Old Money: Financial Understanding for Older Adult Learners.

ERIC Educational Resources Information Center

Carlton, Shiela; Soulsby, Jim; Whitelegg, Di

This document discusses policy and practice addressing the need for financial literacy education for older people in the United Kingdom. The discussion is based largely on the findings of survey and focus groups that were conducted to identify the difficulties older people encounter in dealing with different financial services and managing their…

Decision support for sustainable forestry: enhancing the basic rational model.

Treesearch

H.R. Ekbia; K.M. Reynolds

2007-01-01

Decision-support systems (DSS) have been extensively used in the management of natural resources for nearly two decades. However, practical difficulties with the application of DSS in real-world situations have become increasingly apparent. Complexities of decisionmaking, encountered in the context of ecosystem management, are equally present in sustainable forestry....

Reaching Out: Best Practices for Educating Mexican-Origin Children and Youth.

ERIC Educational Resources Information Center

Romo, Harriett D.

School systems in the United States are not serving Latino students well, especially those from low-income families. This book examines difficulties encountered by Mexican-origin students--one of the fastest growing minority groups--and describes why some schools fall short and how others have improved student outcomes. The focus throughout the…

Living Together in European Intercultural Schools: The Case of the Catalan School System (Spain)

ERIC Educational Resources Information Center

Molina, Fidel; Casado, Núria

2014-01-01

There are practical difficulties in making intercultural education a substantial element of inclusion in both primary and compulsory secondary education in Europe. The Spanish education system and, in particular, the Catalan education system, have developed a series of strategies in response to the new multicultural complexity encountered in both…

My Voice Heard: The Journey of a Young Man with a Cerebral Visual Impairment

ERIC Educational Resources Information Center

Macintyre-Beon, Catriona; Mitchell, Kate; Gallagher, Ian; Cockburn, Debbie; Dutton, Gordon N.; Bowman, Richard

2012-01-01

This longitudinal case study presents John's journey through childhood and adolescence, living with visual difficulties associated with a cerebral visual impairment. It highlights the day-to-day problems that John encountered, giving practical solutions and strategies that have enabled his dream of going to a university to be realized. John and…

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

PubMed

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

1999-12-01

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

A dynamic model of the human postural control system

NASA Technical Reports Server (NTRS)

Hill, J. C.

1972-01-01

A digital simulation of the pitch axis dynamics of a stick man of figures is described. Difficulties encountered in linearizing the equations of motion are discussed; the conclusion reached is that a completely linear simulation is of such restricted validity that only a nonlinear simulation is of any practical use. Typical simulation results obtained from the full nonlinear model are presented.

A dynamic model of the human postural control system.

NASA Technical Reports Server (NTRS)

Hill, J. C.

1971-01-01

Description of a digital simulation of the pitch axis dynamics of a stick man. The difficulties encountered in linearizing the equations of motion are discussed; the conclusion reached is that a completely linear simulation is of such restricted validity that only a nonlinear simulation is of any practical use. Typical simulation results obtained from the full nonlinear model are illustrated.

Evidence Molded by Contact with Staff Culture and Patient Milieu: An Analysis of the Social Process of Knowledge Utilization in Nursing Homes

ERIC Educational Resources Information Center

Øye, Christine; Mekki, Tone Elin; Skaar, Randi; Dahl, Hellen; Forland, Oddvar; Jacobsen, Frode F.

2015-01-01

Knowledge utilization is politically "hot" because it informs decisions on improving the quality of care in nursing homes (NHs). The difficulties encountered in implementing evidence-based knowledge into practice may be explained by contextual factors. Contextual factors are crucial to understanding the process of knowledge utilization;…

Situating beyond the Social: Understanding the Role of Materiality in Danish Nursing Education

ERIC Educational Resources Information Center

Soffer, Ann Katrine B.

2016-01-01

Situated learning serves as an analytical framework for learning in a community of practice and has been widely used to understand the learning process that is entailed in becoming a nurse. Yet in this paper, the difficulties encountered with the original notion of situated learning once it is applied to contemporary Danish nursing education are…

Computer Science Education as a Cultural Encounter: A Socio-Cultural Framework for Articulating Teaching Difficulties

ERIC Educational Resources Information Center

Kolikant, Yifat Ben-David

2011-01-01

This study demonstrates the power of the cultural encounter metaphor in explaining learning and teaching difficulties, using as an example computer science education (CSE). CSE is envisioned as an encounter between veterans of two computer-oriented cultures, that of the teachers and that of the students. Forty questionnaires administered to CS…

Morphological Derivations: Learning Difficulties Encountered by Public Secondary School Students in Amman/Jordan

ERIC Educational Resources Information Center

Naseeb, Maha Zouhair; Ibrahim, Majid Abdulatif

2017-01-01

This study aims at investigating the difficulties encountered by public school students in Amman/ Jordan. The study raises the following questions: What are the obstacles that students may encounter in relation to the derivations? What are the causes of such obstacles? To achieve the aims of the study, the researchers manipulate two methods: A…

Learner Outcomes in Science in South Africa: Role of the Nature of Learner Difficulties with the Language for Learning and Teaching Science

NASA Astrophysics Data System (ADS)

Oyoo, Samuel Ouma

2017-08-01

Paul Leslie Gardner pioneered the study of student difficulties with everyday words presented in the science context (Gardner 1971); several similarly designed studies (e.g. Cassels and Johnstone 1985; Tao in Research in Science Education, 24, 322-330, 1994; Farell and Ventura in Language and Education, 12(4), 243-254, 1998; Childs and O'Farell in Chemistry Education: Research and Practice, 4(3), 233-247, 2003) have since been reported in literature. This article draws from an exploratory study of the difficulties South African High School physical science learners encounter with everyday English words when presented in the science context. The participants (1107 learners and 35 respective physical science teachers) were drawn from 35 public secondary schools in Johannesburg area of South Africa. Data were obtained through a word test to participant learners followed by group interviews but face-to-face interviews with each physical science teacher. This study has revealed that in similar ways as have been reported in each of the studies so far, South African learners also face difficulties with meanings of everyday words presented in a science context. The main source of difficulties encountered was learner inability to distinguish between the meanings of familiar everyday words as used in everyday parlance from the `new' meanings of the same everyday words when used in the science context. Interpretations of learner interview responses revealed that fewer difficulties would have been experienced by learners if science teachers generally explained the context meanings of the words as used during science teaching. The findings suggest that focusing on contextual proficiency more than on general proficiency in the language of learning and teaching (LOLT) during teaching perhaps holds more promise for enhanced learning and achievement in science. Steps necessary to raise teacher awareness of the potential impact of context on meanings of everyday words of the LOLT are discussed. This article stands as an evidence-led discussion of the issues around the language-related difficulties that learners in South Africa may encounter as they learn school science.

Coordination and resource-related difficulties encountered by Quebec's public health specialists and infectious diseases/medical microbiologists in the management of A (H1N1)--a mixed-method, exploratory survey.

PubMed

Nhan, Charles; Laprise, Réjean; Douville-Fradet, Monique; Macdonald, Mary Ellen; Quach, Caroline

2012-02-10

In Quebec, the influenza A (H1N1) pandemic was managed using a top-down style that left many involved players with critical views and frustrations. We aimed to describe physicians' perceptions--infectious diseases specialists/medical microbiologists (IDMM) and public health/preventive medicine specialists (PHPMS)--in regards to issues encountered with the pandemics management at the physician level and highlight suggested improvements for future healthcare emergencies. In April 2010, Quebec IDMM and PHPMS physicians were invited to anonymously complete a web-based learning needs assessment. The survey included both open-ended and multiple-choice questions. Descriptive statistics were used to report on the frequency distribution of multiple choice responses whereas thematic content analysis was used to analyse qualitative data generated from the survey and help understand respondents' experience and perceptions with the pandemics. Of the 102 respondents, 85.3% reported difficulties or frustrations in their practice during the pandemic. The thematic analysis revealed two core themes describing the problems experienced in the pandemic management: coordination and resource-related difficulties. Coordination issues included communication, clinical practice guidelines, decision-making, roles and responsibilities, epidemiological investigation, and public health expert advisory committees. Resources issues included laboratory resources, patient management, and vaccination process. Together, the quantitative and qualitative data suggest a need for improved coordination, a better definition of roles and responsibilities, increased use of information technologies, merged communications, and transparency in the decisional process. Increased flexibility and less contradiction in clinical practice guidelines from different sources and increased laboratory/clinical capacity were felt critical to the proper management of infectious disease emergencies.

Resources for Adapting Low Vision Training Materials for the Adult with Low Literacy Skills. Practice Report

ERIC Educational Resources Information Center

Tucker, Laurel A.

2004-01-01

Adults with low vision who seek clinical low vision services need to be able to read (that is, to interpret or understand words, numbers, and symbols in print meaningfully). Reading difficulties that adults encounter during low vision therapy may be directly connected to a visual impairment or may be related to other reading problems, such as…

Pragmatic Difficulties in the Production of the Speech Act of Apology by Iraqi EFL Learners

ERIC Educational Resources Information Center

Al-Ghazalli, Mehdi Falih; Al-Shammary, Mohanad A. Amert

2014-01-01

The purpose of this paper is to investigate the pragmatic difficulties encountered by Iraqi EFL university students in producing the speech act of apology. Although the act of apology is easy to recognize or use by native speakers of English, non-native speakers generally encounter difficulties in discriminating one speech act from another. The…

Pre-registration house officer rotations incorporating general practice: does the order of rotation matter?

PubMed

Williams, C; Cantillon, P; Cochrane, M

2001-06-01

In relation to pre-registration house officer (PRHO) rotations incorporating general practice, previous research has recommended that where possible, no PRHO should undertake general practice as the first placement, because of the difficulties encountered. It was recognized that logistically, this could make such schemes almost unworkable. Within the context of a larger qualitative evaluation comparing how 24 PRHOs learned in hospital and general practice settings, the issue of rotation order was explored. In-depth semistructured interviews were conducted with the 12 PRHOs who were involved in general practice rotations. They were interviewed at the beginning and end of the PRHO year, and following their return to hospital work after the general practice placement. Each rotation order had both advantages and disadvantages, with no particular rotation order being obviously better or worse for the PRHOs involved. This small qualitative evaluation has highlighted a number of advantages and disadvantages specific to each rotation order, and makes some practical recommendations to help alleviate the problems encountered. It is important that future evaluations of similar schemes consider this issue, as there are conflicting reports about the significance of the rotation order.

Mucinous tumours of appendix and ovary: an overview and evaluation of current practice.

PubMed

Rouzbahman, Marjan; Chetty, Runjan

2014-03-01

Mucinous lesions of the appendix and ovary are commonly encountered in routine practice. There are several published classification schemes for appendiceal mucinous neoplasms with resultant inconsistent use of terms and clinical doubt. While nomenclature is more settled with regards to ovarian mucinous neoplasms, the difficulty here lies with distinguishing primary from secondary mucinous tumours. This review highlights the terminology and nomenclature for appendiceal mucinous tumours, the relationship with ovarian mucinous neoplasms and pseudomyxoma peritonei, and the features that assist in separating primary from secondary ovarian mucinous tumours.

[Residency in family medicine: problems and solutions].

PubMed

Boulé, Richard; Girard, Gilles

2003-04-01

To identify the problems encountered by residents during training and the solutions they proposed. Qualitative study. Family practice program at Sherbrooke University. Sixty-eight residents in the Family practice program between 1999 and 2000. We used the nominal group technique with four groups of participants. Then we held five 3-hour discussion groups to explore difficulties and solutions in depth. Finally, data were validated with a written questionnaire. At least 20% of respondents confirmed 65 difficulties and 61 solutions. Three major themes emerged: the many demands of the residence program, residents' personal experience of the program, and the lack of time for personal life. Publication of these results could help residents develop proactive adaptive strategies to deal with the stress of their training programs. Certain adjustments will be made by the program administration to make it easier for residents to manage their stress.

The Problems Encountered in a CTEV Clinic: Can Better Casting and Bracing Be Accomplished?

PubMed

Agarwal, Anil; Kumar, Anubrat; Shaharyar, Abbas; Mishra, Madhusudan

2016-09-07

The aim of the study is to create awareness in the practicing health care workers toward the problems encountered during casting and bracing of clubfoot following Ponseti method, and in turn avoid them. Retrospective audit of 6 years' clubfoot clinic records to analyze problems associated with Ponseti method. Problems were encountered in 26 cast and in 6 braced patients. Just 4 patients out of 71 syndromic (5.6%) experienced problems during casting compared with 3% overall incidence. The common problems encountered in casted patients were moisture lesions, hematoma, dermatitis due to occlusion, pressure sores, and fractures. There was excessive bleeding in 1 patient at time of tenotomy. In braced patients, pressure sores and tenderness at tenotomy site were major problems. None of the syndromic patients experienced difficulties during bracing. Problems were encountered with Ponseti method during casting, tenotomy, or bracing. Syndromic children had lesser complication rate than idiopathic clubfeet. It is important to be aware of these problems so that appropriate intervention can be done early. Level IV: Retrospective. © 2016 The Author(s).

78 FR 26506 - Disclosure of Returns and Return Information to Designee of Taxpayer

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... with assisting taxpayers in their financial dealings encountered difficulty in obtaining written... have encountered difficulty in obtaining and submitting the written authorizations. The 120-day period... public hearing was cancelled. One written comment responding to the NPRM was received and is available...

Upper-Division Student Difficulties with Separation of Variables

ERIC Educational Resources Information Center

Wilcox, Bethany R.; Pollock, Steven J.

2015-01-01

Separation of variables can be a powerful technique for solving many of the partial differential equations that arise in physics contexts. Upper-division physics students encounter this technique in multiple topical areas including electrostatics and quantum mechanics. To better understand the difficulties students encounter when utilizing the…

76 FR 14827 - Disclosure of Returns and Return Information to Designee of Taxpayer

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... their financial dealings have encountered difficulty in obtaining written authorizations and submitting... encountered difficulty in obtaining written authorizations and submitting the authorizations to the IRS within... regulation. DATES: Written or electronic comments must be received by May 17, 2011. Outlines of topics to be...

PubMed Central

Boulé, Richard; Girard, Gilles

2003-01-01

OBJECTIVE: To identify the problems encountered by residents during training and the solutions they proposed. DESIGN: Qualitative study. SETTING: Family practice program at Sherbrooke University. PARTICIPANTS: Sixty-eight residents in the Family practice program between 1999 and 2000. METHOD: We used the nominal group technique with four groups of participants. Then we held five 3-hour discussion groups to explore difficulties and solutions in depth. Finally, data were validated with a written questionnaire. MAIN FINDINGS: At least 20% of respondents confirmed 65 difficulties and 61 solutions. Three major themes emerged: the many demands of the residence program, residents' personal experience of the program, and the lack of time for personal life. CONCLUSION: Publication of these results could help residents develop proactive adaptive strategies to deal with the stress of their training programs. Certain adjustments will be made by the program administration to make it easier for residents to manage their stress. PMID:12729243

Difficulties That English Teachers Encounter While Teaching Listening Comprehension and Their Attitudes towards Them

ERIC Educational Resources Information Center

Alrawashdeh, Ayah Isam; Al-zayed, Norma Nawaf

2017-01-01

This study is aimed at investigating the difficulties that English teachers encountered while teaching listening comprehension and their attitudes towards the subjectin Karak schools. To achieve the objectives of the study, the researcher used two instruments: a teacher's questionnaire and informal interviews. In order to answer the questions of…

Difficulties in conducting a randomized controlled trial of health service interventions in intellectual disability: implications for evidence-based practice.

PubMed

Oliver, P C; Piachaud, J; Done, J; Regan, A; Cooray, S; Tyrer, P

2002-05-01

In an era of evidence-based medicine, practice is constantly monitored for quality in accordance with the needs of clinical governance (Oyebode et al. 1999). This is likely to lead to a dramatic change in the treatment of those with intellectual disability (ID), in which evidence for effective intervention is limited for much that happens in ordinary practice. As Fraser (2000, p. 10) has commented, the word that best explains "the transformation of learning disability practice in the past 30 years is 'enlightenment'." This is not enough to satisfy the demands of evidence, and Fraser exhorted us to embrace more research-based practice in a subject that has previously escaped randomized controlled trials (RCTs) of treatment because of ethical concerns over capacity and consent, which constitute a denial of opportunity which "is now at last regarded as disenfranchising". The present paper describes the difficulties encountered in setting up a RCT of a common intervention, i.e. assertive community treatment, and concludes that a fundamental change in attitudes to health service research in ID is needed if proper evaluation is to prosper.

'What the patient wants': an investigation of the methods of ascertaining patient values in evidence-based medicine and values-based practice.

PubMed

Wieten, Sarah

2018-02-01

Evidence-Based Medicine (EBM), Values-Based Practice (VBP) and Person-Centered Healthcare (PCH) are all concerned with the values in play in the clinical encounter. However, these recent movements are not in agreement about how to discover these relevant values. In some parts of EBM textbooks, the prescribed method for discovering values is through social science research on the average values in a particular population. VBP by contrast always investigates the individually held values of the different stakeholders in the particular clinical encounter, although the account has some other difficulties. I argue that although average values for populations might be very useful in informing questions of resource distribution and policy making, their use cannot replace the individual solicitation of patient (and other stakeholder) values in the clinical encounter. Because of the inconsistency of the EBM stance on values, the incompatibility of some versions of the EBM treatment of values with PCH, and EBM's attempt to transplant research methods from science into the realm of values, I must recommend the use of the VBP account of values discovery. © 2015 John Wiley & Sons, Ltd.

Antenna testing for the Inmarsat 2 ground control system

NASA Astrophysics Data System (ADS)

Ashton, C.

1992-02-01

This article describes how the antennas of the Inmarsat 2 TT&C and IOT ground stations were tested and calibrated. It explains the main test methods used, giving the theory behind the tests and indicates some of the practical difficulties encountered during testing. Techniques described include the use of radio stars, boresight antennas and satellite verification testing using Intelsat and Inmarsat satellites. Parameters tested include gain, G/T (figure of merit), sidelobe patterns, cross polar discrimination and isolation.

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state

PubMed Central

Silva, Tatiane M.; Costa, Lucíola C. M.; Costa, Leonardo O. P.

2015-01-01

BACKGROUND: Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. OBJECTIVE: To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. METHOD: A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. RESULTS: The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). CONCLUSION: Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully. PMID:26443977

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state.

PubMed

Silva, Tatiane M; Costa, Lucíola C M; Costa, Leonardo O P

2015-01-01

Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully.

Difficulties EFL Jordanian University Students Encounter in Translating English Idioms into Arabic

ERIC Educational Resources Information Center

Alrishan, Amal; Smadi, Oqlah

2015-01-01

This study aimed at investigating the difficulties that Jordanian EFL University students encounter in translating English idioms into Arabic. The participants of the study were all M.A translation students at Yarmouk University and the University of Jordan who were selected purposefully. The total number of the students who participated in the…

Data sharing and reanalysis of randomized controlled trials in leading biomedical journals with a full data sharing policy: survey of studies published in The BMJ and PLOS Medicine

PubMed Central

Naudet, Florian; Sakarovitch, Charlotte; Janiaud, Perrine; Cristea, Ioana; Fanelli, Daniele; Moher, David

2018-01-01

Abstract Objectives To explore the effectiveness of data sharing by randomized controlled trials (RCTs) in journals with a full data sharing policy and to describe potential difficulties encountered in the process of performing reanalyses of the primary outcomes. Design Survey of published RCTs. Setting PubMed/Medline. Eligibility criteria RCTs that had been submitted and published by The BMJ and PLOS Medicine subsequent to the adoption of data sharing policies by these journals. Main outcome measure The primary outcome was data availability, defined as the eventual receipt of complete data with clear labelling. Primary outcomes were reanalyzed to assess to what extent studies were reproduced. Difficulties encountered were described. Results 37 RCTs (21 from The BMJ and 16 from PLOS Medicine) published between 2013 and 2016 met the eligibility criteria. 17/37 (46%, 95% confidence interval 30% to 62%) satisfied the definition of data availability and 14 of the 17 (82%, 59% to 94%) were fully reproduced on all their primary outcomes. Of the remaining RCTs, errors were identified in two but reached similar conclusions and one paper did not provide enough information in the Methods section to reproduce the analyses. Difficulties identified included problems in contacting corresponding authors and lack of resources on their behalf in preparing the datasets. In addition, there was a range of different data sharing practices across study groups. Conclusions Data availability was not optimal in two journals with a strong policy for data sharing. When investigators shared data, most reanalyses largely reproduced the original results. Data sharing practices need to become more widespread and streamlined to allow meaningful reanalyses and reuse of data. Trial registration Open Science Framework osf.io/c4zke. PMID:29440066

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

PubMed

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

2013-04-01

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

Situating beyond the social: understanding the role of materiality in Danish nursing education.

PubMed

Soffer, Ann Katrine B

2016-10-01

Situated learning serves as an analytical framework for learning in a community of practice and has been widely used to understand the learning process that is entailed in becoming a nurse. Yet in this paper, the difficulties encountered with the original notion of situated learning once it is applied to contemporary Danish nursing education are introduced. One issue that has arisen is the analytical requirement for an educational program to be a homogeneous, singular, and social phenomenon thereby discounting the varied and different sites and materialities found within nursing education. By using the materiality of the hospital bed as an empirical example of the way materiality also shapes practices, an alternative understanding of situated participation can emerge. This approach allows different sites and materialities to be conceptualized as equally genuine parts of the situated leaning framework. I suggest the notion of multi-configured learning, which captures the heterogeneity and materiality encountered during ethnographic fieldwork at a Danish nursing school.

Branchial Cleft Cyst.

PubMed

Nahata, Vaishali

2016-01-01

Branchial cleft cyst, sinuses, and fistulae are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulty in diagnosis and surgical management. Here, I report a case of 14-year-old boy who presented with asymptomatic, congenital swelling located just below the jawline in the lateral part of the neck. The lesion was excised surgically. Histopathology showed the cyst lined by squamous as well as columnar ciliated epithelium, which was a characteristic finding of branchial cleft cyst. The aim of presenting this case is its rarity.

Implications for research and practice of the biographic approach for storytelling.

PubMed

Ewens, Beverley; Hendricks, Joyce; Sundin, Deb

2017-01-23

Background Intensive care unit survivors face many physical and psychological difficulties during their recovery following discharge from hospital. These difficulties can significantly affect their quality of life. Healthcare providers and survivors' families often do not understand what recovery means in this population, which may affect the support provided. Aim To consider the potential of the biographical method in helping to create stories that illustrate recovery in intensive care survivors and other populations. Discussion This paper identifies how the biographical approach has provided survivors with a way to uncover the hidden parts of their lives through diaries and interviews, and reveal the hidden stories of intensive care survivorship and recovery. Conclusion The application of the biographical method enabled stories to be created that identified the disruption survivors encounter as they struggle to appear recovered. Implications for practice The biographical method can illuminate experiences uncaptured by other methods. This insight into recovery journeys can help healthcare practitioners and family members to understand and recognise the need for support during recovery.

Ethical difficulties in clinical practice: experiences of European doctors

PubMed Central

Hurst, S A; Perrier, A; Pegoraro, R; Reiter‐Theil, S; Forde, R; Slowther, A‐M; Garrett‐Mayer, E; Danis, M

2007-01-01

Background Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services. Methods A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK. Results Survey respondents (n = 656, response rate 43%) ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority (17.6%) reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision‐making capacity (94.8%), disagreement among caregivers (81.2%) and limitation of treatment at the end of life (79.3%). The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct (47.5%), someone capable of providing specific advice (41.1%), help in weighing outcomes (36%) and clarification of the issues (35.9%). Few of the types of help expected to be useful varied among countries. Conclusion Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. PMID:17209113

Out of the ashes: the new bachelor of midwifery curriculum at Victoria University.

PubMed

Carolan, Mary; Kruger, Gina; Brown, Vera

2007-09-01

In the past decade, midwifery education has changed significantly in Australia. Previously, a nursing qualification (division 1) was required for entry into midwifery programs and on completion, graduands obtained a postgraduate diploma of midwifery. More recently, bachelor of midwifery programs have also been offered in Australia and currently, a considerable percentage of midwives are prepared for practice in this way. In Victoria, the bachelor of midwifery has been available since 2002, and at this time the third group of graduands are poised to enter the field. Implementation of the bachelor of midwifery program has given rise to many concerns about the development and applicability of this course. Concerns include: complexities of registration with a regulatory board set up primarily for nursing registration; concerns about readiness for practice among bachelor of midwifery graduands; escalating requirements within midwifery courses; and difficulties with meeting course requirements. As this course comes of age in Victoria, it is useful to reflect on some of the challenges encountered along the way. Thus, this paper reports on the journey of one university as it approaches the end of a first year of implementing an independent bachelor of midwifery program, following 5 years involvement as a consortium partner. In particular, it addresses concerns and difficulties encountered during early implementation of the program and then outlines strategies used to improve and strengthen the course. The basic premise of the paper is lessons learnt along the way.

Patient anxiety and surgical difficulty in impacted lower third molar extractions: a prospective cohort study.

PubMed

Aznar-Arasa, L; Figueiredo, R; Valmaseda-Castellón, E; Gay-Escoda, C

2014-09-01

Encountering patients who are fearful and anxious is common in dental practice and these factors can increase the complexity of dental procedures. A prospective cohort study was performed to assess whether patient anxiety influences the difficulty of impacted lower third molar extraction and to identify other predictive factors of surgical difficulty; 102 extractions done under local anaesthesia were assessed. Several preoperative variables were recorded (demographic, anatomical, and surgical) and patient anxiety was assessed through the use of various questionnaires. Extraction difficulty was measured using the operation time (OT) and a 100-mm visual analogue scale (difficulty VAS) completed by the surgeon. Patients with deep impacted third molars that required bone removal and tooth sectioning showed higher levels of preoperative anxiety. Significant correlations were found between questionnaire scores and the surgical difficulty (OT and difficulty VAS). OT was also related to age, depth of impaction, third molar angulations, proximity of the third molar roots to the mandibular canal, hard and soft tissue coverage, and the need to perform an ostectomy and tooth sectioning. Impacted lower third molar extraction is significantly more difficult in anxious patients. Other demographic, radiological, and surgical factors were also found to be significantly related to the surgical difficulty. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Virtual rehabilitation: What are the practical barriers for home-based research?

PubMed Central

Threapleton, Kate; Drummond, Avril; Standen, Penny

2016-01-01

Virtual reality technologies are becoming increasingly accessible and affordable to deliver, and consequently the interest in applying virtual reality within rehabilitation is growing. This has resulted in the emergence of research exploring the utility of virtual reality and interactive video gaming interventions for home use by patients. The aim of this paper is to highlight the practical factors and difficulties that may be encountered in research in this area, and to make recommendations for addressing these. Whilst this paper focuses on examples drawn mainly from stroke rehabilitation research, many of the issues raised are relevant to other conditions where virtual reality approaches have the potential to be applied to home-based rehabilitation. PMID:29942551

Succeeding in the first year of practice: heed the wisdom of novice nurses.

PubMed

Chandler, Genevieve Elizabeth

2012-01-01

The transition from student to nurse has been described as traumatic, confusing, and shocking. The difficulties encountered by the graduates have led to the premature termination of their first position, and sometimes they leave nursing altogether. To coach new nurses in preparation for their first year of practice using an appreciative inquiry framework, this study focused on the new graduates' perspective of the processes that enabled them to successfully integrate into their new role. From the analysis of 36 interviews, three themes were identified: "They were there for me," "There are no stupid questions," and "Nurturing the seeds." New nurses know what works for them; educators need to heed their wisdom.

"It´s incredible how much I´ve had to fight." Negotiating medical uncertainty in clinical encounters.

PubMed

Lian, Olaug S; Robson, Catherine

2017-01-01

Clinical encounters related to medically unexplained physical symptoms (MUPS) are associated with high levels of conflict between patients and doctors. Collaborative difficulties are fused by the medical uncertainty that dominates these consultations. The main aim of this study is to explore the interactional dynamics of clinical encounters riddled by medical uncertainty, as experienced by people living with long-term medically unexplained fatigue in Norway. A qualitative thematic analysis of written texts from 256 study participants. We found that patients experience being met with disbelief, inappropriate psychological explanations, marginalisation of experiences, disrespectful treatment, lack of physical examination and damaging health advice. The main source of their discontent is not the lack of biomedical knowledge, but doctors who fail to communicate acknowledgement of patients' experiences, knowledge and autonomy. War metaphors are emblematic of how participants describe their medical encounters. The overarching storyline depicts experiences of being caught in a power struggle with doctors and health systems, fused by a lack of common conceptual ground. When physical symptoms cannot be detected, explained and managed by biomedical knowledge and technology, good doctor-patient partnerships are crucial. Without clearly acknowledging patients' perspectives and capabilities in clinical practice, such partnerships cannot be achieved.

Encounters with a Pedagogista

ERIC Educational Resources Information Center

Vintimilla, C. D.

2018-01-01

This article documents the initial work and encounters of a pedagogista with a group of educators on the west coast of Canada. The article retraces the complexities and vulnerabilities of such encounters, and presents them as generative and rich conversations that were carried along by, and not despite, their difficulty. They followed a practice…

Branchial Cleft Cyst

PubMed Central

Nahata, Vaishali

2016-01-01

Branchial cleft cyst, sinuses, and fistulae are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulty in diagnosis and surgical management. Here, I report a case of 14-year-old boy who presented with asymptomatic, congenital swelling located just below the jawline in the lateral part of the neck. The lesion was excised surgically. Histopathology showed the cyst lined by squamous as well as columnar ciliated epithelium, which was a characteristic finding of branchial cleft cyst. The aim of presenting this case is its rarity. PMID:27904209

Quota sampling in internet research: practical issues.

PubMed

Im, Eun-Ok; Chee, Wonshik

2011-07-01

Quota sampling has been suggested as a potentially good method for Internet-based research and has been used by several researchers working with Internet samples. However, very little is known about the issues or concerns in using a quota sampling method in Internet research. The purpose of this article was to present the practical issues using quota sampling in an Internet-based study. During the Internet study, the research team recorded all recruitment issues that arose and made written notes indicating the possible reasons for the problems. In addition, biweekly team discussions were conducted for which written records were kept. Overall, quota sampling was effective in ensuring that an adequate number of midlife women were recruited from the targeted ethnic groups. However, during the study process, we encountered the following practical issues using quota sampling: (1) difficulty reaching out to women in lower socioeconomic classes, (2) difficulty ensuring authenticity of participants' identities, (3) participants giving inconsistent answers for the screening questions versus the Internet survey questions, (4) potential problems with a question on socioeconomic status, (5) resentment toward the research project and/or researchers because of rejection, and (6) a longer time and more expense than anticipated.

Pharmacy practice simulations: performance of senior pharmacy students at a University in southern Brazil

PubMed Central

Galato, Dayani; Alano, Graziela M.; Trauthman, Silvana C.; França, Tainã F.

Objective A simulation process known as objective structured clinical examination (OSCE) was applied to assess pharmacy practice performed by senior pharmacy students. Methods A cross-sectional study was conducted based on documentary analysis of performance evaluation records of pharmacy practice simulations that occurred between 2005 and 2009. These simulations were related to the process of self-medication and dispensing, and were performed with the use of patients simulated. The simulations were filmed to facilitate the evaluation process. It presents the OSCE educational experience performed by pharmacy trainees of the University of Southern Santa Catarina and experienced by two evaluators. The student general performance was analyzed, and the criteria for pharmacy practice assessment often identified trainees in difficulty. Results The results of 291 simulations showed that students have an average yield performance of 70.0%. Several difficulties were encountered, such as the lack of information about the selected/prescribed treatment regimen (65.1%); inadequate communication style (21.9%); lack of identification of patients’ needs (7.7%) and inappropriate drug selection for self-medication (5.3%). Conclusions These data show that there is a need for reorientation of clinical pharmacy students because they need to improve their communication skills, and have a deeper knowledge of medicines and health problems in order to properly orient their patients. PMID:24367467

Essential therapeutics skills required of junior doctors.

PubMed

Baldwin, Mathew J; Abouyannis, Michael; Butt, Tehreem F

2012-12-01

Junior doctors are responsible for the majority of in-hospital prescription errors. Little research has explored their confidence to prescribe, or practical therapeutics related tasks which they are required to perform in day-to-day practice. This survey aimed to explore these areas, gather feedback regarding therapeutics teaching at undergraduate level, and to apply findings to undergraduate training at University of Birmingham. Questionnaire-based survey of all first-year postgraduate doctors (PG1) attending teaching hospitals in the Birmingham and Worcester regions towards the end of the PG1 year. Doctors were asked about difficulties in prescribing, satisfaction with undergraduate training, and how frequently they undertook particular tasks pertaining to therapeutics. Qualitative data on suggestions for improving the curriculum were also collected. Difficulties were commonly encountered with prescribing warfarin, controlled drugs and syringe-driven drugs. Most (87.4 %) had been required to administer intravenous medications. Nearly all had prescribed to 'special groups' such as the elderly (100 %) and patients with renal disease (98.3 %). Thirty-seven percent were not satisfied with their undergraduate therapeutics teaching, and many (56.2 %) recommended making teaching more relevant to clinical practice. Many PG1s expressed difficulties in prescribing potentially dangerous medications. Although better than other UK surveys, significant numbers were not satisfied with undergraduate teaching. The strong opinion was for teaching to become more practical and more relevant. Prescriptions which PG1s are commonly asked to write have been described. Findings have guided improvements to undergraduate teaching and assessment in therapeutics at the University of Birmingham, and may offer guidance to other medical schools.

Data sharing and reanalysis of randomized controlled trials in leading biomedical journals with a full data sharing policy: survey of studies published in The BMJ and PLOS Medicine.

PubMed

Naudet, Florian; Sakarovitch, Charlotte; Janiaud, Perrine; Cristea, Ioana; Fanelli, Daniele; Moher, David; Ioannidis, John P A

2018-02-13

To explore the effectiveness of data sharing by randomized controlled trials (RCTs) in journals with a full data sharing policy and to describe potential difficulties encountered in the process of performing reanalyses of the primary outcomes. Survey of published RCTs. PubMed/Medline. RCTs that had been submitted and published by The BMJ and PLOS Medicine subsequent to the adoption of data sharing policies by these journals. The primary outcome was data availability, defined as the eventual receipt of complete data with clear labelling. Primary outcomes were reanalyzed to assess to what extent studies were reproduced. Difficulties encountered were described. 37 RCTs (21 from The BMJ and 16 from PLOS Medicine ) published between 2013 and 2016 met the eligibility criteria. 17/37 (46%, 95% confidence interval 30% to 62%) satisfied the definition of data availability and 14 of the 17 (82%, 59% to 94%) were fully reproduced on all their primary outcomes. Of the remaining RCTs, errors were identified in two but reached similar conclusions and one paper did not provide enough information in the Methods section to reproduce the analyses. Difficulties identified included problems in contacting corresponding authors and lack of resources on their behalf in preparing the datasets. In addition, there was a range of different data sharing practices across study groups. Data availability was not optimal in two journals with a strong policy for data sharing. When investigators shared data, most reanalyses largely reproduced the original results. Data sharing practices need to become more widespread and streamlined to allow meaningful reanalyses and reuse of data. Open Science Framework osf.io/c4zke. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Teaching Chemical Equilibrium and Thermodynamics in Undergraduate General Chemistry Classes.

ERIC Educational Resources Information Center

Banerjee, Anil C.

1995-01-01

Discusses some of the conceptual difficulties encountered by undergraduate students in learning certain aspects of chemical equilibrium and thermodynamics. Discusses teaching strategies for dealing with these difficulties. (JRH)

Teaching evolution in the Australian classroom

NASA Astrophysics Data System (ADS)

Vozzo, Les

A summary of the key issues of controversy encountered by science teachers in Australian classrooms. Evolution, cloning and gene manipulation, fertility control, artificial intelligence, irradiation of food, the use of nuclear energy, radiation from powerlines are some of the topics discussed and debated in classrooms. What are some of the difficulties encountered by teachers when students ask questions that raise moral dilemmas and challenges entrenched beliefs and views of the world. What are some of the teaching strategies used that deal with these difficulties.

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.

Pharmacists' Assessment of the Difficulty and Frequency of Ethical Issues Encountered in Community Pharmacy Settings.

PubMed

Crnjanski, Tatjana; Krajnovic, Dusanka; Savic, Mirko

2017-05-23

Researching ethical problems and their frequency could give us a complex picture and greater insight into the types of ethical issues that pharmacists face in providing health care. The overall aim of this study was to assess the pharmacist's perception of difficulty and frequency of selected ethical issues encountered by the community pharmacists in their everyday practice. A quantitative cross sectional multicenter study was performed using a validated survey instrument - Ethical Issue Scale for Community Pharmacy (EISP). The results of the analysis of 690 completely filled out instruments (response rate 78.49%) showed the difference between the ethical issues which always occurred ("A pharmacist is prevented from dispensing a medicine to the patient due to an administrative error in the prescription"), and the ones that pharmacists found most difficult ("A pharmacist dispenses a medicine he/she personally considers inadequate for the therapeutic treatment of the patient, in order to avoid any conflicts with the physician" and "A pharmacist is considering violating the rules and regulations in order to perform an act of humanity"). The majority of respondents (84.78%) were familiar with the Code of Ethics but the correlation between the familiarity and the perceived usefulness of the code in resolving problems in everyday practice was negative (ρ = -0.17, p < 0.001). Results showed that patients' well-being had a high influence on pharmacists' behavior. The results provided quantitative data by the examination of specific ethical issues and their occurrence. Further empirical research is recommended in order to systematically identify the ethical issues faced by community pharmacists.

Mapping and Interpreting Novice Physical Education Teachers' Self-Perceptions of Strengths and Difficulties

ERIC Educational Resources Information Center

Shoval, Ella; Erlich, Ilana; Fejgin, Naomi

2010-01-01

Background: Research regarding beginning teachers' typical responses to the difficulties encountered at work relates to the professional, personal and environmental aspects of teaching. At the professional level, research describes mainly the beginner's difficulties in dealing with discipline problems, in using teaching methods efficiently, in…

Difficulties for University Students with Mental Health Problems: A Critical Interpretive Synthesis

ERIC Educational Resources Information Center

Markoulakis, Roula; Kirsh, Bonnie

2013-01-01

Postsecondary institutions are witnessing an increase in the number and severity of student mental health problems, necessitating an understanding of the difficulties these students encounter in striving for higher education. The authors conducted a critical interpretive synthesis of 10 articles pertaining to difficulties experienced by students…

Effective communication with older adults.

PubMed

Daly, Louise

2017-06-07

Communication is an essential aspect of life, yet it can be taken for granted. Its centrality to being in the world and in professional practice often becomes evident when nurses and older adults encounter communication difficulties. The factors that can affect nurses' communication with older adults relate to the older adult, the nurse, sociocultural considerations and the environment, and the interactions between these factors. In adopting a person-centred approach to communicating with older adults, it is necessary to get to know the person as an individual and ensure communication meets their needs and abilities. Effective communication is essential in nursing practice and requires professional competence and engagement. This article can be used by nurses to support effective communication with older adults across the continuum of care.

Preclinical students’ experiences in early clerkships after skills training partly offered in primary health care centers: a qualitative study from Indonesia

PubMed Central

2012-01-01

Background Students may encounter difficulties when they have to apply clinical skills trained in their pre-clinical studies in clerkships. Early clinical exposure in the pre-clinical phase has been recommended to reduce these transition problems. The aim of this study is to explore differences in students' experiences during the first clerkships between students exclusively trained in a skills laboratory and peers for whom part of their skills training was substituted by early clinical experiences (ECE). Methods Thirty pre-clinical students trained clinical skills exclusively in a skills laboratory; 30 peers received part of their skills training in PHC centers. Within half a year after commencing their clerkships all 60 students shared their experiences in focus group discussions (FGDs). Verbatim transcripts of FGDs were analyzed using Atlas-Ti software. Results Clerkship students who had participated in ECE in PHC centers felt better prepared to perform their clinical skills during the first clerkships than peers who had only practiced in a skills laboratory. ECE in PHC centers impacted positively in particular on students’ confidence, clinical reasoning, and interpersonal communication. Conclusion In the Indonesian setting ECE in PHC centers reduce difficulties commonly encountered by medical students in the first clerkships. PMID:22640419

Web-based objective structured clinical examination with remote standardized patients and Skype: resident experience.

PubMed

Langenau, Erik; Kachur, Elizabeth; Horber, Dot

2014-07-01

Using Skype and remote standardized patients (RSPs), investigators sought to evaluate user acceptance of a web-based objective structured clinical examination (OSCE) among resident physicians. After participating in four web-based clinical encounters addressing pain with RSPs, 59 residents from different training programs, disciplines and geographic locations completed a 52-item questionnaire regarding their experience with Skype and RSPs. Open-ended responses were solicited as well. The majority of participants (97%) agreed or strongly agreed the web-based format was convenient and a practical learning exercise, and 90% agreed or strongly agreed the format was effective in teaching communication skills. Although 93% agreed or strongly agreed they could communicate easily with RSPs using Skype, 80% preferred traditional face-to-face clinical encounters, and 58% reported technical difficulties during the encounters. Open-ended written responses supported survey results. Findings from this study expose challenges with technology and human factors, but positive experiences support the continued investigation of web-based OSCEs as a synchronous e-learning initiative for teaching and assessing doctor-patient communication. Such educational programs are valuable but unlikely to replace face-to-face encounters with patients. This web-based OSCE program provides physician learners with additional opportunity to improve doctor-patient communication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Confronting Task Difficulty in Ego Involvement: Change in Performance Goals

ERIC Educational Resources Information Center

Kumar, Shamala; Jagacinski, Carolyn M.

2011-01-01

Both Dweck (1986) and Nicholls (1984) proposed that when ego-involved individuals encounter difficulty, they would begin to doubt their level of ability, and as a consequence, their commitment to the goal of demonstrating high ability would decline. As difficulty continued, perceived ability would decline, and eventually the goal would be…

Formulation and implementation of a practical algorithm for parameter estimation with process and measurement noise

NASA Technical Reports Server (NTRS)

Maine, R. E.; Iliff, K. W.

1980-01-01

A new formulation is proposed for the problem of parameter estimation of dynamic systems with both process and measurement noise. The formulation gives estimates that are maximum likelihood asymptotically in time. The means used to overcome the difficulties encountered by previous formulations are discussed. It is then shown how the proposed formulation can be efficiently implemented in a computer program. A computer program using the proposed formulation is available in a form suitable for routine application. Examples with simulated and real data are given to illustrate that the program works well.

Practical problems which women encounter with available contraception in Australia.

PubMed

Weisberg, E

1994-06-01

Australian women face major difficulties with contraception because of the limited range of choices, the need for meticulous attention to compliance with most available methods and because of cost limitations for a significant minority of the population. The most commonly used methods are oral contraceptive pills and barrier methods, and each has substantial compliance problems which can be minimized with care and counselling. There is an urgent need for a wider range of options in Australia and for good information and publicity about them. Present progress in this direction gives some hope for the near future.

Multiple targets detection method in detection of UWB through-wall radar

NASA Astrophysics Data System (ADS)

Yang, Xiuwei; Yang, Chuanfa; Zhao, Xingwen; Tian, Xianzhong

2017-11-01

In this paper, the problems and difficulties encountered in the detection of multiple moving targets by UWB radar are analyzed. The experimental environment and the penetrating radar system are established. An adaptive threshold method based on local area is proposed to effectively filter out clutter interference The objective of the moving target is analyzed, and the false target is further filtered out by extracting the target feature. Based on the correlation between the targets, the target matching algorithm is proposed to improve the detection accuracy. Finally, the effectiveness of the above method is verified by practical experiment.

The mind: psychoanalytic understanding then and now.

PubMed

Bergmann, Martin S

2008-01-01

The author discusses the evolution of psychoanalytic understanding from Freud's time to the present, citing the influence of various sociocultural changes. He addresses Freud's proper place in history and notes ways in which Freud's contributions cast him as belonging to Romanticism. Freud's shift from the topographic model of the mind to the structural one, and the influence of this on psychoanalysis, is discussed, as well as important developments in the field since Freud. The author focuses particularly on difficulties encountered in psychoanalytic practice today, and he describes what he has termed organizing interpretations as uniquely valuable in the treatment setting.

Sick-listed employees with severe medically unexplained physical symptoms: burden or routine for the occupational health physician? A cross sectional study

PubMed Central

2010-01-01

Background The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS). Third objective was to determine which disease-, patient-, doctor- and practice-related factors are associated with the difficulties and needs of the OHPs. Methods In this cross-sectional study, 43 participating OHPs from 5 group practices assessed 489 sick-listed employees with and without severe MUPS. The OHPs filled in a questionnaire about difficulties concerning sickness certification tasks, consultation time, their needs with regard to consultation with or referral to a psychiatrist or psychologist, and communication with GPs. The OHPs also completed a questionnaire about their personal characteristics. Results OHPs only experienced task difficulties in employees with severe MUPS in relation to their communication with the treating physician. This only occured in cases in which the OHP attributed the physical symptoms to somatoform causes. If they attributed the physical symptoms to mental causes, the OHPs reported a need to consultate a psychiatrist about the diagnosis and treatment. Conclusions OHPs experience few difficulties with their sickness certification tasks and consultation load concerning employees with severe MUPS. However, they encounter problems if the diagnostic uncertainties of the treating physician interfere with the return to work process. OHPs have a need for psychiatric expertise whenever they are uncertain about the psychiatric causes of a delayed return to work process. We recommend further training programs for OHPs. They should also have more opportunity for consultation and referral to a psychiatrist, and their communication with treating physicians should be improved. PMID:21059232

Conducted electrical weapons within healthcare: a comprehensive use of force model.

PubMed

Ho, Jeffrey D; Williams, Martin F; Coplen, Michael J

2014-01-01

Healthcare settings are experiencing increased amounts of violent activity that are challenging to the health care security profession. There is difficulty in addressing this issue completely. Some of this difficulty is because of factors that include inexperienced and untrained clinicians and administrators that are often the decision-makers in the health care setting. As part of an effective solution, we propose that a security plan, including a comprehensive use of force program incorporating conducted electrical weapons, is a necessary and best-practice goal. This paper outlines the background of the problem and discusses the challenges we encountered in reaching this goal as well as the benefits we have discovered along the way. This paper will be beneficial to any healthcare security professional that is interested in enhancing or improving their current health care security use of force model to further counter the increasing violent activity in their respective healthcare setting.

Prison prescribing practice: practitioners' perspectives on why prison is different.

PubMed

Bartlett, A; Dholakia, N; England, R; Hales, H; van Horn, E; McGeorge, T; Moss, B; Ovaisi, S; Tukmachi, E; Patel, S

2014-04-01

The current prison population in England and Wales has multiple, complex healthcare needs, presenting unique challenges to those caring for prisoners. Prison numbers have increased dramatically in the last 10 years. There are now approximately 84,000 prisoners in England and Wales and 120,000 new episodes of imprisonment each year . The authors all contribute to prison healthcare. Below, we discuss a key issue arising from first-hand experience of prisoners' health and social care needs, the prescription of psycho-active drugs by primary and secondary care practitioners. This is a core medical task, but beset with difficulties. These difficulties are not necessarily encountered in other areas of prison healthcare. However, they do illustrate how providing healthcare to prisoners is complex, often lacking a research base and can have pitfalls that are not obvious to the outsider. © 2014 John Wiley & Sons Ltd.

JPRS Report, China

DTIC Science & Technology

1993-05-06

TAIWAN New KMT Pursues Political Struggle [ HSIN HSIN WEN 6 Mar] 64 HONG KONG, MACAO Newly Elected Local Members of CPPCC Published [MING PAO 20...impartially enforcing them will it be possible to attract more foreign investors. Indeed, some foreign business people said: Today you turn your laws and...difficulties. As for the difficulties we mention here, we do not mean a difficulty in making tax pay- ments. When you encounter temporary difficulties, we

Modelling Difficulties and Their Overcoming Strategies in the Solution of a Modelling Problem

ERIC Educational Resources Information Center

Dede, Ayse Tekin

2016-01-01

The purpose of the study is to reveal the elementary mathematics student teachers' difficulties encountered in the solution of a modelling problem, the strategies to overcome those difficulties and whether the strategies worked or not. Nineteen student teachers solved the modelling problem in their four or five-person groups, and the video records…

To See or Not to See: Analyzing Difficulties in Geometry from the Perspective of Visual Perception

ERIC Educational Resources Information Center

Gal, Hagar; Linchevski, Liora

2010-01-01

In this paper, we consider theories about processes of visual perception and perception-based knowledge representation (VPR) in order to explain difficulties encountered in figural processing in junior high school geometry tasks. In order to analyze such difficulties, we take advantage of the following perspectives of VPR: (1) Perceptual…

The Challenges of Chinese: A Preliminary Study of UK Learners' Perceptions of Difficulty

ERIC Educational Resources Information Center

Hu, Bo

2010-01-01

This study aims to highlight aspects of difficulty encountered by Chinese as a Foreign Language (CFL) learners and to explore the factors underlying these aspects. Data were gathered through a Chinese Language Learning Difficulty Survey from 164 CFL learners, mostly in British higher education. The survey data provided useful exploratory findings.…

Comparative study of procedures for the analysis of chloride in hardened concrete.

DOT National Transportation Integrated Search

1976-01-01

In the widely used potentiometric titration procedure for the analysis of chloride in powdered hardened concrete samples, difficulties have often been encountered when determining the endpoint. These difficulties have been eliminated through the use ...

Project-Based Manufacturing Engineering Practice at Ibaraki University and Its Outcomes

NASA Astrophysics Data System (ADS)

Yamasaki, Kazuhiko; Wang, Dong F.; Maekawa, Katsuhiro

The real world experience of manufacturing processes from an idea stage to a final product must be related to classroom lectures in mechanical engineering curriculum, including design, materials engineering, dynamics and control. Various challenges and difficulties encountered during the manufacturing engineering practice also let students recognize their creativity as well as what kinds of knowledge is missing. Awareness is the start of growth. In line with this principle we have carried out the mechanical engineering practice for 10 years. Some modifications toward “project-based practice” , however, have been made through manufacturing engineers’ real activities. Drawing and specification, process control, cost management, and role-sharing arrangement are stressed during the semester course. The present paper describes how it works and what is left to improve further, such as a refinement of themes and a coaching method for bringing out the hidden talent in students.

Highlight on Bottlenecks in Food Allergen Analysis: Detection and Quantification by Mass Spectrometry.

PubMed

Planque, Mélanie; Arnould, Thierry; Renard, Patricia; Delahaut, Philippe; Dieu, Marc; Gillard, Nathlie

2017-07-01

Food laboratories have developed methods for testing allergens in foods. The efficiency of qualitative and quantitative methods is of prime importance in protecting allergic populations. Unfortunately, food laboratories encounter barriers to developing efficient methods. Bottlenecks include the lack of regulatory thresholds, delays in the emergence of reference materials and guidelines, and the need to detect processed allergens. In this study, ultra-HPLC coupled to tandem MS was used to illustrate difficulties encountered in determining method performances. We measured the major influences of both processing and matrix effects on the detection of egg, milk, soy, and peanut allergens in foodstuffs. The main goals of this work were to identify difficulties that food laboratories still encounter in detecting and quantifying allergens and to sensitize researchers to them.

[Tubal sterilization in mentally handicapped women].

PubMed

Barjot, P; Hervé, C

2001-09-22

When performed for contraception purposes, tubular sterilization for mentally handicapped women poses important ethical issues, including patient's rights, body integrity, and the notion of informed consent. French law guarantees the respect and safety of all patients, but in everyday practice, patient's rights must be upheld by family and healthcare workers searching for the most adapted solutions for each individual situation. We present here our proposals for everyday practice. Our conclusions are based on an analysis of the notion of handicap as defined by the WHO and on the observed sexual activities of this type of patient. In this context, informed consent involves a number of subjective factors pointing out the difficulty encountered in providing dear comprehensible information. Finally we discuss the ethical issue of tubular sterilization which many consider to be a masked form of eugenism.

Challenges of Combining Perspectives.

PubMed

Sundvall, Maria; Titelman, David; Bäärnhielm, Sofie

2018-02-23

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

Experiences of Public Doctors on Managing Work Difficulties and Maintaining Professional Enthusiasm in Acute General Hospitals: A Qualitative Study.

PubMed

Luk, Andrew Leung; Yau, Adrian Fai To

2018-01-01

Overseas studies suggest that 10-20% of doctors are depressed, 30-45% have burnout, and many report dissatisfaction with work-life balance. A local study on public doctors showed that 31.4% of the respondents satisfied the criteria for high burnout. Young, but moderately experienced doctors who need to work shifts appeared most vulnerable. This study aims to explore the experiences of those public doctors who have managed their work difficulties and maintained professional enthusiasm for references in medical education and continuing professional training. Ten public doctors with reputation were invited respectively from three acute general hospitals for an in-depth interview. Interviews were audio recorded and transcribed. Content analysis was carried out to identify major themes in relation to the research questions. Three themes emerging from difficulties encountered were (1) managing people, mostly are patients, followed by colleagues and then patients' relatives; (2) constraints at work, include time and resources; and (3) managing self with decision-making within a short time. Three themes generating from managing work difficulties included (1) self-adjustment with practicing problem solving and learning good communication appeared more frequently, followed by maintaining a professional attitude and accumulating clinical experiences; (2) seeking help from others; and (3) organizational support is also a theme though it is the least mentioned. Four themes emerging from maintaining work enthusiasm were (1) personal conviction and discipline: believing that they are helping the needy, having the sense of vocation and support from religion; disciplining oneself by continuing education, maintaining harmonious family relationship and volunteer work. (2) Challenging work: different challenging natures of their job. (3) Positive feedback from patients: positive encounters with patients keep a connectedness with their clients. (4) Organization support: working with good colleagues and opportunity for continuous training. Some implications for medical education include, developing good communication skill for medical students and junior doctors, preparing senior doctors to be mentors, and exploring the motivating force of spirituality/religion.

A Study on the Difficulties of Learning Phase Transition in Object-Oriented Analysis and Design from the Viewpoint of Semantic Distance

ERIC Educational Resources Information Center

Shin, Shin-Shing

2015-01-01

Students in object-oriented analysis and design (OOAD) courses typically encounter difficulties transitioning from object-oriented analysis (OOA) to logical design (OOLD). This study conducted an empirical experiment to examine these learning difficulties by evaluating differences between OOA-to-OOLD and OOLD-to-object-oriented-physical-design…

Emotional intelligence, empathy and alexithymia in anorexia nervosa during adolescence.

PubMed

Peres, Victoire; Corcos, Maurice; Robin, Marion; Pham-Scottez, Alexandra

2018-02-16

Socio-emotional difficulties have been observed on adult patients suffering from anorexia nervosa (AN). But researches with adolescents are scarce and non-congruent. The aim of this paper is to identify the socio-emotional difficulties that are encountered by AN during adolescence, and to isolate them from those encountered by control adolescents. 41 AN and 38 control adolescents were assessed using the emotional quotient inventory by Bar-On, youth version (EQ-i: YV), the Toronto Alexithymia Questionnaire (TAS-20), the Interpersonal Reactivity Index (IRI), and anxiety and depression were controlled using the Hospital Anxiety and Depression Scale (HADS). Personal distress remains the main difference between the two groups, even when depression and anxiety are controlled. Intrapersonal difficulties are observed in the AN group, as well as alexithymic traits. Research on AN has to focus on the socio-emotional difficulties during adolescence, to properly identify which difficulties are linked to that life period, and which are a trait of AN. Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

Methodological Problems Encountered in the Review of Research in Science Teaching

ERIC Educational Resources Information Center

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

1972-01-01

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

Difficulties encountered in collaborative care: logistics trumps desire.

PubMed

Legault, Frances; Humbert, Jennie; Amos, Stephanie; Hogg, William; Ward, Natalie; Dahrouge, Simone; Ziebell, Laura

2012-01-01

This study examines the development of collaborative relationships between family physicians (FPs) and Anticipatory And Preventative Team Care (APTCare) team members providing care to medically complex patients who have been identified as at-risk for negative health outcomes. We undertook a qualitative study of a primary health care intervention in a family practice. Interviews were held with FPs and ATPCare intervention nurse practitioners (NPs) and pharmacists. Focus groups were conducted and a survey was administered to participating FPs, NPs, and pharmacists. NPs and pharmacists maintained a log recording their tasks and moments of collaboration. Scheduling demands rendered face-to-face collaboration difficult, leaving the team to rely on technological tools to keep in touch. Limited space meant the APTCare team had to work out of a downstairs office, limiting informal interactions with the practitioners on the main level. We demonstrate that the difficulties inherent in collaborative care are independent of the patient population being cared for. Regardless of the patient population and sector of health care, developing collaborative relationships and learning to work collaboratively is difficult and takes time. What many of these teams need is ongoing support and education about how to make these collaborative care practices work.

Circumcision in Australia: prevalence and effects on sexual health.

PubMed

Richters, Juliet; Smith, Anthony M A; de Visser, Richard O; Grulich, Andrew E; Rissel, Christopher E

2006-08-01

The results from a telephone survey in 2001-02 of a probability sample of Australian households including 10,173 men aged 16-59 (response rate 69.4%) are used to assess the prevalence of circumcision across social groups in Australia and examine lifetime history of sexually transmissible infection (STI), sexual difficulties in the last year, sexual practices including masturbation, and sexual attitudes. More than half (59%) of the men were circumcised. Circumcision was less common among younger men (32% aged <20) and more common among the Australian born (69%). After correction for age, circumcision was unrelated to reporting STI, but appeared to protect against penile candidiasis. Circumcision was unrelated to most sexual difficulties, but circumcised men were less likely to report physical pain during intercourse or trouble keeping an erection; reasons for this are unknown. There were no significant differences in practices at last sexual encounter with a female partner or in masturbation alone. Circumcised men had somewhat more liberal sexual attitudes. Neonatal circumcision was routine in Australia until the 1970s. It appears not to be associated with significant protective or harmful sexual health outcomes. This study provides no evidence about the effects on sexual sensitivity.

[Experiences and difficulties in implementing immunization registries in Saxony-Anhalt].

PubMed

Oppermann, H; Borrmann, M; Thriene, B; Gräfe, L; Wilhelms, E; Herrmann, C; Weise, H; Hennig, E; Claus, H

2004-12-01

In the German Federal State of Saxony-Anhalt, the Health Department must be notified of vaccines administered to children <7 years of age including their names. The goal of this mandatory notification is to improve and stabilize the age-appropriate vaccination coverage. However, difficulties have been encountered in implementing mandatory notification. Therefore, the Health Departments of Magdeburg and Halle have launched a model project focusing on analysing and eliminating these problems. Mandatory notification requires parents' approval, endorsement of vaccantors, and availability of human and technicely resources in the Health Department. An enquiry among paediatricians and family doctors in private practice revealed widespread reservations about mandatory notification because of privacy issues related to data and legal protection. Furthermore, family doctors believed that parents disapproved of notification by name. However, a survey among young mothers revealed this not to be the case. Winning young mothers' approval depends largely on the positive attitude of the vaccinators. To implement the mandatory notification of vaccinations to the Health Department, it is necessary to dispel physicians' concerns and to inform young parents about the practical benefits. However, this places high demands on the Health Departments for maintaining immunization registries, communicating with physicians and notifying parents when immunisations are due or late.

Developing prehospital clinical practice guidelines for resource limited settings: why re-invent the wheel?

PubMed

McCaul, Michael; de Waal, Ben; Hodkinson, Peter; Pigoga, Jennifer L; Young, Taryn; Wallis, Lee A

2018-02-05

Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, the volume of literature is not matched by research into alternative methods of CPG development using existing CPG documents-a specific issue for guideline development groups in low- and middle-income countries. We report on how we developed a context specific prehospital CPG using an alternative guideline development method. Difficulties experienced and lessons learnt in applying existing global guidelines' recommendations to a national context are highlighted. The project produced the first emergency care CPG for prehospital providers in Africa. It included > 270 CPGs and produced over 1000 recommendations for prehospital emergency care. We encountered various difficulties, including (1) applicability issues: few pre-hospital CPGs applicable to Africa, (2) evidence synthesis: heterogeneous levels of evidence classifications and (3) guideline quality. Learning points included (1) focusing on key CPGs and evidence mapping, (2) searching other resources for CPGs, (3) broad representation on CPG advisory boards and (4) transparency and knowledge translation. Re-inventing the wheel to produce CPGs is not always feasible. We hope this paper will encourage further projects to use existing CPGs in developing guidance to improve patient care in resource-limited settings.

Considerations for multiple hypothesis correlation on tactical platforms

NASA Astrophysics Data System (ADS)

Thomas, Alan M.; Turpen, James E.

2013-05-01

Tactical platforms benefit greatly from the fusion of tracks from multiple sources in terms of increased situation awareness. As a necessary precursor to this track fusion, track-to-track association, or correlation, must first be performed. The related measurement-to-track fusion problem has been well studied with multiple hypothesis tracking and multiple frame assignment methods showing the most success. The track-to-track problem differs from this one in that measurements themselves are not available but rather track state update reports from the measuring sensors. Multiple hypothesis, multiple frame correlation systems have previously been considered; however, their practical implementation under the constraints imposed by tactical platforms is daunting. The situation is further exacerbated by the inconvenient nature of reports from legacy sensor systems on bandwidth- limited communications networks. In this paper, consideration is given to the special difficulties encountered when attempting the correlation of tracks from legacy sensors on tactical aircraft. Those difficulties include the following: covariance information from reporting sensors is frequently absent or incomplete; system latencies can create temporal uncertainty in data; and computational processing is severely limited by hardware and architecture. Moreover, consideration is given to practical solutions for dealing with these problems in a multiple hypothesis correlator.

On inconsistency in frictional granular systems

NASA Astrophysics Data System (ADS)

Alart, Pierre; Renouf, Mathieu

2018-04-01

Numerical simulation of granular systems is often based on a discrete element method. The nonsmooth contact dynamics approach can be used to solve a broad range of granular problems, especially involving rigid bodies. However, difficulties could be encountered and hamper successful completion of some simulations. The slow convergence of the nonsmooth solver may sometimes be attributed to an ill-conditioned system, but the convergence may also fail. The prime aim of the present study was to identify situations that hamper the consistency of the mathematical problem to solve. Some simple granular systems were investigated in detail while reviewing and applying the related theoretical results. A practical alternative is briefly analyzed and tested.

Developing a general practice library: a collaborative project between a GP and librarian.

PubMed

Pearson, D; Rossall, H

2001-12-01

The authors report on a self-completed questionnaire study from a North Yorkshire based general practice regarding the information needs of its clinicians. The work was carried out with a particular focus on the practice library, and the findings identified that a new approach to maintaining and developing the library was needed. The literature regarding the information needs of primary care clinicians and the role of practice libraries is considered, and compared to those of the clinicians at the practice. Discussion follows on how a collaborative project was set up between the practice and a librarian based at the local NHS Trust library in order to improve the existing practice library. Difficulties encountered and issues unique to the project are explored, including training implications presented by the implementation of electronic resources. Marketing activities implemented are discussed, how the library will operate in its new capacity, and how ongoing support and maintenance of the library will be carried out. It is concluded that although scepticism still exists regarding librarian involvement in practice libraries, collaboration between clinicians and librarians is an effective approach to the successful development and maintenance of a practice library, and recommendations are therefore made for similar collaborative work.

The Dyslexic Student and Mathematics in Higher Education

ERIC Educational Resources Information Center

Perkin, Glynis; Croft, Tony

2007-01-01

Difficulties that are encountered by dyslexic undergraduates with their learning and understanding of mathematics are explored. Specific consideration is given to issues arising through mathematical content, its delivery, the procedures and processes of doing mathematics, and its assessment. Particular difficulties, which have emerged through…

Commognitive Analysis of Undergraduate Mathematics Students' First Encounter with the Subgroup Test

ERIC Educational Resources Information Center

Ioannou, Marios

2018-01-01

This study analyses learning aspects of undergraduate mathematics students' first encounter with the subgroup test, using the commognitive theoretical framework. It focuses on students' difficulties as these are related to the object-level and metalevel mathematical learning in group theory, and, when possible, highlights any commognitive…

The Ecology of the Mind

ERIC Educational Resources Information Center

Mazzetti, Luciano

2013-01-01

Dr. Mazzetti's almost lyrical description of the role of encounters, both human and natural, suggests the terrible difficulty that would occur if the diversity of the natural environment, which is so essential to Montessori's prepared environment was lost. In principle, Dr. Mazzetti suggests that the child's encounter with the world needs deep…

Representing energy efficiency diagnosis strategies in cognitive work analysis.

PubMed

Hilliard, Antony; Jamieson, Greg A

2017-03-01

This article describes challenges encountered in applying Jens Rasmussen's Cognitive Work Analysis (CWA) framework to the practice of energy efficiency Monitoring & Targeting (M&T). Eight theoretic issues encountered in the analysis are described with respect to Rasmussen's work and the modeling solutions we adopted. We grappled with how to usefully apply Work Domain Analysis (WDA) to analyze categories of domains with secondary purposes and no ideal grain of decomposition. This difficulty encouraged us to pursue Control Task (ConTA) and Strategies (StrA) analysis, which are under-explored as bases for interface design. In ConTA we found M&T was best represented by two interlinked work functions; one controlling energy, the other maintaining knowledge representations. From StrA, we identified a popular representation-dependent strategy and inferred information required to diagnose faults in system performance and knowledge representation. This article presents and discusses excerpts from our analysis, and outlines their application to diagnosis support tools. Copyright © 2015 Elsevier Ltd. All rights reserved.

Specific Learning Difficulties--What Teachers Need to Know

ERIC Educational Resources Information Center

Hudson, Diana

2015-01-01

This book clearly explains what Specific Learning Difficulties (SpLD) are, and describes the symptoms of conditions most commonly encountered in the mainstream classroom: dyslexia, dyspraxia, dyscalculia, dysgraphia, Autism Spectrum Disorder, ADHD, and OCD. The author provides an overview of the strengths and weaknesses commonly associated with…

New Start Program Report: September 1985--June 1989.

ERIC Educational Resources Information Center

Winchell, Anne

In 1985, Kingsborough Community College (KCC) in Brooklyn, established the New Start Program to assist students who began their post-secondary education at cooperating senior colleges, but encountered academic difficulties there. The program offers individual and group counseling to help participants overcome previous difficulties and work toward…

Indicators of Multiplicative Reasoning among Fourth Grade Students

ERIC Educational Resources Information Center

Carrier, James A.

2010-01-01

Many students encounter difficulty in their transition to advanced mathematical thinking. Such difficulty may be explained by a lack of understanding of many concepts taught in early school years, especially multiplicative reasoning. Advanced mathematical thinking depends on the development of multiplicative reasoning. The purpose of this study…

'Nobody knows what's around the corner': the challenges of caring for people with long-term conditions in care homes.

PubMed

Martin, Susan; Martin, Joy

2018-06-02

People living with long-term conditions are increasingly being cared for in care homes. Prognostication in this population is particularly challenging, and outcomes are often uncertain. This case history highlights some of the difficulties encountered when clinicians give a time-bound prognosis. It also illustrates how education programmes with high facilitation and ongoing support for care home staff can sustain practice development and enable staff to become highly skilled in working with uncertainty. Practice development programmes such as those based on the Six Steps to Success Programme for care homes give care home staff a framework within which to regularly review a resident's clinical status and the confidence to have the ongoing conversations that empower residents to contribute to decision making and focus on their own goals for care.

Examining organizational change in primary care practices: experiences from using ethnographic methods.

PubMed

Russell, Grant; Advocat, Jenny; Geneau, Robert; Farrell, Barbara; Thille, Patricia; Ward, Natalie; Evans, Samantha

2012-08-01

Qualitative methods are an important part of the primary care researcher's toolkit providing a nuanced view of the complexity in primary care reform and delivery. Ethnographic research is a comprehensive approach to qualitative data collection, including observation, in-depth interviews and document analysis. Few studies have been published outlining methodological issues related to ethnography in this setting. This paper examines some of the challenges of conducting an ethnographic study in primary care setting in Canada, where there recently have been major reforms to traditional methods of organizing primary care services. This paper is based on an ethnographic study set in primary care practices in Ontario, Canada, designed to investigate changes to organizational and clinical routines in practices undergoing transition to new, interdisciplinary Family Health Teams (FHTs). The study was set in six new FHTs in Ontario. This paper is a reflexive examination of some of the challenges encountered while conducting an ethnographic study in a primary care setting. Our experiences in this study highlight some potential benefits of and difficulties in conducting an ethnographic study in family practice. Our study design gave us an opportunity to highlight the changes in routines within an organization in transition. A study with a clinical perspective requires training, support, a mixture of backgrounds and perspectives and ongoing communication. Despite some of the difficulties, the richness of this method has allowed the exploration of a number of additional research questions that emerged during data analysis.

Trainees' Self-Reported Challenges in Knowledge Translation, Research and Practice.

PubMed

Lal, Shalini; Urquhart, Robin; Cornelissen, Evelyn; Newman, Kristine; Van Eerd, Dwayne; Powell, Byron J; Chan, Vivian

2015-12-01

Knowledge translation (KT) refers to the process of moving evidence into healthcare policy and practice. Understanding the experiences and perspectives of individuals who develop careers in KT is important for designing training programs and opportunities to enhance capacity in KT research and practice. To date, however, limited research has explored the challenges that trainees encounter as they develop their careers in KT. The purpose of this study is to identify the challenges that KT trainees face in their KT research or practice. An online survey was conducted with a sample of trainees associated with the Knowledge Translation Trainee Collaborative or the KT Canada Summer Institutes, with written responses thematically analyzed. A total of 35 individual responses were analyzed, resulting in the identification of six interrelated themes, listed in descending order of prevalence: limited availability of KT-specific resources (54%), difficulty inherent in investigating KT (34%), KT not recognized as a distinct field (23%), colleagues' limited knowledge and understanding of KT (20%), competing priorities and limited time (20%), and difficulties in relation to collaboration (14%). KT trainees experience specific challenges in their work: limited understanding of KT in other stakeholder groups; limited structures or infrastructure to support those who do KT; the inherently interdisciplinary and applied nature of KT; and the resultant complexities of scientific inquiry in this field, such as designing and testing multifaceted, multilevel implementation strategies and accounting for contextual factors. KT training and capacity-building efforts are needed to better position health systems to routinely adopt knowledge into healthcare policy and practice. © 2015 Sigma Theta Tau International.

'I still have no idea why this patient was here': An exploration of the difficulties GP trainees experience when gathering information.

PubMed

Giroldi, Esther; Veldhuijzen, Wemke; de Leve, Tijme; van der Weijden, Trudy; Bueving, Herman; van der Vleuten, Cees

2015-07-01

Collecting information during patient encounters is essential for the delivery of patient-centered care. To obtain insight into areas that require more attention in medical communication training, this study explores what difficulties GP trainees encounter when gathering information. In this phenomenological study, we observed a morning clinic of 15 GP trainees. To explore trainees' experiences with information-gathering, we held brief interviews after every consultation and a lengthier interview directly after the morning clinic. The resulting data were analyzed using template analysis. From trainees' reflections, we distilled five difficulties that trainees experience when gathering information: (1) Goal conflicts; (2) Ineffectiveness of trained communication skills in specific situations; (3) Trainees' distress hampers open communication; (4) Untrustworthy information; (5) Tunnel vision. Information-gathering is difficult for GP trainees. Current generic communication skills training does not seem to support trainees sufficiently to handle effectively the challenges they encounter during consultations. Medical communication training needs to support trainees in handling their goal-conflicts and feelings that hamper information-gathering, while also providing them with communication strategies adapted to handling specific challenging situations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Academic Reading Difficulties Encountered by International Graduate Students in a Malaysian University

ERIC Educational Resources Information Center

Alghail, Ali Abdullah Ali; Mahfoodh, Omer Hassan Ali

2016-01-01

This study examines how international graduate students in a Malaysian public university perceive and overcome academic reading difficulties. The target population included all graduate students from Yemen, an Arab country, studying at Universiti Sains Malaysia. Data were collected using questionnaires, focus group interviews, and journal writing.…

Are Communication Strategies Teachable?

ERIC Educational Resources Information Center

Lewis, Samantha

2011-01-01

This article discusses the teachability of communication strategies in the EFL classroom. As well as reflecting on the nature of speech production in the mother tongue, it looks at some of the difficulties encountered when speaking in a foreign language and the inherent difficulties in "teaching" speaking as a skill. It focuses on different types…

Characteristic Interviews, Different Strategies: Methodological Challenges in Qualitative Interviewing among Respondents with Mild Intellectual Disabilities

ERIC Educational Resources Information Center

Sigstad, Hanne Marie Høybråten

2014-01-01

Conducting qualitative research interviews among individuals with intellectual disabilities, including cognitive limitations and difficulties in communication, presents particular research challenges. One question is whether the difficulties that informants encounter affect interviews to such an extent that the validity of the results is weakened.…

Academic Difficulties Encountered by East Asian International University Students in New Zealand

ERIC Educational Resources Information Center

Lee, Boram; Farruggia, Susan P.; Brown, Gavin T. L.

2013-01-01

The study focused on learning difficulties experienced by East Asian International (EAI) students. Participants were 117 EAI students undertaking tertiary study at a major university, all were surveyed and 21 students were interviewed. The findings suggest that language limitations, academic content and learning styles were associated with…

Preactivation of Inhibitory Control Mechanisms Hinders Intuitive Reasoning

ERIC Educational Resources Information Center

Babai, Reuven; Eidelman, Rachel Rosanne; Stavy, Ruth

2012-01-01

Many students encounter difficulties in science and mathematics. Earlier research suggested that although intuitions are often needed to gain new ideas and concepts and to solve problems in science and mathematics, some of students' difficulties could stem from the interference of intuitive reasoning. The literature suggests that overcoming…

REVIEW OF STANISLAUS COUNTY MULTI-OCCUPATIONAL VOCATIONAL TRAINING PROJECT, 1964-1965.

ERIC Educational Resources Information Center

Modesto Junior Coll., CA.

THIS REPORT OUTLINES PROBLEMS ENCOUNTERED AND PROGRESS MADE IN THE STANISLAUS COUNTY, CALIFORNIA, TRAINING PROJECT. INITIAL DIFFICULTY IN SECURING FEDERAL APPROVAL AND FUNDS FOR PREVOCATIONAL OR BASIC EDUCATION WAS ENDED BY THE AMENDED MANPOWER TRAINING AND DEVELOPMENT ACT. HOWEVER, DIFFICULTIES, MAINLY IN REORIENTING PREVOCATIONAL AND VOCATIONAL…

Teaching Mathematical Problem Solving to Students with Limited English Proficiency.

ERIC Educational Resources Information Center

Kaplan, Rochelle G.; Patino, Rodrigo A.

Many mainstreamed students with limited English proficiency continue to face the difficulty of learning English as a second language (ESL) while studying mathematics and other content areas framed in the language of native speakers. The difficulty these students often encounter in mathematics classes and their poor performance on subsequent…

A Therapeutic Approach for Treating Chronic Illness and Disability among College Students

ERIC Educational Resources Information Center

Haemmelmann, Katie L.; McClain, Mary-Catherine

2013-01-01

Research in chronic illness and disability (CID) in college students has demonstrated that students with disabilities encounter more difficulties psychosocially than their nondisabled counterparts. Subsequently, these difficulties impact the ability of these students to successfully adapt. Using the illness intrusiveness model in combination with…

Children Working with Text in Science: disparities with 'Literacy Hour' practice

NASA Astrophysics Data System (ADS)

Peacock, Alan; Weedon, Helen

2002-02-01

The National Literacy Strategy (NLS) provides a coherent plan of what and how children should be taught about non-fiction text. Nevertheless, the difficulties that children actually experience when using science texts are not fully addressed: in particular, the use and interpretation of the visual elements of science text is given limited attention in the prescriptions for teaching the 'Literacy Hour'. Such disparities identified by prior research and by a content analysis of the NLS Framework Document are considered alongside evidence of the difficulties encountered by a class of Year 5 pupils working with a range of non-fiction texts during science lessons. Pupils' text use is studied through observations and interviews with children, through interviews with their teachers and through a questionnaire about text use strategies. The findings suggest that (1) the pupils experienced considerable difficulty in making sense of the science content of non-fiction text, particularly in terms of interpretation of visual elements and their links to written text and (2) use of retrieval strategies taught during the Literacy Hour was not transferred to learning from text during science lessons. The study proposes closer planning of text use in science and literacy lessons.

Difficulties Encountered by Academicians in Academic Research Processes in Universities

ERIC Educational Resources Information Center

Yalçin, Sinan; Altun Yalçin, Sema

2017-01-01

This present research, aimed to determine the occasions, which the academicians encountered during the academic research process and how these affect the research process, was prepared as a case study pattern among the qualitative research methods. 34 academicians, who were working in a university in Turkey, participated in the research. The data…

Tips for Novice Researchers: Operational Difficulties Encountered in Underdeveloped Countries.

ERIC Educational Resources Information Center

Belcher El-Nahhas, Susan M.

This paper provides a general overview of the type of problems encountered in the field of research so that individuals who are contemplating conducting research in an underdeveloped country for the first time are better prepared, and hence, better able to complete their research. The paper recounts a female researcher's personal experiences in…

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

ERIC Educational Resources Information Center

Straubhaar, Rolf

2015-01-01

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

Preoperative ultrasonography and prediction of technical difficulties during laparoscopic cholecystectomy.

PubMed

Daradkeh, S S; Suwan, Z; Abu-Khalaf, M

1998-01-01

A prospective study was carried out to investigate the value of preoperative ultrasound findings for predicting difficulties encountered during laparoscopic cholecystectomy (LC). Altogether 160 consecutive patients with symptomatic gallbladder (GB) disease (130 females, 30 males) referred to the Jordan University Hospital were recruited for the purpose of this study. All patients underwent detailed ultrasound examination 24 hours prior to LC. The overall difficulty score (ODS), as a dependent variable, was based on the following operative parameters: duration of surgery, bleeding, dissection of Calot's triangle, dissection of gallbladder wall, adhesions, spillage of bile, spillage of stone, and difficulty of gallbladder extraction. Multiple regression analysis was used to assess the significance of the following preoperative ultrasound variables (independent) for predicting the variation in the ODS: size of the GB, number of GB stones, size of stones, location of GB stones, thickness of GB wall, common bile duct (CBD) diameter, and liver size. Only thickness of GB wall and CBD diameter were found to be significant predictors of the variation in the ODS (adjusted R2 = 0.25). We conclude that the preoperative ultrasound examination is of value for predicting difficulties encountered during LC, but it is not the sole predictor.

Children learn spurious associations in their math textbooks: Examples from fraction arithmetic.

PubMed

Braithwaite, David W; Siegler, Robert S

2018-04-26

Fraction arithmetic is among the most important and difficult topics children encounter in elementary and middle school mathematics. Braithwaite, Pyke, and Siegler (2017) hypothesized that difficulties learning fraction arithmetic often reflect reliance on associative knowledge-rather than understanding of mathematical concepts and procedures-to guide choices of solution strategies. They further proposed that this associative knowledge reflects distributional characteristics of the fraction arithmetic problems children encounter. To test these hypotheses, we examined textbooks and middle school children in the United States (Experiments 1 and 2) and China (Experiment 3). We asked the children to predict which arithmetic operation would accompany a specified pair of operands, to generate operands to accompany a specified arithmetic operation, and to match operands and operations. In both countries, children's responses indicated that they associated operand pairs having equal denominators with addition and subtraction, and operand pairs having a whole number and a fraction with multiplication and division. The children's associations paralleled the textbook input in both countries, which was consistent with the hypothesis that children learned the associations from the practice problems. Differences in the effects of such associative knowledge on U.S. and Chinese children's fraction arithmetic performance are discussed, as are implications of these differences for educational practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Undergraduate quantum mechanics: lost opportunities for engaging motivated students?

NASA Astrophysics Data System (ADS)

Johansson, Anders

2018-03-01

Quantum mechanics is widely recognised as an important and difficult subject, and many studies have been published focusing on students’ conceptual difficulties. However, the sociocultural aspects of studying such an emblematic subject have not been researched to any large extent. This study explores students’ experiences of undergraduate quantum mechanics using qualitative analysis of semi-structured interview data. The results inform discussions about the teaching of quantum mechanics by adding a sociocultural dimension. Students pictured quantum mechanics as an intriguing subject that inspired them to study physics. The study environment they encountered when taking their first quantum mechanics course was however not always as inspiring as expected. Quantum mechanics instruction has commonly focused on the mathematical framework of quantum mechanics, and this kind of teaching was also what the interviewees had experienced. Two ways of handling the encounter with a traditional quantum mechanics course were identified in the interviews; either students accept the practice of studying quantum mechanics in a mathematical, exercise-centred way or they distance themselves from these practices and the subject. The students who responded by distancing themselves experienced a crisis and disappointment, where their experiences did not match the way they imagined themselves engaging with quantum mechanics. The implications of these findings are discussed in relation to efforts to reform the teaching of undergraduate quantum mechanics.

Challenges in conducting qualitative research in health: A conceptual paper.

PubMed

Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

2015-01-01

Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others.

The global Filipino nurse: An integrative review of Filipino nurses' work experiences.

PubMed

Montayre, Jed; Montayre, Jasmine; Holroyd, Eleanor

2018-05-01

To understand the work-related experiences of Philippine-trained nurses working globally. The Philippines is a major source country of foreign-trained nurses located globally. However, there is paucity of research on professional factors and career related issues affecting foreign-trained nurses' work experiences. An integrative review through a comprehensive search of literature was undertaken from November 2015 and was repeated in August 2016. Seven articles satisfied the selection criteria. Filipino nurses experienced differences in the practice of nursing in terms of work process, roles and autonomy. Moreover, they encountered challenges such as work-related discrimination and technical difficulties within the organisation. A clear understanding of Filipino nurses' work experiences and the challenges they have encountered suggests identification of important constructs influencing effective translation of nursing practice across cultures and health systems, which then form the basis for support strategies. It is critical to recognize foreign-trained nurses' experience of work-related differences and challenges as these foster favorable conditions for the management team to plan and continually evaluate policies around recruitment, retention and support offered to these nurses. Furthermore, findings suggest internationalization of nursing framework and standards integrating a transcultural paradigm among staff members within a work organisation. © 2017 John Wiley & Sons Ltd.

Improving the timeliness and accuracy of injury severity data in road traffic accidents in an emerging economy setting.

PubMed

Lam, Carlos; Chen, Chang-I; Chuang, Chia-Chang; Wu, Chia-Chieh; Yu, Shih-Hsiang; Chang, Kai-Kuo; Chiu, Wen-Ta

2018-05-18

Road traffic injuries (RTIs) are among the leading causes of injury and fatality worldwide. RTI casualties are continually increasing in Taiwan; however, because of a lack of an advanced method for classifying RTI severity data, as well as the fragmentation of data sources, road traffic safety and health agencies encounter difficulties in analyzing RTIs and their burden on the healthcare system and national resources. These difficulties lead to blind spots during policy-making for RTI prevention and control. After compiling classifications applied in various countries, we summarized data sources for RTI severity in Taiwan, through which we identified data fragmentation. Accordingly, we proposed a practical classification for RTI severity, as well as a feasible model for collecting and integrating these data nationwide. This model can provide timely relevant data recorded by medical professionals and is valuable to healthcare providers. The proposed model's pros and cons are also compared to those of other current models.

STOPP/START version 2-development of software applications: easier said than done?

PubMed

Anrys, Pauline; Boland, Benoît; Degryse, Jean-Marie; De Lepeleire, Jan; Petrovic, Mirko; Marien, Sophie; Dalleur, Olivia; Strauven, Goedele; Foulon, Veerle; Spinewine, Anne

2016-09-01

Explicit criteria, such as the STOPP/START criteria, are increasingly used both in clinical practice and in research to identify potentially inappropriate prescribing in older people. In an article on the STOPP/START criteria version 2, O'Mahony et al have pointed out the advantages of developing computerised criteria. Both clinical decision support systems to support healthcare professionals and software applications to automatically detect inappropriate prescribing in research studies can be developed. In the process of developing such tools, difficulties may occur. In the context of a research study, we have developed an algorithm to automatically apply STOPP/START criteria version 2 to our research database. We comment in this paper on different kinds of difficulties encountered and make suggestions that could be taken into account when developing the next version of the criteria. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Caregiving burden in foreign domestic workers caring for frail older adults in Singapore.

PubMed

Ha, Ngoc Huong Lien; Chong, Mei Sian; Choo, Robin Wai Munn; Tam, Wai Jia; Yap, Philip Lin Kiat

2018-03-21

Although foreign domestic workers (FDWs) play a significant role in caring for frail seniors in Singapore and are vulnerable to caregiving burden, there has been little research conducted hitherto. We explored caregiver burden and its determinants in this study. FDWs (N = 221, M age = 32.3, SD = 6.23) recruited from a hospital geriatric unit completed the Zarit Burden Interview (ZBI) administered in English, Bahasa Melayu, or Burmese. Univariate and multivariate regression were employed to investigate factors influencing caregiving burden in FDWs. Majority were Indonesians (60.0%), married (57.5%) with children (62.4%), with secondary-level education (59.7%), and providing care for >1 year (79.9%). Importantly, 25.1% reported physical health problems and 23.1% encountered language difficulties with employers. Univariate analysis revealed three significant factors associated with caregiving burden: nationality (p < 0.001), lack of privacy (p = 0.029), and caring for persons with dementia (PWD) (p = 0.001). On multivariate regression, FDWs who cared for PWD were 5.47 times (p = 0.013) more likely to experience burden, while FDWs who encountered language difficulties were 5.46 times (p = 0.030) more likely to experience burden. Filipinos FDWs were 9.73 times more likely to express burden (p < 0.001) compared to their Indonesian and Burmese counterparts. The study highlights caregiver burden in FDWs and potential ways to alleviate it by empowering FDWs with dementia-specific caregiving skills, providing language training opportunities, and supporting particular FDW ethnic groups with more emotional and practical help.

Tales of resistance and other emancipatory functions of storytelling.

PubMed

Grassley, Jane S; Nelms, Tommie P

2009-11-01

Tales of resistance and other emancipatory functions of storytelling. This paper is the report of a study to explore how the process of storytelling might facilitate women's emancipatory knowing, using examples from women's breastfeeding stories. Storytelling, as an interactive process, can give women a way to explain pivotal life events, justify choices, examine reality and find meaning in experiences. Emancipatory functions of storytelling have been identified as contextual grounding, bonding with others, validating and affirming experiences, venting and catharsis, resisting oppression and educating others. Secondary data analysis was conducted in 2008 on breastfeeding stories originally gathered from 13 women from 2002 to 2004 for a feminist hermeneutic study of maternal breastfeeding confidence. The stories were re-examined through the lens of the emancipatory functions of storytelling. Illustrations of contextual grounding, validating and affirming experiences, venting and catharsis and acts of resistance were found in the breastfeeding stories and presented as exemplars of emancipatory knowing. Women revealed the difficulties they encountered breastfeeding, transforming these experiences as they discovered their meaning. They described collisions that occurred when personal, familial, healthcare professionals' or cultural expectations differed from their experience. The stories suggested possible liberation from old ideologies about breastfeeding as women redefined the difficulties they encountered. Storytelling has potential as a simple, yet profound, and powerful emancipatory intervention which nurses can use to help women in their care make sense of and transform experiences of health and illness. Storytelling may have global implications for nursing practice and research.

Using Constraints to Design Developmentally Appropriate Movement Activities for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Pope, Michelle; Breslin, Casey M.; Getchell, Nancy; Liu, Ting

2012-01-01

Some of the characteristics and behaviors of children with autism spectrum disorder (ASD), such as difficulty with social interactions and sensory integration, make physical education instruction difficult. Children with ASD also encounter movement difficulties, such as motor-planning and anticipatory deficits. One way to enhance the ability of…

Educating Chinese, Japanese, and Korean International Students: Recommendations to American Professors

ERIC Educational Resources Information Center

Roy, Shelly R.

2013-01-01

This paper discusses the unique barriers and learning difficulties encountered by Chinese, Japanese, and Korean international students when they study at institutions of higher education in the US. These learning difficulties arise because of inability of some American professors to use discourse markers, summarize at the end of lectures, write…

Undergraduate ESL Students' Difficulties in Writing the Introduction for Research Reports

ERIC Educational Resources Information Center

Maznun, Mirrah Diyana Binti; Monsefi, Roya; Nimehchisalem, Vahid

2017-01-01

This study was conducted to investigate the difficulties encountered by undergraduate ESL students in writing the introduction section of their project reports. Five introduction sections of bachelor of arts students, majoring in English language, were analyzed and a lecturer was interviewed regarding the areas of the students' weaknesses. Swales'…

Meanings Given to Algebraic Symbolism in Problem-Posing

ERIC Educational Resources Information Center

Cañadas, María C.; Molina, Marta; del Río, Aurora

2018-01-01

Some errors in the learning of algebra suggest that students might have difficulties giving meaning to algebraic symbolism. In this paper, we use problem posing to analyze the students' capacity to assign meaning to algebraic symbolism and the difficulties that students encounter in this process, depending on the characteristics of the algebraic…

Resistances Encountered in Starting a Group Therapy Program for Suicide Attempters in Varied Administrative Settings.

ERIC Educational Resources Information Center

Hackel, Jacqueline; Asimos, Chrisula T.

1980-01-01

Reports areas of difficulty (including funding issues, management and personal bias issues, and theoretical issues) which emerged in the development of five treatment groups of depressed and suicidal patients. Groups reflected efforts between the city-county mental health system and funding agencies. Strategies for overcoming difficulties are…

Teaching about Mechanical Waves and Sound with a Tuning Fork and the Sun

ERIC Educational Resources Information Center

Leccia, Silvio; Colantonio, Arturo; Puddu, Emanuella; Galano, Silvia; Testa, Italo

2015-01-01

Literature in "Physics Education" has shown that students encounter many difficulties in understanding wave propagation. Such difficulties lead to misconceptions also in understanding sound, often used as context to teach wave propagation. To address these issues, we present in this paper a module in which the students are engaged in…

An Investigation of the Difficulties Faced by EFL Undergraduates in Speaking Skills

ERIC Educational Resources Information Center

Al-Jamal, Dina A.; Al-Jamal, Ghadeer A.

2014-01-01

Since speaking well in English is crucial for English language literature undergraduates, the present study aimed at describing difficulties that may be encountered at an EFL setting. The sample was stratified random as drawn from six Jordanian public universities. Survey questionnaires as well as semi-structured interviews were constructed. 64…

Morphological Processing and Learning to Read: The Case of Deaf Children

ERIC Educational Resources Information Center

Berthiaume, Rachel; Daigle, Daniel

2014-01-01

Many deaf students encounter great difficulty in learning to read. Typically, research has cited deaf students' difficulties to use phonological processing as the source of their reading deficit. However, recent studies have shown that morphological processing also plays an important part in reading. Since morphological units are visually…

Automated recognition of microcalcification clusters in mammograms

NASA Astrophysics Data System (ADS)

Bankman, Isaac N.; Christens-Barry, William A.; Kim, Dong W.; Weinberg, Irving N.; Gatewood, Olga B.; Brody, William R.

1993-07-01

The widespread and increasing use of mammographic screening for early breast cancer detection is placing a significant strain on clinical radiologists. Large numbers of radiographic films have to be visually interpreted in fine detail to determine the subtle hallmarks of cancer that may be present. We developed an algorithm for detecting microcalcification clusters, the most common and useful signs of early, potentially curable breast cancer. We describe this algorithm, which utilizes contour map representations of digitized mammographic films, and discuss its benefits in overcoming difficulties often encountered in algorithmic approaches to radiographic image processing. We present experimental analyses of mammographic films employing this contour-based algorithm and discuss practical issues relevant to its use in an automated film interpretation instrument.

Lessons learned from the reimbursement profile of a mature private medical toxicology practice: office-based practice pays.

PubMed

Thompson, Trevonne M; Leikin, Jerrold B

2015-03-01

We previously reported the financial data for the first 5 years of one of the author's medical toxicology practice. The practice has matured; changes have been made. The practice is increasing its focus on office-based encounters and reducing hospital-based acute care encounters. We report the reimbursement rates and other financial metrics of the current practice. Financial records from October 2009 through September 2013 were reviewed. This is a period of 4 fiscal years and represents the currently available financial data. Charges, payments, and reimbursement rates were recorded according to the type and setting of the medical toxicology encounter: forensic consultations, outpatient clinic encounters, nonpsychiatric inpatient consultations, emergency department (ED) consultations, and inpatient psychiatric consultations. All patients were seen regardless of ability to pay or insurance status. The number of billed Current Procedural Terminology (CPT) codes for office-based encounters increased over the study period; the number of billed CPT codes for inpatient and ED consultations reduced. Office-based encounters demonstrate a higher reimbursement rate and higher payments. In the fiscal year (FY) of 2012, office-based revenue exceeded hospital-based acute care revenue by over $140,000 despite a higher number of billed CPT encounters in acute care settings, and outpatient payments were 2.39 times higher than inpatient, inpatient psychiatry, observation unit, and ED payments combined. The average payment per CPT code was higher for outpatient clinic encounters than inpatient encounters for each fiscal year studied. There was an overall reduction in CPT billing volume between FY 2010 and FY 2013. Despite this, there was an increase in total practice revenue. There was no change in payor mix, practice logistics, or billing/collection service company. In this medical toxicology practice, office-based encounters demonstrate higher reimbursement rates and overall payments compared to inpatient and ED consultations. While consistent with our previous studies, these differences have been accentuated. This study demonstrates the results of changes to the practice--reduced inpatient/ED consultations and increased outpatient encounters. These practice changes resulted in higher overall revenue despite a lower patient volume. In this analysis, the office-based practice of medical toxicology has higher reimbursement rates, nearly 2.5 times higher, when compared to hospital-based acute care consultations.

The need for trust and safety inducing encounters: a qualitative exploration of women's experiences of seeking perinatal care when living as undocumented migrants in Sweden.

PubMed

Barkensjö, My; Greenbrook, Josephine T V; Rosenlundh, Josefine; Ascher, Henry; Elden, Helen

2018-06-07

Studies from around the world have shown that women living as undocumented migrants have limited and deficient access to perinatal care, increasing their risks of both physical and psychological complications during pregnancy and childbirth. Failures to provide equal access to healthcare have been criticized extensively by the United Nations. In 2013, undocumented migrants' rights to healthcare in Sweden were expanded to include full access to perinatal care. Research surrounding clinical encounters involving women living as undocumented migrants remains largely lacking. The present study aimed to provide a composite description of women's experiences of clinical encounters throughout pregnancy and childbirth, when living as undocumented migrants in Sweden. Taking an inductive approach, qualitative content analysis was implemented. Thirteen women from ten different countries were interviewed. Meaning-units were extracted from the data collected in order to identify emergent overarching themes. In clinical encounters where healthcare professionals displayed empathic concern and listening behaviours, women felt empowered, acknowledged, and encouraged, leading them to trust clinicians, diminishing fears relating to seeking healthcare services. Conversely, when neglectful behaviour on part of healthcare professionals was perceived in encounters, anxiousness and fear intensified. Vulnerability and distress induced by the women's uncertain living circumstances were apparent across themes, and appeared exacerbated by traumatic memories, difficulties in coping with motherhood, and fears of deportation. The present study contributes unique and important knowledge surrounding women's experience of being pregnant and giving birth when living as undocumented migrants. The overarching findings indicated that the needs of undocumented migrant women were largely similar to those of all expectant mothers, but that due to vulnerabilities relating to their circumstances, flexible and informed care provision is essential. Being knowledgeable on undocumented migrants' rights to healthcare is vital, as clinical encounters appeared highly consequential to the women's well-being and help-seeking behaviours. Negative encounters inflicted emotional distress and fear. Contrastingly, positive encounters promoted trust in clinicians, personal empowerment, and relief. Positive clinical encounters could provide rare opportunities to assist an otherwise elusive population at increased risk for both physical and psychological complications, highlighting the crucial need for adherence to ethical principles in clinical practice.

Surgical ethics: surgical virtue and more.

PubMed

Vercler, Christian J

2015-01-01

The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

A Protocol for Collecting Human Cardiac Tissue for Research.

PubMed

Blair, Cheavar A; Haynes, Premi; Campbell, Stuart G; Chung, Charles; Mitov, Mihail I; Dennis, Donna; Bonnell, Mark R; Hoopes, Charles W; Guglin, Maya; Campbell, Kenneth S

2016-01-01

This manuscript describes a protocol at the University of Kentucky that allows a translational research team to collect human myocardium that can be used for biological research. We have gained a great deal of practical experience since we started this protocol in 2008, and we hope that other groups might be able to learn from our endeavors. To date, we have procured ~4000 samples from ~230 patients. The tissue that we collect comes from organ donors and from patients who are receiving a heart transplant or a ventricular assist device because they have heart failure. We begin our manuscript by describing the importance of human samples in cardiac research. Subsequently, we describe the process for obtaining consent from patients, the cost of running the protocol, and some of the issues and practical difficulties that we have encountered. We conclude with some suggestions for other researchers who may be considering starting a similar protocol.

A Protocol for Collecting Human Cardiac Tissue for Research

PubMed Central

Blair, Cheavar A.; Haynes, Premi; Campbell, Stuart G.; Chung, Charles; Mitov, Mihail I.; Dennis, Donna; Bonnell, Mark R.; Hoopes, Charles W.; Guglin, Maya; Campbell, Kenneth S.

2016-01-01

This manuscript describes a protocol at the University of Kentucky that allows a translational research team to collect human myocardium that can be used for biological research. We have gained a great deal of practical experience since we started this protocol in 2008, and we hope that other groups might be able to learn from our endeavors. To date, we have procured ~4000 samples from ~230 patients. The tissue that we collect comes from organ donors and from patients who are receiving a heart transplant or a ventricular assist device because they have heart failure. We begin our manuscript by describing the importance of human samples in cardiac research. Subsequently, we describe the process for obtaining consent from patients, the cost of running the protocol, and some of the issues and practical difficulties that we have encountered. We conclude with some suggestions for other researchers who may be considering starting a similar protocol. PMID:28042604

Evidence-based medicine Training: Kazakhstan experience.

PubMed

Kamalbekova, G; Kalieva, M

2015-01-01

Understanding principles of evidence-based medicine is of vital importance for improving quality of care, promoting public health and health system development. Understanding principles of evidence-based medicine allows using the most powerful information source, which have ever existed in medicine. To evaluate the effectiveness of teaching Evidence-Based Medicine, including long-term outcomes of training. The study was conducted at the Medical University of Astana, where the Scientific and Educational Center of Evidence-Based Medicine was established in 2010 with the help of the corresponding project of the World Bank. The participants of the study were the faculty trained in Evidence-Based Medicine at the workshop "Introduction to Evidence-Based Medicine" for the period of 2010-2015 years. There were a total of 16 workshops during the period, and 323 employees were trained. All participants were asked to complete our questionnaire two times: before the training - pre-training (to determine the initial level of a listener) and after the training - post-training (to determine the acquired level and get the feedback). Questionnaires were prepared in such a way, that the majority of questions before and after training were identical. Thus, it provided a clear picture of the effectiveness of training. Questions in the survey were open-ended so that the respondents had the opportunity to freely and fully express their views. The main part of the questionnaires included the following questions: "Do you understand what evidence-based medicine is", "how do you understand what the study design means", "what is randomization", "how research is classified", "do you know the steps of decision-making according to Evidence-Based Medicine, list them", "what literature do you prefer to use when searching for information (print, electronic, etc.)", "what resources on the Internet do you prefer to use". Only 30-35% of respondents gave correct answers to the questions on understanding EBM, understanding study designs, randomization. There were no correct or complete answers to the question on study classification. Again, 35% of respondents provided correct answer to the question about the stages of decision-making process from the perspective of EBM, 65% - provided no answer. One fourth (25%) of the respondents preferred using printed literature. Only very few respondents indicated Cochrane Library, Medline (PubMed), Tripdatabasa as preferred Internet sources of information, with 40% indicating Google and 60% - other sources.The results of post-training survey showed that nearly 90% of the respondents gave correct answers to all the questions.With the aim to identify knowledge survival (the long-term training outcomes) we conducted the third survey in May 2014 in previously trained people at the seminar "Introduction to Evidence-Based Medicine". The respondents were asked to answer 4 questions, and to assess previously obtained information on the basics of Evidence-Based Medicine on a 10-point scale.We found that 100% of the respondents answered «Yes» to the question: «Have you changed your behavior after the seminar?» To the question: «Have you encountered difficulties in implementing the principles of evidence-based medicine in the educational process?» 56% of the respondents answered that they had not encountered any difficulties. The other 44% faced the difficulties associated with implementation of Evidence-Based Medicine: lack of understanding by students, low knowledge survival rate among students, too many questions from the students, difficult disputes and discussions.To the question: «Have you encountered difficulties in implementing the principles of Evidence-Based Medicine in practical health-care?» only 37.5% of the respondents answered that they had not encountered difficulties. But the remaining 62.5% of the respondents faced the problems and difficulties in implementing the principles of evidence-based medicine in their practice. These were: failure in implementing, lack of understanding on the part of colleagues, commitment to traditional obsolete methods of treatment, discrepancy between some of the existing standards of diagnosis and treatment and principles of evidence-based medicine.To the question: «Are there any end products after listening to the seminar?» 67% of the respondents answered in affirmative. The end products were mainly marked by the publication of articles and abstracts, including international publications, and participation in the working group on the revision and development of clinical protocols. Barriers to implementation of Evidence-Based Medicine in education and practice are lack of funding to provide access to reliable sources of information, websites; outdated research methodology skills in medical education, lack of skills in critical evaluation of medical information; tradition of authoritarian relationships, use of past experience stencils; failure to comply with continuing education programs ("from training to professional development"). Knowledge of Evidence-Based Medicine, skills to perform searches for scientific data, to evaluate their validity and to transform scientific data into practical solutions are necessary for health workers in their daily activities. This culture needs to be rooted in modern medical education.

An online forum as a qualitative research method: practical issues.

PubMed

Im, Eun-Ok; Chee, Wonshik

2006-01-01

Despite the positive aspects of online forums as a qualitative research method, very little is known on the practical issues involved in using online forums for data collection, especially for a qualitative research project. The aim of this study was to describe the practical issues encountered in implementing an online forum as a qualitative component of a larger study on cancer pain experience. Throughout the study process, the research staff recorded issues ranging from minor technical problems to serious ethical dilemmas as they arose and wrote memos about them. The memos and written records of the discussions were reviewed and analyzed using content analysis. Two practical issues related to credibility were identified: (a) a high response and retention rate and (b) automatic transcripts. An issue related to dependability was the participants' forgetfulness. The issues related to confirmability were difficulties in theoretical saturation and unstandardized computer and Internet jargon. A security issue related to hacking attempts was noted as well. The analysis of these issues suggests several implications for future researchers who want to use online forums as a qualitative data collection method.

A Study of Novice Science Teachers' Conceptualizations of Culturally Relevant Pedagogy

NASA Astrophysics Data System (ADS)

Redman, Elizabeth Horst

This qualitative study examined new science teachers' conceptualization of culturally relevant pedagogy (CRP). The study followed six novice science teachers from their preservice teaching placements into their first jobs as instructors of record, observing in their classrooms and interviewing them about their use of CRP. The study sought to understand (1) how the participating teachers conceptualize CRP in science, and (2) what challenges the teachers faced in trying to implement CRP. Findings suggest that the teachers conceptualized CRP in ways that were consistent with Enyedy, Danish and Fields' (2011) interpretations of relevance: relevance of authentic purpose, relevance of content and/or context, and relevance of practices. The teachers, however, translated those interpretations of relevance into their conceptualizations and classroom practice in a variety of ways. While they encountered difficulties in conceptualizing and practicing CRP, they also made productive moves in their practice and evidenced positive elements in their conceptualizations of CRP. In order to address the challenges these teachers faced in implementing CRP, I suggest an approach to teacher preparation in CRP that builds upon the understandings and productive moves the teachers evidenced in this study.

Later learning stages in procedural memory are impaired in children with Specific Language Impairment.

PubMed

Desmottes, Lise; Meulemans, Thierry; Maillart, Christelle

2016-01-01

According to the Procedural Deficit Hypothesis (PDH), difficulties in the procedural memory system may contribute to the language difficulties encountered by children with Specific Language Impairment (SLI). Most studies investigating the PDH have used the sequence learning paradigm; however these studies have principally focused on initial sequence learning in a single practice session. The present study sought to extend these investigations by assessing the consolidation stage and longer-term retention of implicit sequence-specific knowledge in 42 children with or without SLI. Both groups of children completed a serial reaction time task and were tested 24h and one week after practice. Results showed that children with SLI succeeded as well as children with typical development (TD) in the early acquisition stage of the sequence learning task. However, as training blocks progressed, only TD children improved their sequence knowledge while children with SLI did not appear to evolve any more. Moreover, children with SLI showed a lack of the consolidation gains in sequence knowledge displayed by the TD children. Overall, these results were in line with the predictions of the PDH and suggest that later learning stages in procedural memory are impaired in SLI. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using Biology Education Research and Qualitative Inquiry to Inform Genomic Nursing Education.

PubMed

Ward, Linda D

Decades of research in biology education show that learning genetics is difficult and reveals specific sources of learning difficulty. Little is known about how nursing students learn in this domain, although they likely encounter similar difficulties as nonnursing students. Using qualitative approaches, this study investigated challenges to learning genetics among nursing students. Findings indicate that nursing students face learning difficulties already identified among biology students, suggesting that nurse educators might benefit from biology education research.

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

ERIC Educational Resources Information Center

Babalola, Shade

2015-01-01

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

Thought Suppression and Meaning in Life: A Longitudinal Investigation

ERIC Educational Resources Information Center

Krause, Neal

2007-01-01

The purpose of this study is to see if older adults who experience problems with thought suppression tend to encounter greater difficulty deriving a sense of meaning in life. Data from a longitudinal nationwide survey of older people (N = 988) indicate that greater difficulty with thought suppression is associated with a decline in meaning over…

Direct Evidence of Memory Retrieval as a Source of Difficulty in Non-Local Dependencies in Language

ERIC Educational Resources Information Center

Fedorenko, Evelina; Woodbury, Rebecca; Gibson, Edward

2013-01-01

Linguistic dependencies between non-adjacent words have been shown to cause comprehension difficulty, compared with local dependencies. According to one class of sentence comprehension accounts, non-local dependencies are difficult because they require the retrieval of the first dependent from memory when the second dependent is encountered.…

Cognitive Difficulties in Struggling Comprehenders and Their Relation to Reading Comprehension: A Comparison of Group Selection and Regression-Based Models

ERIC Educational Resources Information Center

Barnes, Marcia A.; Stuebing, Karla K.; Fletcher, Jack M.; Barth, Amy E.; Francis, David J.

2016-01-01

Difficulties suppressing previously encountered but currently irrelevant information from working memory characterize less skilled comprehenders in studies in which they are matched to skilled comprehenders on word decoding and nonverbal IQ. These "extreme" group designs are associated with several methodological issues. When sample size…

Common difficulties encountered in collecting native seed

Treesearch

Richard Dunne

1999-01-01

The increased demand for native seed has surpassed our ability to provide high quality range-collected seed. This paper discusses some of the hazards and common mistakes associated with the collection of wildland native seed. Among the common difficulties in collecting native seed are: (1) native species do not produce seed often in the arid West; (2) there is a...

Problem Solving Instruction for Overcoming Students' Difficulties in Stoichiometric Problems

ERIC Educational Resources Information Center

Shadreck, Mandina; Enunuwe, Ochonogor Chukunoye

2017-01-01

The study sought to find out difficulties encountered by high school chemistry students when solving stoichiometric problems and how these could be overcome by using a problem-solving approach. The study adopted a quasi-experimental design. 485 participants drawn from 8 highs schools in a local education district in Zimbabwe participated in the…

Researching Female Professors: The Difficulties of Representation, Positionality and Power in Feminist Research

ERIC Educational Resources Information Center

Hoskins, Kate

2015-01-01

This article draws on findings from my doctoral research to exemplify some of the difficulties I encountered when interviewing 20 female professors and subsequently writing about their life histories. In this article, I discuss how I addressed the issues of representing and positioning my participants, and I reflect on the power dynamics present…

Difficulties in Academic Writing: From the Perspective of King Saud University Postgraduate Students

ERIC Educational Resources Information Center

Al Fadda, Hind

2012-01-01

The purpose of this study was to determine what difficulties King Saud University students encounter when learning to write academic English and to differentiate between students' learning needs and objectives. The sample consisted of 50 postgraduate students enrolled in King Saud University during the academic year 2009-2010. Analysis of the data…

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

ERIC Educational Resources Information Center

Meerbaum-Salant, Orni; Hazzan, Orit

2009-01-01

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

Spitting, Kicking and Stripping: Technical Difficulties Encountered in the Treatment of Deprived Children

ERIC Educational Resources Information Center

Canham, Hamish

2004-01-01

The technical difficulties posed for the child psychotherapist working with children who have themselves experienced violence and abuse are addressed. A distinction is drawn between violence in the service of communicating about such experiences and violence that arises from more perverse aspects of the patient. The therapist's need to pay close…

The difficulties experienced by nurses and healthcare staff involved in the process of breaking bad news.

PubMed

Warnock, Clare; Buchanan, Jean; Tod, Angela Mary

2017-07-01

The aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news. The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice. The study used a descriptive survey design involving self-reported written accounts and framework analysis. Data were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014. Multiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news. The framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice. © 2017 John Wiley & Sons Ltd.

Regional estimation of groundwater arsenic concentrations through systematical dynamic-neural modeling

NASA Astrophysics Data System (ADS)

Chang, Fi-John; Chen, Pin-An; Liu, Chen-Wuing; Liao, Vivian Hsiu-Chuan; Liao, Chung-Min

2013-08-01

Arsenic (As) is an odorless semi-metal that occurs naturally in rock and soil, and As contamination in groundwater resources has become a serious threat to human health. Thus, assessing the spatial and temporal variability of As concentration is highly desirable, particularly in heavily As-contaminated areas. However, various difficulties may be encountered in the regional estimation of As concentration such as cost-intensive field monitoring, scarcity of field data, identification of important factors affecting As, over-fitting or poor estimation accuracy. This study develops a novel systematical dynamic-neural modeling (SDM) for effectively estimating regional As-contaminated water quality by using easily-measured water quality variables. To tackle the difficulties commonly encountered in regional estimation, the SDM comprises of a neural network and four statistical techniques: the Nonlinear Autoregressive with eXogenous input (NARX) network, Gamma test, cross-validation, Bayesian regularization method and indicator kriging (IK). For practical application, this study investigated a heavily As-contaminated area in Taiwan. The backpropagation neural network (BPNN) is adopted for comparison purpose. The results demonstrate that the NARX network (Root mean square error (RMSE): 95.11 μg l-1 for training; 106.13 μg l-1 for validation) outperforms the BPNN (RMSE: 121.54 μg l-1 for training; 143.37 μg l-1 for validation). The constructed SDM can provide reliable estimation (R2 > 0.89) of As concentration at ungauged sites based merely on three easily-measured water quality variables (Alk, Ca2+ and pH). In addition, risk maps under the threshold of the WHO drinking water standard (10 μg l-1) are derived by the IK to visually display the spatial and temporal variation of the As concentration in the whole study area at different time spans. The proposed SDM can be practically applied with satisfaction to the regional estimation in study areas of interest and the estimation of missing, hazardous or costly data to facilitate water resources management.

Cleaning and Disinfection of Bacillus cereus Biofilm.

PubMed

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

2016-01-01

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

Eye Movements while Reading Biased Homographs: Effects of Prior Encounter and Biasing Context on Reducing the Subordinate Bias Effect

PubMed Central

Leinenger, Mallorie; Rayner, Keith

2013-01-01

Readers experience processing difficulties when reading biased homographs preceded by subordinate-biasing contexts. Attempts to overcome this processing deficit have often failed to reduce the subordinate bias effect (SBE). In the present studies, we examined the processing of biased homographs preceded by single-sentence, subordinate-biasing contexts, and varied whether this preceding context contained a prior instance of the homograph or a control word/phrase. Having previously encountered the homograph earlier in the sentence reduced the SBE for the subsequent encounter, while simply instantiating the subordinate meaning produced processing difficulty. We compared these reductions in reading times to differences in processing time between dominant-biased repeated and non-repeated conditions in order to verify that the reductions observed in the subordinate cases did not simply reflect a general repetition benefit. Our results indicate that a strong, subordinate-biasing context can interact during lexical access to overcome the activation from meaning frequency and reduce the SBE during reading. PMID:24073328

The language divide. The importance of training in the use of interpreters for outpatient practice.

PubMed

Karliner, Leah S; Pérez-Stable, Eliseo J; Gildengorin, Ginny

2004-02-01

Provision of interpreter services for non-English-speaking patients is a federal requirement. We surveyed clinicians to describe their experience using interpreters. In this cross-sectional study we surveyed clinicians in three academic outpatient settings in San Francisco (N = 194) regarding their most recent patient encounter which involved an interpreter. Questions about the visit included type of interpreter, satisfaction with content of clinical encounter, potential problems, and frequency of need. Previous training in interpreter use, languages spoken, and demographics were also asked. Questionnaires were self-administered in approximately 10 minutes. Of 194 questionnaires mailed, 158 were completed (81% response rate) and 67% were from resident physicians. Most respondents (78%) were very satisfied or satisfied with the medical care they provided, 85% felt satisfied with their ability to diagnose a disease and treat a disease, but only 45% were satisfied with their ability to empower the patient with knowledge about their disease, treatment, or medication. Even though 71% felt they were able to make a personal connection with their patient, only 33% felt they had learned about another culture as a result of the encounter. Clinicians reported difficulties eliciting exact symptoms (70%), explaining treatments (44%), and eliciting treatment preferences (51%). Clinicians perceived that lack of knowledge of a patient's culture hindered their ability to provide quality medical care and only 18% felt they were unable to establish trust or rapport. Previous training in interpreter use was associated with increased use of professional interpreters (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.5) and increased satisfaction with medical care provided (OR, 2.6; 95% CI, 1.1 to 6.6). Clinicians reported communication difficulties affecting their ability to understand symptoms and treat disease, as well as their ability to empower patients regarding their healthcare. Training in the use of interpreters may improve communication and clinical care, and thus health outcomes.

Department of Homeland Security (DHS) Proficiency Testing on Small-Scale Safety and Thermal Testing of Improvised Explosives

NASA Astrophysics Data System (ADS)

Reynolds, John; Sandstrom, Mary; Brown, Geoffrey; Warner, Kirstin; Phillips, Jason; Shelley, Timothy; Reyes, Jose; Hsu, Peter

2013-06-01

One of the first steps in establishing safe handling procedures for explosives is small-scale safety and thermal (SSST) testing. To better understand the response of improvised materials or HMEs to SSST testing, 18 HME materials were compared to 3 standard military explosives in a proficiency-type round robin study among five laboratories--2 DoD and 3 DOE--sponsored by DHS. The testing matrix has been designed to address problems encountered with improvised materials--powder mixtures, liquid suspensions, partially wetted solids, immiscible liquids, and reactive materials. Over 30 issues have been identified that indicate standard test methods may require modification when applied to HMEs to derive accurate sensitivity assessments needed for development safe handling and storage practices. This presentation will discuss experimental difficulties encountered when testing these problematic samples, show inter-laboratory testing results, show some statistical interpretation of the results, and highlight some of the testing issues. Some of the work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344. LLNL-ABS-617519 (721812).

Difficulties Experienced by University Students with Severe Mental Illness Who Participate in Supported Education Programs.

PubMed

Shor, Ron

2017-04-01

Knowledge about the difficulties students with severe mental illness (SMI) encounter is essential to helping them meet the challenges of studying in universities. Therefore, a study was conducted in Israel with 80 university students with SMI to ascertain their difficulties and the relationship between these difficulties and their level of recovery. The two subscales of an instrument measuring students' difficulties that were ranked the highest were "Learning Skills and Management of Academic Tasks" and "Social Inclusion Difficulties." Inverse relationships were found between the students' difficulties and their perceived level of recovery. The findings illuminate that one of the major challenges that students with SMI experience is to meet academic requirements while coping with mental illness. They also indicate that students' difficulties may not be limited to academic functioning. Therefore, there is a need to broaden the view of students' difficulties to include social and contextual factors in the university environment.

Challenges in conducting qualitative research in health: A conceptual paper

PubMed Central

Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

2015-01-01

Background: Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. Materials and Methods: This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. Results: One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. Conclusions: The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others. PMID:26793245

Understanding patients in multicultural settings: a personal reflection on ethnicity and culture in clinical practice.

PubMed

Hickling, Frederick W

2012-01-01

To identify and discourse on the complexities of ethnicity and culture, their role in the social and psychological functioning of patients and their potential impact on clinical assessment and treatment of these patients in diverse cultural contexts. Description of aspects of the cultural competence required by clinicians in mental health service provisions in therapeutic interactions involving the therapist and patient and also in the encounter between practitioners. The four-decade clinical experience of the author, an African Jamaican psychiatrist, encompasses clinical experience in the Caribbean, North America, Europe and New Zealand. From this wealth of multicultural clinical practice the author uses personal examples of four experiences with patients and professionals of African Caribbean, British and Maori ethnicities to discuss issues of ethnicity, ethnic identity and stereotyping, culture, cultural competency and alterity in the exchanges between the therapist and patient, and between therapists and the difficulties encountered in effective assessment and treatment of patients in multicultural settings. The author highlights the importance of historical experience in the psychological constitution of patients, which is the basis of a novel analytic model called psychohistoriography. This insight-oriented individual or group-focused intervention was created with the intention of attempting to heal the wounds of history; an aim that is absent from existing psychoanalytic treatment modalities. Psychohistoriography may be a viable therapeutic option in the negotiation of cross-cultural clinical interactions.

Educational Implications of Dyscalculia.

ERIC Educational Resources Information Center

Flinter, Paul F.

1979-01-01

Difficulties encountered by a dyscalculia child are discussed and remedial activities suggested. Disturbances discussed are verbal, visual-spatial, reading and writing numbers, operations, understanding concepts, and place value. (MP)

L'Utilisation de l'ordinateur en lexicometrie (The Use of the Computer in Lexicometry). Series B-1.

ERIC Educational Resources Information Center

Savard, Jean-Guy

This report treats some of the technical difficulties encountered in lexicological studies that were undertaken in order to establish a basic vocabulary. Its purpose is to show that the computer can overcome some of these difficulties, and specifically that computer programming can serve to establish a vocabulary common to scientific and technical…

An Analysis of Difficulties of Children with Stuttering Enrolled in Turkish Primary Inclusive Classes Who Encounter in Academic and Social Activities: From Their Perspectives

ERIC Educational Resources Information Center

Sari, Hakan; Gökdag, Hatice

2017-01-01

Stuttering means that children have difficulties in rhythm, sound, syllable, word and phrase repetitions, or flow of speech cut in the form of extension or block form. In the "International Classification of Diseases" (1992) ("International Classification of Diseases-10" ("ICD-10"), Stuttering was defined as speech…

Chiropractic Observation and Analysis Study (COAST): providing an understanding of current chiropractic practice.

PubMed

French, Simon D; Charity, Melanie J; Forsdike, Kirsty; Gunn, Jane M; Polus, Barbara I; Walker, Bruce F; Chondros, Patty; Britt, Helena C

2013-11-18

COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.

Difficulties encountered at the beginning of professional life: results of a 2003 pilot survey among undergraduate students in Paris Rene Descartes University (France).

PubMed

Benbelaïd, R; Dot, D; Levy, G; Eid, N

2006-11-01

In addition to dental hospital clinical activity, dental students at Paris Rene Descartes University have the opportunity in their final year of study to practise clinically in a dental office, as associates. This paper outlines a pilot, experimental study designed to assess student reaction to this Vocational Clinical Activity (VCA) in order to identify relevant weaknesses of the undergraduate programme. Using questionnaires, data were collected for each of the following clinical or management skills: clinical difficulty, therapeutic decision-making, patient/practitioner relationship, time management, administrative matters and technical problems. Students were asked to rank each item in order of difficulty (1, high level to 6, low level). A high response rate was observed (90%) among the 50 undergraduate VCA students. The results pointed out three main difficulties encountered by undergraduate students during the VCA: time management (90% of the students), administrative matters (85% of the students) and clinical decision-making (80% of the students). These preliminary results need further investigation. However, they give us the incentive to carry on with this type of assessment and to extend it to young, qualified colleagues' perceptions and to other French Universities.

Toll motorway accessibility for wheelchair users: a survey.

PubMed

Prigent, Hélène; Roche, Nicolas; Guillon, Bruno; Hurand, Anne; Moreau, Bernadette; Dufresne, Jean Pierre; Ravaud, Jean-François; Lofaso, Frédéric

2008-09-01

To identify difficulties encountered by wheelchair users who travel on toll motorways, with the goal of defining areas for improvement. Survey. After observing a wheelchair user travelling on a toll motorway and using the associated services, we designed a self-questionnaire on perceptions by wheelchair users of toll motorway accessibility. Toll motorway and rehabilitation hospital in France. We recruited 167 wheelchair users by advertisement and, to assess selection bias, 19 consecutive outpatients who visited our hospital's wheelchair showroom. None. Of the 186 included subjects, 91 (49%) were used to driving independently on toll motorways. Among them, only 16% used automatic toll booths and 32% reported difficulties at toll booths. Furthermore, 53% routinely asked for help at filling stations, and only 27% were aware of the availability of a free-of-charge assistance service for disabled people at some filling stations. Among the 186 toll motorway users, only 84 (45%) reported never encountering difficulties in lay-bys; 162 (87%) felt that toilet accessibility was the most important feature of lay-bys and 143 (77%) preferred the locked toilets reserved for disabled people. Wheelchair users reported difficulties on toll motorways that could be corrected fairly easily.

Depression in the elderly.

PubMed Central

Wasylenki, D.

1980-01-01

Depression in the elderly is very common and may be difficult to diagnose. Because of its varied presentation and its frequent association with physical illness it will be encountered increasingly by all physicians as the elderly population expands. Depression, though treatable, is often not treated, and suicide rates are high among depressed elderly persons. Diagnostic difficulties lie in distinguishing depression from organic brain syndromes, from so-called masked depressions and from normal grief reactions. Pharmacologic treatment is effective, but care must be taken to recognize side effects and to use adequate doses. Psychologic approaches should focus on reducing feelings of helplessness and failing self-esteem. The importance of the losses borne by elderly persons in the pathogenesis of depression continues to be of theoretical and practical interest. PMID:6989463

[Contextualized editorial practices: Carlos Augusto Monteiro and the journal Revista de Saúde Pública].

PubMed

Martinovich, Viviana

2016-01-01

This text is part of a series of interviews that seek to explore diverse editing and publication experiences and the similar difficulties Latin America journals face, in order to begin to encounter contextualized solutions that articulate previously isolated efforts. In this interview, carried out in July 2015 in the Instituto de Salud Colectiva [Institute of Collective Health] of the Universidad Nacional de Lanús, Carlos Augusto Monteiro speaks to us about funding, work processes, technological innovations, and establishing teams and roles. He analyzes the importance of Latin American journals as a platform for spreading research relevant to national agendas, and the connection between journal performance, the quality of graduate training programs and research quality.

Wave optics of the central spot in planetary occultations

NASA Technical Reports Server (NTRS)

Hubbard, W. B.

1977-01-01

The detection of a bright central spot during the occultation of epsilon Geminorum by Mars demonstrates that an exponentially-stratified planetary atmosphere can act as a lens providing very high resolution of distant objects (e.g., quasars, white dwarfs, and pulsars). The diffraction nature of the central occultation spot is investigated, with special reference to Mars and Venus. In practice, however, central occultations by these planets are seldom observable from the earth's surface, and spacecraft would have to be used to obtain a suitable orientation for observers. Further difficulties may be encountered in image deconvolution needed for extended objects, in location of the image of a true point source, and in compensation for peculiarities of planets and their atmospheres.

Multicultural health care in practice. An empirical exploration of multicultural care in The Netherlands.

PubMed

Olthuis, Gert; van Heteren, Godelieve

2003-09-01

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive in their direct interactions with patients. On the basis of the observations of the 24 respondents five strategies were formulated to improve the delivery of care in a multicultural environment. Their findings were further evaluated by confronting the empirical data with care-ethical notions (attentiveness, responsibility, competence, and responsiveness) and intercultural communication-theory.

[Digestive disorders in rabbits and guinea pigs].

PubMed

Hollmann, P

1992-12-01

Numerous digestive tract diseases in pet rabbits and guinea pigs result from both an inherent physiological predisposition and from poor feeding and husbandry. A large proportion of digestive disturbances in rabbits and guinea pigs are secondary to changes in the oral cavity caused by inadequate teeth wear. The required regular trimming of the cheek teeth using a modified spatula and hollow pair of pincers is described and illustrated. The symptoms, diagnosis, prognosis and treatment of a selection of digestive disorders, as commonly encountered in small animal practice, are presented. The difficulties of using antibiotics in view of the gram positive intestinal flora and possible dysbacteria, dysentery and enterotoxaemia are considered. Finally, advice on feeding and on the rearing of orphan neonates is given.

Limits on fundamental limits to computation.

PubMed

Markov, Igor L

2014-08-14

An indispensable part of our personal and working lives, computing has also become essential to industries and governments. Steady improvements in computer hardware have been supported by periodic doubling of transistor densities in integrated circuits over the past fifty years. Such Moore scaling now requires ever-increasing efforts, stimulating research in alternative hardware and stirring controversy. To help evaluate emerging technologies and increase our understanding of integrated-circuit scaling, here I review fundamental limits to computation in the areas of manufacturing, energy, physical space, design and verification effort, and algorithms. To outline what is achievable in principle and in practice, I recapitulate how some limits were circumvented, and compare loose and tight limits. Engineering difficulties encountered by emerging technologies may indicate yet unknown limits.

The perceptual learning of time-compressed speech: A comparison of training protocols with different levels of difficulty

PubMed Central

Gabay, Yafit; Karni, Avi; Banai, Karen

2017-01-01

Speech perception can improve substantially with practice (perceptual learning) even in adults. Here we compared the effects of four training protocols that differed in whether and how task difficulty was changed during a training session, in terms of the gains attained and the ability to apply (transfer) these gains to previously un-encountered items (tokens) and to different talkers. Participants trained in judging the semantic plausibility of sentences presented as time-compressed speech and were tested on their ability to reproduce, in writing, the target sentences; trail-by-trial feedback was afforded in all training conditions. In two conditions task difficulty (low or high compression) was kept constant throughout the training session, whereas in the other two conditions task difficulty was changed in an adaptive manner (incrementally from easy to difficult, or using a staircase procedure). Compared to a control group (no training), all four protocols resulted in significant post-training improvement in the ability to reproduce the trained sentences accurately. However, training in the constant-high-compression protocol elicited the smallest gains in deciphering and reproducing trained items and in reproducing novel, untrained, items after training. Overall, these results suggest that training procedures that start off with relatively little signal distortion (“easy” items, not far removed from standard speech) may be advantageous compared to conditions wherein severe distortions are presented to participants from the very beginning of the training session. PMID:28545039

Wolffian duct derivative anomalies: technical considerations when encountered during robot-assisted radical prostatectomy.

PubMed

Acharya, Sujeet S; Gundeti, Mohan S; Zagaja, Gregory P; Shalhav, Arieh L; Zorn, Kevin C

2009-04-01

Although malformations of the genitourinary tract are typically identified during childhood, they can remain silent until incidental detection in evaluation and treatment of other pathologies during adulthood. The advent of the minimally invasive era in urologic surgery has given rise to unique challenges in the surgical management of anomalies of the genitourinary tract. This article reviews the embryology of anomalies of Wolffian duct (WD) derivatives with specific attention to the seminal vesicles, vas deferens, ureter, and kidneys. This is followed by a discussion of the history of the laparoscopic approach to WD derivative anomalies. Finally, we present two cases to describe technical considerations when managing these anomalies when encountered during robotic-assisted radical prostatectomy. The University of Chicago Robotic Laparoscopic Radical Prostatectomy (RLRP) database was reviewed for cases where anomalies of WD derivatives were encountered. We describe how modifications in technique allowed for completion of the procedure without difficulty. None Of the 1230 RLRP procedures performed at our institution by three surgeons, only two cases (0.16%) have been noted to have a WD anomaly. These cases were able to be completed without difficulty by making simple modifications in technique. Although uncommon, it is important for the urologist to be familiar with the origin and surgical management of WD anomalies, particularly when detected incidentally during surgery. Simple modifications in technique allow for completion of RLRP without difficulty.

Identifying Student and Teacher Difficulties in Interpreting Atomic Spectra Using a Quantum Model of Emission and Absorption of Radiation

ERIC Educational Resources Information Center

Savall-Alemany, Francisco; Domènech-Blanco, Josep Lluís; Guisasola, Jenaro; Martínez-Torregrosa, Joaquín

2016-01-01

Our study sets out to identify the difficulties that high school students, teachers, and university students encounter when trying to explain atomic spectra. To do so, we identify the key concepts that any quantum model for the emission and absorption of electromagnetic radiation must include to account for the gas spectra and we then design two…

Family practice residents' maternity leave experiences and benefits.

PubMed

Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A

1995-09-01

A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.

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

Nixon, J.D., E-mail: j.nixon@kingston.ac.uk; Wright, D.G.; Dey, P.K.

Highlights: • We evaluate operational municipal solid waste incinerators in the UK. • The supply chain of four case study plants are examined and compared in detail. • Technical, financial and operational data has been gathered for the four plants. • We suggest the best business practices for waste incinerators. • Appropriate strategy choices are the major difficulties for waste to energy plants. - Abstract: The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supplymore » chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87–92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste management.« less

Learning about general practice through qualitative interviews: lessons from a seminar course with medical students.

PubMed

von Unger, Hella; Werwick, Katrin; Lichte, Thomas; Herrmann, Markus

2010-01-01

A seminar course was developed in order to train medical students in qualitative research methods, while providing an introduction to the field of General Practice. Students were enabled to conduct semi-structured interviews with general practitioners (GPs), during which they learned about the prevention, diagnosis, and treatment of frequently encountered medical problems. The course was carried out four times at two universities in Germany. The study explores the students' learning experiences focusing on their research experience. Data were collected in four focus groups and analyzed. The students perceived the course as very different from their usual medical education. This was appreciated, but also caused some difficulties. Three themes emerged: (1) Missing 'facts', (2) New horizons: 'Thinking outside the box', and (3) The challenge of interpretation: 'Reading between the lines'. Learning qualitative research methods can be particularly challenging for medical students as the tasks and epistemology of qualitative research run counter to the usual learning formats and research paradigms in medical education. When teaching qualitative research, special care should be taken to address the cognitive dissonance experienced by students and to explain the unique contribution of qualitative research to medical practice and the field of General Practice especially.

An Online Forum As a Qualitative Research Method: Practical Issues

PubMed Central

Im, Eun-Ok; Chee, Wonshik

2008-01-01

Background Despite positive aspects of online forums as a qualitative research method, very little is known about practical issues involved in using online forums for data collection, especially for a qualitative research project. Objectives The purpose of this paper is to describe the practical issues that the researchers encountered in implementing an online forum as a qualitative component of a larger study on cancer pain experience. Method Throughout the study process, the research staff recorded issues ranged from minor technical problems to serious ethical dilemmas as they arose and wrote memos about them. The memos and written records of discussions were reviewed and analyzed using the content analysis suggested by Weber. Results Two practical issues related to credibility were identified: a high response and retention rate and automatic transcripts. An issue related to dependability was the participants’ easy forgetfulness. The issues related to confirmability were difficulties in theoretical saturation and unstandardized computer and Internet jargon. A security issue related to hacking attempts was noted as well. Discussion The analysis of these issues suggests several implications for future researchers who want to use online forums as a qualitative data collection method. PMID:16849979

A critical theory of medical discourse: how patients and health professionals deal with social problems.

PubMed

Waitzkin, H; Britt, T

1989-01-01

Criticism of social context does not generally appear in medical encounters. When contextual issues arise in medical discourse, messages of ideology and social control may become apparent, usually without the conscious awareness of the participants. By easing the physical or psychological impact of contextual difficulties, or by encouraging patients' conformity to mainstream expectations of desirable behavior, encounters with doctors can help win patients' consent to troubling social conditions. Seen in this light, doctor-patient encounters become micropolitical situations that do not typically encourage explicit statements or actions by health professionals to change contextual sources of their patients' difficulties. A critical theory influenced by structuralism suggests that the surface meanings of signs in medical discourse prove less important than their structural relationships. In addition, a theoretical approach adopting elements of post-structuralism and Marxist literary criticism emphasizes the marginal, absent, or excluded elements of medical discourse. Contextual features that shape a text include social class, sex, age, and race. Through the underlying structure of medical discourse, contextual problems are expressed, marginalized, and managed.

Sensemaking: a driving force behind the integration of professional practices.

PubMed

Sylvain, Chantal; Lamothe, Lise

2012-01-01

There has been considerable effort in recent years to link and integrate professional services more closely for patients with comorbidities. However, difficulties persist, especially at the clinical level. This study aims to shed light on these difficulties by examining the process of sensemaking in professionals directly involved in this integration. The authors conducted an eight-year longitudinal case study of an organization specializing in mental health and substance abuse. Different data collection methods were used, including 34 interviews conducted between 2003 and 2009, observations and document analysis. The authors performed a qualitative analysis of the data using a processual perspective. This paper provides empirical insights about the nature of the sensemaking process in which professionals collectively participate and the effects of this process on the evolution of integrated services. It suggests that the development of integrated practices results from an evolutional and collective process of constructing meanings that is rooted in the work activities of the professionals involved. By drawing attention to the capacity of professionals to shape the projects they are implementing, this study questions the capacity of managers to actually manage such a process. In order to obtain the expected benefits of integration projects, such emergent dynamics must first be recognized and then supported. Only then can thought be given to mastering them. The fact that this is a single case study is not a limitation per se, although it does raise the issue of the transferability of results. Replicating the study in other contexts would verify the applicability of the authors' conclusions. This study offers a fresh perspective on the difficulties generally encountered at the clinical level when trying to integrate services. It makes a significant contribution to work on the dynamics of sensemaking in organizational life.

What makes up good consultations? A qualitative study of GPs' discourses.

PubMed

Van Roy, Kaatje; Vanheule, Stijn; Deveugele, Myriam

2013-05-16

In medical literature, several principles that define 'good consultations' have been outlined. These principles tend to be prescriptive in nature, overlooking the complexity of general practitioners (GPs)' perspectives of everyday practice. Focusing on perspectives might be particularly relevant, since they may affect decisions and actions. Therefore, the present study adopts a bottom-up approach, analyzing GPs' narratives about 'good' and 'bad' consultations. We aimed at describing the range of discourses GPs use in relating on their practice. Semi-structured interviews were conducted with 19 Belgian GPs. By means of a qualitative analysis, the authors mapped patterns in the interview narratives and described the range of different discourses. Four discourses were identified: a biomedically-centered discourse, a communication-focused discourse, a problem-solving discourse and a satisfaction-oriented discourse. Each discourse was further specified in terms of predominant themes, problems the GPs prefer to deal with and inherent difficulties. Although most participants used elements from all four discourses, the majority of the GPs relied on an individual set of predominant discourses and focused on a limited number of themes. This study clearly indicates that there is no uniform way in which GPs perceive clinical practice. Each of the participants used a subtle mix of different criteria to define good and bad medical consultations. Some discourse elements appear to be rooted in medical literature, whereas others are of a more personal nature. By focusing on the limitations of each discourse, this study can shed new light on some of the difficulties GPs encounter in their daily practice: being confronted with specific problems might be an effect of adhering to a specific discourse. The typification of different discourses on consultations may function as a framework to help GPs reflect on how they perceive their practice, and help them manage some of the challenges met in daily practice.

A Study of Moroccan Pupils' Difficulties at Second Baccalaureate Year in Solving Chemistry Problems Relating to the Reactivity of Ethanoate Ions and to Copper-Aluminium Cells

ERIC Educational Resources Information Center

Ouasri, Ali

2017-01-01

This paper investigates the difficulties that Moroccan pupils (18-19) of the second Baccalaureate year encountered in solving chemical equilibrium problems relating to ethanoate ions' reactivity with water and methanoic acid, and to copper-aluminum cells. The pupils were asked to provide answers to questions derived from two problems. The…

Hybridization of Practices in Teacher-Researcher Collaboration

ERIC Educational Resources Information Center

Hamza, Karim; Palm, Ola; Palmqvist, Jenny; Piqueras, Jesús; Wickman, Per-Olof

2018-01-01

In this paper we present experiences from a joint collaborative research project which may be described as an encounter between a school science teaching practice and a university science didactics research practice. We provide narratives which demonstrate how the encounter between these two communities of practice interacted to produce…

5 CFR 537.105 - Criteria for payment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... repayment benefits for an employee (or job candidate), an agency must make a written determination that— (1... position, the agency otherwise would encounter difficulty in filling a position with a highly qualified...

5 CFR 537.105 - Criteria for payment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... repayment benefits for an employee (or job candidate), an agency must make a written determination that— (1... position, the agency otherwise would encounter difficulty in filling a position with a highly qualified...

5 CFR 537.105 - Criteria for payment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... repayment benefits for an employee (or job candidate), an agency must make a written determination that— (1... position, the agency otherwise would encounter difficulty in filling a position with a highly qualified...

5 CFR 537.105 - Criteria for payment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... repayment benefits for an employee (or job candidate), an agency must make a written determination that— (1... position, the agency otherwise would encounter difficulty in filling a position with a highly qualified...

Commognitive analysis of undergraduate mathematics students' first encounter with the subgroup test

NASA Astrophysics Data System (ADS)

Ioannou, Marios

2018-06-01

This study analyses learning aspects of undergraduate mathematics students' first encounter with the subgroup test, using the commognitive theoretical framework. It focuses on students' difficulties as these are related to the object-level and metalevel mathematical learning in group theory, and, when possible, highlights any commognitive conflicts. In the data analysis, one can identify three types of difficulties, relevant to object-level learning: namely regarding the frequently observed confusion between groups and sets, the object-level rules of visual mediators, and the object-level rules of contextual notions, such as permutations, exponentials, sets and matrices. In addition, data analysis suggests two types of difficulties, relevant to metalevel learning. The first refers to the actual proof that the three conditions of subgroup test hold, and the second is related to syntactic inaccuracies, incomplete argumentation and problematic use of visual mediators. Finally, this study suggests that there are clear links between object-level and metalevel learning, mainly due to the fact that objectification of the various relevant mathematical notions influences the endorsement of the governing metarules.

Outcomes of a service teaching module on ODEs for physics students

NASA Astrophysics Data System (ADS)

Hyland, Diarmaid; van Kampen, Paul; Nolan, Brien C.

2018-07-01

This paper reports on the first part of a multiphase research project that seeks to identify and address the difficulties encountered by physics students when studying differential equations. Differential equations are used extensively by undergraduate physics students, particularly in the advanced modules of their degree. It is, therefore, necessary that students develop conceptual understanding of differential equations in addition to procedural skills. We have investigated the difficulties encountered by third-year students at Dublin City University in an introductory differential equations module. We developed a survey to identify these difficulties and administered it to students who had recently completed the module. We found that students' mathematical ability in relation to procedural competence is an issue in their study of differential equations, but not as severe an issue as their conceptual understanding. Mathematical competence alone is insufficient if we expect our students to be able to recognize the need for differential equations in a physical context and to be able to set up, solve and interpret the solutions of such equations. We discuss the implications of these results for the next stages of the research project.

Sickness certification difficulties in Ireland--a GP focus group study.

PubMed

Foley, M; Thorley, K; Von Hout, M-C

2013-07-01

Sickness certification causes problems for general practitioners (GPs). Difficulty with the assessment of capacity to work, conflict with patients and other non-medical factors have been shown to influence GPs' decision-making. Inadequate leadership and management of certification issues add to GPs' difficulties. To explore problems associated with sickness certification, as part of a larger mixed method research project exploring GPs' experiences and perceptions of sickness certification in Ireland. A qualitative study in an urban region of Ireland. A focus group of four male and four female GPs explored problems encountered by GPs in certifying sickness absence. Thematic data analysis was used. Three major themes emerged: perception of the sickness certification system, organization of health care and cultural factors in sickness absence behaviour. Employment structures in public and private sectors and lack of communication with other health care providers and employers were identified as complicating sickness certification. GPs encounter a complexity of issues in sick certification and are dissatisfied with their role in certifying sickness absence. Our results open the debate for policy change and development in Ireland.

Advances in quantum simulations of ATPase catalysis in the myosin motor.

PubMed

Kiani, Farooq Ahmad; Fischer, Stefan

2015-04-01

During its contraction cycle, the myosin motor catalyzes the hydrolysis of ATP. Several combined quantum/classical mechanics (QM/MM) studies of this step have been published, which substantially contributed to our thinking about the catalytic mechanism. The methodological difficulties encountered over the years in the simulation of this complex reaction are now understood: (a) Polarization of the protein peptide groups surrounding the highly charged ATP(4-) cannot be neglected. (b) Some unsuspected protein groups need to be treated QM. (c) Interactions with the γ-phosphate versus the β-phosphate favor a concurrent versus a sequential mechanism, respectively. Thus, these practical aspects strongly influence the computed mechanism, and should be considered when studying other catalyzed phosphor-ester hydrolysis reactions, such as in ATPases or GTPases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Clinical instruction: using the strengths-based approach with nursing students.

PubMed

Cederbaum, Julie; Klusaritz, Heather A

2009-08-01

Clinical instruction experience can vary significantly based on the needs of the organization and the individual characteristics of instructors and students. Clinical instructors may encounter difficulties in their relationships with students, such as personality conflicts, differences in style and values, and limited skill levels or a lack of interest on the part of students. To reduce obstacles when working with challenging students, a strengths perspective approach is recommended. This framework emphasizes discovering, affirming, and enhancing the capabilities, interests, knowledge, resources, goals, and objectives of individuals. The strengths perspective can provide an innovative framework for working with nursing students, one that emphasizes student empowerment, collaborative learning, and mutual growth. Strength-based strategies for supervision of students in clinical placements are shared, highlighting the practical application of the framework's tenets. Copyright 2009, SLACK Incorporated.

A Grignard-like Organic Reaction in Water

NASA Astrophysics Data System (ADS)

Breton, Gary W.; Hughey, Christine A.

1998-01-01

The addition of a Grignard reagent to a carbonyl-containing compound to form an alcohol is an important reaction to demonstrate in organic chemistry laboratory courses. However, the reaction presents several practical problems for the lab instructor including the need for anhydrous solvents (e.g., ether), dry glassware, and the occasional problem of slow reaction initiation. We have scaled, and tested, a known Grignard-like reaction between allyl bromide and benzaldehyde mediated by zinc metal in aqueous media. The procedure retains the desirable features of the traditional Grignard reaction, while eliminating some of the commonly encountered difficulties. Thus, addition of allyl bromide (1.2 eq) to benzaldehyde and zinc in a two-phase mixture of THF and saturated aqueous NH4Cl afforded addition product 1-phenyl-3-buten-1-ol in 70-85% yields.

Health Research Ethics: Between Ethics Codes and Culture.

PubMed

Gheondea-Eladi, Alexandra

2017-10-01

This article is meant to describe and analyze some of the ethical difficulties encountered in a pilot research on treatment decisions of patients with chronic viral hepatitis C infection in Romania. It departs from an overview of the main ethics codes, and it shows that social health research on patients falls in between institutional codes of ethics. Furthermore, the article moves on to analyze so-called "important moments" of empirical research, such as the implementation of the ethical protocol, dealing with informal payments and with information on shady actions, as well as requests of information from interviewed patients and deciding when and if to breach confidentiality. In an attempt to evaluate the ad hoc solutions found in the field, the concluding remarks discuss these issues at the threshold of theory and practice.

Learner-controlled practice difficulty in the training of a complex task: cognitive and motivational mechanisms.

PubMed

Hughes, Michael G; Day, Eric Anthony; Wang, Xiaoqian; Schuelke, Matthew J; Arsenault, Matthew L; Harkrider, Lauren N; Cooper, Olivia D

2013-01-01

An inherent aspect of learner-controlled instructional environments is the ability of learners to affect the degree of difficulty faced during training. However, research has yet to examine how learner-controlled practice difficulty affects learning. Based on the notion of desirable difficulties (Bjork, 1994), this study examined the cognitive and motivational antecedents and outcomes of learner-controlled practice difficulty in relation to learning a complex task. Using a complex videogame involving both strong cognitive and psychomotor demands, 112 young adult males were given control over their practice difficulty, which was reflected in the complexity of the training task. Results show that general mental ability, prior experience, pre-training self-efficacy, and error encouragement were positively related to learner-controlled practice difficulty. In turn, practice difficulty was directly related to task knowledge and post-training performance, and it was related to adaptive performance through the mediating influences of task knowledge and post-training performance. In general, this study supports the notion that training difficulty operationalized in terms of task complexity is positively related to both knowledge and performance outcomes. Results are discussed with respect to the need for more research examining how task complexity and other forms of difficulty could be leveraged to advance learner-controlled instructional practices. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Problems in Evaluating Adult Literacy Programmes.

ERIC Educational Resources Information Center

Rajyalakshmi, C.

1980-01-01

The study of the Functional Literacy Program in India encountered problems of opposition to evaluation, inappropriate respondents, and difficulties in contacting participants, which point to changes that should be made in the evaluation methods. (SK)

Modular multiaperatures for light sensors

NASA Technical Reports Server (NTRS)

Rizzo, A. A.

1977-01-01

Process involves electroplating multiaperature masks as unit, eliminating alinement and assembly difficulties previously encountered. Technique may be applied to masks in automated and surveillance light systems, when precise, wide angle field of view is needed.

Morbidity and process of care in urban Malaysian general practice: the impact of payment system.

PubMed

Teng, C L; Aljunid, S M; Cheah, Molly; Leong, K C; Kwa, S K

2003-08-01

The majority of primary care consultations in Malaysia occur in the general practice clinics. To date, there is no comprehensive documentation of the morbidity and practice activities in this setting. We reported the reasons for encounter, diagnoses and process of care in urban general practice and the influence of payment system on the morbidity and practice activities. 115 clinics in Kuala Lumpur, Ipoh and Penang participated in this study. General practitioners in these clinics completed a 2-page questionnaire for each of the 30 consecutive patients. The questionnaire requested for the following information: demographic data, reasons for encounter, important physical findings, diagnoses, investigations ordered, outpatient procedures performed, medical certificate given, medication prescribed and referral made. The morbidity (reasons for encounter and diagnoses) was coded using ICPC-2 and the medication data was coded using MIMS Classification Index. During 3481 encounters, 5300 RFEs (152 RFEs per 100 encounters) and 3342 diagnoses (96 diagnoses per 100 encounters) were recorded. The majority of the RFEs and diagnoses are in the following ICPC Chapters: Respiratory, General and unspecified, Digestive, Neurological, Musculoskeletal and Skin. The frequencies of selected aspects of the process of care (rate per 100 encounters) were: laboratory investigations 14.7, outpatient procedures 2.4, sick certification 26.9, referral 2.4, and medication prescription 244. Consultation for chronic diseases and acute infections were influenced more by demographic variables (age, employment) rather than payment system. Cash-paying patients were more likely to receive laboratory investigations and injections. This study demonstrated the breadth of clinical care in the general practice. Relatively fewer patients consulted specifically for preventive care and treatment of chronic diseases. The frequencies of outpatient procedures and referrals appeared to be low. Payment system results in important differences in patient mix and influences some types of practice activities.

Navigating the Obstacles in Science Education for School Outreach

NASA Technical Reports Server (NTRS)

Rincon, Diana; Roig, Gustavo

2007-01-01

This paper gives an overview of the education outreach initiatives that the authors have personally been involved with, their successes and shortcomings are discussed with ways to overcome the difficulties encountered. Recommendations are given on how to navigate the obstacles. Industry professionals, college professors and even church groups participate in education outreach initiatives. For a successful experience, one has to navigate through various phases of the process. The strategy is to convince stakeholders that there is value in doing the outreach activity, form a partnership with the school, circumnavigate the security and administrative procedures, and finally deliver the material to the students. Successful education outreach programs have well-defined objectives, roles and expectations. Success depends on the level of commitment of all parties involved. Taking a look at individual programs, focusing on their shortcomings and best practices, this paper serves as a compilation of useful ideas for effective science and math education outreach. Navigation techniques mentioned in this paper systematically address each obstacle encountered, making solid recommendations for the future. One of the biggest challenges is showing the direct benefits of the outreach activity to stakeholders, so they can see how they profit from sacrificing their workers as outreach mentors.

Role of plastic surgeons in hepatic artery anastomosis in living donor liver transplantation: our experience of 10 cases.

PubMed

Mangal, Mahesh; Gambhir, Swaroop; Gupta, Anubhav; Shah, Amiti

2012-07-01

To understand the practical difficulties encountered while performing hepatic artery anastomosis by microsurgical technique in living donor liver transplantation. We undertook a retrospective study of 10 cases of hepatic artery anastomosis done at the level of bifurcation of the right hepatic artery and proximal when the plastic surgery team was called in for assistance. All the anastomoses were performed under an operating microscope (up to 24× magnification). In seven of these cases, anterior wall anastomosis was performed primarily, and in three cases, posterior wall approach was chosen. The main indications of calling in the plastic surgery team were to overcome these technical hurdles: (1) in cases where the caliber of the vessel was less than 2 mm in size; (2) dissection (separation of mucosa and adventitia) of the recipient vessel wall; (3) donor pedicle being so short that possibility of revision of the anastomosis seemed unlikely, necessitating single, sure-shot anastomosis without a chance of revision. The problems encountered by our microsurgical team were: (1) a special set of instruments was warranted because of the depth of the hepatic artery; (2) anastomosis had to be done in standing, stooped position with unsupported hands; (3) excessive movements due to respiration and profuse fluid collection in the field added to the hurdles encountered. All patients were prospectively followed by color Doppler ultrasound protocol for the first 5 days after surgery. Hepatic artery thrombosis was encountered in one case on postoperative day 10, which was successfully treated by thrombolytic therapy, but unfortunately the patient died of multiorgan failure on posttransplant day 30. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Australian men's sexual practices in saunas, sex clubs and other male sex on premises venues.

PubMed

Lyons, Anthony; Smith, Anthony M A; Grierson, Jeffrey W; von Doussa, Henry

2010-06-01

Sex on premises venues (SOPVs) where men have sex with men have been implicated in the spread of sexually transmissible infections, but few studies have described men's sexual encounters in SOPVs, particularly the degree to which men from different backgrounds engage in risky sexual practices. Interviewer administered surveys were conducted with 186 Australian men who have sex with men (MSM) within 48 h of visiting an SOPV. They reported their sexual practices, the characteristics of their partners and other circumstances surrounding their sexual encounters. All analyses were based on the number of sexual encounters (n = 430). Oral sex was the most common practice, occurring in 74.9% of encounters, followed by massage, frottage or kissing (53.7%), solo or mutual masturbation (36.3%), and anal sex (32.1%). Multivariate analyses revealed age as a significant factor for having protected anal sex (P = 0.001), insertive anal sex (P = 0.004) and receptive anal sex (P < 0.001). These practices were more frequent in encounters among younger men, while masturbation (P = 0.03) was more frequent among older men. When men's sexual partners were affected by alcohol, encounters were less likely to involve unprotected anal intercourse (P = 0.006) and more likely to involve massage, frottage or kissing (P = 0.009). Men disclosed their HIV status in only 7.7% of encounters. With the likelihood of risky sexual practices varying according to background, results from this study should be used to guide interventions aiming to promote safer sex in SOPVs.

Technology Challenges in Small UAV Development

NASA Technical Reports Server (NTRS)

Logan, Michael J.; Vranas, Thomas L.; Motter, Mark; Shams, Qamar; Pollock, Dion S.

2005-01-01

Development of highly capable small UAVs present unique challenges for technology protagonists. Size constraints, the desire for ultra low cost and/or disposable platforms, lack of capable design and analysis tools, and unique mission requirements all add to the level of difficulty in creating state-of-the-art small UAVs. This paper presents the results of several small UAV developments, the difficulties encountered, and proposes a list of technology shortfalls that need to be addressed.

Has Student Consumerism Gone Too Far?

ERIC Educational Resources Information Center

Pernal, Michael

1977-01-01

Efforts to protect students' consumer rights may encounter difficulty because of the heavy burdens now being placed on colleges and universities. Five ways that the concept of consumerism breaks down the educational setting are discussed. (Editor/LBH)

Teaching 3D computer animation to illustrators: the instructor as translator and technical director.

PubMed

Koning, Wobbe F

2012-01-01

An art instructor discusses the difficulties he's encountered teaching computer graphics skills to undergraduate art students. To help the students, he introduced an automated-rigging script for character animation.

Administrative encounters in general practice: low value or hidden value care?

PubMed

Trevena, Lyndal J; Harrison, Christopher; Britt, Helena C

2018-02-19

To determine the frequency of general practice administrative encounters, and to determine whether they represent low value care. Secondary analysis of data from the Bettering Evaluation and Care of Health (BEACH) dataset. 1 568 100 GP-patient encounters in Australia, 2000-01 to 2015-16. An annual nationally representative random sample of about 1000 GPs, who each recorded the details of 100 consecutive encounters with patients. Proportions of general practice encounters that were potentially low value care encounters (among the patient's reasons for the encounter was at least one administrative, medication, or referral request) and potentially low value care only encounters (such reasons were the sole reason for the encounter). For 2015-16, we also examined other health care provided by GPs at these encounters. During 2015-16, 18.5% (95% CI, 17.7-19.3%) of 97 398 GP-patient encounters were potentially low value care request encounters; 7.4% (95% CI, 7.0-7.9%) were potentially low value care only encounters. Administrative work was requested at 3.8% (95% CI, 3.5-4.0%) of GP visits, 35.4% of which were for care planning and coordination, 33.5% for certification, and 31.2% for other reasons. Medication requests were made at 13.1% (95% CI, 12.4-13.7%) of encounters; other health care was provided at 57.9% of medication request encounters, counselling, advice or education at 23.4%, and pathology testing was ordered at 16.7%. Referrals were requested at 2.8% (95% CI, 1.7-3.0%) of visits, at 69.4% of which additional health care was provided. The problems managed most frequently at potentially low value care only encounters were chronic diseases. Most patients requested certificates, medications and referrals in the context of seeking help for other health needs. Additional health care, particularly for chronic diseases, was provided at most GP administrative encounters. The MBS Review should consider the hidden value of these encounters.

Filter membrane-based automated therapeutic plasma exchange: a report of two cases from Nigeria.

PubMed

Arogundade, Fatiu A; Sanusi, Abubakr A; Akinbodewa, Akinwunmi A; Hassan, Muzamil O; Omotosho, Bolanle O; Balogun, Rasheed A; Akinsola, Adewale

2013-02-01

These case reports demonstrated the diagnostic dilemma encountered in patients with systemic lupus erythematosus and thrombotic thrombocytopenic purpura particularly in settings with limited diagnostic facilities and laboratory support. The similarities in the diagnostic criteria for both conditions make clear distinction as well as management decisions difficult. We present the difficulties encountered with both the diagnosis and the management of these two patients that were managed in our facility. Copyright © 2013 Wiley Periodicals, Inc.

Supersymmetry on the Lattice

NASA Astrophysics Data System (ADS)

Schaich, David

2016-03-01

Lattice field theory provides a non-perturbative regularization of strongly interacting systems, which has proven crucial to the study of quantum chromodynamics among many other theories. Supersymmetry plays prominent roles in the study of physics beyond the standard model, both as an ingredient in model building and as a tool to improve our understanding of quantum field theory. Attempts to apply lattice techniques to supersymmetric field theories have a long history, but until recently these efforts have generally encountered insurmountable difficulties related to the interplay of supersymmetry with the lattice discretization of spacetime. In recent years these difficulties have been overcome for a class of theories that includes the particularly interesting case of maximally supersymmetric Yang-Mills (N = 4 SYM) in four dimensions, which is a cornerstone of AdS/CFT duality. In combination with computational advances this progress enables practical numerical investigations of N = 4 SYM on the lattice, which can address questions that are difficult or impossible to handle through perturbation theory, AdS/CFT duality, or the conformal bootstrap program. I will briefly review some of the new ideas underlying this recent progress, and present some results from ongoing large-scale numerical calculations, including comparisons with analytic predictions.

Considering RNAi experimental design in parasitic helminths.

PubMed

Dalzell, Johnathan J; Warnock, Neil D; McVeigh, Paul; Marks, Nikki J; Mousley, Angela; Atkinson, Louise; Maule, Aaron G

2012-04-01

Almost a decade has passed since the first report of RNA interference (RNAi) in a parasitic helminth. Whilst much progress has been made with RNAi informing gene function studies in disparate nematode and flatworm parasites, substantial and seemingly prohibitive difficulties have been encountered in some species, hindering progress. An appraisal of current practices, trends and ideals of RNAi experimental design in parasitic helminths is both timely and necessary for a number of reasons: firstly, the increasing availability of parasitic helminth genome/transcriptome resources means there is a growing need for gene function tools such as RNAi; secondly, fundamental differences and unique challenges exist for parasite species which do not apply to model organisms; thirdly, the inherent variation in experimental design, and reported difficulties with reproducibility undermine confidence. Ideally, RNAi studies of gene function should adopt standardised experimental design to aid reproducibility, interpretation and comparative analyses. Although the huge variations in parasite biology and experimental endpoints make RNAi experimental design standardization difficult or impractical, we must strive to validate RNAi experimentation in helminth parasites. To aid this process we identify multiple approaches to RNAi experimental validation and highlight those which we deem to be critical for gene function studies in helminth parasites.

Test results of the DOE/Sandia 17 meter VAWT

NASA Technical Reports Server (NTRS)

Nellums, R. O.; Worstell, M. H.

1979-01-01

A review is given of the test program of a 17 meter Vertical Axis Wind Turbine VAWT. Performance test results are discussed including difficulties encountered during the VAWT operation along with ways of solving these problems.

Word problems: a review of linguistic and numerical factors contributing to their difficulty

PubMed Central

Daroczy, Gabriella; Wolska, Magdalena; Meurers, Walt Detmar; Nuerk, Hans-Christoph

2015-01-01

Word problems (WPs) belong to the most difficult and complex problem types that pupils encounter during their elementary-level mathematical development. In the classroom setting, they are often viewed as merely arithmetic tasks; however, recent research shows that a number of linguistic verbal components not directly related to arithmetic contribute greatly to their difficulty. In this review, we will distinguish three components of WP difficulty: (i) the linguistic complexity of the problem text itself, (ii) the numerical complexity of the arithmetic problem, and (iii) the relation between the linguistic and numerical complexity of a problem. We will discuss the impact of each of these factors on WP difficulty and motivate the need for a high degree of control in stimuli design for experiments that manipulate WP difficulty for a given age group. PMID:25883575

"It's like you are just a spectator in this thing": Experiencing social life the 'aspie' way.

PubMed

Ryan, Sara; Räisänen, Ulla

2008-12-01

This study explores the experiences of people with Asperger syndrome (AS) from a sociological perspective using the theoretical approaches of ethnomethodology and symbolic interactionism. In-depth interviews were conducted with 16 people with AS and three key themes of feeling different, trying to fit in and safe spaces are considered here. We suggest that people with AS develop a different symbolic capacity to most people and have difficulties in making sense of social encounters. While these difficulties can be overcome, to some degree, by developing strategies to try to fit in, this learning remains at a superficial level and is not internalised through the process of socialisation. Without being able to derive a firm sense of reality from spontaneous involvement in social encounters, participants feel "unruled, unreal and anomic" (Goffman, 1967: 135) and experience intense autistic emotion (Davidson, 2007a,b).

“It's like you are just a spectator in this thing”: Experiencing social life the ‘aspie’ way

PubMed Central

Ryan, Sara; Räisänen, Ulla

2008-01-01

This study explores the experiences of people with Asperger syndrome (AS) from a sociological perspective using the theoretical approaches of ethnomethodology and symbolic interactionism. In-depth interviews were conducted with 16 people with AS and three key themes of feeling different, trying to fit in and safe spaces are considered here. We suggest that people with AS develop a different symbolic capacity to most people and have difficulties in making sense of social encounters. While these difficulties can be overcome, to some degree, by developing strategies to try to fit in, this learning remains at a superficial level and is not internalised through the process of socialisation. Without being able to derive a firm sense of reality from spontaneous involvement in social encounters, participants feel “unruled, unreal and anomic” (Goffman, 1967: 135) and experience intense autistic emotion (Davidson, 2007a,b). PMID:24683419

A manual carotid compression technique to overcome difficult filter protection device retrieval during carotid artery stenting.

PubMed

Nii, Kouhei; Nakai, Kanji; Tsutsumi, Masanori; Aikawa, Hiroshi; Iko, Minoru; Sakamoto, Kimiya; Mitsutake, Takafumi; Eto, Ayumu; Hanada, Hayatsura; Kazekawa, Kiyoshi

2015-01-01

We investigated the incidence of embolic protection device retrieval difficulties at carotid artery stenting (CAS) with a closed-cell stent and demonstrated the usefulness of a manual carotid compression assist technique. Between July 2010 and October 2013, we performed 156 CAS procedures using self-expandable closed-cell stents. All procedures were performed with the aid of a filter design embolic protection device. We used FilterWire EZ in 118 procedures and SpiderFX in 38 procedures. The embolic protection device was usually retrieved by the accessory retrieval sheath after CAS. We applied a manual carotid compression technique when it was difficult to navigate the retrieval sheath through the deployed stent. We compared clinical outcomes in patients where simple retrieval was possible with patients where the manual carotid compression assisted technique was used for retrieval. Among the 156 CAS procedures, we encountered 12 (7.7%) where embolic protection device retrieval was hampered at the proximal stent terminus. Our manual carotid compression technique overcame this difficulty without eliciting neurologic events, artery dissection, or stent deformity. In patients undergoing closed-cell stent placement, embolic protection device retrieval difficulties may be encountered at the proximal stent terminus. Manual carotid compression assisted retrieval is an easy, readily available solution to overcome these difficulties. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Nominal and functional task difficulty in skill acquisition: Effects on performance in two tests of transfer.

PubMed

Sanli, Elizabeth A; Lee, Timothy D

2015-06-01

The influence of nominal and functional task difficulty during the acquisition of a motor skill was examined in two tests of transfer of learning. The task involved a ballistic, target-directed, finger action. Nominal task difficulty was defined as the distance of the target from the home position. Functional task difficulty was created by manipulating the progression of target distances during practice. Based on the challenge point framework (Guadagnoli & Lee, 2004), we predicted that practice with a set of targets farther away from the performer would benefit from less functional task difficulty, while practice with a closer set of targets would benefit from more functional task difficulty. In single-task transfer tests, learners who practiced using the high nominal task difficulty targets benefitted in terms of persistence of performance over time. In dual-task transfer tests, groups with an intermediate combined (nominal and functional) task difficulty performed with greater persistence over time on tests of transfer than those who practiced with the highest or lowest combined difficulty. Together these findings suggest that the influences of nominal and functional task difficulty during acquisition are weighted differentially depending upon the transfer test context. The challenge point framework does not accurately capture this complex relationship in its current form. Copyright © 2015 Elsevier B.V. All rights reserved.

Mindfulness training for parents of children with special needs: Guidance for nurses in mental health practice.

PubMed

Petcharat, Manika; Liehr, Patricia

2017-02-01

Parents of children with special needs encounter specific challenges in carrying out their caregiving roles. They experience difficulty accepting their children due to unrealistically high expectations. Mindfulness training (MT) may increase parental psychological well-being and acceptance. The purpose of this article is to examine the evidence-base for the effectiveness of MT in enhancing psychological well-being for parents of children with special needs as a foundation for guidance for nurses in mental health practice. A literature review of relevant research studies was undertaken using specific inclusion criteria. The literature was derived from three databases that identified 56 articles narrowed to 5, which met inclusion criteria. The studies indicated that cultivating a more mindful way of parenting is associated with reduced stress, anxiety, and depression. Parents experienced increased mindful awareness and improved psychological well-being, and they were more accepting of their children. Their children also had fewer behavior problems and enhanced positive interaction with their parents. Because mindfulness interventions fall within the scope of independent nursing practice, nurses can play a significant role in applying mindfulness to promote psychological well-being in parents who have children with special needs. © 2017 Wiley Periodicals, Inc.

[Management of patients under 18years of age by adult intensive care unit professionals: Level of training, workload, and specific challenges].

PubMed

Brossier, D; Villedieu, F; Letouzé, N; Pinto Da Costa, N; Jokic, M

2017-03-01

In routine practice, intensive care physicians rarely have to manage children under 18years of age, particularly those under 15. This study's objectives were to assess the quality of training in pediatrics of adult intensive care teams, to document the workload generated by care of pediatric patients, and to identify the difficulties encountered in managing minors as patients. A survey was administered in Lower Normandy from 4 April 2012 to 1 September 2012. Physicians, residents, nurses, and nurses' aides practicing in one of the nine intensive care units of Lower Normandy were asked to complete an electronic or paper format questionnaire. This questionnaire assessed their level of pediatric training, the workload management of pediatric patients entailed, and the challenges posed by these patients. One hundred and nine questionnaires were returned (by 26 attending physicians, 18 residents, 38 nurses, and 27 nurses' aides). Eighty-three of the respondents (76%) had no experience in a pediatric unit of any kind. Forty-two percent thought that the pediatric age range lies between 3months and 15years of age. However, more than 50% of respondents would like the upper limit to be 16years or even older. Ninety-three respondents (85%) estimated having some exposure to pediatric patients in their routine practice, but this activity remained quite low. Seventy-three (67%) reported difficulties with the management of these young patients. This survey provides current information regarding the level of training of adult intensive care unit professionals and their concerns about managing patients under 18years of age, both in terms of workload and specific challenges. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Health literacy training for public health nurses in fukushima: a case-study of program adaptation, implementation and evaluation.

PubMed

Goto, Aya; Rudd, Rima E; Lai, Alden Yuanhong; Yoshida-Komiya, Hiromi

2014-05-01

Health literacy comprises not only an individual's ability to gain access to, understand and use health information, but also health care providers' ability to make health information accessible and usable. The Fukushima nuclear accident has posed challenges related to the communication of radiation-related health information. Public health nurses are gatekeepers of community health in Japan, and have primary responsibility for communicating this complex information about science and risk to lay members of the community. A health literacy training program was designed to augment communication skills of participating nurses with two primary goals: changing communication practices and norms among public health nurses, and improving access to information for community residents. Training content incorporated an overview of health literacy skills (including numeracy), processes for assessing written materials and visual displays, as well as guidelines for text improvement. The workshop was spread across two days with two-hour sessions each day. A proximal post-training evaluation survey was conducted, followed by a more distal one-month follow-up evaluation to assess the application of learned skills in practice. Twenty-six nurses in Fukushima City attended the first trial. Post-training evaluations were highly positive, with agreement from 85-100% of participants on the appropriateness and usefulness of the workshop. During a one-month follow-up, the nurses reported applying new knowledge and skills to develop written materials. However, they faced difficulties sharing their new skills with colleagues and challenges changing work norms. Participants also encountered difficulties using graphics and explaining risks in practice. This paper highlights the importance of providing health literacy training opportunities for professionals to strengthen health system's ability to accessible information and services. This program also serves as important reference for future disaster management efforts.

Pre-operative patient teaching in an acute care ward in Hong Kong: a case study.

PubMed

Lee, David S; Chien, W T

2002-10-01

Many nurses have acknowledged that adequate pre-operative teaching can alleviate patients' anxiety, increase patient participation in their own care, and minimize post-operative complications. However, the organization and degree to which pre-operative patient teachingfeatured in nurses' practice varies in different acute care settings. A case study design was used to explore the practice of pre-operative teaching in a surgical ward of an acute general hospital in Hong Kong. Seventeen registered nurses working on the ward were interviewed and observed in order to explore how they conduct a pre-operative teaching program and the difficulties encountered by them in carrying out pre-operative teaching on this acute care setting. Thefindings of this study indicate that pre-operative teaching workshops are organized and conducted by nursesfrom the operating theatre, in the day surgery center. Ward nurses were not actively involved in this pre-operative teaching. The results of this study present some similarities to a study with the similar design in Australia. There are also issues unique to the Hong Kong context. This case study was to review Hong Kong nurses' current practices of pre-operative teaching and to understand the cultural, conceptual and managementfactors influencing the practice in pre-operative teaching.

Predictors of round window accessibility for adult cochlear implantation based on pre-operative CT scan: a prospective observational study.

PubMed

Park, Edward; Amoodi, Hosam; Kuthubutheen, Jafri; Chen, Joseph M; Nedzelski, Julian M; Lin, Vincent Y W

2015-05-28

Cochlear implantation has become a mainstream treatment option for patients with severe to profound sensorineural hearing loss. During cochlear implant, there are key surgical steps which are influenced by anatomical variations between each patient. The aim of this study is to determine if there are potential predictors of difficulties that may be encountered during the cortical mastoidectomy, facial recess approach and round window access in cochlear implant surgery based upon pre-operative temporal bone CT scan. Fifty seven patients undergoing unilateral cochlear implantation were analyzed. Difficulty with 1) cortical mastoidectomy, 2) facial recess approach, and 3) round window access were scored intra-operatively by the surgeon in a blinded fashion (1 = "easy", 2 = "moderate", 3 = "difficult"). Pre-operative temporal bone CT scans were analyzed for 1) degree of mastoid aeration; 2) location of the sigmoid sinus; 3) height of the tegmen; 4) the presence of air cells in the facial recess, and 5) degree of round window bony overhang. Poor mastoid aeration and lower tegmen position, but not the location of sigmoid sinus, are associated with greater difficulty with the cortical mastoidectomy. Presence of an air cell around the facial nerve was predictive of easier facial recess access. However, the degree of round window bony overhang was not predictive of difficulty associated with round window access. Certain parameters on the pre-operative temporal bone CT scan may be useful in predicting potential difficulties encountered during the key steps involved in cochlear implant surgery.

The work of nurses in Australian general practice: A national survey.

PubMed

Joyce, Catherine M; Piterman, Leon

2011-01-01

Following recent reforms to Australia's health system, nurses now comprise a significant and growing sector of the Australian primary care workforce, but there is little data describing the services they provide. This study aimed to describe the patient consultations of nurses in Australian general practice, including patient characteristics, reasons for the consultation, treatments provided and other actions taken. The study was a national cross-sectional survey, with each participating nurse collecting information about 50 nurse-patient encounters. General practice settings in all regions of Australia. 108 nurses volunteered in response to advertisements and 104 returned completed study materials. Participants included Registered (Division 1) and Enrolled (Division 2) nurses working in a general practice setting. Data were collected between May 2007 and May 2008 using a profile questionnaire and a series of encounter forms. Information was gathered on reasons for encounter, patient characteristics, and actions taken. Data were classified using the International Classification of Primary Care. The final data set included 5,253 nurse-patient encounters. 37.2% of patients (95% CI 33.3-41.2) were aged 65 and over, and 57.1% were female (95% CI 54.9-59.5). The majority of encounters (90.7%) were with existing patients of the practice (95% CI 89.1-92.7). The most common reasons for encounter were general and unspecified problems (35.4 per 100 encounters; 95% CI 31.8-39.1), followed by skin-related problems (20.0; 95% CI 17.3-22.8), and cardiovascular problems (11.0; 95% CI 8.7-13.3). Common management actions included medical examinations (20.7 per 100 encounters), immunisations (22.5), diagnostic tests (10.6), and dressings (15.8). Approximately 30% of encounters involved advice-giving. The findings confirm the generalist nature of the General Practice Nurse role, with a wide range of patient types and clinical conditions. There is a clear influence of current funding and organisational arrangements on work patterns, with tasks that have specific funding (including immunisations and wound care) featuring prominently in nurses' work. Whilst nurses' rates for presenting conditions were similar to doctors at a general level, specific actions taken and problems managed differed. New policy reforms in Australia are supporting greater flexibility in the General Practice Nurse role, maximising efficient use of nurses' skills in the primary health care context. Copyright © 2010 Elsevier Ltd. All rights reserved.

Lack of Impact of Direct-to-Consumer Advertising on the Physician-Patient Encounter in Primary Care: A SNOCAP Report

PubMed Central

Parnes, Bennett; Smith, Peter C.; Gilroy, Christine; Quintela, Javan; Emsermann, Caroline B.; Dickinson, L. Miriam; Westfall, John M.

2009-01-01

PURPOSE Direct-to-consumer advertising (DTCA) has increased tremendously during the past decade. Recent changes in the DTCA environment may have affected its impact on clinical encounters. Our objective was to determine the rate of patient medication inquiries and their influence on clinical encounters in primary care. METHODS Our methods consisted of a cross-sectional survey in the State Networks of Colorado Ambulatory Practices and Partners, a collaboration of 3 practice-based research networks. Clinicians completed a short patient encounter form after consecutive patient encounter for one-half or 1 full day. The main outcomes were the rate of inquiries, independent predictors of inquiries, and overall impact on clinical encounters. RESULTS One hundred sixty-eight clinicians in 22 practices completed forms after 1,647 patient encounters. In 58 encounters (3.5%), the patient inquired about a specific new prescription medication. Community health center patients made fewer inquiries than private practice patients (1.7% vs 7.2%, P<.001). Predictors of inquiries included taking 3 or more chronic medications and the clinician being female. Most clinicians reported the requested medication was not their first choice for treatment (62%), but it was prescribed in 53% of the cases. Physicians interpreted the overall impact on the visit as positive in 24% of visits, neutral in 66%, and negative in 10%. CONCLUSIONS Patient requests for prescription medication were uncommon overall, and even more so among patients in lower income groups. These requests were rarely perceived by clinicians as having a negative impact on the encounter. Future mixed methods studies should explore specific socioeconomic groups and reasons for clinicians’ willingness to prescribe these medications. PMID:19139448

Lack of impact of direct-to-consumer advertising on the physician-patient encounter in primary care: a SNOCAP report.

PubMed

Parnes, Bennett; Smith, Peter C; Gilroy, Christine; Quintela, Javan; Emsermann, Caroline B; Dickinson, L Miriam; Westfall, John M

2009-01-01

Direct-to-consumer advertising (DTCA) has increased tremendously during the past decade. Recent changes in the DTCA environment may have affected its impact on clinical encounters. Our objective was to determine the rate of patient medication inquiries and their influence on clinical encounters in primary care. Our methods consisted of a cross-sectional survey in the State Networks of Colorado Ambulatory Practices and Partners, a collaboration of 3 practice-based research networks. Clinicians completed a short patient encounter form after consecutive patient encounter for one-half or 1 full day. The main outcomes were the rate of inquiries, independent predictors of inquiries, and overall impact on clinical encounters. One hundred sixty-eight clinicians in 22 practices completed forms after 1,647 patient encounters. In 58 encounters (3.5%), the patient inquired about a specific new prescription medication. Community health center patients made fewer inquiries than private practice patients (1.7% vs 7.2%, P<.001). Predictors of inquiries included taking 3 or more chronic medications and the clinician being female. Most clinicians reported the requested medication was not their first choice for treatment (62%), but it was prescribed in 53% of the cases. Physicians interpreted the overall impact on the visit as positive in 24% of visits, neutral in 66%, and negative in 10%. Patient requests for prescription medication were uncommon overall, and even more so among patients in lower income groups. These requests were rarely perceived by clinicians as having a negative impact on the encounter. Future mixed methods studies should explore specific socioeconomic groups and reasons for clinicians' willingness to prescribe these medications.

Patenting nature or protecting culture? Ethnopharmacology and indigenous intellectual property rights

PubMed Central

McGonigle, Ian Vincent

2016-01-01

Ethnopharmacologists are scientists and anthropologists that study indigenous medicines and healing practices, and who often develop new therapies and medicines for wider use. Ethnopharmacologists do fieldwork with indigenous peoples in traditional societies, where they encounter a wide range of cultural values and varying ideas about the nature of property relations. This poses difficulties for protecting indigenous intellectual property and for making just trade agreements. This Note reviews the legal issues relevant to the protection of indigenous resources in ethnopharmacology trade agreements, and suggests that recent developments in anthropology and the social study of science could be instructive in furthering the legal discourse and in providing policy directions. Specifically, the Note introduces the concepts of ‘ontological pluralism’ and ‘epistemic subsidiarity’, which could help lawmakers write sui generis trade agreements to better protect indigenous knowledge and resources. PMID:27774245

Patenting nature or protecting culture? Ethnopharmacology and indigenous intellectual property rights.

PubMed

McGonigle, Ian Vincent

2016-04-01

Ethnopharmacologists are scientists and anthropologists that study indigenous medicines and healing practices, and who often develop new therapies and medicines for wider use. Ethnopharmacologists do fieldwork with indigenous peoples in traditional societies, where they encounter a wide range of cultural values and varying ideas about the nature of property relations. This poses difficulties for protecting indigenous intellectual property and for making just trade agreements. This Note reviews the legal issues relevant to the protection of indigenous resources in ethnopharmacology trade agreements, and suggests that recent developments in anthropology and the social study of science could be instructive in furthering the legal discourse and in providing policy directions. Specifically, the Note introduces the concepts of 'ontological pluralism' and 'epistemic subsidiarity', which could help lawmakers write sui generis trade agreements to better protect indigenous knowledge and resources.

Ethical analysis in public health.

PubMed

Roberts, Marc J; Reich, Michael R

2002-03-23

Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy.

Continuing the conversation in nursing on race and racism.

PubMed

Hall, Joanne M; Fields, Becky

2013-01-01

Nursing values include diversity and a commitment to the elimination of health disparities. However, nursing comprises predominantly white, female nurses. The authors explore structural and interpersonal sources of disparities experienced by black persons, including white privilege. Here, the authors advocate for a continuation of the racism conversation, specifically among white nurses. Racial disadvantages stem from structural inequalities from daily slights, and usually unintended subtle racism toward black people on the part of white people, including white nurses. By raising consciousness on how we propagate subtle racism, nursing can progress faster in eliminating health disparities. Topics include postracialism, colorblindness, institutional racism, white privilege, health disparities, clinical encounters, subtle racism, and racial microaggressions. Suggestions for open dialogue, historical awareness, education, research, and practice are highlighted. Difficulties involved in confronting racism and white privilege are explored. Copyright © 2013 Elsevier Inc. All rights reserved.

[Practical lessons from the risk management of an outbreak of acute gastroenteritis in a public school].

PubMed

Morillo-García, Aurea; Sillero-Sánchez, Rocío; Aldana-Espinal, Josefa María; Nieto-Cervera, Pilar

2005-01-01

We present our reflections on the management of an acute gastroenteritis outbreak in a public school, which caused a public health crisis, and the conclusions drawn from this experience. The methodology of strengths, weaknesses, opportunities, and threats (SWOT) analysis was used. This article describes the epidemiology of the incident and the policy decisions made, but focuses on operational aspects of outbreak management. The experience of the outbreak control team, liaison with other organizations, and data management are discussed. The difficulties encountered by the outbreak team related to delay in declaring in the outbreak, lack of training in some of the entities involved, and incorrect use of the surveillance circuits. Current protocols and specific action plans for the management of outbreaks should be improved through self-evaluation and updating of resources and knowledge.

THE EFFECT OF FLUORIDE ON LEAD SOLUBILITY

EPA Science Inventory

Difficulties in predicting and controlling lead corrosion are encountered by hundreds of water systems across the country. Inorganic carbonate, sulfate, silicate, orthophosphate, pH, total organic carbon, temperature and the type/amount of chlorine residual are all known factors ...

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

Circumcision in Australia: further evidence on its effects on sexual health and wellbeing.

PubMed

Ferris, Jason A; Richters, Juliet; Pitts, Marian K; Shelley, Julia M; Simpson, Judy M; Ryall, Richard; Smith, Anthony M A

2010-04-01

To report on the prevalence and demographic variation in circumcision in Australia and examine sexual health outcomes in comparison with earlier research. A representative household sample of 4,290 Australian men aged 16-64 years completed a computer-assisted telephone interview including questions on circumcision status, demographic variables, reported lifetime experience of selected sexually transmissible infections (STIs), experience of sexual difficulties in the previous 12 months, masturbation, and sexual practices at last heterosexual encounter. More than half the men (58%) were circumcised. Circumcision was less common (33%) among men under 30 and more common (66%) among those born in Australia. After adjustment for age and number of partners, circumcision was unrelated to STI history except for non-specific urethritis (higher among circumcised men, OR=2.11, p<0.001) and penile candidiasis (lower among circumcised men, OR=0.49, p<0.001). Circumcision was unrelated to any of the sexual difficulties we asked about (after adjusting for age) except that circumcised men were somewhat less likely to have worried during sex about whether their bodies looked unattractive (OR=0.77, p=0.04). No association between lack of circumcision and erection difficulties was detected. After correction for age, circumcised men were somewhat more likely to have masturbated alone in the previous 12 months (OR=1.20, p=0.02). Circumcision appears to have minimal protective effects on sexual health in Australia. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

'Botanic Man:' Education or Entertainment?

ERIC Educational Resources Information Center

Freeman, Richard

1979-01-01

The experience of Thames Television in presenting an educational series during prime time is described. "The Botanic Man," a series on ecology, is a rating success. Several difficulties encountered in collaboration efforts and follow-up activities, including courses and workbook publications, are identified. (JMF)

The Sun in a Drawer

ERIC Educational Resources Information Center

Anderson, Bruce

1975-01-01

Widespread use of solar energy is unsuccessful with large scale integration required and conservatism of responsible institutions. Rising fuel costs and government promotion may initiate expansion in commercial, environmental, and government establishments, homes, and schools. Difficulties encountered include financing, tax incentives, design,…

The Use of Programmable Calculators in the Teaching of Economics, Part II

ERIC Educational Resources Information Center

Addis, G. H.

1978-01-01

Describes the use of programmable calculators to perform classroom controlled experiments on economic models. The complete program for exploring the dynamics of the Harrod-Domar equation is given. Some difficulties encountered and statistical uses are mentioned. (BC)

Recognizing dying in terminal illness.

PubMed

Taylor, Paul M; Johnson, Miriam

2011-08-01

Recognizing dying in terminally ill patients is a complex clinical skill. This article outlines the approach to the decision, common difficulties encountered in patients with both malignant and non-malignant disease, and a simple approach to considering the question 'Is this patient dying?'

Barriers Encountered in the Transfer of Educational Training to Workplace Practice in Saudi Arabia

ERIC Educational Resources Information Center

Almannie, Mohamed

2015-01-01

This study introduces a critical issue in the practicality of training programs, not only in Saudi Arabia, but also in other developing countries where billions of dollars are spent on training human resources without evaluation of these programs on workplace practice and organization development. This study investigates barriers encountered in…

Working with a patient claiming a direct relationship with god: encountering otherness.

PubMed

Charles, Marilyn

2009-01-01

Although we expect to encounter otherness in the consulting room, some types of otherness are more difficult to encounter than others. Differing ethnicities, religions, lifestyles, or other aspects of worldview can bring us into uneasy alliance with the other, as we also encounter disowned or unclaimed aspects of self in this process. I will discuss some of my difficulties working with a man who was born into my own religion-thus offering some common heritage of world view-but subsequently adopted another religion with such intensity that his faith seemed to have psychotic aspects. I struggled to keep my bearings with a man who could at times be cogent, at other times seem quite crazy, and also struggled to keep in mind how prejudices in my own culture might skew my perspective such that intense faith and devoted adherence to scripture seems suspect rather than worthy of respect.

[Pediatrician's experience in announcing bad news].

PubMed

Crosnier-Schoedel, C; Trocmé, N; Carbajal, R; Leverger, G

2018-02-01

Few studies are available on pediatricians' experience with announcing bad news. Announcing bad news is an important component of medical practice and is even more complex in pediatrics because parents must be associated. We had 20 hospital pediatricians complete a questionnaire containing 30 questions about their own experience announcing bad news to a child or a teenager. In spite of their experience and the time they have spent practicing medicine, there are many limitations stemming from different factors concerning children, teenagers, their families, and themselves. The difficulties encountered by pediatricians are mainly related to the timing of the announcement, the location, the choice of the words used, and the poor understanding of children and families, due to intellectual, cultural, or psychological limitations. Pediatricians question their own capacity to make such an announcement, wondering if the information has actually been well understood. They indicate that they are themselves affected. Most of them develop and implement strategies to refute the emotional instability caused by the announcement of bad news. Yet many of them feel weak, even talking about a deep sense of loneliness and guilt. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Psychogenic Non-epileptic Seizures: An Updated Primer.

PubMed

Baslet, Gaston; Seshadri, Ashok; Bermeo-Ovalle, Adriana; Willment, Kim; Myers, Lorna

2016-01-01

Psychogenic non-epileptic seizures are the most common paroxysmal event misdiagnosed as epilepsy. They significantly affect quality of life, functional status, and use of medical resources. The goal of this review is to provide guidance to psychiatrists and other mental health professionals in the understanding and practical management of this condition. An abundance of new reports on the pathogenesis and effective treatments have become available over the last decade, yet specific barriers impede the fluid transition to treatment and remain an important challenge in the management of patients with psychogenic non-epileptic seizures. In the context of these difficulties, we initially present background information on psychogenic non-epileptic seizures covering their historic context, epidemiology, etiologic factors (including psychiatric, neuromedical, and neuropsychological factors), and current neurobiological models. Updated evidence-based treatments are discussed along with data on long-term outcomes. We also provide practical tools to help clinicians navigate differential diagnoses, establish their interdisciplinary roles, communicate the diagnosis, deliver treatment, and sort out commonly encountered challenges in the management of this condition. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

On the prevailing construction waste recycling practices: a South East Queensland study.

PubMed

Tam, Vivian W Y; Kotrayothar, Duangthidar; Loo, Yew-Chaye

2009-03-01

Waste generated from construction and building demolition work constitutes about 68% of all solid waste generated each year in South East Queensland. Consequently, it has created a serious waste management problem. The State Governments of Victoria and New South Wales have been encouraging the use of recycled materials from construction and related waste; they have also promulgated specifications for their use. In Queensland, however, similar regulations are not anticipated in the near future, which explains the lack of funded research conducted in this important arena. This paper presents an evaluation of the prevailing waste recycling practices in Queensland. Nine sites were visited, including two construction sites, three demolition sites, three recycling plants and one landfill in South East Queensland. The difficulties encountered by the recycling programme operators and their associates at these sites are described and the benefits of recycling construction materials are presented. One of the major barriers is that the local councils disallow the use of recycled materials in new construction work. To help rectify these impediments to recycling, recommendations are given to increase the use of recycled construction waste in South East Queensland.

Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection.

PubMed

Dobler, Claudia C; Bosnic-Anticevich, Sinthia; Armour, Carol L

2018-01-01

The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds) and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk-benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters.

Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection

PubMed Central

Bosnic-Anticevich, Sinthia; Armour, Carol L.

2018-01-01

The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds) and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk–benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters. PMID:29577042

Teaching biotechnology in NSW schools

NASA Astrophysics Data System (ADS)

Steele, Frances A.

Agriculture, industry and medicine are being altered by new biological technologies. Today's students are the citizens who will make decisions about associated ethical issues. They need to have the knowledge that will enable them to make informed choices. Hence biotechnology has an important place in science education. The aims of the research were to: 1. describe the state of biotechnology teaching in NSW; 2. determine whether teachers in NSW do not teach biotechnology because they do not have the necessary knowledge and experience; 3. identify other reasons why NSW teachers choose not to teach biotechnology; 4. describe problems encountered in teaching biotechnology in NSW; 5. suggest ways in which the problems encountered in the teaching of biotechnology can be overcome. Quantitative and qualitative methods were used in a complementary way to investigate these aims. In a sample of teachers surveyed, many reported that they chose not to teach biotechnology because they did not have adequate knowledge and experience. Other obstacles were identified. These were: 1. the difficulty of the subject matter; 2. the lack of practical work; 3. lack of a program for biotechnology in junior science. The results of this trial suggested that a biotechnology unit should be developed in collaboration with the teacher and that time needs to be made available for school based program development.

The difficulties of conducting maternal death reviews in Malawi.

PubMed

Kongnyuy, Eugene J; van den Broek, Nynke

2008-09-11

Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. SWOT (strengths, weaknesses, opportunities and threats) analysis of the process of maternal death review during a workshop in Malawi. Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

High temperature strain measurement with a resistance strain gage

NASA Technical Reports Server (NTRS)

Lei, Jih-Fen; Fichtel, ED; Mcdaniel, Amos

1993-01-01

A PdCr based electrical resistance strain gage was demonstrated in the laboratory to be a viable sensor candidate for static strain measurement at high temperatures. However, difficulties were encountered while transferring the sensor to field applications. This paper is therefore prepared for recognition and resolution of the problems likely to be encountered with PdCr strain gages in field applications. Errors caused by the measurement system, installation technique and lead wire attachment are discussed. The limitations and some considerations related to the temperature compensation technique used for this gage are also addressed.

Learner-Controlled Practice Difficulty in the Training of a Complex Task: Cognitive and Motivational Mechanisms

ERIC Educational Resources Information Center

Hughes, Michael G.; Day, Eric Anthony; Wang, Xiaoqian; Schuelke, Matthew J.; Arsenault, Matthew L.; Harkrider, Lauren N.; Cooper, Olivia D.

2013-01-01

An inherent aspect of learner-controlled instructional environments is the ability of learners to affect the degree of difficulty faced during training. However, research has yet to examine how learner-controlled practice difficulty affects learning. Based on the notion of "desirable difficulties" (Bjork, 1994), this study examined the…

Language Policy and Science Instruction in Kenyan Primary Schools.

ERIC Educational Resources Information Center

Cleghorn, Ailie; And Others

1989-01-01

Describes the difficulties encountered in Kenyan eighth grade science instruction when language policy restricts the use of local vernacular terms. Provides examples from three schools with differing policies on the use of English, Swahili, and tribal languages. Contains 21 references. (SV)

International Students' Confidence and Academic Success

ERIC Educational Resources Information Center

Telbis, Nicola Miky; Helgeson, Lars; Kingsbury, Cheryl

2014-01-01

Research shows that the international student population is showing significant growth. This article deals with issues affecting a growing international student population. Studies show that foreign students are encountering difficulties in social adaptability, language barriers, academic ability, and financial need. There is evidence that a…

Marketing of Group Counseling Services.

ERIC Educational Resources Information Center

Wilson, F. Robert; And Others

1987-01-01

Provides social marketing guidelines for attracting members of appropriate target groups and encouraging their participation in group activities. Includes examination of the personal and social framework of the group counselor, elements of social marketing theory, a case study illustrating difficulties encountered by novice group counselors in…

Starting of rocket engine at conditions of simulated altitude using crude monoethylaniline and other fuels with mixed acid

NASA Technical Reports Server (NTRS)

Ladanyi, Dezso J; Sloop, John L; Humphrey, Jack C; Morrell, Gerald

1950-01-01

Experiments were conducted at sea level and pressure altitude of about 55,000 feet at various temperatures to determine starting characteristics of a commercial rocket engine using crude monoethylaniline and other fuels with mixed acid. With crude monoethylaniline, ignition difficulties were encountered at temperatures below about 20 degrees F. With mixed butyl mercaptans, water-white turpentine, and x-pinene, no starting difficulties were experienced at temperatures as low as minus 74 degrees F. Turpentine and x-pinene, however, sometimes left deposits on the injector face. With blends containing furfuryl alcohol and with other blends, difficulties were experienced either from appreciable deposits or from starting.

A "migrant friendly hospital" initiative in Geneva, Switzerland: evaluation of the effects on staff knowledge and practices.

PubMed

Hudelson, Patricia; Dominice Dao, Melissa; Perneger, Thomas; Durieux-Paillard, Sophie

2014-01-01

International migration poses important challenges to European health care systems. The development of "migrant friendly hospitals" has been identified as a priority in both Europe and Switzerland. A multi-pronged initiative was developed at Geneva University Hospitals (HUG) to improve staff knowledge and use of existing "migrant friendly" resources. A self-administered questionnaire was sent pre and post-intervention to random samples of 4 major professional groups with direct patient contact at the HUG. The questionnaire assessed staff knowledge, attitudes and reported practices regarding the care of migrant patients. Overall response rate was 51% (N = 1460) in 2010 but only 19% (N = 761) in 2013 owing to an institutionally imposed change in survey method. Despite these difficulties, and after adjusting for sample differences, we found that respondents in 2013 were significantly more likely to have received training in how to organize an appointment with an interpreter, how to work with an interpreter and about health and social services available for migrant patients. Respondents were also significantly more likely to have used several Migrant Friendly structures at the HUG. Use of, preference for and perceived skill at working with professional interpreters all improved, and respondents were both more likely to be encouraged by their supervisors to use professional interpreters, and less likely to be encouraged to look for alternative solutions for communicating with non francophone patients. Finally, 2013 respondents encountered fewer difficulties caring for migrant patients, although lack of time and language barriers continued to be the most important sources of difficulty. Our results suggest that an institution-wide information campaign may contribute to increased awareness and use of migrant friendly resources by clinical staff. Hospital commitment and financing, along with inter-departmental participation in all activities were important in creating and maintaining project visibility, and in contributing to a migrant friendly institutional culture.

Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

PubMed

Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

2014-07-01

Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs.

Medical students' and residents' clinical and educational experiences with defensive medicine.

PubMed

O'Leary, Kevin J; Choi, Jennifer; Watson, Katie; Williams, Mark V

2012-02-01

To assess medical students' and residents' experiences with defensive medicine, which is any deviation from sound medical practice due to a perceived threat of liability through either assurance or avoidance behaviors. Assurance behaviors include providing additional services of minimal clinical value. Avoidance behaviors include withholding services that are, or avoiding patients who are, perceived as high risk. The authors conducted a cross-sectional survey of fourth-year medical students and third-year residents in 2010. Respondents rated how often malpractice liability concerns caused their teams to engage in four types of assurance and two types of avoidance behaviors using a four-point scale (never, rarely, sometimes, often). Respondents also rated how often their attending physicians explicitly recommended that liability concerns be taken into account when making clinical decisions. Overall, 126 of 194 medical students (65%) and 76 of 141 residents (54%) completed the survey. Of the responding medical students, 116 (92%) reported sometimes or often encountering at least one assurance practice, and 43 (34%) reported encountering at least one avoidance practice. Of the responding residents, 73 (96%) reported encountering at least one assurance practice, and 33 (43%) reported encountering at least one avoidance practice. Overall, 50 of 121 medical students (41%) and 36 of 68 residents (53%) reported that their attending physicians sometimes or often explicitly taught them to take liability into account when making clinical decisions. Medical trainees reported frequently encountering defensive medicine practices and often being taught to take malpractice liability into consideration during clinical decision making.

Encountering Pedagogy through Relational Art Practices

ERIC Educational Resources Information Center

Irwin, Rita L.; O'Donoghue, Donal

2012-01-01

Two artists involved in "socially engaged art" practice were invited to work with art education teacher candidates and instructors in an effort to rethink notions of teaching, learning and art. We initiated this residency, which we called "The Summerhill Residency", to examine how learning encounters might create environments…

The Fate of Progressive Language Policies and Practices.

ERIC Educational Resources Information Center

Dudley-Marling, Curt, Ed.; Edelsky, Carole, Ed.

Noting that progressive language policies have encountered and will always encounter fierce resistance, this book presents a collection of essays by progressive language educators, theorists, and policymakers that reflect on the fate of progressive language practices and policies. Part 1 comprises three contextualizing chapters that provide a…

Fabricated Childhoods: Uncanny Encounters with the More-than-Human

ERIC Educational Resources Information Center

Blaise, Mindy

2016-01-01

This article is based on uncanny encounters with Julia deVille's exhibit, "Phantasmagoria". Inspired by Deleuzian-informed research practices, the author experiments with provoking practices to defy dominant developmental notions of childhood. This article reworks a humanist ontology by bringing together the discursive, the material, the…

Transitions from Elementary to Middle School Math

ERIC Educational Resources Information Center

Schielack, Janie; Seeley, Cathy L.

2010-01-01

In the move from elementary to middle school mathematics, students encounter major changes in instructional materials and approaches, work expectations, school structure, and general level of difficulty in material. Research shows that, in general, students suffer significant declines in academic achievement in the transition from elementary…

The CHEM Study Story.

ERIC Educational Resources Information Center

Merrill, Richard J.; Ridgway, David W.

The history of the planning, funding, preparation of preliminary materials, teacher preparation, trial teaching, evaluation, revision and final publication of the CHEM Study materials is presented. The anecdotal account points out the difficulties encountered, the solutions found and the pitfalls avoided so that the experience gained may be useful…

Mealtime Manual for the Aged and Handicapped.

ERIC Educational Resources Information Center

Klinger, Judith Lannefeld; And Others

Specific techniques to alleviate difficulties encountered in routine kitchen tasks are described for the elderly and the handicapped, particularly those persons with upper extremity weakness or amputees, arthritis, incoordination, wheelchair confinement, loss of sensation, and limited vision. Helpful information is provided in areas of kitchen…

Gender Discrimination in Jessica's Career.

ERIC Educational Resources Information Center

Cook, Ellen Piel

1997-01-01

Focuses on the sexual harassment and other gender-related difficulties faced by a Chinese-American woman. Profiles her encounters with gender discrimination and how it hindered career advancement and led to professional isolation. Relates how this case study can be used to sensitize workers to gender discrimination. (RJM)

Platelet counting using the Coulter electronic counter.

PubMed

Eggleton, M J; Sharp, A A

1963-03-01

A method for counting platelets in dilutions of platelet-rich plasm using the Coulter electronic counter is described.(1) The results obtained show that such platelet counts are at least as accurate as the best methods of visual counting. The various technical difficulties encountered are discussed.

CURVILINEAR FINITE ELEMENT MODEL FOR SIMULATING TWO-WELL TRACER TESTS AND TRANSPORT IN STRATIFIED AQUIFERS

EPA Science Inventory

The problem of solute transport in steady nonuniform flow created by a recharging and discharging well pair is investigated. Numerical difficulties encountered with the standard Galerkin formulations in Cartesian coordinates are illustrated. An improved finite element solution st...

Multimodal Career Counseling: An Application of the "BASIC ID."

ERIC Educational Resources Information Center

Smith, Robert L.; Southern, Stephen

1980-01-01

The multimodal career counseling model is a logical extension of Lazarus' multimodal behavior therapy through the assessment of seven modalities that affect the career of the individual. Interventions may be directed at the early decision-making stage or when difficulties are encountered. (Author)

International Students' Confidence and Academic Success

ERIC Educational Resources Information Center

Telbis, Nicola Miky

2013-01-01

Research shows that the international student population is showing significant growth. Studies also show that foreign students are encountering difficulties such as social adaptability, language barriers, academic ability, and financial need. There is compelling evidence that establishes a correlation between a person's self-efficacy and his or…

Work and Female Identity.

ERIC Educational Resources Information Center

Reohr, Janet R.

In climbing an organizational ladder dominated by males, the professional woman encounters obstacles to the more traditional feminine behaviors and mannerisms to which she may be accustomed. These obstacles may erode her sense of identity, creating difficulties both inside and outside of her work environment. Traditional distinctions between…

Variations in Sexual Behavior.

ERIC Educational Resources Information Center

Juhasz, Anne McCreary

1983-01-01

Questions are raised about the difficulty of defining normal and atypical sexual behavior. Variations from normalcy that students, parents, and educators are most likely to encounter are discussed. The importance of dealing with variations in ways that are best for the individual and the group is emphasized. (PP)

The Future of Psychology. A Reply to Buss

ERIC Educational Resources Information Center

Abrahams, J. P.; And Others

1975-01-01

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

Impact of Interpreters' Approach on Latinas" Use of Amniocentesis

ERIC Educational Resources Information Center

Preloran, H. Mabel; Browner, C. H.; Lieber, Eli

2005-01-01

Communication difficulties in multicultural clinical settings can be exacerbated by translators, but their actual impact on medical decisions has not been systematically evaluated. This study sought to determine the influence of translators participating in clinical encounters in which English-speaking clinicians offered amniocentesis to…

A new method for teaching physical examination to junior medical students.

PubMed

Sayma, Meelad; Williams, Hywel Rhys

2016-01-01

Teaching effective physical examination is a key component in the education of medical students. Preclinical medical students often have insufficient clinical knowledge to apply to physical examination recall, which may hinder their learning when taught through certain understanding-based models. This pilot project aimed to develop a method to teach physical examination to preclinical medical students using "core clinical cases", overcoming the need for "rote" learning. This project was developed utilizing three cycles of planning, action, and reflection. Thematic analysis of feedback was used to improve this model, and ensure it met student expectations. A model core clinical case developed in this project is described, with gout as the basis for a "foot and ankle" examination. Key limitations and difficulties encountered on implementation of this pilot are discussed for future users, including the difficulty encountered in "content overload". This approach aims to teach junior medical students physical examination through understanding, using a simulated patient environment. Robust research is now required to demonstrate efficacy and repeatability in the physical examination of other systems.

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

PubMed Central

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

2014-01-01

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

Current challenges and pitfalls in the pharmacological treatment of depression

PubMed Central

Popa-Velea, O; Gheorghe, IR; Truţescu, CI; Purcărea, VL

2015-01-01

The multifactorial etiology of depression obliges needs an individual assessment, the psychopharmacological approach involving a biopsychosocial analysis for each individual case. The rebalancing of the depressive patient, seen as a return to a normal level of psychosocial functioning and reduced risk of relapse is achieved with a prompt and constant support of specialized teams. Treatment should include psychopharmacological and psychosocial approaches, the results being interrelated and contributing to the prognosis of the disorder. Progress in clinical and pharmacological research, vivid dynamics of socio-economic environment, the complexity of diagnostic evaluation and the need for an interdisciplinary approach may cause difficulties in addressing the depressive patient and the ethical controversies. The aim of this paper is to present a brief analysis of challenges encountered in the present psychiatric practice, starting from the heterogeneity of depressive manifestations and finishing with the prioritization of interventional forms. PMID:25866576

Cumulative impact assessment: Application of a methodology

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

Witmer, G.W.; Bain, M.B.; Irving, J.S.

We expanded upon the Federal Energy Regulatory Commission's (FERC) Cluster Impact Assessment Procedure (CIAP) to provide a practical methodology for assessing potential cumulative impacts from multiple hydroelectric projects within a river basin. The objectives in designing the methodology were to allow the evaluation of a large number of combinations of proposed projects and to minimize constraints on the use of ecological knowledge for planning and regulating hydroelectric development at the river basin level. Interactive workshops and evaluative matrices were used to identify preferred development scenarios in the Snohomish (Washington) and Salmon (Idaho) River Basins. Although the methodology achieved its basicmore » objectives, some difficulties were encountered. These revolved around issues of (1) data quality and quantity, (2) alternatives analysis, (3) determination of project interactions, (4) determination of cumulative impact thresholds, and (5) the use of evaluative techniques to express degrees of impact. 8 refs., 1 fig., 2 tabs.« less

Accurate guide wire of lag screw placement in the intertrochanteric fractures: a technical note.

PubMed

Li, Jiang; Wang, Liao; Li, Xiaodong; Feng, Kai; Tang, Jian; Wang, Xiaoqing

2017-09-01

Cephalomedullary fixations are commonly used in the treatment of intertrochanteric fractures. In clinical practice, one of the difficulties is when we exit the guide wire in a wrong position of femoral neck and insert near the hole again, the guide wire often flow into the previous track. This study develops a surgical technique to direct the guide wire to slip away the previous track and slip into a right position. When guide wire is exited to the cortex of femoral, we let the wire in and out at the cortical layer for several times to enlarge the entry hole. After that, electric drill is inverted, rubbed and entered slowly at a right angle. When guide wire encountered new resistance, the electric drill is turned back instantly. This technique can help trauma and orthopedic surgeons to obtain precision placement of the lag screw after the first try is failed.

The Kinematic Analysis of Flat Leverage Mechanism of the Third Class

NASA Astrophysics Data System (ADS)

Zhauyt, A.; Mamatova, G.; Abdugaliyeva, G.; Alipov, K.; Sakenova, A.; Alimbetov, A.

2017-10-01

It is necessary to make link mechanisms calculation to the strength at designing of flat link mechanisms of high class after definition of block diagrams and link linear sizes i.e. it is rationally to choose their forms and to determine the section sizes. The algorithm of the definition of dimension of link mechanism lengths of high classes (MHC) and their metric parameters at successive approach is offered in this work. It this paper educational and research software named GIM is presented. This software has been developed with the aim of approaching the difficulties students usually encounter when facing up to kinematic analysis of mechanisms. A deep understanding of the kinematic analysis is necessary to go a step further into design and synthesis of mechanisms. In order to support and complement the theoretical lectures, GIM software is used during the practical exercises, serving as an educational complementary tool reinforcing the knowledge acquired by the students.

Development of a Clinical Data Warehouse for Hospital Infection Control

PubMed Central

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

2003-01-01

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

Professional values, self-esteem, and ethical confidence of baccalaureate nursing students.

PubMed

Iacobucci, Trisha A; Daly, Barbara J; Lindell, Debbie; Griffin, Mary Quinn

2013-06-01

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg's Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students' professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses.

Assessment of lifestyle and eating habits among undergraduate students in northern Italy.

PubMed

Lupi, Silvia; Bagordo, Francesco; Stefanati, Armando; Grassi, Tiziana; Piccinni, Lucia; Bergamini, Mauro; De Donno, Antonella

2015-01-01

Dietary habits of university students were analyzed in order to investigate any differences between students living at and away from home. Two hundred and fifty-eight undergraduate students attending University of Ferrara completed a self-administered questionnaire on demographic characteristics, food frequency consumption habits and body weight perception. Students living at home practiced more sport and consumed more frequently raw and cooked vegetables, fish, meat and poultry, fresh fruit, eggs, bread/cereals. Conversely, students living away from home consumed more often packaged/ready food, beer and spirits, milk and chips. The majority of students living alone reported a modification of dietary habits since leaving family. Furthermore they perceived to have a weight condition different from normal in a greater extent than students living with family. Students living alone encountered more difficulties in adopting a healthy diet so it would be desirable to adopt nutritional educational interventions on university students, usually neglected by these measures.

Encountering unexpected difficult airway: relationship with the intubation difficulty scale

PubMed Central

Koh, Wonuk; Kim, Hajung; Kim, Kyongsun; Ro, Young-Jin

2016-01-01

Background An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. Methods We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. Results For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. Conclusions Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation. PMID:27274369

Describing knowledge encounters in healthcare: a mixed studies systematic review and development of a classification.

PubMed

Hurst, Dominic; Mickan, Sharon

2017-03-14

Implementation science seeks to promote the uptake of research and other evidence-based findings into practice, but for healthcare professionals, this is complex as practice draws on, in addition to scientific principles, rules of thumb and a store of practical wisdom acquired from a range of informational and experiential sources. The aims of this review were to identify sources of information and professional experiences encountered by healthcare workers and from this to build a classification system, for use in future observational studies, that describes influences on how healthcare professionals acquire and use information in their clinical practice. This was a mixed studies systematic review of observational studies. OVID MEDLINE and Embase and Google Scholar were searched using terms around information, knowledge or evidence and sharing, searching and utilisation combined with terms relating to healthcare groups. Studies were eligible if one of the intentions was to identify information or experiential encounters by healthcare workers. Data was extracted by one author after piloting with another. Studies were assessed using the Mixed Methods Appraisal Tool (MMAT). The primary outcome extracted was the information source or professional experience encounter. Similar encounters were grouped together as single constructs. Our synthesis involved a mixed approach using the top-down logic of the Bliss Bibliographic Classification System (BC2) to generate classification categories and a bottom-up approach to develop descriptive codes (or "facets") for each category, from the data. The generic terms of BC2 were customised by an iterative process of thematic content analysis. Facets were developed by using available theory and keeping in mind the pragmatic end use of the classification. Eighty studies were included from which 178 discreet knowledge encounters were extracted. Six classification categories were developed: what information or experience was encountered; how was the information or experience encountered; what was the mode of encounter; from whom did the information originate or with whom was the experience; how many participants were there; and where did the encounter take place. For each of these categories, relevant descriptive facets were identified. We have sought to identify and classify all knowledge encounters, and we have developed a faceted description of key categories which will support richer descriptions and interrogations of knowledge encounters in healthcare research.

Both Posterior Root Lateral-Medial Meniscus Tears With Anterior Cruciate Ligament Rupture: The Step-by-Step Systematic Arthroscopic Repair Technique.

PubMed

Chernchujit, Bancha; Prasetia, Renaldi

2017-10-01

The occurrence of posterior root tear of both the lateral and medial menisci, combined with anterior cruciate ligament rupture, is rare. Problems may be encountered such as the difficulty to access the medial meniscal root tear, the confusing circumstances about which structure to repair first, and the possibility of the tunnel for each repair to become taut inside the tibial bone. We present the arthroscopy technique step by step to overcome the difficulties in an efficient and time-preserving manner.

Recommendations to address the difficulties encountered when determining linezolid resistance from whole genome sequencing data.

PubMed

Beukers, Alicia G; Hasman, Henrik; Hegstad, Kristin; van Hal, Sebastiaan J

2018-05-29

Mutations associated with linezolid resistance within the V domain of 23S rRNA are annotated using an Escherichia coli numbering system. The 23S rRNA gene varies in length, nucleotide sequence and copy number between bacterial species. Consequently, this numbering system is not intuitive and can lead to confusion when locating mutation sites using whole genome sequencing data. Using the mutation G2576T as an example, we demonstrate the difficulties associated with using the E. coli numbering system. © Crown copyright 2018.

When less is more: validating a brief scale to rate interprofessional team competencies.

PubMed

Lie, Désirée A; Richter-Lagha, Regina; Forest, Christopher P; Walsh, Anne; Lohenry, Kevin

2017-01-01

There is a need for validated and easy-to-apply behavior-based tools for assessing interprofessional team competencies in clinical settings. The seven-item observer-based Modified McMaster-Ottawa scale was developed for the Team Objective Structured Clinical Encounter (TOSCE) to assess individual and team performance in interprofessional patient encounters. We aimed to improve scale usability for clinical settings by reducing item numbers while maintaining generalizability; and to explore the minimum number of observed cases required to achieve modest generalizability for giving feedback. We administered a two-station TOSCE in April 2016 to 63 students split into 16 newly-formed teams, each consisting of four professions. The stations were of similar difficulty. We trained sixteen faculty to rate two teams each. We examined individual and team performance scores using generalizability (G) theory and principal component analysis (PCA). The seven-item scale shows modest generalizability (.75) with individual scores. PCA revealed multicollinearity and singularity among scale items and we identified three potential items for removal. Reducing items for individual scores from seven to four (measuring Collaboration, Roles, Patient/Family-centeredness, and Conflict Management) changed scale generalizability from .75 to .73. Performance assessment with two cases is associated with reasonable generalizability (.73). Students in newly-formed interprofessional teams show a learning curve after one patient encounter. Team scores from a two-station TOSCE demonstrate low generalizability whether the scale consisted of four (.53) or seven items (.55). The four-item Modified McMaster-Ottawa scale for assessing individual performance in interprofessional teams retains the generalizability and validity of the seven-item scale. Observation of students in teams interacting with two different patients provides reasonably reliable ratings for giving feedback. The four-item scale has potential for assessing individual student skills and the impact of IPE curricula in clinical practice settings. IPE: Interprofessional education; SP: Standardized patient; TOSCE: Team objective structured clinical encounter.

Tutoring ESL: A Handbook for Volunteers.

ERIC Educational Resources Information Center

Tacoma Community House, WA.

This handbook contains several different sections to aid volunteers teaching English-as-a-Second-Language (ESL) to refugees. Part 1, "Getting Started," discusses cultural differences and difficulties the students may encounter. Part 2, "Mechanics of Teaching," offers tips on teaching refugees and general teaching methods. Lesson planning,…

Introducing Complex Numbers

ERIC Educational Resources Information Center

Trudgian, Timothy

2009-01-01

One of the difficulties in any teaching of mathematics is to bridge the divide between the abstract and the intuitive. Throughout school one encounters increasingly abstract notions, which are more and more difficult to relate to everyday experiences. This article examines a familiar approach to thinking about negative numbers, that is an…

Teaching Differentials in Thermodynamics Using Spatial Visualization

ERIC Educational Resources Information Center

Wang, Chih-Yueh; Hou, Ching-Han

2012-01-01

The greatest difficulty that is encountered by students in thermodynamics classes is to find relationships between variables and to solve a total differential equation that relates one thermodynamic state variable to two mutually independent state variables. Rules of differentiation, including the total differential and the cyclic rule, are…

The Use of Citation Counting to Identify Research Trends

ERIC Educational Resources Information Center

Rothman, Harry; Woodhead, Michael

1971-01-01

The analysis and application of manpower statistics to identify some long-term international research trends in economic entomology and pest conrol are described. Movements in research interests, particularly towards biological methods of control, correlations between these sectors, and the difficulties encountered in the construction of a…

Social Skills of Children with Specific Language Impairment: Peer Relationships.

ERIC Educational Resources Information Center

Craig, Holly K.

1993-01-01

This paper reviews literature on peer relationships of children with specific language impairment and provides a clinical case to illustrate the social-interactional difficulties encountered. The paper analyzes the quantity and quality of peer interactions, child's knowledge of interactive access behaviors, disputes, responsiveness, assertiveness,…

International Students on an American Campus: An Undergraduate Research Study.

ERIC Educational Resources Information Center

Matthews, Judith; Quattrocki, Carolyn

1981-01-01

Describes a seminar in which undergraduate students in home economics were provided with research training and the opportunity to work together on a research project which included housing, clothing, nutrition, consumer services, child development, and family relations. Students also explored difficulties international students encounter in…

Platelet counting using the Coulter electronic counter

PubMed Central

Eggleton, M. J.; Sharp, A. A.

1963-01-01

A method for counting platelets in dilutions of platelet-rich plasm using the Coulter electronic counter is described.1 The results obtained show that such platelet counts are at least as accurate as the best methods of visual counting. The various technical difficulties encountered are discussed. PMID:16811002

Records Management with Optical Disk Technology: Now Is the Time.

ERIC Educational Resources Information Center

Retherford, April; Williams, W. Wes

1991-01-01

The University of Kansas record management system using optical disk storage in a network environment and the selection process used to meet existing hardware and budgeting requirements are described. Viability of the technology, document legality, and difficulties encountered during implementation are discussed. (Author/MSE)

The Remedial Effect of a Biological Learning Game.

ERIC Educational Resources Information Center

Blum, Abraham

1979-01-01

Investigates the effectiveness of a structured learning game in overcoming learning difficulties encountered by Israeli students when studying the life cycles of fungi because of lack of structural conceptualization. The Fungi Life Cycle Game (FLCG) was used by undergraduate students enrolled in a phytopathology course. (HM)

A Death in the Family: Parental Bereavement in the First Year.

ERIC Educational Resources Information Center

Cook, Judith A.

1983-01-01

Examined 145 parents' experiences after a child's death from cancer or a blood disorder. Data revealed men and women differed significantly in the extent to which they encountered distance and lack of comfort in spousal relationships and difficulty during first-year postdeath holidays. (JAC)

Spanish for Professionals.

ERIC Educational Resources Information Center

Casellas de Kelly, Maria del Rosario

A University of New Mexico program in Spanish for professionals began in 1981 as a Spanish and Portuguese program to provide language training for personnel in health care, business, law, and education. The program encountered early problems of uneven enrollments, funding difficulties, and some lack of interest from the campus professional schools…

Problemes linguistiques des enfants de travailleurs migrants (Linguistic Problems of the Children of Migrant Workers).

ERIC Educational Resources Information Center

de Greve, Marcel, Ed.; Rosseel, Eddy, Ed.

Papers on language difficulties encountered by migrant workers' children include: "Anomie in Bicultural Education" (Hugo Baetens Beardsmore); "An Investigation into Bilingual Education for Children from Favoured Socio-Economic Backgrounds" (Hugo Baetens Beardsmore); "Orientations of Foreign Children Relating to Placement…

Considerations for choosing an electronic medical record for an ophthalmology practice.

PubMed

DeBry, P W

2001-04-01

To give a brief overview of issues pertinent to selecting an ophthalmic electronic medical record (EMR) program and to outline the company demographics and software capabilities of the major vendors in this area. Software companies shipping an EMR package were contacted to obtain information on their software and company demographics. The focus was on companies selectively marketing to ophthalmology practices, and, therefore, most were selected based on their representation at the 1998 and/or 1999 American Academy of Ophthalmology meeting. Software companies that responded to repeated inquiries in a timely fashion were included. Sixteen companies were evaluated. Electronic medical records packages ranged from $3000 to $80 000 (mean, approximately $30 000). Company demographics revealed a range from 1 to 1600 employees (mean, 204). Most of these companies have been in business for 6 years or less (range, 1-15 years; mean, 6 years). My opinions concerning various aspects of the EMR are presented. There is a wide range of EMR products available for the ophthalmology practice. Computer technology has matured to a point at which the graphical demands of the ophthalmology EMR can be satisfied. Weaknesses do exist in the inherent difficulty of recording an ophthalmology encounter, the relative adolescence of software companies, and the lack of standards in the industry.

Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion.

PubMed

Jones, Christine D; Scott, Serena J; Anoff, Debra L; Pierce, Read G; Glasheen, Jeffrey J

2015-01-01

Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P < .001), uninsured encounters decreased (18.4% to 6.3%, P < 0.001), and private payer encounters also decreased (14.1% to 13.3%, P = .001). The median reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P < .001). In a sensitivity analysis, changes in length of stay, proportions in encounter type by payer, payer mix, and reimbursement for encounter type by payer accounted for -0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion. © The Author(s) 2015.

Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion

PubMed Central

Jones, Christine D.; Scott, Serena J.; Anoff, Debra L.; Pierce, Read G.; Glasheen, Jeffrey J.

2015-01-01

Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P < .001), uninsured encounters decreased (18.4% to 6.3%, P < 0.001), and private payer encounters also decreased (14.1% to 13.3%, P = .001). The median reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P < .001). In a sensitivity analysis, changes in length of stay, proportions in encounter type by payer, payer mix, and reimbursement for encounter type by payer accounted for −0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion. PMID:26310500

Family medicine outpatient encounters are more complex than those of cardiology and psychiatry.

PubMed

Katerndahl, David; Wood, Robert; Jaén, Carlos Roberto

2011-01-01

comparison studies suggest that the guideline-concordant care provided for specific medical conditions is less optimal in primary care compared with cardiology and psychiatry settings. The purpose of this study is to estimate the relative complexity of patient encounters in general/family practice, cardiology, and psychiatry settings. secondary analysis of the 2000 National Ambulatory Medical Care Survey data for ambulatory patients seen in general/family practice, cardiology, and psychiatry settings was performed. The complexity for each variable was estimated as the quantity weighted by variability and diversity. there is minimal difference in the unadjusted input and total encounter complexity of general/family practice and cardiology; psychiatry's input is less complex. Cardiology encounters involved more input quantitatively, but the diversity of general/family practice input eliminated the difference. Cardiology also involved more complex output. However, when the duration of visit is factored in, the complexity of care provided per hour in general/family practice is 33% more relative to cardiology and 5 times more relative to psychiatry. care during family physician visits is more complex per hour than the care during visits to cardiologists or psychiatrists. This may account for a lower rate of completion of process items measured for quality of care.

A Pilot Quality Improvement Collaborative to Improve Safety Net Dental Access for Pregnant Women and Young Children.

PubMed

Vander Schaaf, Emily B; Quinonez, Rocio B; Cornett, Amanda C; Randolph, Greg D; Boggess, Kim; Flower, Kori B

2018-02-01

Objectives To determine acceptability and feasibility of a quality improvement (QI) collaborative in safety net dental practices, and evaluate its effects on financial stability, access, efficiency, and care for pregnant women and young children. Methods Five safety net dental practices participated in a 15-month learning collaborative utilizing business assessments, QI training, early childhood oral health training, and prenatal oral health training. Practices collected monthly data on: net revenue, no-show rates, total encounters, and number of encounters for young children and pregnant women. We analyzed quantitative data using paired t-tests before and after the collaborative and collected supplemental qualitative feedback from clinic staff through focus groups and directed email. Results All mean measures improved, including: higher monthly revenue ($28,380-$33,102, p = 0.37), decreased no-show rate (17.7-14.3%, p = 0.11), higher monthly dental health encounters (283-328, p = 0.08), and higher monthly encounters for young children (8.8-10.5, p = 0.65), and pregnant women (2.8-9.7, p = 0.29). Results varied by practice, with some demonstrating largest increases in encounters for young children and others pregnant women. Focus group participants reported that the collaborative improved access for pregnant women and young children, and that QI methods were often new and difficult. Conclusion for practice Participation by safety net dental practices in a QI collaborative is feasible and acceptable. Individual sites saw greater improvements in different outcomes areas, based on their own structures and needs. Future efforts should focus on specific needs of each dental practice and should offer additional QI training.

Are externalizing and internalizing difficulties of young children with spelling impairment related to their ADHD symptoms?

PubMed

Rietz, Chantal Sabrina; Hasselhorn, Marcus; Labuhn, Andju Sara

2012-08-01

Children with literacy difficulties often suffer from a variety of co-occurring externalizing and internalizing difficulties, as well as comorbid ADHD. Therefore, these externalizing and internalizing problems might be more related to comorbid ADHD, rather than being a correlate of literacy difficulties per se. In the present study, we investigated the occurrence of externalizing and internalizing difficulties in elementary school children (third grade) with and without spelling impairment. Taking the high rate of comorbidity between literacy difficulties and ADHD into account, we investigated whether co-occurring difficulties are associated with spelling impairment per se or with comorbid ADHD symptoms. Results indicated that these young children with spelling impairment showed more co-occurring difficulties compared with children without spelling impairment. Hierarchical regression analysis indicated that occurrence of externalizing symptoms is more strongly related to comorbid ADHD symptoms than to spelling impairment per se. The pattern of results concerning internalizing problems was not as distinct but showed a similar trend. Preferably, carers and educators should be aware of co-occurring socio-emotional and behavioural problems in children with spelling impairment. Particularly children with spelling impairment and comorbid ADHD symptoms seem to have an increased risk of encountering further co-occurring difficulties. Copyright © 2012 John Wiley & Sons, Ltd.

Private pharmacy staff in Hanoi dispensing steroids - theory and practice

PubMed Central

Larsson, Mattias; Binh, Nguyen Thanh; Tomson, Göran; Chuc, Nguyen TK; Falkenberg, Torkel

Objective To investigate self reported practice and actual practice of private pharmacy staff in relation to drug regulations and provision of prednisolone (a prescription-only corticosteroid) on request to treat lower back pain. Method Sixty private pharmacies in Hanoi were randomly selected. Self reported practice was assessed through interviews with pharmacy staff using a questionnaire; actual practice was assessed with the Simulated Client Method with 5 encounters in each pharmacy (a total of 295 encounters). Results Sixty percent of the pharmacy staff interviewed said that they would not dispense corticosteroids without prescription and 60% could mention some adverse effects. In practice all but one pharmacy dispensed corticosteroids without prescription in 76 % of all the encounters. Questions and advice given to the clients were associated with significantly lower dispensing of corticosteroids. Conclusion The low compliance with prescription regulations and the discrepancy between stated practice and actual practice raises concerns. This study indicates that commercial pressures exceed the deterrent effect of current drug regulations and their implementation and hence enforcement of regulations needs to be improved. PMID:25247001

Implementation and Results of a Learning Assistant Program

NASA Astrophysics Data System (ADS)

Bogue, Thomas B.; Seeley, L.; Vokos, S.

2006-12-01

The Physics Department at Seattle Pacific University has recently completed a three-year CCLI grant to integrate Tutorials in Introductory Physics , Activity Based Physics , and Real Time Physics into our one-year introductory curriculum. One of the difficulties encountered in doing this at a small undergraduate university was the need for additional instructors. This need is met through the use of undergraduate learning assistants. The development of recruitment and implementation methods will be discussed, along with the advantages to physics education, and the challenges encountered. We will also discuss several strategies we have identified as critical to a successful learning assistant program.

Anesthetic management of achondroplastic dwarf undergoing cesarean section--a case report.

PubMed

Cevik, Banu; Colakoğlu, Serhan

2010-10-01

There are more than 100 different types of dwarfism. Achondroplasia is the most common of these conditions. The aim of this report is to describe the anesthetic management of these patient, discussing the anesthetic considerations and emphasizing the difficulties encountered. A 32-year-old achondroplastic parturient underwent cesarean section under general anesthesia. We did not encounter problems related with airway management. The operation went without any complication. There are risks for both regional and general anesthesia in achondroplastic patients. The most important point is the careful preoperative assessment. Anesthesia plan should be specified to individual basis.

Improved Apparatus for the Measurement of Fluctuations of Air Speed in Turbulent Flow

NASA Technical Reports Server (NTRS)

Mock, W C , Jr; Dryden, H L

1934-01-01

This report describes recent improvements in the design of the equipment associated with the hot-wire anemometer for the measurement of fluctuating air speeds in turbulent air flow, and presents the results of some experimental investigations dealing with the response of the hot wire to speed fluctuations of various frequencies. Attempts at measuring the frequency of the fluctuations encountered in the Bureau of Standards' 54-inch wind tunnel are also reported. In addition, the difficulties encountered in the use of such apparatus and the precautions found helpful in avoiding them are discussed.

Monitoring Reasons for Encounter via an Electronic Patient Record System: the Case of a Rural Practice Initiative

PubMed Central

Klinis, Spyridon; Markaki, Adelais; Kounalakis, Dimitrios; Symvoulakis, Emmanouil K.

2012-01-01

The objective of this brief communication was to tabulate common reasons for encounter in a Greek rural general practice, as result of a recently adopted electronic patient record (EPR) application. Twenty encounter reasons accounted for 3,797 visits (61% of all patient encounters), whereas 565 other reasons accounted for the remaining 2,429 visits (39%). Number one reason for encounter was health maintenance or disease prevention seeking services, including screening examinations for malignancies, immunization and provision of medical opinion reports. Hypertension, lipid disorder and ischemic heart disease without angina were among the most common reasons for seeking care. A strengths/weaknesses/opportunities/threats (SWOT) analysis on the key role of an EPR system in collecting data from rural and remote primary health care settings is also presented. PMID:23091407

Retrospective analysis of reasons for failure of DDD pacemaker implantation in patients operated on between 1993 and 2005.

PubMed

Lelakowski, Jacek; Majewski, Jacek; Małecka, Barbara; Bednarek, Jacek; Stypuła, Paweł; Szeglowski, Marcin

2007-01-01

During implantation of a DDD pacemaker the following difficulties may be encountered: venous anomalies (the absence of vessels of adequate calibre or difficulty in subclavian vein puncture), arrhythmias during implantation (episodes of atrial flutter/fibrillation while the atrial leads are being positioned), lack of mechanical stability of the electrode in the heart chamber and inability to achieve an acceptable pacing and sensing threshold during implantation. The purpose of the study was to analyse retrospectively the reasons for DDD pacemaker failure in patients operated on between 1993 and 2005. We reviewed retrospectively all implantation data from 1988 to 2005 to identify patients with primary failure of DDD pacemaker implantation. Further analysis included patients who had received a DDD pacemaker between 1993 and 2005, when this type of pacemaker made up between 9 and 40% of all pacemaker implantations. We implanted 7469 pacemakers, including 1958 (26.2%) dual-chamber pacemakers, in 783 patients with atrioventricular block (AVB), 392 with sick sinus syndrome (SSS), 450 with AVB +/- SSS and 333 with tachy-brady syndrome (TBS). The mean age of the patients was 65.5 +/- 17.3 years. DDD pacing was unsuccessful in 108 (1.4%) patients, including 32 with AVB, 22 with SSS, 16 with SSS +/- AVB and 38 with TBS. The mean age of these patients was 78.5 +/- 19.4 years. The reasons for failed implantation were venous anomalies in 12%, an arrhythmia episode in 27.8%, a high pacing threshold in the atrium in 17.6%, low atrial potential amplitude in 25.9% and lack of mechanical stability of the electrode in 16.7% of patients. The difficulties were encountered in elderly patients (p < 0.01), most frequently in patients with SSS and TBS (71). Between 2004 and 2005 venous anomalies and a high pacing threshold were the main causes of failure. Currently the main difficulties encountered during pacemaker implantation are venous anomalies and a high pacing threshold. Arrhythmia episodes, low atrial potential amplitude and lack of mechanical stability are of minor importance. Elderly patients with sick sinus syndrome and tachy-brady syndrome have the highest failure rate. (Cardiol J 2007; 14: 155-159).

Putting informed and shared decision making into practice.

PubMed

Towle, Angela; Godolphin, William; Grams, Garry; Lamarre, Amanda

2006-12-01

To investigate the practice, experiences and views of motivated and trained family physicians as they attempt to implement informed and shared decision making (ISDM) in routine practice and to identify and understand the barriers they encounter. Patient involvement in decision making about their health care has been the focus of much academic activity. Although significant conceptual and experimental work has been done, ISDM rarely occurs. Physician attitudes and lack of training are identified barriers. Qualitative analysis of transcripts of consultations and key informant group interviews. Six family physicians received training in the ISDM competencies. Audiotapes of office consultations were made before and after training. Transcripts of consultations were examined to identify behavioural markers associated with each competency and the range of expression of the competencies. The physicians attended group interviews at the end of the study to explore experiences of ISDM. The physicians liked the ISDM model and thought that they should put it into practice. Evidence from transcripts indicated they were able to elicit concerns, ideas and expectations (although not about management) and agree an action plan. They did not elicit preferences for role or information. They sometimes offered choices. They had difficulty achieving full expression of any of the competencies and integrating ISDM into their script for the medical interview. The study also identified a variety of competency-specific barriers. A major barrier to the practice of ISDM by motivated physicians appears to be the need to change well-established patterns of communication with patients.

Improvising in the Vulnerable Encounter: Using Improvised Participatory Theatre in Change for Healthcare Practice

ERIC Educational Resources Information Center

Larsen, Henry; Friis, Preben; Heape, Chris

2018-01-01

Healthcare practitioners are often presented with vulnerable encounters where their professional experience is insufficient when dealing with patients who suffer from illnesses such as chronic pain. How can one otherwise understand chronic pain and develop practices whereby medical healthcare practitioners can experience alternative ways of doing…

Using research to enhance student learning in intermediate mechanics

NASA Astrophysics Data System (ADS)

Ambrose, Bradley

2011-03-01

For many undergraduate physics majors the sophomore/junior level course in intermediate mechanics represents their first step beyond the introductory sequence. Over the past several years research has shown that intermediate mechanics students often encounter conceptual and reasoning difficulties similar to those that arise at the introductory level. Many difficulties suggest deeply-seated alternate conceptions, while others suggest loosely or spontaneously connected intuitions. Furthermore, students often do not connect the physics to the more sophisticated mathematics they are expected to use. This presentation will highlight results from research conducted at Grand Valley State University, the University of Maine (by co-PI Michael Wittmann) and pilot sites in the Intermediate Mechanics Tutorials project. These results, taken from the analysis of pretests (ungraded quizzes), written exams, and classroom observations, will illustrate specific student difficulties as well as examples of guided-inquiry teaching strategies that appear to address these difficulties. (Supported by NSF grants DUE-0441426 and DUE-0442388.)

Emergency coronary angioplasty with stenting using Cordis® diagnostic coronary catheters when there is difficulty in engaging guide catheters and bench evaluation of diagnostic and guide catheters.

PubMed

Arokiaraj, Mark Christopher

2018-02-01

Difficulty in engaging with guide catheters is not uncommon in acute emergencies. We aimed to evaluate the use of Cordis ® INFINITI diagnostic catheters to perform angioplasty in patients in whom the coronaries cannot be engaged using standard guide catheters. In 34 cases of acute coronary syndrome, when difficulty in engagement with two standard guide catheters was encountered with reasonable manipulations, angioplasty was performed using diagnostic catheters. In total, 40 stents were placed by this technique. Pushability and trackability, distal tip flexion and three-point bending tests were performed to evaluate the performance of the guide and diagnostic catheters. Angioplasty was performed easily in a setting where it would have been very difficult to perform. Coronary dissection occurred in one patient, treated by a stent. The stent and dilatation balloons were easily passed through the diagnostic catheters. Pressure tracings were clearly preserved with certain stent delivery systems, and at angioplasty, although there was slightly reduced opacification of the respective artery, the coronary anatomy was sufficiently visualized to perform angioplasty. No periprocedural target lesion complications were seen in any cases. Pushability and trackability tests showed good force transmission along a tortuous path with diagnostic catheters, and balanced force-displacement curves from three-point bending tests and distal tip softness tests. Angioplasty with stenting can be performed safely through 6F Cordis ® infiniti diagnostic catheters when difficulty in engaging guide catheters is encountered. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Annealed Importance Sampling Reversible Jump MCMC algorithms

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

Karagiannis, Georgios; Andrieu, Christophe

2013-03-20

It will soon be 20 years since reversible jump Markov chain Monte Carlo (RJ-MCMC) algorithms have been proposed. They have significantly extended the scope of Markov chain Monte Carlo simulation methods, offering the promise to be able to routinely tackle transdimensional sampling problems, as encountered in Bayesian model selection problems for example, in a principled and flexible fashion. Their practical efficient implementation, however, still remains a challenge. A particular difficulty encountered in practice is in the choice of the dimension matching variables (both their nature and their distribution) and the reversible transformations which allow one to define the one-to-one mappingsmore » underpinning the design of these algorithms. Indeed, even seemingly sensible choices can lead to algorithms with very poor performance. The focus of this paper is the development and performance evaluation of a method, annealed importance sampling RJ-MCMC (aisRJ), which addresses this problem by mitigating the sensitivity of RJ-MCMC algorithms to the aforementioned poor design. As we shall see the algorithm can be understood as being an “exact approximation” of an idealized MCMC algorithm that would sample from the model probabilities directly in a model selection set-up. Such an idealized algorithm may have good theoretical convergence properties, but typically cannot be implemented, and our algorithms can approximate the performance of such idealized algorithms to an arbitrary degree while not introducing any bias for any degree of approximation. Our approach combines the dimension matching ideas of RJ-MCMC with annealed importance sampling and its Markov chain Monte Carlo implementation. We illustrate the performance of the algorithm with numerical simulations which indicate that, although the approach may at first appear computationally involved, it is in fact competitive.« less

Special Education in Hawaii--Some Current Problems. Report No. 6.

ERIC Educational Resources Information Center

Hayashi, Junie

The report examines the Hawaii Department of Education's procedures and criteria in the identification and evaluation of handicapped children, as well as difficulties encountered in recruiting and maintaining qualified special services evaluation personnel. An introductory chapter notes the legislative authority for the study; provisions of Public…

Children Learn Spurious Associations in Their Math Textbooks: Examples from Fraction Arithmetic

ERIC Educational Resources Information Center

Braithwaite, David W.; Siegler, Robert S.

2018-01-01

Fraction arithmetic is among the most important and difficult topics children encounter in elementary and middle school mathematics. Braithwaite, Pyke, and Siegler (2017) hypothesized that difficulties learning fraction arithmetic often reflect reliance on associative knowledge--rather than understanding of mathematical concepts and procedures--to…

Therapy with Law Enforcement Couples: Clinical Management of the "High-Risk Lifestyle."

ERIC Educational Resources Information Center

Borum, Randy; Philpot, Carol

1993-01-01

Reviews three primary ways in which law enforcement can affect relationships (organizational influences, peer/socialization influences, and police role influences). Identifies some common difficulties encountered by law enforcement couples and provides some basic goals and strategies for engaging them in treatment and addressing these issues in…

Automation--planning to implementation; the problems en route.

PubMed Central

Pizer, I H

1976-01-01

Once the major decision to automate library processes is made, there are a variety of problems which may be encountered before the planned system becomes operational. These include problems of personnel, budget, procurement of adjunct services, institutional priorities, and manufacturing uncertainties. Actual and potential difficulties are discussed. PMID:1247703

Bilateral bifid mandibular canal

PubMed Central

Sheikhi, Mahnaz; Badrian, Hamid; Ghorbanizadeh, Sajad

2012-01-01

One of the normal interesting variations that we may encounter in the mandible is bifid mandibular canal. This condition can lead to difficulties when performing mandibular anesthesia or during extraction of lower third molar, placement of implants, and surgery in the mandible. Therefore diagnosis of this variation is sometimes very important and necessary. PMID:23814555

The Helium Atom and Isoelectronic Ions in Two Dimensions

ERIC Educational Resources Information Center

Patil, S. H.

2008-01-01

The energy levels of the helium atom and isoelectronic ions in two dimensions are considered. The difficulties encountered in the analytical evaluation of the perturbative and variational expressions for the ground state, promote an interesting factorization of the inter-electronic interaction, leading to simple expressions for the energy. This…

The Application of Piaget's Theory of Cognitive Development to Education.

ERIC Educational Resources Information Center

Kuhn, Deanna

1979-01-01

The difficulties encountered in attempting to apply Piaget's theory of cognitive development to education reveal ambiguities existing within the theory itself. Research activity by educators and by developmental theoreticians must be integrated in order to achieve either a comprehensive developmental theory or an effective application of it. (CT)

The Mole Concept

ERIC Educational Resources Information Center

Duncan, I. M.; Johnstone, A. H.

1973-01-01

Reports a study of difficulties encountered by 14.5- to 15.0- year-old children in learning the mole concept with a programed instruction. Concludes that three respective disturbing factors were embedded in manipulation of molarity of solutions, balancing equations, and misapprehension that one mole of a compound always reacts with one mole of…

Biological Impact of Music and Software-Based Auditory Training

ERIC Educational Resources Information Center

Kraus, Nina

2012-01-01

Auditory-based communication skills are developed at a young age and are maintained throughout our lives. However, some individuals--both young and old--encounter difficulties in achieving or maintaining communication proficiency. Biological signals arising from hearing sounds relate to real-life communication skills such as listening to speech in…

Promoting Social and Emotional Growth of Students with Disabilities

ERIC Educational Resources Information Center

Darrow, Alice-Ann

2014-01-01

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

Internet Investigations: Mixing Talent with Teachers and Telecommunications.

ERIC Educational Resources Information Center

Brown, Mark E.; Riley, Tracy L.

1998-01-01

Describes how teams of grade 4-9 gifted students investigated unsolved mysteries like Bigfoot, aliens and UFOs, the Loch Ness Monster, and Stonehenge to develop Internet and research skills. Highlights student observations on difficulties encountered using the Internet for research, notes student evaluation of the workshop, and provides addresses…

Physics Lab Experiments and Correlated Computer Aids. Teacher Edition.

ERIC Educational Resources Information Center

Gottlieb, Herbert H.

Forty-nine physics experiments are included in the teacher's edition of this laboratory manual. Suggestions are given in margins for preparing apparatus, organizing students, and anticipating difficulties likely to be encountered. Sample data, graphs, calculations, and sample answers to leading questions are also given for each experiment. It is…

Enabling Integration in Sports for Adolescents with Intellectual Disabilities

ERIC Educational Resources Information Center

Grandisson, Marie; Tetreault, Sylvie; Freeman, Andrew R.

2012-01-01

Background: Promoting the health and social participation of adolescents with intellectual disability is important as they are particularly vulnerable to encountering difficulties in those areas. Integration of these individuals in integrated sports is one strategy to address this issue. Methods: The main objective of this study was to gain a…

12 CFR 1102.103 - Disclosure of requested records.

Code of Federal Regulations, 2013 CFR

2013-01-01

... shall be informed in writing of the difficulties encountered and an indication shall be given as to when... access, unless the individual making the request is notified in writing within the 30 day period that... amended, the individual requesting the records, before being granted access, shall execute a written...

48 CFR 14.404-1 - Cancellation of invitations after opening.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., the agency head determines in writing that— (1) Inadequate or ambiguous specifications were cited in...) Should administrative difficulties be encountered after bid opening that may delay award beyond bidders... period specified in the bid) should be requested, before expiration of their bids, to extend in writing...

48 CFR 14.404-1 - Cancellation of invitations after opening.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., the agency head determines in writing that— (1) Inadequate or ambiguous specifications were cited in...) Should administrative difficulties be encountered after bid opening that may delay award beyond bidders... period specified in the bid) should be requested, before expiration of their bids, to extend in writing...

12 CFR 1102.103 - Disclosure of requested records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... shall be informed in writing of the difficulties encountered and an indication shall be given as to when... access, unless the individual making the request is notified in writing within the 30 day period that... amended, the individual requesting the records, before being granted access, shall execute a written...

48 CFR 14.404-1 - Cancellation of invitations after opening.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., the agency head determines in writing that— (1) Inadequate or ambiguous specifications were cited in...) Should administrative difficulties be encountered after bid opening that may delay award beyond bidders... period specified in the bid) should be requested, before expiration of their bids, to extend in writing...

12 CFR 1102.103 - Disclosure of requested records.

Code of Federal Regulations, 2014 CFR

2014-01-01

... shall be informed in writing of the difficulties encountered and an indication shall be given as to when... access, unless the individual making the request is notified in writing within the 30 day period that... amended, the individual requesting the records, before being granted access, shall execute a written...

48 CFR 14.404-1 - Cancellation of invitations after opening.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., the agency head determines in writing that— (1) Inadequate or ambiguous specifications were cited in...) Should administrative difficulties be encountered after bid opening that may delay award beyond bidders... period specified in the bid) should be requested, before expiration of their bids, to extend in writing...

12 CFR 1102.103 - Disclosure of requested records.

Code of Federal Regulations, 2011 CFR

2011-01-01

... shall be informed in writing of the difficulties encountered and an indication shall be given as to when... access, unless the individual making the request is notified in writing within the 30 day period that... amended, the individual requesting the records, before being granted access, shall execute a written...

48 CFR 14.404-1 - Cancellation of invitations after opening.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., the agency head determines in writing that— (1) Inadequate or ambiguous specifications were cited in...) Should administrative difficulties be encountered after bid opening that may delay award beyond bidders... period specified in the bid) should be requested, before expiration of their bids, to extend in writing...

12 CFR 1102.103 - Disclosure of requested records.

Code of Federal Regulations, 2012 CFR

2012-01-01

... shall be informed in writing of the difficulties encountered and an indication shall be given as to when... access, unless the individual making the request is notified in writing within the 30 day period that... amended, the individual requesting the records, before being granted access, shall execute a written...

Preparing Instructional Objectives: Agony or Ecstasy?

ERIC Educational Resources Information Center

Roberts, Wesley K.

This paper 1) discusses the problems encountered in preparing objectives for instructional programs; 2) describes an informal research project in which seven instructional designers working on the same project attempted to determine agreement on an objective; and 3) suggests how to prepare objectives so that difficulties can be minimized. One…

Training Women for Rural Employment in Fiji's Changing Economic and Cultural Environment.

ERIC Educational Resources Information Center

Jones, Adele M. E.; Waqanivalu, Makario

1996-01-01

A young women's employment program in Fiji focused on personal development, self-reliance, and small business development. The responsibilities of women's traditional roles and lack of capital and credit were difficulties encountered, but the human development sessions were most valued by the participants. (SK)

Simulator Studies of the Deep Stall

NASA Technical Reports Server (NTRS)

White, Maurice D.; Cooper, George E.

1965-01-01

Simulator studies of the deep-stall problem encountered with modern airplanes are discussed. The results indicate that the basic deep-stall tendencies produced by aerodynamic characteristics are augmented by operational considerations. Because of control difficulties to be anticipated in the deep stall, it is desirable that adequate safeguards be provided against inadvertent penetrations.

Academic Library Consortium in Jordan: An Evaluation Study

ERIC Educational Resources Information Center

Ahmed, Mustafa H.; Suleiman, Raid Jameel

2013-01-01

Purpose: Due to the current financial and managerial difficulties that are encountered by libraries in public universities in Jordan and the geographical diffusion of these academic institutions, the idea of establishing a consortium was proposed by the Council of Higher Education to combine these libraries. This article reviews the reality of…

A Method to Assess Work Task Preferences

ERIC Educational Resources Information Center

Cobigo, Virginie; Morin, Diane; Lachapelle, Yves

2009-01-01

Persons with intellectual disability may encounter difficulties in making choices and expressing preferences because of restricted communication skills or a tendency to acquiesce. In addition, many studies provide evidence that these persons have less opportunity to make choices and express their preferences. The aim of this study was to conduct a…

Mitigating Transitional Challenges of Chinese Students in U.S. Higher Education

ERIC Educational Resources Information Center

Liu, Dongfang; Vogel, Linda R.

2016-01-01

The number of Chinese international students enrolled in U.S. higher education has significantly grown over the past two decades. In 2015, Chinese international students accounted for the largest group of international students from any one single country. Previous research acknowledges Chinese students encountering significant difficulties in…

Receptive Congress, Resistant Executive: The Legislative Fight for Tribal Colleges in the '80s.

ERIC Educational Resources Information Center

Deegan, Gregory G.

1997-01-01

Describes the legislative difficulties encountered in the struggle for tribal college funding in the 1980s, including executive classification of Native American higher education as nontrust, decreasing funds despite increased enrollment, and opposition from the Bureau of Indian Affairs. (18 citations) (YKH)

Animal models of respiratory syncytial virus infection and disease

USDA-ARS?s Scientific Manuscript database

The study of human respiratory syncytial virus pathogenesis and immunity has been hampered by its exquisite host specificity, and the difficulties encountered in adapting this virus to a murine host. The reasons for this obstacle are not well understood, but appear to reflect, at least in part, the ...

Effects of Prompting Critical Reading of Science News on Seventh Graders' Cognitive Achievement

ERIC Educational Resources Information Center

Tsai, Pei-Ying; Chen, Sufen; Chang, Huey-Por; Chang, Wen-Hua

2013-01-01

Science teachers frequently select science news articles as supplementary teaching materials; however, the literature indicates that students encounter difficulties in examining and evaluating the news content and textual elements. This paper reports an instructional strategy of utilizing science news articles and investigates its effectiveness in…

PREDICTING LEAD DISSOLUTION IN DRINKING WATER DISTRIBUTION SYSTEMS: EFFECT OF FLUORIDE ADDITIVES ON LEAD SOLUBILITY AND CORROSION

EPA Science Inventory

Many water systems have encountered difficulties in meeting the action levels established by the Lead and Copper Rule. Several chemical parameters contribute to the corrosion of lead plumbing and may influence the nature of the passivating films formed on distribution materials....

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

ERIC Educational Resources Information Center

Yanagi, Miho; Baker, Amanda A.

2016-01-01

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

Mutual Information Item Selection in Adaptive Classification Testing

ERIC Educational Resources Information Center

Weissman, Alexander

2007-01-01

A general approach for item selection in adaptive multiple-category classification tests is provided. The approach uses mutual information (MI), a special case of the Kullback-Leibler distance, or relative entropy. MI works efficiently with the sequential probability ratio test and alleviates the difficulties encountered with using other local-…

A Simple and Novel Approach to Delineating Stereochemistry of Electrocyclic Reactions

ERIC Educational Resources Information Center

Mandal, Dipak K.

2012-01-01

The dynamic stereochemistry of electrocyclic reactions (a class of pericyclic reactions) stems from the operation of either conrotatory (con) or disrotatory (dis) mode of ring-closing and ring-opening processes. Difficulty is often encountered in depicting product stereochemistry resulting from such movements of substituents. A novel, simple,…

What Comes after Stable Octet? Stable Sub-Shell!

ERIC Educational Resources Information Center

Tan, Kim Chwee Daniel; Taber, Keith S.

2005-01-01

Previous research has shown that students' existing conceptions are critical to subsequent learning because there is interaction between the new knowledge that the students encounter and their existing knowledge from previous lessons. Taber (1999a) found A-level students in the UK had difficulty in understanding the principles determining the…

Teaching Listening Skills to JFL Students in Australia.

ERIC Educational Resources Information Center

Danaher, Mike

1996-01-01

Examines issues affecting the teaching and learning of listening skills within the study of Japanese as a Foreign Language. Listening within foreign-language learning is a complex skill, and students encounter several difficulties in learning to listen for comprehension. Teachers face concerns ranging from resource availability to how to teach…

Aboriginal Students' Achievement in Science Education: The Effect of Teaching Methods

ERIC Educational Resources Information Center

Bourque, Jimmy; Bouchamma, Yamina; Larose, Francois

2010-01-01

Some authors assume that the academic difficulties encountered by Aboriginal students can be partly explained by the discrepancy between teaching methods and Aboriginal learning styles. However, this hypothesis lacks empirical foundations. Using pan-Canadian data, we tried to identify the most efficient teaching methods for Aboriginal students and…

"Delays and Vexation": Jack London and the Russo-Japanese War.

ERIC Educational Resources Information Center

Sweeney, Michael S.

1998-01-01

Contributes to scholarship on journalism history and censorship by discussing Jack London's efforts as a war correspondent to cover the Russo-Japanese War in Korea and Manchuria in 1904. Focuses on the difficulties he encountered as a result of systematic and highly restrictive censorship by the Japanese. (SR)

Reconceptualising Family: Negotiating Sexuality in a Governmental Climate of Neoliberalism

ERIC Educational Resources Information Center

Davies, Cristyn; Robinson, Kerry H.

2013-01-01

Based on qualitative research, this article examines the complex kinship relations involved in constructing queer families. The discussion focuses on the heterogeneity of queer families; the difficulties encountered in association with processes of recognition and how this is negotiated across different contexts within queer families, extended…

Flight Flutter Testing of Supersonic Interceptors

NASA Technical Reports Server (NTRS)

Dublin, M.; Peller, R.

1975-01-01

A summary is presented of experiences in connection with flight flutter testing of supersonic interceptors. The planning and operational aspects involved are described along with the difficulties encountered, and the correlation between measurement and theory. Recommendations for future research and development to advance the science of flight flutter testing are included.

Investigating Mixed-Ability Teaching in Taiwanese Primary Schools

ERIC Educational Resources Information Center

Huang, Ling-Ying

2014-01-01

In 2001, Taiwan reformed English language teaching in primary schools, and a mixed ability approach was taken as an organisational method for this. Many teachers claim that they encounter numerous difficulties in catering for different needs because of the large number of differences between students. However, the debate and comparisons between…

Taking Flight: Using a Wind Tunnel to Teach Aeronautic Principles

ERIC Educational Resources Information Center

Zembal-Saul, Carla; Huckans, John H.; Walker, Dean C.; Hershberger, Kimber; Kurz, Nathan A.; Reed, Diane; Cole, Milton W.

2007-01-01

Several teachers from State College (Pennsylvania) Area School District became intrigued with helping their students better understand the science associated with a unit on air and aviation. In particular, they observed that students often encountered difficulty with abstract flight concepts, such as lift, thrust, and drag. Content issues became…

Student Test Performances on Behavior of Gas Particles and Mismatch of Teacher Predictions

ERIC Educational Resources Information Center

Liang, Jia-Chi; Chou, Chin-Cheng; Chiu, Mei-Hung

2011-01-01

The nature and behavior of gas particles are essential concepts in teaching and learning of school chemistry. However, findings about students' understanding of gas particles--their composition, structure, and interactions involving movement and distribution--revealed that the difficulties students encounter in understanding gas particles vary…

Dr. David Blackwell Memorial Conference on Mathematics, Probability and Statistics

DTIC Science & Technology

first black scholar to be admitted to the National Academy of Sciences passed away on July 8, 2010 at the age of 91. Even though he encountered the many...difficulties that African Americans experienced in society , and in particular, the mathematical community, he prevailed to become the greatest

Families and nurses: building partnerships for growth and health.

PubMed

Grace, J T

1995-05-01

The newborn's social and emotional development depends on a relationship in which attention, affect, and information are shared with the mother. Young, disadvantaged families may encounter characteristic difficulties in maintaining these social relationships. Partnerships for health between nurses and disadvantaged clients require sharing similar relationships, and they present parallel challenges.

Bullying Prevention Strategies in Early Childhood Education

ERIC Educational Resources Information Center

Saracho, Olivia N.

2017-01-01

Bullying is a serious problem that affects the young children's well being. Early childhood educators find it difficult to manage bullying in the classroom. Preschool is the first environment outside of the home setting where children encounter difficulties when they socially interact with their peers. Based on the principles of protecting and…

Propeller study. Part 3: Experimental determination of thrust and torque on the YO-3A aircraft

NASA Technical Reports Server (NTRS)

Ormsbee, A. I.; Siddiqi, S. A.; Sivier, K. R.

1977-01-01

Instrumentation and procedures for obtaining in-flight measurements of the torque and thrust of a propeller mounted on a YO-3A aircraft are described. Problems encountered in the study are discussed and methods for eliminating these difficulties are suggested.

The Extension of the Voting Rights Act: The Case of Arizona.

ERIC Educational Resources Information Center

Garcia, John A.

Although Arizona's Chicano population has increased since 1960, their generally lower socioeconomic status has had a direct impact on their voting participation. Such problems as language, altered polling places and precinct boundaries, absence of bilingual staff, and literacy tests have also contributed to the voting difficulties encountered by…

Learning for autonomous navigation

NASA Technical Reports Server (NTRS)

Angelova, Anelia; Howard, Andrew; Matthies, Larry; Tang, Benyang; Turmon, Michael; Mjolsness, Eric

2005-01-01

Autonomous off-road navigation of robotic ground vehicles has important applications on Earth and in space exploration. Progress in this domain has been retarded by the limited lookahead range of 3-D sensors and by the difficulty of preprogramming systems to understand the traversability of the wide variety of terrain they can encounter.

History of Physical Terms: "Energy"

ERIC Educational Resources Information Center

Frontali, Clara

2014-01-01

Difficulties encountered by teachers in giving a definition of the term "energy", and by students in grasping its actual meaning, reflect the lengthy process through which the concept eventually came to maturity around 1850. Tracing the history of this process illuminates the different aspects covered by the term and shows the important…

Strategy Keys as Tools for Problem Solving

ERIC Educational Resources Information Center

Herold-Blasius, Raja

2017-01-01

Problem solving is one of the main competences we seek to teach students at school for use in their future lives. However, when dealing with mathematical problems, teachers encounter a wide variety of difficulties. To foster students' problem-solving skills, the authors developed "strategy keys." Strategy keys can serve as material to…

The fabrication of plastic cages for suspension in mass air flow racks.

PubMed

Nielsen, F H; Bailey, B

1979-08-01

A cage for suspension in mass air flow racks was constructed of plastic and used to house rats. Little or no difficulty was encountered with the mass air flow rack-suspended cage system during the 4 years it was used for the study of trace elements.

IFLA General Conference, 1986. Pre-Session Seminar, Kanasawa. Papers.

ERIC Educational Resources Information Center

International Federation of Library Associations and Institutions, The Hague (Netherlands).

The two papers in this document were presented at a pre-session held before the IFLA general conference in 1986. In "Problems of Document Delivery in the Science and Technology Information Environment--An African View," Lucilda Hunter (Sierra Leone) discusses typical difficulties encountered in the process of information retrieval in…

Biological Simulations in Distance Learning. CAL Research Group Technical Report No. 12.

ERIC Educational Resources Information Center

Murphy, P. J.

When two biological simulations on evolution and genetics (one originally developed for a conventional university undergraduate course) were introduced into Open University distance education classes, the difficulties encountered required a reappraisal of the concept of using computer simulation for distance learning and decisions on which…

Designing a Technology-Enhanced Learning Environment to Support Scientific Modeling

ERIC Educational Resources Information Center

Wu, Hsin-Kai; Hsu, Ying-Shao; Hwang, Fu-Kwun

2010-01-01

Modeling of a natural phenomenon is of value in science learning and increasingly emphasized as an important component of science education. However, previous research has shown that secondary school students encounter difficulties when engaging in modeling activities and need substantial support in order to create meaningful scientific models.…

MECHANISM(S) OF UPTAKE AND SEQUESTRATION OF LEAD AND OTHER HEAVY METALS BY PSEUDOMONAS AERUGINOSA CHL-004

EPA Science Inventory

Heavy metals in soils and sediments of anthropogenic origin are a major environmental concern, due to the significant health risks they pose and due to the difficulties encountered with their remediation. Diverse industries involved in energy production, pigment synthesis and the...

The Treatment of Male Sexual Offenders: Countertransference Reactions.

ERIC Educational Resources Information Center

Mitchell, Cynthia; Melikian, Karen

1995-01-01

Addresses the therapist's reactions to clinical work with sex offenders. Focuses on the particular experiences of one case, and discusses the female therapist's responses to the male client that may be the result of other experiences. Explores some reactions and difficulties that professionals may encounter in work with sex offenders. (JPS)

Finding One's Place in the Republic: Educating for Citizenship in a Diversifying France

ERIC Educational Resources Information Center

Nesbitt, Travis William

2013-01-01

The school, France's traditional vehicle for integrating diverse populations into a national culture and fostering civic participation, has encountered difficulties in fulfilling its central mission as demographic shifts have given rise to competing conceptions of religious, cultural, ethnic, political and national identity. For French society the…

It's a Salmon's Life!

ERIC Educational Resources Information Center

French, M. Jenice; Skochdopole, Laura Downey

1998-01-01

Describes an integrated science unit to help preservice teachers gain confidence in their abilities to learn and teach science. The teachers role played being salmon as they learned about the salmon's life cycle and the difficulties salmon encounter. The unit introduced the use of investigative activities that begin with questions and end with…

Another Look at the Language Difficulties of International Students

ERIC Educational Resources Information Center

Zhang, Yanyin; Mi, Yinan

2010-01-01

International students encounter language-related problems in their academic studies. Specific problem areas have been identified and possible underlying causes have been explored. The present study investigates the impact of two variables--length of study and academic disciplines--in relation to the problems. The findings from a survey and…

Teaching Controversial Materials: Teaching about the Nuclear Issue.

ERIC Educational Resources Information Center

Wall, Joseph

1986-01-01

Describes difficulties encountered in presenting a college course on nuclear weapons and disarmament. Maintains that such courses must strive for a fuller historical account of the arms race, in addition to stressing the humanistic and ethical questions involved. Warns that controversy will arise and concludes that even blind anger is preferable…

Learning to Understand Others through Relationally Oriented Reading

ERIC Educational Resources Information Center

Lysaker, Judith; Tonge, Clare

2013-01-01

Children with reading difficulties often face social and emotional challenges as well. These struggles may be particularly taxing for these children as classrooms increase in diversity and they encounter fewer people like themselves. In response to these issues, we developed an approach to teaching reading called Relationally Oriented Reading…

Assessment of Pragmatic Difficulties and Socioemotional Adjustment in Practice

ERIC Educational Resources Information Center

Farmer, Marion; Oliver, Alice

2005-01-01

Background: In professional practice, psychologists and other professionals such as therapists and teachers receive referrals of many children who present with social, emotional and behavioural difficulties that are difficult to understand and assess. The problems of some of these children may stem from pragmatic difficulties in communication.…

Bureaucracy stifles medical research in Britain: a tale of three trials.

PubMed

Snooks, Helen; Hutchings, Hayley; Seagrove, Anne; Stewart-Brown, Sarah; Williams, John; Russell, Ian

2012-08-16

Recent developments aiming to standardise and streamline processes of gaining the necessary approvals to carry out research in the National Health Service (NHS) in the United Kingdom (UK), have resulted in lengthy and costly delays. The national UK governmental Department of Health's Research Governance Framework (RGF) for Health and Social Care requires that appropriate checks be conducted before research involving human participants, their organs, tissues or data can commence in the NHS. As a result, medical research has been subjected to increased regulation and governance, with the requirement for approvals from numerous regulatory and monitoring bodies. In addition, the processes and outcomes of the attribution of costs in NHS research have caused additional difficulties for researchers. The purpose of this paper is to illustrate, through three trial case studies, the difficulties encountered during the set-up and recruitment phases of these trials, related to gaining the necessary ethical and governance approvals and applying for NHS costs to undertake and deliver the research. Empirical evidence about delays and difficulties related to regulation and governance of medical research was gathered during the period 2009-2010 from three UK randomised controlled trials with sites in England, Wales and Scotland (1. SAFER 2- an emergency care based trial of a protocol for paramedics to refer patients directly to community based falls services; 2. COnStRUCT- a trial of two drugs for acute ulcerative colitis; and 3. Family Links - a trial of a public health intervention, a 10 week community based parenting programme). Findings and recommendations were reported in response to a call for evidence from The Academy of Medical Sciences regarding difficulties encountered in conducting medical research arising from R&D governance and regulation, to inform national policy. Difficulties and delays in navigating and gaining the appropriate approvals and NHS costs required to undertake the research were encountered in all three trials, at various points in the bureaucratic processes of ethical and research and information governance approvals. Conduct of each of the three trials was delayed by at least 12 months, with costs increasing by 30 - 40%. Whilst the three trials encountered a variety of challenges, there were common issues. The processes for gaining approvals were overly complex and differed between sites and UK countries; guidance about processes was unclear; and information regarding how to define and claim NHS costs for undertaking the research was inconsistent. The competitive advantage of a publicly funded, open access health system for undertaking health services research and clinical trials within the UK has been outweighed in recent years by stifling bureaucratic structures and processes for governance of research. The recommendations of the Academy of Medical Sciences are welcomed, and the effects of their implementation are awaited with interest. SAFER 2: ISRCTN 60481756; COnStRUCT: ISRCTN22663589; Family Links: ISRCTN 13929732.

Delivery of Clinical Preventive Services in Family Medicine Offices

PubMed Central

Crabtree, Benjamin F.; Miller, William L.; Tallia, Alfred F.; Cohen, Deborah J.; DiCicco-Bloom, Barbara; McIlvain, Helen E.; Aita, Virginia A.; Scott, John G.; Gregory, Patrice B.; Stange, Kurt C.; McDaniel, Reuben R.

2005-01-01

BACKGROUND This study aimed to elucidate how clinical preventive services are delivered in family practices and how this information might inform improvement efforts. METHODS We used a comparative case study design to observe clinical preventive service delivery in 18 purposefully selected Midwestern family medicine offices from 1997 to 1999. Medical records, observation of outpatient encounters, and patient exit cards were used to calculate practice-level rates of delivery of clinical preventive services. Field notes from direct observation of clinical encounters and prolonged observation of the practice and transcripts from in-depth interviews of practice staff and physicians were systematically examined to identify approaches to delivering clinical preventive services recommended by the US Preventive Services Task Force. RESULTS Practices developed individualized approaches for delivering clinical preventive services, with no one approach being successful across practices. Clinicians acknowledged a 3-fold mission of providing acute care, managing chronic problems, and prevention, but only some made prevention a priority. The clinical encounter was a central focus for preventive service delivery in all practices. Preventive services delivery rates often appeared to be influenced by competing demands within the clinical encounter (including between different preventive services), having a physician champion who prioritized prevention, and economic concerns. CONCLUSIONS Practice quality improvement efforts that assume there is an optimal approach for delivering clinical preventive services fail to account for practices’ propensity to optimize care processes to meet local contexts. Interventions to enhance clinical preventive service delivery should be tailored to meet the local needs of practices and their patient populations. PMID:16189059

The supervisory encounter and the senior GP trainee: managing for, through and with.

PubMed

Brown, James; Nestel, Debra; Clement, Tim; Goldszmidt, Mark

2018-02-01

Help-seeking supervisory encounters provide important learning experiences for trainees preparing for independent practice. Although there is a body of expert opinion and theories on how supervisor encounters should happen, supporting empirical data are limited. This is particularly true for the senior general practice (GP) trainee. Without knowing what happens during these encounters, we cannot know how to maximise their educational potential. This study aimed to understand what happens when senior GP trainees call on their supervisor when caring for patients and how learning can be enhanced when this occurs. This is an analysis of data from a multi-case study of five GP supervisory pairs, each with a GP registrar and their supervisor. The data are recordings of 45 supervisory encounters, 78 post-encounter reflections and six interviews. We used Wenger's communities of practice theory and rhetorical genre theory as analytical lenses. The supervisory encounters followed a consistent format, which fitted the form of a genre. Within this genre, three dominant interactional patterns were identified, which we labelled 'managing for', 'managing through' and 'managing with'. Each pattern presented different opportunities and drew on different skills. The primary agenda was always developing a plan for the patient. Education agendas included acquiring knowledge, developing skills and achieving independence. Other agendas were issues of control, credibility and relationship building. Both supervisor and trainee could be purposeful in their supervisory engagement. For supervisors and trainees to achieve the educational potential of their supervisory encounters they require flexibility. This depends on understanding the genre of the supervisory encounter, the agendas at play, the options they have in engaging and having the skills to utilise these options. Educators can facilitate supervisors and trainees in acquiring this understanding and these skills. We recommend further research into the genre of the supervisory encounter. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

The importance of motivation, weapons, and foul odors in driving encounter competition in carnivores.

PubMed

Allen, Maximilian L; Wilmers, Christopher C; Elbroch, L Mark; Golla, Julie M; Wittmer, Heiko U

2016-08-01

Encounter competition is interference competition in which animals directly contend for resources. Ecological theory predicts the trait that determines the resource holding potential (RHP), and hence the winner of encounter competition, is most often body size or mass. The difficulties of observing encounter competition in complex organisms in natural environments, however, has limited opportunities to test this theory across diverse species. We studied the outcome of encounter competition contests among mesocarnivores at deer carcasses in California to determine the most important variables for winning these contests. We found some support for current theory in that body mass is important in determining the winner of encounter competition, but we found that other factors including hunger and species-specific traits were also important. In particular, our top models were "strength and hunger" and "size and hunger," with models emphasizing the complexity of variables influencing outcomes of encounter competition. In addition, our wins above predicted (WAP) statistic suggests that an important aspect that determines the winner of encounter competition is species-specific advantages that increase their RHP, as bobcats (Lynx rufus) and spotted skunks (Spilogale gracilis) won more often than predicted based on mass. In complex organisms, such as mesocarnivores, species-specific adaptations, including strategic behaviors, aggressiveness, and weapons, contribute to competitive advantages and may allow certain species to take control or defend resources better than others. Our results help explain how interspecific competition shapes the occurrence patterns of species in ecological communities. © 2016 by the Ecological Society of America.

Facilitators and barriers to adjustment of international nurses: an integrative review.

PubMed

Kawi, J; Xu, Y

2009-06-01

There is a scarcity of research focusing on issues encountered by international nurses (INs) in their adjustment to foreign health-care environments. Increasingly, INs are relied upon to address staffing shortages in many Western countries. As such, it is vital to identify what facilitates and what the barriers are to the successful adjustment in order to assist their integration into new workplace environments. This integrative review identifies facilitators and barriers encountered by INs as they adjust to foreign health-care environments. Based on Cooper's Five Stages of Integrative Research Review, a systematic search of eight electronic databases was conducted, combined with hand and ancestral searches. Two authors independently reviewed each qualified study for relevance and significance. Subsequently, facilitators and barriers were identified and categorized into themes and subthemes. Twenty-nine studies conducted in Australia, Canada, Iceland, UK and the USA were included in this review. Findings indicated that positive work ethic, persistence, psychosocial and logistical support, learning to be assertive and continuous learning facilitated the adjustment of INs to their new workplace environments. In contrast, language and communication difficulties, differences in culture-based lifeways, lack of support, inadequate orientation, differences in nursing practice and inequality were barriers. The review findings provide the basis for the development and testing of an evidence-informed programme to facilitate the successful adjustment of INs to their new work environments.

One hand cannot clap-a study of Arab practitioners of traditional and complementary medicine in Israel: identifying barriers to integrative oncology care.

PubMed

Popper-Giveon, Ariela; Schiff, Elad; Hatem, David; Samuels, Noah; Ben-Arye, Eran

2014-01-01

The integration of complementary medicine is gradually becoming an accepted part of standard care for patients with cancer. In our integrative oncology program, we have encountered difficulties in recruiting Arab patients. In order to understand the special needs of this population, we conducted interviews among Arab practitioners of complementary and traditional medicine (CTM). The characteristics of practitioners and their views regarding the therapeutic process were examined. Semi-structured qualitative interviews were administered to 27 Arab practitioners of CTM whose clientele was comprised primarily of Arab cancer patients. Conventional content analysis of the transcribed interviews and field notes was performed in order to identify key themes. Three groups of CTM practice were identified: Folk-herbal medicine (n = 9), complementary medicine (CM; n = 14), and religious healing (n = 4). Seven factors were identified in the practitioner accounts: the duration and scheduling of treatment sessions, the language of communication, the presence of family members, the appearance of the practitioner, the definition of treatment goals, the discussion of behavioral and lifestyle changes, and finally, the use of tangible elements in treatment. The study of Arab CTM practitioner recommendations may help facilitate a culture-sensitive encounter with Arab patients with cancer. This approach may also have implications for other ethno-culturally unique populations. Copyright © 2014 Elsevier Inc. All rights reserved.

Bi-Stability of Movement Coordination as a Function of Skill Level and Task Difficulty

ERIC Educational Resources Information Center

Liu, Yeou-Teh; Mayer-Kress, Gottfried; Newell, Karl M.

2010-01-01

This study investigated whether the level of practice interacts with the initial conditions (here manipulated as preparatory movements) and task difficulty (ball angular velocity and friction) in determining the stability of movement coordination for a roller ball motor task. Practice level and task difficulty were manipulated as two control…

Use of Social Media by Spanish Hospitals: Perceptions, Difficulties, and Success Factors

PubMed Central

Bermúdez-Tamayo, Clara; Jiménez-Pernett, Jaime; García Gutiérrez, José-Francisco; Traver-Salcedo, Vicente; Yubraham-Sánchez, David

2013-01-01

Abstract This exploratory study has two aims: (1) to find out if and how social media (SM) applications are used by hospitals in Spain and (2) to assess hospital managers' perception of these applications in terms of their evaluation of them, reasons for use, success factors, and difficulties encountered during their implementation. A cross-sectional survey has been carried out using Spanish hospitals as the unit of analysis. Geographical differences in the use of SM were found. Social networks are used most often by larger hospitals (30% by medium-size, 28% by large-size). They are also more frequently used by public hospitals (19%, p<0.01) than by private ones. Respondents with a negative perception of SM felt that there is a chance they may be abused by healthcare professionals, whereas those with a positive perception believed that they can be used to improve communication both within and outside the hospital. Reasons for the use of SM include the idea of maximizing exposure of the hospital. The results show that Spanish hospitals are only just beginning to use SM applications and that hospital type can influence their use. The perceptions, reasons for use, success factors, and difficulties encountered during the implementation of SM mean that it is very important for healthcare professionals to use SM correctly and adequately. PMID:23368890

A basic recursion concept inventory

NASA Astrophysics Data System (ADS)

Hamouda, Sally; Edwards, Stephen H.; Elmongui, Hicham G.; Ernst, Jeremy V.; Shaffer, Clifford A.

2017-04-01

Recursion is both an important and a difficult topic for introductory Computer Science students. Students often develop misconceptions about the topic that need to be diagnosed and corrected. In this paper, we report on our initial attempts to develop a concept inventory that measures student misconceptions on basic recursion topics. We present a collection of misconceptions and difficulties encountered by students when learning introductory recursion as presented in a typical CS2 course. Based on this collection, a draft concept inventory in the form of a series of questions was developed and evaluated, with the question rubric tagged to the list of misconceptions and difficulties.

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

PubMed

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

2018-01-01

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

A personalized snack-based intervention for hip fracture patients: development, feasibility and acceptability.

PubMed

Price, Rosemary J G; McMurdo, Marion E T; Anderson, Annie S

2006-04-01

Undernutrition is common in older people admitted to hospital with hip fracture. Oral supplementation with sip feeds may be provided but compliance is a major problem. To develop a personalized snack-based intervention for practical implementation in hip fracture patients and to assess feasibility, adherence, acceptability and cost. Twenty-three older hip fracture patients with a mean age (SD) 84.1 (6.3) were provided with three between-meal snacks daily for 4 weeks following surgery. Dietary counselling, assessment of acceptability and feasibility were undertaken and costs of intervention calculated. Sixteen of the 23 participants recruited completed the study. Mean estimated energy derived from the snacks provided 26% of daily energy requirements. Monitoring adherence proved problematic and stocktakes highlighted discrepancies. Although several participants reported that they did not usually eat between meals, overall the intervention was acceptable to participants. The cost of implementation was 21.29 UK pounds per participant per week. Although it proved feasible, practical difficulties were encountered with implementation and adherence due to timing. A more appropriate time to deliver such an intervention may be after the acute phase is over and patients are back home. The costs compared favourably with the alternative of providing sip feeds.

The use of films as a teaching tool for the teaching-learning process in bioethics.

PubMed

Pereira Rates, Camila Maria; Maciel Silva, Larriny; Moura Pereira, Lívia; Reis Pessalacia, Juliana Dias

2014-01-01

Identifying the contribution of using films in the process of teaching-learning in bioethics and verifying the facilities and difficulties in using this teaching resource. A qualitative study analyzed from the Bardin referential. Semi-structured interviews were carried out, recorded, and transcribed in full. For definition of the sample was used the criteria of repetition. In total, participated in the study 21 students of Nursing and Biochemistry, members of a Center for Teaching and Research in Bioethics of a public federal university in the city of Divinópolis, Minas Gerais, Brazil. During the analysis of interviews, two thematic categories and two subcategories emerged. In their responses, students indicated the importance of viewing the bioethical problem for the reflection and decision-making in professional practice. Many reported that from the experience in discussions of the films showed, were made changes in the ethical position. The use of films as a teaching resource contributes to the process of teaching-learning in bioethics for undergraduate students. The discussions of the films are stimulating and provide a space for reflection and dialogue on bioethical problems that students may encounter in their professional practice.

Summary of workshop 'Theory Meets Industry'—the impact of ab initio solid state calculations on industrial materials research

NASA Astrophysics Data System (ADS)

Wimmer, E.

2008-02-01

A workshop, 'Theory Meets Industry', was held on 12-14 June 2007 in Vienna, Austria, attended by a well balanced number of academic and industrial scientists from America, Europe, and Japan. The focus was on advances in ab initio solid state calculations and their practical use in industry. The theoretical papers addressed three dominant themes, namely (i) more accurate total energies and electronic excitations, (ii) more complex systems, and (iii) more diverse and accurate materials properties. Hybrid functionals give some improvements in energies, but encounter difficulties for metallic systems. Quantum Monte Carlo methods are progressing, but no clear breakthrough is on the horizon. Progress in order-N methods is steady, as is the case for efficient methods for exploring complex energy hypersurfaces and large numbers of structural configurations. The industrial applications were dominated by materials issues in energy conversion systems, the quest for hydrogen storage materials, improvements of electronic and optical properties of microelectronic and display materials, and the simulation of reactions on heterogeneous catalysts. The workshop is a clear testimony that ab initio computations have become an industrial practice with increasingly recognized impact.

GLOBALLY ADAPTIVE QUANTILE REGRESSION WITH ULTRA-HIGH DIMENSIONAL DATA

PubMed Central

Zheng, Qi; Peng, Limin; He, Xuming

2015-01-01

Quantile regression has become a valuable tool to analyze heterogeneous covaraite-response associations that are often encountered in practice. The development of quantile regression methodology for high dimensional covariates primarily focuses on examination of model sparsity at a single or multiple quantile levels, which are typically prespecified ad hoc by the users. The resulting models may be sensitive to the specific choices of the quantile levels, leading to difficulties in interpretation and erosion of confidence in the results. In this article, we propose a new penalization framework for quantile regression in the high dimensional setting. We employ adaptive L1 penalties, and more importantly, propose a uniform selector of the tuning parameter for a set of quantile levels to avoid some of the potential problems with model selection at individual quantile levels. Our proposed approach achieves consistent shrinkage of regression quantile estimates across a continuous range of quantiles levels, enhancing the flexibility and robustness of the existing penalized quantile regression methods. Our theoretical results include the oracle rate of uniform convergence and weak convergence of the parameter estimators. We also use numerical studies to confirm our theoretical findings and illustrate the practical utility of our proposal. PMID:26604424

Observed Human Errors in Interpreting 3D visualizations: implications for Teaching Students how to Comprehend Geological Block Diagrams

NASA Astrophysics Data System (ADS)

Bemis, K. G.; Pirl, E.; Chiang, J.; Tremaine, M.

2009-12-01

Block diagrams are commonly used to communicate three dimensional geological structures and other phenomena relevant to geological science (e.g., water bodies in the ocean). However, several recent studies have suggested that these 3D visualizations create difficulties for individuals with low to moderate spatial abilities. We have therefore initiated a series of studies to understand what it is about the 3D structures that make them so difficult for some people and also to determine if we can improve people’s understanding of these structures through web-based training not related to geology or other underlying information. Our first study examined what mistakes subjects made in a set of 3D block diagrams designed to represent progressively more difficult internal structures. Each block was shown bisected by a plane either perpendicular or at an angle to the block sides. Five low to medium spatial subjects were asked to draw the features that would appear on the bisecting plane. They were asked to talk aloud as they solved the problem. Each session was videotaped. Using the time it took subjects to solve the problems, the subject verbalizations of their problem solving and the drawings that were found to be in error, we have been able to find common patterns in the difficulties the subjects had with the diagrams. We have used these patterns to generate a set of strategies the subjects used in solving the problems. From these strategies, we are developing methods of teaching. A problem found in earlier work on geology structures was not observed in our study, that is, one of subjects failing to recognize the 2D representation of the block as 3D and drawing the cross-section as a combined version of the visible faces of the object. We attribute this to our experiment introduction, suggesting that even this simple training needs to be carried out with students encountering 3D block diagrams. Other problems subjects had included difficulties in perceptually recognizing variations in layer thicknesses, difficulties in recognizing an internal structure from the visible cues on the block walls, difficulties in mentally constructing objects and intersections that were not perpendicular, and difficulties in keeping track of the number of folds of a layer, and thus, the number of intersections of the layer with the bisecting plane. All of these problems suggest that web-based games giving mass practice with these variations in block diagram representations are likely to give any person appropriate skills in their interpretation. The time to complete the drawings and the errors in the drawings were also correlated with quantifiable properties of the diagrams, e.g., number of layers, number of folds in the layers, angle of bisection of the plane, etc. These will be used in further research to organize the training from easy to hard problems following what is known already about mass practice and developing abstracted skill sets. The plan is to also make the training adaptive, that is, to provide practice in those areas where an individual user is having the most problems.

Empathy in general practice-the gap between wishes and reality: comparing the views of patients and physicians.

PubMed

Derksen, F A W M; Olde Hartman, Tim; Bensing, Jozien; Lagro-Janssen, Antoine

2018-03-27

Empathy is regarded by patients and general practitioners (GPs) as fundamental in patient-GP communication. Patients do not always experience empathy and GPs encounter circumstances which hamper applying it. To explore why receiving and offering empathy during the encounter in general practice does not always meet the wishes of both patients and GPs. A qualitative research method, based on focus group interviews with patients and in-depth interviews with GPs, was carried out. Within the research process, iterative data collection and analysis were applied. Both patients and GPs perceive a gap between what they wish for with regard to empathy, and what they actually encounter in general practice. Patients report on circumstances which hamper receiving empathy and GPs on circumstances offering it. Various obstacles were mentioned: (i) circumstances related to practice organization, (ii) circumstances related to patient-GP communication or connectedness, (iii) differences between the patient's and the GP's expectations, (iv) time pressure and its causes and (v) the GP's individual capability to offer empathy. When patients do not receive empathy from their GP or practice staff, they feel frustrated. This causes a gap between their expectations on the one hand and their actual experiences on the other. GPs generally want to incorporate empathy; the GP's private, professional and psychological well-being appears to be an important contributing factor in practicing empathy in daily practice. But they encounter various obstacles to offer this. It is up to GPs to take responsibility for showing practice members the importance of an appropriate empathical behaviour towards patients.

Training and Local Development. An Experiment in Cooperation between Different Bodies for the Provision of Training on the Mediterranean Coast.

ERIC Educational Resources Information Center

Mascarell, Josep Vicent

1995-01-01

This description of the difficulties encountered in achieving cooperation among local agencies to provide vocational training in a Spanish district highlights the need for collaborating parties to listen to each other and the importance of understanding the environment in which agencies operate. (SK)

Integrated Functional and Executional Modelling of Software Using Web-Based Databases

NASA Technical Reports Server (NTRS)

Kulkarni, Deepak; Marietta, Roberta

1998-01-01

NASA's software subsystems undergo extensive modification and updates over the operational lifetimes. It is imperative that modified software should satisfy safety goals. This report discusses the difficulties encountered in doing so and discusses a solution based on integrated modelling of software, use of automatic information extraction tools, web technology and databases.

E-Learning in a Large Organization: A Study of the Critical Role of Information Sharing

ERIC Educational Resources Information Center

Netteland, Grete; Wasson, Barbara; Morch, Anders I

2007-01-01

Purpose: The purpose of this paper is to provide new insights into the implementation of large-scale learning projects; thereby better understanding the difficulties, frustrations, and obstacles encountered when implementing enterprise-wide e-learning as a tool for training and organization transformation in a complex organization.…

Student Connections between Algebraic and Graphical Polynomial Representations in the Context of a Polynomial Relation

ERIC Educational Resources Information Center

Adu-Gyamfi, Kwaku; Bossé, Michael J.; Chandler, Kayla

2017-01-01

When establishing connections among representations of associated mathematical concepts, students encounter different difficulties and successes along the way. The purpose of this study was to uncover information about and gain greater insight into how student processes connections. Pre-calculus students were observed and interviewed while…

Response of Planted Royal Paulownia to Weed Control Treatments After Coppice

Treesearch

David O. Mitchem; James E. Johnson; Richard E. Kreh

2002-01-01

Today there is an increased interest in growing royal paulownia (Paulownia tomentosa) in the southeastern United States, but difficulties have been encountered in the Piedmont due to heavy clays and intense competition for moisture. Two royal paulownia plantations were established on the Virginia Piedmont to evaluate the effects that weedmats have on...

Transition for Teenagers with Intellectual Disability: Carers' Perspectives

ERIC Educational Resources Information Center

Bhaumik, Sabyasachi; Watson, Joanna; Barrett, Mary; Raju, Bala; Burton, Tracey; Forte, Jane

2011-01-01

Teenagers with intellectual disabilities (ID) have significantly more health problems than the rest of the population and many encounter difficulties accessing the services they need during the transition from children's to adult services. A multidisciplinary, interagency study was carried out in one area of the UK with the intent to estimate the…

Spatial Learning Using Locomotion Interface to Virtual Environment

ERIC Educational Resources Information Center

Patel, K. K.; Vij, S.

2012-01-01

The inability to navigate independently and interact with the wider world is one of the most significant handicaps that can be caused by blindness, second only to the inability to communicate through reading and writing. Many difficulties are encountered when visually impaired people (VIP) need to visit new and unknown places. Current speech or…

Film Study: "Nothing But a Man."

ERIC Educational Resources Information Center

Manchel, Frank

1967-01-01

To examine new approaches to film study, "Nothing But a Man," which portrays the difficulties encountered by a young Negro in the South, was taught experimentally in three 11th-grade English classes at Cheshire High School, Connecticut. A different method of approaching the movie was used in each class to determine effective teaching methods for…

Organizing Instruction for Struggling Readers in Tutorial Settings

ERIC Educational Resources Information Center

Mokhtari, Kouider; Hutchison, Amy C.; Edwards, Patricia A.

2010-01-01

In this article, the authors suggest that many of the problems struggling readers encounter while reading stem from distinct yet fundamental sources of difficulty related to the types of text read (print or online), the task or activity readers engage in, and the sociocultural context of reading. The authors further argue that although these…

How Easy Is It for Adult Educators To Use the Information Superhighway?

ERIC Educational Resources Information Center

Rosen, David J.

In November 1995, an online survey was conducted of 113 adult literacy practitioners who were actively using the Internet. Respondents reported the following difficulties encountered in learning to use the Internet: purchasing and learning to use hardware or software; getting access to a telephone line; getting an Internet account; learning…

Managing Laboratory Data Using Cloud Computing as an Organizational Tool

ERIC Educational Resources Information Center

Bennett, Jacqueline; Pence, Harry E.

2011-01-01

One of the most significant difficulties encountered when directing undergraduate research and developing new laboratory experiments is how to efficiently manage the data generated by a number of students. Cloud computing, where both software and computer files reside online, offers a solution to this data-management problem and allows researchers…

No Such Word as "Can't": The Uphill Struggle of the Black Classical Singer.

ERIC Educational Resources Information Center

Verdino-Sullwold, Carla Maria

1991-01-01

Although the difficulties encountered during the first half of the twentieth century by such singers as Paul Robeson, Marian Anderson, and Roland Hayes are history, the recent struggles of black classical singers for recognition illustrate current barriers. Several prominent black opera and concert artists recount their experiences. (SLD)

The Perceived Success of Tutoring Students with Learning Disabilities: Relations to Tutee and Tutoring Variables

ERIC Educational Resources Information Center

Michael, Rinat

2016-01-01

The current study examined the contribution of two types of variables to the perceived success of a tutoring project for college students with learning disabilities (LD): tutoring-related variables (the degree of engagement in different tutoring activities and difficulties encountered during tutoring), and tutee-related variables (learning…

Using Photography and Art in Concept Mapping Research with Adults with Dyslexia

ERIC Educational Resources Information Center

Williams Carawan, Lena; Nalavany, Blace

2010-01-01

Reflexive photography for individual interviews and the use of art with focus groups provides a valuable method for exploring the psychosocial issues encountered by adults with dyslexia. Reflexive photography and art is particularly appropriate when interviewing adults with dyslexia who may have difficulty expressing and focusing on what they want…

Unpredictability, Transformation, and the Pedagogical Encounter: Reflections on "What Is Effective" in Education

ERIC Educational Resources Information Center

O'Donnell, Aislinn

2013-01-01

In this article, Aislinn O'Donnell offers a set of reflections on the relation between therapy and education. In the first section, she examines criticisms of therapeutic education, mobilizing the example of prison education to highlight the difficulties that arise from imposing prescriptive modes of subjectification and socialization in…

Symbolic and Nonsymbolic Number Comparison in Children with and without Dyscalculia

ERIC Educational Resources Information Center

Mussolin, Christophe; Mejias, Sandrine; Noel, Marie-Pascale

2010-01-01

Developmental dyscalculia (DD) is a pervasive difficulty affecting number processing and arithmetic. It is encountered in around 6% of school-aged children. While previous studies have mainly focused on general cognitive functions, the present paper aims to further investigate the hypothesis of a specific numerical deficit in dyscalculia. The…

Advocating for the McKinney-Vento Homelessness Act: The Role of Professional Counselors

ERIC Educational Resources Information Center

Sosa, Sandra I.; Peek, Sarah; Muhammad, Sharien; Gonder, Ty; Cook, Janice; Bolton, Jessica; Parrish, Mark S.

2015-01-01

Homeless youth in the United States is rapidly increasing with more children living in unstable or temporary environments. They may encounter difficulties meeting enrollment requirements, have poor attendance, low academic performance, and experience behavioral and emotional issues. The reauthorization of McKinney-Vento Act (MCKV) in 2002 was…

Development of a new noninvasive method to determine the integrity of bone in vivo

NASA Technical Reports Server (NTRS)

Saha, S.

1980-01-01

An electromagnetic sensor for monitoring elastic waves in bone was developed. It does not require the use of traction pins and the output is not affected by soft tissue properties, a difficulty commonly encountered when using ultrasonic and vibration methods to determine in vivo properties of bone.

17 CFR 200.304 - Disclosure of requested records.

Code of Federal Regulations, 2013 CFR

2013-04-01

... individual making the request is notified in writing within the 30 day period that, for good cause shown, a longer time is required. In such cases, the individual making the request shall be informed in writing of the difficulties encountered and an indication shall be given as to when it is anticipated that access...

17 CFR 200.304 - Disclosure of requested records.

Code of Federal Regulations, 2012 CFR

2012-04-01

... individual making the request is notified in writing within the 30 day period that, for good cause shown, a longer time is required. In such cases, the individual making the request shall be informed in writing of the difficulties encountered and an indication shall be given as to when it is anticipated that access...

17 CFR 200.304 - Disclosure of requested records.

Code of Federal Regulations, 2014 CFR

2014-04-01

... individual making the request is notified in writing within the 30 day period that, for good cause shown, a longer time is required. In such cases, the individual making the request shall be informed in writing of the difficulties encountered and an indication shall be given as to when it is anticipated that access...

How Spatial Abilities and Dynamic Visualizations Interplay When Learning Functional Anatomy with 3D Anatomical Models

ERIC Educational Resources Information Center

Berney, Sandra; Bétrancourt, Mireille; Molinari, Gaëlle; Hoyek, Nady

2015-01-01

The emergence of dynamic visualizations of three-dimensional (3D) models in anatomy curricula may be an adequate solution for spatial difficulties encountered with traditional static learning, as they provide direct visualization of change throughout the viewpoints. However, little research has explored the interplay between learning material…

Using a Simulation Game to Make Learning about Angles Meaningful. An Exploratory Study in Primary School

ERIC Educational Resources Information Center

Piu, Angela; Fregola, Cesare; Santoro, Anna

2016-01-01

As indicated in numerous research studies, schoolchildren encounter many difficulties and obstacles in learning the multifaceted concept of the angle. In order to explore the possibility of enhancing schoolchildren's understanding of such a concept, the authors present a study that aims at investigating some structural characteristics of…

Operant Strategies in the Training of Community Action Organizers.

ERIC Educational Resources Information Center

Vargas, Ernest A.; Breslaw, Jerome

Planning, funding and operating anti-poverty programs require skilled community organizers. Training organizers deals with problems of how to motivate others and what tactics should be used when difficulty is encountered. Two approaches to these problems determined by images of 20th Century Man have been employed: (1) rational economic man who…

Preferences on Internet Based Learning Environments in Student-Centered Education

ERIC Educational Resources Information Center

Cubukcu, Zuhal

2008-01-01

Nowadays, educational systems are being questioned to find effective solutions to problems that are being encountered, and discussions are centered on the ways of restructuring systems so as to overcome difficulties. As the consequences of the traditional teaching approach, we can indicate that the taught material is not long-lasting but easily…

Replantation of an avulsed ear, using a single arterial anastamosis.

PubMed

O'Toole, G; Bhatti, K; Masood, S

2008-01-01

Avulsion of the ear is relatively uncommon and replantation a technical challenge. A case in which an avulsed ear was successfully replanted using a single arterial anastamosis is described. The surgical difficulties encountered, the pharmaceutical approach to postoperative care and the problems which resulted from the lack of venous drainage are discussed.

Fragile Knowledge and Neglected Strategies in Novice Programmers. IR85-22.

ERIC Educational Resources Information Center

Perkins, David; Martin, Fay

As part of an ongoing program of research to identify the difficulties encountered by novice programmers and to develop teaching strategies to help them overcome these obstacles, researchers employed a scaffolded interview procedure with 20 high school students enrolled in the second semester of a year-long BASIC course. Investigators presented…

Management of airway difficulties during induction of general anesthesia in an American miniature horse with dwarfism.

PubMed

Hatfield, Cindy L; Riley, Christopher B

2007-02-01

This report describes previously unreported upper airway abnormalities encountered in a 5-month-old American miniature horse colt presented for elective surgery. Caution should be exercised when administering general anesthesia or heavy sedation to individuals of this breed that present with multiple congenital abnormalities.

Augmenting Paper-Based Reading Activity with Direct Access to Digital Materials and Scaffolded Questioning

ERIC Educational Resources Information Center

Chen, Nian-Shing; Teng, Daniel Chia-En; Lee, Cheng-Han; Kinshuk

2011-01-01

Comprehension is the goal of reading. However, students often encounter reading difficulties due to the lack of background knowledge and proper reading strategy. Unfortunately, print text provides very limited assistance to one's reading comprehension through its static knowledge representations such as symbols, charts, and graphs. Integrating…

"Once There Was El'zunia": Approaching Affect in Holocaust Literature

ERIC Educational Resources Information Center

Berlin, Gail Ivy

2012-01-01

The encounter with literature of the Holocaust, saturated as it is with unfathomable grief, loss, terror, and death, presents its readers with difficulties rare in literatures not dealing with the extreme. Specifically, usual academic discourse lacks a register for addressing the intense emotions that Holocaust narratives or poetry may generate.…

PROBLEMS OF AMERICANS IN MASTERING THE PRONUNCIATION OF EGYPTIAN ARABIC.

ERIC Educational Resources Information Center

KENNEDY, NANCY M.

THE DIFFICULTIES ENCOUNTERED BY SPEAKERS OF AMERICAN ENGLISH IN ATTEMPTING TO MASTER THE PRONUNCIATION OF EGYPTIAN ARABIC WERE ANALYZED DURING THE REPORTED RESEARCH. THE LANGUAGE UNDER CONSIDERATION WAS THE URBAN COLLOQUIAL ARABIC OF THE EGYPTIAN DELTA. THIS STUDY DEALT WITH THE SEGMENTAL PHONEMES ONLY, WITH SOME REFERENCE TO STRESS AND…

Transformations in the Visual Representation of a Figural Pattern

ERIC Educational Resources Information Center

Montenegro, Paula; Costa, Cecília; Lopes, Bernardino

2018-01-01

Multiple representations of a given mathematical object/concept are one of the biggest difficulties encountered by students. The aim of this study is to investigate the impact of the use of visual representations in teaching and learning algebra. In this paper, we analyze the transformations from and to visual representations that were performed…

Student Understanding of Function Composition and the Effect of Dynamic Visualization

ERIC Educational Resources Information Center

Ratliff, Bobby Kevin

2009-01-01

The purpose of this study was to determine (1) strategies students use when solving composition problems and the difficulties they encounter; (2) conceptions and/or misconceptions students have with respect to composition of functions; and (3) the effect of using dynamic visualization during instruction on students' understanding of composition of…

Entry of Young People into Working Life. General Report.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

This booklet examines the problems encountered by youth while making the school-to-work transition and analyzes the measures undertaken in the Organization for Economic Co-operation and Development (OECD) member countries to deal with youth unemployment. Part I in an analysis of young people's difficulties in entering the working life describes…

Web-Based Learning System for Developing and Assessing Clinical Diagnostic Skills for Dermatology Residency Program

ERIC Educational Resources Information Center

Kuo, Fan-Ray; Chin, Yi-Ying; Lee, Chao-Hsien; Chiu, Yu-Hsien; Hong, Chien-Hu; Lee, Kuang-Lieh; Ho, Wen-Hsien; Lee, Chih-Hung

2016-01-01

Few studies have explored the learning difficulties and misconceptions that students encounter when using information and communication technology for e-learning. To address this issue, this research developed a system for evaluating the learning efficiency of medical students by applying two-tier diagnosis assessment. The effectiveness of the…

America's First People: Factors Which Affect Their Persistence in Higher Education. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Taylor, Janis Swenson

To determine the factors that have contributed to persistence in successful Native American students, this study investigated student expectations, life experiences on campus, perceptions of support and lack of support for cultural identity, difficulties encountered, perceptions of how the Native American's college experience differs from that of…

Mathematics Undergraduates' Responses to Semantic Abbreviations, 'Geometric' Images and Multi-Level Abstractions in Group Theory.

ERIC Educational Resources Information Center

Nardi, Elena

2000-01-01

Identifies and explores the difficulties in the novice mathematician's encounter with mathematical abstraction. Observes 20 first-year mathematics undergraduates and extracts sets of episodes from the transcripts of the tutorials and interviews within five topics in pure mathematics. Discusses issues related to the learning of one mathematical…

Prediction of Internet Addiction of University Students Based on Various Variables

ERIC Educational Resources Information Center

Yilmaz, Fatma Gizem Karaoglan; Yilmaz, Ramazan; Teker, Necmettin; Keser, Hafize

2014-01-01

That internet is developing fast and its cost is becoming cheaper rapidly increases the number of people using this technology. Although internet provides miscellaneous benefits for the users, it also causes them to encounter certain difficulties. Particularly, those young people, who leave their families to study at a university spend most of…

Transitioning from High School Service to College Service-Learning in a First-Year Seminar

ERIC Educational Resources Information Center

Ross, Laurie; Boyle, Mary-Ellen

2007-01-01

This article analyzes the challenges encountered in a first-year service-learning course in which students had high expectations for community involvement and a commitment to social responsibility, yet significant difficulty connecting their service orientation to the intellectual inquiry expected of them at the college level. This conflict…

The Cost to Industry. Basic Skills and the UK Workforce.

ERIC Educational Resources Information Center

Adult Literacy and Basic Skills Unit, London (England).

In Fall 1992, 400 telephone interviews established levels of basic skills difficulties among the work force as encountered or perceived by employers in the United Kingdom. Costs to employers of poor basic skills and the effect of these on their operation were quantified and described. Respondents were mainly personnel/training managers or…

Transition Experiences of Community College Transfer Students: A Qualitative Study.

ERIC Educational Resources Information Center

Harrison, Patricia Lynne

This qualitative study sought to determine what academic and social difficulties are encountered by community college transfer students in adjusting to their transfer institutions. Data was collected from interviews with 12 students who transferred from Piedmont Virginia Community College (PVCC) to the University of Virginia (UVA) in the fall of…

Integration through a Card-Sort Activity

ERIC Educational Resources Information Center

Green, Kris; Ricca, Bernard P.

2015-01-01

Learning to compute integrals via the various techniques of integration (e.g., integration by parts, partial fractions, etc.) is difficult for many students. Here, we look at how students in a college level Calculus II course develop the ability to categorize integrals and the difficulties they encounter using a card sort-resort activity. Analysis…

Suggesting a General ESP Model for Adult Learners

ERIC Educational Resources Information Center

Al-Jumaily, Samir

2011-01-01

The study suggests a general model that could guarantee the cooperation between teachers and their students to overcome the difficulties encountered in ESP learning. It tries to join together different perspectives in the research of adult education, specifically in the teaching of English for Specific Purposes. It also provides some sort of trust…

Inventory Control: A Small Electronic Device for Studying Chemical Kinetics.

ERIC Educational Resources Information Center

Perez-Rodriguez, A. L.; Calvo-Aguilar, J. L.

1984-01-01

Shows how the rate of reaction can be studied using a simple electronic device that overcomes the difficulty students encounter in solving the differential equations describing chemical equilibrium. The device, used in conjunction with an oscilloscope, supplies the voltages that represent the chemical variables that take part in the equilibrium.…

VOLUME COMPENSATING MEANS FOR PULSATING PUMPS

DOEpatents

Weaver, D.L.W.; MacCormack, R.S. Jr.

1959-12-01

A double diaphragm, two-liquid pulsating pump for remote control use, having as an improvement an apparatus for maintaining constant the volume of the liquid such as kerosene between the two diaphragms is described. Phase difficulties encountered in the operation of such pumps when the volume of the liquid is altered by changes in temperature are avoided.

Challenges Facing Asian International Graduate Students in the US: Pedagogical Considerations in Higher Education

ERIC Educational Resources Information Center

Lin, Shu-Yuan; Scherz, Susan Day

2014-01-01

Non-Native English Speaking (NNES) international students attending colleges and universities in the United States often encounter difficulties in adjusting to their new cultural environment. In addition, they often struggle with academic language while learning the content and conceptual structures of various graduate level disciplines. This…

International Student-Athletes and Stress: Implications for American Universities' Administrators

ERIC Educational Resources Information Center

Rodriguez, Arturo

2014-01-01

This article explores the difficulties that international student-athletes encounter while attending an institution of higher education in the U.S. Most international student-athletes are able to quickly adapt to their new environment; however, there are some that struggle to integrate themselves into the new culture and the new team environment.…

An Introduction to Equilibrium Thermodynamics: A Rational Approach to Its Teaching. Part 1: Notation and Mathematics.

ERIC Educational Resources Information Center

Williams, Donald F.; Glasser, David

1991-01-01

Introduces and develops mathematical notation to assist undergraduate students in overcoming conceptual difficulties involving the underlying mathematics of state functions, which tend to be different from functions encountered by students in previous mathematical courses, because of the need to manipulate special types of partial derivatives and…

Pre-Service Teachers' Perceptions with Regard to Teaching-Learning Processes

ERIC Educational Resources Information Center

Özdas, Faysal

2018-01-01

Teaching-learning process has a great important medium where pre-service teachers develop experiences and competences. Pre-service teachers are introduced to this process in a professional sense through the school experience course in teacher training. In this process, it is crucial to identify the encountered difficulties and matters. For this…

Engaging Sources through Reading-Writing Connections across the Disciplines

ERIC Educational Resources Information Center

Carillo, Ellen C.

2016-01-01

This essay argues that what might otherwise be considered "plagiarism" in student writing is a symptom of the difficulties students encounter in their reading and writing, moments in which students' inabilities to critically assess, read, and respond to sources through the act of writing come to the surface. Expanding the context within…

What's in Your Name? Exploring Name Awareness with Children

ERIC Educational Resources Information Center

Chakraborty, Basanti; Stone, Basanti

2007-01-01

When children come to school, they bring with them a common thread they all have their individual names. Children from minority cultures, however, often encounter difficulties for being different; one obvious difference can be their given names. Names that are unfamiliar to other children may cause social tension or ridicule when a teacher calls…

International Education Management: Implications of Relational Perspectives and Ethnographic Insights to Nurture International Students' Academic Experience

ERIC Educational Resources Information Center

Shams, S. M. Riad

2017-01-01

Purpose: International students, who have a non-English speaking background (NESB), encounter many difficulties, in comparison to their local fellows of an English-speaking country. Literature demonstrates that leveraging various relational perspectives in a multicultural teaching environment has favourable implications to manage the NESB…

Professors Can Be Friends of a Free Press Too.

ERIC Educational Resources Information Center

Ciofalo, Andrew

A faculty adviser to the student newspaper at Loyola College, a small Catholic liberal arts college in Maryland, encountered difficulties concerning First Amendment rights. Previous efforts to establish guidelines for the student press by factions in the administration had failed, and the student newspaper has been able to solidify its First…

Repression to Reform: Education in the Republic of Paraguay, 1811-1850.

ERIC Educational Resources Information Center

Cooney, Jerry W.

1983-01-01

A social question faced by Latin American countries when they gained their independence from Spain was that of education. An extreme example of the difficulties encountered can be found in Paraguay where education was affected by the events of independence and by a new phenomenon, the Spanish American dictator. (RM)

The Effect of Picture Story Books on Students' Reading Comprehension

ERIC Educational Resources Information Center

Roslina

2017-01-01

As a non formal education students, PKBM (a Non-Formal Community Learning Center) Medaso Kolaka students tend to encounter some difficulties in reading such as low motivation, infrequent tutors (non-formal education teachers) coming, inappropriate teaching materials, etc. This research aimed to investigate the effects of picture story books on the…

Culture and Behavior in Hawaii: An Annotated Bibliography. Hawaii Series Number 3.

ERIC Educational Resources Information Center

Rubano, Judith, Comp.

The multi-ethnic character of the population of Hawaii has long attracted students of the behavioral sciences. Many of these scientists, and especially the visiting researchers, have encountered difficulty in obtaining or even locating literature specific to Hawaii and relevant to their fields of scientific interest. This bibliography is an effort…

The Electronic Library and the Online Classroom: A Technical, Legal, Ethical, and Moral Perspective.

ERIC Educational Resources Information Center

Latimore, Ritchie R.

This paper addresses online classroom and electronic library issues which include the myriad of technical difficulties encountered, along with physical and intellectual property rights. It also makes a statistical comparison of two proportions of Internet access between city and rural schools. An inescapable time lag between the introduction of…

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

ERIC Educational Resources Information Center

Shoemaker, Robert

2005-01-01

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

Teaching the First Law of Thermodynamics via Real-Life Examples

ERIC Educational Resources Information Center

Chang, Wheijen

2011-01-01

The literature has revealed that many students encounter substantial difficulties in applying the first law of thermodynamics. For example, university students sometimes fail to recognize that heat and work are independent means of energy transfer. When discussing adiabatic processes for an ideal gas, few students can correctly refer to the…

Tough Teens: The Methodological Challenges of Interviewing Teenagers as Research Participants

ERIC Educational Resources Information Center

Bassett, Raewyn; Beagan, Brenda L.; Ristovski-Slijepcevic, Svetlana; Chapman, Gwen E.

2008-01-01

Encouraging a teenager to have a conversation in a semistructured research interview is fraught with difficulties. The authors discuss the methodological challenges encountered when interviewing adolescents of European Canadian, African Canadian, and Punjabi Canadian families who took part in the Family Food Decision-Making Study in two regions of…

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

ERIC Educational Resources Information Center

Baytiyeh, Hoda; Naja, Mohamad

2012-01-01

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

Career and Workplace Experiences of Australian University Graduates Who Are Deaf or Hard of Hearing

ERIC Educational Resources Information Center

Punch, Renee; Hyde, Merv; Power, Des

2007-01-01

This article reports on the experiences of a group of deaf and hard-of-hearing alumni of Griffith University in south-east Queensland, Australia. Participants completed a survey answering questions about their communication patterns and preferences, working lives, career barriers or difficulties anticipated and encountered, and workplace…

The Tentative Nature of Scientific Knowledge: Why Should We Teach More about Diabetes Mellitus?

ERIC Educational Resources Information Center

Biermann, Carol A.

1993-01-01

Almost 70 years of scientific research leaves many unanswered questions concerning diabetes mellitus. This disease can be viewed as an illustration of the complexity of biological systems. Textbooks stress normal rather than abnormal physiology and rarely share the difficulties encountered in understanding those abnormal conditions (PR)

Minority Parents Should Know More about School Culture and Its Impact on Their Children's Education

ERIC Educational Resources Information Center

Vang, Christopher T.

2006-01-01

Many immigrant children encounter many difficulties and challenges in the public school. As a result, countless bilingual and limited-English-proficient students are lagging behind their peers. Minority students are labeled and treated differently from their classmates. Although equally capable, they are receiving a second-class education. The…

The Limits to Catholic Racial Liberalism: The Villanova Encounter with Race, 1940-1985

ERIC Educational Resources Information Center

Mogan, Thomas

2013-01-01

This dissertation examines the process of desegregation on the campus of a Catholic university in the North. Focusing on Villanova University during the period from 1940-1985, the narrative explores the tension between the University's public commitment to desegregation and the difficulties of implementing integration on a predominately white…

High-Five Fridays: (Mis)Trust-Building in One White Liberal Community

ERIC Educational Resources Information Center

Ives, Denise; Cammack, Camille

2017-01-01

The shocking election of President Donald Trump following a campaign characterized by hateful and divisive rhetoric has left many people fearful. In this essay the authors recount their story about the difficulties they encountered trying to disrupt the normalization of white experience through a local community policing initiative in their…

Plasma, The Fourth State of Matter

ERIC Educational Resources Information Center

Zandy, Hassan F.

1970-01-01

Discusses plasma as a source of energy through nuclear fission processes, as well as the difficulties encountered in such a process. States that 99 percent of the matter in the universe is plasma, and only 1 percent is the common three states of matter. Describes the fundamental properties of plasma, plasma "pinch, and plasma oscillations. (RR)

Processes Underlying Young Children's Spatial Orientation during Movement.

ERIC Educational Resources Information Center

Bremner, J. Gavin; And Others

1994-01-01

Tested children 18 months to 4 years for their ability to relocate a hidden object after self-produced movement around an array of 4 locations. Children encountered no specific difficulty in coordinating dimensions, or they solved the task without recourse to such a system. They also appeared to change strategy when the problem requires more…

A new method for teaching physical examination to junior medical students

PubMed Central

Sayma, Meelad; Williams, Hywel Rhys

2016-01-01

Introduction Teaching effective physical examination is a key component in the education of medical students. Preclinical medical students often have insufficient clinical knowledge to apply to physical examination recall, which may hinder their learning when taught through certain understanding-based models. This pilot project aimed to develop a method to teach physical examination to preclinical medical students using “core clinical cases”, overcoming the need for “rote” learning. Methods This project was developed utilizing three cycles of planning, action, and reflection. Thematic analysis of feedback was used to improve this model, and ensure it met student expectations. Results and discussion A model core clinical case developed in this project is described, with gout as the basis for a “foot and ankle” examination. Key limitations and difficulties encountered on implementation of this pilot are discussed for future users, including the difficulty encountered in “content overload”. Conclusion This approach aims to teach junior medical students physical examination through understanding, using a simulated patient environment. Robust research is now required to demonstrate efficacy and repeatability in the physical examination of other systems. PMID:26937208

Ability of Social Work Students to Determine the Appropriateness of Solutions to Problems Encountered in Social Work Practice.

ERIC Educational Resources Information Center

Sturges, Jack; Yarbrough, Roy D.

The purpose of this study was to determine whether there was an association between the amount of formal social work education completed and ability of students to judge the degree of appropriateness of proposed solutions to problems frequently encountered in social work practice, and secondarily to determine whether students' judgments of problem…

Mothers' Perceptions of Citizenship, Practices for Developing Citizenship Conscience of Their Children and Problems They Encountered

ERIC Educational Resources Information Center

Ersoy, A. Figen

2012-01-01

Family plays an important role in the development of citizenship awareness of children. The purpose of the present study is to figure out the citizenship perceptions of mothers, their practices for developing citizenship conscience of their children and to explore the problems they have encountered. In this study, critical case sampling method has…

Elucidating Article 45.6 of the International Code of Zoological Nomenclature: a dichotomous key for the determination of subspecific or infrasubspecific rank.

PubMed

Lingafelter, Steven W; Nearns, Eugenio H

2013-01-01

We present an overview of the difficulties sometimes encountered when determining whether a published name following a binomen is available or infrasubspecific and unavailable, following Article 45.6 of the International Code of Zoological Nomenclature (ICZN, 1999). We propose a dichotomous key that facilitates this determination and as a preferable method, given the convoluted and subordinate discussion, exceptions, and qualifications laid out in ICZN (1999: 49-50). Examples and citations are provided for each case one can encounter while making this assessment of availability status of names following the binomen.

A New Era of Science Education: Science Teachers' Perceptions and Classroom Practices of Science, Technology, Engineering, and Mathematics (STEM) Integration

NASA Astrophysics Data System (ADS)

Wang, Hui-Hui

Quality STEM education is the key in helping the United States maintain its lead in global competitiveness and in preparing for new economic and security challenges in the future. Policymakers and professional societies emphasize STEM education by legislating the addition of engineering standards to the existing science standards. On the other hand, the nature of the work of most STEM professionals requires people to actively apply STEM knowledge to make critical decisions. Therefore, using an integrated approach to teaching STEM in K-12 is expected. However, science teachers encounter numerous difficulties in adapting the new STEM integration reforms into their classrooms because of a lack of knowledge and experience. Therefore, high quality STEM integration professional development programs are an urgent necessity. In order to provide these high quality programs, it is important to understand teachers' perceptions and classroom practices regarding STEM integration. A multiple-case study was conducted with five secondary school science teachers in order to gain a better understanding of teachers' perceptions and classroom practices in using STEM integration. This study addresses the following research questions: 1) What are secondary school science teachers' practices of STEM integration? 2) What are secondary science teachers' overall perceptions of STEM integration? and 3) What is the connection between secondary science teachers' perceptions and understanding of STEM integration with their classroom practices? This research aims to explore teachers' perceptions and classroom practices in order to set up the baseline for STEM integration and also to determine STEM integration professional development best practices in science education. Findings from the study provide critical data for making informed decision about the direction for STEM integration in science education in K-12.

Evaluation of a novel, hybrid model (Mumbai EUS II) for stepwise teaching and training in EUS-guided biliary drainage and rendezvous procedures.

PubMed

Dhir, Vinay; Itoi, Takao; Pausawasdi, Nonthalee; Khashab, Mouen A; Perez-Miranda, Manuel; Sun, Siyu; Park, Do Hyun; Iwashita, Takuji; Teoh, Anthony Y B; Maydeo, Amit P; Ho, Khek Yu

2017-11-01

 EUS-guided biliary drainage (EUS-BD) and rendezvous (EUS-RV) are acceptable rescue options for patients with failed endoscopic retrograde cholangiopancreatography (ERCP). However, there are limited training opportunities at most centers owing to low case volumes. The existing models do not replicate the difficulties encountered during EUS-BD. We aimed to develop and validate a model for stepwise learning of EUS-BD and EUS-RV, which replicates the actual EUS-BD procedures.  A hybrid model was created utilizing pig esophagus and stomach, with a synthetic duodenum and biliary system. The model was objectively assessed on a grade of 1 - 4 by two experts. Twenty-eight trainees were given initial training with didactic lectures and live procedures. This was followed by hands-on training in EUS-BD and EUS-RV on the hybrid model. Trainees were assessed for objective criteria of technical difficulties.  Both the experts graded the model as very good or above for all parameters. All trainees could complete the requisite steps of EUS-BD and EUS-RV in a mean time of 11 minutes (8 - 18 minutes). Thirty-six technical difficulties were noted during the training (wrong scope position, 13; incorrect duct puncture, 12; guidewire related problems, 11). Technical difficulties peaked for EUS-RV, followed by hepaticogastrostomy (HGS) and choledochoduodenostomy (CDS) (20, 9, and 7, P  = 0.001). At 10 days follow-up, nine of 28 trainees had successfully performed three EUS-RV and seven EUS-BD procedures independently.  The Mumbai EUS II hybrid model replicates situations encountered during EUS-RV and EUS-BD. Stepwise mentoring improves the chances of success in EUS-RV and EUS-BD procedures.

Disrespect, harassment, and abuse: all in a day's work for family physicians.

PubMed

Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

2009-03-01

To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians from across the province. A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick's physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. Although the original intent of this study was to examine the work environment of family physicians in light of the increasing number of women entering the profession, harassment and abusive encounters in the workplace emerged as a main theme. These encounters ranged from minor to severe. Minor abusive encounters included disrespectful behaviour and verbal threats by patients, their families, and occasionally colleagues. More severe forms of harassment involved physical threats, physical encounters, and stalking. Demanding patients, such as heavy drug users, were often seen as threatening. Location of practice, years in practice, and sex of the physician seemed to affect abusive encounters--young, female, rural physicians appeared to experience such encounters most often. Abusive encounters in the workplace are concerning. It is essential to address these issues of workplace harassment and abuse in order to protect physician safety and avoid workplace dissatisfaction. Abusive encounters might push family physicians to leave clinical practice prematurely or refuse to work in higher-risk environments, such as emergency departments or rural areas.

[Aims and core contents of basic and post basic courses of nursing management].

PubMed

Saiani, Luisa; Brugnolli, Anna

2006-01-01

The second part of the issue, dedicated to the nursing management offers a discussion on some of the relevant areas of debate for the organization of nursing care. A reflection on the core contents and main aims of basic and post basic (master, advanced level, specialistic degree) nursing courses is proposed in the first contribution. Then a selection of topics is presented, focusing on the main research contributions available in the literature and on the ongoing debate for the following areas: the role of communication at the inter-shift handover and the new model of bedside reporting; the problems and challenges of doctors nurses collaboration in the health care team; the problems and expectations of new nurses joining the health care team and the process of development of practical skills; the hot debate on nursing roles and level of practice and the difficulties in differentiating between elementary, specialist and advanced nursing practice; the new emerging roles: the characteristics and achievements of Nurse Consultant; the new challenges of coordinators of the health care teams with the management of the multigenerational nursing team. For each topic a definition of the problem is presented, an example of relevant study, a critical debate and suggestions for further studies and areas of research. A list of the main journals that deal with nursing management is proposed with comments on the main characteristics of each journal. A study protocol that aims at describing the outcomes of the different styles and models of organization of medical wards on patients and nurses is presented as an example of organizative research; an experience of, and a model for, participation of the nurses to health policy planning is proposed. Nurses were, asked to identify health care problems encountered in their daily practice, their causes and propose solutions at basic and policy level. The session of International Observatory explores the main problems and difficulties of the research on the organization of care, focusing more on opportunities than on the challenges and drawbacks of the available literature.

Practices and representations of health education among primary school teachers.

PubMed

Jourdan, Didier; Pommier, Jeanine; Quidu, Frédérique

2010-02-01

School is one of the key settings for health education (HE). The objectives of this study are to assess primary school teachers' self-reported teaching practices in HE and to describe their representation concerning their role in HE. A quantitative study was conducted on a sample of primary school teachers (n = 626) in two French regions in order to analyze their practices and representations in HE. A hierarchical clustering dendogram was performed on questions exploring representations of HE. Multiple linear regression analysis helped explain the motivation and self-perceived competency score. Three quarters of the teachers declare they work in HE. Only one third of them declare they work in a comprehensive HE perspective. The HE approach is often considered in terms of specific unique curriculum intervention. Two thirds of the teachers say they work alone in HE, the other third associate other partners and choose mainly school health services. Parents are rarely (12%) involved in HE initiatives. It is essentially the practice of HE, teacher training and teachers' representation of HE that condition their motivation to develop HE. Teachers can take different approaches to HE. Teachers' representation of HE plays an important role in the development of HE activities: some teachers consider that HE is the mission of the health professionals and the parents. Our expectations of teacher involvement should be realistic, should take into account the representations of their role, the difficulties they encounter, and should be sustained by specific training.

Can incident reporting improve safety? Healthcare practitioners' views of the effectiveness of incident reporting.

PubMed

Anderson, Janet E; Kodate, Naonori; Walters, Rhiannon; Dodds, Anneliese

2013-04-01

Recent critiques of incident reporting suggest that its role in managing safety has been over emphasized. The objective of this study was to examine the perceived effectiveness of incident reporting in improving safety in mental health and acute hospital settings by asking staff about their perceptions and experiences. Qualitative research design using documentary analysis and semi-structured interviews. Two large teaching hospitals in London; one providing acute and the other mental healthcare. Sixty-two healthcare practitioners with experience of reporting and analysing incidents. Incident reporting was perceived as having a positive effect on safety, not only by leading to changes in care processes but also by changing staff attitudes and knowledge. Staff discussed examples of both instrumental and conceptual uses of the knowledge generated by incident reports. There are difficulties in using incident reports to improve safety in healthcare at all stages of the incident reporting process. Differences in the risks encountered and the organizational systems developed in the two hospitals to review reported incidents could be linked to the differences we found in attitudes to incident reporting between the two hospitals. Incident reporting can be a powerful tool for developing and maintaining an awareness of risks in healthcare practice. Using incident reports to improve care is challenging and the study highlighted the complexities involved and the difficulties faced by staff in learning from incident data.

Ad hoc supervision of general practice registrars as a 'community of practice': analysis, interpretation and re-presentation.

PubMed

Clement, T; Brown, J; Morrison, J; Nestel, D

2016-05-01

General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

Pharmacy users’ expectations of pharmacy encounters: a Q‐methodological study

PubMed Central

Renberg, Tobias; Wichman Törnqvist, Kristina; Kälvemark Sporrong, Sofia; Kettis Lindblad, Åsa; Tully, Mary P.

2010-01-01

Abstract Background  Pharmacy practice is evolving according to general health‐care trends such as increased patient involvement and public health initiatives. In addition, pharmacists strive to find new professional roles. Clients’ expectations of service encounters at pharmacies is an under‐explored topic but crucial to understanding how pharmacy practice can evolve efficiently. Objective  To identify and describe different normative expectations of the pharmacy encounter among pharmacy clients. Methods  Q methodology, an approach to systematically explore subjectivity that retains complete patterns of responses and organizes these into factors of operant subjectivity. Setting and participants  Eighty‐five regular prescription medication users recruited at Swedish community pharmacies and by snowballing. Results  Seven factors of operant subjectivity were identified, and organized into two groups. Factors that emphasized the physical drug product as the central object of the pharmacy encounter were labelled as independent drug shopping; logistics of drug distribution; and supply of individual’s own drugs. Factors that emphasized personal support as desirable were labelled competence as individual support; individualist professional relations, just take care of me; and practical health‐care and lifestyle support. Discussion and conclusions  The systematic Q‐methodological approach yielded valuable insights into how pharmacy clients construct their expectations for service encounters. They hold differentiating normative expectations for pharmacy services. Understanding these varying viewpoints may be important for developing and prioritizing among efficient pharmacy services. Clients’ expectations do not correspond with trends that guide current pharmacy practice development. This might be a challenge for promoting or implementing services based on such trends. PMID:21199199

Pharmacy users' expectations of pharmacy encounters: a Q-methodological study.

PubMed

Renberg, Tobias; Wichman Törnqvist, Kristina; Kälvemark Sporrong, Sofia; Kettis Lindblad, Asa; Tully, Mary P

2011-12-01

Pharmacy practice is evolving according to general health-care trends such as increased patient involvement and public health initiatives. In addition, pharmacists strive to find new professional roles. Clients' expectations of service encounters at pharmacies is an under-explored topic but crucial to understanding how pharmacy practice can evolve efficiently. To identify and describe different normative expectations of the pharmacy encounter among pharmacy clients. Q methodology, an approach to systematically explore subjectivity that retains complete patterns of responses and organizes these into factors of operant subjectivity. Eighty-five regular prescription medication users recruited at Swedish community pharmacies and by snowballing. Seven factors of operant subjectivity were identified, and organized into two groups. Factors that emphasized the physical drug product as the central object of the pharmacy encounter were labelled as independent drug shopping; logistics of drug distribution; and supply of individual's own drugs. Factors that emphasized personal support as desirable were labelled competence as individual support; individualist professional relations, just take care of me; and practical health-care and lifestyle support. The systematic Q-methodological approach yielded valuable insights into how pharmacy clients construct their expectations for service encounters. They hold differentiating normative expectations for pharmacy services. Understanding these varying viewpoints may be important for developing and prioritizing among efficient pharmacy services. Clients' expectations do not correspond with trends that guide current pharmacy practice development. This might be a challenge for promoting or implementing services based on such trends. © 2010 Blackwell Publishing Ltd.

Consequences of contextual factors on clinical reasoning in resident physicians.

PubMed

McBee, Elexis; Ratcliffe, Temple; Picho, Katherine; Artino, Anthony R; Schuwirth, Lambert; Kelly, William; Masel, Jennifer; van der Vleuten, Cees; Durning, Steven J

2015-12-01

Context specificity and the impact that contextual factors have on the complex process of clinical reasoning is poorly understood. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of resident physicians in order to describe what impact the presence of contextual factors have on their clinical reasoning. Participants viewed three video recorded clinical encounters portraying straightforward diagnoses in internal medicine with select patient contextual factors modified. After watching each video recording, participants completed a think-aloud protocol. Transcripts from the think-aloud protocols were analyzed using a constant comparative approach. After iterative coding, utterances were analyzed for emergent themes with utterances grouped into categories, themes and subthemes. Ten residents participated in the study with saturation reached during analysis. Participants universally acknowledged the presence of contextual factors in the video recordings. Four categories emerged as a consequence of the contextual factors: (1) emotional reactions (2) behavioral inferences (3) optimizing the doctor patient relationship and (4) difficulty with closure of the clinical encounter. The presence of contextual factors may impact clinical reasoning performance in resident physicians. When confronted with the presence of contextual factors in a clinical scenario, residents experienced difficulty with closure of the encounter, exhibited as diagnostic uncertainty. This finding raises important questions about the relationship between contextual factors and clinical reasoning activities and how this relationship might influence the cost effectiveness of care. This study also provides insight into how the phenomena of context specificity may be explained using situated cognition theory.

Putting informed and shared decision making into practice

PubMed Central

Towle, Angela; Godolphin, William; Grams, Garry; LaMarre, Amanda

2006-01-01

Abstract Objective  To investigate the practice, experiences and views of motivated and trained family physicians as they attempt to implement informed and shared decision making (ISDM) in routine practice and to identify and understand the barriers they encounter. Background  Patient involvement in decision making about their health care has been the focus of much academic activity. Although significant conceptual and experimental work has been done, ISDM rarely occurs. Physician attitudes and lack of training are identified barriers. Design  Qualitative analysis of transcripts of consultations and key informant group interviews. Settings and participants  Six family physicians received training in the ISDM competencies. Audiotapes of office consultations were made before and after training. Transcripts of consultations were examined to identify behavioural markers associated with each competency and the range of expression of the competencies. The physicians attended group interviews at the end of the study to explore experiences of ISDM. Results  The physicians liked the ISDM model and thought that they should put it into practice. Evidence from transcripts indicated they were able to elicit concerns, ideas and expectations (although not about management) and agree an action plan. They did not elicit preferences for role or information. They sometimes offered choices. They had difficulty achieving full expression of any of the competencies and integrating ISDM into their script for the medical interview. The study also identified a variety of competency‐specific barriers. Conclusion  A major barrier to the practice of ISDM by motivated physicians appears to be the need to change well‐established patterns of communication with patients. PMID:17083559

Impact of Evidence-Based Dentistry Workshops on Educators' Use of Evidence in Teaching and Practice: A Pilot Study.

PubMed

Moreira, Narjara C F; Leonardi-Dutra, Kamile; Feres, Murilo F N; Colangelo, Erica A M; Balevi, Ben; Matthews, Debora; Flores-Mir, Carlos

2018-06-01

The aims of this pilot study were to evaluate the short-term impact of evidence-based dentistry (EBD) workshops on educators' use of clinical evidence in their clinical practice and educational activities and to identify barriers they encountered in implementing evidence in their teaching and clinical practice. Between April 2012 and January 2014, a series of EBD workshops was delivered to 31 dental faculty members and postdoctoral students at three Canadian dental schools. Survey I, assessing participants' perceptions of various aspects of the workshops, was administered immediately following the workshops. Survey II, evaluating the impact of the workshops on participants' EBD implementation, was conducted 10 to 31 months after their completion. Survey I was completed by all 31 participants (100% response rate); their mean scores ranged from 3.94 to 4.65 on a five-point scale. Survey II was completed by 20 participants (64.5% response rate; five postdoctoral students and 15 faculty members), using an online 20-item questionnaire. Of the respondents, 19 (95%) reported implementing EBD in their professional activities at that time, and 14 (70%) stated that the workshops had positively helped with EBD implementation. Eight respondents (40%) reported having experienced barriers to EBD implementation, while 15 (75%) reported that their patients/students welcomed use of EBD. The respondents reported believing that strategies such as increasing EBD education and dissemination and improving quality and accessibility of evidence would facilitate the transition to EBD practice. Reported barriers to EBD implementation included resistance and criticism from colleagues, difficulty in changing current practice model, and lack of time.

[Usefulness and limitations of rapid automatized naming to predict reading difficulties after school entry in preschool children].

PubMed

Kaneko, Masato; Uno, Akira; Haruhara, Noriko; Awaya, Noriko

2012-01-01

We investigated the usability and limitations of Rapid Automatized Naming (RAN) results in 6-year-old Japanese preschool children to estimate whether reading difficulties will be encountered after school entry. We administered a RAN task to 1,001 preschool children. Then after they had entered school, we performed follow-up surveys yearly to assess their reading performance when these children were in the first, second, third and fourth grades. Also, we examined Hiragana non-words and Kanji words at each time point to detect the children who were having difficulty with reading Hiragana and Kanji. Results by Receiver Operating Characteristic analysis showed that the RAN result in 6-year-old preschool children was predictive of Kanji reading difficulty in the lower grades of elementary school, especially in the second grade with a probability of 0.86, and the area under the curve showed a probability of 0.84 in the third grade. These results suggested that the RAN task was useful as a screening tool.

Tracking the Stages of Learning: Concept Maps as Representations of Liminal Space

ERIC Educational Resources Information Center

Cuthell, John; Preston, Christina

2012-01-01

The concept of liminal space has recently been applied to ways of learning: the learning journey through this space encounters difficulties and misunderstandings, that are resolved as knowledge is mastered. Since 1992 the MirandaNet Fellowship, a growing international community of educators, has investigated the ways in which this relates to the…

Elucidating Article 45.6 of the International Code of Zoological Nomenclature: A dichotomous key for the determination of subspecific or infrasubspecific rank

USDA-ARS?s Scientific Manuscript database

We present an overview of the difficulties sometimes encountered when determining whether a published name following a binomen is available or infrasubspecific and unavailable, following Article 45.6 of the International Code of Zoological Nomenclature (ICZN, 1999). We propose a dichotomous key that...

Reducing Abstraction in High School Computer Science Education: The Case of Definition, Implementation, and Use of Abstract Data Types

ERIC Educational Resources Information Center

Sakhnini, Victoria; Hazzan, Orit

2008-01-01

The research presented in this article deals with the difficulties and mental processes involved in the definition, implementation, and use of abstract data types encountered by 12th grade advanced-level computer science students. Research findings are interpreted within the theoretical framework of "reducing abstraction" [Hazzan 1999]. The…

University Undergraduate Science Students' Validation and Comprehension of Written Proof in the Context of Infinite Series

ERIC Educational Resources Information Center

Moru, Eunice Kolitsoe; Nchejane, John; Ramollo, Motlatsi; Rammea, Lisema

2017-01-01

The reported study explored undergraduate science students' validation and comprehension of written proofs, reasons given either to accept or reject mathematical procedures employed in the proofs, and the difficulties students encountered in reading the proofs. The proofs were constructed using both the Comparison and the Integral tests in the…

The "Dance" of Communication: Counseling Families and Children with Asperger's Syndrome

ERIC Educational Resources Information Center

Lozzi-Toscano, Bettina

2004-01-01

Counselors are trained to deal with many issues within the realm of human experience; many specialize in helping families cope with a variety of internal and external stressors. However, counselors are seldom given all the tools to handle the myriad possible difficulties families may encounter. When counselors are asked to help families cope with…

Very Early Signs of Autism Reported by Parents Include Many Concerns Not Specific to Autism Criteria

ERIC Educational Resources Information Center

Guinchat, Vincent; Chamak, Brigitte; Bonniau, Beatrice; Bodeau, Nicolas; Perisse, Didier; Cohen, David; Danion, Anne

2012-01-01

This study assessed parents' first concerns about their autistic child. This information was categorized so that it could help healthcare professionals improve early detection of autism. We designed a questionnaire using an open-ended format, and 459 questionnaires were completed by parents to assess difficulties encountered in obtaining a…

More Fun and Curiosity with Magnetic Guns in the Classroom

ERIC Educational Resources Information Center

Chittasirinuwat, O.; Kruatong, T.; Paosawatyanyong, B.

2011-01-01

The magnetic gun was chosen as a hands-on activity for our high school students. When conducting this activity in the classroom, we found some interesting points were raised following difficulties encountered by the students. Some students proposed that during the collision, the magnet changed its pole then it pushed the last ball out of the…

About the Concept of Angle in Elementary School: Misconceptions and Teaching Sequences

ERIC Educational Resources Information Center

Devichi, Claude; Munier, Valerie

2013-01-01

This paper reports classroom research dealing with the difficulties encountered by schoolchildren in the acquisition of angle concept. Two obstacles were pointed out in previous studies: the side-length obstacle and the salience of the prototypical right angle. The first aim of the present study is to determine the extent to which a teaching…