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

ERIC Educational Resources Information Center

Papadiamantaki, Yiouli

2014-01-01

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

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

ERIC Educational Resources Information Center

Aydogdu, Cemil

2017-01-01

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

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

ERIC Educational Resources Information Center

Crossman, Joanna; Bordia, Sarbari

2012-01-01

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

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

ERIC Educational Resources Information Center

Salem, Boshra B.

2012-01-01

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

Lessons Learnt from Past Incidents and Accidents in Radiation Oncology.

PubMed

Knöös, T

2017-09-01

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

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

Treesearch

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

2016-01-01

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

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

ERIC Educational Resources Information Center

Lord, Beverley

2011-01-01

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

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

PubMed

Uth, Hans-Joachim; Wiese, Norbert

2004-07-26

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

Social media campaigns that make a difference: what can public health learn from the corporate sector and other social change marketers?

PubMed

Freeman, Becky; Potente, Sofia; Rock, Vanessa; McIver, Jacqueline

2015-03-30

A great deal of enthusiasm and interest exists in using social media for public health communications, but few research studies have examined its success in promoting and adopting protective health behaviours. To begin to understand how best to develop effective online social marketing campaigns, this paper provides a summary of success factors and key lessons learnt from selected social media campaign case studies. Case study review Methods: A selection of case studies was reviewed for lessons in campaign development, delivery and evaluation from both the corporate and public health sectors. Information about the objective of the campaign, the tactics used and the lessons learnt was extracted from each case study. Lessons learnt from across the case studies were then sorted according to themes. Lessons from the nine case studies selected were categorised into eight themes: planning, use of social media tools, community, content, personal benefits, promotion, costs and challenges. Outcome evaluation data were lacking in the case studies. Overall, the nine case studies show that social media hold promise in changing user behaviours and that social media are highly effective in recruiting participants and motivating them to take small, concrete actions. The case studies also demonstrate that there is room in social media for targeted, inexpensive, small-scale projects, as well as large, well-funded, mass-reach marketing blitzes. Social media campaign process and impact evaluation measures are readily available. Outcome evaluation models and measures are needed to better assess the effectiveness of social media campaigns in changing health behaviours.

The assessment of professional competence: building blocks for theory development.

PubMed

van der Vleuten, C P M; Schuwirth, L W T; Scheele, F; Driessen, E W; Hodges, B

2010-12-01

This article presents lessons learnt from experiences with assessment of professional competence. Based on Miller's pyramid, a distinction is made between established assessment technology for assessing 'knows', 'knowing how' and 'showing how' and more recent developments in the assessment of (clinical) performance at the 'does' level. Some general lessons are derived from research of and experiences with the established assessment technology. Here, many paradoxes are revealed and empirical outcomes are often counterintuitive. Instruments for assessing the 'does' level are classified and described, and additional general lessons for this area of performance assessment are derived. These lessons can also be read as general principles of assessment (programmes) and may provide theoretical building blocks to underpin appropriate and state-of-the-art assessment practices. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

PubMed

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

2007-01-01

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

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

PubMed Central

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

2007-01-01

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

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

ERIC Educational Resources Information Center

Aziato, Lydia

2015-01-01

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

Applying Real-Time UML: Real-World Experiences

NASA Astrophysics Data System (ADS)

Cooling, Niall; Pachschwoell, Stefan

2004-06-01

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

Modern military surgery: lessons from Iraq and Afghanistan.

PubMed

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

2012-04-01

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

Reflections on Pedagogy: A Journey of Collaboration

ERIC Educational Resources Information Center

Woods, Christine

2011-01-01

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

Learning from Hong Kong Alumni: Lessons for School Leadership

ERIC Educational Resources Information Center

Jabal, Eric

2006-01-01

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

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

PubMed

Fakhri, Ali; Harris, Patrick; Maleki, Mohammadreza

2016-12-01

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

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

NASA Astrophysics Data System (ADS)

Cabello, Angels; Velasco, Marc; Escaler, Isabel

2010-05-01

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

Taking Stock

ERIC Educational Resources Information Center

Wykes, James

1970-01-01

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

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Affordance, Learning Opportunities, and the Lesson Plan Pro Forma

ERIC Educational Resources Information Center

Anderson, Jason

2015-01-01

This article argues that the most commonly used lesson plan pro formas in language teacher education are inappropriately premised on an outcomes-based approach to teaching, one that is in conflict with what we know about how languages are learnt and how experienced teachers teach. It proposes an alternative, affordance-based approach to lesson…

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

PubMed

Frantz, J M; Rhoda, A J

2017-03-01

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

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

PubMed

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

2017-10-01

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

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

PubMed

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

2014-01-01

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

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

NASA Astrophysics Data System (ADS)

Treves, R.

2013-12-01

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

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

PubMed

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

2006-04-01

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

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

PubMed

Kunwar, R; Prakash, R

2015-01-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-02-01

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

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

PubMed Central

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

2006-01-01

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

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

PubMed

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

2010-04-01

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

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

PubMed

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

2018-01-01

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

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2017-09-04

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

Preparing for Citizenship: Bring Back John Dewey

ERIC Educational Resources Information Center

Pring, Richard

2016-01-01

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

A MAPPING BASED ON PHYSICO-CHEMICAL FEATURES: LESSONS LEARNT

EPA Science Inventory

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

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

PubMed

Srinivas, Hari; Nakagawa, Yuko

2008-10-01

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

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

PubMed

Bridgman, S A

1999-06-01

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

Benchmarking neuromorphic vision: lessons learnt from computer vision

PubMed Central

Tan, Cheston; Lallee, Stephane; Orchard, Garrick

2015-01-01

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

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

PubMed

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

2016-08-01

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

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

PubMed Central

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

2017-01-01

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

Results and lessons from the GMOS survey of transiting exoplanet atmospheres

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

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

PubMed

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

2013-12-01

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

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

ERIC Educational Resources Information Center

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

2012-01-01

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

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

PubMed

Lopez, Dahianna S; Hemenway, David

2017-08-03

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

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

NASA Astrophysics Data System (ADS)

Xian, Deling

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

Helium refrigerator maintenance and reliability at the OPAL cold neutron source

NASA Astrophysics Data System (ADS)

Thiering, Russell; Taylor, David; Lu, Weijian

2012-06-01

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

The ALMA OT in early science: supporting multiple customers

NASA Astrophysics Data System (ADS)

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

2012-09-01

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

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

ERIC Educational Resources Information Center

Griffiths, Paul; Arenas, Teresita

2014-01-01

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

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

ERIC Educational Resources Information Center

Menkhoff, Thomas; Bengtsson, Magnus Lars

2012-01-01

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

Recognising the Effects of Costing Assumptions in Educational Business Simulation Games

ERIC Educational Resources Information Center

Eckardt, Gordon; Selen, Willem; Wynder, Monte

2015-01-01

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

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

ERIC Educational Resources Information Center

Puukka, Jaana; Marmolejo, Francisco

2008-01-01

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

An Institution in Search of Excellence: Lessons Learnt

ERIC Educational Resources Information Center

Hashim, Fatimah; Awang, Halimah

2005-01-01

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

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

ERIC Educational Resources Information Center

Despujol, Ignacio; Castaneda, Linda; Turro, Carlos

2018-01-01

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

Student Reflection and Learning through Peer Reviews

ERIC Educational Resources Information Center

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

2013-01-01

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

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

PubMed

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

2013-09-01

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

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

PubMed

2005-01-01

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

Restoring Forest Landscapes: Important Lessons Learnt

NASA Astrophysics Data System (ADS)

Mansourian, Stephanie; Vallauri, Daniel

2014-02-01

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

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

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

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

PubMed

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

2012-08-31

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

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

PubMed

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

2015-05-01

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

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

ERIC Educational Resources Information Center

Wilson, Fran; Keys, Jacki

2004-01-01

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

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

ERIC Educational Resources Information Center

Ali, Nazlena Mohamad; Smeaton, Alan F.

2011-01-01

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

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

ERIC Educational Resources Information Center

Maheshwari, B.

2011-01-01

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

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

ERIC Educational Resources Information Center

Fukahori, Satoko

2014-01-01

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

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

PubMed Central

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

2016-01-01

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

Lessons Learnt from a Secondary School Sex Education Program in Portugal

ERIC Educational Resources Information Center

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

2007-01-01

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

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

ERIC Educational Resources Information Center

Çer, Erkan; Solak, Ekrem

2018-01-01

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

Stroke Units: The Implementation of a Complex Intervention

ERIC Educational Resources Information Center

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

2005-01-01

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

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

ERIC Educational Resources Information Center

Oakley, Grace; Pegrum, Mark; Johnston, Shannon

2014-01-01

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

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

ERIC Educational Resources Information Center

Crawford, Megan

2007-01-01

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

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

ERIC Educational Resources Information Center

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

2014-01-01

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

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

ERIC Educational Resources Information Center

Jantjies, Mmaki; Joy, Mike

2016-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2012-07-01

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

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

ERIC Educational Resources Information Center

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

2005-01-01

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

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

ERIC Educational Resources Information Center

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

2016-01-01

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

Ecological Education: What Resources Are There in Confucian Ethics?

ERIC Educational Resources Information Center

Nuyen, Anh Tuan

2008-01-01

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

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

ERIC Educational Resources Information Center

Tsui, Eric; Sabetzadeh, Farzad

2014-01-01

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

School-Based Professional Development in a Developing Context: Lessons Learnt from a Case Study in Zambia

ERIC Educational Resources Information Center

Haßler, Björn; Hennessy, Sara; Cross, Andrew; Chileshe, Eness; Machiko, Brian

2015-01-01

This paper reports on the development and outcomes of the second phase of OER4Schools, a school-based professional development programme supporting interactive forms of subject teaching in conjunction with Open Educational Resources (OER) and technology in Zambian primary schools. We worked with partners to identify the needs of school-based…

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

ERIC Educational Resources Information Center

Bennett, Robert J.

1994-01-01

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

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

ERIC Educational Resources Information Center

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

2016-01-01

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

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

ERIC Educational Resources Information Center

Fadeeva, Zinaida; Mochizuki, Yoko

2010-01-01

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

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

ERIC Educational Resources Information Center

Hill, Christopher; Thabet, Rawy Abdelrahman

2018-01-01

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

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

ERIC Educational Resources Information Center

Woolfe, Jennifer; Stockley, Lynn

2005-01-01

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

Polio Eradication–Lessons from the Past and Future Perspective

PubMed Central

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

2014-01-01

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

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

PubMed

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

2005-09-01

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

Art and theatre for health in rural Cambodia.

PubMed

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

2018-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

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

PubMed Central

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

2015-01-01

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

Lessons learnt from the Climate Dialogue initiative

NASA Astrophysics Data System (ADS)

Crok, Marcel; Strengers, Bart; Vasileiadou, Eleftheria

2015-04-01

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

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

PubMed

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

[Lessons from a heart valve prosthesis controversy].

PubMed

Vandenbroucke, J P; Grobbee, D E

1998-07-18

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

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

ERIC Educational Resources Information Center

Qhobela, Makomosela

2012-01-01

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

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

ERIC Educational Resources Information Center

Muftau, Rufai

2016-01-01

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

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

ERIC Educational Resources Information Center

Baines, Ed; Blatchford, Peter; Webster, Rob

2015-01-01

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

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

ERIC Educational Resources Information Center

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

2015-01-01

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

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

ERIC Educational Resources Information Center

Cramer, Hendrik; Dewulf, Geert; Voordijk, Hans

2015-01-01

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

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

ERIC Educational Resources Information Center

Akyeampong, Kwame

2014-01-01

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

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

ERIC Educational Resources Information Center

Alex, Jogymol Kalariparambil; Mammen, Kuttickattu John

2016-01-01

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

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

DTIC Science & Technology

2004-12-01

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

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

ERIC Educational Resources Information Center

Wright, Chris

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

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

ERIC Educational Resources Information Center

Carneiro, Roberto, Ed.

2011-01-01

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

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

ERIC Educational Resources Information Center

Sprlak, Tomas

2016-01-01

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

Lessons from natural and artificial polyploids in higher plants.

PubMed

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

2013-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2004-12-01

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

Preliminary Evaluation Of Commercial Supercapacitors For Space Applications

NASA Astrophysics Data System (ADS)

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

2011-10-01

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

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

PubMed

Cittolin, Sergio

2012-02-28

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

Tracheal agenesis in a new born: lessons learnt.

PubMed

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

2018-06-17

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

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

PubMed

Petersson, Fredrik; Murugasu, Euan

2014-06-01

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

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

PubMed

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

2003-01-01

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

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

PubMed Central

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

2003-01-01

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

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Early interventions and lessons from Harvard Business Review.

PubMed

Chong, Siow-Ann

2007-11-01

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

Students' Experience of Working with Socioscientific Issues - a Quantitative Study in Secondary School

NASA Astrophysics Data System (ADS)

Ottander, Christina; Ekborg, Margareta

2012-12-01

This research project aims to investigate how students in lower secondary school experience work with socioscientific issues (SSI). The six socioscientific cases developed and used in this project are relevant according to characteristics of SSI and to the national curriculum. Approximately 1,500 students in Sweden have worked with one SSI case chosen by the teachers. A questionnaire-based instrument was used to measure the affective domain of students' attitudes towards and interest in science before starting to work with the case and a second questionnaire after finishing a case. The second student questionnaire, measured the situational characteristics of the SSI work and perceived cognitive and affective outcomes. According to the students' self-reported experience, all cases were interesting and related to a current issue. Most cases were equally interesting to boys and girls, the only exception was You are what you eat, which girls found more interesting than boys did. Almost all students claim that they learnt new facts, learnt to argue for their standpoint and to search and evaluate information during the work with the cases. The girls' average scores were higher on several aspects of learning outcomes. Furthermore the students, especially the girls, perceived that the outcome of working with SSI had relevance for their future, with some cases more relevant than others. The more interesting the student found the case, the more they claimed they learnt. The students do not, however, claim that they learnt more science than during ordinary lessons.

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

PubMed Central

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

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

ERIC Educational Resources Information Center

Hardy, Alison

2015-01-01

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

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

PubMed

Hoggart, Lesley

2018-05-21

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

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

NASA Astrophysics Data System (ADS)

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

2010-09-01

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

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

DOE PAGES

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

2014-03-21

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

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

PubMed

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

2013-05-01

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

Surgical adverse outcome reporting as part of routine clinical care.

PubMed

Kievit, J; Krukerink, M; Marang-van de Mheen, P J

2010-12-01

In The Netherlands, health professionals have created a doctor-driven standardised system to report and analyse adverse outcomes (AO). The aim is to improve healthcare by learning from past experiences. The key elements of this system are (1) an unequivocal definition of an adverse outcome, (2) appropriate contextual information and (3) a three-dimensional hierarchical classification system. First, to assess whether routine doctor-driven AO reporting is feasible. Second, to investigate how doctors can learn from AO reporting and analysis to improve the quality of care. Feasibility was assessed by how well doctors reported AO in the surgical department of a Dutch university hospital over a period of 9 years. AO incidence was analysed per patient subgroup and over time, in a time-trend analysis of three equal 3-year periods. AO were analysed case by case and statistically, to learn lessons from past events. In 19,907 surgical admissions, 9189 AOs were reported: one or more AO in 18.2% of admissions. On average, 55 lessons were learnt each year (in 4.3% of AO). More AO were reported in P3 than P1 (OR 1.39 (1.23-1.57)). Although minor AO increased, fatal AO decreased over time (OR 0.59 (0.45-0.77)). Doctor-driven AO reporting is shown to be feasible. Lessons can be learnt from case-by-case analyses of individual AO, as well as by statistical analysis of AO groups and subgroups (illustrated by time-trend analysis), thus contributing to the improvement of the quality of care. Moreover, by standardising AO reporting, data can be compared across departments or hospitals, to generate (confidential) mirror information for professionals cooperating in a peer-review setting.

Surgical adverse outcome reporting as part of routine clinical care

PubMed Central

Krukerink, M; Marang-van de Mheen, P J

2010-01-01

Background In The Netherlands, health professionals have created a doctor-driven standardised system to report and analyse adverse outcomes (AO). The aim is to improve healthcare by learning from past experiences. The key elements of this system are (1) an unequivocal definition of an adverse outcome, (2) appropriate contextual information and (3) a three-dimensional hierarchical classification system. Objectives First, to assess whether routine doctor-driven AO reporting is feasible. Second, to investigate how doctors can learn from AO reporting and analysis to improve the quality of care. Methods Feasibility was assessed by how well doctors reported AO in the surgical department of a Dutch university hospital over a period of 9 years. AO incidence was analysed per patient subgroup and over time, in a time-trend analysis of three equal 3-year periods. AO were analysed case by case and statistically, to learn lessons from past events. Results In 19 907 surgical admissions, 9189 AOs were reported: one or more AO in 18.2% of admissions. On average, 55 lessons were learnt each year (in 4.3% of AO). More AO were reported in P3 than P1 (OR 1.39 (1.23–1.57)). Although minor AO increased, fatal AO decreased over time (OR 0.59 (0.45–0.77)). Conclusions Doctor-driven AO reporting is shown to be feasible. Lessons can be learnt from case-by-case analyses of individual AO, as well as by statistical analysis of AO groups and subgroups (illustrated by time-trend analysis), thus contributing to the improvement of the quality of care. Moreover, by standardising AO reporting, data can be compared across departments or hospitals, to generate (confidential) mirror information for professionals cooperating in a peer-review setting. PMID:20430928

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

NASA Astrophysics Data System (ADS)

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

2014-06-01

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

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

PubMed

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

2016-01-01

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

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

PubMed

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

2016-04-01

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

Public health in transition: views of the specialist workforce.

PubMed

Griffiths, Sian; Thorpe, Allison

2007-09-01

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

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

PubMed

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

2004-12-01

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

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

NASA Astrophysics Data System (ADS)

Sinthuwa, Waralee; Sangpradit, Theerapong

2018-01-01

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

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

NASA Technical Reports Server (NTRS)

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

Assessing the value of real-time snow and avalanche information

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2017-10-01

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

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

DTIC Science & Technology

2008-01-01

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

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

PubMed

Shrimanker, Rahul; Pavord, Ian D

2017-04-01

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

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

PubMed

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

2015-04-28

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

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

PubMed

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

2015-08-15

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

Mobile clinics for antiretroviral therapy in rural Mozambique

PubMed Central

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

2014-01-01

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

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

PubMed

Mudumbai, Seshadri C

2016-01-01

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

Incorporating Semantics into Data Driven Workflows for Content Based Analysis

NASA Astrophysics Data System (ADS)

Argüello, M.; Fernandez-Prieto, M. J.

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

CERNBox + EOS: end-user storage for science

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

Cardiomed System for Medical Monitoring Onboard ISS

NASA Astrophysics Data System (ADS)

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

2008-06-01

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

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

NASA Astrophysics Data System (ADS)

Stamatelos, A. M.

2010-06-01

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

Impact of a mental health teaching programme on adolescents.

PubMed

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

2009-04-01

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

Surfing pathogens and the lessons learned for actin polymerization.

PubMed

Frischknecht, F; Way, M

2001-01-01

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

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

PubMed

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

2014-01-21

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

From LPF to eLISA: new approach in payload software

NASA Astrophysics Data System (ADS)

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

2017-05-01

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

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

PubMed

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

2016-08-04

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

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

NASA Astrophysics Data System (ADS)

Cutter, Mike; Lobb, Dan

2017-11-01

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

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

PubMed

Bunyan, Kate

2011-01-01

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

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

PubMed

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

2014-10-03

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

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

PubMed Central

2013-01-01

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

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

PubMed

Wilder-Smith, Annelies

2006-03-01

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

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

PubMed

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

2015-03-01

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

Preparing medical students for clinical practice: easing the transition.

PubMed

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

2017-08-01

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

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

PubMed

Chan, Dorothy N S; So, Winnie K W

2016-11-01

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

Nursing shaping and influencing health and social care policy.

PubMed

Fyffe, Theresa

2009-09-01

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

Species coexistence in a changing world

PubMed Central

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

2015-01-01

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

Species coexistence in a changing world.

PubMed

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

2015-01-01

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

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

PubMed

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

2016-02-01

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

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

PubMed Central

Vineis, Paolo

2015-01-01

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

The lessons of SARS in Hong Kong.

PubMed

Lai, Thomas Sik To; Yu, Wai Cho

2010-02-01

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

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

PubMed

Silcocks, P; Needham, P; Hemsley, F

1999-07-01

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

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

PubMed Central

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

2015-01-01

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

Drug discovery: lessons from evolution

PubMed Central

Warren, John

2011-01-01

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

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

PubMed

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

2009-04-01

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

The burden of disease and injury in Australia.

PubMed Central

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

2001-01-01

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

Fetal stem cell transplantation: Past, present, and future

PubMed Central

Ishii, Tetsuya; Eto, Koji

2014-01-01

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

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

PubMed

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

2009-12-01

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

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

DOE PAGES

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

2012-12-01

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

Social and ethical issues in environmental risk management.

PubMed

Oughton, Deborah H

2011-07-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

The evolution of the simulation environment in the ALMA Observatory

NASA Astrophysics Data System (ADS)

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

2016-07-01

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

Learning from the Mexico City Earthquake in 1985

NASA Astrophysics Data System (ADS)

Santos-Reyes, Jaime; Alvarado-Corona, Rafael

2010-05-01

Natural disasters are increasing alarmingly worldwide in recent years. They have killed millions of people, and adversely affected the life of at least one billion people. Given this, natural disasters present a great challenge to society today concerning how they are to be mitigated so as to produce an acceptable risk is a question which has come to the fore in dramatic ways recently. The paper addresses the following question: what could be learnt from natural disasters? The paper presents some preliminary results of the analysis of the Mexico City earthquake in 1985, by applying the Management Oversight Risk Tree (MORT) model. On September 19, 1985, at 7:19 hrs local time an intense earthquake with a magnitude of 8.1 on the Richter scale struck the country. The epicentre was located near the coast of the state of Guerrero, about 400 kilometres southeast of Mexico City. It is believed that thousands of people were affected and more than 10000 people were killed by the earthquake. On the other hand, the MORT model may be regarded as a structured checklist in the form of a complex ‘fault-tree' model that is intended to ensure that all aspects of an organization's management are looked into when assessing the possible causes of an incident. Moreover, the MORT has been applied extensively to the analysis of past failure of socio-technical systems; this is the first time that it has been applied to the case of natural disasters. A number of organizational failures have been highlighted by the model. It is hoped that by conducting such analysis lessons can be learnt and disseminated so that the impact of natural disasters such as Earthquakes can be mitigated in the future.

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

PubMed

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

2015-01-01

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

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

PubMed

Ramareddy, Raghu Sampalli; Alladi, Anand

2016-01-01

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

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

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

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

"Estuaries and coasts" CLIL* lesson plans in English and geology fieldtrip to Cornwall for students in European section

NASA Astrophysics Data System (ADS)

Bontempelli, Nathalie; Voyer, Karine; Lebourgeois, Patrick

2013-04-01

When the European section was created in our high school we had to choose an overarching theme. After considering that we live both in the River Seine estuary and near the English Channel it became obvious that our theme should be "estuaries and coasts". We began the 2012-2013 school year with a day-trip around the River Seine estuary to introduce the theme. First we made a general landscape study from a viewpoint, then we discussed the history of the navigation on the Seine, of local farming on marshland and finally we focused on farmhouse architecture. To conclude we visited the natural reserve near the "Normandy Bridge". As an introduction our poster aims at presenting this part of Normandy. And then we would like to show some examples of our CLIL lesson plans about this chosen topic. The aim of a CLIL lesson is to create interactive speaking between students working in pairs or in groups. There are three different stages: - Warm-up activities - In-depth study: listening, reading, echoing, looking for information on the internet, making a slide show and doing an oral presentation, participating to a role play… - Assessment : using what has been learnt to answer questions Finally we wish to present our field trip to Cornwall. We have already done it twice before (in 2002 and 2004) and this year it is scheduled in May 2013 with our European section students. The aim of this trip is to study geology and botany in English in order to extend what we teach in our CLIL lessons about estuaries and coasts. It also helps promoting exchanges with British families and building intercultural knowledge and understanding. Our program includes for example, fossil hunting and studying the Jurassic cliffs in Charmouth, observing an old ocean crust in Coverack, visiting Saint-Mickael's mount, discovering a tin mine in Geevor, walking through the "Lost Gardens of Heligan" and thus discovering an example of this world-renowned restored English garden, and last but not least having an overview of the biodiversity in the Lizard peninsula. *(Content and Language Integrated Learning)

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

PubMed Central

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

2010-01-01

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

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

PubMed

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

2015-08-01

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

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2014-06-16

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

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

NASA Astrophysics Data System (ADS)

Wu, N.; Zhang, X.

2015-08-01

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

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

PubMed

Middleton, Warwick; Higson, David

2004-12-01

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

Challenges presented by MERS corona virus, and SARS corona virus to global health.

PubMed

Al-Hazmi, Ali

2016-07-01

Numerous viral infections have arisen and affected global healthcare facilities. Millions of people are at severe risk of acquiring several evolving viral infections through several factors. In the present article we have described about risk factors, chance of infection, and prevention methods of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV), human coronaviruses (CoVs) frequently cause a normal cold which is mild and self-restricting. Zoonotic transmission of CoVs such as the newly discovered MERS-CoV and SARS-CoV, may be associated with severe lower respiratory tract infection. The present review provides the recent clinical and pathological information on MERS and SARS. The task is to transform these discoveries about MERS and SARS pathogenesis and to develop intervention methods that will eventually allow the effective control of these recently arising severe viral infections. Global health sector has learnt many lessons through the recent outbreak of MERS and SARS, but the need for identifying new antiviral treatment was not learned. In the present article we have reviewed the literature on the several facets like transmission, precautions and effectiveness of treatments used in patients with MERS-CoV and SARS infections.

Water management in Angkor: human impacts on hydrology and sediment transportation.

PubMed

Kummu, Matti

2009-03-01

The city of Angkor, capital of the Khmer empire from the 9th to 15th century CE, is well known for its impressive temples, but recent research has uncovered an extensive channel network stretching across over 1000 km2. The channel network with large reservoirs (termed baray) formed the structure of the city and was the basis for its water management. The annual long dry season associated with the monsoon climate has challenged water management for centuries, and the extensive water management system must have played an important role in the mitigation of such marked seasonality. However, by changing the natural water courses with off-take channels the original catchments were also reshaped. Moreover, severe problems of erosion and sedimentation in human built channels evolved and impacted on the whole water management system. This paper describes the present hydrology of the area and discusses the impacts of water management on hydrology during the Angkor era. The paper, moreover, attempts to summarise lessons that could be learnt from Angkorian water management that might apply to present challenges within the field.

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

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

Biomedical research in a Digital Health Framework

PubMed Central

2014-01-01

This article describes a Digital Health Framework (DHF), benefitting from the lessons learnt during the three-year life span of the FP7 Synergy-COPD project. The DHF aims to embrace the emerging requirements - data and tools - of applying systems medicine into healthcare with a three-tier strategy articulating formal healthcare, informal care and biomedical research. Accordingly, it has been constructed based on three key building blocks, namely, novel integrated care services with the support of information and communication technologies, a personal health folder (PHF) and a biomedical research environment (DHF-research). Details on the functional requirements and necessary components of the DHF-research are extensively presented. Finally, the specifics of the building blocks strategy for deployment of the DHF, as well as the steps toward adoption are analyzed. The proposed architectural solutions and implementation steps constitute a pivotal strategy to foster and enable 4P medicine (Predictive, Preventive, Personalized and Participatory) in practice and should provide a head start to any community and institution currently considering to implement a biomedical research platform. PMID:25472554

The Robust Software Feedback Model: An Effective Waterfall Model Tailoring for Space SW

NASA Astrophysics Data System (ADS)

Tipaldi, Massimo; Gotz, Christoph; Ferraguto, Massimo; Troiano, Luigi; Bruenjes, Bernhard

2013-08-01

The selection of the most suitable software life cycle process is of paramount importance in any space SW project. Despite being the preferred choice, the waterfall model is often exposed to some criticism. As matter of fact, its main assumption of moving to a phase only when the preceding one is completed and perfected (and under the demanding SW schedule constraints) is not easily attainable. In this paper, a tailoring of the software waterfall model (named “Robust Software Feedback Model”) is presented. The proposed methodology sorts out these issues by combining a SW waterfall model with a SW prototyping approach. The former is aligned with the SW main production line and is based on the full ECSS-E-ST-40C life-cycle reviews, whereas the latter is carried out in advance versus the main SW streamline (so as to inject its lessons learnt into the main streamline) and is based on a lightweight approach.

Nanomanufacturing and sustainability: opportunities and challenges

NASA Astrophysics Data System (ADS)

Busnaina, Ahmed A.; Mead, Joey; Isaacs, Jacqueline; Somu, Sivasubramanian

2013-10-01

New nanomanufacturing technologies, although still in research labs, present a great opportunity to drastically reduce the cost of making nanostructures on a large scale and at high-rates. Such new bottom-up directed assembly-based approaches involve adding materials selectively thereby both reducing waste and the number of required processes. Directed assembly-based processes are conducted at room pressure and temperatures which significantly reduces the cost of nanomanufacturing equipment and tools, ensuring long-term sustainability by reducing energy, consumables, and waste costs. This paradigm shift in nanomanufacturing will unleash not only a wave of creativity in sustainable nanomanufacturing but lessons learnt along the way can be used in various other sectors. Along with the exquisite technological promise that nanotechnology holds, nano-enabled products are heralded as a means for energy and resource reduction, resulting in potential manufacturing cost reductions and further, for potential improvements to environmental remediation. Sustainable nanomanufacturing will, by dramatically lowering current nanomanufacturing barriers, spur innovation, and the creation of entirely new industries by leveling the playing and ultimately leading to the democratization of nanomanufacturing.

Is naturalistic driving research possible with highly instrumented cars? Lessons learnt in three research centres.

PubMed

Valero-Mora, Pedro M; Tontsch, Anita; Welsh, Ruth; Morris, Andrew; Reed, Steven; Touliou, Katerina; Margaritis, Dimitris

2013-09-01

This paper provides an overview of the experiences using Highly Instrumented Cars (HICs) in three research Centres across Europe; Spain, the UK and Greece. The data collection capability of each car is described and an overview presented relating to the relationship between the level of instrumentation and the research possible. A discussion then follows which considers the advantages and disadvantages of using HICs for ND research. This includes the obtrusive nature of the data collection equipment, the cost of equipping the vehicles with sophisticated Data Acquisition Systems (DAS) and the challenges for data storage and analysis particularly with respect to video data. It is concluded that the use of HICs substantially increases the depth of knowledge relating to the driver's behaviour and their interaction with the vehicle and surroundings. With careful study design and integration into larger studies with Low(ly) instrumented Cars (LICs), HICs can contribute significantly and in a relatively naturalistic manner to the driver behaviour research. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using portfolio assignment to support students individually and sustainably -There's always a first time

NASA Astrophysics Data System (ADS)

Mayer, M.

2009-04-01

The recent education of engineers, using the example of satellite geodesy at the Geodetic Institute of the University Karlsruhe (GIK, Germany), is still suffering from time pressure as well as from heavy curriculum content loading. Within this education students, where the academic teachers have to fulfill high requests from the new generation of students as well as from industry and from research institutions respectively, advanced satellite geodetic knowledge has to be transferred effectively and sustainably. In order to enable the students to train newest aspects related to satellite geodesy as well as important key competences, e.g. capacity for independent and academic work, reflection and evaluation skills, presentation skills, an innovative teaching concept was developed, tested, and evaluated. This teaching concept makes use of very different teaching techniques like portfolio assignment, project work, input from experts, jig saw, advance and post organizer. This presentation will focus on the portfolio assignment component. This teaching technique was used at the GIK during the last two years for the first time, in order to support students individually. The lessons learnt within this teaching experiment are going to be presented.

Calibration of neutron detectors on the Joint European Torus.

PubMed

Batistoni, Paola; Popovichev, S; Conroy, S; Lengar, I; Čufar, A; Abhangi, M; Snoj, L; Horton, L

2017-10-01

The present paper describes the findings of the calibration of the neutron yield monitors on the Joint European Torus (JET) performed in 2013 using a 252 Cf source deployed inside the torus by the remote handling system, with particular regard to the calibration of fission chambers which provide the time resolved neutron yield from JET plasmas. The experimental data obtained in toroidal, radial, and vertical scans are presented. These data are first analysed following an analytical approach adopted in the previous neutron calibrations at JET. In this way, a calibration function for the volumetric plasma source is derived which allows us to understand the importance of the different plasma regions and of different spatial profiles of neutron emissivity on fission chamber response. Neutronics analyses have also been performed to calculate the correction factors needed to derive the plasma calibration factors taking into account the different energy spectrum and angular emission distribution of the calibrating (point) 252 Cf source, the discrete positions compared to the plasma volumetric source, and the calibration circumstances. All correction factors are presented and discussed. We discuss also the lessons learnt which are the basis for the on-going 14 MeV neutron calibration at JET and for ITER.

Key Programme Science lessons from an HIV prevention 'Learning Site' for sex workers in Mombasa, Kenya.

PubMed

McClarty, Leigh M; Bhattacharjee, Parinita; Isac, Shajy; Emmanuel, Faran; Kioko, Japheth; Njiraini, Margaret; Gichangi, Peter; Okoth, Clifford Duncan; Musimbi-Mbole, Janet; Blanchard, James F; Moses, Stephen; Muysyoki, Helgar; Becker, Marissa L

2017-12-14

In 2013, Kenya's National AIDS and STI Control Programme established a Learning Site (LS) in Mombasa County to support and strengthen capacity for HIV prevention programming within organisations working with sex workers. A defining feature of LS was the use of a Programme Science approach throughout its development and implementation. We provide an overview of the key components of LS, present findings from 23 months of programme monitoring data, and highlight key Programme Science lessons from its implementation and monitoring. Routine monitoring data collected from September 2013 through July 2015 are presented. Individual-level service utilisation data were collected monthly and indicators of interest were analysed over time to illustrate trends in enrolment, programme coverage and service utilisation among sex workers in Mombasa County. Over the monitoring period, outreach programme enrolment occurred rapidly; condom distribution targets were met consistently; rates of STI screening remained high and diagnoses declined; and reporting of and response to violent incidents increased. At the same time, enrolment in LS clinics was relatively low among female sex workers, and HIV testing at LS was low among both female and male sex workers. Lessons learnt from operationalising the Programme Science framework through the Mombasa LS can inform the development and implementation of similar LS in different geographical and epidemiological contexts. Importantly, meaningful involvement of sex workers in the design, implementation and monitoring processes ensures that overall programme performance is optimised in the context of local, 'on-the-ground' realities. Additionally, learnings from LS highlight the importance of introducing enhanced monitoring and evaluations systems into complex programmes to better understand and explain programme dynamics over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed

Dua, Kulwinder S

2017-02-01

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

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

PubMed

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

2008-09-01

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

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

PubMed

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

2017-11-01

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

Transonic Blunt Body Aerodynamic Coefficients Computation

NASA Astrophysics Data System (ADS)

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

2011-05-01

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

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

PubMed

Jones, C Rick

2004-01-01

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

Aligning Technology with the Organisation Using Focus and User Groups

NASA Astrophysics Data System (ADS)

Owens, Simeon

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

Patient satisfaction questionnaire--how to do them successfully.

PubMed

Holt, Vernon P

2006-01-01

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

Linguistic influence on mathematical development is specific rather than pervasive: revisiting the Chinese Number Advantage in Chinese and English children

PubMed Central

Mark, Winifred; Dowker, Ann

2015-01-01

The relative linguistic transparency of the Asian counting system has been used to explain Asian students’ relative superiority in cross-cultural comparisons of mathematics achievement. To test the validity and extent of linguistic transparency in accounting for mathematical abilities, this study tested Chinese and British primary school children. Children in Hong Kong can learn mathematics using languages with both regular (Chinese) and irregular (English) counting systems, depending on their schools’ medium of instruction. This makes it possible to compare groups with varying levels of exposure to the regular and irregular number systems within the same educational system, curriculum, and cultural environment. The study included three groups of first/second graders and third/fourth graders with varying degrees of experience to the Chinese language and counting systems: no experience (UK; n = 49); spoke Chinese at home and learnt to count in English at school (HK-E; n = 43); spoke Chinese at home and learnt to count in Chinese at school (HK-C; n = 47). They were compared on counting, numerical abilities and place value representation. The present study also measured nonverbal reasoning, attitude toward mathematics, involvement of parents, and extra-curricular mathematics lessons to explore alternative explanations of children’s numeric ability. Results indicated that students in HK-C were better at counting backward and on the numeric skills test than those in HK-E, who were in turn better than the UK students. However, there was no statistical difference in counting forward, place value understanding, and a measure of arithmetic. Our findings add to existent literature suggesting that linguistic transparency does not have an all-pervasive influence on cross-national differences in arithmetic performance. PMID:25767456

Dynamic Emotional Faces Generalise Better to a New Expression but not to a New View.

PubMed

Liu, Chang Hong; Chen, Wenfeng; Ward, James; Takahashi, Nozomi

2016-08-08

Prior research based on static images has found limited improvement for recognising previously learnt faces in a new expression after several different facial expressions of these faces had been shown during the learning session. We investigated whether non-rigid motion of facial expression facilitates the learning process. In Experiment 1, participants remembered faces that were either presented in short video clips or still images. To assess the effect of exposure to expression variation, each face was either learnt through a single expression or three different expressions. Experiment 2 examined whether learning faces in video clips could generalise more effectively to a new view. The results show that faces learnt from video clips generalised effectively to a new expression with exposure to a single expression, whereas faces learnt from stills showed poorer generalisation with exposure to either single or three expressions. However, although superior recognition performance was demonstrated for faces learnt through video clips, dynamic facial expression did not create better transfer of learning to faces tested in a new view. The data thus fail to support the hypothesis that non-rigid motion enhances viewpoint invariance. These findings reveal both benefits and limitations of exposures to moving expressions for expression-invariant face recognition.

Dynamic Emotional Faces Generalise Better to a New Expression but not to a New View

PubMed Central

Liu, Chang Hong; Chen, Wenfeng; Ward, James; Takahashi, Nozomi

2016-01-01

Prior research based on static images has found limited improvement for recognising previously learnt faces in a new expression after several different facial expressions of these faces had been shown during the learning session. We investigated whether non-rigid motion of facial expression facilitates the learning process. In Experiment 1, participants remembered faces that were either presented in short video clips or still images. To assess the effect of exposure to expression variation, each face was either learnt through a single expression or three different expressions. Experiment 2 examined whether learning faces in video clips could generalise more effectively to a new view. The results show that faces learnt from video clips generalised effectively to a new expression with exposure to a single expression, whereas faces learnt from stills showed poorer generalisation with exposure to either single or three expressions. However, although superior recognition performance was demonstrated for faces learnt through video clips, dynamic facial expression did not create better transfer of learning to faces tested in a new view. The data thus fail to support the hypothesis that non-rigid motion enhances viewpoint invariance. These findings reveal both benefits and limitations of exposures to moving expressions for expression-invariant face recognition. PMID:27499252

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

PubMed

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

2018-03-13

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

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

PubMed

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

2016-11-09

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

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

PubMed

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

2014-09-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2012-05-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

Bolte, John F B

2016-09-01

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

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

PubMed

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

2016-01-01

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

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

PubMed

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

2012-03-03

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

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

NASA Astrophysics Data System (ADS)

Chen, Junjun; Cowie, Bronwen

2013-12-01

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

Sensors for the End-cap prototype of the Inner Tracker in the ATLAS Detector Upgrade

NASA Astrophysics Data System (ADS)

Benítez, V.; Ullán, M.; Quirion, D.; Pellegrini, G.; Fleta, C.; Lozano, M.; Sperlich, D.; Hauser, M.; Wonsak, S.; Parzefall, U.; Mahboubi, K.; Kuehn, S.; Mori, R.; Jakobs, K.; Bernabeu, J.; García, C.; Lacasta, C.; Marco, R.; Rodriguez, D.; Santoyo, D.; Solaz, C.; Soldevila, U.; Ariza, D.; Bloch, I.; Diez, S.; Gregor, I. M.; Keller, J.; Lohwasser, K.; Peschke, R.; Poley, L.; Brenner, R.; Affolder, A.

2016-10-01

The new silicon microstrip sensors of the End-cap part of the HL-LHC ATLAS Inner Tracker (ITk) present a number of challenges due to their complex design features such as the multiple different sensor shapes, the varying strip pitch, or the built-in stereo angle. In order to investigate these specific problems, the "petalet" prototype was defined as a small End-cap prototype. The sensors for the petalet prototype include several new layout and technological solutions to investigate the issues, they have been tested in detail by the collaboration. The sensor description and detailed test results are presented in this paper. New software tools have been developed for the automatic layout generation of the complex designs. The sensors have been fabricated, characterized and delivered to the institutes in the collaboration for their assembly on petalet prototypes. This paper describes the lessons learnt from the design and tests of the new solutions implemented on these sensors, which are being used for the full petal sensor development. This has resulted in the ITk strip community acquiring the necessary expertise to develop the full End-cap structure, the petal.

Lessons learnt from the development of the Patient Safety Incidents Reporting an Learning System for the Spanish National Health System: SiNASP.

PubMed

Vallejo-Gutiérrez, Paula; Bañeres-Amella, Joaquim; Sierra, Eduardo; Casal, Jesús; Agra, Yolanda

2014-01-01

To describe the development process and characteristics of a patient safety incidents reporting system to be implemented in the Spanish National Health System, based on the context and the needs of the different stakeholders. Literature review and analysis of most relevant reporting systems, identification of more than 100 stakeholder's (patients, professionals, regional governments representatives) expectations and requirements, analysis of the legal context, consensus of taxonomy, development of the software and pilot test. Patient Safety Events Reporting and Learning system (Sistema de Notificación y Aprendizajepara la Seguridad del Paciente, SiNASP) is a generic reporting system for all types of incidents related to patient safety, voluntary, confidential, non punitive, anonymous or nominative with anonimization, system oriented, with local analysis of cases and based on the WHO International Classification for Patient Safety. The electronic program has an on-line form for reporting, a software to manage the incidents and improvement plans, and a scoreboard with process indicators to monitor the system. The reporting system has been designed to respond to the needs and expectations identified by the stakeholders, taking into account the lessons learned from the previous notification systems, the characteristics of the National Health System and the existing legal context. The development process presented and the characteristics of the system provide a comprehensive framework that can be used for future deployments of similar patient safety systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

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

PubMed

Paton, Carol; Barnes, Thomas R E

2014-06-01

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

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

PubMed

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

2011-06-24

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

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

PubMed Central

Trček, Denis

2016-01-01

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

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

PubMed

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

2016-10-01

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

Source mechanisms of volcanic tsunamis.

PubMed

Paris, Raphaël

2015-10-28

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

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

PubMed

Trček, Denis

2016-01-02

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

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

PubMed

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

2017-06-19

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

Using Competitions to Engage the Public: Lessons Learnt from Rosetta

NASA Astrophysics Data System (ADS)

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

2016-03-01

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

Lessons from SARS in an age of emerging infections.

PubMed

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

2006-01-01

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

The need for guidelines and the use of economic evidence in decision-making in Thailand: lessons learnt from the development of the national list of essential drugs.

PubMed

Wibulpolprasert, Suwit

2008-06-01

Since 2004, the Subcommittee for Development of the National List of Essential Drugs (NLED) has embarked upon an historical evolution of applying evidence to the revision, inclusion and exclusion of medicines into and from the list. Then, the revision of the 2008 NLED was the first time in Thai history where the drug selection process in Thailand formally incorporated pharmacoeconomics. At present, the lack of a standard methodology for conducting economic evaluation is a major barrier that diminishes the potential use of economic evidence. The development of national economic evaluation guidelines by a group of national experts was subsequently endorsed by members in the Subcommittee as useful tools for future NLED revision. They emphasize that these guidelines should be applied not only to those evaluations conducted by public institutions but also by private pharmaceutical companies that often use this evidence for their marketing, or even for future requirements of economic information from industry, as complementary evidence for inclusion of health technology.

(Sn)DICE: A Calibration System Designed for Wide Field Imagers

NASA Astrophysics Data System (ADS)

Regnault, N.; Barrelet, E.; Guyonnet, A.; Juramy, C.; Rocci, P.-F.; Le Guillou, L.; Schahmanèche, K.; Villa, F.

2016-05-01

Dark Energy studies with type Ia supernovae set very tight constraints on the photometric calibration of the imagers used to detect the supernovae and follow up their flux variations. Among the key challenges is the measurement of the shape and normalization of the instrumental throughput. The DICE system was developed by members of the Supernova Legacy Survey (SNLS) , building upon the lessons learnt working with the MegaCam imager. It consists in a very stable light source, placed in the telescope enclosure, and generating compact, conical beams, yielding an almost flat illumination of the imager focal plane. The calibration light is generated by narrow spectrum LEDs selected to cover the entire wavelength range of the imager. It is monitored in real time using control photodiodes. A first DICE demonstrator, SnDICE has been installed at CFHT. A second generation instrument (SkyDICE) has been installed in the enclosure of the SkyMapper telescope. We present the main goals of the project. We discuss the main difficulties encoutered when trying to calibrate a wide field imager, such as MegaCam (or SkyMapper) using such a calibrated light source.

Taking innovative vector control interventions in urban Latin America to scale: lessons learnt from multi-country implementation research.

PubMed

Quintero, Juliana; García-Betancourt, Tatiana; Caprara, Andrea; Basso, Cesar; Garcia da Rosa, Elsa; Manrique-Saide, Pablo; Coelho, Giovanini; Sánchez-Tejeda, Gustavo; Dzul-Manzanilla, Felipe; García, Diego Alejandro; Carrasquilla, Gabriel; Alfonso-Sierra, Eduardo; Monteiro Vasconcelos Motta, Cyntia; Sommerfeld, Johannes; Kroeger, Axel

2017-09-01

Prior to the current public health emergency following the emergence of chikungunya and Zika Virus Disease in the Americas during 2014 and 2015, multi-country research investigated between 2011 and 2013 the efficacy of novel Aedes aegypti intervention packages through cluster randomised controlled trials in four Latin-American cities: Fortaleza (Brazil); Girardot (Colombia), Acapulco (Mexico) and Salto (Uruguay). Results from the trials led to a scaling up effort of the interventions at city levels. Scaling up refers to deliberate efforts to increase the impact of successfully tested health interventions to benefit more people and foster policy and program development in a sustainable way. The different scenarios represent examples for  a 'vertical approach' and a 'horizontal approach'. This paper presents the analysis of a preliminary process evaluation of the scaling up efforts in the mentioned cites, with a focus on challenges and enabling factors encountered by the research teams, analysing the main social, political, administrative, financial and acceptance factors.

Clinical negligence and duty of candour.

PubMed

Shekar, Vinita; Singh, Mark; Shekar, Kishore; Brennan, Peter

2011-12-01

The Department of Health is considering imposing a legal duty of candour on health care providers to ensure that an apology and explanation are given to patients when errors occur during medical treatment. This aims to improve quality of care and reduce adverse events during medical treatment. We present the current system of clinical negligence and the future of medical ethics. We discuss relevant cases with regard to duty of candour, and highlight the existence of serious imbalances in which patients' rights and corresponding ethical duties of professionals predominate over the responsibilities of patients themselves. It is known that most adverse events arise because of multiple factors for which no individual should be blamed. To improve healthcare services there is a need for a system in which lessons can be learnt from mistakes, and services can be improved in the interest of patient safety, and for transparency in the broad principles on which the decisions are based within which clinical performance is supervised and monitored. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Designing 3 Dimensional Virtual Reality Using Panoramic Image

NASA Astrophysics Data System (ADS)

Wan Abd Arif, Wan Norazlinawati; Wan Ahmad, Wan Fatimah; Nordin, Shahrina Md.; Abdullah, Azrai; Sivapalan, Subarna

The high demand to improve the quality of the presentation in the knowledge sharing field is to compete with rapidly growing technology. The needs for development of technology based learning and training lead to an idea to develop an Oil and Gas Plant Virtual Environment (OGPVE) for the benefit of our future. Panoramic Virtual Reality learning based environment is essential in order to help educators overcome the limitations in traditional technical writing lesson. Virtual reality will help users to understand better by providing the simulations of real-world and hard to reach environment with high degree of realistic experience and interactivity. Thus, in order to create a courseware which will achieve the objective, accurate images of intended scenarios must be acquired. The panorama shows the OGPVE and helps to generate ideas to users on what they have learnt. This paper discusses part of the development in panoramic virtual reality. The important phases for developing successful panoramic image are image acquisition and image stitching or mosaicing. In this paper, the combination of wide field-of-view (FOV) and close up image used in this panoramic development are also discussed.

Optical biosensing strategies for DNA methylation analysis.

PubMed

Nazmul Islam, Md; Yadav, Sharda; Hakimul Haque, Md; Munaz, Ahmed; Islam, Farhadul; Al Hossain, Md Shahriar; Gopalan, Vinod; Lam, Alfred K; Nguyen, Nam-Trung; Shiddiky, Muhammad J A

2017-06-15

DNA methylation is an epigenetic modification of DNA, where a methyl group is added at the fifth carbon of the cytosine base to form 5 methyl cytosine (5mC) without altering the DNA sequences. It plays important roles in regulating many cellular processes by modulating key genes expression. Alteration in DNA methylation patterns becomes particularly important in the aetiology of different diseases including cancers. Abnormal methylation pattern could contribute to the pathogenesis of cancer either by silencing key tumor suppressor genes or by activating oncogenes. Thus, DNA methylation biosensing can help in the better understanding of cancer prognosis and diagnosis and aid the development of therapies. Over the last few decades, a plethora of optical detection techniques have been developed for analyzing DNA methylation using fluorescence, Raman spectroscopy, surface plasmon resonance (SPR), electrochemiluminescence and colorimetric readouts. This paper aims to comprehensively review the optical strategies for DNA methylation detection. We also present an overview of the remaining challenges of optical strategies that still need to be focused along with the lesson learnt while working with these techniques. Copyright © 2016 Elsevier B.V. All rights reserved.

What kind of leadership does integrated care need?

PubMed

Kelley-Patterson, Deirdre

2012-01-01

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

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

PubMed

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

2015-05-01

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

Hospital design for better infection control

PubMed Central

Lateef, Fatimah

2009-01-01

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

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

PubMed

Boidin, B

2015-02-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed Central

2011-01-01

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

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

PubMed Central

Iacobuzio-Donahue, Christine A

2012-01-01

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

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

PubMed

Kumagai, Atsushi; Yamashita, Shunichi

2012-11-01

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

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

PubMed

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

2018-01-01

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

Project to expand diversity in the nursing workforce.

PubMed

Georges, Catherine

2012-05-01

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

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

PubMed Central

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

2018-01-01

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

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

PubMed Central

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

2016-01-01

Improving farm productivity is essential for increasing farm profitability and meeting the rapidly growing demand for food that is fuelled by rapid population growth across the world. Farm productivity can be increased by understanding and forecasting crop performance in a variety of environmental conditions. Crop recommendation is currently based on data collected in field-based agricultural studies that capture crop performance under a variety of conditions (e.g., soil quality and environmental conditions). However, crop performance data collection is currently slow, as such crop studies are often undertaken in remote and distributed locations, and such data are typically collected manually. Furthermore, the quality of manually collected crop performance data is very low, because it does not take into account earlier conditions that have not been observed by the human operators but is essential to filter out collected data that will lead to invalid conclusions (e.g., solar radiation readings in the afternoon after even a short rain or overcast in the morning are invalid, and should not be used in assessing crop performance). Emerging Internet of Things (IoT) technologies, such as IoT devices (e.g., wireless sensor networks, network-connected weather stations, cameras, and smart phones) can be used to collate vast amount of environmental and crop performance data, ranging from time series data from sensors, to spatial data from cameras, to human observations collected and recorded via mobile smart phone applications. Such data can then be analysed to filter out invalid data and compute personalised crop recommendations for any specific farm. In this paper, we present the design of SmartFarmNet, an IoT-based platform that can automate the collection of environmental, soil, fertilisation, and irrigation data; automatically correlate such data and filter-out invalid data from the perspective of assessing crop performance; and compute crop forecasts and personalised crop recommendations for any particular farm. SmartFarmNet can integrate virtually any IoT device, including commercially available sensors, cameras, weather stations, etc., and store their data in the cloud for performance analysis and recommendations. An evaluation of the SmartFarmNet platform and our experiences and lessons learnt in developing this system concludes the paper. SmartFarmNet is the first and currently largest system in the world (in terms of the number of sensors attached, crops assessed, and users it supports) that provides crop performance analysis and recommendations. PMID:27834862

Methods for implementing a medicine outlet survey: lessons from the anti-malarial market.

PubMed

O'Connell, Kathryn A; Poyer, Stephen; Solomon, Tsione; Munroe, Erik; Patouillard, Edith; Njogu, Julius; Evance, Illah; Hanson, Kara; Shewchuk, Tanya; Goodman, Catherine

2013-02-05

In recent years an increasing number of public investments and policy changes have been made to improve the availability, affordability and quality of medicines available to consumers in developing countries, including anti-malarials. It is important to monitor the extent to which these interventions are successful in achieving their aims using quantitative data on the supply side of the market. There are a number of challenges related to studying supply, including outlet sampling, gaining provider cooperation and collecting accurate data on medicines. This paper provides guidance on key steps to address these issues when conducting a medicine outlet survey in a developing country context. While the basic principles of good survey design and implementation are important for all surveys, there are a set of specific issues that should be considered when conducting a medicine outlet survey. This paper draws on the authors' experience of designing and implementing outlet surveys, including the lessons learnt from ACTwatch outlet surveys on anti-malarial retail supply, and other key studies in the field. Key lessons and points of debate are distilled around the following areas: selecting a sample of outlets; techniques for collecting and analysing data on medicine availability, price and sales volumes; and methods for ensuring high quality data in general. The authors first consider the inclusion criteria for outlets, contrasting comprehensive versus more focused approaches. Methods for developing a reliable sampling frame of outlets are then presented, including use of existing lists, key informants and an outlet census. Specific issues in the collection of data on medicine prices and sales volumes are discussed; and approaches for generating comparable price and sales volume data across products using the adult equivalent treatment dose (AETD) are explored. The paper concludes with advice on practical considerations, including questionnaire design, field worker training, and data collection. Survey materials developed by ACTwatch for investigating anti-malarial markets in sub-Saharan Africa and Asia provide a helpful resource for future studies in this area.

'Nurture the sprouting bud; do not uproot it'. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda.

PubMed

Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Muhumuza Kananura, Rornald; Mutebi, Aloysius; Jane, Pacuto; Tumuhairwe, Juliet; Tetui, Moses; Kiwanuka, Suzanne N

2017-08-01

Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups. This qualitative study was done in three districts in Eastern Uganda. Saving groups were identified and provided with support to enhance members' access to maternal and newborn health. Fifteen focus group discussions (FGDs) and 18 key informant interviews (KIIs) were conducted to elicit members' views about saving practices. Document review was undertaken to identify key lessons for supporting saving groups. Qualitative data are presented thematically. Awareness of the importance of saving, safe custody of money saved, flexible saving arrangements and easy access to loans for personal needs including transport during obstetric emergencies increased willingness to save with saving groups. Saving groups therefore provided a safety net for the poor during emergencies. Poor management of saving groups and detrimental economic practices like gambling constrained saving. Efficient running of saving groups requires that they have a clear management structure, which is legally registered with relevant authorities and that it is governed by a constitution. Saving groups were considered a useful form of saving that enabled easy acess to cash for birth preparedness and transportation during emergencies. They are like 'a sprouting bud that needs to be nurtured rather than uprooted', as they appear to have the potential to act as a safety net for poor communities that have no health insurance. Local governments should therefore strengthen the management capacity of saving groups so as to ensure their efficient running through partnerships with non-governmental organizations that can provide support to such groups.

‘Nurture the sprouting bud; do not uproot it’. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda

PubMed Central

Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Muhumuza Kananura, Rornald; Mutebi, Aloysius; Jane, Pacuto; Tumuhairwe, Juliet; Tetui, Moses; Kiwanuka, Suzanne N

2017-01-01

ABSTRACT Background: Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. Objectives: This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups. Methods: This qualitative study was done in three districts in Eastern Uganda. Saving groups were identified and provided with support to enhance members’ access to maternal and newborn health. Fifteen focus group discussions (FGDs) and 18 key informant interviews (KIIs) were conducted to elicit members’ views about saving practices. Document review was undertaken to identify key lessons for supporting saving groups. Qualitative data are presented thematically. Results: Awareness of the importance of saving, safe custody of money saved, flexible saving arrangements and easy access to loans for personal needs including transport during obstetric emergencies increased willingness to save with saving groups. Saving groups therefore provided a safety net for the poor during emergencies. Poor management of saving groups and detrimental economic practices like gambling constrained saving. Efficient running of saving groups requires that they have a clear management structure, which is legally registered with relevant authorities and that it is governed by a constitution. Conclusions: Saving groups were considered a useful form of saving that enabled easy acess to cash for birth preparedness and transportation during emergencies. They are like ‘a sprouting bud that needs to be nurtured rather than uprooted’, as they appear to have the potential to act as a safety net for poor communities that have no health insurance. Local governments should therefore strengthen the management capacity of saving groups so as to ensure their efficient running through partnerships with non-governmental organizations that can provide support to such groups. PMID:28820046

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

PubMed Central

2013-01-01

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

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

PubMed

Benson, D Woodrow; Cohen, Mitchell I

2017-01-01

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

Studying the hydro-meteorological extremes. The benefits from the European Flash Flood research oriented HYDRATE project.

NASA Astrophysics Data System (ADS)

Tsanis, Ioannis K.; Koutroulis, Aristeidis G.; Daliakopoulos, Ioannis N.; Grillakis, Emmanouil G.

2010-05-01

The present paper summarizes the advances of flash flood research for the Greek case study, within the frame of HYDRATE EC funded project. As a first step, a collation of homogenous primary data on flash floods occurred in Greece based on various data sources resulted in 21 documented events, enriching the HYDRATE database. Specific major events were selected for further detailed data collation and analysis. A common intensive post event field survey was conducted by various researchers with different skills and experience, in order to document the 18th of September 2007, Western Slovenia flash flood event. The observation strategy and the lessons learned during this campaign were applied successfully for surveying an event in Crete. Two flash flood events occurred in Crete were selected for detailed analysis, the 13th of January 1994 event occurred in Giofiros basin and the 17th of October 2006 event occurred in Almirida basin. Several techniques, like distributed rainfall-runoff modelling, hydraulic modelling, indirect and empirical peak discharge estimation, were applied for the understanding of the dominant flash flood processes and the effect of initial conditions on peak discharge. In a more general framework, the seasonality of the hydrometeorologic characteristics of floods that occurred in Crete during the period 1990-2007 and the atmospheric circulation conditions during the flood events were examined. During the three and a half years research period, many lessons have learnt from a fruitful collaboration among the project partners. HYDRATE project improved the scientific basis of flash flood research and provided research knowledge on flood risk management.

Review paper on research ethics in Ethiopia: experiences and lessons learnt from Addis Ababa University College of Health Sciences 2007-2012.

PubMed

Feleke, Yeweyenhareg; Addissie, Adamu; Wamisho, Biruk L; Davey, Gail

2015-01-01

Health research in Ethiopia is increasing both in volume and type, accompanied with expansion of higher education and research since the past few years. This calls for a proportional competence in the governance of medical research ethics in Ethiopia in the respective research and higher learning institutes. The paper highlights the evolution and progress ofthe ethics review at Addis Ababa University - College of Health Sciences (AAU-CHS) in the given context of health research review system in Ethiopia. Reflections are made on the key lessons to be drawnfrom the formative experiences of the Institutional Review Board (IRB) and their implications to the Ethiopian health research review system. This article is a review paper based on review of published and un published documents on research ethics in Ethiopia and the AAU-CHS (2007-2012). Thematic summaries of review findings are presented in thematic areas - formation of ethics review and key factors in the evolution of ethics review and implications. The IRB at AAU-CHS has been pivotal in providing review and follow-up for important clinical studies in Ethiopia. It has been one of the first IRBs to get WHO/SIDCER recognition from Africa and Ethiopia. Important factors in the successes of the IRB among others included leadership commitment, its placement in institutional structure, and continued capacity building. Financial challenges and sustainability issues need to be addressed for the sustained gains registered so far. Similar factors are considered important for the new and younger IRBs within the emergent Universities and research centers in the country.

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2018-01-01

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

DREAMS-SIS: The Solar Irradiance Sensor on-board the ExoMars 2016 lander

NASA Astrophysics Data System (ADS)

Arruego, I.; Apéstigue, V.; Jiménez-Martín, J.; Martínez-Oter, J.; Álvarez-Ríos, F. J.; González-Guerrero, M.; Rivas, J.; Azcue, J.; Martín, I.; Toledo, D.; Gómez, L.; Jiménez-Michavila, M.; Yela, M.

2017-07-01

The Solar Irradiance Sensor (SIS) was part of the DREAMS (Dust characterization, Risk assessment, and Environment Analyzer on the Martian Surface) payload package on board the ExoMars 2016 Entry and Descent Module (EDM), "Schiaparelli". DREAMS was a meteorological station aimed at the measurement of several atmospheric parameters, as well as the presence of electric fields, during the surface operations of EDM. DREAMS-SIS is a highly miniaturized lightweight sensor designed for small meteorological stations, capable of estimating the aerosol optical depth (AOD) several times per sol, as well as performing a direct measurement of the global (direct plus scattered) irradiance on the Martian surface in the spectral range between 200 and 1100 nm. AOD is estimated from the irradiance measurements at two different spectral bands - Ultraviolet (UV) and near infrared (NIR) - which also enables color index (CI) analysis for the detection of clouds. Despite the failure in the landing of Schiaparelli, DREAMS-SIS is a valuable precursor for new developments being carried-on at present. The concept and design of DREAMS-SIS are here presented and its operating principles, supported by preliminary results from a short validation test, are described. Lessons learnt and future work towards a new generation of Sun irradiance sensors is also outlined.

Design of a testing strategy using non-animal based test methods: lessons learnt from the ACuteTox project.

PubMed

Kopp-Schneider, Annette; Prieto, Pilar; Kinsner-Ovaskainen, Agnieszka; Stanzel, Sven

2013-06-01

In the framework of toxicology, a testing strategy can be viewed as a series of steps which are taken to come to a final prediction about a characteristic of a compound under study. The testing strategy is performed as a single-step procedure, usually called a test battery, using simultaneously all information collected on different endpoints, or as tiered approach in which a decision tree is followed. Design of a testing strategy involves statistical considerations, such as the development of a statistical prediction model. During the EU FP6 ACuteTox project, several prediction models were proposed on the basis of statistical classification algorithms which we illustrate here. The final choice of testing strategies was not based on statistical considerations alone. However, without thorough statistical evaluations a testing strategy cannot be identified. We present here a number of observations made from the statistical viewpoint which relate to the development of testing strategies. The points we make were derived from problems we had to deal with during the evaluation of this large research project. A central issue during the development of a prediction model is the danger of overfitting. Procedures are presented to deal with this challenge. Copyright © 2012 Elsevier Ltd. All rights reserved.

Developing Health Promotion Interventions on Social Networking Sites: Recommendations from The FaceSpace Project

PubMed Central

Pedrana, Alisa E; Stoove, Mark A; Chang, Shanton; Howard, Steve; Asselin, Jason; Ilic, Olivia; Batrouney, Colin; Hellard, Margaret E

2012-01-01

Online social networking sites offer a novel setting for the delivery of health promotion interventions due to their potential to reach a large population and the possibility for two-way engagement. However, few have attempted to host interventions on these sites, or to use the range of interactive functions available to enhance the delivery of health-related messages. This paper presents lessons learnt from “The FaceSpace Project”, a sexual health promotion intervention using social networking sites targeting two key at-risk groups. Based on our experience, we make recommendations for developing and implementing health promotion interventions on these sites. Elements crucial for developing interventions include establishing a multidisciplinary team, allowing adequate time for obtaining approvals, securing sufficient resources for building and maintaining an online presence, and developing an integrated process and impact evaluation framework. With two-way interaction an important and novel feature of health promotion interventions in this medium, we also present strategies trialled to generate interest and engagement in our intervention. Social networking sites are now an established part of the online environment; our experience in developing and implementing a health promotion intervention using this medium are of direct relevance and utility for all health organizations creating a presence in this new environment. PMID:22374589

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

PubMed Central

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

2014-01-01

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

Bridging the Divide- Adventures of an academic entrepreneur

NASA Astrophysics Data System (ADS)

Venkatesan, Thirumalai

2017-01-01

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

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

PubMed

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

2015-12-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

Alfani, Guido

2010-03-01

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

What kind of leadership does integrated care need?

PubMed Central

2012-01-01

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

Smart-DS: Synthetic Models for Advanced, Realistic Testing: Distribution Systems and Scenarios

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

Krishnan, Venkat K; Palmintier, Bryan S; Hodge, Brian S

The National Renewable Energy Laboratory (NREL) in collaboration with Massachusetts Institute of Technology (MIT), Universidad Pontificia Comillas (Comillas-IIT, Spain) and GE Grid Solutions, is working on an ARPA-E GRID DATA project, titled Smart-DS, to create: 1) High-quality, realistic, synthetic distribution network models, and 2) Advanced tools for automated scenario generation based on high-resolution weather data and generation growth projections. Through these advancements, the Smart-DS project is envisioned to accelerate the development, testing, and adoption of advanced algorithms, approaches, and technologies for sustainable and resilient electric power systems, especially in the realm of U.S. distribution systems. This talk will present themore » goals and overall approach of the Smart-DS project, including the process of creating the synthetic distribution datasets using reference network model (RNM) and the comprehensive validation process to ensure network realism, feasibility, and applicability to advanced use cases. The talk will provide demonstrations of early versions of synthetic models, along with the lessons learnt from expert engagements to enhance future iterations. Finally, the scenario generation framework, its development plans, and co-ordination with GRID DATA repository teams to house these datasets for public access will also be discussed.« less

First operational experience with the HIE-Isolde helium cryogenic system including several RF cryo-modules

NASA Astrophysics Data System (ADS)

Guillotin, N.; Dupont, T.; Gayet, Ph; Pirotte, O.

2017-12-01

The High Intensity and Energy ISOLDE (HIE-ISOLDE) upgrade project at CERN includes the deployment of new superconducting accelerating structures operated at 4.5 K (ultimately of six cryo-modules) installed in series, and the refurbishing of the helium cryo-plant previously used to cool the ALEPH magnet during the operation of the LEP accelerator from 1989 to 2000. The helium refrigerator is connected to a new cryogenic distribution line, supplying a 2000-liter storage dewar and six interconnecting valve boxes (i.e jumper boxes), one for each cryo-module. After a first operation period with one cryo-module during six months in 2015, a second cryo-module has been installed and operated during 2016. The operation of the cryo-plant with these two cryo-modules has required significant technical enhancements and tunings for the compressor station, the cold-box and the cryogenic distribution system in order to reach nominal and stable operational conditions. The present paper describes the commissioning results and the lessons learnt during the operation campaign of 2016 together with the preliminary experience acquired during the 2017 operation phase with a third cryo-module.

Targeting as a Mode of Science Communication: Principles, Issues and a Practical Example

NASA Astrophysics Data System (ADS)

Holland, G. J.; Vigh, J. L.

2011-12-01

Today's media landscape contains a rich and diverse range of communications opportunities. New media, such as the internet, blogosphere and social networks, are complementing, supplementing and also replacing the traditional mass media communications through print, radio and television. This diversification certainly contains pitfalls and difficulties as has been demonstrated in the Climategate affair. But there are also real opportunities for utilizing the diversity to provide targeted science communications that are framed in the context of the specific group of interest. That such targeting of audience attitudes and beliefs is an important key to effective science communications has been demonstrated by, for example, Leiserowitz, Maibach et al (2009). This approach does require an understanding of the audience and a careful framing of the message in terms familiar to the targeted group. Here many factors come into play, including: including immediacy, economics, culture, community leaders, emotional framing, and ideological filters. In this talk we shall elaborate on the principles, issues and opportunities. A practical example of working with the religious community on communicating the science of climate change will also be presented. This will include the approach adopted, progress to date and the lessons learnt.

Putting the rise of the Inca Empire within a climatic and land management context

NASA Astrophysics Data System (ADS)

Chepstow-Lusty, A. J.; Frogley, M. R.; Bauer, B. S.; Leng, M. J.; Boessenkool, K. P.; Carcaillet, C.; Ali, A. A.; Gioda, A.

2009-07-01

The rapid expansion of the Inca from the Cuzco area of highland Peru (ca. AD 1400-1532) produced the largest empire in the New World. Although this meteoric growth may in part be due to the adoption of innovative societal strategies, supported by a large labour force and a standing army, we argue that it would not have been possible without increased crop productivity, which was linked to more favourable climatic conditions. Here we present a multi-proxy, high-resolution 1200-year lake sediment record from Marcacocha, located 12 km north of Ollantaytambo, in the heartland of the Inca Empire. This record reveals a period of sustained aridity that began from AD 880, followed by increased warming from AD 1100 that lasted beyond the arrival of the Spanish in AD 1532. These increasingly warmer conditions would have allowed the Inca and their immediate predecessors the opportunity to exploit higher altitudes (post-AD 1150) by constructing agricultural terraces that employed glacial-fed irrigation, in combination with deliberate agroforestry techniques. There may be some important lessons to be learnt today from these strategies for sustainable rural development in the Andes in the light of future climate uncertainty.

Cooperative Vehicular Traffic Monitoring in Realistic Low Penetration Scenarios: The COLOMBO Experience

PubMed Central

Caselli, Federico; Corradi, Antonio

2018-01-01

The relevance of effective and efficient solutions for vehicle traffic surveillance is widely recognized in order to enable advanced strategies for traffic management, e.g., based on dynamically adaptive and decentralized traffic light management. However, most related solutions in the literature, based on the powerful enabler of cooperative vehicular communications, assume the complete penetration rate of connectivity/communication technologies (and willingness to participate in the collaborative surveillance service) over the targeted vehicle population, thus making them not applicable nowadays. The paper originally proposes an innovative solution for cooperative traffic surveillance based on vehicular communications capable of: (i) working with low penetration rates of the proposed technology and (ii) of collecting a large set of monitoring data about vehicle mobility in targeted areas of interest. The paper presents insights and lessons learnt from the design and implementation work of the proposed solution. Moreover, it reports extensive performance evaluation results collected on realistic simulation scenarios based on the usage of iTETRIS with real traces of vehicular traffic of the city of Bologna. The reported results show the capability of our proposal to consistently estimate the real vehicular traffic even with low penetration rates of our solution (only 10%). PMID:29522427

The Use, Evolution and Lessons Learnt of Deployable Static Solar Array Mechanisms

NASA Technical Reports Server (NTRS)

Ferris, Mark; Haslehurst, Andrew

2014-01-01

This paper focuses on the mechanisms incorporated into SSTL's static deployable arrays; namely the sprung-hinges and hold down and release mechanism (HDRM). Combined, the HDRM and hinges form the hold down release system (HDRS). The deployable static solar array HDRS has been successfully used on several missions, first launched upon the DMC-CFESAT spacecraft in 2007 for a U.S. customer (Figure 1), and later used on DMC-UK2 and EXACTVIEW-1 launched in 2009 and 2012, respectively. The simple, robust and low-cost solution HDRS has been evident in allowing missions to satisfy an ever increasing power demand, allowing the solar arrays to increase in size and have a preferable sun angle for increased cell efficiency. The system is now being employed on the first mission out of SSTL's U.S. office (SST-US) on the Orbital Test Bed platform. This paper shall cover details of the original design and development program, problems incurred on latter missions, and evolution of the HDRS for the present Orbital Test Bed mission. Both the original development and recent evolutions have taken place in rapid timescales, to satisfy the high-turnaround of SSTL missions.

Evidence-informed decision making for nutrition: African experiences and way forward.

PubMed

Aryeetey, Richmond; Holdsworth, Michelle; Taljaard, Christine; Hounkpatin, Waliou Amoussa; Colecraft, Esi; Lachat, Carl; Nago, Eunice; Hailu, Tesfaye; Kolsteren, Patrick; Verstraeten, Roos

2017-11-01

Although substantial amount of nutrition research is conducted in Africa, the research agenda is mainly donor-driven. There is a clear need for a revised research agenda in Africa which is both driven by and responding to local priorities. The present paper summarises proceedings of a symposium on how evidence can guide decision makers towards context-appropriate priorities and decisions in nutrition. The paper focuses on lessons learnt from case studies by the Evidence Informed Decision Making in Nutrition and Health Network implemented between 2015 and 2016 in Benin, Ghana and South Africa. Activities within these countries were organised around problem-oriented evidence-informed decision-making (EIDM), capacity strengthening and leadership and horizontal collaboration. Using a combination of desk-reviews, stakeholder influence-mapping, semi-structured interviews and convening platforms, these country-level studies demonstrated strong interest for partnership between researchers and decision makers, and use of research evidence for prioritisation and decision making in nutrition. Identified capacity gaps were addressed through training workshops on EIDM, systematic reviews, cost-benefit evaluations and evidence contextualisation. Investing in knowledge partnerships and development of capacity and leadership are key to drive appropriate use of evidence in nutrition policy and programming in Africa.

Photodynamic therapy (PDT) for lung cancer

NASA Astrophysics Data System (ADS)

Moghissi, K.; Dixon, Kate

2005-11-01

The Yorkshire Laser Centre has been engaged in Photodynamic Therapy (PDT) since 1990. In this article we present our experience highlighting the lesson learnt. 280 bronchoscopic PDT treatments have been carried out in 160 patients divided in 2 groups. Group A: (Nr 144) with advanced inoperable disease and Group E (Nr 16) with early stage cancer. PDT method was intravenous administration of 2mg/kg bw of Photofrin followed by bronchoscopic illumination of 630nm laser light. There was no procedure-related mortality. A total of 9 cases of photosensitivity (skin burn) occurred in the series (5.6% of patients). Every patient in both groups expressed their total satisfaction to treatment. Group A: Symptom relief was achieved in all. This was matched by improvement in significant bronchial opening (58.1%). Survival was 9.6 months (mean).This was greater in patients with better performance status and lower stage of disease. Group E: Every patient had a complete response to treatment. Survival in this group was 75.4 months (mean). We conclude that bronchoscopic PDT is indicated in both advanced and early stage lung cancer. In the former it provides symptomatic relief in all and survival benefit in some; in the latter it achieves long survival and potential cure.

Scientix in our school- discovering STEM

NASA Astrophysics Data System (ADS)

Melcu, Cornelia

2017-04-01

My name is Cornelia Melcu and I am a primary school teacher in Brasov. Additionally, I am a teacher trainer of Preparatory Class Curriculum, Google Application in Education Course and European Projects Course and a mentor to new teachers and students in university. I am an eTwinning, Scientix and ESERO ambassador too. During the last three school years my school was involved in several STEM projects, part of Scientix community. The main goal of those projects was to develop basic STEM skills of our students based on project work integrated into the curriculum. Open the Gates to the Universe (http://gatestotheuniverse.blogspot.ro; https://twinspace.etwinning.net/12520/home) is an eTwinning project for primary school students started on September 2015 and finished on September 2016. Some of our partners were from the Mediterranean area. The students discovered different aspects of space science and astronomy working on international groups. They explored some aspects of Science included in their curriculum using resources from ESERO, ROEDUSEIS and Space Awareness (e.g. Calculate with Rosetta, Writing the travel diary, Build Rosetta, How to become an astronaut, etc.) The project was a great opportunity to apply integrated learning methods for developing competencies which are a part of the primary school curriculum in Romania. In Language and Communication classes the students talked about their partners living places and their traditions and habits. They learnt some basic words in their partners language related to the weather. They created stories- both in Romanian and English; they described life in space and astronomical phenomena. They talked to the other partners during the several online meetings we organized and wrote short stories in English. In Mathematics and Science they found out about the Milky Way, the Solar System, the weather, famous astronauts and astronomers. They calculated, solved problems, made experiments and explained specific natural phenomena related to Space. During the ICT lessons, they used different devices for creating and playing online games and quizzes, took photos and edited them, searched for and found specific information related to the topic. In Art they made cards, posters, drawings and paintings. They learnt songs in Music and in PE made outdoor experiments (like calculating the distance between planets in our Solar System using a scale). During the Personal Development lessons the students found out solutions for problems (e.g. How would you survive in Space?) and they presented their project work to their schoolmates, teachers and parents. The project 'started where the children were', it was built on the knowledge and ideas children brought with them to lessons and helped them to develop their understanding of scientific concepts related to the Universe. It helped them to understand the diversity of weather conditions and as part of a world community and their responsibility for the environment. The students are able to identify main planets and stars on the sky and they have of basic notions related to Earth and Sun; In conclusion, the project provides opportunities for learning STEM topics in pre-primary and primary education. Implementing the project gave the children and all the adults involved (staff, parents) a lot of fun and satisfaction.

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

PubMed

Hough, Denise; Swart, Pieter; Cloete, Schalk

2013-05-17

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

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

PubMed

Yamashita, Shunichi

2014-06-01

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

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

PubMed

Phua, Kai Hong; Chew, Amelia Huibin

2002-01-01

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

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

PubMed

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

2012-02-01

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

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

PubMed

Campbell, C; Scott, K

2011-01-01

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

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

PubMed

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

2010-01-01

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

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

PubMed

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

2011-03-01

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

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

PubMed

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

2017-03-01

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

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

PubMed Central

2014-01-01

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

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

PubMed Central

Bhojani, Upendra; Venkataraman, Vidya; Manganawar, Bheemaray

2013-01-01

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

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

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

Landman, Joanne; Kulawansa, Sagarika; McCarthy, Michael

2015-03-15

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

Training clinicians treating HIV to diagnose cytomegalovirus retinitis

PubMed Central

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

2014-01-01

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

PA6 Death chat: engaging with dying and death.

PubMed

Goodhead, Andrew; Hartley, Nigel

2015-04-01

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

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

PubMed

Dhai, Amaboo

2017-05-24

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

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

PubMed

van Loo, John; Leonard, Niamh

2006-06-01

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

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

PubMed Central

Séroussi, Brigitte; Bouaud, Jacques

2016-01-01

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

The Evolution of the Stem Cell Theory for Heart Failure.

PubMed

Silvestre, Jean-Sébastien; Menasché, Philippe

2015-12-01

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

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2015-01-01

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

The IBM Story

NASA Astrophysics Data System (ADS)

Loving, Charles

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

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

PubMed

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

2002-01-01

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

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

PubMed

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

2013-08-13

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

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

PubMed Central

Kumpel, B M

2008-01-01

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

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

NASA Astrophysics Data System (ADS)

Shastri, Prajval

2015-08-01

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

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

NASA Astrophysics Data System (ADS)

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

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

Reprint of: Client interfaces to the Virtual Observatory Registry

NASA Astrophysics Data System (ADS)

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

2015-06-01

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

Client interfaces to the Virtual Observatory Registry

NASA Astrophysics Data System (ADS)

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

2015-04-01

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

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

PubMed

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

2015-01-01

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

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

PubMed

Ablain, Julien; de Thé, Hugues

2014-11-15

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

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

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

Malaria vaccines: looking back and lessons learnt

PubMed Central

Lorenz, Veronique; Karanis, Panagiotis

2011-01-01

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

Mathematics is always invisible, Professor Dowling

NASA Astrophysics Data System (ADS)

Cable, John

2015-09-01

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

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

PubMed Central

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

2013-01-01

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

An evaluation of medical student-led podcasts: what are the lessons learnt?

PubMed

Kapoor, Smriti; Catton, Rory; Khalil, Hisham

2018-01-01

Student-led podcasts were developed by 5th year Peninsula Medical School students as part of an educational grant. The students completed 35 video podcasts using PREZI software, and based on clinical indicative presentations of the Peninsula Medical School curriculum. Third, 4th and 5th year medical students were invited to complete the evaluation of the indicative presentation video podcasts they watched. Both quantitative and qualitative data were collected through anonymized questionnaires. A thematic analysis of qualitative data was carried out. Seven hundred and fifty students were invited to evaluate the podcasts of which 142 responded to the email. One hundred and forty-two students were assigned podcasts, of whom 122 completed the podcast questionnaire (85.9%), with 20 students dropping out for unknown reasons. The majority of the students found the podcasts to be clear, of an appropriate length, targeted at the right academic level and providing a good method of learning. However, there were mixed views in relation to the preference of podcasts over conventional learning methods. The thematic analysis identified positive comments and areas of improvement for the podcasts. Podcasts conducted in an interview style with an engaging voice and images are thought to help maintain student engagement from their perspective. Further evaluation/research is required to help establish the correct depth and breadth of information to be included in podcasts.

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

PubMed

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

2015-06-24

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

Integrating the Clearance in NPP Residual Material Management

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

Garcia-Bermejo, R.; Lamela, B.

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

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

NASA Astrophysics Data System (ADS)

Fukuoka, H.; Wang, C.

2015-12-01

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

Image dependency in the recognition of newly learnt faces.

PubMed

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

2017-05-01

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

Critical elements and lessons learnt from the implementation of an RFID-enabled healthcare management system in a medical organization.

PubMed

Ting, S L; Kwok, S K; Tsang, Albert H C; Lee, W B

2011-08-01

Healthcare services are complex and life-critical. One mistake in any procedure may lead to irremediable consequences; numerous researchers, thus, introduce information and communication technology to improve quality of services and enhance patient safety by reducing the medical errors. Radio frequency identification (RFID) is considered as one of the emerging tool assist in meeting the challenges of the present situation. In recent years, RFID has been applied in medical organizations for the purpose of managing and tracking medical equipment, monitoring and identifying patients, ensuring that the right medication is given to the right patient, and preventing the use of counterfeit medicine. However, most of the existing literature focuses on demonstrating how RFID can benefit the healthcare industry, whereas little attention has been given to the management issues involved in constructing an RFID project in medical organizations. In this paper, an exploratory case study is conducted in a medical organization to illustrate the development framework and critical issues that should be taken into consideration in the preparation, implementation and maintenance stage of constructing such a project. All the experiences and results discussed in this paper offer valuable and useful insights to steer those who would like to start their journey using RFID in medical organizations.

Delivering patient education by group videoconferencing into the home: Lessons learnt from the Telehealth Literacy Project.

PubMed

Banbury, Annie; Parkinson, Lynne; Nancarrow, Susan; Dart, Jared; Gray, Leonard C; Buckley, Jennene

2016-12-01

We examined the procedures for implementing group videoconference (VC) education for older people delivered into the home environment to identify the most common themes affecting the optimum delivery of VC home-based groups to older people. Participants (n = 52) were involved in a six-week group VC patient education program. There were a total of 44 sessions, undertaken by nine groups, with an average of four participants (range 1-7) and the facilitator. Participants could see and hear each other in real-time whilst in their homes with customised tablets or a desktop computer. The data presented here are based on a program log maintained by the facilitator throughout the implementation phase of the project and post intervention. The VC group experience is influenced by factors including the VC device location, connection processes, meeting times, use of visual aids and test calls. Social presence can be improved by communication protocols and strategies. Robust information technology (IT) support is essential in mitigating technical problems to enhance users' experience. Group patient education can be delivered by VC into homes of older people. However, careful pre-program planning, training and support should be considered when implementing such programs. © The Author(s) 2016.

A molecular Rayleigh scattering setup to measure density fluctuations in thermal boundary layers

NASA Astrophysics Data System (ADS)

Panda, J.

2016-12-01

A Rayleigh scattering-based density fluctuation measurement system was set up inside a low-speed wind tunnel of NASA Ames Research Center. The immediate goal was to study the thermal boundary layer on a heated flat plate. A large number of obstacles had to be overcome to set up the system, such as the removal of dust particles using air filters, the use of photoelectron counting electronics to measure low intensity light, an optical layout to minimize stray light contamination, the reduction in tunnel vibration, and an expanded calibration process to relate photoelectron arrival rate to air density close to the plate surface. To measure spectra of turbulent density fluctuations, a two-PMT cross-correlation system was used to minimize the shot noise floor. To validate the Rayleigh measurements, temperature fluctuations spectra were calculated from density spectra and then compared with temperature spectra measured with a cold-wire probe operated in constant current mode. The spectra from the downstream half of the plate were found to be in good agreement with cold-wire probe, whereas spectra from the leading edge differed. Various lessons learnt are discussed. It is believed that the present effort is the first measurement of density fluctuations spectra in a boundary layer flow.

Community-based early warning systems for flood risk mitigation in Nepal

NASA Astrophysics Data System (ADS)

Smith, Paul J.; Brown, Sarah; Dugar, Sumit

2017-03-01

This paper focuses on the use of community-based early warning systems for flood resilience in Nepal. The first part of the work outlines the evolution and current status of these community-based systems, highlighting the limited lead times currently available for early warning. The second part of the paper focuses on the development of a robust operational flood forecasting methodology for use by the Nepal Department of Hydrology and Meteorology (DHM) to enhance early warning lead times. The methodology uses data-based physically interpretable time series models and data assimilation to generate probabilistic forecasts, which are presented in a simple visual tool. The approach is designed to work in situations of limited data availability with an emphasis on sustainability and appropriate technology. The successful application of the forecast methodology to the flood-prone Karnali River basin in western Nepal is outlined, increasing lead times from 2-3 to 7-8 h. The challenges faced in communicating probabilistic forecasts to the last mile of the existing community-based early warning systems across Nepal is discussed. The paper concludes with an assessment of the applicability of this approach in basins and countries beyond Karnali and Nepal and an overview of key lessons learnt from this initiative.

The dimensions of land use change in rural landscapes: lessons learnt from the GB Countryside Surveys.

PubMed

Petit, Sandrine

2009-07-01

Rural landscapes are highly dynamic and their change impacts on a number of ecological processes such as the dynamics of biodiversity. Although a substantial amount of research has focused on quantifying these changes and their impact on biodiversity, most studies have focused on single dimensions of land use change. This lack of integration in land use change studies can be explained by the fact that data on the spatial, temporal, and ecological dimensions of land use are seldom available for the same geographical location. In this paper, the benefits of taking into account these three dimensions are illustrated with results derived from the Great Britain Countryside Surveys (CS), a large-scale monitoring programme designed to assess change in the extent and ecological condition of British habitats. The overview of CS results presented in this paper shows that (1) changes in land use composition will translate into a variety of spatial patterns; (2) the temporal stability of land use is often lower than can be expected; and (3) there can be large-scale shifts in the ecological condition of the land use types that form our rural landscapes. The benefits of integrated rural landscape studies are discussed in the context of other national monitoring programmes.

Code Modernization of VPIC

NASA Astrophysics Data System (ADS)

Bird, Robert; Nystrom, David; Albright, Brian

2017-10-01

The ability of scientific simulations to effectively deliver performant computation is increasingly being challenged by successive generations of high-performance computing architectures. Code development to support efficient computation on these modern architectures is both expensive, and highly complex; if it is approached without due care, it may also not be directly transferable between subsequent hardware generations. Previous works have discussed techniques to support the process of adapting a legacy code for modern hardware generations, but despite the breakthroughs in the areas of mini-app development, portable-performance, and cache oblivious algorithms the problem still remains largely unsolved. In this work we demonstrate how a focus on platform agnostic modern code-development can be applied to Particle-in-Cell (PIC) simulations to facilitate effective scientific delivery. This work builds directly on our previous work optimizing VPIC, in which we replaced intrinsic based vectorisation with compile generated auto-vectorization to improve the performance and portability of VPIC. In this work we present the use of a specialized SIMD queue for processing some particle operations, and also preview a GPU capable OpenMP variant of VPIC. Finally we include a lessons learnt. Work performed under the auspices of the U.S. Dept. of Energy by the Los Alamos National Security, LLC Los Alamos National Laboratory under contract DE-AC52-06NA25396 and supported by the LANL LDRD program.

Bilevel Model-Based Discriminative Dictionary Learning for Recognition.

PubMed

Zhou, Pan; Zhang, Chao; Lin, Zhouchen

2017-03-01

Most supervised dictionary learning methods optimize the combinations of reconstruction error, sparsity prior, and discriminative terms. Thus, the learnt dictionaries may not be optimal for recognition tasks. Also, the sparse codes learning models in the training and the testing phases are inconsistent. Besides, without utilizing the intrinsic data structure, many dictionary learning methods only employ the l 0 or l 1 norm to encode each datum independently, limiting the performance of the learnt dictionaries. We present a novel bilevel model-based discriminative dictionary learning method for recognition tasks. The upper level directly minimizes the classification error, while the lower level uses the sparsity term and the Laplacian term to characterize the intrinsic data structure. The lower level is subordinate to the upper level. Therefore, our model achieves an overall optimality for recognition in that the learnt dictionary is directly tailored for recognition. Moreover, the sparse codes learning models in the training and the testing phases can be the same. We further propose a novel method to solve our bilevel optimization problem. It first replaces the lower level with its Karush-Kuhn-Tucker conditions and then applies the alternating direction method of multipliers to solve the equivalent problem. Extensive experiments demonstrate the effectiveness and robustness of our method.

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

PubMed Central

2014-01-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed Central

JR, Luft; EH, Snell; GT, DeTitta

2011-01-01

Introduction X-ray crystallography provides the majority of our structural biological knowledge at a molecular level and in terms of pharmaceutical design is a valuable tool to accelerate discovery. It is the premier technique in the field, but its usefulness is significantly limited by the need to grow well-diffracting crystals. It is for this reason that high-throughput crystallization has become a key technology that has matured over the past 10 years through the field of structural genomics. Areas covered The authors describe their experiences in high-throughput crystallization screening in the context of structural genomics and the general biomedical community. They focus on the lessons learnt from the operation of a high-throughput crystallization screening laboratory, which to date has screened over 12,500 biological macromolecules. They also describe the approaches taken to maximize the success while minimizing the effort. Through this, the authors hope that the reader will gain an insight into the efficient design of a laboratory and protocols to accomplish high-throughput crystallization on a single-, multiuser-laboratory or industrial scale. Expert Opinion High-throughput crystallization screening is readily available but, despite the power of the crystallographic technique, getting crystals is still not a solved problem. High-throughput approaches can help when used skillfully; however, they still require human input in the detailed analysis and interpretation of results to be more successful. PMID:22646073

JERM model of care: an in-principle model for dental health policy.

PubMed

Lam, Raymond; Kruger, Estie; Tennant, Marc

2014-01-01

Oral diseases are the most prevalent conditions in the community. Their economic burden is high and their impact on quality of life is profound. There is an increasing body of evidence indicating that oral diseases have wider implications beyond the confines of the mouth. The importance of oral health has not been unnoticed by the government. The Commonwealth (Federal) government under the Howard-led Coalition in 2004 had broken tradition by placing dentistry in its universal health insurance scheme, Medicare. Known as the Chronic Disease Dental Scheme (CDDS), the program aimed to manage patients with chronic conditions as part of the Enhanced Primary Care initiative. This scheme was a landmark policy for several reasons. Besides being the first major dental policy under Medicare, the program proved to be the most expensive and controversial. Unfortunately, cost containment and problems with service provision led to its cessation in 2012 by the Gillard Labor Government. Despite being seen as a failure, the CDDS provided a unique opportunity to assess national policy in practice. By analysing the policy-relevant effects of the CDDS, important lessons can be learnt for policy development. This paper discusses these lessons and has formulated a set of principles recommended for effective oral health policy. The JERM model represents the principles of a justified, economical and research-based model of care.

Implementing a new governance model.

PubMed

Stanley-Clarke, Nicky; Sanders, Jackie; Munford, Robyn

2016-05-16

Purpose - The purpose of this paper is to discuss the lessons learnt from the process of implementing a new model of governance within Living Well, a New Zealand statutory mental health agency. Design/methodology/approach - It presents the findings from an organisational case study that involved qualitative interviews, meeting observations and document analysis. Archetype theory provided the analytical framework for the research enabling an analysis of both the formal structures and informal value systems that influenced the implementation of the governance model. Findings - The research found that the move to a new governance model did not proceed as planned. It highlighted the importance of staff commitment, the complexity of adopting a new philosophical approach and the undue influence of key personalities as key determining factors in the implementation process. The findings suggest that planners and managers within statutory mental health agencies need to consider the implications of any proposed governance change on existing roles and relationships, thinking strategically about how to secure professional commitment to change. Practical implications - There are ongoing pressures within statutory mental health agencies to improve the efficiency and effectiveness of organisational structures and systems. This paper has implications for how planners and managers think about the process of implementing new governance models within the statutory mental health environment in order to increase the likelihood of sustaining and embedding new approaches to service delivery. Originality/value - The paper presents insights into the process of implementing new governance models within a statutory mental health agency in New Zealand that has relevance for other jurisdictions.

Double degree master program: Optical Design

NASA Astrophysics Data System (ADS)

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

2015-10-01

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

Informing evidence-based policies for ageing and health in Ghana

PubMed Central

Byles, Julie; Aquah, Charles; Amofah, George; Biritwum, Richard; Panisset, Ulysses; Goodwin, James; Beard, John

2015-01-01

Abstract Problem Ghana’s population is ageing. In 2011, the Government of Ghana requested technical support from the World Health Organization (WHO) to help revise national policies on ageing and health. Approach We applied WHO’s knowledge translation framework on ageing and health to assist evidence based policy-making in Ghana. First, we defined priority problems and health system responses by performing a country assessment of epidemiologic data, policy review, site visits and interviews of key informants. Second, we gathered evidence on effective health systems interventions in low- middle- and high-income countries. Third, key stakeholders were engaged in a policy dialogue. Fourth, policy briefs were developed and presented to the Ghana Health Services. Local setting Ghana has a well-structured health system that can adapt to meet the health care needs of older people. Relevant changes Six problems were selected as priorities, however after the policy dialogue, only five were agreed as priorities by the stakeholders. The key stakeholders drafted evidence-based policy recommendations that were used to develop policy briefs. The briefs were presented to the Ghana Health Service in 2014. Lessons learnt The framework can be used to build local capacity on evidence-informed policy-making. However, knowledge translation tools need further development to be used in low-income countries and in the field of ageing. The terms and language of the tools need to be adapted to local contexts. Evidence for health system interventions on ageing populations is very limited, particularly for low- and middle-income settings. PMID:25558107

Building the Synergy between Public Sector and Research Data Infrastructures

NASA Astrophysics Data System (ADS)

Craglia, Massimo; Friis-Christensen, Anders; Ostländer, Nicole; Perego, Andrea

2014-05-01

INSPIRE is a European Directive aiming to establish a EU-wide spatial data infrastructure to give cross-border access to information that can be used to support EU environmental policies, as well as other policies and activities having an impact on the environment. In order to ensure cross-border interoperability of data infrastructures operated by EU Member States, INSPIRE sets out a framework based on common specifications for metadata, data, network services, data and service sharing, monitoring and reporting. The implementation of INSPIRE has reached important milestones: the INSPIRE Geoportal was launched in 2011 providing a single access point for the discovery of INSPIRE data and services across EU Member States (currently, about 300K), while all the technical specifications for the interoperability of data across the 34 INSPIRE themes were adopted at the end of 2013. During this period a number of EU and international initiatives has been launched, concerning cross-domain interoperability and (Linked) Open Data. In particular, the EU Open Data Portal, launched in December 2012, made provisions to access government and scientific data from EU institutions and bodies, and the EU ISA Programme (Interoperability Solutions for European Public Administrations) promotes cross-sector interoperability by sharing and re-using EU-wide and national standards and components. Moreover, the Research Data Alliance (RDA), an initiative jointly funded by the European Commission, the US National Science Foundation and the Australian Research Council, was launched in March 2013 to promote scientific data sharing and interoperability. The Joint Research Centre of the European Commission (JRC), besides being the technical coordinator of the implementation of INSPIRE, is also actively involved in the initiatives promoting cross-sector re-use in INSPIRE, and sustainable approaches to address the evolution of technologies - in particular, how to support Linked Data in INSPIRE and the use of global persistent identifiers. It is evident that government and scientific data infrastructures are currently facing a number of issues that have already been addressed in INSPIRE. Sharing experiences and competencies will avoid re-inventing the wheel, and help promoting the cross-domain adoption of consistent solutions. Actually, one of the lessons learnt from INSPIRE and the initiatives in which JRC is involved, is that government and research data are not two separate worlds. Government data are commonly used as a basis to create scientific data, and vice-versa. Consequently, it is fundamental to adopt a consistent approach to address interoperability and data management issues shared by both government and scientific data. The presentation illustrates some of the lessons learnt during the implementation of INSPIRE and in work on data and service interoperability coordinated with European and international initiatives. We describe a number of critical interoperability issues and barriers affecting both scientific and government data, concerning, e.g., data terminologies, quality and licensing, and propose how these problems could be effectively addressed by a closer collaboration of the government and scientific communities, and the sharing of experiences and practices.

Process, practice and priorities — key lessons learnt undertaking sensitive social reconnaissance research as part of an (UNESCO-IOC) International Tsunami Survey Team

NASA Astrophysics Data System (ADS)

van Zijll de Jong, Shona L.; Dominey-Howes, Dale; Roman, Carolina E.; Calgaro, Emma; Gero, Anna; Veland, Siri; Bird, Deanne K.; Muliaina, Tolu; Tuiloma-Sua, Dawn; Afioga, Taulagi Latu

2011-07-01

The 29 September 2009 South Pacific tsunami has had a lasting impact upon local coastal villages and global collaborative research efforts. Locally, the impact of the tsunami is one of the most severe disasters Samoa has experienced in the last several decades. Within one week of the event, 143 people died. Approximately 6000 traumatized men, women and children - terrified of the sea - refused to return to live or work in their rural, coastal villages, which in turn has had broad consequences for humanitarian emergency relief distribution networks and early recovery planning efforts. Researchers came from all over the world to participate in the UNESCO International Oceanographic Commission (IOC) Samoa International Tsunami Survey Team (ITST). Focusing on the need for interdisciplinary research, for the first time, a social impact assessment team (SIT) was expressly invited to participate. Within days of the tsunami, a group of Australian, New Zealand, American, Fijian, and Japanese disaster researchers began to discuss how they might develop a social science reconnaissance research plan using innovative approaches and best practice. This paper presents an overview of challenges faced by the social impact assessment team with a focus on lessons to be learnt from this experience. We discuss the need to clarify project boundaries, develop a core research agenda and project milestones, and develop day-to-day fieldwork work plans and at the same time be sensitive to the emotional needs of the interviewees as well as the researchers. We also make several practical suggestions for future social reconnaissance research with a set of recommendations to support disaster researchers as they plan their own research projects. The inclusion of a social impacts assessment group within a UNESCO-IOC ITST was a valuable response to the increasing need for responsible social research in sensitive topics of post-disaster analysis. Social scientists are aware that disaster social science research should not be a risk to the public, and that misconduct in such work should be avoided as far as possible. We believe that the inclusion of social science experts will revolutionise conceptual, methodological and empirical approaches in future ITSTs. Social scientists will provide unprecedented volumes of high quality information on post-disaster movements, communication and response activities by individuals, communities, private and public sectors — because social scientists are concerned about the integrity of the research process and results. Building upon our experiences, future ITSTs may tap into the potential that social science has to transform ITST's capacity to gather information about disaster preparedness, what tsunami survivors saw, heard and experienced, and to reconstruct the socio-economic and political dynamics of affected communities. This paper contributes to the limited literature that outlines how to develop responsible plans and processes for post-tsunami disaster work; and, it furthers a line of inquiry applicable to a wide variety of hazards, such as flooding, cyclones, earthquakes, bushfires, pandemics and terrorism.

SMART-1 operations experience and lessons learnt

NASA Astrophysics Data System (ADS)

Camino, Octavio; Alonso, Maria; Gestal, Daniel; de Bruin, Jurriaan; Rathsman, Peter; Kugelberg, Joakim; Bodin, Per; Ricken, Sascha; Blake, Rick; Voss, Pablo Pardo; Stagnaro, Luca

2007-06-01

SMART-1 is the first of a series of ESA Small Missions for Advance Research and Technology where elements of the platform and the payload technology have been conceived as a demonstration for future cornerstone missions and an early opportunity for science. SMART-1 has also been an opportunity to experiment with new ways of conducting ground operations taking advantage of both increased satellite autonomy and ground automation tools. The paper will focus on three areas: The accumulated performance of the technology demonstration components since launch as the electrical propulsion engine, the triple-junction solar cells, the lithium-ion batteries, the 32 bit CPU ERC32 Single Chip, the CAN bus, the DTU Star Trackers and the complex on-board autonomy. The changes implemented on-board and on the ground during the lunar phase to increase the data return. The pros and contras in some of the choices made for SMART-1, the developments and solutions implemented to mitigate the problems, the tools developed to automate the operations and the distribution of data.

Pesticide leaching through sandy and loamy fields - long-term lessons learnt from the Danish Pesticide Leaching Assessment Programme.

PubMed

Rosenbom, Annette E; Olsen, Preben; Plauborg, Finn; Grant, Ruth; Juhler, René K; Brüsch, Walter; Kjær, Jeanne

2015-06-01

The European Union authorization procedure for pesticides includes an assessment of the leaching risk posed by pesticides and their degradation products (DP) with the aim of avoiding any unacceptable influence on groundwater. Twelve-year's results of the Danish Pesticide Leaching Assessment Programme reveal shortcomings to the procedure by having assessed leaching into groundwater of 43 pesticides applied in accordance with current regulations on agricultural fields, and 47 of their DP. Three types of leaching scenario were not fully captured by the procedure: long-term leaching of DP of pesticides applied on potato crops cultivated in sand, leaching of strongly sorbing pesticides after autumn application on loam, and leaching of various pesticides and their DP following early summer application on loam. Rapid preferential transport that bypasses the retardation of the plow layer primarily in autumn, but also during early summer, seems to dominate leaching in a number of those scenarios. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health care – an everlasting challenge in temporal and spatial domains

PubMed Central

Chen, Wenxi

2010-01-01

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

Method and application of ocean environmental awareness measurement: Lessons learnt from university students of China.

PubMed

Umuhire, Marie Louise; Fang, Qinhua

2016-01-30

Different studies have proved that enhancing public Ocean Environmental Awareness (OEA) will lead to increased public support for ocean environmental protection. Our study develops a questionnaire to investigate current levels of students' OEA from three aspects including ocean environmental concerns, ocean environment knowledge and willingness to participate in ocean related activities. This questionnaire was applied to students from Xiamen University to understand the OEA of university students in China, of which there are few studies. Using data gathered from a random purposive sample, the OEA level of students in Xiamen University was investigated and then the influencing factors (education, geographical situation, age and gender etc.) were further analyzed. Findings suggest that most students are concerned about the ocean environment but their knowledge is not enough that makes the willingness to participate in ocean related actions limited as well. The results show there is an urgent need to improve students' OEA. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving compliance with requirements on junior doctors' hours

PubMed Central

Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E

2003-01-01

Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942

Policy Support and Resources Mobilization for the National Schistosomiasis Control Programme in The People's Republic of China.

PubMed

Zhu, H; Yap, P; Utzinger, J; Jia, T-W; Li, S-Z; Huang, X-B; Cai, S-X

2016-01-01

Schistosomiasis remains a public health problem in many developing countries around the world. After the founding of The People's Republic of China, from 1949 till date, all levels of government, from central to local, have been attaching great importance to schistosomiasis control in The People's Republic of China. With considerable policy support and resources mobilization, the national schistosomiasis control programmes have been implemented during the past 65years. Here, we summarize the successful experience of schistosomiasis control during the process. Recommendations for the future management of the Chinese national schistosomiasis elimination programme are put forward after considering the remaining challenges, shortcomings and lessons learnt from 65years of schistosomiasis control drives in The People's Republic of China. They will help to sustain past achievements, foster the attainment of the ultimate goal of schistosomiasis elimination for the country and provide reference for schistosomiasis control programme in other countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

Osborne, M; Smith, J E

2015-01-01

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

The Evolution of the Stem Cell Theory for Heart Failure

PubMed Central

Silvestre, Jean-Sébastien; Menasché, Philippe

2015-01-01

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

EU-AIMS Longitudinal European Autism Project (LEAP): the autism twin cohort.

PubMed

Isaksson, Johan; Tammimies, Kristiina; Neufeld, Janina; Cauvet, Élodie; Lundin, Karl; Buitelaar, Jan K; Loth, Eva; Murphy, Declan G M; Spooren, Will; Bölte, Sven

2018-01-01

EU-AIMS is the largest European research program aiming to identify stratification biomarkers and novel interventions for autism spectrum disorder (ASD). Within the program, the Longitudinal European Autism Project (LEAP) has recruited and comprehensively phenotyped a rare sample of 76 monozygotic and dizygotic twins, discordant, or concordant for ASD plus 30 typically developing twins. The aim of this letter is to complete previous descriptions of the LEAP case-control sample, clinically characterize, and investigate the suitability of the sample for ASD twin-control analyses purposes and share some 'lessons learnt.' Among the twins, a diagnosis of ASD is associated with increased symptom levels of ADHD, higher rates of intellectual disability, and lower family income. For the future, we conclude that the LEAP twin cohort offers multiple options for analyses of genetic and shared and non-shared environmental factors to generate new hypotheses for the larger cohort of LEAP singletons, but particularly cross-validate and refine evidence from it.

Ineffective pictorial health warnings on tobacco products: lessons learnt from India.

PubMed

Arora, Monika; Tewari, Abha; Nazar, Gaurang P; Gupta, Vinay K; Shrivastav, Radhika

2012-01-01

Pictorial warnings are effective in promoting smoking cessation as shown by research in the developed countries. This study aims to determine perceptions of Indians about the effectiveness of pictorial health warnings on tobacco packs which existed from May 31, 2009, to December 1, 2011. A cross-sectional survey was undertaken in five states of India with 1897 participants (56% males; 54% tobacco users). More tobacco users expressed that the pictorial warnings are inadequate to convey the health impact of tobacco use when compared with nonusers (71.50% vs. 62.75%; P < 0.001). More illiterates when compared with literates expressed their concern that the current pictorial warnings will not motivate them to quit (61.17% vs. 51.01%; P < 0.001). The new warnings implemented from December 1, 2011, in India are also not field-tested. Field testing and assessment of effectiveness of health warnings should be a mandatory requirement for Parties reporting on Article 11 of Framework Convention on Tobacco Control (FCTC).

Listening to the student voice to improve educational software.

PubMed

van Wyk, Mari; van Ryneveld, Linda

2017-01-01

Academics often develop software for teaching and learning purposes with the best of intentions, only to be disappointed by the low acceptance rate of the software by their students once it is implemented. In this study, the focus is on software that was designed to enable veterinary students to record their clinical skills. A pilot of the software clearly showed that the program had not been received as well as had been anticipated, and therefore the researchers used a group interview and a questionnaire with closed-ended and open-ended questions to obtain the students' feedback. The open-ended questions were analysed with conceptual content analysis, and themes were identified. Students made valuable suggestions about what they regarded as important considerations when a new software program is introduced. The most important lesson learnt was that students cannot always predict their needs accurately if they are asked for input prior to the development of software. For that reason student input should be obtained on a continuous and regular basis throughout the design and development phases.

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

PubMed Central

Dussault, Gilles; Franceschini, Maria Cristina

2006-01-01

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

The international development of forensic science standards - A review.

PubMed

Wilson-Wilde, Linzi

2018-04-16

Standards establish specifications and procedures designed to ensure products, services and systems are safe, reliable and consistently perform as intended. Standards can be used in the accreditation of forensic laboratories or facilities and in the certification of products and services. In recent years there have been various international activities aiming at developing forensic science standards and guidelines. The most significant initiative currently underway within the global forensic community is the development of International Organization for Standardization (ISO) standards. This paper reviews the main bodies working on standards for forensic science, the processes used and the implications for accreditation. This paper specifically discusses the work of ISO Technical Committee TC272, the future TC272 work program for the development of forensic science standards and associated timelines. Also discussed, are the lessons learnt to date in navigating the complex environment of multi-country stakeholder deliberations in standards development. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Google Books: making the public domain universally accessible

NASA Astrophysics Data System (ADS)

Langley, Adam; Bloomberg, Dan S.

2007-01-01

Google Book Search is working with libraries and publishers around the world to digitally scan books. Some of those works are now in the public domain and, in keeping with Google's mission to make all the world's information useful and universally accessible, we wish to allow users to download them all. For users, it is important that the files are as small as possible and of printable quality. This means that a single codec for both text and images is impractical. We use PDF as a container for a mixture of JBIG2 and JPEG2000 images which are composed into a final set of pages. We discuss both the implementation of an open source JBIG2 encoder, which we use to compress text data, and the design of the infrastructure needed to meet the technical, legal and user requirements of serving many scanned works. We also cover the lessons learnt about dealing with different PDF readers and how to write files that work on most of the readers, most of the time.

Community participation in natural resources management: reality or rhetoric? Lessons learnt from the Kasanka Game Management Area (GMA) communities, Serenje District, Zambia.

PubMed

Mutamba, Emmanuel

2004-12-01

In the developing world, the term 'participation' has in recent years become a household word in the same way that 'democracy' or 'gender' have. Development agencies are demanding increased participation in their programmes. The use of the word or its application has become a centre of debate. Due to the difficulties involved in measuring 'participation' or indeed determining levels at which participation should take place, who participates and when, many 'doubting Thomases' have questioned its effectiveness. It has, however been acknowledged in many areas that popular participation changes policies and enhances management and governance. In complex issues of natural resources management, participatory techniques have helped communities develop collective responsibilities towards management of their resources and projects. This paper discusses the complexities of community participation in natural resources management, ranging from interrelations among stakeholders to resource ownership based on the experiences in the Kasanka Game Management Area (KGMA).

Setting research priorities for HIV/AIDS-related research in a post-graduate training programme: lessons learnt from the Nigeria Field Epidemiology and Laboratory Training Programme scientific workshop.

PubMed

Poggensee, Gabriele; Waziri, Ndadilnasiya Endie; Bashorun, Adebobola; Nguku, Patrick Mboya; Fawole, Olufunmilayo Ibitola; Sabitu, Kabir

2014-01-01

In Nigeria the current prevalence of HIV is 4.1% with over 3.5 million infected and estimated 1.5 million in need of anti-retroviral treatment. Epidemiological and implementation studies are necessary for monitoring and evaluation of interventions. To define research areas which can be addressed by participants of the Nigeria Field Epidemiology and Training Programme (NFELTP) a workshop was held in April 2013 in Abuja, Nigeria. Priority research areas were identified using criteria lists for ranking of the relevance of research questions. Based on a research matrix, NFELTP residents developed the aims and objectives, study design for HIV-related research proposals. This workshop was the first workshop held by the NFELTP to establish an inventory of research questions which can be addressed by the residents within their training period. This inventory will help to increase HIV/AIDS-related activities of NFELTP which are in accordance with research needs in Nigeria and PEPFAR objectives.

Comprehensive strategies for the prevention and control of diabetes and cardiovascular diseases in Africa: future directions.

PubMed

Muna, Walinjom F T

2013-01-01

The countries of the Sub Saharan African region have insufficient resources and healthcare systems that are poorly adapted to cope with the longstanding burden associated with communicable diseases and the ongoing HIV/AIDS pandemic. In addition, the rising burden of non-communicable diseases, including diabetes, cardiovascular diseases, and their risk factors, poses additional challenges. These countries need to urgently develop strategies to address these challenges of disease prevention and control. These strategies will require a new vision and more relevant and 'suitable' vocabulary in dealing with healthcare design, planning and implementation (using a cross-sectorial approach). Lessons learnt from the past (e.g. primary health care) in sub-Saharan Africa and other regions of the world may equally prove useful in developing strategies for the prevention and control of non-communicable diseases. Any potential strategy must emphasize the crucial role of economic, social, and environmental health determinants as well as the use of appropriate health technology. © 2013.

Dysonian Approach to SETI: A Fruitful Middle Ground?

NASA Astrophysics Data System (ADS)

Bradbury, R. J.; Cirkovic, M. M.; Dvorsky, G.

We critically assess the prevailing currents in the Search for Extraterrestrial Intelligence (SETI), embodied in the notion of radio-searches for intentional artificial signals as envisioned by pioneers such as Frank Drake, Philip Morrison, Michael Papagiannis and others. In particular, we emphasize (1) the necessity of integrating SETI into a wider astrobiological and future studies context, (2) the relevance of and lessons to be learnt from the anti-SETI arguments, in particular Fermi's paradox, and (3) a need for complementary approach which we dub the Dysonian SETI. It is meaningfully derived from the inventive and visionary ideas of Freeman J. Dyson and his imaginative precursors, like Konstantin E. Tsiolkovsky, Olaf Stapledon, Nikola Tesla or John B. S. Haldane, who suggested macro-engineering projects as the focal points in the context of extrapolations about the future of humanity and, by analogy, other intelligent species. We consider practical ramifications of the Dysonian SETI and indicate some of the promising directions for future work.

Bilateral Malar Reconstruction Using Patient-Specific Polyether Ether Ketone Implants in Treacher-Collins Syndrome Patients With Absent Zygomas.

PubMed

Sainsbury, David C G; George, Alan; Forrest, Christopher R; Phillips, John H

2017-03-01

The authors performed bilateral malar reconstruction using polyether ether ketone implants in 3 patients with Treacher-Collins syndrome with absent, as opposed to hypoplastic, zygomata. These patient-specific implants were fabricated using computed-aided design software reformatted from three-dimensional bony preoperative computed tomography images. The first time the authors performed this procedure the implant compressed the globe resulting in temporary anisocoria that was quickly recognized intraoperatively. The implant was immediately removed and the patient made a full-recovery with no ocular disturbance. The computer-aided design and manufacturing process was adjusted to include periorbital soft-tissue boundaries to aid in contouring the new implants. The same patient, and 2 further patients, subsequently underwent malar reconstruction using this soft tissue periorbital boundary fabrication process with an additional 2 mm relief removed from the implant's orbital surface. These subsequent procedures were performed without complication and with pleasing aesthetic results. The authors describe their experience and the salutary lessons learnt.

Disaster relief and initial response to the earthquake and tsunami in Meulaboh, Indonesia.

PubMed

Lee, V J; Low, E; Ng, Y Y; Teo, C

2005-10-01

The Singapore Humanitarian Assistance Support Group deployed a team of 32 medical relief workers to Meulaboh, Indonesia to provide medical assistance for victims of the 26 December earthquake and tsunami disaster. The team was deployed at a primary healthcare clinic at an internally displaced persons' (IDP) camp and at the sole hospital's emergency and surgical departments. The team saw a total of 1841 patients, 1371 at the clinic and 446 at the hospital's emergency department, and performed surgery on 24 patients. Tsunami-related trauma cases accounted for 31.8% (142) of cases at the emergency department, 1.6% (22) of cases at the clinic, and 91.7% (22) of surgeries. This paper details the difficulties and lessons learnt by the team, including the lack of important resources for healthcare delivery. Water, sanitation, hygiene, and vector control were some of the problems faced, with the goal to provide the most effective public health for the greatest number of people given the limited resources available.

A review of the National pharmacovigilance system in Malta - implementing and operating a pharmacovigilance management system.

PubMed

Tanti, Amy; Micallef, Benjamin; Serracino-Inglott, Anthony; Borg, John-Joseph

2017-01-01

Regulatory authorities have a legal mandate to implement and maintain a Pharmacovigilance System designed to monitor the safety of authorised medicinal products and detect any change to their risk-benefit balance. Areas covered: This review maps the implementation of pharmacovigilance activities in Malta since accession in the EU in mid 2004 and discusses the challenges the Maltese Regulator encountered while setting up adequate and effective systems to fulfil its legal mandate. Areas reviewed are those around ADR reporting, promotion and safety communications including rapid alerts and recalls, direct healthcare professional communications, risk minimisation measures and safety circulars and quality systems. Expert opinion: Within a ten year period, 3 EU directives on pharmacovigilance were implemented by our agency. Despite limitations to resources, based on a prioritised implementation, the legislation provisions are now fully operational with a good level of sustainability. Lessons learnt from this process are discussed in this review. The coming years will involve strengthening and consolidation of existing processes.

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

PubMed

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

2011-10-01

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

Challenges associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience.

PubMed

Sidze, Estelle M; Beekink, Erik; Maina, Beatrice W

2015-05-05

Universal access to reproductive health services entails strengthening health systems, but requires significant resource commitments as well as efficient and effective use of those resources. A number of international organizations and governments in developing countries are putting efforts into tracking the flow of health resources in order to inform resource mobilization and allocation, strategic planning, priority setting, advocacy and general policy making. The UNFPA/NIDI-led Resource Flows Project ("The UNFPA/NIDI RF Project") has conducted annual surveys since 1997 to monitor progress achieved by developing countries in implementing reproductive health financial targets. This commentary summarizes the Project experiences and challenges in gathering data on allocation of resources for reproductive health at the domestic level in sub-Saharan African countries. One key lesson learnt from the Project experience is the need for strengthening tracking mechanisms in sub-Saharan African countries and making information on reproductive health resources and expenditures available, in particular the private sector resources.

A Survey of Geosensor Networks: Advances in Dynamic Environmental Monitoring

PubMed Central

Nittel, Silvia

2009-01-01

In the recent decade, several technology trends have influenced the field of geosciences in significant ways. The first trend is the more readily available technology of ubiquitous wireless communication networks and progress in the development of low-power, short-range radio-based communication networks, the miniaturization of computing and storage platforms as well as the development of novel microsensors and sensor materials. All three trends have changed the type of dynamic environmental phenomena that can be detected, monitored and reacted to. Another important aspect is the real-time data delivery of novel platforms today. In this paper, I will survey the field of geosensor networks, and mainly focus on the technology of small-scale geosensor networks, example applications and their feasibility and lessons learnt as well as the current research questions posed by using this technology today. Furthermore, my objective is to investigate how this technology can be embedded in the current landscape of intelligent sensor platforms in the geosciences and identify its place and purpose. PMID:22346721

Considerations for sustainable influenza vaccine production in developing countries.

PubMed

Nannei, Claudia; Chadwick, Christopher; Fatima, Hiba; Goldin, Shoshanna; Grubo, Myriam; Ganim, Alexandra

2016-10-26

Through its Global Action Plan for Influenza Vaccines (GAP), the World Health Organization (WHO) in collaboration with the United States Department of Health and Human Services has produced a checklist to support policy-makers and influenza vaccine manufacturers in identifying key technological, political, financial, and logistical issues affecting the sustainability of influenza vaccine production. This checklist highlights actions in five key areas that are beneficial for establishing successful local vaccine manufacturing. These five areas comprise: (1) the policy environment and health-care systems; (2) surveillance systems and influenza evidence; (3) product development and manufacturing; (4) product approval and regulation; and (5) communication to support influenza vaccination. Incorporating the checklist into national vaccine production programmes has identified the policy gaps and next steps for countries involved in GAP's Technology Transfer Initiative. Lessons learnt from country experiences provide context and insight that complement the checklist's goal of simplifying the complexities of influenza prevention, preparedness, and vaccine manufacturing. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

PubMed Central

Miravitlles, Marc; Anzueto, Antonio

2009-01-01

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

Teaching Science differently

NASA Astrophysics Data System (ADS)

Collery, Véronique

2014-05-01

Using different kind of activities is a good way to motivate students. Depending on the class i suggest them to carry out experiments and write a report of them, to prepare a video (about 3 minutes long) presenting some experiments on a theme they choose among selected topics (working in groups of 2 or 3), to do an oral presentation, to debate on a topic, to participate in scientific breakfast/tea-time. The scientific breakfast or tea-time is an opportunity for students to meet great researchers and to exchange with them friendly sharing a breakfast or a tea-time. For example, to prepare the video, the lesson consists of three steps for a total length of three or four hours.The first step is the selection of the theme and the selection of 2 or 3 impressive, funny, original, visual experiments. The second step is trying out the experiments and the writing of the script. The third step is the making of the video. During the last step the students are supposed to watch and to grade the video. For example, to impulse a debate in a class of 16-year-old students I use a part of the movie 'Appolo 13' (chapter 28). This activity is a new approach of the theme 'the gravitational force' the students learnt in their Physic's curriculum. It's a quite difficult phenomenon to visualize. The lesson consists of three steps for a total length of two hours. During the pre-task phase, students are supposed to do a matching activity to introduce scientific words and their definitions. In the task phase, an extract of the movie APOLLO 13 is shown in order to stimulate students' listening and comprehension. To help them exchange around gravity, and space flights, students are engaged in a CLIL game. In the post-task phase, the pairs join together to form 2 groups. These groups correspond the two options the controllers in Houston make to get the astronauts back home safely. A debate is requested to argue each point of view.

Assessment of the Effectiveness of the Educational Environment Supported by Computer Aided Presentations at Primary School Level

ERIC Educational Resources Information Center

Kose, Erdogan

2009-01-01

The objective of this study is to assess the effectiveness of the educational environment supported by computer aided presentations at primary school. The effectiveness of the environment has been evaluated in terms of students' learning and remembering what they have learnt. In the study, we have compared experimental group and control group in…

Communication in a Human biomonitoring study: Focus group work, public engagement and lessons learnt in 17 European countries.

PubMed

Exley, Karen; Cano, Noemi; Aerts, Dominique; Biot, Pierre; Casteleyn, Ludwine; Kolossa-Gehring, Marike; Schwedler, Gerda; Castaño, Argelia; Angerer, Jürgen; Koch, Holger M; Esteban, Marta; Schoeters, Greet; Den Hond, Elly; Horvat, Milena; Bloemen, Louis; Knudsen, Lisbeth E; Joas, Reinhard; Joas, Anke; Dewolf, Marie-Christine; Van de Mieroop, Els; Katsonouri, Andromachi; Hadjipanayis, Adamos; Cerna, Milena; Krskova, Andrea; Becker, Kerstin; Fiddicke, Ulrike; Seiwert, Margarete; Mørck, Thit A; Rudnai, Peter; Kozepesy, Szilvia; Cullen, Elizabeth; Kellegher, Anne; Gutleb, Arno C; Fischer, Marc E; Ligocka, Danuta; Kamińska, Joanna; Namorado, Sónia; Reis, M Fátima; Lupsa, Ioana-Rodica; Gurzau, Anca E; Halzlova, Katarina; Jajcaj, Michal; Mazej, Darja; Tratnik, Janja Snoj; Huetos, Olga; López, Ana; Berglund, Marika; Larsson, Kristin; Sepai, Ovnair

2015-08-01

A communication strategy was developed by The Consortium to Perform Human Biomonitoring on a European Scale (COPHES), as part of its objectives to develop a framework and protocols to enable the collection of comparable human biomonitoring data throughout Europe. The framework and protocols were tested in the pilot study DEMOCOPHES (Demonstration of a study to Coordinate and Perform Human biomonitoring on a European Scale). The aims of the communication strategy were to raise awareness of human biomonitoring, encourage participation in the study and to communicate the study results and their public health significance. It identified the audiences and key messages, documented the procedure for dissemination of results and was updated as the project progressed. A communication plan listed the tools and materials such as press releases, flyers, recruitment letters and information leaflets required for each audience with a time frame for releasing them. Public insight research was used to evaluate the recruitment material, and the feedback was used to improve the documents. Dissemination of results was coordinated in a step by step approach by the participating countries within DEMOCOPHES, taking into account specific national messages according to the needs of each country. Participants received individual results, unless they refused to be informed, along with guidance on what the results meant. The aggregate results and policy recommendations were then communicated to the general public and stakeholders, followed by dissemination at European level. Several lessons were learnt that may assist other future human biomonitoring studies. Recruitment took longer than anticipated and so social scientists, to help with community engagement, should be part of the research team from the start. As a European study, involving multiple countries, additional considerations were needed for the numerous organisations, different languages, cultures, policies and priorities. Therefore, communication documents should be seen as templates with essential information clearly indicated and the option for each country to tailor the material to reflect these differences. Future studies should consider setting up multidisciplinary networks of medical professionals and communication experts, and holding training workshops to discuss the interpretation of results and risk communication. Publicity and wide dissemination of the results helped to raise awareness of human biomonitoring to the general public, policy makers and other key stakeholders. Effective and timely communication, at all stages of a study, is essential if the potential of human biomonitoring research to improve public health is to be realised. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Early implementation of WHO recommendations for the retention of health workers in remote and rural areas.

PubMed

Buchan, James; Couper, Ian D; Tangcharoensathien, Viroj; Thepannya, Khampasong; Jaskiewicz, Wanda; Perfilieva, Galina; Dolea, Carmen

2013-11-01

The maldistribution of health workers between urban and rural areas is a policy concern in virtually all countries. It prevents equitable access to health services, can contribute to increased health-care costs and underutilization of health professional skills in urban areas, and is a barrier to universal health coverage. To address this long-standing concern, the World Health Organization (WHO) has issued global recommendations to improve the rural recruitment and retention of the health workforce. This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries - the Lao People's Democratic Republic and South Africa - and provides a broader perspective in two regions - Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and evidence-based policies. At regional level, the recommendations sparked a more sustained effort for cross-country policy assessment and joint learning. There is a need for impact assessment and evaluation that focus on the links between the rural availability of health workers and universal health coverage. The effects of any health-financing reforms on incentive structures for health workers will also have to be assessed if the central role of more equitably distributed health workers in achieving universal health coverage is to be supported.

The Road Traffic Injuries Research Network: a decade of research capacity strengthening in low- and middle-income countries.

PubMed

Hyder, Adnan A; Norton, Robyn; Pérez-Núñez, Ricardo; Mojarro-Iñiguez, Francisco R; Peden, Margie; Kobusingye, Olive

2016-02-27

Road traffic crashes have been an increasing threat to the wellbeing of road users worldwide; an unacceptably high number of people die or become disabled from them. While high-income countries have successfully implemented effective interventions to help reduce the burden of road traffic injuries (RTIs) in their countries, low- and middle-income countries (LMICs) have not yet achieved similar results. Both scientific research and capacity development have proven to be useful for preventing RTIs in high-income countries. In 1999, a group of leading researchers from different countries decided to join efforts to help promote research on RTIs and develop the capacity of professionals from LMICs. This translated into the creation of the Road Traffic Injuries Research Network (RTIRN) - a partnership of over 1,100 road safety professionals from 114 countries collaborating to facilitate reductions in the burden of RTIs in LMICs by identifying and promoting effective, evidenced-based interventions and supporting research capacity building in road safety research in LMICs. This article presents the work that RTIRN has done over more than a decade, including production of a dozen scientific papers, support of nearly 100 researchers, training of nearly 1,000 people and 35 scholarships granted to researchers from LMICs to attend world conferences, as well as lessons learnt and future challenges to maximize its work.

Neural architectures for robot intelligence.

PubMed

Ritter, H; Steil, J J; Nölker, C; Röthling, F; McGuire, P

2003-01-01

We argue that direct experimental approaches to elucidate the architecture of higher brains may benefit from insights gained from exploring the possibilities and limits of artificial control architectures for robot systems. We present some of our recent work that has been motivated by that view and that is centered around the study of various aspects of hand actions since these are intimately linked with many higher cognitive abilities. As examples, we report on the development of a modular system for the recognition of continuous hand postures based on neural nets, the use of vision and tactile sensing for guiding prehensile movements of a multifingered hand, and the recognition and use of hand gestures for robot teaching. Regarding the issue of learning, we propose to view real-world learning from the perspective of data-mining and to focus more strongly on the imitation of observed actions instead of purely reinforcement-based exploration. As a concrete example of such an effort we report on the status of an ongoing project in our laboratory in which a robot equipped with an attention system with a neurally inspired architecture is taught actions by using hand gestures in conjunction with speech commands. We point out some of the lessons learnt from this system, and discuss how systems of this kind can contribute to the study of issues at the junction between natural and artificial cognitive systems.

The impact of the web and social networks on vaccination. New challenges and opportunities offered to fight against vaccine hesitancy.

PubMed

Stahl, J-P; Cohen, R; Denis, F; Gaudelus, J; Martinot, A; Lery, T; Lepetit, H

2016-05-01

Vaccine hesitancy is a growing and threatening trend, increasing the risk of disease outbreaks and potentially defeating health authorities' strategies. We aimed to describe the significant role of social networks and the Internet on vaccine hesitancy, and more generally on vaccine attitudes and behaviors. Presentation and discussion of lessons learnt from: (i) the monitoring and analysis of web and social network contents on vaccination; (ii) the tracking of Google search terms used by web users; (iii) the analysis of Google search suggestions related to vaccination; (iv) results from the Vaccinoscopie(©) study, online annual surveys of representative samples of 6500 to 10,000 French mothers, monitoring vaccine behaviors and attitude of French parents as well as vaccination coverage of their children, since 2008; and (v) various studies published in the scientific literature. Social networks and the web play a major role in disseminating information about vaccination. They have modified the vaccination decision-making process and, more generally, the doctor/patient relationship. The Internet may fuel controversial issues related to vaccination and durably impact public opinion, but it may also provide new tools to fight against vaccine hesitancy. Vaccine hesitancy should be fought on the Internet battlefield, and for this purpose, communication strategies should take into account new threats and opportunities offered by the web and social networks. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Breast conservation in locally advanced breast cancer in developing countries: wise or waste.

PubMed

Tewari, Mallika; Krishnamurthy, Arvind; Shukla, Hari S

2009-03-01

Breast conservation as an additional benefit was beyond the initial expectations of the investigators who pioneered neoadjuvant chemotherapy (NACT). In recent years an increasing number of patients with locally advanced breast cancer (LABC) are being treated with NACT, followed by breast conservation surgery with axillary dissection and radiation as a part of the multimodality management. Breast conservation has not been the standard of care for women with LABC, owing to concerns of increased chances of local recurrence, and possible survival disadvantage and psychological trauma from experiencing a recurrence of malignancy. LABC is still a common form of presentation of breast cancer in developing countries. Strict adherence to treatment protocols and regular follow-ups for years may not be practical for a large majority of patients hailing from the regions most affected by LABC. Defaulters often thus have a heavy price to pay. Hence lies the importance of carefully selecting LABC patients for a breast conservation approach from others that would have a higher risk of locoregional recurrence. Can we extrapolate the lessons learnt in early breast cancer to LABC and offer selected patients with LABC breast conservation therapy? Would the local control and survival results with conservative therapy be comparable to those obtained using mastectomy, or does the increased tumor burden in LABC necessitate ablative surgery in all women? This review aims to address these important questions.

Managing diabetes at high altitude: personal experience with support from a Multidisciplinary Physical Activity and Diabetes Clinic.

PubMed

Malcolm, Gary; Rilstone, Sian; Sivasubramaniyam, Sivasujan; Jairam, Carol; Chew, Stephen; Oliver, Nick; Hill, Neil E

2017-01-01

Physical activity is important for well-being but can be challenging for people with diabetes. Data informing support of specialist activities such as climbing and high-altitude trekking are limited. A 42-year-old man with type 1 diabetes (duration 30 years) attended a Multidisciplinary Physical Activity and Diabetes Clinic planning to climb Mont Blanc during the summer and trek to Everest Base Camp in the autumn. His aims were to complete these adventures without his diabetes impacting on their success. We report the information provided that enabled him to safely facilitate his objectives, in particular, the requirement for frequent checking of blood glucose levels, the effects of altitude on insulin dose requirements, and recognition that acute mountain sickness may mimic the symptoms of hypoglycaemia and vice versa. Real-time continuous glucose monitoring was made available for his treks. The effects of high altitude on blood glucose results and glycaemic variability while treated on multiple daily injections of insulin are reported. In addition, we present a first-person account of his experience and lessons learnt from managing diabetes at high altitude. A dedicated Multidisciplinary Physical Activity and Diabetes Clinic delivering individualised, evidence-based, patient-focused advice on the effects of altitude on blood glucose levels, and provision of real-time continuous glucose monitoring enabled uneventful completion of a trek to Everest Base Camp in a person with type 1 diabetes.

Environmental and socio-economic sustainability appraisal of contaminated land remediation strategies: A case study at a mega-site in China.

PubMed

Song, Yinan; Hou, Deyi; Zhang, Junli; O'Connor, David; Li, Guanghe; Gu, Qingbao; Li, Shupeng; Liu, Peng

2018-01-01

Green and sustainable remediation (GSR) has become a global trend in the contaminated land remediation field. Growing numbers of countries have adopted GSR procedures published in regulatory and/or technical guidance. China is fast becoming one of the largest remediation markets in the world, and is beginning to engage with GSR. Among other efforts, a taskforce is currently developing the first Chinese technical standard on GSR. This paper presents the context positioning and development of a sustainable remediation assessment indicator set for China. This sustainability indicator set was formed based on existing sustainable remediation guidelines and literature. LCA was used to evaluate environmental impacts, and the results combined with social and economic appraisal via MCA. The indicator set was applied to a remediation 'mega-site' in China. The results showed that compared to excavation and landfill, an alternative treatment strategy of soil washing, thermal desorption and S/S brought about relatively less waste generation, better worker safety, and preferable local impacts, leading to higher scores in the environmental and social-economic domains. However, the social-economic scores were limited by a lack of public engagement. The results of the case study have shown that the indicator set is valid, with lessons learnt and suggestions for improvement discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Forgotten public health impacts of cancer - an overview.

PubMed

Viegas, Susana; Ladeira, Carina; Costa-Veiga, Ana; Perelman, Julian; Gajski, Goran

2017-12-20

Cancer is one of the diseases of greatest concern in developed countries and much effort has been invested in discovering and developing therapeutics for curing cancer. Despite the improvements in antineoplastic therapeutics in the last decades, cancer is still one of the most harmful diseases worldwide. The global burden of cancer also implies financial costs: these can be direct costs, such as those related to treatment, care, and rehabilitation and indirect, which include the loss of economic output due to missed work (morbidity costs) and premature death (mortality costs). There are also hidden costs such as health insurance premiums and nonmedical expenses that are worth noting. This paper intends to present an overview of the generally forgotten impacts that the increasing number of cancer cases can have on the environment, workers who handle antineoplastic drugs, and health services. The knowledge available of each of the impacts will be addressed and discussed regarding the expected development. Overall, lessons learnt reflect on the impact of cancer through aspects not commonly evidenced in the literature or even considered in socio-economic analysis, in part due to the fact that these are difficult to contemplate in direct and indirect cancer costs already defined. Attention may be drawn to the need of continuous investment in prevention to reduce the negative impact on the environment, and in the health of workers who handle antineoplastic drugs for patients' treatment.

Lessons from the pilot of a mobile application to map assistive technology suppliers in Africa.

PubMed

Visagie, Surona J; Matter, Rebecca; Kayange, George M; Chiwaula, Mussa; Harniss, Mark; Mji, Gubela; Scheffler, Elsje

2018-01-01

A pilot project to develop and implement a mobile smartphone application (App) that tracks and maps assistive technology (AT) availability in southern Africa was launched in Botswana in 2016. The App was developed and tested through an iterative process. The concept of the App (AT-Info-Map) was well received by most stakeholders within the pilot country, and broader networks. Several technical and logistical obstacles were encountered. These included high data costs; difficulty in accessing AT information from the public healthcare sector, the largest supplier of AT; and the high human resource demand of collecting and keeping up-to-date device-level information within a complex and fragmented supply sector that spans private, public and civil society entities. The challenges were dealt with by keeping the data burden low and eliminating product-level tracking. The App design was expanded to include disability services, contextually specific AT categories and make navigation more intuitive. Long-term sustainability strategies like generating funding through advertisements on the App or supplier usage fees must be explored. Outreach and sensitisation programmes about both the App and AT in general must be intensified. The project team must continually strengthen partnerships with private and public stakeholders to ensure ongoing project engagement. The lessons learnt might be of value to others who wish to embark on initiatives in AT and/or implement Apps in health or disability in southern Africa and in low-resourced settings around the world.

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

Hyman, E.L.

Efforts at promoting more fuel-efficient charcoal stoves to replace traditional charcoal stoves in Kenya offer some lessons for the dissemination of appropriate technologies. This paper looks at the market-based approach which has made the Kenyan charcoal stoves project a success. Trends in woodfuels (wood and charcoal) consumption in Kenya are identified; the traditional technology for charcoal combustion and the upgraded traditional technologies are described; production achievement and the dissemination and promotion strategy used are examined; and a financial and economic analysis is performed with social, health and environmental effects assessed. Other ways to achieve a more favourable balance between woodfuelsmore » consumption and supply are then discussed looking at more efficient charcoal kilns and household woodstoves, improved institutional stoves and increased wood production. The replication potential of the Kenya experiment in other countries is also explored. The lessons learnt from the the Kenya experience concern the relationship between technology, choice and delivery systems as they interact with, economic, institutional, and policy factors. In this case, the design work accepted the traditional technology as a starting point which helped ensure widespread acceptance by households. The potential desirability of relying on local artisans to manufacture consumer durables using existing private sector channels to market these goods is also shown. It also highlights the importance of going beyond a laissez-faire approach and supporting training, demonstration, and publicity to faciliate the workings of the private sector. In the Kenyan case, technology choice was relatively unsubsidized and left ot the preferences of consumers.« less

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

PubMed

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

2012-06-14

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

Ebola virus - epidemiology, diagnosis, and control: threat to humans, lessons learnt, and preparedness plans - an update on its 40 year's journey.

PubMed

Singh, Raj Kumar; Dhama, Kuldeep; Malik, Yashpal Singh; Ramakrishnan, Muthannan Andavar; Karthik, Kumaragurubaran; Khandia, Rekha; Tiwari, Ruchi; Munjal, Ashok; Saminathan, Mani; Sachan, Swati; Desingu, Perumal Arumugam; Kattoor, Jobin Jose; Iqbal, Hafiz M N; Joshi, Sunil Kumar

2017-12-01

Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are underway for testing against EBOV. In the absence of any effective control measure, the adaptation of high standards of biosecurity measures, strict sanitary and hygienic practices, strengthening of surveillance and monitoring systems, imposing appropriate quarantine checks and vigilance on trade, transport, and movement of visitors from EVD endemic countries remains the answer of choice for tackling the EBOV spread. Herein, we converse with the current scenario of EBOV giving due emphasis on animal and veterinary perspectives along with advances in diagnosis and control strategies to be adopted, lessons learned from the recent outbreaks and the global preparedness plans. To retrieve the evolutionary information, we have analyzed a total of 56 genome sequences of various EBOV species submitted between 1976 and 2016 in public databases.

The role of the food industry in health: lessons from tobacco?

PubMed

Capewell, Simon; Lloyd-Williams, Ffion

2018-03-01

In this review, we highlight poor diet as the biggest risk factor for non-communicable diseases. We examine the denial tactics used by the food industry, how they reflect the tactics previously used by the tobacco industry, and how campaigners can use this knowledge to achieve future public health successes. Data sources are wide ranging, notably publications relating to public health, obesity and processed food, the effectiveness hierarchy and food industry denialism tactics. Global burden of disease analyses consistently demonstrate that poor diet produces a bigger burden of non-communicable disease than tobacco, alcohol and inactivity put together. The lessons learnt from the tobacco control experience of successfully fighting the tobacco industry can be applied to other industries including processed food and sugary drinks. Tackling obesity and poor diet is a more complex issue than tobacco. Food industries continue to promote weak or ineffective policies such as voluntary reformulation, and resist regulation and taxation. However, the UK food industry now faces increasing pressure from professionals, public and politicians to accept reformulation and taxes, or face more stringent measures. The rise in childhood and adult obesity needs to be arrested and then reversed. Unhealthy processed food and sugary drinks are a major contributing factor. There is increasing interest in the tactics being used by the food industry to resist change. Advocacy and activism will be essential to counter these denialism tactics and ensure that scientific evidence is translated into effective regulation and taxation.

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

PubMed Central

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

2012-01-01

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

Learning in the Circumstances of Practice

ERIC Educational Resources Information Center

Billett, Stephen

2014-01-01

Learning in the circumstances of practice stands as the commonest and most enduring way occupational capacities have been learnt across human history, and, likely, are currently learnt. Yet, a comprehensive account of this means of learning remains absent, which limits the legitimacy of workplaces as sites of learning, the learning arising from…

SMOS and SMAP: from Lessons Learned to Future Mission Requirements

NASA Astrophysics Data System (ADS)

Kerr, Y. H.; Wigneron, J. P.; Cabot, F.; Escorihuela, M. J.; Anterrieu, E.; Rouge, B.; Rodriguez Fernandez, N.; Bindlish, R.; Khazaal, A.; Al-Bitar, A.; Mialon, A.; Lesthievent, G.

2017-12-01

The SMOS (Soil Moisture and Ocean Salinity) satellite was successfully launched in November 2009. This ESA led mission for Earth Observation is dedicated to provide soil moisture over continental surface, vegetation water content over land, and ocean salinity. The Soil Moisture and Ocean Salinity mission has now been collecting data for over 7 years. TheSoil Moisture Active and Passive for over 2 years.The two data set have been reprocessed (Version 620 for levels 1 and 2 and version 3 for level 3 CATDS) to be merged into one product, while operational near real time soil moisture data is now available and assimilation of SMOS data in NWP has proved successful. After 7 years of L-Band data acquisition, it seems important to start using data for having a look at anomalies and see how they can relate to large scale events. We have also produced a 15 year soil moisture data set by merging SMOS and AMSR using a neural network approach. The purpose of this communication is to present the two mission results after more than seven years in orbit in a climatic trend perspective, as through such a period anomalies can be detected. Thereby we benefit from consistent datasets provided through the latest reprocessing using most recent algorithm enhancements. Using the above mentioned products it is possible to follow large events such as the evolution of the droughts in North America, or water fraction evolution over the Amazonian basin. In this occasion we will focus on the analysis of SMOS and ancillary products anomalies to reveal two climatic trends, the temporal evolution of water storage over the Indian continent in relation to rainfall anomalies, and the global impact of El Nino types of events on the general water storage distribution. This presentation shows in detail the use of long term data sets of L-band microwave radiometry in two specific cases, namely droughts and water budget over a large basin. Several other analyses are under way currently. Obviously, vegetation water content, but also dielectric constant, are carrying a wealth of information and some interesting perspectives will be presented. More important it is now possible to draw conclusions from the lessons learnt and, with the help of the user's community, define the requirements for future missions. And, finally, from these requirement to propose mission scenarii.

Curating Big Data Made Simple: Perspectives from Scientific Communities.

PubMed

Sowe, Sulayman K; Zettsu, Koji

2014-03-01

The digital universe is exponentially producing an unprecedented volume of data that has brought benefits as well as fundamental challenges for enterprises and scientific communities alike. This trend is inherently exciting for the development and deployment of cloud platforms to support scientific communities curating big data. The excitement stems from the fact that scientists can now access and extract value from the big data corpus, establish relationships between bits and pieces of information from many types of data, and collaborate with a diverse community of researchers from various domains. However, despite these perceived benefits, to date, little attention is focused on the people or communities who are both beneficiaries and, at the same time, producers of big data. The technical challenges posed by big data are as big as understanding the dynamics of communities working with big data, whether scientific or otherwise. Furthermore, the big data era also means that big data platforms for data-intensive research must be designed in such a way that research scientists can easily search and find data for their research, upload and download datasets for onsite/offsite use, perform computations and analysis, share their findings and research experience, and seamlessly collaborate with their colleagues. In this article, we present the architecture and design of a cloud platform that meets some of these requirements, and a big data curation model that describes how a community of earth and environmental scientists is using the platform to curate data. Motivation for developing the platform, lessons learnt in overcoming some challenges associated with supporting scientists to curate big data, and future research directions are also presented.

Implementing maternal death surveillance and response: a review of lessons from country case studies.

PubMed

Smith, Helen; Ameh, Charles; Roos, Natalie; Mathai, Matthews; Broek, Nynke van den

2017-07-17

Maternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify lessons for improving implementation. A secondary analysis of ten case studies from countries at different stages of MDSR implementation, using a policy analysis framework to draw out lessons learnt and opportunities for improvement. We identify the consistent drivers of success in countries with well-established systems for MDSR, and common barriers in countries were Maternal Death Review (MDR) systems have been less successful. MDR is accepted and ongoing at subnational level in many countries, but it is not adequately institutionalised and the shift from facility based MDR to continuous MDSR that informs the wider health system still needs to be made. Our secondary analysis of country experiences highlights the need for a) social and team processes at facility level, for example the existence of a 'no shame, no blame' culture, and the ability to reflect on practice and manage change as a team for recommendations to be acted upon, b) health system inputs including adequate funding and reliable health information systems to enable identification and analysis of cases c) national level coordination of dissemination, and monitoring implementation of recommendations at all levels and d) mandatory notification of maternal deaths (and enforcement of this) and a professional requirement to participate in MDRs. Case studies from countries with established MDSR systems can provide valuable guidance on ways to set up the processes and overcome some of the barriers; but the challenge, as with many health system interventions, is to find a way to provide catalytic assistance and strengthen capacity for MDSR such that this becomes embedded in the health system.

Challenges and lessons learned from implementing a risk-based approach to school advice and closure during the containment phase of the 2009 influenza pandemic in the West Midlands, England.

PubMed

Awofisayo, A; Ibbotson, S; Smith, G E; Janmohamed, K; Mohamed, H; Olowokure, B

2013-07-01

School closure as a social distancing measure was used in some countries during the initial phases of the influenza A(H1N1)pdm09 pandemic. The objective of this paper is to describe the use of a risk-based approach to public health interventions for schools during the 'containment phase' of the pandemic and to describe lessons learnt. The development of a framework for risk assessment and decision-making to determine school closures in the West Midlands, England, during the 'containment phase' of influenza A(H1N1)pdm09 pandemic is described. Using the framework developed during the 'containment phase', assessments were conducted for 344 educational institutions who reported confirmed cases or 'particularly high absenteeism'. Of these, 209 (60%) had confirmed cases and 65 were closed, mainly for public health or operational reasons. Schools were closed on an individual basis, during the most intense period of the pandemic and for an average period of six days (maximum 11 days). The risk-based approach evolved as experience and knowledge of influenza A(H1N1)pdm09 pandemic virus increased, however some decisions were difficult to communicate to parents, schools and stakeholders particularly when the number of schools affected escalated and the pandemic response phases changed. The management of school closures is an 'uncertain art'. Numerous challenges and lessons were identified in attempting, during the containment phase of the influenza A(H1N1)pdm09 pandemic, to ensure consistency and transparency in an increasingly complex process. The overall approach described could be further developed to improve decision-making for infectious diseases in schools. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Risk factors and costs of oral cancer in a tertiary care hospital in Delhi.

PubMed

Goyal, Sandeep; Tiwari, Vijay Kumar; Nair, Kesavan Sreekantan; Raj, Sherin

2014-01-01

The present study conducted with 100 oral cancer patients at a private tertiary care hospital in Delhi demonstrated that stage III cancer was associated with longer use of tobacco and poor oral hygiene. There was also statistically significant association (p<.05) between consumption of tobacco and alcohol. More than 60% treatment expenditure was on surgery followed by accommodation (9%) and investigations (8%). The effect of tobacco was well known among patients as 76% of the patients knew that common cancer in tobacco chewer is 'oral cancer', 22% of the patients however responded that they did not know which cancer is common in tobacco chewers. 58% said that they learnt about ill effects of tobacco from media while 24% said they learnt from family and friends. Out of 78 tobacco users, 60 (77%) said that they never received help to quit tobacco while 18(23%) have received help to quit.

Grammar Errors Made by ESL Tertiary Students in Writing

ERIC Educational Resources Information Center

Singh, Charanjit Kaur Swaran; Singh, Amreet Kaur Jageer; Razak, Nur Qistina Abd; Ravinthar, Thilaga

2017-01-01

The educational context in Malaysia demands students to be equipped with sound grammar so that they can produce good essays in the examination. However, despite having learnt English in primary and secondary schools, students in the higher learning institutions tend to make some grammatical errors in their writing. This study presents the…

First- and Second-Language Learnability Explained by Orthographic Depth and Orthographic Learning: A "Natural" Scandinavian Experiment

ERIC Educational Resources Information Center

van Daal, Victor H. P.; Wass, Malin

2017-01-01

Effects of orthographic depth on orthographic learning ability were examined in 10- to 13-year-old children who learnt to read in similar orthographies differing in orthographic depth, defined as consistency of grapheme-to-phoneme correspondences. Danish children who learnt to read a deep orthography underperformed their Swedish counterparts who…

Sequences show rapid motor transfer and spatial translation in the oculomotor system.

PubMed

Stainer, Matthew J; Carpenter, R H S; Brotchie, Peter; Anderson, Andrew J

2016-07-01

Every day we perform learnt sequences of actions that seem to happen almost without awareness. It has been argued that for learning such sequences parallel learning networks exist - one using spatial coordinates and one using motor coordinates - with sequence acquisition involving a progressive shift from the former to the latter as a sequence is rehearsed. When sequences are interrupted by an out-of-sequence target, there is a delay in the response to the target, and so here we transiently interrupt oculomotor sequences to probe the influence of oculomotor rehearsal and spatial coordinates in sequence acquisition. For our main experiments, we used a repeating sequences of eight targets in length that was first learnt either using saccadic eye movements (left/right), manual responses (left/right or up/down) or as a sequence of colour (blue/red) requiring no motor response. The sequence was immediately repeated for saccadic eye movements, during which the influence of on out-of-sequence target (an interruption) was assessed. When a sequence is learnt beforehand in an abstract way (for example, as a sequence of colours or of orthogonally mapped manual responses), interruptions are immediately disruptive to latency, suggesting neither motor rehearsal nor specific spatial coordinates are essential for encoding sequences of actions and that sequences - no matter how they are encoded - can be rapidly translated into oculomotor coordinates. The magnitude of a disruption does, however, correspond to how well a sequence is learnt: introducing an interruption to an extended sequence before it was reliably learnt reduces the magnitude of the latency disruption. Copyright © 2016 Elsevier Ltd. All rights reserved.

Creutzfeldt-Jakob disease and mad cows: lessons learnt from yeast cells.

PubMed

Hofmann, J; Wolf, H; Grassmann, A; Arndt, V; Graham, J; Vorberg, I

2012-01-24

Transmissible spongiform encephalopathies are fatal neurodegenerative diseases that affect mammals including humans. The proteinaceous nature of the infectious agent, the prion, and its propagation, challenge established dogmas in biology. It is now widely accepted that prion diseases are caused by unconventional agents principally composed of a misfolded host-encoded protein, PrP. Surprisingly, major break-throughs in prion research came from studies on functionally unrelated proteins in yeast and filamentous fungi. Aggregates composed of these proteins act as epigenetic elements of inheritance that can propagate their alternative states by a conformational switch into an ordered ß-sheet rich polymer just like mammalian prions. Since their discovery prions of lower eukaryotes have provided invaluable insights into all aspects of prion biogenesis. Importantly, yeast prions provide proof-of-principle that distinct protein conformers can be infectious and can serve as genetic elements that have the capacity to encipher strain specific information. As a powerful and tractable model system, yeast prions will continue to increase our understanding of prion-host cell interaction and potential mechanisms of protein-based epigenetic inheritance.

Paperless registration during survey enumerations and large oral cholera mass vaccination in Zanzibar, the United Republic of Tanzania

PubMed Central

Deen, Jaqueline L; Khatib, Ahmed; Enwere, Godwin; von Seidlein, Lorenz; Reyburn, Rita; Ali, Said Mohammed; Chang, Na Yoon; Perroud, Valérie; Marodon, Frédérique; Saleh, Abdul A; Hashim, R; Lopez, Anna Lena; Beard, James; Ley, Benedikt N; Thriemer, Kamala; Puri, Mahesh K; Sah, Binod; Jiddawi, Mohamed Saleh; Clemens, John D

2010-01-01

Abstract Problem Field trials require extensive data preparation and complex logistics. The use of personal digital assistants (PDAs) can bypass many of the traditional steps that are necessary in a paper-based data entry system. Approach We programmed, designed and supervised the use of PDAs for a large survey enumeration and mass vaccination campaign. Local setting The project was implemented in Zanzibar in the United Republic of Tanzania. Zanzibar is composed of two main islands, Unguja and Pemba, where outbreaks of cholera have been reported since the 1970s. Relevant changes PDAs allowed us to digitize information at the initial point of contact with the respondents. Immediate response by the system in case of error helped ensure the quality and reliability of the data. PDAs provided quick data summaries that allowed subsequent research activities to be implemented in a timely fashion. Lessons learnt Portability, immediate recording and linking of information enhanced structure data collection in our study. PDAs could be more useful than paper-based systems for data collection in the field, especially in impoverished settings in developing countries. PMID:20616976

Status of the Consolidation of the LHC Superconducting Magnets and Circuits

NASA Astrophysics Data System (ADS)

Tock, J. Ph; Atieh, S.; Bodart, D.; Bordry, F.; Bourcey, N.; Cruikshank, P.; Dahlerup-Petersen, K.; Dalin, J. M.; Garion, C.; Musso, A.; Ostojic, R.; Perin, A.; Pojer, M.; Savary, F.; Scheuerlein, C.

2014-05-01

The first LHC long shutdown (LS1) started in February 2013. It was triggered by the need to consolidate the 13 kA splices between the superconducting magnets to allow the LHC to reach safely its design energy of 14 TeV center of mass. The final design of the consolidated splices is recalled. 1695 interconnections containing 10 170 splices have to be opened. In addition to the work on the 13 kA splices, the other interventions performed during the first long shut-down on all the superconducting circuits are described. All this work has been structured in a project, gathering about 280 persons. The opening of the interconnections started in April 2013 and consolidation works are planned to be completed by August 2014. This paper describes first the preparation phase with the building of the teams and the detailed planning of the operation. Then, it gives feedback from the worksite, namely lessons learnt and adaptations that were implemented, both from the technical and organizational points of view. Finally, perspectives for the completion of this consolidation campaign are given.

Listening to the student voice to improve educational software

PubMed Central

van Wyk, Mari; van Ryneveld, Linda

2017-01-01

ABSTRACT Academics often develop software for teaching and learning purposes with the best of intentions, only to be disappointed by the low acceptance rate of the software by their students once it is implemented. In this study, the focus is on software that was designed to enable veterinary students to record their clinical skills. A pilot of the software clearly showed that the program had not been received as well as had been anticipated, and therefore the researchers used a group interview and a questionnaire with closed-ended and open-ended questions to obtain the students’ feedback. The open-ended questions were analysed with conceptual content analysis, and themes were identified. Students made valuable suggestions about what they regarded as important considerations when a new software program is introduced. The most important lesson learnt was that students cannot always predict their needs accurately if they are asked for input prior to the development of software. For that reason student input should be obtained on a continuous and regular basis throughout the design and development phases. PMID:28678678

The rise of governmentality in the Italian National Health System: physiology or pathology of a decentralized and (ongoing) federalist system?

PubMed

Lega, Federico; Sargiacomo, Massimo; Ianni, Luca

2010-11-01

In this paper, we aim to discuss the implications and lessons that can be learnt from the ongoing process of federalism affecting the Italian National Health System (INHS). Many countries are currently taking decisions concerning the decentralization or re-centralization of their health-care systems, with several key issues that are illustrated in the recent history of the INHS. The decentralization process of INHS has produced mixed results, as some regions took advantage of it to strengthen their systems, whereas others were not capable of developing an effective steering role. We argue that the mutual reinforcement of the decentralization and recentralization processes is not paradoxical, but is actually an effective way for the State to maintain control over the equity and efficiency of its health-care system while decentralizing at a regional level. In this perspective, we provide evidence backing up some of the assumptions made in previous works as well as new food-for thought - specifically on how governmentality and federalism should meet - to reshape the debate on decentralization in health care.

Improving the efficiency and standards of a National Immunization Program Review: lessons learnt from United Republic of Tanzania.

PubMed

Lyimo, Dafrossa; Kamugisha, Christopher; Yohana, Emmanuel; Eshetu, Messeret; Wallace, Aaron; Ward, Kirsten; Mantel, Carsten; Hennessey, Karen

2017-01-01

A National Immunization Program Review (NIP Review) is a comprehensive external assessment of the performance of a country's immunization programme. The number of recommended special-topic NIP assessments, such as those for vaccine introduction or vaccine management, has increased. These assessments often have substantial overlap with NIP reviews, raising concern about duplication. Innovative technical and management approaches, including integrating several assessments into one, were applied in the United Republic of Tanzania's 2015 NIP Review. These approaches and processes were documented and a post-Review survey and group discussion. The Tanzania Review found that integrating assessments so they can be conducted at one time was feasible and efficient. There are concrete approaches for successfully managing a Review that can be shared and practiced including having a well-planned desk review and nominating topic-leads. The use of tablets for data entry has the potential to improve Review data quality and timely analysis; however, careful team training is needed. A key area to improve was to better coordinate and link findings from the national-level and field teams.

Setting Research Priorities for HIV/AIDS-related research in a post-graduate training programme: lessons learnt from the Nigeria Field Epidemiology and Laboratory Training Programme scientific workshop

PubMed Central

Poggensee, Gabriele; Waziri, Ndadilnasiya Endie; Bashorun, Adebobola; Nguku, Patrick Mboya; Fawole, Olufunmilayo Ibitola; Sabitu, Kabir

2014-01-01

In Nigeria the current prevalence of HIV is 4.1% with over 3.5 million infected and estimated 1.5 million in need of anti-retroviral treatment. Epidemiological and implementation studies are necessary for monitoring and evaluation of interventions. To define research areas which can be addressed by participants of the Nigeria Field Epidemiology and Training Programme (NFELTP) a workshop was held in April 2013 in Abuja, Nigeria. Priority research areas were identified using criteria lists for ranking of the relevance of research questions. Based on a research matrix, NFELTP residents developed the aims and objectives, study design for HIV-related research proposals. This workshop was the first workshop held by the NFELTP to establish an inventory of research questions which can be addressed by the residents within their training period. This inventory will help to increase HIV/AIDS-related activities of NFELTP which are in accordance with research needs in Nigeria and PEPFAR objectives. PMID:25426209

Measles Elimination Activities in the Western Pacific Region: Experience from the Republic of Korea

PubMed Central

Choe, Young June; Jee, Youngmee; Oh, Myoung-don

2015-01-01

We describe the global status of measles control and elimination, including surveillance and vaccination coverage data provided by the World Health Organization (WHO). Since 2000, two doses of measles vaccine (MCV2) became recommended globally and the achievement of high vaccination coverage has led to dramatic decrease in the measles incidence. Our finding indicates that, in the Western Pacific Region (WPR), substantial progress has been made to control measles transmission in some countries; however, the measles virus continues to circulate, causing outbreaks. The Republic of Korea (ROK) experienced a series of resurgence of measles due to the importation and healthcare-associated transmission in infants, however overall incidence and surveillance indicators met the WHO criteria for measles elimination. The ROK was verified to be measles-free along with Australia, Mongolia, and Macau, China in 2014. One of the effective elimination activities was the establishment of solid keep-up vaccination system in school settings. The lessons learnt from the measles elimination activities in Korea may contribute to enhancing the surveillance schemes and strengthening of vaccination programs in member countries and areas of WPR. PMID:26617443

Lessons learnt from a birthday party: a Bacillus cereus outbreak, Bari, Italy, January 2012.

PubMed

Martinelli, Domenico; Fortunato, Francesca; Tafuri, Silvio; Cozza, Vanessa; Chironna, Maria; Germinario, Cinzia; Pedalino, Biagio; Prato, Rosa

2013-01-01

Bacillus cereus, a ubiquitous bacterium, can be isolated in various starchy food items, causing both emetic and diarrhoeal disease. The real burden of B. cereus outbreaks is actually poorly known in Italy. We report a B. cereus foodborne outbreak that occurred in a pub in Bari (Italy) on January 22nd 2012 during a birthday party, promptly reported by the pub owner. Between January 22nd and 24th 2012, we performed a retrospective cohort study among the guests of the party to identify risk factors associated with illness. Leftovers of different meals were available for microbiological analysis. Faecal specimens were collected from cases. A total of 12 cases among the 13 customers (attack rate: 92%) were reported. All cases had consumed basmati rice and sweet and sour vegetables (aetiological fraction: 100%). B. cereus was isolated from both basmati rice served during the party and faecal specimens. The close collaboration between the pub owner and the public health officers and the possibility to test food leftovers and stool samples contributed to prevent further cases.

Measles Elimination Activities in the Western Pacific Region: Experience from the Republic of Korea.

PubMed

Choe, Young June; Jee, Youngmee; Oh, Myoung-don; Lee, Jong-Koo

2015-11-01

We describe the global status of measles control and elimination, including surveillance and vaccination coverage data provided by the World Health Organization (WHO). Since 2000, two doses of measles vaccine (MCV2) became recommended globally and the achievement of high vaccination coverage has led to dramatic decrease in the measles incidence. Our finding indicates that, in the Western Pacific Region (WPR), substantial progress has been made to control measles transmission in some countries; however, the measles virus continues to circulate, causing outbreaks. The Republic of Korea (ROK) experienced a series of resurgence of measles due to the importation and healthcare-associated transmission in infants, however overall incidence and surveillance indicators met the WHO criteria for measles elimination. The ROK was verified to be measles-free along with Australia, Mongolia, and Macau, China in 2014. One of the effective elimination activities was the establishment of solid keep-up vaccination system in school settings. The lessons learnt from the measles elimination activities in Korea may contribute to enhancing the surveillance schemes and strengthening of vaccination programs in member countries and areas of WPR.

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

PubMed

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

2015-09-01

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

The role of experts in postaccident recovery: lessons learnt from Chernobyl and Fukushima.

PubMed

Gariel, J C; Rollinger, F; Schneider, T

2018-01-01

Following a nuclear accident, a major dilemma for affected people is whether to stay or leave the affected area, or, for those who have been evacuated, whether or not to return to the decontaminated zones. Populations who have to make such decisions have to consider many parameters, one of which is the radiological situation. Feedback from Chernobyl and Fukushima has demonstrated that involvement and empowerment of the affected population is a way to provide them with the necessary elements to make informed decisions and, if they decide to return to decontaminated areas, to minimise exposure by contributing to the development of a prudent attitude and vigilance towards exposure. However, involving stakeholders in postaccident management raises the question of the role of experts and public authorities in supporting the inhabitants who have to make decisions about their future. Based on experiences in Chernobyl and Fukushima, this paper will discuss various principles that have to be taken into account by experts and public authorities about their role and position when dealing with stakeholders in a postaccident recovery process.

Visiting Holocaust-Related Sites with Medical Students as an Aid in Teaching Medical Ethics.

PubMed

González-López, Esteban; Ríos-Cortés, Rosa

2016-05-01

During the Nazi period numerous doctors and nurses played a nefarious role. In Germany they were responsible for the sterilization and killing of disabled persons. Furthermore, the Nazi doctors used concentration camp inmates as guinea pigs in medical experiments for military or racial purposes. A study of the collaboration of doctors with National Socialism exemplifies behavior that must be avoided. Combining medical teaching with lessons from the Holocaust could be a way to transmit Medical Ethics to doctors, nurses and students. The authors describe a study tour with medical students to Poland, to the largest Nazi extermination camp, Auschwitz, and to the city of Krakow. The tour is the final component of a formal course entitled: "The Holocaust, a Reflection from Medicine" at the Autónoma University of Madrid, Spain. Visiting sites related to the Holocaust, the killing centers and the sites where medical experiments were conducted has a singular meaning for medical students. Tolerance, non-discrimination, and the value of human life can be both learnt and taught at the very place where such values were utterly absent.

Multifaceted contributions: health workers and smallpox eradication in India.

PubMed

Bhattacharya, Sanjoy

2008-01-01

Smallpox eradication in South Asia was a result of the efforts of many grades of health-workers. Working from within the confines of international organisations and government structures, the role of the field officials, who were of various nationalities and also drawn from the cities and rural enclaves of the countries in these regions, was crucial to the development and deployment of policies. However, the role of these personnel is often downplayed in official histories and academic histories, which highlight instead the roles played by a handful of senior officials within the World Health Organization and the federal governments in the sub-continent. This article attempts to provide a more rounded assessment of the complex situation in the field. In this regard, an effort is made to underline the great usefulness of the operational flexibility displayed by field officers, wherein lessons learnt in the field were made an integral part of deploying local campaigns; careful engagement with the communities being targeted, as well as the employment of short term workers from amongst them, was an important feature of this work.

Uncertainty in structural interpretation: Lessons to be learnt

NASA Astrophysics Data System (ADS)

Bond, Clare E.

2015-05-01

Uncertainty in the interpretation of geological data is an inherent element of geology. Datasets from different sources: remotely sensed seismic imagery, field data and borehole data, are often combined and interpreted to create a geological model of the sub-surface. The data have limited resolution and spatial distribution that results in uncertainty in the interpretation of the data and in the subsequent geological model(s) created. Methods to determine the extent of interpretational uncertainty of a dataset, how to capture and express that uncertainty, and consideration of uncertainties in terms of risk have been investigated. Here I review the work that has taken place and discuss best practice in accounting for uncertainties in structural interpretation workflows. Barriers to best practice are reflected on, including the use of software packages for interpretation. Experimental evidence suggests that minimising interpretation error through the use of geological reasoning and rules can help decrease interpretation uncertainty; through identification of inadmissible interpretations and in highlighting areas of uncertainty. Understanding expert thought processes and reasoning, including the use of visuospatial skills, during interpretation may aid in the identification of uncertainties, and in the education of new geoscientists.

The 2010 outbreak of poliomyelitis in Tajikistan: epidemiology and lessons learnt.

PubMed

Yakovenko, M L; Gmyl, A P; Ivanova, O E; Eremeeva, T P; Ivanov, A P; Prostova, M A; Baykova, O Y; Isaeva, O V; Lipskaya, G Y; Shakaryan, A K; Kew, O M; Deshpande, J M; Agol, V I

2014-02-20

A large outbreak of poliomyelitis, with 463 laboratory-confirmed and 47 polio-compatible cases, took place in 2010 in Tajikistan. Phylogenetic analysis of the viral VP1 gene suggested a single importation of wild poliovirus type 1 from India in late 2009, its further circulation in Tajikistan and expansion into neighbouring countries, namely Kazakhstan, Russia, Turkmenistan and Uzbekistan. Whole-genome sequencing of 14 isolates revealed recombination events with enterovirus C with cross-overs within the P2 region. Viruses with one class of recombinant genomes co-circulated with the parental virus, and representatives of both caused paralytic poliomyelitis. Serological analysis of 327 sera from acute flaccid paralysis cases as well as from patients with other diagnoses and from healthy people demonstrated inadequate immunity against polio in the years preceding the outbreak. Evidence was obtained suggesting that vaccination against poliomyelitis, in rare cases, may not prevent the disease. Factors contributing to the peculiarities of this outbreak are discussed. The outbreak emphasises the necessity of continued vaccination against polio and the need, at least in risk areas, of quality control of this vaccination through well planned serological surveillance.

Winning the battle against the scourge of poliomyelitis in the African Region.

PubMed

Moeti, Matshidiso

2016-10-10

Recently we have recorded some progress against the transmission of poliovirus in the African Region. This is attributable to a number of factors, including commitment of global partnerships against polio, improvement of existing strategies as well as a number of innovations in response to the disease in the Region. The WHO Regional Office in Africa documented these practices that led to the noticeable progress in the polio eradication initiative in the African Region, as lessons learnt and as part of polio legacy planning. The documentation exercise covered eight countries, namely Angola, Chad, Cote d'Ivoire, Democratic Republic of Congo, Ethiopia, Nigeria, Tanzania and Togo. A number of practices were identified. Some of these practices cut across countries while others were peculiar to specific countries. We have thus developed some manuscripts to capture these practices for publication in scientific journal so as to place them in the public domain for use. It is hoped that these practices will be deployed to other public health programmes in the Region and beyond. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Developing an Inpatient Group Psychotherapy Program: Challenges and Lessons Learnt

PubMed Central

Razaghi, Emran Mohammad; Tabatabaee, Maryam; Pourramzani, Ali; Shirali Mohammadpour, Reza; Mousazade Moghaddam, Arezou; Yahyavi, Seyyed Taha

2015-01-01

In Iran, inpatient group psychotherapy has been limited to transient practices for research purposes or fulfilling personal interest of therapists. The goal of this paper is to share and explain the experience of developing an inpatient group psychotherapy program in Roozbeh Psychiatric Hospital, Tehran, Iran. After theoretical delineation and preparation of a draft of the program guideline, two pilot sessions were held. Based on this initial experience a final treatment guideline was prepared. Afterwards, the program was continued for more than 1 year in a female ward at Roozbeh Psychiatric Hospital. The output of this exercise was a guideline that covers important topics in development of inpatient group psychotherapy. It is concluded that inpatient group psychotherapy has its unique challenges. Of the most important challenges that can be mentioned in this regard are the participation of patients with significant differences in levels of psychopathology and psychiatric signs and symptoms, and high comorbidity with specific personality traits or disorders. Other challenges relevant to the structure of the group include items such as very limited time for working through and inevitable out-of-group contacts. PMID:26576176

Planning for post disaster recovery: Lesson learnt from flood events in Kelantan Malaysia

NASA Astrophysics Data System (ADS)

Rani, Wan Nurul Mardiah Wan Mohd; Nifa, Faizatul Akmar Abdul; Ismail, Mohd Noorizhar; Khalid, Khairin Norhashidah

2017-10-01

As the frequency of disaster occurrence increases, the world cities today are getting more difficult in terms of the management of the event. One of the most discussed issues today is the management of the post-disaster recovery that involves several stages such as the planning, management of multiple stakeholders, restoration, reconstruction and delivery. It is important to note that input from related stakeholders is necessary to make the right decision during this most critical period. In the process of building back after a disaster, it is important to ensure the newly constructed infrastructures are built to be more resilient and able to withstand a certain level of disaster recurrence. Elements of disaster risk reduction should be incorporated in the planning, redesign, construction and the operation of the built environment. In Malaysia, the disaster management has been the responsibility of the Disaster Management and Relief Committee that consists of agencies at the central, state and local levels. This is to ensure that all aspects are being considered and to be more effective in managing the situation.

Euro-VO-Coordination of virtual observatory activities in Europe

NASA Astrophysics Data System (ADS)

Genova, Françoise; Allen, Mark G.; Arviset, Christophe; Lawrence, Andy; Pasian, Fabio; Solano, Enrique; Wambsganss, Joachim

2015-06-01

The European Virtual Observatory Euro-VO has been coordinating European VO activities through a series of projects co-funded by the European Commission over the last 15 years. The bulk of VO work in Europe is ensured by the national VO initiatives and those of intergovernmental agencies. VO activities at the European level coordinate the work in support of the three "pillars" of the Virtual Observatory: support to the scientific community, take-up by the data providers, and technological activities. Several Euro-VO projects have also provided direct support to selected developments and prototyping. This paper explains the methodology used by Euro-VO over the years. It summarises the activities which were performed and their evolutions at different stages of the development of the VO, explains the Euro-VO role with respect to the international and national levels of VO activities, details the lessons learnt for best practices for the coordination of the VO building blocks, and the liaison with other European initiatives, documenting the added-value of European coordination. Finally, the current status and next steps of Euro-VO are briefly addressed.

CO2 evaporative cooling: The future for tracking detector thermal management

NASA Astrophysics Data System (ADS)

Tropea, P.; Daguin, J.; Petagna, P.; Postema, H.; Verlaat, B.; Zwalinski, L.

2016-07-01

In the last few years, CO2 evaporative cooling has been one of the favourite technologies chosen for the thermal management of tracking detectors at LHC. ATLAS Insertable B-Layer and CMS Pixel phase 1 upgrade have adopted it and their systems are now operational or under commissioning. The CERN PH-DT team is now merging the lessons learnt on these two systems in order to prepare the design and construction of the cooling systems for the new Upstream Tracker and the Velo upgrade in LHCb, due by 2018. Meanwhile, the preliminary design of the ATLAS and CMS full tracker upgrades is started, and both concepts heavily rely on CO2 evaporative cooling. This paper highlights the performances of the systems now in operation and the challenges to overcome in order to scale them up to the requirements of the future generations of trackers. In particular, it focuses on the conceptual design of a new cooling system suited for the large phase 2 upgrade programmes, which will be validated with the construction of a common prototype in the next years.

Maternal Near-Miss Audit: Lessons to Be Learnt.

PubMed

Kalhan, Meenakshi; Singh, Srishti; Punia, Anita; Prakash, Jai

2017-01-01

Mother and child constitute a large, vulnerable, and a priority group as the risk is involved with childbearing in women and of growth and development in children. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications. These women who nearly escape death are categorized under "near miss" which has been defined as "a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy." Maternal near-miss audits give us an opportunity to study the cases which were almost similar to those where maternal deaths happened; thus, their review may give concrete evidence of reasons/deficiencies in health care leading to severe complications and even grave consequences as maternal deaths. Near-miss audits will allow the care of critically ill women to be analyzed, deficiencies in the provision of care to be identified, and comparison within and between institutions and, ultimately, improve the quality of obstetric care and further reduce maternal morbidity and mortality.

'Treat to Target' - Lessons Learnt.

PubMed

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

2016-01-01

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

Drug treatment for obesity in the post-sibutramine era.

PubMed

Cheung, Bernard M Y

2011-08-01

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

Establishing support groups for HIV-infected women: using experiences to develop guiding principles for project implementation.

PubMed

Visser, Maretha J; Mundell, Jonathan P

2008-07-01

HIV-infected women need support to deal with their diagnosis as well as with the stigma attached to HIV. As part of their practical training, Master's-level psychology students negotiated with the staff of four clinics in townships in Tshwane, South Africa, to establish support groups for HIV+ women and offered to assist them in facilitating the groups. This study aimed to understand why the implementation of groups was successful in one clinic and not other clinics. The student reports on their experiences and interaction with clinic staff and clients were used as sources of data. Using qualitative data analysis, different dynamics and factors that could affect project implementation were identified in each clinic. The socio-ecological and systems theories were used to understand implementation processes and obstacles in implementation. The metaphor of building a bridge over a gorge was used to describe the different phases in and obstacles to the implementation of the intervention. Valuable lessons were learnt, resulting in the development of guiding principles for the implementation of support groups in community settings.

One-Click Data Analysis Software for Science Operations

NASA Astrophysics Data System (ADS)

Navarro, Vicente

2015-12-01

One of the important activities of ESA Science Operations Centre is to provide Data Analysis Software (DAS) to enable users and scientists to process data further to higher levels. During operations and post-operations, Data Analysis Software (DAS) is fully maintained and updated for new OS and library releases. Nonetheless, once a Mission goes into the "legacy" phase, there are very limited funds and long-term preservation becomes more and more difficult. Building on Virtual Machine (VM), Cloud computing and Software as a Service (SaaS) technologies, this project has aimed at providing long-term preservation of Data Analysis Software for the following missions: - PIA for ISO (1995) - SAS for XMM-Newton (1999) - Hipe for Herschel (2009) - EXIA for EXOSAT (1983) Following goals have guided the architecture: - Support for all operations, post-operations and archive/legacy phases. - Support for local (user's computer) and cloud environments (ESAC-Cloud, Amazon - AWS). - Support for expert users, requiring full capabilities. - Provision of a simple web-based interface. This talk describes the architecture, challenges, results and lessons learnt gathered in this project.

Water reform in Sub-Saharan Africa: what is the difference?

NASA Astrophysics Data System (ADS)

Van Koppen, Barbara

Since the early 1990s African governments took an active part in the global movement of water reform towards Integrated Water Resources Management (IWRM). The first step consisted primarily of assimilating the generic principles of IWRM. At this generic level, water reform in Sub-Saharan Africa seems quite similar to water reform elsewhere in the developed and developing world. However, in taking the second step of operationalizing generic principles into concrete actions on the ground, at least three salient differences between Sub-Saharan Africa and elsewhere emerged: (a) Africa’s relative abundance of water resources but its scarcity of economic means to harness available water resources; (b) the importance of agriculture and agricultural water development for economic growth and poverty eradication; and (c) the need for systems of water rights and financial resource mobilization that are separated and suit the African reality in which large water users are relatively few, while the bulk of water users are scattered smallholders. This paper discusses the early operationalization with regard to these three unique features and identifies lessons learnt.

Heavy-flavour and quarkonium production in the LHC era: from proton-proton to heavy-ion collisions

DOE PAGES

Andronic, A.; Arleo, F.; Arnaldi, R.; ...

2016-02-29

This report reviews the study of open heavy-flavour and quarkonium production in high-energy hadronic collisions, as tools to investigate fundamental aspects of Quantum Chromodynamics, from the proton and nucleus structure at high energy to deconfinement and the properties of the Quark-Gluon Plasma. Emphasis is given to the lessons learnt from LHC Run 1 results, which are reviewed in a global picture with the results from SPS and RHIC at lower energies, as well as to the questions to be addressed in the future. The report covers heavy flavour and quarkonium production in proton-proton, proton-nucleus and nucleus-nucleus collisions. This includes discussionmore » of the effects of hot and cold strongly interacting matter, quarkonium photo-production in nucleus-nucleus collisions and perspectives on the study of heavy flavour and quarkonium with upgrades of existing experiments and new experiments. The report results from the activity of the SaporeGravis network of the I3 Hadron Physics programme of the European Union 7th Framework Programme.« less

Respect for patient autonomy as a medical virtue.

PubMed

Cook, Thomas; Mavroudis, Constantine D; Jacobs, Jeffrey P; Mavroudis, Constantine

2015-12-01

Respect for patient autonomy is an important and indispensable principle in the ethical practice of clinical medicine. Legal tenets recognise the centrality of this principle and the inherent right of patients of sound mind - properly informed - to make their own personal medical decisions. In the course of everyday medical practice, however, challenging cases may result in ethical dilemmas for the patient, the physician, and society. Resolution of these dilemmas requires a thorough understanding of the underlying principles that allow the clinician to make informed decisions and to offer considered therapeutic options to the patient. We argue in this paper that there is also need for a transition of moral competency from understanding principles to attaining virtue in the classic Aristotelian tradition. Achieving moral virtue is based on a lifetime of learning, practising, and watching how others, who have achieved virtue, act and perform their duties. We further claim that learning moral virtue in medical practice is best realised by incorporating the lessons learnt during daily rounds where frank discussions and considered resolutions can occur under the leadership of senior practitioners who have achieved a semblance of moral excellence.

Integrated multisensor perimeter detection systems

NASA Astrophysics Data System (ADS)

Kent, P. J.; Fretwell, P.; Barrett, D. J.; Faulkner, D. A.

2007-10-01

The report describes the results of a multi-year programme of research aimed at the development of an integrated multi-sensor perimeter detection system capable of being deployed at an operational site. The research was driven by end user requirements in protective security, particularly in threat detection and assessment, where effective capability was either not available or prohibitively expensive. Novel video analytics have been designed to provide robust detection of pedestrians in clutter while new radar detection and tracking algorithms provide wide area day/night surveillance. A modular integrated architecture based on commercially available components has been developed. A graphical user interface allows intuitive interaction and visualisation with the sensors. The fusion of video, radar and other sensor data provides the basis of a threat detection capability for real life conditions. The system was designed to be modular and extendable in order to accommodate future and legacy surveillance sensors. The current sensor mix includes stereoscopic video cameras, mmWave ground movement radar, CCTV and a commercially available perimeter detection cable. The paper outlines the development of the system and describes the lessons learnt after deployment in a pilot trial.

Deeply learnt hashing forests for content based image retrieval in prostate MR images

NASA Astrophysics Data System (ADS)

Shah, Amit; Conjeti, Sailesh; Navab, Nassir; Katouzian, Amin

2016-03-01

Deluge in the size and heterogeneity of medical image databases necessitates the need for content based retrieval systems for their efficient organization. In this paper, we propose such a system to retrieve prostate MR images which share similarities in appearance and content with a query image. We introduce deeply learnt hashing forests (DL-HF) for this image retrieval task. DL-HF effectively leverages the semantic descriptiveness of deep learnt Convolutional Neural Networks. This is used in conjunction with hashing forests which are unsupervised random forests. DL-HF hierarchically parses the deep-learnt feature space to encode subspaces with compact binary code words. We propose a similarity preserving feature descriptor called Parts Histogram which is derived from DL-HF. Correlation defined on this descriptor is used as a similarity metric for retrieval from the database. Validations on publicly available multi-center prostate MR image database established the validity of the proposed approach. The proposed method is fully-automated without any user-interaction and is not dependent on any external image standardization like image normalization and registration. This image retrieval method is generalizable and is well-suited for retrieval in heterogeneous databases other imaging modalities and anatomies.

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

NASA Astrophysics Data System (ADS)

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

2016-05-01

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

One WEEE, many species: lessons from the European experience.

PubMed

Deepali Sinha Khetriwal; Widmer, Rolf; Kuehr, Ruediger; Huisman, Jaco

2011-09-01

Electrical and electronic equipment (EEE) pervades modern lifestyles, but its quick obsolescence is resulting in huge quantities of EEE to be disposed of. This fast-growing waste stream has been recognized for its hazard potential. The European Union's (EU) Waste Electrical and Electronic Equipment (WEEE) Directive was essentially in response to the toxicity of e-waste - to ensure that it was collected and treated in an environmentally sound manner. Since then, the WEEE Directive has expanded its aims to include recovery of valuable resources as a means to reduce raw material extraction. With these objectives in mind, the Directive sets a common minimum legislative framework for all EU member states. However, the transposition of the Directive into national legislations has meant many differences in actual implementation models. There are 27 national transpositions of the Directive with different definitions, provisions and agreements. Each legislation reflects national situations, whether they are geographical considerations, legislative history, the influence of lobby groups and other national priorities. Although this diversity in legislations has meant massive problems in compliance and enforcement, it provides an opportunity to get an insight into the possible operational models of e-waste legislation. Building on the study by the United Nations University commissioned by the European Commission as part of its 2008 Review of the WEEE Directive, the paper identifies some key features of the Directive as well as legislative and operational differences in transposition and implementation in the various members states. The paper discusses the successes and challenges of the Directive and concludes with lessons learnt from the European experience.

Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective.

PubMed

Epping-Jordan, JoAnne E; van Ommeren, Mark; Ashour, Hazem Nayef; Maramis, Albert; Marini, Anita; Mohanraj, Andrew; Noori, Aqila; Rizwan, Humayun; Saeed, Khalid; Silove, Derrick; Suveendran, T; Urbina, Liliana; Ventevogel, Peter; Saxena, Shekhar

2015-01-01

Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development. Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste. These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders. Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

Management of rural drinking water supplies and waste using the participatory hygiene and sanitation transformation (PHAST) initiative in Zimbabwe.

PubMed

Musabayane, N

2000-01-01

This paper focuses on the use of Participatory Hygiene and Sanitation Transformation (PHAST) and how the methodology can be taken to scale. It uses the Zimbabwe experience and highlights some of the benefits in the application of PHAST, conditions necessary for scaling up and possible constraints. The PHAST initiative started off as a pilot process seeking to promote improved hygiene behaviour and promotion of sanitation. Having successfully piloted PHAST, Zimbabwe has scaled up the use of the methodology at a country level. While impact studies have not yet been conducted, reviews of the effects of the process have indicated positive behaviour change in such areas as management of water, construction and use of latrines. The process has also led to a change of institutional approaches in planning for improved water and sanitation from supply driven projects to demand responsive approaches. Some lessons learnt have included the need for baseline surveys at the start of the use of PHAST, the difficulty in developing monitoring indicators and hence difficulty in measuring impacts. Conclusions being drawn using assessment studies are that the use of participatory approaches has led to improved hygiene behaviour with communities being able to link causes and effects. The use of participatory methods also necessitates a change in institutional approaches from supply driven approaches to demand responsiveness. Other lessons drawn were related to the creation of an enabling environment for the application of participatory processes. Such enabling environment includes capacity building, resource allocation, policy and institutional support.

The principles and practices of nutrition advocacy: evidence, experience and the way forward for stunting reduction.

PubMed

Pelletier, David; Haider, Rukhsana; Hajeebhoy, Nemat; Mangasaryan, Nune; Mwadime, Robert; Sarkar, Satyajit

2013-09-01

Advocacy represents an intervention into complex, dynamic and highly contextual socio-political systems, in which strategies and tactics must be adjusted on a continual basis in light of rapidly changing conditions, reactions from actors and feedback. For this reason, the practice of advocacy is often considered more art than science. However, capacities and practices for advocacy can be strengthened by sharing and analysing experiences in varying contexts, deriving general principles and learning to adapt these principles to new contexts. Nutrition is a particular context for advocacy, but to date, there has been little systematic analysis of experiences. The purpose of this paper is to illustrate and draw lessons from the practice of nutrition advocacy, especially in relation to stunting and complementary feeding, and suggest ways to strengthen capacities and practices in the future. The strategies and tactics, achievements and lessons learnt are described for three case studies: Uganda, Vietnam and Bangladesh. These cases, and experience from elsewhere, demonstrate that concerted, well-planned and well-implemented advocacy can bring significant achievements, even in short period of time. In light of the global and national attention being given to stunting reduction through the SUN (Scaling Up Nutrition) movement and other initiatives, there is now a need for much stronger investments in strategic and operational capacities for advocacy, including the human, organisational and financial resources for the advocacy and strategic communication themselves, as well as for monitoring and evaluation, supportive research and institutional capacity-building. © 2013 John Wiley & Sons Ltd.

Family Functioning, Identity Formation, and the Ability of Conflict Resolution among Adolescents

ERIC Educational Resources Information Center

Kiani, Behnaz; Hojatkhah, Seyed Mohsen; Torabi-Nami, Mohammad

2016-01-01

Family is perhaps the most influential system in individuals' life in which various behaviors are learnt. Family functioning refers to the ability of family to meet its responsibilities. The present correlation study used a multi-stage cluster sampling method to recruit 686 subjects including 338 males and 348 females from all high school students…

Semantic Representation of Newly Learned L2 Words and Their Integration in the L2 Lexicon

ERIC Educational Resources Information Center

Bordag, Denisa; Kirschenbaum, Amit; Rogahn, Maria; Opitz, Andreas

2017-01-01

The present semantic priming study explores the integration of newly learnt L2 German words into the L2 semantic network of German advanced learners. It provides additional evidence in support of earlier findings reporting semantic inhibition effects for emergent representations. An inhibitory mechanism is proposed that temporarily decreases the…

Impact of Managerial Skills Learnt through MA Educational Planning Management Programme of AIOU on the Performance of Institutional Heads

ERIC Educational Resources Information Center

Chuadhry, Muhammad Asif; Shah, Syed Manzoor Hussain

2012-01-01

Management provides formal coordination in an organization for achieving pre-determined goals. The educational manager particulary performs his duties by using different planning and management techniques. These techniques are equally important for the manager of other sectors. The present study was focused on the impact of managerial skills…

Models of the strongly lensed quasar DES J0408-5354

NASA Astrophysics Data System (ADS)

Agnello, A.; Lin, H.; Buckley-Geer, L.; Treu, T.; Bonvin, V.; Courbin, F.; Lemon, C.; Morishita, T.; Amara, A.; Auger, M. W.; Birrer, S.; Chan, J.; Collett, T.; More, A.; Fassnacht, C. D.; Frieman, J.; Marshall, P. J.; McMahon, R. G.; Meylan, G.; Suyu, S. H.; Castander, F.; Finley, D.; Howell, A.; Kochanek, C.; Makler, M.; Martini, P.; Morgan, N.; Nord, B.; Ostrovski, F.; Schechter, P.; Tucker, D.; Wechsler, R.; Abbott, T. M. C.; Abdalla, F. B.; Allam, S.; Benoit-Lévy, A.; Bertin, E.; Brooks, D.; Burke, D. L.; Rosell, A. Carnero; Kind, M. Carrasco; Carretero, J.; Crocce, M.; Cunha, C. E.; D'Andrea, C. B.; da Costa, L. N.; Desai, S.; Dietrich, J. P.; Eifler, T. F.; Flaugher, B.; Fosalba, P.; García-Bellido, J.; Gaztanaga, E.; Gill, M. S.; Goldstein, D. A.; Gruen, D.; Gruendl, R. A.; Gschwend, J.; Gutierrez, G.; Honscheid, K.; James, D. J.; Kuehn, K.; Kuropatkin, N.; Li, T. S.; Lima, M.; Maia, M. A. G.; March, M.; Marshall, J. L.; Melchior, P.; Menanteau, F.; Miquel, R.; Ogando, R. L. C.; Plazas, A. A.; Romer, A. K.; Sanchez, E.; Schindler, R.; Schubnell, M.; Sevilla-Noarbe, I.; Smith, M.; Smith, R. C.; Sobreira, F.; Suchyta, E.; Swanson, M. E. C.; Tarle, G.; Thomas, D.; Walker, A. R.

2017-12-01

We present detailed modelling of the recently discovered, quadruply lensed quasar J0408-5354, with the aim of interpreting its remarkable configuration: besides three quasar images (A,B,D) around the main deflector (G1), a fourth image (C) is significantly reddened and dimmed by a perturber (G2) which is not detected in the Dark Energy Survey imaging data. From lens models incorporating (dust-corrected) flux ratios, we find a perturber Einstein radius 0.04 arcsec ≲ RE, G2 ≲ 0.2 arcsec and enclosed mass Mp(RE, G2) ≲ 1.0 × 1010 M⊙. The main deflector has stellar mass log _{10}(M_{\\star }/M_{⊙})=11.49^{+0.46}_{-0.32}, a projected mass Mp(RE, G1) ≈ 6 × 1011 M⊙ within its Einstein radius RE, G1 = (1.85 ± 0.15) arcsec and predicted velocity dispersion 267-280 km s-1. Follow-up images from a companion monitoring campaign show additional components, including a candidate second source at a redshift between the quasar and G1. Models with free perturbers, and dust-corrected and delay-corrected flux ratios, are also explored. The predicted time-delays (ΔtAB = (135.0 ± 12.6) d, ΔtBD = (21.0 ± 3.5) d) roughly agree with those measured, but better imaging is required for proper modelling and comparison. We also discuss some lessons learnt from J0408-5354 on lensed quasar finding strategies, due to its chromaticity and morphology.

An historical account of shell shock during the First World War and reforms in mental health in Australia 1914-1939.

PubMed

Rae, Ruth

2007-08-01

The study of the disorders of the mind at the turn of the twentieth century offered useful knowledge about the psyche and the First World War (FWW) provided an avalanche of case studies. Prior to the war the mentally ill were treated with disdain and the social distrust of individuals who did not present as 'normal' was high. The level of diagnostic expertise of psychiatric illness by doctors and nurses was low and as a consequence medicine and nursing was ill-equipped to deal with the phenomenon initially referred to as 'shell shock'. However, the soldiers of the FWW who endured the varied and seemingly unrelated symptoms of shell-shock were respected men - occasional heroes - who were reduced to the status of 'mentals'. There is evidence that civilian trained health professionals altered their views about mental illness during the FWW but initially, the military imperatives inherent in a global conflict perpetuated the notion that mental illness was linked with defective morality. This paper provides an historical account of changes in attitude toward the mentally ill as a consequence of the FWW. The interregnum (1918-39) was a period of advancement in the field of mental health within the civilian sector. However, the imperatives of war negated these developments and there is evidence that the management of soldiers suffering from post-traumatic stress disorders in the Second World War did not benefit from the lessons learnt in the FWW.

Developing mental health research in sub-Saharan Africa: capacity building in the AFFIRM project.

PubMed

Schneider, M; Sorsdahl, K; Mayston, R; Ahrens, J; Chibanda, D; Fekadu, A; Hanlon, C; Holzer, S; Musisi, S; Ofori-Atta, A; Thornicroft, G; Prince, M; Alem, A; Susser, E; Lund, C

2016-01-01

There remains a large disparity in the quantity, quality and impact of mental health research carried out in sub-Saharan Africa, relative to both the burden and the amount of research carried out in other regions. We lack evidence on the capacity-building activities that are effective in achieving desired aims and appropriate methodologies for evaluating success. AFFIRM was an NIMH-funded hub project including a capacity-building program with three components open to participants across six countries: (a) fellowships for an M.Phil. program; (b) funding for Ph.D. students conducting research nested within AFFIRM trials; (c) short courses in specialist research skills. We present findings on progression and outputs from the M.Phil. and Ph.D. programs, self-perceived impact of short courses, qualitative data on student experience, and reflections on experiences and lessons learnt from AFFIRM consortium members. AFFIRM delivered funded research training opportunities to 25 mental health professionals, 90 researchers and five Ph.D. students across 6 countries over a period of 5 years. A number of challenges were identified and suggestions for improving the capacity-building activities explored. Having protected time for research is a barrier to carrying out research activities for busy clinicians. Funders could support sustainability of capacity-building initiatives through funds for travel and study leave. Adoption of a train-the-trainers model for specialist skills training and strategies for improving the rigor of evaluation of capacity-building activities should be considered.

Planet Press: an EGU initiative to bring geoscientific research to children

NASA Astrophysics Data System (ADS)

Ferreira, Bárbara

2016-04-01

Planet Press (http://www.egu.eu/education/planet-press/) is an EGU educational project that aims to get children (mainly 7-13 year olds), as well as their parents and educators, interested in and engaged with up-to-date scientific research and news. Planet Press articles are short versions of EGU press releases written in child-friendly language. Because EGU press releases cover research published in the various EGU scientific journals, Planet Press focuses on topics as varied as air pollution, glaciers, climate change, earthquakes, ocean sciences, droughts and floods, or space sciences. The texts are reviewed by both scientists and educators to make sure they are accurate and clear to their target audience. By sharing new and exciting geoscientific research with young kids, we hope to inspire them to develop an interest in the Earth, planetary and space sciences. In this presentation, we describe how the Planet Press idea came about, how the project is run, and the challenges and lessons learnt since the launch of this educational initiative in 2014. Planet Press, which has the support of the EGU Committee on Education, is made possible by the work of volunteer scientists and educators who review and translate the texts. We are grateful for the help of Jane Robb, former EGU Educational Fellow, with launching the project. Planet Press is inspired by Space Scoop (http://www.spacescoop.org/), an initiative by UNAWE, the EU-Universe Awareness organisation, that brings astronomy news to children every week.

The ASTRI SST-2M prototype for the Cherenkov Telescope Array: prototype technologies goals and strategies for the future SST

NASA Astrophysics Data System (ADS)

Marchiori, Gianpietro; Busatta, Andrea; Giacomel, Stefano; Folla, Ivan; Valsecchi, Marco; Canestrari, Rodolfo; Bonnoli, Giacomo; Cascone, Enrico; Conconi, Paolo; Fiorini, Mauro; Giro, Enrico; La Palombara, Nicola; Pareschi, Giovanni; Perri, Luca; Rodeghiero, Gabriele; Sironi, Giorgia; Stringhetti, Luca; Toso, Giorgio; Tosti, Gino; Pellicciari, Carlo

2014-07-01

The Cherenkov Telescope Array (CTA) observatory will represent the next generation of Imaging Atmospheric Cherenkov Telescope. Using a combination of large-, medium-, and small-scale telescopes (LST, MST, SST, respectively), it will explore the Very High Energy domain from a few tens of GeVup to about few hundreds of TeV with unprecedented sensitivity, angular resolution and imaging quality. In this framework, the Italian ASTRI program, led by the Italian National Institute of Astrophysics (INAF) developed a 4-meter class telescope, which will adopt an aplanatic, wide-field, double-reflection optical layout in a Schwarzschild- Couder configuration. Within this program INAF assigned to the consortium between Galbiati Group and EIE Group the construction, assembly and tests activities of the prototype named ASTRI SST-2M. On the basis of the lesson learnt from the prototype, other telescopes will be produced, starting from a re-design phase, in order to optimize performances and the overall costs and production schedule for the CTA-SST telescope. This paper will firstly give an overview of the concept for the SST prototype mount structure. In this contest, the technologies adopted for the design, manufacturing and tests of the entire system will be presented. Moreover, a specific focus on the challenges of the prototype and the strategies associated with it will be provided, in order to outline the near future performance goals for this type of Cherenkov telescopes employed for Gamma ray science.

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

PubMed

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

2015-08-01

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

Recce NG: from Recce sensor to image intelligence (IMINT)

NASA Astrophysics Data System (ADS)

Larroque, Serge

2001-12-01

Recce NG (Reconnaissance New Generation) is presented as a complete and optimized Tactical Reconnaissance System. Based on a new generation Pod integrating high resolution Dual Band sensors, the system has been designed with the operational lessons learnt from the last Peace Keeping Operations in Bosnia and Kosovo. The technical solutions retained as component modules of a full IMINT acquisition system, take benefit of the state of art in the following key technologies: Advanced Mission Planning System for long range stand-off Manned Recce, Aircraft and/or Pod tasking, operating sophisticated back-up software tools, high resolution 3D geo data and improved/combat proven MMI to reduce planning delays, Mature Dual Band sensors technology to achieve the Day and Night Recce Mission, including advanced automatic operational functions, as azimuth and roll tracking capabilities, low risk in Pod integration and in carrier avionics, controls and displays upgrades, to save time in operational turn over and maintenance, High rate Imagery Down Link, for Real Time or Near Real Time transmission, fully compatible with STANAG 7085 requirements, Advanced IMINT Exploitation Ground Segment, combat proven, NATO interoperable (STANAG 7023), integrating high value software tools for accurate location, improved radiometric image processing and open link to the C4ISR systems. The choice of an industrial Prime contractor mastering across the full system, all the prior listed key products and technologies, is mandatory to a successful delivery in terms of low Cost, Risk and Time Schedule.

Producing or reproducing reasoning? Socratic dialog is very effective, but only for a few.

PubMed

Goldin, Andrea Paula; Pedroncini, Olivia; Sigman, Mariano

2017-01-01

Successful communication between a teacher and a student is at the core of pedagogy. A well known example of a pedagogical dialog is 'Meno', a socratic lesson of geometry in which a student learns (or 'discovers') how to double the area of a given square 'in essence, a demonstration of Pythagoras' theorem. In previous studies we found that after engaging in the dialog participants can be divided in two kinds: those who can only apply a rule to solve the problem presented in the dialog and those who can go beyond and generalize that knowledge to solve any square problems. Here we study the effectiveness of this socratic dialog in an experimental and a control high-school classrooms, and we explore the boundaries of what is learnt by testing subjects with a set of 9 problems of varying degrees of difficulty. We found that half of the adolescents did not learn anything from the dialog. The other half not only learned to solve the problem, but could abstract something more: the geometric notion that the diagonal can be used to solve diverse area problems. Conceptual knowledge is critical for achievement in geometry, and it is not clear whether geometric concepts emerge spontaneously on the basis of universal experience with space, or reflect intrinsic properties of the human mind. We show that, for half of the learners, an exampled-based Socratic dialog in lecture form can give rise to formal geometric knowledge that can be applied to new, different problems.

[Lessons learnt from the German smallpox outbreaks after World War II].

PubMed

Sasse, Julia; Gelderblom, Hans R

2015-07-01

Even though smallpox was declared eradicated by WHO in 1980, it cannot be ruled out that the etiological variola virus could be used as a biological weapon. Undestroyed viruses from biowarfare programmes, virus strains left undetected in a freezer or dangerous recombinant poxvirus constructs could cause dangerous outbreaks in a relatively unprotected population. Despite an abundance of studies performed during the eradication of smallpox, epidemiological data for preparedness planning and outbreak control in modern, industrialized countries are scarce. Full-text hand search for the period from 1945 to 1975 in the main German public health journals. After World War II 12 smallpox outbreaks occurred in Germany. They were studied with the focus on the period of contagiousness, the protective effect of vaccination, booster-effect of revaccination and the place of infection. A total of 95 individuals contracted smallpox, including 10 fatalities. Despite having been previously vaccinated, 81 vaccinated persons came down with smallpox, yet 91% of them developed only mild symptoms. These patients presented a high risk for spreading the infection to contact persons due to misinterpretation of symptoms and the continuing social contacts. Basically, the risk of transmission in the first 2 to 3 days after onset of symptoms was low, thus facilitating antiepidemic measures. The importance of hospital preparedness is emphasized by the fact that most infections occurred in hospitals. The data analyzed provide valuable information for today's outbreak response planning and counter bioterrorism preparedness.

Lessons learnt from tropical cyclone losses

NASA Astrophysics Data System (ADS)

Honegger, Caspar; Wüest, Marc; Zimmerli, Peter; Schoeck, Konrad

2016-04-01

Swiss Re has a long history in developing natural catastrophe loss models. The tropical cyclone USA and China model are examples for event-based models in their second generation. Both are based on basin-wide probabilistic track sets and calculate explicitly the losses from the sub-perils wind and storm surge in an insurance portfolio. Based on these models, we present two cases studies. China: a view on recent typhoon loss history Over the last 20 years only very few major tropical cyclones have caused severe insurance losses in the Pearl River Delta region and Shanghai, the two main exposure clusters along China's southeast coast. Several storms have made landfall in China every year but most struck areas with relatively low insured values. With this study, we make the point that typhoon landfalls in China have a strong hit-or-miss character and available insured loss experience is too short to form a representative view of risk. Historical storm tracks and a simple loss model applied to a market portfolio - all from publicly available data - are sufficient to illustrate this. An event-based probabilistic model is necessary for a reliable judgement of the typhoon risk in China. New York: current and future tropical cyclone risk In the aftermath of hurricane Sandy 2012, Swiss Re supported the City of New York in identifying ways to significantly improve the resilience to severe weather and climate change. Swiss Re provided a quantitative assessment of potential climate related risks facing the city as well as measures that could reduce those impacts.

Applications of FBG sensors on telecom satellites

NASA Astrophysics Data System (ADS)

Abad, S.; Araújo, F. M.; Ferreira, L. A.; Pedersen, F.; Esteban, M. A.; McKenzie, I.; Karafolas, N.

2017-11-01

Monitoring needs of spacecraft are rapidly increasing due to new and more challenging missions, along with demands to reduce launching costs by minimizing the manufacture, assembly, integration and test time and employing new low weight materials balanced by the need for maximizing system lifetime while maintaining good reliability. Conventional electronic sensors are characterized by their low multiplexing capability and their EMI/RF susceptibility and it is in this scenario that Fiber Optic Sensors (FOS) in general, and more specifically Fiber Bragg Grating (FBG) technology offers important benefits, improving in various ways the already deployed sensing subsystems (e.g. reducing the weight associated with sensor cabling, increasing the number of sensing points) and enabling new monitoring applications that were not possible by using conventional sensing technologies. This work presents the activities performed and the lessons learnt in the frame of ESA's ARTES-5 project "Fiber Optic Sensing Subsystem for Spacecraft Health Monitoring in Telecommunication Satellites". This project finished in July 2009, with the implementation and testing of two different demonstrators employing FBG sensor technology: FBG sensors for temperature monitoring in high voltage environments, and in particular in several parts of electric propulsion subsystems [1], and FBG sensors for thermal monitoring of array-antennas during RF testing [2]. In addition, the contacts performed with different actors within the space community allowed the identification of a special area of interest for the substitution of regular thermocouple instrumentation by FBG technology for thermal vacuum ground testing of satellites.

Surgical aspects of Operation Bali Assist: initial wound surgery on the tarmac and in flight.

PubMed

Read, David; Ashford, Bruce

2004-11-01

The explosion of three bombs on 12 October 2002 in Kuta, Bali resulted in mass casualties akin to those seen in war. The aim of the present report is to describe the sequence of events of Operation Bali Assist including triage, resuscitation and initial wound surgery in Bali at Sanglah Hospital in the aeromedical staging facility (ASF), Denpasar airport and the evacuation to Darwin. A descriptive report is provided of the event and includes; resuscitation, anaesthesia, initial burns surgery management including escharotomy and fasciotomy, head injury management and importance of supplies and medical records with a description of the evacuation to Darwin. Operation Bali Assist involved five C130 Hercules aircraft and aeromedical evacuation medical and nursing teams managing 66 casualties in the Denpasar area and their evacuation to Royal Darwin Hospital with ketamine the most useful anaesthetic agent and cling film the most useful burns dressing. Twelve procedures were performed at the ASF including seven escharotomies, three fasciotomies and two closed reductions. One escharotomy was performed in flight. The important lessons learnt from the exercise is the inclusion of a surgeon in the aeromedical evacuation team, the importance of debridement and delayed primary closure, the usefulness of cling film as a burns dressing and the importance of continuous assessment. Future disaster planning exercises need to consider a patient age mix that might be expected in a shopping mall, rather than the young adult encountered in Bali, a more familiar age mix for Australian Defence Force medical staff.

Targeting the DNA damage response in oncology: past, present and future perspectives.

PubMed

Basu, Bristi; Yap, Timothy A; Molife, L Rhoda; de Bono, Johann S

2012-05-01

The success of poly(ADP-ribose) polymerase inhibition in BRCA1 or BRCA2 deficient tumors as an anticancer strategy provided proof-of-concept for a synthetic lethality approach in oncology. There is therefore now active interest in expanding this approach to include other agents targeting the DNA damage response (DDR). We review lessons learnt from the development of inhibitors against DNA damage response mechanisms and envision the future of DNA repair inhibition in oncology. Preclinical synthetic lethality screens may potentially identify the best combinations of DNA-damaging drugs with inhibitors of DNA repair and the DDR or two agents acting within the DDR. Efforts are currently being made to establish robust and cost-effective assays that may be implemented within appropriate time-scales in parallel with future clinical studies. Detection of relevant mutations in a high-throughput manner, such as with next-generation sequencing for genes implicated in homologous recombination, including BRCA1, BRCA2, and ataxia telangiectasia mutated is anticipated. Novel approaches targeting the DDR are currently being evaluated and inhibitors of ATM, RAD51 and DNA-dependent protein kinase are now in early drug discovery and development. There remains great enthusiasm in oncology practice for pursuing the strategy of synthetic lethality. The future development of antitumor agents targeting the DDR should include detailed correlative biomarker work within early phase clinical studies wherever possible, with clear attempts to identify doses at which robust target modulation is observed.

Structural stigma, sex work and HIV: contradictions and lessons learnt from a community-led structural intervention in southern India.

PubMed

Biradavolu, Monica Rao; Blankenship, Kim M; Jena, Asima; Dhungana, Nimesh

2012-10-01

Recent theorisation has pushed stigma research in new directions, arguing for a need to challenge the unequal power relations that impact groups most at risk for HIV-related stigma rather than locate stigma in the individual. Such a conceptualisation resonates with the growing emphasis on structural interventions for HIV prevention that attempt to alter the social context of risk. The paper predominantly relies on longitudinal interviews conducted three times over a 2-year period with sex workers with varying degrees of involvement with the non-governmental organisation (NGO) and community-based organisation. Recognising that stigma is socially constructed and structurally reproduced, the NGO helped mobilise marginalised and hitherto scattered female sex workers to form community-based organisations to challenge their disadvantaged status in society. The authors show how stigma alleviation strategies presented a contradiction: emboldening one group of female sex workers to self-identify as sex workers while making others reluctant to access the intervention-run clinic. The paper builds on a growing body of research that acknowledges the struggles in implementing structural interventions, particularly for NGOs working in regions with a diverse population of sex workers with varying needs. The authors argue that intervention goals of reducing stigma and increasing the use of sexually transmitted infection services do not have to conflict and, in fact, must go hand-in-hand for an implementation to be considered a structural intervention.

Promoting operational research through fellowships: a case study from the South-East Asia Union Office.

PubMed

Kumar, A M V; Satyanarayana, S; Berger, S Dar; Chadha, S S; Singh, R J; Lal, P; Tonsing, J; Harries, A D

2015-03-21

In 2009, the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) jointly developed a new paradigm for operational research (OR) capacity building and started a new process of appointing and supporting OR fellows in the field. This case study describes 1) the appointment of two OR fellows in The Union South-East Asia Office (USEA), New Delhi, India; 2) how this led to the development of an OR unit in that organisation; 3) achievements over the 5-year period from June 2009 to June 2014; and 4) challenges and lessons learnt. In June 2009, the first OR fellow in India was appointed on a full-time basis and the second was appointed in February 2012-both had limited previous experience in OR. From 2009 to 2014, annual research output and capacity building initiatives rose exponentially, and included 1) facilitation at 61 OR training courses/modules; 2) publication of 96 papers, several of which had a lasting impact on national policy and practice; 3) providing technical assistance in promoting OR; 4) building the capacity of medical college professionals in data management; 5) support to programme staff for disseminating their research findings; 6) reviewing 28 scientific papers for national or international peer-reviewed journals; and 7) developing 45 scientific abstracts for presentation at national and international conferences. The reasons for this success are highlighted along with ongoing challenges. This experience from India provides good evidence for promoting similar models elsewhere.

Using video games for volcanic hazard education and communication: an assessment of the method and preliminary results

NASA Astrophysics Data System (ADS)

Mani, Lara; Cole, Paul D.; Stewart, Iain

2016-07-01

This paper presents the findings from a study aimed at understanding whether video games (or serious games) can be effective in enhancing volcanic hazard education and communication. Using the eastern Caribbean island of St. Vincent, we have developed a video game - St. Vincent's Volcano - for use in existing volcano education and outreach sessions. Its twin aims are to improve residents' knowledge of potential future eruptive hazards (ash fall, pyroclastic flows and lahars) and to integrate traditional methods of education in a more interactive manner. Here, we discuss the process of game development including concept design through to the final implementation on St. Vincent. Preliminary results obtained from the final implementation (through pre- and post-test knowledge quizzes) for both student and adult participants provide indications that a video game of this style may be effective in improving a learner's knowledge. Both groups of participants demonstrated a post-test increase in their knowledge quiz score of 9.3 % for adults and 8.3 % for students and, when plotted as learning gains (Hake, 1998), show similar overall improvements (0.11 for adults and 0.09 for students). These preliminary findings may provide a sound foundation for the increased integration of emerging technologies within traditional education sessions. This paper also shares some of the challenges and lessons learnt throughout the development and testing processes and provides recommendations for researchers looking to pursue a similar study.

Avoidance of crack inducement when laser welding hot-formed car body components - a variable analysis

NASA Astrophysics Data System (ADS)

Larsson, Johnny K.

The Volvo XC60 car body contains numerous parts in Ultra High Strength Steels (UHSS) in order to guarantee the structural integrity of the car in the event of a crash situation. Most of the parts are manufactured in a hot-forming process, so called presshardening, resulting in component tensile strength in the range of 1,500 MPa. As this type of material also presents fairly high carbon content (˜0.22%) it brings a challenge when it comes to welding. The Volvo XC60 car body is at the same time to a large extent assembled by laser welding technology. In early development stages of the project (Y413), it was observed that laser welding of hot-formed components presented a number of challenges due to the unique conditions offered by this welding method. The presentation will thoroughly describe the modes of procedure how to avoid crack inducement during the welding operation. A variable analysis approach was used based on the present circumstances at the production facility in the Gent plant. Crucial variables at laser welding such as gap between sheets, focal point position, welding speed and laser weld position relative to the flange edge were included in a test matrix and welding trials were carried out accordingly in the Pilot Plant in Gothenburg. The paper will discuss those welding results, the subsequent analysis and plausible theoretic explanations. From the lessons learnt in this research, the optimum laser welding parameters were then transferred to the laser welding stations in the Gent plant. There it has been proven, that also at high volume automotive manufacturing, it is possible to provide an outstanding weld quality also at such difficult pre-conditions. The presentation ends with some facts and figures and experiences from high volume series production, which also includes aspects on quality assurance.

To Prosecute or Not? Enforcement of Federal Criminal Regulatory Statutes. Revised Edition. A Student's Lesson Plan [and] A Teacher's Lesson Plan [and] A Lawyer's Lesson Plan.

ERIC Educational Resources Information Center

Howard, Estelle; And Others

One of a series of secondary level teaching units presenting case studies with pro and con analyses of particular legal problems, the document consists of a student's lesson plan, a teacher's lesson plan, and a lawyer's lesson plan for a unit about the enforcement of federal criminal regulatory statutes. The lesson plan presents an analysis of the…

Blending Pan-European and local hydrological models for water resource assessment in Mediterranean areas: lessons learnt from a mountainous catchment

NASA Astrophysics Data System (ADS)

José Polo, María; José Pérez-Palazón, María; Saénz de Rodrigáñez, Marta; Pimentel, Rafael; Arheimer, Berit

2017-04-01

Global hydrological models provide scientists and technicians with distributed data over medium to large areas from which assessment of water resource planning and use can be easily performed. However, scale conflicts between global models' spatial resolution and the local significant spatial scales in heterogeneous areas usually pose a constraint for the direct use and application of these models' results. The SWICCA (Service for Water Indicators in Climate Change Adaptation) Platform developed under the Copernicus Climate Change Service (C3S) offers a wide range of both climate and hydrological indicators obtained on a global scale with different time and spatial resolutions. Among the different study cases supporting the SWICCA demonstration of local impact assessment, the Sierra Nevada study case (South Spain) is a representative example of mountainous coastal catchments in the Mediterranean region. This work shows the lessons learnt during the study case development to derive local impact indicator tailored to suit the local end-users of water resource in this snow-dominated area. Different approaches were followed to select the most accurate method to downscale the global data and variables to the local level in a highly abrupt topography, in a sequential step approach. 1) SWICCA global climate variable downscaling followed by river flow simulation from a local hydrological model in selected control points in the catchment, together with 2) SWICCA global river flow values downscaling to the control points followed by corrections with local transfer functions were both tested against the available local river flow series of observations during the reference period. This test was performed for the different models and the available spatial resolutions included in the SWICCA platform. From the results, the second option, that is, the use of SWICCA river flow variables, performed the best approximations, once the local transfer functions were applied to the global values and an additional correction was performed based on the relative anomalies obtained instead of the absolute values. This approach was used to derive the future projections of selected local indicators for each end-user in the area under different climate change scenarios. Despite the spatial scale conflicts, the SWICCA river flow indicators (simulated by the E-HYPEv3.1.2 model) succeeded in approximating the observations during the reference period 1970-2000 when provided on a catchment scale, once local transfer functions and further anomaly correction were performed. Satisfactory results were obtained on a monthly scale for river flow in the main stream of the watershed, and on a daily scale for the headwater streams. The accessibility to the hydrological model WiMMed, which includes a snow module, locally validated in the study area has been crucial to downscale the SWICCA results and prove their usefulness.

Revisiting an interdisciplinary hydrological modelling project. A socio-hydrology (?) example from the early 2000s

NASA Astrophysics Data System (ADS)

Seidl, Roman; Barthel, Roland

2016-04-01

Interdisciplinary scientific and societal knowledge plays an increasingly important role in global change research. Also, in the field of water resources interdisciplinarity as well as cooperation with stakeholders from outside academia have been recognized as important. In this contribution, we revisit an integrated regional modelling system (DANUBIA), which was developed by an interdisciplinary team of researchers and relied on stakeholder participation in the framework of the GLOWA-Danube project from 2001 to 2011 (Mauser and Prasch 2016). As the model was developed before the current increase in literature on participatory modelling and interdisciplinarity, we ask how a socio-hydrology approach would have helped and in what way it would have made the work different. The present contribution firstly presents the interdisciplinary concept of DANUBIA, mainly with focus on the integration of human behaviour in a spatially explicit, process-based numerical modelling system (Roland Barthel, Janisch, Schwarz, Trifkovic, Nickel, Schulz, and Mauser 2008; R. Barthel, Nickel, Meleg, Trifkovic, and Braun 2005). Secondly, we compare the approaches to interdisciplinarity in GLOWA-Danube with concepts and ideas presented by socio-hydrology. Thirdly, we frame DANUBIA and a review of key literature on socio-hydrology in the context of a survey among hydrologists (N = 184). This discussion is used to highlight gaps and opportunities of the socio-hydrology approach. We show that the interdisciplinary aspect of the project and the participatory process of stakeholder integration in DANUBIA were not entirely successful. However, important insights were gained and important lessons were learnt. Against the background of these experiences we feel that in its current state, socio-hydrology is still lacking a plan for knowledge integration. Moreover, we consider necessary that socio-hydrology takes into account the lessons learnt from these earlier examples of knowledge integration (see also, Hamilton, ElSawah, Guillaume, Jakeman, and Pierce 2015; Jakeman and Letcher 2003). Our contribution attempts to close a gap between previous concepts of integration of socio-economic aspects into hydrology (typically inspired by Integrated Water Resources Management) and the new socio-hydrology approach. We suppose that socio-hydrology could benefit from widening its scope and considering previous research at the boundaries between hydrology and social sciences. At the same time, concepts developed prior to socio-hydrology were seldom entirely successful. It might be beneficial to review these approaches developed earlier and those that are being developed in parallel from the perspective of socio-hydrology. References: Barthel, R., S. Janisch, N. Schwarz, A. Trifkovic, D. Nickel, C. Schulz, and W. Mauser. 2008. An integrated modelling framework for simulating regional-scale actor responses to global change in the water domain. Environmental Modelling & Software, 23: 1095-1121. Barthel, R., D. Nickel, A. Meleg, A. Trifkovic, and J. Braun. 2005. Linking the physical and the socio-economic compartments of an integrated water and land use management model on a river basin scale using an object-oriented water supply model. Physics and Chemistry of the Earth, 30: 389-397. doi: 10.1016/j.pce.2005.06.006 Hamilton, S. H., S. ElSawah, J. H. A. Guillaume, A. J. Jakeman, and S. A. Pierce. 2015. Integrated assessment and modelling: Overview and synthesis ofsalient dimensions. Environmental Modelling and Software, 64: 215-229. doi: 10.1016/j.envsoft.2014.12.005 Jakeman, A. J., and R. A. Letcher. 2003. Integrated assessment and modelling: features, principles and examples for catchment management. Environmental Modelling & Software, 18: 491-501. doi: http://dx.doi.org/10.1016/S1364-8152(03)00024-0 Mauser, W., and M. Prasch. 2016. Regional Assessment of Global Change Impacts - The Project GLOWA-Danube: Springer International Publishing.

Human factors research as part of a Mars exploration analogue mission on Devon Island

NASA Astrophysics Data System (ADS)

Binsted, Kim; Kobrick, Ryan L.; Griofa, Marc Ó.; Bishop, Sheryl; Lapierre, Judith

2010-06-01

Human factors research is a critical element of space exploration as it provides insight into a crew's performance, psychology and interpersonal relationships. Understanding the way humans work in space-exploration analogue environments permits the development and testing of countermeasures for and responses to potential hazardous situations, and can thus help improve mission efficiency and safety. Analogue missions, such as the one described here, have plausible mission constraints and operational scenarios, similar to those that a real Mars crew would experience. Long duration analogue studies, such as those being conducted at the Flashline Mars Arctic Research Station (FMARS) on Devon Island, Canada, offer an opportunity to study mission operations and human factors in a semi-realistic environment, and contribute to the design of missions to explore the Moon and Mars. The FMARS XI Long Duration Mission (F-XI LDM) was, at four months, the longest designed analogue Mars mission conducted to date, and thus provides a unique insight into human factors issues for long-duration space exploration. Here, we describe the six human factors studies that took place during F-XI LDM, and give a summary of their results, where available. We also present a meta-study, which examined the impact of the human-factors research itself on crew schedule and workload. Based on this experience, we offer some lessons learnt: some aspects (perceived risk and crew motivation, for example) of analogue missions must be realistic for study results to be valid; human factors studies are time-consuming, and should be fully integrated into crew schedules; and crew-ground communication and collaboration under long-term exploration conditions can present serious challenges.

Activation of endogenous antioxidants as a common therapeutic strategy against cancer, neurodegeneration and cardiovascular diseases: A lesson learnt from DJ-1.

PubMed

Chan, Julie Y H; Chan, Samuel H H

2015-12-01

This review aims at presenting a new concept pertaining to the development of antioxidants, namely, to evolve from disease-oriented therapy to mechanism-oriented therapy. Using as our illustrative example is DJ-1, a homodimeric protein that is ubiquitously expressed in a variety of mammalian tissues, including the brain, and is found in the matrix and the intermembrane space of the mitochondria. DJ-1 is known to be an endogenous antioxidant against cancer, neurodegeneration and cardiovascular diseases, of which oxidative stress plays a causal role. Interestingly, the mechanistic targets of DJ-1 as an antioxidant, including Daxx, Nrf2, thioredoxin, glutathione, α-synuclein, PTEN/PI3K/Akt, and Pink/Parkin are also associated with those oxidative stress-related diseases. Furthermore, activators of DJ-1 are available in the form of mortalin, phenylbutyrate and quinone oxidoreductase 1. It follows that activation of DJ-1 as a common endogenous antioxidant provides a new strategy against cancer, neurodegeneration and cardiovascular diseases. Since clinical trials on exogenous application of the known antioxidants have basically failed, an alternative approach would logically be to activate the endogenous antioxidants that are already present in the appropriate cellular locale where elevated oxidative stress is the culprit for the disease. At the same time, since oxidative stress is a common denominator among cancer, neurodegeneration and cardiovascular diseases, development of antioxidant therapy should target the reduction in reactive oxygen species. Instead of focusing on disease-oriented therapy, pharmaceutical companies should concentrate on developing agents and dosing schemes for effective activation of the endogenous antioxidants that are associated with a multitude of oxidative stress-related diseases (mechanism-oriented therapy). Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of a pilot volunteer feeding assistance program: influences on the dietary intakes of elderly hospitalised patients and lessons learnt.

PubMed

Huang, C S; Dutkowski, K; Fuller, A; Walton, K

2015-02-01

Malnutrition is a serious concern in hospitals and is known to be associated with increased complications for patients, increased hospital costs and length of stay. Trained volunteers that assist 'at risk' and malnourished patients at lunch meals have been shown to effectively increase nutritional intake in a suburban hospital in Sydney. The pilot study reported here aimed to evaluate and share learnings from a similar, newly implemented program, comparing energy and macronutrient intakes on days with no volunteer assistance, to days with volunteers. Dietary intakes were determined by visual estimation of meal trays before and after meals, for two days without volunteers, and two days with volunteer assistance at lunch. Macronutrient and energy intakes were compared and data such as weight, height, diet type and medical history were obtained from medical records. Questionnaires were completed by nurses and volunteers in regards to their views and experiences with the program. Hospital based. Eight patients (83±4.5 years) participated in the study. When volunteers were present at lunch, the average macronutrient and energy intakes increased, though not statistically significantly. The mean increases were 316 kJ (p=0.175) for energy, 3.1 g (p=0.468) for protein, 1.4 g (p=0.418) for fat and 11.6 g (p=0.084) for carbohydrates. Non-significant increases in macronutrients were also noted for the average daily intakes. Although not statistically significant, energy and macronutrient intakes increased when volunteers were present. The implementation of a volunteer feeding assistance program is one strategy to assist dietary intakes but requires a ready team of volunteers, training, acceptance and significant time to develop.

With Interest It Comes To...Unconscionable Clauses in Sales Contracts. A Student's Lesson Plan [and] A Teacher's Lesson Plan [and] A Lawyer's Lesson Plan.

ERIC Educational Resources Information Center

Howard, Estelle; And Others

One of a series of secondary level teaching units presenting case studies with pro and con analysis of particular legal problems, the document presents a student's lesson plan, a teacher's lesson plan, and a lawyer's lesson plan on unconscionable clauses in sales contracts. The unit acquaints students with the operation of sales contracts and…

Reasoning, Not Recipes: Helping Your Students Develop Statistical Understanding and Enjoy the Experience!

ERIC Educational Resources Information Center

Mooney, Gai

2010-01-01

Statistics is often presented to students as a series of algorithms to be learnt by heart and applied at the appropriate time to get "the correct answer". This approach, while it may in fact produce the right answer, has been shown to be minimally effective at helping students understand the underlying statistical concepts. As Holmes noted,…

Safety and Mission Assurance for In-House Design Lessons Learned from Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Anderson, Joel M.

2011-01-01

This viewgraph presentation identifies lessons learned in the course of the Ares I Upper Stage design and in-house development effort. The contents include: 1) Constellation Organization; 2) Upper Stage Organization; 3) Presentation Structure; 4) Lesson-Importance of Systems Engineering/Integration; 5) Lesson-Importance of Early S&MA Involvement; 6) Lesson-Importance of Appropriate Staffing Levels; 7) Lesson-Importance S&MA Team Deployment; 8) Lesson-Understanding of S&MA In-Line Engineering versus Assurance; 9) Lesson-Importance of Close Coordination between Supportability and Reliability/Maintainability; 10) Lesson-Importance of Engineering Data Systems; 11) Lesson-Importance of Early Development of Supporting Databases; 12) Lesson-Importance of Coordination with Safety Assessment/Review Panels; 13) Lesson-Implementation of Software Reliability; 14) Lesson-Implementation of S&MA Technical Authority/Chief S&MA Officer; 15) Lesson-Importance of S&MA Evaluation of Project Risks; 16) Lesson-Implementation of Critical Items List and Government Mandatory Inspections; 17) Lesson-Implementation of Critical Items List Mandatory Inspections; 18) Lesson-Implementation of Test Article Safety Analysis; and 19) Lesson-Importance of Procurement Quality.

Keep Out - Danger! Use of Devices Which Can Cause Death or Serious Bodily Injury in Defense of Real and/or Personal Property. A Student's Lesson Plan [and] A Teacher's Lesson Plan [and] A Lawyer's Lesson Plan.

ERIC Educational Resources Information Center

Howard, Estelle; And Others

One of a series of secondary level teaching units presenting case studies with pro and con analysis of particular legal problems, the document presents a student's lesson plan, a teacher's lesson plan, and a lawyer's lesson plan for introducing torts (any wrong, other than a breach of contract, resulting in a personal injury or property damage…

Regular rehearsal helps in consolidation of long term memory.

PubMed

Parle, Milind; Singh, Nirmal; Vasudevan, Mani

2006-01-01

Memory, one of the most complex functions of the brain comprises of multiple components such as perception, registration, consolidation, storage, retrieval and decay. The present study was undertaken to evaluate the impact of different training sessions on the retention capacity of rats. The capacity of retention of learnt task was measured using exteroceptive behavioral models such as Hexagonal swimming pool apparatus, Hebb-Williams maze and Elevated plus-maze. A total of 150 rats divided into fifteen groups were employed in the present study. The animals were subjected to different training sessions during first three days. The ability to retain the learned task was tested after single, sub-acute, acute, sub-chronic and chronic exposure to above exteroceptive memory models in separate groups of animals. The memory score of all animals was recorded after 72 h, 192 h and 432 h of their last training trial. Rats of single exposure group did not show any effect on memory. Sub-acute training group animals showed improved memory up to 72 h only, where as in acute and sub-chronic training groups this memory improvement was extended up to 192 h. The rats, which were subjected to chronic exposures showed a significant improvement in retention capacity that lasted up to a period of eighteen days. These observations suggest that repeated rehearsals at regular intervals are probably necessary for consolidation of long-term memory. It was observed that sub-acute, acute and sub-chronic exposures, improved the retrieval ability of rats but this memory improving effect was short lived. Thus, rehearsal or training plays a crucial role in enhancing one's capacity of retaining the learnt information. Key PointsThe present study underlines the importance of regular rehearsals in enhancing one's capacity of retaining the learnt information. " Sub-acute, acute & sub-chronic rehearsals result in storing of information for a limited period of time.Quick decay of information or forgetting is a natural continuously active process designed to wipe out unnecessary and useless information.The capacities of grasping, understanding and memory are all crucial for career growth.Single exposure to a new environment is not sufficient enough to form a permanent memory trace in brain.

School-based sex education is associated with reduced risky sexual behaviour and sexually transmitted infections in young adults.

PubMed

Vivancos, R; Abubakar, I; Phillips-Howard, P; Hunter, P R

2013-01-01

To quantify the effectiveness of school-based sexual education on risky sexual behaviour and sexually transmitted infection (STI) acquisition in adulthood. Online survey of sexual attitudes and behaviours. Students at a British university were surveyed regarding where they learnt most about sex at 14 years of age, how easy they found talking about sexual issues with their parents and age at first intercourse. The effects of these factors were modelled on risk of recent unprotected intercourse and self-reported STIs in adulthood. Seventy-eight of 711 (11%) students reported unprotected intercourse in the 4 weeks before the survey, and 44 (6.2%) students had ever been diagnosed with an STI. Both age at first intercourse (risk reduced by 11% per year of delayed intercourse, 95% confidence interval (CI) 3-19%) and learning about sex from lessons at school (66% reduction in risk compared with learning from one's mother, 95% CI 5-88%) were associated with reductions in risk of unprotected intercourse. Factors associated with fewer STIs were age at first intercourse (17% reduction per year of delayed intercourse, 95% CI 5-28%); and learning about sex from lessons at school (85% reduction, 95% CI 32-97%), from friends of the same age (54% reduction, CI 7-77%) and from first boy/girlfriend (85% reduction, 95% CI 35-97%) compared with learning from one's mother. School-based sexual education is effective at reducing the risk of unprotected intercourse and STIs in early adulthood. Influence from friends in adolescence may also have a positive effect on the risk of STIs in later life. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

Lessons learnt from the management of a case of Lassa fever and follow-up of nosocomial primary contacts in Nigeria during Ebola virus disease outbreak in West Africa.

PubMed

Iroezindu, Michael O; Unigwe, Uche S; Okwara, Celestine C; Ozoh, Gladys A; Ndu, Anne C; Ohanu, Martin E; Nwoko, Ugochukwu O; Okoroafor, Uwadiegwu W; Ejimudo, Esinulo; Tobin, Ekaete A; Asogun, Danny A

2015-11-01

To describe our experiences in the management of a case of Lassa fever (LF) and follow-up of nosocomial primary contacts during the 2014 Ebola outbreak in West Africa. Clinical management of the index case and infection control/surveillance activities for primary contacts are described. Laboratory confirmation was by Lassa virus-specific reverse-transcriptase PCR. A 28-year-old man with a 10-day history of febrile illness was referred to a major tertiary hospital in south-east Nigeria from a city that previously experienced a LF outbreak and was recently affected by Ebola. On observation of haemorrhagic features, clinicians were at a crossroads. Diagnosis of LF was confirmed at a National Reference Centre. The patient died despite initiation of ribavirin therapy. Response activities identified 121 primary contacts comprising 78 (64.5%) hospital staff/interns, 19 (15.7%) medical students, 18 (14.9%) inpatients and 6 (5.0%) relatives. Their mean age was 32.8 ± 6.6 years, and 65.3% were women. Twenty (16.5%) had high-risk exposure and were offered ribavirin as post-exposure prophylaxis. No secondary case of LF occurred. Fatigue (43.8%) and dizziness (31.3%) were the commonest side effects of ribavirin. Response activities contained nosocomial spread of LF, but challenges were experienced including lack of a purpose-built isolation facility, absence of local Lassa virus laboratory capacity, failure to use appropriate protective equipment and stigmatisation of contacts. A key lesson is that the weak health systems of Africa should be comprehensively strengthened; otherwise, we might win the Ebola battle but lose the one against less virulent infections for which effective treatment exists. © 2015 John Wiley & Sons Ltd.

Power supplies and equipment for military field research: lessons from the British Service Dhaulagiri Research Expedition 2016.

PubMed

Howard, Matt; Bakker-Dyos, J; Gallagher, L; O'Hara, J P; Woods, D; Mellor, A

2018-02-01

The British Service Dhaulagiri Research Expedition (BSDMRE) took place from 27 March to 31 May 2016. The expedition involved 129 personnel, with voluntary participation in nine different study protocols. Studies were conducted in three research camps established at 3600, 4600 and 5140 m and involved taking and storing blood samples, cardiac echocardiography and investigations involving a balance plate. Research in this remote environment requires careful planning in order to provide a robust and resilient power plan. In this paper we aim to report the rationale for the choices we made in terms of power supply, the equipment used and potential military applicability. This is a descriptive account from the expedition members involved in planning and conducting the medical research. Power calculations were used to determine estimates of requirement prior to the expedition. The primary sources used to generate power were internal combustion engine (via petrol fuelled electric generators) and solar panels. Having been generated, power was stored using lithium-ion batteries. Special consideration was given to the storage of samples taken in the field, for which electric freezers and dry shippers were used. All equipment used functioned well during the expedition, with the challenges of altitude, temperature and transport all overcome due to extensive prior planning. Power was successfully generated, stored and delivered during the BSDMRE, allowing extensive medical research to be undertaken. The challenges faced and overcome are directly applicable to delivering military medical care in austere environments, and lessons learnt can help with the planning and delivery of future operations, training exercises or expeditions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed Central

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

2016-01-01

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

From Ethical Exceptionalism to Ethical Exceptions: The Rule and exception Model and the Changing Meaning of Ethics In German Bioregulation.

PubMed

Braun, Kathrin

2017-12-01

Germany is an interesting case with respect to the governance of reprogenetics. It has a strong profile in the technosciences and high aims regarding the global bioeconomy, yet her regulation of human genetics, reproductive medicine and embryo research has for a long time been rather restrictive. German biopolitical exceptionalism has often been explained by reference to Catholicism and the legacy of the Nazi past. The Germans, so goes the common story, have learnt the lessons of history and translated them into unconditional respect for human dignity, which in turn translates into unconditional protection of human life, including the human embryo, and the firm repudiation of any eugenic distinction between 'life worth to live' and 'life not worth to live'. This, however, is not the whole story. Alongside deontological strictness we find another strand of governing body politics and reprogenetics in Germany, the rule-and-exception model, running from the mid-1970s abortion law via the 2002 Stem Cell Act to the 2011 regulation of pre-implantation genetic diagnosis. In contrast to the former, that strongly draws on Kant and his concept of human dignity, the latter bears resemblances to Carl Schmitt's concept of state of exception. The article will show that the rule-and-exception model builds the exception into the rule and transforms the meaning and mandate of ethics, namely from safeguarding ethical standards to deciding about the exception. Given that the exception has now tended to become the rule, the question is whether the lessons of history will govern German reprogenetics for much longer. © 2016 John Wiley & Sons Ltd.

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

PubMed

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

2016-01-01

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

Predicting the evolution of large cholera outbreaks: lessons learnt from the Haiti case study

NASA Astrophysics Data System (ADS)

Bertuzzo, Enrico; Mari, Lorenzo; Righetto, Lorenzo; Knox, Allyn; Finger, Flavio; Casagrandi, Renato; Gatto, Marino; Rodriguez-Iturbe, Ignacio; Rinaldo, Andrea

2013-04-01

Mathematical models can provide key insights into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and possibly anticipating the impact of alternative interventions. Spatially explicit models of waterborne disease are made routinely possible by widespread data mapping of hydrology, road network, population distribution, and sanitation. Here, we study the ex-post reliability of predictions of the ongoing Haiti cholera outbreak. Our model consists of a set of dynamical equations (SIR-like, i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water, which are, in turn, driven by hydrologic transport through waterways and by mobility of susceptible and infected individuals. Following the evidence of a clear correlation between rainfall events and cholera resurgence, we test a new mechanism explicitly accounting for rainfall as a driver of enhanced disease transmission by washout of open-air defecation sites or cesspool overflows. A general model for Haitian epidemic cholera and the related uncertainty is thus proposed and applied to the dataset of reported cases now available. The model allows us to draw predictions on longer-term epidemic cholera in Haiti from multi-season Monte Carlo runs, carried out up to January 2014 by using a multivariate Poisson rainfall generator, with parameters varying in space and time. Lessons learned and open issues are discussed and placed in perspective. We conclude that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control.

What can wave energy learn from offshore oil and gas?

PubMed

Jefferys, E R

2012-01-28

This title may appear rather presumptuous in the light of the progress made by the leading wave energy devices. However, there may still be some useful lessons to be learnt from current 'offshore' practice, and there are certainly some awful warnings from the past. Wave energy devices and the marine structures used in oil and gas exploration as well as production share a common environment and both are subject to wave, wind and current loads, which may be evaluated with well-validated, albeit imperfect, tools. Both types of structure can be designed, analysed and fabricated using similar tools and technologies. They fulfil very different missions and are subject to different economic and performance requirements; hence 'offshore' design tools must be used appropriately in wave energy project and system design, and 'offshore' cost data should be adapted for 'wave' applications. This article reviews the similarities and differences between the fields and highlights the differing economic environments; offshore structures are typically a small to moderate component of field development cost, while wave power devices will dominate overall system cost. The typical 'offshore' design process is summarized and issues such as reliability-based design and design of not normally manned structures are addressed. Lessons learned from poor design in the past are discussed to highlight areas where care is needed, and wave energy-specific design areas are reviewed. Opportunities for innovation and optimization in wave energy project and device design are discussed; wave energy projects must ultimately compete on a level playing field with other routes to low CO₂ energy and/or energy efficiency. This article is a personal viewpoint and not an expression of a ConocoPhillips position.

Epidemiological and Surveillance Response to Ebola Virus Disease Outbreak in Lofa County, Liberia (March-September, 2014); Lessons Learned.

PubMed

Kouadio, Koffi Isidore; Clement, Peter; Bolongei, Josephus; Tamba, Alpha; Gasasira, Alex Ntale; Warsame, Abdihamid; Okeibunor, Joseph Chukwudi; Ota, Martin Okechukwu; Tamba, Boima; Gumede, Nicksy; Shaba, Keith; Poy, Alain; Salla, Mbaye; Mihigo, Richard; Nshimirimana, Deo

2015-05-06

Ebola Virus Disease (EVD) outbreak was confirmed in Liberia on March 31st 2014. A response comprising of diverse expertise was mobilized and deployed to the country to contain transmission of Ebola and give relief to a people already impoverished from protracted civil war. This paper describes the epidemiological and surveillance response to the EVD outbreak in Lofa County in Liberia from March to September 2014. Five of the 6 districts of Lofa were affected. The most affected districts were Voinjama/Guardu Gbondi and Foya. By 26th September, 2014, a total of 619 cases, including 19.4% probable cases, 20.3% suspected cases and 44.2% confirmed cases were recorded by the Ebola Emergency Response Team (EERT) of Lofa County. Adults (20-50 years) were the most affected. Overall fatality rate was 53.3%.  Twenty two (22) cases were reported among the Health Care Workers with a fatality rate of 81.8%. Seventy eight percent (78%) of the contacts successfully completed 21 days follow-up while 134 (6.15%) that developed signs and symptoms of EVD were referred to the ETU in Foya. The contributions of the weak health systems as well as socio-cultural factors in fueling the epidemic are highlighted. Importantly, the lessons learnt including the positive impact of multi-sectorial and multidisciplinary and coordinated response led by the government and community.  Again, given that the spread of infectious disease can be considered a security threat every effort has to put in place to strengthen the health systems in developing countries including the International Health Regulation (IHR)'s core capacities. Key words:  Ebola virus disease, outbreak, epidemiology and surveillance, socio-cultural factors, health system, West Africa.

Scale-up of a comprehensive harm reduction programme for people injecting opioids: lessons from north-eastern India

PubMed Central

Lalmuanpuii, Melody; Biangtung, Langkham; Mishra, Ritu Kumar; Reeve, Matthew J; Tzudier, Sentimoa; Singh, Angom L; Sinate, Rebecca

2013-01-01

Abstract Problem Harm reduction packages for people who inject illicit drugs, including those infected with human immunodeficiency virus (HIV), are cost-effective but have not been scaled up globally. In the north-eastern Indian states of Manipur and Nagaland, the epidemic of HIV infection is driven by the injection of illicit drugs, especially opioids. These states needed to scale up harm reduction programmes but faced difficulty doing so. Approach In 2004, the Bill & Melinda Gates Foundation funded Project ORCHID to scale up a harm reduction programme in Manipur and Nagaland. Local setting In 2003, an estimated 10 000 and 16 000 people were injecting drugs in Manipur and Nagaland, respectively. The prevalence of HIV infection among people injecting drugs was 24.5% in Manipur and 8.4% in Nagaland. Relevant changes By 2012, the harm reduction programme had been scaled up to an average of 9011 monthly contacts outside clinics (80% of target); an average of 1709 monthly clinic visits (15% of target, well above the 5% monthly goal) and an average monthly distribution of needles and syringes of 16 each per programme participant. Opioid agonist maintenance treatment coverage was 13.7% and retention 6 months after enrolment was 63%. Antiretroviral treatment coverage for HIV-positive participants was 81%. Lessons learnt A harm reduction model consisting of community-owned, locally relevant innovations and business approaches can result in good harm reduction programme scale-up and influence harm reduction policy. Project ORCHID has influenced national harm reduction policy in India and contributed to the development of harm reduction guidelines. PMID:23599555

Lessons from the Johns Hopkins Multi-Disciplinary Venous Thromboembolism (VTE) Prevention Collaborative

PubMed Central

Streiff, Michael B; Carolan, Howard T; Hobson, Deborah B; Kraus, Peggy S; Holzmueller, Christine G; Demski, Renee; Lau, Brandyn D; Biscup-Horn, Paula; Pronovost, Peter J

2012-01-01

Problem Venous thromboembolism (VTE) is a common cause of potentially preventable mortality, morbidity, and increased medical costs. Risk-appropriate prophylaxis can prevent most VTE events, but only a small fraction of patients at risk receive this treatment. Design Prospective quality improvement programme. Setting Johns Hopkins Hospital, Baltimore, Maryland, USA. Strategies for change A multidisciplinary team established a VTE Prevention Collaborative in 2005. The collaborative applied the four step TRIP (translating research into practice) model to develop and implement a mandatory clinical decision support tool for VTE risk stratification and risk-appropriate VTE prophylaxis for all hospitalised adult patients. Initially, paper based VTE order sets were implemented, which were then converted into 16 specialty-specific, mandatory, computerised, clinical decision support modules. Key measures for improvement VTE risk stratification within 24 hours of hospital admission and provision of risk-appropriate, evidence based VTE prophylaxis. Effects of change The VTE team was able to increase VTE risk assessment and ordering of risk-appropriate prophylaxis with paper based order sets to a limited extent, but achieved higher compliance with a computerised clinical decision support tool and the data feedback which it enabled. Risk-appropriate VTE prophylaxis increased from 26% to 80% for surgical patients and from 25% to 92% for medical patients in 2011. Lessons learnt A computerised clinical decision support tool can increase VTE risk stratification and risk-appropriate VTE prophylaxis among hospitalised adult patients admitted to a large urban academic medical centre. It is important to ensure the tool is part of the clinician’s normal workflow, is mandatory (computerised forcing function), and offers the requisite modules needed for every clinical specialty. PMID:22718994

How to build up the actionable knowledge base: the role of ‘best fit’ framework synthesis for studies of improvement in healthcare

PubMed Central

Booth, Andrew; Carroll, Christopher

2015-01-01

Increasing recognition of the role and value of theory in improvement work in healthcare offers the prospect of capitalising upon, and consolidating, actionable lessons from synthesis of improvement projects and initiatives. We propose that informed use of theory can (i) provide a mechanism by which to collect and organise data from a body of improvement work, (ii) offer a framework for analysis and identification of lessons learnt and (iii) facilitate an evaluation of the feasibility, effectiveness and acceptability of improvement programmes. Improvement practitioners can benefit from using an underpinning external structure as a lens by which to examine the specific achievements of their own projects alongside comparable initiatives led by others. We demonstrate the utility of a method known as ‘best fit framework synthesis’ (BFFS) in offering a ubiquitous and versatile means by which to collect, analyse and evaluate improvement work in healthcare. First reported in 2011, BFFS represents a pragmatic, flexible approach to integrating theory with findings from practice. A deductive phase, where a review team seeks to accommodate a substantial part of the data, is followed by an inductive phase, in which the team explores data not accommodated by the framework. We explore the potential for BFFS within improvement work by drawing upon the evidence synthesis methodology literature and practical examples of improvement work reported in BMJ Quality and Safety (2011–2015). We suggest four variants of BFFS that may have particular value in synthesising a body of improvement work. We conclude that BFFS, alongside other approaches that seek to optimise the contribution of theory to improvement work, represents one important enabling mechanism by which to establish the rigour and scientific credentials of the emerging discipline of ‘improvement science’. PMID:26306609

The Gujarat Earthquake: Mitigations Failures and Lessons learnt for Future Strategies

NASA Astrophysics Data System (ADS)

Katuri, A. K.; Mittal, J.; Kumar, K.

Time and again, the Indian subcontinent has been suffering from diverse natural calamities, ranging from droughts to floods, landslides to earthquakes, and cyclones to spells of famines. Recently, in October 1999, a severe cyclone battered the eastern coast of Orissa affecting millions of people, blowing away homes, damaging buildings, destroying crops and wiping out a huge cattle population. The Gujarat earthquake of January 2001 was another monumental disaster that affected more than 15 million people causing colossal loss of life and property estimated at US 1.30 billion, though actual may be much higher. More than 200 international and domestic voluntary agencies promptly rushed aid to the damaged areas at the shake of the quake-2001. In this crucial rescue phase, teams were scattered across affected villages and urban centers, clueless of precise locations and extent of damage. Problems faced during the relief and rehabilitation were- absence of a comprehensive information system (both spatial and attribute), absence of a nodal agency to disseminate information on the type of relief required, absence of high precision remotely sensed data, appropriate for preparation and implementation of long term reconstruction and rehabilitation plan (Development Plan). Repeated disaster assessments by multiple agencies led to wastage of time and resources. All this led to non-coherence amongst the coordinating agencies, and rescue &relief teams. Spatial and attribute damage assessment could have been easier in the presence of comprehensive geographic and demographic information supported by high precision satellite imageries to compare pre and post disaster situation. Disaster management includes pre-disaster preparedness planning, post- disaster damage assessment, search and rescue, rehabilitation and reconstruction activities. Unlike other disasters, scientific alerts, forecasts and warnings of impending earthquake still require more attention. Disaster Preparedness Plan for speedy rescue and relief operations needs to be in place with improved information system for post disaster recovery. This paper draws upon the shortfalls faced in the management of Gujarat earthquake; a lesson learnt and presents a comprehensive strategy for Systems networking including the role of space programs in disaster management. The proposed structure is a top down approach for cooperation, emerging from bottom level demand. The missing key elements in the post-disaster situation were - effective information system, high resolution remote sensing data (for effective town planning), operational GIS, with support network from some or all of the governmental agencies. An integrated global communication network for wider dissemination of forecasts, warning and monitoring on a global level and sharing of related knowledge and information can play a vital role in disaster reduction. Needless to say, the local, regional and national disaster communication networks must be fully integrated in the global grid. The proposed structure for disaster management has a National Disaster Mitigation Establishment (NDME) as the apex body under the auspices of the central government, which would be networked across nations to similar other NDMEs. Each NDME would handle the coordination and monitoring of its state units which may be called as State Disaster Management Establishments (SDME). The SDMEs with various district or sub-district level units would collate data. The Network would be supported with field staff at its offices and would liaison with respective higher level DMEs where the lowest unit may be a village / town or cluster of villages. This paper emphasizes the need for comprehensive information system with Spatial Decision Support System (DSS) at three different levels for total disaster management.

The Impeachment of Andrew Johnson. Web Lesson.

ERIC Educational Resources Information Center

Constitutional Rights Foundation, Los Angeles, CA.

This lesson presents the historical background of Abraham Lincoln's selection of Andrew Johnson as his running mate in the election of 1864. The lesson considers the climate in the U.S. Congress after President Lincoln's assassination. The details of the impeachment and trial of President Andrew Johnson are given. The lesson presents three…

Tricks of the trade: time management tips for newly qualified doctors.

PubMed

Offiah, Gozie; Doherty, Eva

2018-03-01

The transition from medical student to doctor is an important milestone. The discovery that their time is no longer their own and that the demands of their job are greater than the time they have available is extremely challenging. At a recent surgical boot camp training programme, 60 first-year surgical trainees who had just completed their internship were invited to reflect on the lessons learnt regarding effective time management and to recommend tips for their newly qualified colleagues. They were asked to identify clinical duties that were considered urgent and important using the time management matrix and the common time traps encountered by newly qualified doctors. The surgical trainees identified several practical tips that ranged from writing a priority list to working on relationships within the team. These tips are generic and so applicable to all newly qualified medial doctors. We hope that awareness of these tips from the outset as against learning them through experience will greatly assist newly qualified doctors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed

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

2011-05-01

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

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

PubMed Central

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

2014-01-01

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

Risk Mitigation Testing with the BepiColombo MPO SADA

NASA Astrophysics Data System (ADS)

Zemann, J.; Heinrich, B.; Skulicz, A.; Madsen, M.; Weisenstein, W.; Modugno, F.; Althaus, F.; Panhofer, T.; Osterseher, G.

2013-09-01

A Solar Array (SA) Drive Assembly (SADA) for the BepiColombo mission is being developed and qualified at RUAG Space Zürich (RSSZ). The system is consisting of the Solar Array Drive Mechanism (SADM) and the Solar Array Drive Electronics (SADE) which is subcontracted to RUAG Space Austria (RSA).This paper deals with the risk mitigation activities and the lesson learnt from this development. In specific following topics substantiated by bread board (BB) test results will be addressed in detail:Slipring Bread Board Test: Verification of lifetime and electrical performance of carbon brush technology Potentiometer BB Tests: Focus on lifetime verification (> 650000 revolution) and accuracy requirement SADM EM BB Test: Subcomponent (front-bearing and gearbox) characterization; complete test campaign equivalent to QM test.EM SADM/ SADE Combined Test: Verification of combined performance (accuracy, torque margin) and micro-vibration testing of SADA systemSADE Bread Board Test: Parameter optimization; Test campaign equivalent to QM testThe main improvements identified in frame of BB testing and already implemented in the SADM EM/QM and SADE EQM are:• Improved preload device for gearbox• Improved motor ball-bearing assembly• Position sensor improvements• Calibration process for potentiometer• SADE motor controller optimization toachieve required running smoothness• Overall improvement of test equipment.

A pilot study of interprofessional palliative care education of medical students in the UK and USA.

PubMed

Gadoud, Amy; Lu, Wei-Hsin; Strano-Paul, Lisa; Lane, Susan; Boland, Jason W

2018-03-01

Educating medical students to care for patients at the end-of-life is increasingly recognised as an essential component of training. Traditionally, medical student programmes are run by doctors, but patient care is delivered by an interprofessional team. Our programmes in the UK and USA independently developed a teaching experience led by an interprofessional team of palliative care health professionals. This study explores the palliative care health professionals' perceptions, regarding their unique role in medical student palliative care education. This is the first study to ascertain views of an interprofessional team delivering palliative care education to medical students. Focus groups enable interaction between members of the group as well as the generation of consensus of comments among group members. Two major themes were identified: perceived benefits and value of the experience, and the challenges and lessons learnt from the experiences. Despite different structures and settings, this experiential learning in palliative care provided a rewarding interprofessional experience that has historically been difficult to achieve. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Monitoring HIV-Related Laws and Policies: Lessons for AIDS and Global Health in Agenda 2030.

PubMed

Torres, Mary Ann; Gruskin, Sofia; Buse, Kent; Erkkola, Taavi; Bendaud, Victoria; Alfvén, Tobias

2017-07-01

The National Commitments and Policy Instrument (NCPI) has been used to monitor AIDS-related laws and policies for over 10 years. What can be learnt from this process? Analyses draw on NCPI questionnaires, NCPI responses, the UNAIDS Law Database, survey data and responses to a 2014 survey on the NCPI. The NCPI provides the first and only systematic data on country self-reported national HIV laws and policies. High NCPI reporting rates and survey responses suggest the majority of countries consider the process relevant. Combined civil society and government engagement and reporting is integral to the NCPI. NCPI experience demonstrates its importance in describing the political and legal environment for the HIV response, for programmatic reviews and to stimulate dialogue among stakeholders, but there is a need for updating and in some instances to complement results with more objective quantitative data. We identify five areas that need to be updated in the next iteration of the NCPI and argue that the NCPI approach is relevant to participatory monitoring of targets in the health and other goals of the UN 2030 Agenda for Sustainable Development.

Distance learning in the public health workplace.

PubMed

Patel, M

2000-09-01

The Master of Applied Epidemiology (MAE) Program implemented in Canberra to produce public health practitioners with specified competencies in the control of communicable diseases. Twenty one of the 24 months of training is distance learning defined as, 'where the learner is physically remote from the training institution'. During this time the trainees are in supervised employment in Public Health centres across the country. Here they learn directly from first hand experiences in the work place. They return to Canberra for short, intensive periods of interactive sessions with their peers and supervisors. Lessons learnt from conducting this program are discussed in this article. They include: all trainees are not suited to this form of training; the quality of support from the field supervisors is highly variable and their role in modelling crucial to the trainees performance; demands on the academic staff is high; and the frequency of contact between trainee and academic supervisor varies considerably. To date this program has made major contributions by enhancing communicable disease surveillance and control but it demands intensive resources to sustain, quality training, and support. This model of distance learning can be adapted in the Pacific both for graduate degree courses and also for continuing education for all levels of health professionals.

Asbestos Ban in Italy: A Major Milestone, Not the Final Cut

PubMed Central

Marsili, Daniela; Bruno, Caterina; Marinaccio, Alessandro; Zona, Amerigo; Comba, Pietro

2017-01-01

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use. PMID:29137208

Asbestos Ban in Italy: A Major Milestone, Not the Final Cut.

PubMed

Marsili, Daniela; Angelini, Alessia; Bruno, Caterina; Corfiati, Marisa; Marinaccio, Alessandro; Silvestri, Stefano; Zona, Amerigo; Comba, Pietro

2017-11-13

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use.

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

PubMed

Taylor, Kate P; Thompson, Sandra C

2011-08-01

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

Putting the rise of the Inca Empire within a climatic and land management context

NASA Astrophysics Data System (ADS)

Chepstow-Lusty, A. J.; Frogley, M. R.; Bauer, B. S.; Leng, M. J.; Boessenkool, K. P.; Carcaillet, C.; Ali, A. A.; Gioda, A.

2009-03-01

The rapid expansion of the Inca from the Cuzco area of highland Peru produced the largest empire in the New World between ca. AD 1400-1532. Although this meteoric rise may in part be due to the adoption of innovative societal strategies, supported by a large labour force and standing army, we argue that this would not have been possible without increased crop productivity, which was linked to more favourable climatic conditions. A multi-proxy, high-resolution 1200-year lake sediment record was analysed at Marcacocha, 12 km north of Ollantaytambo, in the heartland of the Inca Empire. This record reveals a period of sustained aridity that began from AD 880, followed by increased warming from AD 1100 that lasted beyond the arrival of the Spanish in AD 1532. These increasingly warmer conditions allowed the Inca and their predecessors the opportunity to exploit higher altitudes from AD 1150, by constructing agricultural terraces that employed glacial-fed irrigation, in combination with deliberate agroforestry techniques. There may be some important lessons to be learnt today from these strategies for sustainable rural development in the Andes in the light of future climate uncertainty.

The MobiSan approach: informal settlements of Cape Town, South Africa.

PubMed

Naranjo, A; Castellano, D; Kraaijvanger, H; Meulman, B; Mels, A; Zeeman, G

2010-01-01

Pook se Bos informal settlement and the Cape Town Water & Sanitation Services Department are partnering on an urban sanitation project with a Dutch Consortium consisting of Lettinga Associates Foundation (LeAF), Landustrie Sneek and Vitens-Evides International. The aim of the project is to improve the basic sanitation services provided in informal settlements through the implementation of the MobiSan approach. The approach consists of a communal Urine-Diversion and Dehydration Toilet (UDDT) built in a former sea shipping container. The system is independent of water, electricity or sewerage connection and it is maintained by full-time community caretakers who also act as hygiene promoters. The project seeks to link sanitation services with hygiene promotion in informal settlements while enhancing user satisfaction and reducing costs in providing basic sanitation services. This paper describes the preliminary experiences and lessons learnt during the implementation and evaluation of the MobiSan prototype and discusses its potential for replication. The MobiSan has proved to be an appropriate option by means of dealing successfully with shallow groundwater table, land availability and high settlement densities. In addition it has been demonstrated to be cost-competitive in terms of operating cost compared to chemical toilets.

High-precision cryogenic wheel mechanisms of the JWST/MIRI instrument: performance of the flight models

NASA Astrophysics Data System (ADS)

Krause, O.; Müller, F.; Birkmann, S.; Böhm, A.; Ebert, M.; Grözinger, U.; Henning, Th.; Hofferbert, R.; Huber, A.; Lemke, D.; Rohloff, R.-R.; Scheithauer, S.; Gross, T.; Fischer, T.; Luichtel, G.; Merkle, H.; Übele, M.; Wieland, H.-U.; Amiaux, J.; Jager, R.; Glauser, A.; Parr-Burman, P.; Sykes, J.

2010-07-01

The Mid Infrared Instrument (MIRI) aboard JWST is equipped with one filter wheel and two dichroic-grating wheel mechanisms to reconfigure the instrument between observing modes such as broad/narrow-band imaging, coronagraphy and low/medium resolution spectroscopy. Key requirements for the three mechanisms with up to 18 optical elements on the wheel include: (1) reliable operation at T = 7 K, (2) high positional accuracy of 4 arcsec, (3) low power dissipation, (4) high vibration capability, (5) functionality at 7 K < T < 300 K and (6) long lifetime (5-10 years). To meet these requirements a space-proven wheel concept consisting of a central MoS2-lubricated integrated ball bearing, a central torque motor for actuation, a ratchet system with monolithic CuBe flexural pivots for precise and powerless positioning and a magnetoresistive position sensor has been implemented. We report here the final performance and lessons-learnt from the successful acceptance test program of the MIRI wheel mechanism flight models. The mechanisms have been meanwhile integrated into the flight model of the MIRI instrument, ready for launch in 2014 by an Ariane 5 rocket.

Speaking to the yet unknowing world: Hamlet, Horatio and the problem of imperfect witness.

PubMed

Phillips, Christine

2010-12-01

Every day doctors bear witness to others about the experiences, needs and feelings of their patients, drawing on what they have learnt from clinical consultations. This paper considers the medical task of bearing honourable and truthful witness through an examination of the role and actions of Horatio in Hamlet. Horatio is simultaneously located among the background machinery of the play, separate from the lives of the protagonists, and in the foreground, where his authoritative witness is repeatedly called upon by the play's characters. Horatio is invited to watch an unfolding disaster, his warnings are not heard, and at its conclusion he stands apart from the drama to give its account. The tensions between engagement and observation, and between partial and impartial accounting echo those faced by doctors in everyday clinical practice. The act of bearing witness, Shakespeare suggests, even for those who are tasked with being objective, is necessarily imperfect, and not dispassionate. Those people, including doctors, who are expected to construct authoritative accounts of the motives and actions of others may find in Hamlet a small lesson on the need to approach their summary narratives about others more humbly, aware of the narrowness and partiality of their perspective.

Characterization of post-disaster environmental management for Hazardous Materials Incidents: Lessons learnt from the Tianjin warehouse explosion, China.

PubMed

Zhang, Hui; Duan, Huabo; Zuo, Jian; Song, MingWei; Zhang, Yukui; Yang, Bo; Niu, Yongning

2017-09-01

Hazardous Materials Incidents (HMIs) have attracted a growing public concern worldwide. The health risks and environmental implications associated with HMIs are almost invariably severe, and underscore the urgency for sound management. Hazardous Materials Explosion incidents (HMEIs) belong to a category of extremely serious HMIs. Existing studies placed focuses predominately on the promptness and efficiency of emergency responses to HMIs and HMEIs. By contrast, post-disaster environmental management has been largely overlooked. Very few studies attempted to examine the post-disaster environmental management plan particularly its effectiveness and sufficiency. In the event of the Tianjin warehouse explosion (TWE), apart from the immediate emergency response, the post-disaster environmental management systems (P-EMSs) have been reported to be effective and sufficient in dealing with the environmental concerns. Therefore, this study aims to critically investigate the P-EMSs for the TWE, and consequently to propose a framework and procedures for P-EMSs in general for HMIs, particularly for HMEIs. These findings provide a useful reference to develop P-EMSs for HMIs in the future, not only in China but also other countries. Copyright © 2017. Published by Elsevier Ltd.

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.