti-tumour immunity through the blockade of immune checkpoints. We conclude by proposing a two-phase combinatorial strategy in which initial OV replication and spread is maximised through transient HDAC inhibition, with anti-tumour immune responses subsequently enhanced by immune checkpoint blockade.

  14. Setting Learning Analytics in Context: Overcoming the Barriers to Large-Scale Adoption

    ERIC Educational Resources Information Center

    Ferguson, Rebecca; Macfadyen, Leah P.; Clow, Doug; Tynan, Belinda; Alexander, Shirley; Dawson, Shane

    2014-01-01

    A core goal for most learning analytic projects is to move from small-scale research towards broader institutional implementation, but this introduces a new set of challenges because institutions are stable systems, resistant to change. To avoid failure and maximize success, implementation of learning analytics at scale requires explicit and…

  15. Videos Bridging Asia and Africa: Overcoming Cultural and Institutional Barriers in Technology-Mediated Rural Learning

    ERIC Educational Resources Information Center

    Van Mele, Paul; Wanvoeke, Jonas; Akakpo, Cyriaque; Dacko, Rosaline Maiga; Ceesay, Mustapha; Beavogui, Louis; Soumah, Malick; Anyang, Robert

    2010-01-01

    Will African farmers watch and learn from videos featuring farmers in Bangladesh? Learning videos on rice seed management were made with rural women in Bangladesh. By using a new approach, called zooming-in, zooming-out, the videos were of regional relevance and locally appropriate. When the Africa Rice Center (AfricaRice) introduced them to…

  16. Women Community College Presidents: A Qualitative Approach to Exploring Leadership and Overcoming Potential Barriers

    ERIC Educational Resources Information Center

    O'Roark, Jordan J.

    2015-01-01

    Since the establishment of American higher education, the presidential profile for institutions has lacked the gender diversity in presidential leadership positions. Though women have taken positive strides as senior executive officers in higher education in the past quarter-century, the conventional post-secondary president is a white, married…

  17. Overcoming perceptions of financial barriers to rotavirus vaccine introduction in Asia

    PubMed Central

    Nelson, E Anthony S; de Quadros, Ciro A; Santosham, Mathuram; Parashar, Umesh D; Steele, A Duncan

    2013-01-01

    Despite a WHO recommendation in 2009, reaffirmed in 2013, that all countries should consider introducing rotavirus vaccines into their National Immunization Programs, as of June 2013 only 45 have done so. One major consideration appears to have been the costs of the vaccine to countries. Of concern, is that Asian countries have been slow to introduce rotavirus vaccines despite having robust data that could inform the decision-making process. Although decisions on new vaccine introduction are very complex and vary by country and region, economic evaluations are often pivotal once vaccine efficacy and safety has been established, and disease burden documented and communicated. Unfortunately, with private sector list prices of vaccines often used in economic evaluations, rather than a potential public health sector pricing structure, policy-makers may defer decisions on rotavirus vaccine introduction based on the belief that “the vaccine price is too high,” even though this might be based on erroneous data. The Pan American Health Organization’s Revolving Fund provides one example of how vaccine price can be made more competitive and transparent through a regional tendering process. Other mechanisms, such as tiered pricing and UNICEF procurement, also exist that could help Asian and other countries move forward more quickly with rotavirus vaccine introduction. PMID:23955246

  18. Overcoming the stromal barrier for targeted delivery of HPMA copolymers to pancreatic tumors.

    PubMed

    Buckway, Brandon; Wang, Yongjian; Ray, Abhijit; Ghandehari, Hamidreza

    2013-11-01

    Delivery of macromolecules to pancreatic cancer is inhibited by a dense extracellular matrix composed of hyaluronic acid, smooth muscle actin and collagen fibers. Hyaluronic acid causes a high intratumoral fluidic pressure which prevents diffusion and penetration into the pancreatic tumor. This study involves the breaking down of hyaluronic acid by treating CAPAN-1 xenograft tumors in athymic nu/nu mice with targeted N-(2-hydroxypropyl)methacrylamide (HPMA) copolymers radiolabeled with (111)In for single photon emission computerized tomography (SPECT) imaging. Two targeting strategies were investigated including αvβ3 integrin and HER2 receptors. HPMA copolymers were targeted to these receptors by conjugating short peptide ligands cRGDfK and KCCYSL to the side chains of the copolymer. Results demonstrate that tumor targeting can be achieved in vivo after treatment with hyaluronidase. This approach shows promise for enhanced delivery of polymer-peptide conjugates to solid tumors.

  19. Overcoming Barriers in Oncolytic Virotherapy with HDAC Inhibitors and Immune Checkpoint Blockade

    PubMed Central

    Marchini, Antonio; Scott, Eleanor M.; Rommelaere, Jean

    2016-01-01

    Oncolytic viruses (OVs) target and destroy cancer cells while sparing their normal counterparts. These viruses have been evaluated in numerous studies at both pre-clinical and clinical levels and the recent Food and Drug Administration (FDA) approval of an oncolytic herpesvirus-based treatment raises optimism that OVs will become a therapeutic option for cancer patients. However, to improve clinical outcome, there is a need to increase OV efficacy. In addition to killing cancer cells directly through lysis, OVs can stimulate the induction of anti-tumour immune responses. The host immune system thus represents a “double-edged sword” for oncolytic virotherapy: on the one hand, a robust anti-viral response will limit OV replication and spread; on the other hand, the immune-mediated component of OV therapy may be its most important anti-cancer mechanism. Although the relative contribution of direct viral oncolysis and indirect, immune-mediated oncosuppression to overall OV efficacy is unclear, it is likely that an initial period of vigorous OV multiplication and lytic activity will most optimally set the stage for subsequent adaptive anti-tumour immunity. In this review, we consider the use of histone deacetylase (HDAC) inhibitors as a means of boosting virus replication and lessening the negative impact of innate immunity on the direct oncolytic effect. We also discuss an alternative approach, aimed at potentiating OV-elicited anti-tumour immunity through the blockade of immune checkpoints. We conclude by proposing a two-phase combinatorial strategy in which initial OV replication and spread is maximised through transient HDAC inhibition, with anti-tumour immune responses subsequently enhanced by immune checkpoint blockade. PMID:26751469

  20. Using synthetic biology to distinguish and overcome regulatory and functional barriers related to nitrogen fixation.

    PubMed

    Wang, Xia; Yang, Jian-Guo; Chen, Li; Wang, Ji-Long; Cheng, Qi; Dixon, Ray; Wang, Yi-Ping

    2013-01-01

    Biological nitrogen fixation is a complex process requiring multiple genes working in concert. To date, the Klebsiella pneumoniae nif gene cluster, divided into seven operons, is one of the most studied systems. Its nitrogen fixation capacity is subject to complex cascade regulation and physiological limitations. In this report, the entire K. pneumoniae nif gene cluster was reassembled as operon-based BioBrick parts in Escherichia coli. It provided ~100% activity of native K. pneumoniae system. Based on the expression levels of these BioBrick parts, a T7 RNA polymerase-LacI expression system was used to replace the σ(54)-dependent promoters located upstream of nif operons. Expression patterns of nif operons were critical for the maximum activity of the recombinant system. By mimicking these expression levels with variable-strength T7-dependent promoters, ~42% of the nitrogenase activity of the σ(54)-dependent nif system was achieved in E. coli. When the newly constructed T7-dependent nif system was challenged with different genetic and physiological conditions, it bypassed the original complex regulatory circuits, with minor physiological limitations. Therefore, we have successfully replaced the nif regulatory elements with a simple expression system that may provide the first step for further research of introducing nif genes into eukaryotic organelles, which has considerable potentials in agro-biotechnology.

  1. Overcoming Barriers to Educational Analytics: How Systems Thinking and Pragmatism Can Help

    ERIC Educational Resources Information Center

    Macfadyen, Leah P.

    2017-01-01

    Learning technologies are now commonplace in education, and generate large volumes of educational data. Scholars have argued that analytics can and should be employed to optimize learning and learning environments. This article explores what is really meant by "analytics", describes the current best-known examples of institutional…

  2. Overcoming Language Barriers in Health Care: Costs and Benefits of Interpreter Services

    PubMed Central

    Jacobs, Elizabeth A.; Shepard, Donald S.; Suaya, Jose A.; Stone, Esta-Lee

    2004-01-01

    Objectives. We assessed the impact of interpreter services on the cost and the utilization of health care services among patients with limited English proficiency. Methods. We measured the change in delivery and cost of care provided to patients enrolled in a health maintenance organization before and after interpreter services were implemented. Results. Compared with English-speaking patients, patients who used the interpreter services received significantly more recommended preventive services, made more office visits, and had more prescriptions written and filled. The estimated cost of providing interpreter services was $279 per person per year. Conclusions. Providing interpreter services is a financially viable method for enhancing delivery of health care to patients with limited English proficiency. PMID:15117713

  3. Evolving from academic to academic entrepreneur: overcoming barriers to scientific progress and finance.

    PubMed

    Miller, Andrew D

    2016-07-01

    The overall goal of my career as an academic chemist has always been the design and creation of advanced therapeutics and diagnostics that address unmet medical need in the management of chronic diseases. Realising this goal has been an immensely difficult process involving multidisciplinary problem-driven research at the chemistry-biology-medicine interfaces. With success in the laboratory, I started seriously to question the value of remaining an academic whose career is spent in the pursuit of knowledge and understanding alone without making any significant effort to translate knowledge and understanding gained into products of genuine utility for public benefit. Therefore, I elected by choice to become an academic entrepreneur, seeking opportunities wherever possible for the translation of the best of my personal and collaborative academic research work into potentially valuable and useful products. This choice has brought with it many unexpected difficulties and challenges. Nevertheless, progress bas been made and sufficient learnt to suggest that this would be an appropriate moment to take stock and provide some personal reflections on what it takes to design and create advanced therapeutics and diagnostics in the laboratory then seek to develop, innovate and translate the best towards market.

  4. Colonisation in social species: the importance of breeding experience for dispersal in overcoming information barriers

    PubMed Central

    Payo-Payo, A.; Genovart, M.; Sanz-Aguilar, A.; Greño, J. L.; García-Tarrasón, M.; Bertolero, A.; Piccardo, J.; Oro, D.

    2017-01-01

    Studying colonisation is crucial to understand metapopulations, evolutionary ecology and species resilience to global change. Unfortunately, few empirical data are available because field monitoring that includes empty patches at large spatiotemporal scales is required. We examine the colonisation dynamics of a long-lived seabird over 34 years in the western Mediterranean by comparing population and individual data from both source colony and the newly-formed colonies. Since social information is not available, we hypothesize that colonisation should follow particular dispersal dynamics and personal information must be crucial in decision making. We test if adverse breeding conditions trigger colonisation events, if personal information plays a role in colonisation and if colonisers experience greater fitness. Our results show a temporal mismatch between colonisation events and both density-dependence and perturbations at the source colony, probably because colonisers needed a longer prospecting period to compensate for the lack of public information. Colonisers were mostly experienced individuals gaining higher breeding success in the new colony. Our results highlight the demographic value that experienced individuals can have on metapopulation dynamics of social long-lived organisms. PMID:28211483

  5. Primary health care in developing countries: overcoming operational, technical, and social barriers.

    PubMed

    Chen, L C

    1986-11-29

    An analysis of survey data from Matlab, Bangladesh, suggests that the provision of primary health care is a more complex process than is reflected by current strategies. The Bangladesh experience indicates that single-outcome indicators (e.g., deaths averted) for assessing the effect of health measures, while necessary for comparing the cost-effectiveness of various approaches, rarely encapsulate all the aims of an intervention. For example, in the year after the introduction in Matlab of modern contraception and tetanus immunization for pregnant women, the intervention population had ab0ut a 25% lower crude birth and death rate, yet little difference was observed in infant mortality rates. Policies aimed at contering single diseases may cause factors such as nutrition, which has important biosocial interactions with infection, to be undervalued. Rather than viewing childhood morality in relation to specific diseases--an approach that promotes an emphsis on tchnology--childhood mortality should be seen as the result of sequential insults accumulated over time. the reluctance of eligible women to accept tetanus vaccine and the greater utilization of diarrhea treatment services for male than female children are examples of the significance of the demand factor. Also needed is improved knowledge of the interaction between the structure of health care delivery systems and a population's political economy. Public investments for primary health care in India have been targeted to large-scale public systems operated by a bureaucracy biased toward procedure rather than performance. Finally, future research should incorporate the strengths of both the natural and the social sciencs.

  6. Overcoming Barriers: Tailoring Climate Education for Latino and non-Latino Citizen to Impact Decision Making

    NASA Astrophysics Data System (ADS)

    Estrada, M.; Boudrias, M. A.; Silva-Send, N. J.; Gershunov, A.; Anders, S.

    2013-12-01

    Culture has been shown to be an important determinant of Latino/Hispanic American environmental attitudes (Schultz, Unipan, & Gamba, 2000), which might help to explain the underrepresentation of Latinos in the U.S. 'environmental' movement. With shifting U.S. demographics, however, there is increased urgency to understand how Latinos integrate into the community that is concerned and literate about climate change. As part of the Climate Education Partners (CEP) work in San Diego, we investigated how to address this ethnic group disparity. In this paper, we describe a study of how climate change science knowledge relates to Latino and Non-Latino citizen (a) engagement in conservation behaviors and (b) more informed decision-making. Drawing upon previous work on the Tripartite Integration Model of Social Influence (TIMSI) (Estrada et al., 2011), we hypothesized that climate change knowledge that promotes efficacy (i.e., a sense that one can do something) would relate to greater engagement in conservation behaviors and more informed decision-making (both common of community members concerned about climate change). To test this model, 1001 San Diego residence participated in a telephone survey in which the attitudes towards climate change were assessed using '6 Americas' segmentation (Leiserowitz et al., 2011), in addition to climate change science knowledge, efficacy, values, and engagement in weekly and yearly climate change friendly behaviors (e.g., conservation, transportation, community engagement behaviors). Results showed that there were significant differences in the 6 America segmentation distributions, knowledge, efficacy and behavioral engagement with Latinos significantly more concerned than Non-Latinos, and reporting greater knowledge, efficacy and engagement in behaviors. However, data from both groups showed support for the TIMSI theoretical framework, such that efficacy mediated the relationship between climate change knowledge and behavior. Thus, for both groups, climate change science knowledge was more likely to result in behavioral engagement when the science knowledge was accompanied with the belief that one has the ability to engage in behaviors that mitigate or adapt to climate change (i.e., efficacy). Implications for how to improve both Latino and Non-Latino climate change education that results in informed decision-making and greater integration into the community concerned about climate change will be discussed.

  7. Using Synthetic Biology to Distinguish and Overcome Regulatory and Functional Barriers Related to Nitrogen Fixation

    PubMed Central

    Wang, Xia; Yang, Jian-Guo; Chen, Li; Wang, Ji-Long; Cheng, Qi; Dixon, Ray; Wang, Yi-Ping

    2013-01-01

    Biological nitrogen fixation is a complex process requiring multiple genes working in concert. To date, the Klebsiella pneumoniae nif gene cluster, divided into seven operons, is one of the most studied systems. Its nitrogen fixation capacity is subject to complex cascade regulation and physiological limitations. In this report, the entire K. pneumoniae nif gene cluster was reassembled as operon-based BioBrick parts in Escherichia coli. It provided ∼100% activity of native K. pneumoniae system. Based on the expression levels of these BioBrick parts, a T7 RNA polymerase–LacI expression system was used to replace the σ54-dependent promoters located upstream of nif operons. Expression patterns of nif operons were critical for the maximum activity of the recombinant system. By mimicking these expression levels with variable-strength T7-dependent promoters, ∼42% of the nitrogenase activity of the σ54-dependent nif system was achieved in E. coli. When the newly constructed T7-dependent nif system was challenged with different genetic and physiological conditions, it bypassed the original complex regulatory circuits, with minor physiological limitations. Therefore, we have successfully replaced the nif regulatory elements with a simple expression system that may provide the first step for further research of introducing nif genes into eukaryotic organelles, which has considerable potentials in agro-biotechnology. PMID:23935879

  8. Can An Academic Health Care System Overcome Barriers to Clinical Guideline Implementation?

    DTIC Science & Technology

    2005-01-01

    Cardiology/ American Heart Association (ACC/AHA) practice guidelines state that the utilization of beta- blockers in patients with known coronary disease or...surgery: a report of the American College of Cardiology/ American Heart Association task force on practice guidelines [American College of Cardiology

  9. Overcoming the Practical Barriers to Spinal Cord Cell Transplantation for ALS

    DTIC Science & Technology

    2014-10-01

    Multilevel Intraspinal Stem Cell Therapy for Amyotrophic Lateral Sclerosis (ALS). Congress of Neurological Surgeons Annual Meeting (Boston, October...NM. Preclinical Validation of Multilevel Intraspinal Stem Cell Therapy for Amyotrophic Lateral Sclerosis (ALS). Submitted. Appendix 3...transplant and serially post-transplant. Furthermore, plasma was collected from six patients with Amyotrophic Lateral Sclerosis enrolled in the Phase 1

  10. Older Teens in TANF Families: Overcoming Barriers to Self-Sufficiency.

    ERIC Educational Resources Information Center

    Kaplan, Jan

    2001-01-01

    Older teens living in families receiving Temporary Assistance to Needy Families (TANF) face serious sociodemographic disadvantages. When combined with the characteristic risk-taking behaviors of adolescence, these disadvantages pose a threat to TANF teens' immediate and future physical, psychological, and emotional health and to their long-term…

  11. Understanding and overcoming barriers to timely discharge from the pediatric units

    PubMed Central

    Mustafa, Amira; Mahgoub, Samar

    2016-01-01

    Delays in the discharge of hospital patients cause a backlog for new admissions from the Emergency Departments (ED), outpatient clinics, and transfers from the Intensive Care Units (ICU). A variety of initiatives have been reported on previously which aim to tackle this problem with variable success. In this quality improvement project, we aimed to increase the proportion of discharged patients who leave the paediatric unit by 12:00 Noon from 7% to 30% by May 2015. A baseline discharge process map was studied to understand the possible causes of the delays. A survey was conducted to look for the most likely cause for the delay. A data collection tool was designed to record the various steps in the discharge process for the pre-and post-intervention phases. Using a series of PDSA cycles, interventions were introduced. The average time for the discharge process was two hours and the baseline average percent of patients discharged by 12:00 Noon was 7% of all discharges. The leading cause for the delayed discharges was late orders by the physicians. Post-intervention, there was increase in the percentage of patients discharged by 12:00 Noon from 7% to 34%. 42% of discharged patients had appropriate reasons for afternoon discharge. By excluding these patients, the percentage of adjusted timely morning discharge has increased from 36% to 70%. Continuous monitoring and engagement of teams with regular feedback were the most important factors in achieving and sustaining improvement in the timely morning discharge of patients from our paediatric units. PMID:27752313

  12. Overcoming the nail barrier: A systematic investigation of ungual chemical penetration enhancement.

    PubMed

    Brown, M B; Khengar, R H; Turner, R B; Forbes, B; Traynor, M J; Evans, C R G; Jones, S A

    2009-03-31

    This study investigated the in vitro nail permeability of penetrants of varying lipophilicity-caffeine (CF, logP -0.07), methylparaben (MP, logP 1.96) and terbinafine (TBF, logP 3.3) and the effect of 2 novel penetration enhancers (PEs), thioglycolic acid (TA) and urea hydrogen peroxide (urea H(2)O(2)) on their permeation. Studies were conducted using full thickness human nail clippings and ChubTur((R)) diffusion cells and penetrants were applied as saturated solutions. The rank order of steady-state penetrant flux through nails without PE application (MP>CF>TBF) suggested a greater sensitivity to penetrant molecular weight rather than logP. TA increased the flux of CF and MP approximately 4- and approximately 2-fold, respectively, whilst urea H(2)O(2) proved ineffective at enhancing permeability. The sequential application of TA followed by urea H(2)O(2) increased TBF and CF flux ( approximately 19- and approximately 4-fold, respectively) but reversing the application order of the PEs was only mildly effective at increasing just MP flux ( approximately 2-fold). Both nail PEs are likely to function via disruption of keratin disulphide bonds and the associated formation of pores that provide more 'open' drug transport channels. Effects of the PEs were penetrant specific, but the use of a reducing agent (TA) followed by an oxidising agent (urea H(2)O(2)) dramatically improved human nail penetration.

  13. Overcoming Medicaid Reimbursement Barriers to Funding School Nursing Services for Low-Income Children with Asthma

    ERIC Educational Resources Information Center

    Malcarney, Mary-Beth; Horton, Katherine; Seiler, Naomi

    2016-01-01

    Background: School nurses can provide direct services for children with asthma, educate, and reinforce treatment recommendations to children and their families, and coordinate the school-wide response to students' asthma emergencies. Unfortunately, school-based health services today depend on an unreliable patchwork of funding. Limited state and…

  14. Overcoming Barriers to Improve Breastfeeding Self-Efficacy in Older Adolescent Mothers

    ERIC Educational Resources Information Center

    Beattie-Fairchild, Cindy

    2013-01-01

    A lack of breastfeeding has negative consequences on mother and infant by creating health disparities with a higher incidence of morbidity and mortality. Nationwide, fewer than 60% of mothers younger than age 20 years breastfed exclusively, while fewer than 20% did so in the community being studied. The purpose of this qualitative case study was…

  15. Education for All Aspects of the Industry: Overcoming Barriers to Broad-Based Training.

    ERIC Educational Resources Information Center

    Bailey, Thomas; And Others

    This report is designed to help the educational community develop the "all aspects of the industry" (AAI) strategy promoted in the Perkins Vocational Education Act. The introduction describes the current status of AAI and elaborates on three arguments for it: (1) AAI is a pedagogic strategy that promotes more effective learning; (2) better…

  16. Colonisation in social species: the importance of breeding experience for dispersal in overcoming information barriers

    NASA Astrophysics Data System (ADS)

    Payo-Payo, A.; Genovart, M.; Sanz-Aguilar, A.; Greño, J. L.; García-Tarrasón, M.; Bertolero, A.; Piccardo, J.; Oro, D.

    2017-02-01

    Studying colonisation is crucial to understand metapopulations, evolutionary ecology and species resilience to global change. Unfortunately, few empirical data are available because field monitoring that includes empty patches at large spatiotemporal scales is required. We examine the colonisation dynamics of a long-lived seabird over 34 years in the western Mediterranean by comparing population and individual data from both source colony and the newly-formed colonies. Since social information is not available, we hypothesize that colonisation should follow particular dispersal dynamics and personal information must be crucial in decision making. We test if adverse breeding conditions trigger colonisation events, if personal information plays a role in colonisation and if colonisers experience greater fitness. Our results show a temporal mismatch between colonisation events and both density-dependence and perturbations at the source colony, probably because colonisers needed a longer prospecting period to compensate for the lack of public information. Colonisers were mostly experienced individuals gaining higher breeding success in the new colony. Our results highlight the demographic value that experienced individuals can have on metapopulation dynamics of social long-lived organisms.

  17. Overcoming the Barriers of Civil/Military Industrial Integration and of Buying Commercial Goods and Services

    DTIC Science & Technology

    2015-05-13

    Chair Director, Center for Public Policy and Private Enterprise School of Public Policy University of Maryland Naval Postgraduate School 12th...University of Maryland,School of Public Policy/Center for Public Policy and Private Enterprise,2101 Van Munching Hall ,College Park,MD,20742 8...Property • Extensive Oversight and auditing • 50% Depot law (on maintenance and “core” work) • Legislative Elimination of Public / Private competitions

  18. Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study

    DTIC Science & Technology

    2011-06-01

    inadequate previous education -low health literacy Presence of co-morbidities interfering with self-care -cognitive dysfunction -depression...suggesting overall problems with adherence, and were having trouble reading food labels (p=0.05) suggesting possible problems with health literacy . Higher

  19. Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study

    DTIC Science & Technology

    2009-06-01

    food labels (p=0.05), suggesting possible problems with health literacy . Higher frequency of falls, fear of falls, and difficulty walking were more...problems with health literacy . Higher frequency of falls, fear of falls, and difficulty walking were more common in the group having problems taking

  20. Overcoming Barriers in the Use of Adaptive and Assistive Technology in Special Education.

    ERIC Educational Resources Information Center

    Bushrow, Kathy M.; Turner, Keith D.

    This paper examines change and change facilitators as they affect full use of adaptive and assistive technology (AAT) in special education, and compares qualitative versus quantitative methods of researching the change process. Four administrators and two teachers from a rural school district completed the Stages of Concern Questionnaire, which…

  1. Overcoming Unintentional Barriers with Intentional Strategies: Educating Faculty about Student Disabilities

    ERIC Educational Resources Information Center

    Forrest, Krista D.

    2003-01-01

    Krista Forrest is an Assistant Professor in the Department of Psychology at the University of Nebraska at Kearney, where she teaches general psychology and life span development as well as advanced courses in adolescent psychology, group dynamics, and psychology and law. A graduate of North Carolina State University with a MS in developmental…

  2. Workflow technology: the new frontier. How to overcome the barriers and join the future.

    PubMed

    Shefter, Susan M

    2006-01-01

    Hospitals are catching up to the business world in the introduction of technology systems that support professional practice and workflow. The field of case management is highly complex and interrelates with diverse groups in diverse locations. The last few years have seen the introduction of Workflow Technology Tools, which can improve the quality and efficiency of discharge planning by the case manager. Despite the availability of these wonderful new programs, many case managers are hesitant to adopt the new technology and workflow. For a myriad of reasons, a computer-based workflow system can seem like a brick wall. This article discusses, from a practitioner's point of view, how professionals can gain confidence and skill to get around the brick wall and join the future.

  3. Overcoming the Language Barrier. Third European Congress on Information Systems and Networks, Vol. 1.

    ERIC Educational Resources Information Center

    Commission des Communautes Europeennes (Luxembourg).

    The papers presented here have a double objective: to give those responsible for the Action plan for the improvement of information transfer between European languages a good view of existing and developing systems and to make future users of EURONET acquainted with methods and tools that will soon be available. The papers are arranged under six…

  4. Educational Planning for the Gifted. Overcoming Cultural, Geographic and Socioeconomic Barriers

    ERIC Educational Resources Information Center

    Baldwin, Alexinia Y., Ed.; And Others

    The book presents theoretical considerations and practical recommendations concerned with school planning for gifted children who might not be identified nor have an opportunity to develop their mental capacities because of external influences such as cultural diversity, socioeconomic status, or geographic isolation. Six different approaches to…

  5. Overcoming the Practical Barriers to Spinal Cord Cell Transplantation for ALS

    DTIC Science & Technology

    2012-10-01

    first utilized oriP/EBNA1 ( Epstein - Barr nuclear antigen-1)-based reprogramming vectors that utilize episomal expression of the 6 pluripotency factors...phenotype observed in during transplantation. Non-integrating methods, such as plasmid-based and Sendai single-stranded RNA viruses , avoid random...reprogramming factors is required in Yucatan minipig cells. Recently, Sendai virus (SeV)-based reprogramming technology has been reported as an

  6. Achieving Cross-Domain Synergy: Overcoming Service Barriers to Joint Force 2020

    DTIC Science & Technology

    2014-06-13

    Davis, Mr. Russ Crumrine, and Mr. Kevin Gentzler for their continued support during this lengthy process . Your prompt feedback and excellent guidance...and guiding me every step of the way. I know that this process has helped me to see the big picture and has developed my understanding of military...Component Commander JOAC Joint Operational Access Concept JOPP Joint Operational Planning Process JOPPA Joint Operational Planning Process Air

  7. Confidence-Based Learning CME: Overcoming Barriers in Irritable Bowel Syndrome with Constipation

    ERIC Educational Resources Information Center

    Cash, Brooks; Mitchner, Natasha A.; Ravyn, Dana

    2011-01-01

    Introduction: Performance of health care professionals depends on both medical knowledge and the certainty with which they possess it. Conventional continuing medical education interventions assess the correctness of learners' responses but do not determine the degree of confidence with which they hold incorrect information. This study describes…

  8. Overcoming language and literacy barriers in safety and health training of agricultural workers.

    PubMed

    Arcury, Thomas A; Estrada, Jorge M; Quandt, Sara A

    2010-07-01

    The workforce in all areas of United States agriculture and forestry is becoming increasingly diverse in language, culture, and education. Many agricultural workers are immigrants who have limited English language skills and limited educational attainment. Providing safety and health training to this large, diverse, dispersed, and often transient population of workers is challenging. This review, prepared for the 2010 Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," is divided into five sections. First, we describe the occupational and demographic characteristics of agricultural workers in the United States to highlight their safety and health training needs. Second, we summarize current research on the social and cultural attributes of agricultural workers and agricultural employers that affect the provision of safety and health training. Worker and employer attributes include language, literacy, financial limitations, work beliefs, and health beliefs. Third, we review current initiatives addressing safety and health training for agricultural workers that consider worker language and literacy. These initiatives are limited to a few specific topics (e.g., pesticides, heat stress); they do not provide general programs of safety training that would help establish a culture of workplace safety. However, several innovative approaches to health and safety training are being implemented, including the use of community-based participatory approaches and lay health promoter programs. Fourth, the limited industry response for safety training with this linguistically diverse and educationally limited workforce is summarized. Finally, gaps in knowledge and practice are summarized and recommendations to develop educationally, culturally, and linguistically appropriate safety and health training are presented.

  9. Overcoming Psychosocial Barriers to Maternal Exercise: Intervention Strategies to Improve Participation and Adherence

    ERIC Educational Resources Information Center

    Schoenfeld, Brad; Tiryaki-Sonmez, Gul

    2011-01-01

    Poor adherence to physical activity programmes during pregnancy is a serious national issue, one that has detrimental effects on a large percentage of the population. Not only does a lack of activity result in a decrease in quality of life for women during term, but the effects can carry over well after pregnancy, potentially leading to increased…

  10. Tropism-modified AAV vectors overcome barriers to successful cutaneous therapy.

    PubMed

    Sallach, Jessica; Di Pasquale, Giovanni; Larcher, Fernando; Niehoff, Nadine; Rübsam, Matthias; Huber, Anke; Chiorini, Jay; Almarza, David; Eming, Sabine A; Ulus, Hikmet; Nishimura, Stephen; Hacker, Ulrich T; Hallek, Michael; Niessen, Carien M; Büning, Hildegard

    2014-05-01

    Autologous human keratinocytes (HK) forming sheet grafts are approved as skin substitutes. Genetic engineering of HK represents a promising technique to improve engraftment and survival of transplants. Although efficacious in keratinocyte-directed gene transfer, retro-/lentiviral vectors may raise safety concerns when applied in regenerative medicine. We therefore optimized adeno-associated viral (AAV) vectors of the serotype 2, characterized by an excellent safety profile, but lacking natural tropism for HK, through capsid engineering. Peptides, selected by AAV peptide display, engaged novel receptors that increased cell entry efficiency by up to 2,500-fold. The novel targeting vectors transduced HK with high efficiency and a remarkable specificity even in mixed cultures of HK and feeder cells. Moreover, differentiated keratinocytes in organotypic airlifted three-dimensional cultures were transduced following topical vector application. By exploiting comparative gene analysis we further succeeded in identifying αvβ8 integrin as a target receptor thus solving a major challenge of directed evolution approaches and describing a promising candidate receptor for cutaneous gene therapy.

  11. Overcoming Language and Literacy Barriers in Safety and Health Training of Agricultural Workers

    PubMed Central

    Arcury, Thomas A.; Estrada, Jorge M.; Quandt, Sara A.

    2010-01-01

    The workforce in all areas of United States agriculture and forestry is becoming increasingly diverse in language, culture, and education. Many agricultural workers are immigrants who have limited English language skills and limited educational attainment. Providing safety and health training to this large, diverse, dispersed, and often transient population of workers is challenging. This review, prepared for the 2010 Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, “Be Safe, Be Profitable: Protecting Workers in Agriculture,” is divided into five sections. First, we describe the occupational and demographic characteristics of agricultural workers in the US to highlight their safety and health training needs. Second, we summarize current research on the social and cultural attributes of agricultural workers and agricultural employers that affect the provision of safety and health training. Worker and employer attributes include language, literacy, financial limitations, work beliefs, and health beliefs. Third, we review current initiatives addressing safety and health training for agricultural workers that consider worker language and literacy. These initiatives are limited to a few specific topics (e.g., pesticides, heat stress); they do not provide general programs of safety training that would help establish a culture of workplace safety. However, several innovative approaches to health and safety training are being implemented, including the use of community-based participatory approaches and lay health promoter programs. Fourth, the limited industry response for safety training with this linguistically diverse and educationally limited workforce is summarized. Finally, gaps in knowledge and practice are summarized and recommendations to develop educationally, culturally, and linguistically appropriate safety and health training are presented. PMID:20665309

  12. Overcoming the Barrier of Low Efficiency during Genetic Transformation of Streptococcus mitis

    PubMed Central

    Salvadori, Gabriela; Junges, Roger; Morrison, Donald A.; Petersen, Fernanda C.

    2016-01-01

    Objective: Streptococcus mitis is a predominant oral colonizer, but difficulties in genetic manipulation of this species have hampered our understanding of the mechanisms it uses for colonization of oral surfaces. The aim of this study was to reveal optimal conditions for natural genetic transformation in S. mitis and illustrate its application in direct genome editing. Methods: Luciferase reporter assays were used to assess gene expression of the alternative sigma factor (σX) in combination with natural transformation experiments to evaluate the efficiency by which S. mitis activates the competence system and incorporates exogenous DNA. Optimal amounts and sources of donor DNA (chromosomal, amplicon, or replicative plasmid), concentrations of synthetic competence-stimulating peptide, and transformation media were assessed. Results: A semi-defined medium showed much improved results for response to the competence stimulating peptide when compared to rich media. The use of a donor amplicon with large homology flanking regions also provided higher transformation rates. Overall, an increase of transformation efficiencies from 0.001% or less to over 30% was achieved with the developed protocol. We further describe the construction of a markerless mutant based on this high efficiency strategy. Conclusion: We optimized competence development in S. mitis, by use of semi-defined medium and appropriate concentrations of synthetic competence factor. Combined with the use of a large amplicon of donor DNA, this method allowed easy and direct editing of the S. mitis genome, broadening the spectrum of possible downstream applications of natural transformation in this species. PMID:27458432

  13. Working with Schools in Identifying and Overcoming Emotional Barriers to Learning

    ERIC Educational Resources Information Center

    Nash, Poppy; Schlösser, Annette

    2015-01-01

    This paper reports a case study on working closely with a secondary school, to enhance understanding of disruptive behaviour, through the use of bespoke Continuing Professional Development (CPD) materials. This project evolved from the researchers' previous research on the extent to which teachers believe disruptive pupils can control their…

  14. Overcoming the Practical Barriers to Spinal Cord Cell Transplantation for ALS

    DTIC Science & Technology

    2015-12-01

    Commons Attribution-NonCommercial License, which permits non- commercial use, distribution, and reproduction , provided the original work is properly cited...www.neurosurgery-online.com Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited replace diseased...CORD NEUROSURGERY VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 605 Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is

  15. Electrical and electronic waste management in China: progress and the barriers to overcome.

    PubMed

    Liu, Xianbing; Tanaka, Masaru; Matsui, Yasuhiro

    2006-02-01

    Serious adverse impacts on the environment and human health from e-waste recycling have occurred in the past and continue to occur in China today, due to a lack of national management strategies. China has made great efforts to face the challenges of the approaching peak increase in the domestic generation of e-waste and the illegal shipment of e-waste from other countries. This study examined recent progress and analysed the main problems associated with this issue in China. It was found that the material and the financial flows of e-waste in China had their own specific characteristics. Nearly 60% of the generated e-wastes were sold to private individual collectors and passed into informal recycling processes. More than 90% of Chinese citizens are reluctant to pay for the recycling of their e-waste. This is due to their traditional understanding that there remained value in these end-of-life products. Regulations concerning e-waste in China have been drafted but their deficiencies are obvious. The extended producer responsibilities (EPR) have been introduced but are not well defined. Eight formal facilities have been planned and are under construction or are in operation along the eastern coast of China but it will be difficult for them to compete with the informal processes for the reasons identified during the study.

  16. Communicating to Overcome Barriers: I Can't Do "One" More Thing!

    ERIC Educational Resources Information Center

    Molony, Terry

    2011-01-01

    While many school psychologists agree that part of the satisfaction in their profession lies in the challenges, dealing with these challenges daily can be exhausting. With NASP's 2010 "Model of Comprehensive and Integrated School Psychological Services" (also known as the NASP Practice Model), school psychologists are challenged to take time to…

  17. Overcoming the Practical Barriers to Spinal Cord Cell Transplantation for ALS

    DTIC Science & Technology

    2013-10-01

    Animals received intravenous treatment with Basiliximab (two 10mg IV doses on post-op day 0 and day 4) + MMF (10 mg/kg, BID, IV) + Tacrolimus (0.025mg...op day 0 and day 4) + MMF (10 mg/kg, BID, IV) + Tacrolimus (0.025mg/kg, BID, IV) 21d (Svendsen Laboratory) - Generated, labeled, and shipped

  18. Solid lipid nanoparticles loaded with iron to overcome barriers for treatment of iron deficiency anemia.

    PubMed

    Hosny, Khaled Mohamed; Banjar, Zainy Mohammed; Hariri, Amani H; Hassan, Ali Habiballah

    2015-01-01

    According to the World Health Organization, 46% of the world's children suffer from anemia, which is usually treated with iron supplements such as ferrous sulfate. The aim of this study was to prepare iron as solid lipid nanoparticles, in order to find an innovative way for alleviating the disadvantages associated with commercially available tablets. These limitations include adverse effects on the digestive system resulting in constipation and blood in the stool. The second drawback is the high variability in the absorption of iron and thus in its bioavailability. Iron solid lipid nanoparticles (Fe-SLNs) were prepared by hot homogenization/ultrasonication. Solubility of ferrous sulfate in different solid lipids was measured, and effects of process variables such as the surfactant type and concentration, homogenization and ultrasonication times, and charge-inducing agent on the particle size, zeta potential, and encapsulation efficiency were determined. Furthermore, in vitro drug release and in vivo pharmacokinetics were studied in rabbits. Results indicated that Fe-SLNs consisted of 3% Compritol 888 ATO, 1% Lecithin, 3% Poloxamer 188, and 0.2% dicetylphosphate, with an average particle size of 25 nm with 92.3% entrapment efficiency. In vivo pharmacokinetic study revealed more than fourfold enhanced bioavailability. In conclusion, Fe-SLNs could be a promising carrier for iron with enhanced oral bioavailability.

  19. Educating Students in Rural America: Capitalizing on Strengths, Overcoming Barriers

    ERIC Educational Resources Information Center

    National Association of State Boards of Education, 2016

    2016-01-01

    In 2004, the National Association of State Boards of Education (NASBE) released a "State Education Standard" focused on the issues and challenges facing rural schools. Ten years later, NASBE facilitated a study group on rural education to discuss what has changed and what new challenges require the attention of state education…

  20. Solid lipid nanoparticles loaded with iron to overcome barriers for treatment of iron deficiency anemia

    PubMed Central

    Hosny, Khaled Mohamed; Banjar, Zainy Mohammed; Hariri, Amani H; Hassan, Ali Habiballah

    2015-01-01

    According to the World Health Organization, 46% of the world’s children suffer from anemia, which is usually treated with iron supplements such as ferrous sulfate. The aim of this study was to prepare iron as solid lipid nanoparticles, in order to find an innovative way for alleviating the disadvantages associated with commercially available tablets. These limitations include adverse effects on the digestive system resulting in constipation and blood in the stool. The second drawback is the high variability in the absorption of iron and thus in its bioavailability. Iron solid lipid nanoparticles (Fe-SLNs) were prepared by hot homogenization/ultrasonication. Solubility of ferrous sulfate in different solid lipids was measured, and effects of process variables such as the surfactant type and concentration, homogenization and ultrasonication times, and charge-inducing agent on the particle size, zeta potential, and encapsulation efficiency were determined. Furthermore, in vitro drug release and in vivo pharmacokinetics were studied in rabbits. Results indicated that Fe-SLNs consisted of 3% Compritol 888 ATO, 1% Lecithin, 3% Poloxamer 188, and 0.2% dicetylphosphate, with an average particle size of 25 nm with 92.3% entrapment efficiency. In vivo pharmacokinetic study revealed more than fourfold enhanced bioavailability. In conclusion, Fe-SLNs could be a promising carrier for iron with enhanced oral bioavailability. PMID:25609917

  1. Overcoming Barriers to Family Involvement in Title I Schools. Report to Congress.

    ERIC Educational Resources Information Center

    Policy Studies Associates, Inc., Washington, DC.

    Title I of the Elementary and Secondary Education Act as amended by the Improving America's Schools Act (IASA) requires all schools and districts receiving Title I money to engage in an extensive array of activities to build the capacity of parents and school staff to work together in support of students' learning. Title I also requires schools to…

  2. Identifying, Understanding, and Overcoming Barriers to the Use of Clinical Practice Guidelines in Pediatric Oncology

    ClinicalTrials.gov

    2017-02-14

    B-Cell Non-Hodgkin Lymphoma; Chemotherapy-Related Nausea and/or Vomiting; Childhood Acute Myeloid Leukemia; Childhood Burkitt Lymphoma; Childhood Neoplasm; Febrile Neutropenia; Hematopoietic Cell Transplantation Recipient; Recurrent Childhood Acute Lymphoblastic Leukemia; Untreated Childhood Acute Lymphoblastic Leukemia

  3. Innovative Strategies to Overcome Biofilm Resistance

    PubMed Central

    Taraszkiewicz, Aleksandra; Fila, Grzegorz; Grinholc, Mariusz; Nakonieczna, Joanna

    2013-01-01

    We review the recent literature concerning the efficiency of antimicrobial photodynamic inactivation toward various microbial species in planktonic and biofilm cultures. The review is mainly focused on biofilm-growing microrganisms because this form of growth poses a threat to chronically infected or immunocompromised patients and is difficult to eradicate from medical devices. We discuss the biofilm formation process and mechanisms of its increased resistance to various antimicrobials. We present, based on data in the literature, strategies for overcoming the problem of biofilm resistance. Factors that have potential for use in increasing the efficiency of the killing of biofilm-forming bacteria include plant extracts, enzymes that disturb the biofilm structure, and other nonenzymatic molecules. We propose combining antimicrobial photodynamic therapy with various antimicrobial and antibiofilm approaches to obtain a synergistic effect to permit efficient microbial growth control at low photosensitizer doses. PMID:23509680

  4. Overcoming catastrophic forgetting in neural networks

    PubMed Central

    Kirkpatrick, James; Pascanu, Razvan; Rabinowitz, Neil; Veness, Joel; Desjardins, Guillaume; Rusu, Andrei A.; Milan, Kieran; Quan, John; Ramalho, Tiago; Grabska-Barwinska, Agnieszka; Hassabis, Demis; Clopath, Claudia; Kumaran, Dharshan; Hadsell, Raia

    2017-01-01

    The ability to learn tasks in a sequential fashion is crucial to the development of artificial intelligence. Until now neural networks have not been capable of this and it has been widely thought that catastrophic forgetting is an inevitable feature of connectionist models. We show that it is possible to overcome this limitation and train networks that can maintain expertise on tasks that they have not experienced for a long time. Our approach remembers old tasks by selectively slowing down learning on the weights important for those tasks. We demonstrate our approach is scalable and effective by solving a set of classification tasks based on a hand-written digit dataset and by learning several Atari 2600 games sequentially. PMID:28292907

  5. T7 replisome directly overcomes DNA damage

    NASA Astrophysics Data System (ADS)

    Sun, Bo; Pandey, Manjula; Inman, James T.; Yang, Yi; Kashlev, Mikhail; Patel, Smita S.; Wang, Michelle D.

    2015-12-01

    Cells and viruses possess several known `restart' pathways to overcome lesions during DNA replication. However, these `bypass' pathways leave a gap in replicated DNA or require recruitment of accessory proteins, resulting in significant delays to fork movement or even cell division arrest. Using single-molecule and ensemble methods, we demonstrate that the bacteriophage T7 replisome is able to directly replicate through a leading-strand cyclobutane pyrimidine dimer (CPD) lesion. We show that when a replisome encounters the lesion, a substantial fraction of DNA polymerase (DNAP) and helicase stay together at the lesion, the replisome does not dissociate and the helicase does not move forward on its own. The DNAP is able to directly replicate through the lesion by working in conjunction with helicase through specific helicase-DNAP interactions. These observations suggest that the T7 replisome is fundamentally permissive of DNA lesions via pathways that do not require fork adjustment or replisome reassembly.

  6. Drivers and barriers in health IT adoption: a proposed framework.

    PubMed

    Avgar, A C; Litwin, A S; Pronovost, P J

    2012-01-01

    Despite near (and rare) consensus that the adoption and diffusion of health information technology (health IT) will bolster outcomes for organizations, individuals, and the healthcare system as a whole, there has been surprisingly little consideration of the structures and processes within organizations that might drive the adoption and effective use of the technology. Management research provides a useful lens through which to analyze both the determinants of investment and the benefits that can ultimately be derived from these investments. This paper provides a conceptual framework for understanding health IT adoption. In doing so, this paper highlights specific organizational barriers or enablers at different stages of the adoption process - investment, implementation, and use - and at different levels of organizational decision-making - strategic, operational, and frontline. This framework will aid both policymakers and organizational actors as they make sense of the transition from paper-based to electronic systems.

  7. Overcoming the obstacles: Life stories of scientists with learning disabilities

    NASA Astrophysics Data System (ADS)

    Force, Crista Marie

    Scientific discovery is at the heart of solving many of the problems facing contemporary society. Scientists are retiring at rates that exceed the numbers of new scientists. Unfortunately, scientific careers still appear to be outside the reach of most individuals with learning disabilities. The purpose of this research was to better understand the methods by which successful learning disabled scientists have overcome the barriers and challenges associated with their learning disabilities in their preparation and performance as scientists. This narrative inquiry involved the researcher writing the life stories of four scientists. These life stories were generated from extensive interviews in which each of the scientists recounted their life histories. The researcher used narrative analysis to "make sense" of these learning disabled scientists' life stories. The narrative analysis required the researcher to identify and describe emergent themes characterizing each scientist's life. A cross-case analysis was then performed to uncover commonalities and differences in the lives of these four individuals. Results of the cross-case analysis revealed that all four scientists had a passion for science that emerged at an early age, which, with strong drive and determination, drove these individuals to succeed in spite of the many obstacles arising from their learning disabilities. The analysis also revealed that these scientists chose careers based on their strengths; they actively sought mentors to guide them in their preparation as scientists; and they developed coping techniques to overcome difficulties and succeed. The cross-case analysis also revealed differences in the degree to which each scientist accepted his or her learning disability. While some demonstrated inferior feelings about their successes as scientists, still other individuals revealed feelings of having superior abilities in areas such as visualization and working with people. These individuals revealed

  8. Identifying barriers for implementation of computer based nursing documentation.

    PubMed

    Vollmer, Anna-Maria; Prokosch, Hans-Ulrich; Bürkle, Thomas

    2014-01-01

    This study was undertaken in the planning phase for the introduction of a comprehensive computer based nursing documentation system at Erlangen University Hospital. There, we expect a wide range of difficult organizational changes, because the nurses currently neither used computer based nursing documentation nor did they follow strongly the nursing process model within paper based documentation. Thus we were eager to recognize potential pitfalls early and to identify potential barriers for digital nursing documentation. In a questionnaire study we surveyed all German university hospitals for their experience with the implementation of computer based nursing documentation implementation. We received answers from 11 of the 23 hospitals. Furthermore we performed a questionnaire study about expectations and fears among the nurses of four pilot wards of our hospital. Most respondents stated a positive attitude towards the nursing process documentation, but many respondents note technical (e.g. bad performance of the software) and organizational barriers (e.g. lack of time).

  9. Overcoming Breakdowns and Engaging the Public

    NASA Astrophysics Data System (ADS)

    Bowman, T. E.

    2012-12-01

    With strong climate science evidence readily available, why do major segments of the public remain disengaged? Decades of social science research and practical communications experience indicate that prioritizing and structuring information, choosing appropriate messengers, and adapting to audience interests and learning styles are vital, yet often ignored criteria. This session will explore key differences between communications models within the science community and effective outreach to non-scientist audiences. Here, prioritizing goals, understanding preconceptions and identifying intervention opportunities require careful examination. "Public engagement" is defined as encouraging and enabling people to make informed choices on their own behalf. Crucial barriers identified in economics, political psychology and audience segmentation research will be addressed, and recommendations for more effective engagement will emerge including: defining realistic goals, simplifying science content accurately, avoiding values conflicts that prevent learning, enlisting trusted messengers, and matching a call to action to the scale of the challenge in ways people can embrace.

  10. Organizational socialization of physical therapists.

    PubMed

    Smith, D M

    1989-04-01

    Organizational socialization is the process by which an individual becomes a member of an organization. It involves interaction between the employee and the organization during recruitment, hiring, and training and continues as the employee's role in the organization is defined and develops. The individual and the employee each have a set of expectations for the other; the extent to which these expectations are recognized, communicated, and combined in a mutually agreeable "psychological contract" can influence the eventual effectiveness, satisfaction, and longevity of the individual as an employee. The purpose of this article is to describe organizational socialization as it applies to the physical therapy setting. The author makes recommendations for management of the process.

  11. The immunological barriers to xenotransplantation.

    PubMed

    Vadori, M; Cozzi, E

    2015-10-01

    The availability of cells, tissues and organs from a non-human species such as the pig could, at least in theory, meet the demand of organs necessary for clinical transplantation. At this stage, the important goal of getting over the first year of survival has been reported for both cellular and solid organ xenotransplantation in relevant preclinical primate models. In addition, xenotransplantation is already in the clinic as shown by the broad use of animal-derived medical devices, such as bioprosthetic heart valves and biological materials used for surgical tissue repair. At this stage, however, prior to starting a wide-scale clinical application of xenotransplantation of viable cells and organs, the important obstacle represented by the humoral immune response will need to be overcome. Likewise, the barriers posed by the activation of the innate immune system and coagulative pathway will have to be controlled. As far as xenogeneic nonviable xenografts, increasing evidence suggests that considerable immune reactions, mediated by both innate and adaptive immunity, take place and influence the long-term outcome of xenogeneic materials in patients, possibly precluding the use of bioprosthetic heart valves in young individuals. In this context, the present article provides an overview of current knowledge on the immune processes following xenotransplantation and on the possible therapeutic interventions to overcome the immunological drawbacks involved in xenotransplantation.

  12. Organizational Culture: Analysis and Change

    DTIC Science & Technology

    1983-09-01

    of the organization; 2. The assumptions, values, and perspectives of a given culture emerge as... perspectives of a culture can be changed without disturbing its basic assumptions or values to any great . degree. Workers in the system can see that some...ABSTRACT (Continue an reverse aide It neceseary and identify by block number)This paper examines the concept of organizational culture , and presents a

  13. Organizational change through Lean Thinking.

    PubMed

    Tsasis, Peter; Bruce-Barrett, Cindy

    2008-08-01

    In production and manufacturing plants, Lean Thinking has been used to improve processes by eliminating waste and thus enhancing efficiency. In health care, Lean Thinking has emerged as a comprehensive approach towards improving processes embedded in the diagnostic, treatment and care activities of health-care organizations with cost containment results. This paper provides a case study example where Lean Thinking is not only used to improve efficiency and cost containment, but also as an approach to effective organizational change.

  14. Organizational change strategies within healthcare.

    PubMed

    Steinke, Claudia; Dastmalchian, Ali; Blyton, Paul; Hasselback, Paul

    2013-01-01

    This study explores ways in which healthcare organizations can improve their organizational fitness for change using Beer and Nohria's framework of Theory E (concentrating on the economic value of change) and Theory O (concentrating on the organization's long-term capabilities for change). Data were collected from senior leaders/medical directors from health regions in Alberta. The results show that even though there is a tendency for reliance on Theory E change strategies, the respondents demonstrated other preferred approaches to change.

  15. Readings on Managing Organizational Quality

    DTIC Science & Technology

    1990-05-01

    April-November 1989 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Readings on Managing Organizational Quality Program Element O&M, N, Work Unit 98-9POC0012...competitive advantage. Several articles make explicit old working assumptions and suggest new ones to replace them. 14. SUBJECT TERMS 15. NUMBER OF...sponsored by the Office of the Under Secretary of the Navy and funded under Operations and Maintenance, Navy (O&M,N), Work Unit No. 98-9POC0012. This

  16. Puncture detecting barrier materials

    DOEpatents

    Hermes, R.E.; Ramsey, D.R.; Stampfer, J.F.; Macdonald, J.M.

    1998-03-31

    A method and apparatus for continuous real-time monitoring of the integrity of protective barrier materials, particularly protective barriers against toxic, radioactive and biologically hazardous materials has been developed. Conductivity, resistivity or capacitance between conductive layers in the multilayer protective materials is measured by using leads connected to electrically conductive layers in the protective barrier material. The measured conductivity, resistivity or capacitance significantly changes upon a physical breach of the protective barrier material. 4 figs.

  17. Puncture detecting barrier materials

    DOEpatents

    Hermes, Robert E.; Ramsey, David R.; Stampfer, Joseph F.; Macdonald, John M.

    1998-01-01

    A method and apparatus for continuous real-time monitoring of the integrity of protective barrier materials, particularly protective barriers against toxic, radioactive and biologically hazardous materials has been developed. Conductivity, resistivity or capacitance between conductive layers in the multilayer protective materials is measured by using leads connected to electrically conductive layers in the protective barrier material. The measured conductivity, resistivity or capacitance significantly changes upon a physical breach of the protective barrier material.

  18. Understanding and overcoming metformin gastrointestinal intolerance.

    PubMed

    Bonnet, Fabrice; Scheen, André

    2017-04-01

    Metformin is the most widely prescribed drug for patients with type 2 diabetes mellitus and the first-line pharmacological option as supported by multiple international guidelines, yet a rather large proportion of patients cannot tolerate metformin in adequate amounts because of its associated gastrointestinal (GI) adverse events (AEs). GI AEs typically encountered with metformin therapy include diarrhoea, nausea, flatulence, indigestion, vomiting and abdominal discomfort, with diarrhoea and nausea being the most common. Although starting at a low dose and titrating slowly may help prevent some GI AEs associated with metformin, some patients are unable to tolerate metformin at all and it may also be difficult to convince patients to start metformin again after a bout of GI AEs. Despite this clinical importance, the underlying mechanisms of the GI intolerance associated with metformin are poorly known. In the present review, we discuss: the epidemiology of metformin-associated GI intolerance and its underlying mechanisms; genotype variability and associated factors affecting metformin GI intolerance, such as comorbidities, co-medications and bariatric surgery; clinical consequences and therapeutic strategies to overcome metformin GI intolerance. These strategies include appropriate titration of immediate-release metformin, use of extended-release metformin, the promise of delayed-release metformin and gut microbiome modulators, as well as alternative pharmacological therapies when metformin cannot be tolerated at all. Given the available data, all efforts should be made to maintain metformin before considering a shift to another drug therapy.

  19. Overcoming Old in Age-Friendliness

    PubMed Central

    Lindenberg, J.; Westendorp, R.G.J.

    2015-01-01

    In this article, we explore views on an age-friendly space in the Netherlands by analysing the responses of older individuals (N = 54) in focus groups and by examining the perspectives around an age-friendly zone in the Netherlands, Parkstad Limburg. We found that a central issue in the wishes for living at a later age are adjustments to envisioned physical limitations that come with the ageing process; this includes adjustments to ensure safety, accessibility and mobility, in order to facilitate older individuals' efforts to stay engaged with the world around them. In their wishes, the older participants constructed ideal dwelling places that closely resembled a senior home, but at the same time they rejected wishing to live in a place that was identified as a senior home. We explain this paradox by the representation of such a space as being for old people, i.e. needy older individuals, which was not how the older participants wished to be identified. We conclude that the conception of age-friendly environments will have to face the difficult challenge of overcoming the association with old age, while simultaneously taking into account adjustments that signify and relate to the ageing process and that seem inescapably tied to oldness. PMID:26028795

  20. NANOPREPARATIONS TO OVERCOME MULTIDRUG RESISTANCE IN CANCER

    PubMed Central

    Patel, Niravkumar R.; Pattni, Bhushan S.; Abouzeid, Abraham H.; Torchilin, Vladimir P.

    2013-01-01

    Multidrug resistance is the most widely exploited phenomenon by which cancer eludes chemotherapy. Broad variety of factors, ranging from the cellular ones, such as over-expression of efflux transporters, defective apoptotic machineries, and altered molecular targets, to the physiological factors such as higher interstitial fluid pressure, low extracellular pH, and formation of irregular tumor vasculature are responsible for multidrug resistance. A combination of various undesirable factors associated with biological surroundings together with poor solubility and instability of many potential therapeutic small & large molecules within the biological systems and systemic toxicity of chemotherapeutic agents has necessitated the need for nano-preparations to optimize drug delivery. The physiology of solid tumors presents numerous challenges for successful therapy. However, it also offers unique opportunities for the use of nanotechnology. Nanoparticles, up to 400 nm in size, have shown great promise for carrying, protecting and delivering potential therapeutic molecules with diverse physiological properties. In this review, various factors responsible for the MDR and the use of nanotechnology to overcome the MDR, the use of spheroid culture as well as the current technique of producing micro tumor tissues in vitro are discussed in detail. PMID:23973912

  1. Barriers to Healthier Eating in a Disadvantaged Community

    ERIC Educational Resources Information Center

    O'Neill, Martin; Rebane, Deanne; Lester, Carolyn

    2004-01-01

    Objective: The research objective was to identify how healthy eating was understood in a disadvantaged community and how barriers to healthy eating might be overcome. Design: Participatory action research. Setting: Communities in Gurnos, Merthyr Tydfil, one of the most deprived areas in the UK. Method: Trainees on a participative methods course…

  2. Building an ethical organizational culture.

    PubMed

    Nelson, William A; Taylor, Emily; Walsh, Thom

    2014-01-01

    The success of a health care institution-as defined by delivering high-quality, high-value care, positive patient outcomes, and financial solvency-is inextricably tied to the culture within that organization. The ability to achieve and sustain alignment between its mission, values, and everyday practices defines a positive organizational culture. An institution that has a diminished organizational culture, reflected in the failure to consistently align management and clinical decisions and practices with its mission and values, will struggle. The presence of misalignment or of ethics gaps affects the quality of care being delivered, the morale of the staff, and the organization's image in the community. Transforming an organizational culture will provide a foundation for success and a framework for daily ethics-grounded operations in any organization. However, building an ethics-grounded organization is a challenging process requiring strong organization leadership and planning. Using a case study, the authors provide a multiyear, continuous step-by-step strategy consisting of identifying ethics culture gaps, establishing an ethics taskforce, clarifying and prioritizing the problems, developing strategy for change, implementing the strategy, and evaluating outcomes. This process will assist organizations in aligning its actions with its mission and values, to find success on all fronts.

  3. Visual thinking in organizational analysis

    NASA Astrophysics Data System (ADS)

    Grantham, Charles E.

    1991-06-01

    The ability to visualize the relationship among elements of large complex databases is a trend which is yielding new insights into several fields. The author demonstrates the use of 'visual thinking' as an analytical tool to the analysis of formal, complex organizations. Recent developments in organizational design and office automation are making the visual analysis of workflows possible. An analytical mental model of organizational functioning can be built upon a depiction of information flows among work group members. The dynamics of organizational functioning can be described in terms of six essential processes. Furthermore, each of these sub-systems develop within a staged cycle referred to as an enneagram model. Together these mental models present a visual metaphor of healthy function in large formal organizations; both in static and dynamic terms. These models can be used to depict the 'state' of an organization at points in time by linking each process to quantitative data taken from the monitoring of the flow of information in computer networks.

  4. Cross-cultural organizational behavior.

    PubMed

    Gelfand, Michele J; Erez, Miriam; Aycan, Zeynep

    2007-01-01

    This article reviews research on cross-cultural organizational behavior (OB). After a brief review of the history of cross-cultural OB, we review research on work motivation, or the factors that energize, direct, and sustain effort across cultures. We next consider the relationship between the individual and the organization, and review research on culture and organizational commitment, psychological contracts, justice, citizenship behavior, and person-environment fit. Thereafter, we consider how individuals manage their interdependence in organizations, and review research on culture and negotiation and disputing, teams, and leadership, followed by research on managing across borders and expatriation. The review shows that developmentally, cross-cultural research in OB is coming of age. Yet we also highlight critical challenges for future research, including moving beyond values to explain cultural differences, attending to levels of analysis issues, incorporating social and organizational context factors into cross-cultural research, taking indigenous perspectives seriously, and moving beyond intracultural comparisons to understand the dynamics of cross-cultural interfaces.

  5. The Barriers Project.

    ERIC Educational Resources Information Center

    Confederation Coll. of Applied Arts and Technology, Thunder Bay (Ontario).

    In 1987, the Barriers Project was initiated by Confederation College of Applied Arts and Technology to engage 31 selected community colleges in Canada in an organized self-appraisal of institutional barriers to the enrollment of part-time credit students. From the outset, colleges were encouraged to limit their investigation to barriers over which…

  6. Development of the Motivators of and Barriers to Health-Smart Behaviors Inventory

    ERIC Educational Resources Information Center

    Tucker, Carolyn M.; Rice, Kenneth G.; Hou, Wei; Kaye, Lillian B.; Nolan, Sarah E. M.; Grandoit, Delphia J.; Gonzales, Lucia; Smith, Mary B.; Desmond, Frederic F.

    2011-01-01

    The Motivators of and Barriers to Health-Smart Behaviors Inventory (MB-HSBI) was developed for use in identifying self-reported motivators of and barriers to the following health-promoting behaviors (called "health-smart behaviors") that should occur daily to help promote health and overcome illnesses/diseases: eating a healthy…

  7. Barriers and Strategies for Success for American Indian College Students: A Review

    ERIC Educational Resources Information Center

    Keith, Jill F.; Stastny, Sherri N.; Brunt, Ardith

    2016-01-01

    American Indian and Alaska Native students have a significantly lower college graduation rate than that of other ethnic groups in the United States. These students often face a variety of barriers to the completion of their education. Overcoming barriers for the achievement of an advanced education takes commitment, hard work, and dedication on…

  8. Nested barriers to low-carbon infrastructure investment

    NASA Astrophysics Data System (ADS)

    Granoff, Ilmi; Hogarth, J. Ryan; Miller, Alan

    2016-12-01

    Low-carbon, 'green' economic growth is necessary to simultaneously improve human welfare and avoid the worst impacts of climate change and environmental degradation. Infrastructure choices underpin both the growth and the carbon intensity of the economy. This Perspective explores the barriers to investing in low-carbon infrastructure and some of the policy levers available to overcome them. The barriers to decarbonizing infrastructure 'nest' within a set of barriers to infrastructure development more generally that cause spending on infrastructure--low-carbon or not--to fall more than 70% short of optimal levels. Developing countries face additional barriers such as currency and political risks that increase the investment gap. Low-carbon alternatives face further barriers, such as commercialization risk and financial and public institutions designed for different investment needs. While the broader barriers to infrastructure investment are discussed in other streams of literature, they are often disregarded in literature on renewable energy diffusion or climate finance, which tends to focus narrowly on the project costs of low- versus high-carbon options. We discuss how to overcome the barriers specific to low-carbon infrastructure within the context of the broader infrastructure gap.

  9. The Relationship Between Organizational Culture and Organizational Commitment in Zahedan University of Medical Sciences

    PubMed Central

    Azizollah, Arbabisarjou; Abolghasem, Farhang; Amin, Dadgar Mohammad

    2016-01-01

    Background and Objective: Organizations effort is to achieve a common goal. There are many constructs needed for organizations. Organizational culture and organizational commitment are special concepts in management. The objective of the current research is to study the relationship between organizational culture and organizational commitment among the personnel of Zahedan University of Medical Sciences. Materials and Methods: This is a descriptive- correlational study. The statistical population was whole tenured staff of Zahedan University of Medical Sciences that worked for this organization in 2012-2013. Random sampling method was used and 165 samples were chosen. Two standardized questionnaires of the organizational culture (Schein, 1984) and organizational commitment (Meyer & Allen, 2002) were applied. The face and construct validity of the questionnaires were approved by the lecturers of Management and experts. Reliability of questionnaires of the organizational culture and organizational commitment were 0.89 and 0.88 respectively, by Cronbach’s Alpha coefficient. All statistical calculations performed using Statistical Package for the Social Sciences version 21.0 (SPSS Inc., Chicago, IL, USA). The level of significance was set at P<0.05. Findings: The findings of the study showed that there was a significant relationship between organizational culture and organizational commitment (P value=0.027). Also, the results showed that there was a significant relation between organizational culture and affective commitment (P-value=0.009), organizational culture and continuance commitment (P-value=0.009), and organizational culture and normative commitment (P-value=0.009). PMID:26925884

  10. A theory of organizational readiness for change

    PubMed Central

    Weiner, Bryan J

    2009-01-01

    Background Change management experts have emphasized the importance of establishing organizational readiness for change and recommended various strategies for creating it. Although the advice seems reasonable, the scientific basis for it is limited. Unlike individual readiness for change, organizational readiness for change has not been subject to extensive theoretical development or empirical study. In this article, I conceptually define organizational readiness for change and develop a theory of its determinants and outcomes. I focus on the organizational level of analysis because many promising approaches to improving healthcare delivery entail collective behavior change in the form of systems redesign--that is, multiple, simultaneous changes in staffing, work flow, decision making, communication, and reward systems. Discussion Organizational readiness for change is a multi-level, multi-faceted construct. As an organization-level construct, readiness for change refers to organizational members' shared resolve to implement a change (change commitment) and shared belief in their collective capability to do so (change efficacy). Organizational readiness for change varies as a function of how much organizational members value the change and how favorably they appraise three key determinants of implementation capability: task demands, resource availability, and situational factors. When organizational readiness for change is high, organizational members are more likely to initiate change, exert greater effort, exhibit greater persistence, and display more cooperative behavior. The result is more effective implementation. Summary The theory described in this article treats organizational readiness as a shared psychological state in which organizational members feel committed to implementing an organizational change and confident in their collective abilities to do so. This way of thinking about organizational readiness is best suited for examining organizational

  11. Space patrol: Variants of the optical barrier scheme

    NASA Astrophysics Data System (ADS)

    Akhmetshin, R. Z.

    2013-07-01

    Different variants of the space patrol system to be designed for discovering and cataloging space objects hazardous for the Earth have been investigated. The basic idea of this system is to create an optical barrier using the telescopes deployed in a heliocentric orbit. Difficulties (as well as ways of overcoming them) of this program are analyzed, associated with form and position of the orbit of a space object relative to the patrol spacecraft, determination of orbit parameters, and mutual motion of space objects and the telescopes on spacecraft. The barrier's schemes with scanning vertical or horizontal belts are considered. Some examples of observational conditions are presented for space objects crossing the barrier region: angular positions, velocities, distances, and numbers of days during which they are observed in the barrier region. The barrier's characteristics are given for telescopes deployed in the orbits of the Earth and Venus.

  12. The Need for More Research on Language Barriers in Health Care: A Proposed Research Agenda

    PubMed Central

    Jacobs, Elizabeth; Chen, Alice HM; Karliner, Leah S; Agger-Gupta, Niels; Mutha, Sunita

    2006-01-01

    Many U.S. residents who speak little English may face language barriers when seeking health care. This article describes what is currently known about language barriers in health care and outlines a research agenda based on mismatches between the current state of knowledge of language barriers and what health care stakeholders need to know. Three broad areas needing more research are discussed: the ways in which language barriers affect health and health care, the efficacy of linguistic access service interventions, and the costs of language barriers and efforts to overcome them. In each of these areas, we outline specific research questions and recommendations. PMID:16529570

  13. Barriers to pain management: focus on opioid therapy.

    PubMed

    Zuccaro, Stefano Maria; Vellucci, Renato; Sarzi-Puttini, Piercarlo; Cherubino, Paolo; Labianca, Roberto; Fornasari, Diego

    2012-02-22

    Despite the availability of effective pain treatments, there are numerous barriers to effective management resulting in a large proportion of patients not achieving optimal pain control. Chronic pain is inadequately treated because of a combination of cultural, societal, educational, political and religious constraints. The consequences of inadequately treated pain are physiological and psychological effects on the patient, as well as socioeconomic implications. Unreasonable failure to treat pain is viewed as unethical and an infringement of basic human rights. The numerous barriers to the clinical management of pain vary depending on whether they are viewed from the standpoint of the patient, the physician, or the institution. Identification and acknowledgement of the barriers involved are the first steps to overcoming them. Successful initiatives to overcome patient, physician and institutional barriers need to be multifaceted in their approach. Multidisciplinary initiatives to improve pain management include dissemination of community-based information, education and awareness programmes to attempt to change attitudes towards pain treatment. A better awareness and insight into the problems caused by unrelieved pain and greater knowledge about the efficacy and tolerability of available pain management options should enable physicians to seek out and adhere to treatment guidelines, and participate in interventional and educational programmes designed to improve pain management, and for institutions to implement the initiatives required. Although much work is underway to identify and resolve the issues in pain management, many patients still receive inadequate treatment. Continued effort is required to overcome the known barriers to effective pain management.

  14. Overcoming regulatory and economic challenges facing pharmacogenomics.

    PubMed

    Cohen, Joshua P

    2012-09-15

    The number of personalized medicines and companion diagnostics in use in the United States has gradually increased over the past decade, from a handful of medicines and tests in 2001 to several dozen in 2011. However, the numbers have not reached the potential hoped for when the human genome project was completed in 2001. Significant clinical, regulatory, and economic barriers exist and persist. From a regulatory perspective, therapeutics and companion diagnostics are ideally developed simultaneously, with the clinical significance of the diagnostic established using data from the clinical development program of the corresponding therapeutic. Nevertheless, this is not (yet) happening. Most personalized medicines are personalized post hoc, that is, a companion diagnostic is developed separately and approved after the therapeutic. This is due in part to a separate and more complex regulatory process for diagnostics coupled with a lack of clear regulatory guidance. More importantly, payers have placed restrictions on reimbursement of personalized medicines and their companion diagnostics, given the lack of evidence on the clinical utility of many tests. To achieve increased clinical adoption of diagnostics and targeted therapies through more favorable reimbursement and incorporation in clinical practice guidelines, regulators will need to provide unambiguous guidance and manufacturers will need to bring more and better clinical evidence to the market place.

  15. Extremal surface barriers

    NASA Astrophysics Data System (ADS)

    Engelhardt, Netta; Wall, Aron C.

    2014-03-01

    We present a generic condition for Lorentzian manifolds to have a barrier that limits the reach of boundary-anchored extremal surfaces of arbitrary dimension. We show that any surface with nonpositive extrinsic curvature is a barrier, in the sense that extremal surfaces cannot be continuously deformed past it. Furthermore, the outermost barrier surface has nonnegative extrinsic curvature. Under certain conditions, we show that the existence of trapped surfaces implies a barrier, and conversely. In the context of AdS/CFT, these barriers imply that it is impossible to reconstruct the entire bulk using extremal surfaces. We comment on the implications for the firewall controversy.

  16. Addressing disruptive behaviors in the organizational setting: the win-win approach.

    PubMed

    Rosenstein, Alan H

    2013-01-01

    Disruptive behaviors can have a significant impact on organizational dynamics and work relationships and a profound negative effect on staff and patient satisfaction, performance efficiency, and patient outcomes. Despite the growing call for action, many organizations still have difficulty in addressing these issues in a consistent, effective manner. Presented below is a model that focuses on causes and barriers and offers solutions designed to promote a "What's in it for me?" win-win approach for improving morale, job satisfaction, and patient care.

  17. Impact of organizational change on organizational culture: implications for introducing evidence-based practice.

    PubMed

    Austin, Michael J; Claassen, Jennette

    2008-01-01

    Evidence-based practice (EBP) seeks to integrate the expertise of individual practitioners with the best available evidence within the context of the values and expectations of clients. Prior to implementing EBP, it is important to understand the significance that organizational change and organizational culture play. This article seeks to explore the literature associated with both organizational change and organizational culture. The analysis of organizational culture and change draw upon findings from both the private, for-profit sector, and the public, non-profit field. It is divided into four sections: organizational change and innovation, organizational culture, managing organizational culture and change, and finally, applying the findings to the implementation of EBP. While the audience for this analysis is managers in public and nonprofit human service organizations who are considering implementing EBP into their work environment, it is not intended to provide a "how to" guide, but rather a framework for critical thinking.

  18. Effects of organizational justice on organizational citizenship behaviors: mediating effects of institutional trust and affective commitment.

    PubMed

    Guh, Wei-Yuan; Lin, Shang-Ping; Fan, Chwei-Jen; Yang, Chin-Fang

    2013-06-01

    This study investigated the mediating role of institutional trust and affective commitment on the relationship between organizational justice and organizational citizenship behaviors. The study participants were 315 faculty members at 67 public/private universities of technology and vocational colleges in Taiwan. Structural equation modeling was used to analyze the relationships between the variables and assess the goodness of fit of the overall model. Organizational justice was positively related to institutional trust and there was an indirect effect of organizational justice on affective commitment through institutional trust. In addition, the relation between institutional trust and affective commitment was positive and affective commitment was shown to have a positive relation to organizational citizenship behaviors. Institutional trust was found to indirectly affect organizational citizenship behaviors through affective commitment. Most importantly, this study suggested a mediating effect of institutional trust and affective commitment on the relation between organizational justice and organizational citizenship behaviors. Implications, limitations, and future research were also discussed.

  19. [Organizational capacity for continuous improvement of health services].

    PubMed

    Saturno-Hernández, Pedro J; Hernández-Avila, Mauricio; Magaña-Valladares, Laura; Garcia-Saisó, Sebastián; Vertiz-Ramírez, José de Jesús

    2015-01-01

    While the Mexican health system has achieved significant progress, as reflected in the growing improvement in population health, heterogeneity in the quality of services and its impact on health in different population groups is still a challenge. The costs or poor quality represent about 20 to 40% of the health system's expenditure. We need to develop organizational capacity to implement quality management systems in order to identify, evaluate, prevent and eventually overcome the health system's challenges. A competency-based comprehensive strategy for training human resources is proposed including undergraduate and graduate education as well as continuing education, which will contribute to improve the quality function at the various levels of responsibility in the health system. The proposed strategy responds to the context of the Mexican health system, but it could be adapted to other systems and contexts.

  20. Organizational management practices for achieving software process improvement

    NASA Technical Reports Server (NTRS)

    Kandt, Ronald Kirk

    2004-01-01

    The crisis in developing software has been known for over thirty years. Problems that existed in developing software in the early days of computing still exist today. These problems include the delivery of low-quality products, actual development costs that exceed expected development costs, and actual development time that exceeds expected development time. Several solutions have been offered to overcome out inability to deliver high-quality software, on-time and within budget. One of these solutions involves software process improvement. However, such efforts often fail because of organizational management issues. This paper discusses business practices that organizations should follow to improve their chances of initiating and sustaining successful software process improvement efforts.