Differences in Alcohol Use and Alcohol-Related Problems between Transgender- and Nontransgender-identified Young Adults

PubMed Central

Coulter, Robert W.S.; Blosnich, John R.; Bukowski, Leigh A.; Herrick, A. L.; Siconolfi, Daniel E.; Stall, Ron D.

2015-01-01

Background Little is known about differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified populations. Using data from a large-scale health survey, we compare the drinking patterns and prevalence of alcohol-related problems of transgender-identified individuals to nontransgender-identified males and females. For transgender-identified people, we examine how various forms of victimization relate to heavy episodic drinking (HED). Methods Cross-sectional surveys were completed by 75,192 students aged 18–29 years attending 120 post-secondary educational institutions in the United States from 2011–2013. Self-reported measures included alcohol use, alcohol-related problems, victimization, and sociodemographics, including 3 gender-identity groups: transgender-identified individuals; nontransgender-identified males; and nontransgender-identified females. Results Compared to transgender-identified individuals, nontransgender-identified males were more likely to report HED in the past 2 weeks (relative risk=1.42; p=0.006); however, nontransgender-identified males and females reported HED on fewer days than transgender-identified people (incidence-rate ratios [IRRs] ranged from 0.28–0.43; p-values<0.001). Compared to transgender-identified people, nontransgender-identified males and females had lower odds of past-year alcohol-related sexual assault and suicidal ideation (odds ratios ranged from 0.24–0.45; p-values<0.05). Among transgender-identified people, individuals who were sexually assaulted (IRR=3.21, p=0.011) or verbally threatened (IRR=2.42, p=0.021) in the past year had greater HED days than those who did not experience those forms of victimization. Conclusions Compared to transgender-identified people, nontransgender-identified males and females: have fewer HED occasions (despite nontransgender-identified males having greater prevalence of HED); and are at lower risk for alcohol-related sexual assaults and suicidal ideation. Experiences of sexual assault and verbal threats are associated with greater HED occasions for transgender-identified people. PMID:26210734

Behavior problems in children at time of first recognized seizure and changes over the following 3 years.

PubMed

Austin, J K; Perkins, S M; Johnson, C S; Fastenau, P S; Byars, A W; deGrauw, T J; Dunn, D W

2011-08-01

The purposes of this 36-month study of children with first recognized seizures were: (1) to describe baseline differences in behavior problems between children with and without prior unrecognized seizures; (2) to identify differences over time in behavior problems between children with seizures and their healthy siblings; (3) to identify the proportions of children with seizures and healthy siblings who were consistently at risk for behavior problems for 36 months; and (4) to identify risk factors for behavior problems 36 months following the first recognized seizure. Risk factors explored included demographic (child age and gender, caregiver education), neuropsychological (IQ, processing speed), seizure (epileptic syndrome, use of antiepileptic drug, seizure recurrence), and family (family mastery, satisfaction with family relationships, parent response) variables. Participants were 300 children aged 6 through 14 years with a first recognized seizure and 196 healthy siblings. Data were collected from medical records, structured interviews, self-report questionnaires, and neuropsychological testing. Behavior problems were measured using the Child Behavior Checklist and the Teacher's Report Form. Data analyses included descriptive statistics and linear mixed models. Children with prior unrecognized seizures were at higher risk for behavior problems at baseline. As a group, children with seizures showed a steady reduction in behavior problems over time. Children with seizures were found to have significantly more behavior problems than their siblings over time, and significantly more children with seizures (11.3%) than siblings (4.6%) had consistent behavior problems over time. Key risk factors for child behavior problems based on both caregivers and teachers were: less caregiver education, slower initial processing speed, slowing of processing speed over the first 36 months, and a number of family variables including lower levels of family mastery or child satisfaction with family relationships, lower parent support of the child's autonomy, and lower parent confidence in their ability to discipline their child. Children with new-onset seizures who are otherwise developing normally have higher rates of behavior problems than their healthy siblings; however, behavior problems are not consistently in the at-risk range in most children during the first 3 years after seizure onset. When children show behavior problems, family variables that might be targeted include family mastery, parent support of child autonomy, and parents' confidence in their ability to handle their children's behavior.

Helping Families Adjust to Economic Change. A Project Report.

ERIC Educational Resources Information Center

Matejic, Denise M.

A project was developed to gain more insight into family financial problems, to identify these problems, and to formulate educational strategies to deal with and help solve these problems. This project was conducted in three phases, which included community outreach, development of educational materials, and evaluation. Three communities with…

A Simulated Research Problem for Undergraduate Metamorphic Petrology.

ERIC Educational Resources Information Center

Amenta, Roddy V.

1984-01-01

Presents a laboratory problem in metamorphic petrology designed to simulate a research experience. The problem deals with data on scales ranging from a geologic map to hand specimens to thin sections. Student analysis includes identifying metamorphic index minerals, locating their isograds on the map, and determining the folding sequence. (BC)

Special Problems of People with Diabetes and Visual Impairment.

ERIC Educational Resources Information Center

Rosenthal, J. L.

1993-01-01

This article addresses the types of visual impairment caused by diabetes and the unique problems that people with diabetes and visual impairment face. Diabetic retinopathy, cataracts, glaucoma, and diabetic optic neuropathy are discussed as causes of visual impairment, and specific problems in basic living are identified, including diet,…

The Difficult Patron in the Academic Library: Problem Issues or Problem Patrons?

ERIC Educational Resources Information Center

Simmonds Patience L.; Ingold, Jane L.

2002-01-01

Identifies difficult patron issues in academic libraries from the librarians' perspectives and offers solutions to try and prevent them from becoming problems. Topics include labeling academic library users; eliminating sources of conflict between faculty and library staff; and conflicts between students and library staff. (Author/LRW)

7 CFR 1291.10 - Reporting and oversight requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., identify and share the lessons learned to help expedite problem-solving. (6) Contact Person. List the... period to meet measurable outcomes for each project. (2) Problems and Delays. Note unexpected delays or... include the following: (1) Project Summary. An outline of the issue, problem, interest, or need for each...

Cognitive Functioning in Children with Learning Problems

ERIC Educational Resources Information Center

Schwenck, Christina; Dummert, Friederike; Endlich, Darius; Schneider, Wolfgang

2015-01-01

Several cognitive deficits associated with reading and mathematics problems have been identified. However, only few studies assessed the impact of these variables in children with combined problems in reading and arithmetics, and none of these studies included children with low IQ. This longitudinal study was designed to assess the impact of…

Marine geodesy a multipurpose approach to solve oceanic problems. [including submersible navigation under iced seas, demarcation and determination of boundaries in deep ocean, tsunamis, and ecology

NASA Technical Reports Server (NTRS)

Saxena, N.

1974-01-01

Various current and future problem areas of marine geodesy are identified. These oceanic problem areas are highly diversified and include submersible navigation under ice seas, demarcation and determination of boundaries in deep ocean, tsunamis, ecology, etc., etc. Their achieved as well as desired positional accuracy estimates, based upon publications and discussions, are also given. A multipurpose approach to solve these problems is described. An optimum configuration of an ocean-bottom control-net unit is provided.

Partnership in Teacher Education--A Research Mapping

ERIC Educational Resources Information Center

Lillejord, Sølvi; Børte, Kristin

2016-01-01

This mapping of research on partnership in teacher education provides an overview of themes and analyses problems identified in the studies that were included. The mapping gives a status of research in the field; identifies knowledge gaps and suggests improvements in partnership models. Studies included describe partnerships as complex and…

Activities to Enhance Social, Emotional, and Problem-Solving Skills: Seventy-Six Activities that Teach Children, Adolescents, and Adults Skills Crucial to Success in Life. Second Edition

ERIC Educational Resources Information Center

Malouff, John M.; Schutte, Nicola S.

2007-01-01

This book provides descriptions of 76 engaging activities that can be used to teach children, adolescents, and adults valuable social, emotional, and problem-solving skills. Some of the skills taught include identifying and expressing one's own emotions, identifying emotions in others, coping with stressors, making and keeping friends, setting…

Chronically ill rural women: self-identified management problems and solutions.

PubMed

Cudney, Shirley; Sullivan, Therese; Winters, Charlene A; Paul, Lynn; Oriet, Pat

2005-03-01

To add to the knowledge base of illness management of chronically ill, rural women by describing the self-identified problems and solutions reported by women participants in the online health-education segment of the Women to Women (WTW) computer outreach project. WTW is a research-based computer intervention providing health education and online peer support for rural women with chronic diseases. Messages posted to the online chat room were examined to determine the women's self-management problems and solutions. The self-identified problems were: (1) difficulties in carrying through on self-management programmes; (2) negative fears and feelings; (3) poor communication with care providers; and (4) disturbed relationships with family and friends. The self-identified solutions to these problems included problem-solving techniques that were tailored to the rural lifestyle. Although not all problems were 'solvable', they could be 'lived with' if the women's prescriptions for self-management were used. Glimpses into the women's day-to-day experiences of living with chronic illness gleaned from the interactive health-education discussions will give health professionals insights into the women's efforts to manage their illnesses. The data provide health professionals with information to heighten their sensitivity to their clients' day-to-day care and educational needs.

Criterion-Referenced Testing for College-Level General Education: Some Problems and Recommendations.

ERIC Educational Resources Information Center

Benoist, Howard

1979-01-01

The adoption of a criterion-referenced assessment system and the resulting disadvantages of this form of evaluation for the college general education program are discussed, including problems in identifying assessment validation procedures. (RAO)

JFK airport ground control recommendations.

DOT National Transportation Integrated Search

1971-11-01

The object of this effort was to generate a detailed recommendation on what to do about the JFK Airport Ground Traffic Control Problem, including a review of STRACS, a Surface Traffic Control System. Problem areas were identified by direct observatio...

Strength Testing.

ERIC Educational Resources Information Center

Londeree, Ben R.

1981-01-01

Postural deviations resulting from strength and flexibility imbalances include swayback, scoliosis, and rounded shoulders. Screening tests are one method for identifying strength problems. Tests for the evaluation of postural problems are described, and exercises are presented for the strengthening of muscles. (JN)

Children with Co-occurring Academic and Behavior Problems in First grade: Distal Outcomes in Twelfth Grade

PubMed Central

Darney, Dana; Reinke, Wendy M.; Herman, Keith C.; Stormont, Melissa; Ialongo, Nicholas S.

2012-01-01

The aim of the current study was to evaluate the eleven year longitudinal association between students identified in first grade as having academic and behavior problems and distal outcomes in twelfth grade. The study extends prior research that identified latent classes of academic and behavior problems in a longitudinal community sample of 678 predominately African American first-grade students. The type and number of classes identified in first grade differed by gender, but results indicated that students within the classes of behavior and academic problems had long-term negative outcomes in the twelfth grade. The class with co-occurring academic and behavior problems in first grade had the greatest risk for negative distal outcomes for both boys and girls including higher likelihood of special education placement, mental health service use, poor academic achievement, and school dropout. Implications for prevention, early intervention, and current practices in schools are discussed. PMID:23375176

General aviation IFR operational problems

NASA Technical Reports Server (NTRS)

Bolz, E. H.; Eisele, J. E.

1979-01-01

Operational problems of general aviation IFR operators (particularly single pilot operators) were studied. Several statistical bases were assembled and utilized to identify the more serious problems and to demonstrate their magnitude. These bases include official activity projections, historical accident data and delay data, among others. The GA operating environment and cockpit environment were analyzed in detail. Solutions proposed for each of the problem areas identified are based on direct consideration of currently planned enhancements to the ATC system, and on a realistic assessment of the present and future limitations of general aviation avionics. A coordinated set of research program is suggested which would provide the developments necessary to implement the proposed solutions.

INQUIRY TRAINING AND PROBLEM SOLVING IN ELEMENTARY SCHOOL CHILDREN.

ERIC Educational Resources Information Center

BUTTS, DAVID P.; JONES, HOWARD L.

THE EFFECT OF PLANNED GUIDANCE ON THE PROBLEM-SOLVING BEHAVIOR OF ELEMENTARY STUDENTS WAS INVESTIGATED. FACTORS RELATED TO CHANGES IN PROBLEM-SOLVING BEHAVIORS WERE IDENTIFIED. APPROXIMATELY 50 PERCENT OF THE SIXTH-GRADE STUDENTS INCLUDED IN THE STUDY WERE GIVEN INQUIRY TRAINING 30 TO 60 MINUTES DAILY FOR 3 WEEKS. AN INVENTORY OF SCIENCE PROCESSES…

77 FR 14565 - Information Collection Request Sent to the Office of Management and Budget (OMB) for Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... client evaluation helps refuge managers detect potential problems with guide services so that we can take... public record. Before including your address, phone number, email address, or other personal identifying information in your comment, you should be aware that your entire comment, including your personal identifying...

Mistaken Identifiers: Gene name errors can be introduced inadvertently when using Excel in bioinformatics

PubMed Central

Zeeberg, Barry R; Riss, Joseph; Kane, David W; Bussey, Kimberly J; Uchio, Edward; Linehan, W Marston; Barrett, J Carl; Weinstein, John N

2004-01-01

Background When processing microarray data sets, we recently noticed that some gene names were being changed inadvertently to non-gene names. Results A little detective work traced the problem to default date format conversions and floating-point format conversions in the very useful Excel program package. The date conversions affect at least 30 gene names; the floating-point conversions affect at least 2,000 if Riken identifiers are included. These conversions are irreversible; the original gene names cannot be recovered. Conclusions Users of Excel for analyses involving gene names should be aware of this problem, which can cause genes, including medically important ones, to be lost from view and which has contaminated even carefully curated public databases. We provide work-arounds and scripts for circumventing the problem. PMID:15214961

Reintegration after bone marrow transplantation.

PubMed

Baker, F; Zabora, J; Polland, A; Wingard, J

1999-01-01

This study examines the problems of bone marrow transplantation (BMT) survivors in returning to "normal" life in the community after BMT. Before being released from The Johns Hopkins Oncology Center, 84 recipients of BMT were interviewed regarding their quality of life and psychosocial adaptation. Survivors were reinterviewed at 6 months, and at 1 year post-BMT, producing considerable qualitative data regarding their problems in living. Eighty-four patients who had received BMT completed qualitative interviews and standardized measures before treatment, before the return home, and at 6 and 12 months post-BMT. The interviews were subjected to a content analysis methodology to establish units and categories to examine the body of material. Content analysis of these interviews from the first year after BMT identified three areas of psychosocial morbidity; 1) physical problems, which included fatigue, appearance, troubles in eating, and physical restrictions; 2) psychological problems, which included fears about the future, sense of loss of control, anxiety, and depression; and 3) community reintegration problems, which included difficulty in returning to former social roles, separation from home, family, and friends, difficulty in resuming social relations, dealing with stigmatization, problems with family and children, and financial and employment difficulties. Identification of these problems for BMT survivors can be used to guide the development of specific materials and services to prepare recipients of BMTs and their families for life after the transplant. These qualitative results can also be used to direct the development of assessment tools to identify potential patient and family problems.

Creation of an ODOT specification for patching or overlay of bridge decks.

DOT National Transportation Integrated Search

2009-09-01

Bridge deck cracking is a huge problem in the United States, and various agencies have sponsored research endeavoring to determine the underlying problems. A number of causes have been identified, including thermal movement, plastic shrinkage, and ea...

Playing "Twenty Questions" with Attribute Blocks.

ERIC Educational Resources Information Center

Pagni, David L.

1993-01-01

Investigates the problem of finding the expected number of questions necessary to identify 1 out of a set of 30 attribute blocks. Solutions include the use of a tree diagram or a computer simulation. Generalizes the problem for increased numbers of attributes. (MDH)

What Mathematical Competencies Are Needed for Success in College.

ERIC Educational Resources Information Center

Garofalo, Joe

1990-01-01

Identifies requisite math skills for a microeconomics course, offering samples of supply curves, demand curves, equilibrium prices, elasticity, and complex graph problems. Recommends developmental mathematics competencies, including problem solving, reasoning, connections, communication, number and operation sense, algebra, relationships,…

Identifiability in N-mixture models: a large-scale screening test with bird data.

PubMed

Kéry, Marc

2018-02-01

Binomial N-mixture models have proven very useful in ecology, conservation, and monitoring: they allow estimation and modeling of abundance separately from detection probability using simple counts. Recently, doubts about parameter identifiability have been voiced. I conducted a large-scale screening test with 137 bird data sets from 2,037 sites. I found virtually no identifiability problems for Poisson and zero-inflated Poisson (ZIP) binomial N-mixture models, but negative-binomial (NB) models had problems in 25% of all data sets. The corresponding multinomial N-mixture models had no problems. Parameter estimates under Poisson and ZIP binomial and multinomial N-mixture models were extremely similar. Identifiability problems became a little more frequent with smaller sample sizes (267 and 50 sites), but were unaffected by whether the models did or did not include covariates. Hence, binomial N-mixture model parameters with Poisson and ZIP mixtures typically appeared identifiable. In contrast, NB mixtures were often unidentifiable, which is worrying since these were often selected by Akaike's information criterion. Identifiability of binomial N-mixture models should always be checked. If problems are found, simpler models, integrated models that combine different observation models or the use of external information via informative priors or penalized likelihoods, may help. © 2017 by the Ecological Society of America.

Data Acquisition from tcpdump: Recovering and Reconstituting Clickstream Data

DTIC Science & Technology

2012-08-02

Analytics. The questions she seeks to answer include: • Can we identify individuals from their web browsing behavior given past browsing history ? Why or...why not? • Can we distinguish between two web browsing histories as belonging to the same person or to different persons? The objective of the...behind one IP address . Heuristics exists to get around those problems. We have identified in this project a third problem: disambiguation between

Conceptual, Methodological, and Ethical Problems in Communicating Uncertainty in Clinical Evidence

PubMed Central

Han, Paul K. J.

2014-01-01

The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”— second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making. PMID:23132891

Accelerated weathering of tough shales : final report.

DOT National Transportation Integrated Search

1977-01-01

The purpose of this study was to find or develop a test that would identify a very tough but relatively rapid weathering type of shale that has caused problems when used in embankments as rock. Eight shales, including the problem shale, were collecte...

Solving the 10 Most Common Carpet Problems.

ERIC Educational Resources Information Center

Hilton, Michael

1998-01-01

Identifies the 10 most common carpet problems in school facilities and offers solutions. These include: transition areas, moisture, spot removal, recurring spots, cleaning agents, allergens, wicking, biological contamination, equipment selection, and cleaning methods. Ensuring a successful maintenance program results in satisfactory appearance,…

78 FR 21598 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

... http://www.regulations.gov as they are received without change, including any personal identifiers or... growth and development, in order to prevent the occurrence of health problems, including drug and other...

Applications of aerospace technology to petroleum exploration. Volume 1: Efforts and results

NASA Technical Reports Server (NTRS)

Jaffe, L. D.

1976-01-01

The feasibility of applying aerospace techniques to help solve significant problems in petroleum exploration is studied. Through contacts with petroleum industry and petroleum service industry, important petroleum exploration problems were identified. For each problem, areas of aerospace technology that might aid in its solution were also identified where possible. Topics selected for investigation include: seismic reflection systems; down-hole acoustic techniques; identification of geological analogies; drilling methods; remote geological sensing; and sea floor imaging and mapping. Specific areas of aerospace technology are applied to 21 concepts formulated from the topics of concern.

A Unified Framework for Association Analysis with Multiple Related Phenotypes

PubMed Central

Stephens, Matthew

2013-01-01

We consider the problem of assessing associations between multiple related outcome variables, and a single explanatory variable of interest. This problem arises in many settings, including genetic association studies, where the explanatory variable is genotype at a genetic variant. We outline a framework for conducting this type of analysis, based on Bayesian model comparison and model averaging for multivariate regressions. This framework unifies several common approaches to this problem, and includes both standard univariate and standard multivariate association tests as special cases. The framework also unifies the problems of testing for associations and explaining associations – that is, identifying which outcome variables are associated with genotype. This provides an alternative to the usual, but conceptually unsatisfying, approach of resorting to univariate tests when explaining and interpreting significant multivariate findings. The method is computationally tractable genome-wide for modest numbers of phenotypes (e.g. 5–10), and can be applied to summary data, without access to raw genotype and phenotype data. We illustrate the methods on both simulated examples, and to a genome-wide association study of blood lipid traits where we identify 18 potential novel genetic associations that were not identified by univariate analyses of the same data. PMID:23861737

Individual heterogeneity and identifiability in capture-recapture models

USGS Publications Warehouse

Link, W.A.

2004-01-01

Individual heterogeneity in detection probabilities is a far more serious problem for capture-recapture modeling than has previously been recognized. In this note, I illustrate that population size is not an identifiable parameter under the general closed population mark-recapture model Mh. The problem of identifiability is obvious if the population includes individuals with pi = 0, but persists even when it is assumed that individual detection probabilities are bounded away from zero. Identifiability may be attained within parametric families of distributions for pi, but not among parametric families of distributions. Consequently, in the presence of individual heterogeneity in detection probability, capture-recapture analysis is strongly model dependent.

Barriers and Facilitators of Responding to Problem Gambling: Perspectives from Australian Mental Health Services.

PubMed

Rodda, S N; Manning, V; Dowling, N A; Lee, S J; Lubman, D I

2018-03-01

Despite high rates of comorbidity between problem gambling and mental health disorders, few studies have examined barriers or facilitators to the implementation of screening for problem gambling in mental health services. This exploratory qualitative study identified key themes associated with screening in mental health services. Semi-structured interviews were undertaken with 30 clinicians and managers from 11 mental health services in Victoria, Australia. Major themes and subthemes were identified using qualitative content analysis. Six themes emerged including competing priorities, importance of routine screening, access to appropriate screening tools, resources, patient responsiveness and workforce development. Barriers to screening included a focus on immediate risk as well as gambling being often considered as a longer-term concern. Clinicians perceived problem gambling as a relatively rare condition, but did acknowledge the need for brief screening. Facilitators to screening were changes to system processes, such as identification of an appropriate brief screening instrument, mandating its use as part of routine screening, as well as funded workforce development activities in the identification and management of problem gambling.

Methodological problems in the use of indirect comparisons for evaluating healthcare interventions: survey of published systematic reviews.

PubMed

Song, Fujian; Loke, Yoon K; Walsh, Tanya; Glenny, Anne-Marie; Eastwood, Alison J; Altman, Douglas G

2009-04-03

To investigate basic assumptions and other methodological problems in the application of indirect comparison in systematic reviews of competing healthcare interventions. Survey of published systematic reviews. Inclusion criteria Systematic reviews published between 2000 and 2007 in which an indirect approach had been explicitly used. Identified reviews were assessed for comprehensiveness of the literature search, method for indirect comparison, and whether assumptions about similarity and consistency were explicitly mentioned. The survey included 88 review reports. In 13 reviews, indirect comparison was informal. Results from different trials were naively compared without using a common control in six reviews. Adjusted indirect comparison was usually done using classic frequentist methods (n=49) or more complex methods (n=18). The key assumption of trial similarity was explicitly mentioned in only 40 of the 88 reviews. The consistency assumption was not explicit in most cases where direct and indirect evidence were compared or combined (18/30). Evidence from head to head comparison trials was not systematically searched for or not included in nine cases. Identified methodological problems were an unclear understanding of underlying assumptions, inappropriate search and selection of relevant trials, use of inappropriate or flawed methods, lack of objective and validated methods to assess or improve trial similarity, and inadequate comparison or inappropriate combination of direct and indirect evidence. Adequate understanding of basic assumptions underlying indirect and mixed treatment comparison is crucial to resolve these methodological problems. APPENDIX 1: PubMed search strategy. APPENDIX 2: Characteristics of identified reports. APPENDIX 3: Identified studies. References of included studies.

Disciplinary Counseling: The First Step toward Due Process.

ERIC Educational Resources Information Center

Cunningham, Patrick J.

1980-01-01

The oral reprimand is seen as the most important step in a corrective discipline procedure. Steps of disciplinary counseling include: always counsel in a private place; identify the problem; identify the desired behavior; define the consequences; get commitment from employee; identify session as oral reprimand; and monitor and follow up.(MLW)

Children with co-occurring academic and behavior problems in first grade: distal outcomes in twelfth grade.

PubMed

Darney, Dana; Reinke, Wendy M; Herman, Keith C; Stormont, Melissa; Ialongo, Nicholas S

2013-02-01

The aim of the current study was to evaluate the eleven year longitudinal association between students identified in first grade as having academic and behavior problems and distal outcomes in twelfth grade. The study extends prior research that identified latent classes of academic and behavior problems in a longitudinal community sample of 678 predominately African American first-grade students. The type and number of classes identified in first grade differed by gender, but results indicated that students within the classes of behavior and academic problems had long-term negative outcomes in the twelfth grade. The class with co-occurring academic and behavior problems in first grade had the greatest risk for negative distal outcomes for both boys and girls including higher likelihood of special education placement, mental health service use, poor academic achievement, and school dropout. Implications for prevention, early intervention, and current practices in schools are discussed. Published by Elsevier Ltd.

Foreign Language "Think Tank" Symposium.

ERIC Educational Resources Information Center

Thomas, Kathleen H.

At the Foreign Language"Think Tank" Symposium of April 1975, the following major problems of community college foreign language teachers were identified: (1) low enrollment; (2) attrition; (3) low achievers; (4) articulation with universities; and (5) lack of interest. Suggested solutions included: (Problem 1) advertisement, a foreign language…

Promoting Interdisciplinary Collaboration: Trainees Addressing Siloed Medical Education

ERIC Educational Resources Information Center

Kitts, Robert Li; Christodoulou, Joanna; Goldman, Stuart

2011-01-01

Objective: Professional siloing within medical institutions has been identified as a problem in medical education, including resident training. The authors discuss how trainees from different disciplines can collaborate to address this problem. Method: A group of trainees from psychiatry, developmental medicine, neurology, and education came…

Processing Problems and Language Impairment in Children.

ERIC Educational Resources Information Center

Watkins, Ruth V.

1990-01-01

The article reviews studies on the assessment of rapid auditory processing abilities. Issues in auditory processing research are identified including a link between otitis media with effusion and language learning problems. A theory that linguistically impaired children experience difficulty in perceiving and processing low phonetic substance…

42 CFR 441.464 - State assurances.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Self-Directed Personal Assistance Services Program § 441.464 State assurances. A State must assure that... problems that might be associated with budget underutilization. (2) These safeguards may include the... that budget problems are identified on a timely basis so that corrective action may be taken, if...

Professional service use for a serious personal problem: Comparing older African Americans, Black Caribbeans, and non-Hispanic Whites using the National Survey of American Life

PubMed Central

Woodward, Amanda Toler; Chatters, Linda M.; Taylor, Harry Owen; Taylor, Robert Joseph

2014-01-01

Objectives Examines combinations of professionals visited for a serious personal problem. Methods The sample includes those aged 55 and older (n=862) from the National Survey of American Life (NSAL). Latent class analysis was used to identify groups of respondents based on types of professionals visited. Multinomial logistic regression was used to identify factors associated with group membership. Results Classes included health provider plus clergy, physician plus mental health provider, and limited provider use. Whites were more likely than African Americans to fall into the health provider plus clergy and physician plus mental health provider classes. Those with physical and emotional problems were more likely to be in the health provider plus clergy and physician plus mental health provider classes, respectively. Discussion Most respondents were in the limited provider use class suggesting that for many of problems, minimal professional help is utilized. Physicians and clergy were important across all three classes. PMID:25552527

Cause-and-effect analysis of risk management files to assess patient care in the emergency department.

PubMed

White, Andrew A; Wright, Seth W; Blanco, Roberto; Lemonds, Brent; Sisco, Janice; Bledsoe, Sandy; Irwin, Cindy; Isenhour, Jennifer; Pichert, James W

2004-10-01

Identifying the etiologies of adverse outcomes is an important first step in improving patient safety and reducing malpractice risks. However, relatively little is known about the causes of emergency department-related adverse outcomes. The objective was to describe a method for identification of common causes of adverse outcomes in an emergency department. This methodology potentially can suggest ways to improve care and might provide a model for identification of factors associated with adverse outcomes. This was a retrospective analysis of 74 consecutive files opened by a malpractice insurer between 1995 and 2000. Each risk-management file was analyzed to identify potential causes of adverse outcomes. The main outcomes were rater-assigned codes for alleged problems with care (e.g., failures of communication or problems related to diagnosis). About 50% of cases were related to injuries or abdominal complaints. A contributing cause was found in 92% of cases, and most had more than one contributing cause. The most frequent contributing categories included failure to diagnose (45%), supervision problems (31%), communication problems (30%), patient behavior (24%), administrative problems (20%), and documentation (20%). Specific relating factors within these categories, such as lack of timely resident supervision and failure to follow policies and procedures, were identified. This project documented that an aggregate analysis of risk-management files has the potential to identify shared causes related to real or perceived adverse outcomes. Several potentially correctable systems problems were identified using this methodology. These simple, descriptive management tools may be useful in identifying issues for problem solving and can be easily learned by physicians and managers.

Treatment of severe problem behaviour in children with autism spectrum disorder and intellectual disabilities.

PubMed

Newcomb, Eli T; Hagopian, Louis P

2018-02-01

Children with autism spectrum disorder (ASD) and intellectual disabilities (ID) present with problem behaviour at rates disproportionately higher than their typically-developing peers. Problem behaviour, such as self-injury, aggression, pica, disruption, and elopement result in a diminished quality-of-life for the individual and family. Applied behaviour analysis has a well-established research base, detailing a number of assessment and treatment methods designed to address behaviour problems in children with ASD and ID. Although the variables that lead to the emergence of problem behaviour are not precisely known, those that are currently responsible for the maintenance of these problems can be identified via functional behaviour assessment, which is designed to identify events that occasion problem behaviour, consequences that maintain it, as well as other environmental factors that exert influence on the behaviour. Corresponding function-based treatment is implemented when environmental determinants are identified, with the aim of decreasing or eliminating problem behaviour, as well as teaching the individual to engage in more appropriate, alternative behaviour. In some cases, when problem behaviour is under the control of both environmental and biological variables, including psychiatric conditions, combining behavioural and pharmacological interventions is viewed as optimal, although there is limited empirical support for integrating these approaches.

Radiological clinical trials: Proposal of a problem-finding questionnaire to improve study success.

PubMed

Valdora, Francesca; Bignotti, Bianca; Calabrese, Massimo; Houssami, Nehmat; Tagliafico, Alberto

2016-12-26

To develop a survey to help define the main problems in radiological clinical trials. Since 2006, we have managed seven different radiological clinical trials recruiting patients in academic and non-academic centres. We developed a preliminary questionnaire using a four-round Delphi approach to identify problems occurring in radiological clinical trials run at our centre. We investigated the recruitment experience, involvement of all multi-disciplinary team members and main obstacles to completing the projects. A final round of Delphi processes elucidated solutions to the identified problems. Among 19/20 (95%) respondents, 10 (53%) were young physicians (under 35 years old), and the respondents included non-faculty members, fellows, residents, and undergraduate students. Ninety-four percent (18/19) of respondents showed interest in conducting clinical trials. On a scale of 1 to 10, the problems with higher/worse scores (8-9) were related to technical or communication problems. The most frequent problems across all studies were technical problems related to clinical trial equipment, insufficient willingness to participate, obstacles to understanding the design of electronic-case report form and extra work. The developed questionnaire identified the main recurring problems in radiological clinical trials as perceived by end-users and helped define possible solutions that are mostly related to having dedicated clinical trial research staff.

Improving supervision: a team approach.

PubMed

1993-01-01

This issue of "The Family Planning Manager" outlines an interactive team supervision strategy as a means of improving family planning service quality and enabling staff to perform to their maximum potential. Such an approach to supervision requires a shift from a monitoring to a facilitative role. Because supervisory visits to the field are infrequent, the regional supervisor, clinic manager, and staff should form a team to share ongoing supervisory responsibilities. The team approach removes individual blame and builds consensus. An effective team is characterized by shared leadership roles, concrete work problems, mutual accountability, an emphasis on achieving team objectives, and problem resolution within the group. The team supervision process includes the following steps: prepare a visit plan and schedule; meet with the clinic manager and staff to explain how the visit will be conducted; supervise key activity areas (clinical, management, and personnel); conduct a problem-solving team meeting; conduct a debriefing meeting with the clinic manager; and prepare a report on the visit, including recommendations and follow-up plans. In Guatemala's Family Planning Unit, teams identify problem areas on the basis of agreement that a problem exists, belief that the problem can be solved with available resources, and individual willingness to accept responsibility for the specific actions identified to correct the problem.

Analysis of small crack behavior for airframe applications

NASA Technical Reports Server (NTRS)

Mcclung, R. C.; Chan, K. S.; Hudak, S. J., Jr.; Davidson, D. L.

1994-01-01

The small fatigue crack problem is critically reviewed from the perspective of airframe applications. Different types of small cracks-microstructural, mechanical, and chemical-are carefully defined and relevant mechanisms identified. Appropriate analysis techniques, including both rigorous scientific and practical engineering treatments, are briefly described. Important materials data issues are addressed, including increased scatter in small crack data and recommended small crack test methods. Key problems requiring further study are highlighted.

Child-Level Predictors of Responsiveness to Evidence-Based Mathematics Intervention.

PubMed

Powell, Sarah R; Cirino, Paul T; Malone, Amelia S

2017-07-01

We identified child-level predictors of responsiveness to 2 types of mathematics (calculation and word-problem) intervention among 2nd-grade children with mathematics difficulty. Participants were 250 children in 107 classrooms in 23 schools pretested on mathematics and general cognitive measures and posttested on mathematics measures. We assigned classrooms randomly assigned to calculation intervention, word-problem intervention, or business-as-usual control. Intervention lasted 17 weeks. Path analyses indicated that scores on working memory and language comprehension assessments moderated responsiveness to calculation intervention. No moderators were identified for responsiveness to word-problem intervention. Across both intervention groups and the control group, attentive behavior predicted both outcomes. Initial calculation skill predicted the calculation outcome, and initial language comprehension predicted word-problem outcomes. These results indicate that screening for calculation intervention should include a focus on working memory, language comprehension, attentive behavior, and calculations. Screening for word-problem intervention should focus on attentive behavior and word problems.

78 FR 6130 - Notice of Proposed Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-29

... for the collection of information for the Abandoned Mine Land Problem Area Description form. This... collection is contained in the Form OSM-76, Abandoned Mine Land Problem Area Description form. OSM will... requests to OMB. Before including your address, phone number, email address, or other personal identifying...

The Teacher/Scientist: From Trainer to Educator.

ERIC Educational Resources Information Center

Ellerbrock, Michael J.

Problems and issues in U.S. undergraduate education are identified, and 10 recommendations for improvement are offered. Specific reference is made to agriculture faculty. Problems and issues include: current emphasis on academic specialization rather than the development of integrated, holistic students; the purpose of a liberal education versus…

Life after critical illness: an overview.

PubMed

Rattray, Janice

2014-03-01

To illustrate the potential physical and psychological problems faced by patients after an episode of critical illness, highlight some of the interventions that have been tested and identify areas for future research. Recovery from critical illness is an international problem and as an issue is likely to increase. For some, recovery from critical illness is prolonged, subject to physical and psychological problems that may negatively impact upon health-related quality of life. The literature accessed for this review includes the work of a number of key researchers in the field of critical care research. These were identified from a number of sources include (1) personal knowledge of the research field accumulated over the last decade and (2) using the search engine 'The Knowledge Network Scotland'. Fatigue and weakness are significant problems for critical care survivors and are common in patients who have been in ICU for more than one week. Psychological problems include anxiety, depression, post-traumatic stress, delirium and cognitive impairment. Prevalence of these problems is difficult to establish for a number of methodological reasons that include the use of self-report questionnaires, the number of different questionnaires used and the variation in administration and timing. Certain subgroups of ICU survivors especially those at the more severe end of the illness severity spectrum are more at risk and this has been demonstrated for both physical and psychological problems. Findings from international studies of a range of potential interventions are presented. However, establishing effectiveness for most of these still has to be empirically demonstrated. What seems clear is the need for a co-ordinated, multidisciplinary, designated recovery and rehabilitation pathway that begins as soon as the patient is admitted into an intensive care unit. © 2013 John Wiley & Sons Ltd.

Identifying failure in a tree network of a parallel computer

DOEpatents

Archer, Charles J.; Pinnow, Kurt W.; Wallenfelt, Brian P.

2010-08-24

Methods, parallel computers, and products are provided for identifying failure in a tree network of a parallel computer. The parallel computer includes one or more processing sets including an I/O node and a plurality of compute nodes. For each processing set embodiments include selecting a set of test compute nodes, the test compute nodes being a subset of the compute nodes of the processing set; measuring the performance of the I/O node of the processing set; measuring the performance of the selected set of test compute nodes; calculating a current test value in dependence upon the measured performance of the I/O node of the processing set, the measured performance of the set of test compute nodes, and a predetermined value for I/O node performance; and comparing the current test value with a predetermined tree performance threshold. If the current test value is below the predetermined tree performance threshold, embodiments include selecting another set of test compute nodes. If the current test value is not below the predetermined tree performance threshold, embodiments include selecting from the test compute nodes one or more potential problem nodes and testing individually potential problem nodes and links to potential problem nodes.

Latent profiles of problem behavior within learning, peer, and teacher contexts: identifying subgroups of children at academic risk across the preschool year.

PubMed

Bulotsky-Shearer, Rebecca J; Bell, Elizabeth R; Domínguez, Ximena

2012-12-01

Employing a developmental and ecological model, the study identified initial levels and rates of change in academic skills for subgroups of preschool children exhibiting problem behavior within routine classroom situations. Six distinct latent profile types of emotional and behavioral adjustment were identified for a cohort of low-income children early in the preschool year (N=4417). Profile types provided a descriptive picture of patterns of classroom externalizing, internalizing, and situational adjustment problems common to subgroups of children early in the preschool year. The largest profile type included children who exhibited low problem behavior and were characterized as well-adjusted to the preschool classroom early in the year. The other profile types were characterized by distinct combinations of elevated internalizing, externalizing, and situational problem behavior. Multinomial logistic regression identified younger children and boys at increased risk for classification in problem types, relative to the well-adjusted type. Latent growth models indicated that children classified within the extremely socially and academically disengaged profile type, started and ended the year with the lowest academic skills, relative to all other types. Implications for future research, policy, and practice are discussed. Copyright © 2012 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Caregiving-Related Sleep Problems and Their Relationship to Mental Health and Daytime Function in Female Veterans.

PubMed

Song, Yeonsu; Washington, Donna L; Yano, Elizabeth M; McCurry, Susan M; Fung, Constance H; Dzierzewski, Joseph M; Rodriguez, Juan Carlos; Jouldjian, Stella; Mitchell, Michael N; Alessi, Cathy A; Martin, Jennifer L

2018-01-01

To identify caregiving-related sleep problems and their relationship to mental health and daytime function in female Veterans. Female Veterans (N = 1,477) from cross-sectional, nationwide, postal survey data. The survey respondent characteristics included demographics, comorbidity, physical activity, health, use of sleep medications, and history of sleep apnea. They self-identified caregiving- related sleep problems (i.e., those who had trouble sleeping because of caring for a sick adult, an infant/child, or other respondents). Patient Health Questionnaire (PHQ-4) was used to assess mental health, and daytime function was measured using 11 items of International Classification of Sleep Disorders-2 (ICSD-2). Female Veterans with self-identified sleep problems due to caring for a sick adult (n = 59) experienced significantly more symptoms of depression and anxiety (p < 0.001) and impairment in daytime function (e.g., fatigue, daytime sleepiness, loss of concentration, p < 0.001) than those with self-identified sleep problems due to caring for an infant or child (n = 95) or all other respondents (n = 1,323) after controlling for the respondent characteristics. Healthcare providers should pay attention to assessing sleep characteristics of female Veterans with caregiving responsibilities, particularly those caregiving for a sick adult.

Development of a problem solving evaluation instrument; untangling of specific problem solving assets

NASA Astrophysics Data System (ADS)

Adams, Wendy Kristine

The purpose of my research was to produce a problem solving evaluation tool for physics. To do this it was necessary to gain a thorough understanding of how students solve problems. Although physics educators highly value problem solving and have put extensive effort into understanding successful problem solving, there is currently no efficient way to evaluate problem solving skill. Attempts have been made in the past; however, knowledge of the principles required to solve the subject problem are so absolutely critical that they completely overshadow any other skills students may use when solving a problem. The work presented here is unique because the evaluation tool removes the requirement that the student already have a grasp of physics concepts. It is also unique because I picked a wide range of people and picked a wide range of tasks for evaluation. This is an important design feature that helps make things emerge more clearly. This dissertation includes an extensive literature review of problem solving in physics, math, education and cognitive science as well as descriptions of studies involving student use of interactive computer simulations, the design and validation of a beliefs about physics survey and finally the design of the problem solving evaluation tool. I have successfully developed and validated a problem solving evaluation tool that identifies 44 separate assets (skills) necessary for solving problems. Rigorous validation studies, including work with an independent interviewer, show these assets identified by this content-free evaluation tool are the same assets that students use to solve problems in mechanics and quantum mechanics. Understanding this set of component assets will help teachers and researchers address problem solving within the classroom.

The Environmental Education Act of 1970: Success or Failure?

ERIC Educational Resources Information Center

Marcus, Melvin G.

1984-01-01

Identifies and interprets several problems that beset environmental education (EE) and the Office of Environmental Education (OEE). Areas addressed include Public Law 91-516 (Environmental Education Act) and the OEE, problems related to implementing the act, funding, misinterpretation of the act's intent, the act's identity, and the status of EE…

Measurement of Emotional/Psychological Child Maltreatment: A Review

ERIC Educational Resources Information Center

Tonmyr, Lil; Draca, Jasminka; Crain, Jennifer; MacMillan, Harriet L.

2011-01-01

Background: Emotional/psychological child maltreatment (ECM) is a major public health problem with serious consequences including emotional and behavioral problems. Nevertheless, ECM is an understudied area. Objectives: The aims of this review are to identify measures of ECM and to evaluate their psychometric properties and utilities. We provide a…

77 FR 69925 - Assessment of Hazardous Materials Incident Data Collection, Analysis, Reporting, and Use

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... posted without change to the Federal Docket Management System (FDMS), including any personal information... effectiveness; 2. Determine the need for regulatory changes to address changing transportation safety problems; 3. Identify major problem or risk areas that should receive priority attention; 4. Chart trends; 5...

49 CFR 24.103 - Criteria for appraisals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... defining the appraisal problem. The scope of work and development of an appraisal under these requirements depends on the complexity of the appraisal problem. (2) The Agency has the responsibility to assure that...), including items identified as personal property, a statement of the known and observed encumbrances, if any...

The Equal Pay Boondoggle

ERIC Educational Resources Information Center

Lester, Richard A.

1975-01-01

Problems of extending the Equal Pay Act to university faculty are examined in light of the complicated market forces and merit systems affecting faculty appointments and salaries. Solutions to the problem are suggested including guidelines for the Wage and Hour Division of the Department of Labor to use in identifying sex discrimination. (JT)

Children and Youth: Interdisciplinary Perspectives. Issues in Children's and Families' Lives. Volume 7.

ERIC Educational Resources Information Center

Walberg, Herbert J., Ed.; Reyes, Olga, Ed.; Weissberg, Roger P., Ed.

This volume exemplifies the overall interdisciplinary, multiprofessional view of the problems and potential of urban children and youth. The contributors were encouraged to identify current problems and better solutions. Contributions are grouped into sections on families, schools, and health. The following chapters are included: (1) "Introduction…

Y2K for Librarians: Exactly What You Need To Do.

ERIC Educational Resources Information Center

Doering, William

1999-01-01

Addresses how libraries can prepare for Y2K problems. Discusses technology that might be affected and equipment that should be examined, difficulty of fixing noncompliant hardware and software, identifying problem areas and developing solutions, and dealing with vendors. Includes a checklist of necessary preparations. (AEF)

Tackling a Local Problem.

ERIC Educational Resources Information Center

Cook, Martin

1995-01-01

Students studying water as a class project were concerned by levels of pollution at a nearby river and the local beach. They identified three environmental problems for research including sewage discharge, beach litter, and quality of swimming water. Research consisted of field trips which allowed for opportunities to improve skills in collecting…

Real Questions, Real Answers. Focusing Teacher Leadership on School Improvement.

ERIC Educational Resources Information Center

Clarke, John H.; Sanborn, Stephen D.; Aiken, Judith A.; Cornell, Nancy A.; Goodman, Jane Briody; Hess, Karin K.

This book examines how a relationship between the University of Vermont and school districts throughout the state enables teachers to earn graduate credits through year-long Problem-Based School Development Institutes. The institutes take participants through a cycle that includes identifying a problem, conducting background and action research,…

Parent-Teacher Communication about Children with Autism Spectrum Disorder: An Examination of Collaborative Problem-Solving

PubMed Central

Azad, Gazi F.; Kim, Mina; Marcus, Steven C.; Mandell, David S.; Sheridan, Susan M.

2016-01-01

Effective parent-teacher communication involves problem-solving concerns about students. Few studies have examined problem solving interactions between parents and teachers of children with autism spectrum disorder (ASD), with a particular focus on identifying communication barriers and strategies for improving them. This study examined the problem-solving behaviors of parents and teachers of children with ASD. Participants included 18 teachers and 39 parents of children with ASD. Parent-teacher dyads were prompted to discuss and provide a solution for a problem that a student experienced at home and at school. Parents and teachers also reported on their problem-solving behaviors. Results showed that parents and teachers displayed limited use of the core elements of problem-solving. Teachers displayed more problem-solving behaviors than parents. Both groups reported engaging in more problem-solving behaviors than they were observed to display during their discussions. Our findings suggest that teacher and parent training programs should include collaborative approaches to problem-solving. PMID:28392604

Parent-Teacher Communication about Children with Autism Spectrum Disorder: An Examination of Collaborative Problem-Solving.

PubMed

Azad, Gazi F; Kim, Mina; Marcus, Steven C; Mandell, David S; Sheridan, Susan M

2016-12-01

Effective parent-teacher communication involves problem-solving concerns about students. Few studies have examined problem solving interactions between parents and teachers of children with autism spectrum disorder (ASD), with a particular focus on identifying communication barriers and strategies for improving them. This study examined the problem-solving behaviors of parents and teachers of children with ASD. Participants included 18 teachers and 39 parents of children with ASD. Parent-teacher dyads were prompted to discuss and provide a solution for a problem that a student experienced at home and at school. Parents and teachers also reported on their problem-solving behaviors. Results showed that parents and teachers displayed limited use of the core elements of problem-solving. Teachers displayed more problem-solving behaviors than parents. Both groups reported engaging in more problem-solving behaviors than they were observed to display during their discussions. Our findings suggest that teacher and parent training programs should include collaborative approaches to problem-solving.

The indoor air we breathe.

PubMed Central

Oliver, L C; Shackleton, B W

1998-01-01

Increasingly recognized as a potential public health problem since the outbreak of Legionnaire's disease in Philadelphia in 1976, polluted indoor air has been associated with health problems that include asthma, sick building syndrome, multiple chemical sensitivity, and hypersensitivity pneumonitis. Symptoms are often nonspecific and include headache, eye and throat irritation, chest tightness and shortness of breath, and fatigue. Air-borne contaminants include commonly used chemicals, vehicular exhaust, microbial organisms, fibrous glass particles, and dust. Identified causes include defective building design and construction, aging of buildings and their ventilation systems, poor climate control, inattention to building maintenance. A major contributory factor is the explosion in the use of chemicals in building construction and furnishing materials over the past four decades. Organizational issues and psychological variables often contribute to the problem and hinder its resolution. This article describes the health problems related to poor indoor air quality and offers solutions. Images p398-a p399-a PMID:9769764

Performance of activities of daily living among hospitalized cancer patients.

PubMed

Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen; la Cour, Karen; Søndergaard, Jens

2015-03-01

Many cancer patients report unmet rehabilitation needs. Rehabilitation may include activities of daily living (ADL) tasks, but little is known about how cancer patients perform these tasks and how they prioritize their daily activities. Hence, this study aims to identify and characterize ADL task performance problems among a group of adult disabled hospitalized cancer patients using interview and questionnaire data. Cross-sectional study on prevalence of ADL task performance problems experienced by disabled hospitalized cancer patients using the Activities of Daily Living Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results differed between women and men. There was significant overlap between problems identified using the COPM and the ADL-Q instruments. RESULTS from the COPM showed that 65% of problems were related to self-care, 25% to leisure, and 19% to productivity. Using both instruments identified more ADL problems than when using only one of the instruments. Adult hospitalized disabled cancer patients experience a high degree and variation in difficulties performing ADL, illustrating the need for a comprehensively planned assessment of problems and needs.

Assessment of alcohol problems using AUDIT in a prison setting: more than an 'aye or no' question.

PubMed

MacAskill, Susan; Parkes, Tessa; Brooks, Oona; Graham, Lesley; McAuley, Andrew; Brown, Abraham

2011-11-14

Alcohol problems are a major UK and international public health issue. The prevalence of alcohol problems is markedly higher among prisoners than the general population. However, studies suggest alcohol problems among prisoners are under-detected, under-recorded and under-treated. Identifying offenders with alcohol problems is fundamental to providing high quality healthcare. This paper reports use of the AUDIT screening tool to assess alcohol problems among prisoners. Universal screening was undertaken over ten weeks with all entrants to one male Scottish prison using the AUDIT standardised screening tool and supplementary contextual questions. The questionnaire was administered by trained prison officers during routine admission procedures. Overall 259 anonymised completed questionnaires were analysed. AUDIT scores showed a high prevalence of alcohol problems with 73% of prisoner scores indicating an alcohol use disorder (8+), including 36% having scores indicating 'possible dependence' (20-40). AUDIT scores indicating 'possible dependence' were most apparent among 18-24 and 40-64 year-olds (40% and 56% respectively). However, individual questions showed important differences, with younger drinkers less likely to demonstrate habitual and addictive behaviours than the older age group. Disparity between high levels of harmful/hazardous/dependent drinking and low levels of 'treatment' emerged (only 27% of prisoners with scores indicating 'possible dependence' reported being 'in treatment'). Self-reported associations between drinking alcohol and the index crime were identified among two-fifths of respondents, rising to half of those reporting violent crimes. To our knowledge, this is the first study to identify differing behaviours and needs among prisoners with high AUDIT score ranges, through additional analysis of individual questions. The study has identified high prevalence of alcohol use, varied problem behaviours, and links across drinking, crime and recidivism, supporting the argument for more extensive provision of alcohol-focused interventions in prisons. These should be carefully targeted based on initial screening and assessment, responsive, and include care pathways linking prisoners to community services. Finally, findings confirm the value and feasibility of routine use of the AUDIT screening tool in prison settings, to considerably enhance practice in the detection and understanding of alcohol problems, improving on current more limited questioning (e.g. 'yes or no' questions).

Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

PubMed

Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

2009-09-01

Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

Best Possible Medication History for Hemodialysis Patients Obtained by a Pharmacy Technician

PubMed Central

Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

2009-01-01

Background: Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). Objectives: The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. Methods: All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician’s BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. Results: The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. Conclusion: An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems. PMID:22478921

Analysis and control of hourglass instabilities in underintegrated linear and nonlinear elasticity

NASA Technical Reports Server (NTRS)

Jacquotte, Olivier P.; Oden, J. Tinsley

1994-01-01

Methods are described to identify and correct a bad finite element approximation of the governing operator obtained when under-integration is used in numerical code for several model problems: the Poisson problem, the linear elasticity problem, and for problems in the nonlinear theory of elasticity. For each of these problems, the reason for the occurrence of instabilities is given, a way to control or eliminate them is presented, and theorems of existence, uniqueness, and convergence for the given methods are established. Finally, numerical results are included which illustrate the theory.

Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base.

PubMed

McCoy, Allison B; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J; Sittig, Dean F

2014-04-01

Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of previously described knowledge bases. A reputation metric may be a valuable measure for identifying high quality clinician-entered, crowdsourced data. Copyright © 2013 Elsevier Inc. All rights reserved.

Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base

PubMed Central

McCoy, Allison B.; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J.; Sittig, Dean F.

2014-01-01

Background Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. Objective We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. Approach We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Results Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of previously described knowledge bases. Conclusion A reputation metric may be a valuable measure for identifying high quality clinician-entered, crowdsourced data. PMID:24321170

A method and knowledge base for automated inference of patient problems from structured data in an electronic medical record.

PubMed

Wright, Adam; Pang, Justine; Feblowitz, Joshua C; Maloney, Francine L; Wilcox, Allison R; Ramelson, Harley Z; Schneider, Louise I; Bates, David W

2011-01-01

Accurate knowledge of a patient's medical problems is critical for clinical decision making, quality measurement, research, billing and clinical decision support. Common structured sources of problem information include the patient problem list and billing data; however, these sources are often inaccurate or incomplete. To develop and validate methods of automatically inferring patient problems from clinical and billing data, and to provide a knowledge base for inferring problems. We identified 17 target conditions and designed and validated a set of rules for identifying patient problems based on medications, laboratory results, billing codes, and vital signs. A panel of physicians provided input on a preliminary set of rules. Based on this input, we tested candidate rules on a sample of 100,000 patient records to assess their performance compared to gold standard manual chart review. The physician panel selected a final rule for each condition, which was validated on an independent sample of 100,000 records to assess its accuracy. Seventeen rules were developed for inferring patient problems. Analysis using a validation set of 100,000 randomly selected patients showed high sensitivity (range: 62.8-100.0%) and positive predictive value (range: 79.8-99.6%) for most rules. Overall, the inference rules performed better than using either the problem list or billing data alone. We developed and validated a set of rules for inferring patient problems. These rules have a variety of applications, including clinical decision support, care improvement, augmentation of the problem list, and identification of patients for research cohorts.

Diagnosing gastro-oesophageal reflux disease or lactose intolerance in babies who cry a lot in the first few months overlooks feeding problems.

PubMed

Douglas, Pamela Sylvia

2013-04-01

This paper explores two areas in which the translation of research into practice may be improved in the management of cry-fuss behaviours in the first few months of life. Firstly, babies who cry excessively are often prescribed proton pump inhibitors, despite evidence that gastro-oesophageal reflux disease is very rarely a cause. The inaccuracy of commonly used explanatory mechanisms, the side-effects of acid-suppressive medications, and the failure to identify treatable problems, including feeding difficulty when the diagnosis of 'reflux' is applied, are discussed. Secondly, crying breastfed babies are still prescribed lactase or lactose-free formula, despite evidence that the problem of functional lactose overload is one of breastfeeding management. The mechanisms and management of functional lactose overload are discussed. These two problems of research translation need to be addressed because failure to identify and manage other causes of cry-fuss problems, including feeding difficulty, may have adverse outcomes for a small but significant minority of families. © 2013 The Author. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Association of Anxiety, Depression, and Somatization with Menstrual Problems among North Korean Women Defectors in South Korea.

PubMed

Kim, Hyun Kyoung; Kim, Hee Sook; Kim, Seog Ju

2017-11-01

North Korean women defectors have suffered from anxiety, depression, and somatization after defection. Also they have had many menstrual problems like amenorrhea. This study was done to identify the correlations of anxiety, depression, and somatization to menstrual problems among North Korean woman defectors in South Korea. The participants in this study were 126 women from 5 government resettlement centers throughout South Korea. Questionnaires which included State-Trait Anxiety Inventory (STAI), Center for Epidemiological studies-Depression Scale (CED-S), and Symptom Checklist-90-Revised (SCL-90-R) were used to identify anxiety and somatization. Data were collected between June and September, 2012. The women reported the following problems; amenorrhea (9.5%), hypomenorrhea (13.6%), menorrhagia (19.8%), polymenorrhea (13.5%), oligomenorrhea (4.8%), changes in amount of menstrual discharge (4.0%), and changes in amount of blood clot (9.5%). Anxiety (r=0.20, p=0.002), depression (r=0.25, p=0.005), and Somatization (r=0.35, p<0.001) were correlated with number of menstrual problems. The results of this study indicate that mental health services need to be taken into account in interventions for North Korean woman defectors to improve their reproductive health including addressing menstrual problems.

Measurement tools for mental health problems and mental well-being in people with severe or profound intellectual disabilities: A systematic review.

PubMed

Flynn, Samantha; Vereenooghe, Leen; Hastings, Richard P; Adams, Dawn; Cooper, Sally-Ann; Gore, Nick; Hatton, Chris; Hood, Kerry; Jahoda, Andrew; Langdon, Peter E; McNamara, Rachel; Oliver, Chris; Roy, Ashok; Totsika, Vasiliki; Waite, Jane

2017-11-01

Mental health problems affect people with intellectual disabilities (ID) at rates similar to or in excess of the non-ID population. People with severe ID are likely to have persistent mental health problems. In this systematic review (PROSPERO 2015:CRD42015024469), we identify and evaluate the methodological quality of available measures of mental health problems or well-being in individuals with severe or profound ID. Electronic searches of ten databases identified relevant publications. Two reviewers independently reviewed titles and abstracts of retrieved records (n=41,232) and full-text articles (n=573). Data were extracted and the quality of included papers was appraised. Thirty-two papers reporting on 12 measures were included. Nine measures addressed a broad spectrum of mental health problems, and were largely observational. One physiological measure of well-being was included. The Aberrant Behavior Checklist, Diagnostic Assessment for the Severely Handicapped Scale-II and Mood, Interest and Pleasure Questionnaire are reliable measures in this population. However, the psychometric properties of six other measures were only considered within a single study - indicating a lack of research replication. Few mental health measures are available for people with severe or profound ID, particularly lacking are tools measuring well-being. Assessment methods that do not rely on proxy reports should be explored further. Copyright © 2017 Elsevier Ltd. All rights reserved.

Do On-site Mental Health Professionals Change Pediatricians’ Responses to Children’s Mental Health Problems?

PubMed Central

Horwitz, Sarah McCue; Storfer-Isser, Amy; Kerker, Bonnie D.; Szilagyi, Moira; Garner, Andrew S.; O’Connor, Karen G.; Hoagwood, Kimberly E.; Green, Cori M.; Foy, Jane M.; Stein, Ruth E.K.

2016-01-01

Objective The objectives were to: assess the availability of on-site mental health professionals (MHP) in primary care; examine practice/pediatrician characteristics associated with on-site MHPs; and determine whether presence of on-site MHPs is related to pediatricians’ co-managing or more frequently identifying, treat/managing or referring MH problems. Methods Analyses included AAP members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (N=321). Measures included socio-demographics, practice characteristics, questions on about on-site MHPs, co-management of MH problems and pediatricians’ behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate and multivariable analyses were performed. Results Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools/universities/HMOs, <100 visits/week, <80% of patients privately insured), and interactions of practice location (urban) with visits and patient insurance, were associated with on-site MHPs. There was no overall association between co-location and co-management or whether pediatricians usually identified, treat/managed or referred 5 common child MH problems. Among the subset of pediatricians who reported co-managing there was an association with co-management when the on-site MHP was a child psychiatrist, SA counselor, or social worker. Conclusions On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who co-manage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, SA counselor, or social worker. Overall, on-site MHPs were not associated with co-management or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems. PMID:27064141

Do On-Site Mental Health Professionals Change Pediatricians' Responses to Children's Mental Health Problems?

PubMed

McCue Horwitz, Sarah; Storfer-Isser, Amy; Kerker, Bonnie D; Szilagyi, Moira; Garner, Andrew S; O'Connor, Karen G; Hoagwood, Kimberly E; Green, Cori M; Foy, Jane M; Stein, Ruth E K

2016-01-01

To assess the availability of on-site mental health professionals (MHPs) in primary care; to examine practice/pediatrician characteristics associated with on-site MHPs; and to determine whether the presence of on-site MHPs is related to pediatricians' comanaging or more frequently identifying, treating/managing, or referring mental health (MH) problems. Analyses included American Academy of Pediatrics (AAP) members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (n = 321). Measures included sociodemographics, practice characteristics, questions about on-site MHPs, comanagement of MH problems, and pediatricians' behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate, and multivariable analyses were performed. Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools, universities, health maintenance organizations, <100 visits per week, <80% of patients privately insured) and interactions of practice location (urban) with visits and patient insurance were associated with on-site MHPs. There was no overall association between colocation and comanagement, or whether pediatricians usually identified, treated/managed, or referred 5 common child MH problems. Among the subset of pediatricians who reported comanaging, there was an association with comanagement when the on-site MHP was a child psychiatrist, substance abuse counselor, or social worker. On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who comanage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, substance abuse counselor, or social worker. Overall, on-site MHPs were not associated with comanagement or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Leadership Skills.

ERIC Educational Resources Information Center

Hutchison, Cathleen; And Others

1988-01-01

Lists skills identified by the Leadership Development Task Force as being critical skills for a leader. Discussion focuses on information managing skills, including problem solving, decision making, setting goals and objectives; project management; and people managing skills, including interpersonal communications, conflict management, motivation,…

Preventing Unintended Disclosure of Personally Identifiable Data Following Anonymisation.

PubMed

Smith, Chris

2017-01-01

Errors and anomalies during the capture and processing of health data have the potential to place personally identifiable values into attributes of a dataset that are expected to contain non-identifiable values. Anonymisation focuses on those attributes that have been judged to enable identification of individuals. Attributes that are judged to contain non-identifiable values are not considered, but may be included in datasets that are shared by organisations. Consequently, organisations are at risk of sharing datasets that unintendedly disclose personally identifiable values through these attributes. This would have ethical and legal implications for organisations and privacy implications for individuals whose personally identifiable values are disclosed. In this paper, we formulate the problem of unintended disclosure following anonymisation, describe the necessary steps to address this problem, and discuss some key challenges to applying these steps in practice.

Legal Issues in Higher Education.

ERIC Educational Resources Information Center

Branton, Wiley A.

1984-01-01

Legal problems that colleges and universities might avoid are identified. Colleges are being sued over a broad range of legal issues and are expending money for legal and court fees, settlements, and judgments. Legal problems include right of admission to particular colleges, the right to stay in school, questions of faculty promotion and tenure,…

THE ARTICULATION OF FOREIGN LANGUAGE STUDY.

ERIC Educational Resources Information Center

WOLOSHIN, DAVID J.

ARTICULATION PROBLEMS HAVE BEEN IDENTIFIED BY A 3-YEAR STUDY OF STUDENTS WHO HAD BEGUN THEIR LANGUAGE STUDY IN AN ARIZONA HIGH SCHOOL AND CONTINUED THE STUDY OF THE SAME LANGUAGE AT THE UNIVERSITY OF ARIZONA. PROBLEMS INCLUDE AN ADMINISTRATION POLICY WHICH PERMITS MOST UNIVERSITY STUDENTS TO REPEAT LANGUAGE STUDY AT THEIR OWN DISCRETION, POOR HIGH…

Strategic Planning for Information Systems: The Evidence from a Successful Implementation in an Academic Setting.

ERIC Educational Resources Information Center

Carter, Richard B.; And Others

1991-01-01

Demonstrates how an information systems plan can be successfully developed and implemented within an academic setting. Six guidelines for information systems planning are provided; problems are identified and recommendations to address the problems are suggested; and information systems objectives are discussed, including business communications,…

Fostering Authentic Problem Seeking: A Step toward Social Justice Engagement

ERIC Educational Resources Information Center

Bruce-Davis, Micah N.; Gilson, Cindy M.; Matthews, Michael S.

2017-01-01

Because of these learners' potential as future leaders, it is imperative that educators develop gifted students' ability to identify and solve complex social justice problems. Nourishing students' affective traits, including empathy for others, understanding of themselves, and the ability to connect to others in local and global society, will help…

High School Teachers' Experience of Student Behavior Problems: A Phenomenological Approach

ERIC Educational Resources Information Center

Bean, Roy A.; Gillet, Kyle S.

2009-01-01

In this article, we examine the findings of a qualitative study exploring high school teachers' perceptions of student behavior problems. Four focus groups, each including four to eight teachers, were conducted through major school districts in two Southwestern states (Texas and Arizona). Descriptive phenomenology was used to identify patterns and…

Organizational factors in fire prevention: roles, obstacles, and recommendations

Treesearch

John R. Christiansen; William S. Folkman; Keith W. Warner; Michael L. Woolcott

1976-01-01

Problems being encountered in implementing fire prevention programs were explored by studying the organization for fire prevention at the Fish Lake, Uinta, and Wasatch National Forests in Utah. The study focused on role congruency in fire prevention activities and on the social and organizational obstacles to effective programs. The problems identified included lack of...

Visual, Algebraic and Mixed Strategies in Visually Presented Linear Programming Problems.

ERIC Educational Resources Information Center

Shama, Gilli; Dreyfus, Tommy

1994-01-01

Identified and classified solution strategies of (n=49) 10th-grade students who were presented with linear programming problems in a predominantly visual setting in the form of a computerized game. Visual strategies were developed more frequently than either algebraic or mixed strategies. Appendix includes questionnaires. (Contains 11 references.)…

Earthquakes Threaten Many American Schools

ERIC Educational Resources Information Center

Bailey, Nancy E.

2010-01-01

Millions of U.S. children attend schools that are not safe from earthquakes, even though they are in earthquake-prone zones. Several cities and states have worked to identify and repair unsafe buildings, but many others have done little or nothing to fix the problem. The reasons for ignoring the problem include political and financial ones, but…

Toward Greater Specificity in Identifying Associations among Interparental Aggression, Child Emotional Reactivity to Conflict, and Child Problems

ERIC Educational Resources Information Center

Davies, Patrick T.; Cicchetti, Dante; Martin, Meredith J.

2012-01-01

This study examined specific forms of emotional reactivity to conflict and temperamental emotionality as explanatory mechanisms in pathways among interparental aggression and child psychological problems. Participants of the multimethod, longitudinal study included 201 two-year-old children and their mothers who had experienced elevated violence…

Development of a Tool to Identify Problems Related to Medication Adherence in Home Healthcare Patients.

PubMed

Mahan, Kathryn R; Clark, Jeffrey A; Anderson, Kurt D; Koller, Nolan J; Gates, Brian J

2017-05-01

In the home healthcare setting, clinicians are required to evaluate patient's medication therapy, including adherence. To facilitate this conversation, a pilot question list to help uncover potential medication nonadherence was created after completing a review of the literature and ascertaining the common themes as to why patients were nonadherent to their medication therapies. Pharmacy personnel who provide onsite consultations in a home healthcare setting used the question list to identify medication-related problems that could contribute to nonadherence and to document potential solutions. Through pharmacist-patient interactions, which occurred after admission to the home healthcare agency, pharmacy personnel found on average 2.3 issues per patient, which could affect medication adherence. Side effects were the most common problem identified. After this tool was tested with 65 patient interviews, the questions were analyzed and condensed into a shorter list more specific to the identification of medication-related problems for use by home care clinicians.

Clinical Profiles of Children with Disruptive Behaviors Based on the Severity of Their Conduct Problems, Callous-Unemotional Traits and Emotional Difficulties.

PubMed

Andrade, Brendan F; Sorge, Geoff B; Na, Jennifer Jiwon; Wharton-Shukster, Erika

2015-08-01

This study identified clinical profiles of referred children based on the severity of callous-unemotional (CU) traits, emotional difficulties, and conduct problems. Parents of 166 children (132 males) aged 6-12 years referred to a hospital clinic because of disruptive behavior completed measures to assess these key indicators, and person-centered analysis was used to identify profiles. Four distinct profiles were identified that include: (1) Children low in severity on the three domains, (2) Children high in severity on the three domains, (3) Children high in severity in conduct problems and CU traits with minimal emotional difficulties, and (4) Children high in severity in conduct problems and emotional difficulties with minimal CU traits. Profiles differed in degree of aggression and behavioral impairment. Findings show that clinic-referred children with disruptive behaviors can be grouped based on these important indicators into profiles that have important implications for assessment and treatment selection.

Development process of an assessment tool for disruptive behavior problems in cross-cultural settings: the Disruptive Behavior International Scale – Nepal version (DBIS-N)

PubMed Central

Burkey, Matthew D.; Ghimire, Lajina; Adhikari, Ramesh P.; Kohrt, Brandon A.; Jordans, Mark J. D.; Haroz, Emily; Wissow, Lawrence

2017-01-01

Systematic processes are needed to develop valid measurement instruments for disruptive behavior disorders (DBDs) in cross-cultural settings. We employed a four-step process in Nepal to identify and select items for a culturally valid assessment instrument: 1) We extracted items from validated scales and local free-list interviews. 2) Parents, teachers, and peers (n=30) rated the perceived relevance and importance of behavior problems. 3) Highly rated items were piloted with children (n=60) in Nepal. 4) We evaluated internal consistency of the final scale. We identified 49 symptoms from 11 scales, and 39 behavior problems from free-list interviews (n=72). After dropping items for low ratings of relevance and severity and for poor item-test correlation, low frequency, and/or poor acceptability in pilot testing, 16 items remained for the Disruptive Behavior International Scale—Nepali version (DBIS-N). The final scale had good internal consistency (α=0.86). A 4-step systematic approach to scale development including local participation yielded an internally consistent scale that included culturally relevant behavior problems. PMID:28093575

Complex Mental Health Sequelae of Psychological Trauma Among Women in Prenatal Care

PubMed Central

Seng, Julia S.; D’Andrea, Wendy; Ford, Julian D.

2014-01-01

Pregnancy is a critical time to identify and address maternal mental health problems, for the health of both mother and child. Pregnant women with histories of exposure to interpersonal psychological trauma may experience a range of mental health problems including but not limited to posttraumatic stress disorder (PTSD). In a community sample of 1,581 pregnant women, 25% reported symptoms consistent with at least one of six syndromes, including PTSD, major depressive disorder (MDD), generalized anxiety disorder (GAD), or clinically significant dissociation, somatization, or affect dysregulation. Six sub-groups with distinct mental health problem profiles were identified by cluster analysis. Controlling for sociodemographic risk factors, women with histories of interpersonal trauma were over-represented in four sub-groups characterized by: (1) PTSD comorbid with depression (childhood sexual abuse), (2) PTSD comorbid with affect/interpersonal dysregulation (childhood physical or emotional abuse), (3) somatization (adult abuse), and (4) GAD (foster/adoptive placement). Findings suggest risk relationships warranting further study between different types of interpersonal trauma exposure and psychiatric outcomes in pregnant women, including PTSD with two types of comorbidity. PMID:25558308

Validation of an association rule mining-based method to infer associations between medications and problems.

PubMed

Wright, A; McCoy, A; Henkin, S; Flaherty, M; Sittig, D

2013-01-01

In a prior study, we developed methods for automatically identifying associations between medications and problems using association rule mining on a large clinical data warehouse and validated these methods at a single site which used a self-developed electronic health record. To demonstrate the generalizability of these methods by validating them at an external site. We received data on medications and problems for 263,597 patients from the University of Texas Health Science Center at Houston Faculty Practice, an ambulatory practice that uses the Allscripts Enterprise commercial electronic health record product. We then conducted association rule mining to identify associated pairs of medications and problems and characterized these associations with five measures of interestingness: support, confidence, chi-square, interest and conviction and compared the top-ranked pairs to a gold standard. 25,088 medication-problem pairs were identified that exceeded our confidence and support thresholds. An analysis of the top 500 pairs according to each measure of interestingness showed a high degree of accuracy for highly-ranked pairs. The same technique was successfully employed at the University of Texas and accuracy was comparable to our previous results. Top associations included many medications that are highly specific for a particular problem as well as a large number of common, accurate medication-problem pairs that reflect practice patterns.

Teaching community diagnosis to medical students: evaluation of a case study approach.

PubMed

Bair, C W

1980-01-01

A unique case study approach to training medical students in community diagnosis techniques was initiated at the Medical College of Ohio at Toledo. This paper describes the five elements of this teaching method: preliminary specification of target community and data base; group problem-solving requirement; specification of desired output; defined performance objectives; and regularly scheduled time for analysis. Experience with the case study method over two years was evaluated to identify specific strengths and weaknesses. The identified strengths include use of limited educational time to introduce community health problems, development of experience in a collegial team work setting, and specific awareness of the types of data useful to the analysis of community health service problems. Negative evaluations suggested that the method was not conducive to the development of skills in three areas: ability to establish the relative importance of health problems in communities; ability to identify an appropriate health system response to a community health problem from feasible alternatives; and ability to anticipate the community impact of health program modifications or improvements. Potential explanations for these deficiencies include: need for increased didactic support in the classroom for particular skill areas; need to establish a direct field experience in community diagnosis; inappropriateness of the data base used for evaluation of particular skills; and the probability that quantitative analysis, as used in this evaluation, may not be sufficient in and of itself to measure the outcome of a community diagnosis experience.

Application of Information-Theoretic Data Mining Techniques in a National Ambulatory Practice Outcomes Research Network

PubMed Central

Wright, Adam; Ricciardi, Thomas N.; Zwick, Martin

2005-01-01

The Medical Quality Improvement Consortium data warehouse contains de-identified data on more than 3.6 million patients including their problem lists, test results, procedures and medication lists. This study uses reconstructability analysis, an information-theoretic data mining technique, on the MQIC data warehouse to empirically identify risk factors for various complications of diabetes including myocardial infarction and microalbuminuria. The risk factors identified match those risk factors identified in the literature, demonstrating the utility of the MQIC data warehouse for outcomes research, and RA as a technique for mining clinical data warehouses. PMID:16779156

Apollo Saturn 511 effluent measurements from the Apollo 16 launch operations: An experiment

NASA Technical Reports Server (NTRS)

Gregory, G. L.; Hulten, W. C.; Wornom, D. E.

1974-01-01

An experiment was performed in conjunction with the Apollo 16 launch to define operational and instrumentational problems associated with launch-vehicle exhaust effluent monitoring. Ground and airborne sampling were performed for CO, CO2, hydrocarbons, and particulates. Sampling systems included filter pads and photometers for particulates and whole-air grab samples for gases. Launch debris was identified in the particulate samples at ground level(taken immediately after launch) and in the airborne measurements (taken 40 to 50 minutes after launch approximately 40 km downwind of the pad). Operational problems were identified and included the need for higher instrumentation mobility and the need for real-time sampling instrumentation as opposed to collection-type samples such as the whole-air grab sample.

Innovative use of technologies and methods to redesign care: the problem of care transitions.

PubMed

Richman, Mark; Sklaroff, Laura Myerchin; Hoang, Khathy; Wasson, Elijah; Gross-Schulman, Sandra

2014-01-01

Organizations are redesigning models of care in today's rapidly changing health care environment. Using proven innovation techniques maximizes likelihood of effective change. Our safety-net hospital aims to reduce high emergency department visit, admission, and readmission rates, key components to health care cost control. Twenty-five clinical stakeholders participated in mixed-methods innovation exercises to understand stakeholders, frame problems, and explore solutions. We identified existing barriers and means to improve post-emergency department/post-inpatient discharge care coordination/communication among patient-centered medical home care team members, including patients. Physicians and staff preferred automated e-mail notifications, including patient identifiers, medical home/primary care provider information, and relevant clinical documentation, to improve communication efficiency/efficacy.

Tackling 'wicked' health promotion problems: a New Zealand case study.

PubMed

Signal, Louise N; Walton, Mat D; Ni Mhurchu, Cliona; Maddison, Ralph; Bowers, Sharron G; Carter, Kristie N; Gorton, Delvina; Heta, Craig; Lanumata, Tolotea S; McKerchar, Christina W; O'Dea, Des; Pearce, Jamie

2013-03-01

This paper reports on a complex environmental approach to addressing 'wicked' health promotion problems devised to inform policy for enhancing food security and physical activity among Māori, Pacific and low-income people in New Zealand. This multi-phase research utilized literature reviews, focus groups, stakeholder workshops and key informant interviews. Participants included members of affected communities, policy-makers and academics. Results suggest that food security and physical activity 'emerge' from complex systems. Key areas for intervention include availability of money within households; the cost of food; improvements in urban design and culturally specific physical activity programmes. Seventeen prioritized intervention areas were explored in-depth and recommendations for action identified. These include healthy food subsidies, increasing the statutory minimum wage rate and enhancing open space and connectivity in communities. This approach has moved away from seeking individual solutions to complex social problems. In doing so, it has enabled the mapping of the relevant systems and the identification of a range of interventions while taking account of the views of affected communities and the concerns of policy-makers. The complex environmental approach used in this research provides a method to identify how to intervene in complex systems that may be relevant to other 'wicked' health promotion problems.

A hidden curriculum: gambling and problem gambling among high school students in Auckland.

PubMed

Sullivan, Sean

2005-12-01

Participation in gambling by young people aged 13-18 years. During 2001, prior to the passing of legislation to minimise gambling harm, more than 500 students from six high schools completed a survey of their participation in gambling during the previous 12 months, and completed three problem gambling screens. Gambling, including under-age gambling, was a common event. Up to one in five were identified as at risk for problem gambling on at least one screen. Students who were non-European, or were from low socioeconomic areas, were more likely to be at risk for problem gambling. Help for gambling problems was preferred from friends and family rather than others, while inclusion of information in the education curriculum about risk of gambling problems was supported. The survey provided evidence for pre-legislation baseline gambling behaviour, and risk for problem gambling, of students attending high schools in Auckland. Levels of risk for problem gambling paralleled the elevated risk found for youth in many countries. Raising awareness, through a school curriculum, of risk for gambling problems among adolescents may be explored as a strategy to reduce the high levels of risk for gambling problems identified.

Investigation of Mechanical Breakdowns Leading to Lock Closures

DTIC Science & Technology

2017-06-01

wide variety of issues lead to emergency clo- sures, yet no specific problem (s) that frequently cause unscheduled clo- sures were identified. Table 2-3...Reporting Used to create basic work orders, report problems or malfunctions, or request work to be done. Used to create and process work orders from...work order page for recording the failure class, problem , cause, and remedy (Figure 3-1). Appendix C includes a full list of failure classes

Mathematical justification of a viscoelastic elliptic membrane problem

NASA Astrophysics Data System (ADS)

Castiñeira, Gonzalo; Rodríguez-Arós, Ángel

2017-12-01

We consider a family of linearly viscoelastic elliptic shells, and we use asymptotic analysis to justify that what we have identified as the two-dimensional viscoelastic elliptic membrane problem is an accurate approximation when the thickness of the shell tends to zero. Most noticeable is that the limit problem includes a long-term memory that takes into account the previous history of deformations. We provide convergence results which justify our asymptotic approach.

A method and knowledge base for automated inference of patient problems from structured data in an electronic medical record

PubMed Central

Pang, Justine; Feblowitz, Joshua C; Maloney, Francine L; Wilcox, Allison R; Ramelson, Harley Z; Schneider, Louise I; Bates, David W

2011-01-01

Background Accurate knowledge of a patient's medical problems is critical for clinical decision making, quality measurement, research, billing and clinical decision support. Common structured sources of problem information include the patient problem list and billing data; however, these sources are often inaccurate or incomplete. Objective To develop and validate methods of automatically inferring patient problems from clinical and billing data, and to provide a knowledge base for inferring problems. Study design and methods We identified 17 target conditions and designed and validated a set of rules for identifying patient problems based on medications, laboratory results, billing codes, and vital signs. A panel of physicians provided input on a preliminary set of rules. Based on this input, we tested candidate rules on a sample of 100 000 patient records to assess their performance compared to gold standard manual chart review. The physician panel selected a final rule for each condition, which was validated on an independent sample of 100 000 records to assess its accuracy. Results Seventeen rules were developed for inferring patient problems. Analysis using a validation set of 100 000 randomly selected patients showed high sensitivity (range: 62.8–100.0%) and positive predictive value (range: 79.8–99.6%) for most rules. Overall, the inference rules performed better than using either the problem list or billing data alone. Conclusion We developed and validated a set of rules for inferring patient problems. These rules have a variety of applications, including clinical decision support, care improvement, augmentation of the problem list, and identification of patients for research cohorts. PMID:21613643

The loneliness of the long-duration astronaut.

PubMed

Cooper, H S

1996-01-01

This paper investigates the psychological implications of long duration spaceflight. Initial psychological problems associated with a heavy workload were identified during Skylab missions. Since then, most of our knowledge of psychological problems has come from experience onboard Russian spacecraft. Noted problems include anxiety, boredom, crew interactions, problems associated with isolation and confinement, and others. Efforts to alleviate or prevent these problems are discussed, as well as comparisons to similar environments such as arctic regions or submarines. As the U.S. participates in longer space missions, it will be wise to study psychological issues and to learn from our Russian counterparts.

Identifying at-risk profiles and protective factors for problem gambling: A longitudinal study across adolescence and early adulthood.

PubMed

Allami, Youssef; Vitaro, Frank; Brendgen, Mara; Carbonneau, René; Tremblay, Richard E

2018-05-01

Past studies have identified various risk and protective factors for problem gambling (PG). However, no study has examined the interplay between these factors using a combination of person-centered and variable-centered approaches embedded within a longitudinal design. The present study aimed to (a) identify distinct profiles in early adolescence based on a set of risk factors commonly associated with PG (impulsivity, depression, anxiety, drug-alcohol use, aggressiveness, and antisociality), (b) explore the difference in reported gambling problems between these profiles during midadolescence and early adulthood, and (c) identify family- and peer-related variables that could operate as protective or compensatory factors in this context. Two samples were used: (a) a population sample (N = 1,033) living in low socioeconomic-status neighborhoods and (b) a population sample (N = 3,017) representative of students attending Quebec schools. Latent profile analyses were conducted to identify at-risk profiles based on individual risk factors measured at age 12 years. Negative binomial regression models were estimated to compare profiles in terms of their reported gambling problems at ages 16 and 23. Finally, family- and peer-related variables measured at age 14 were included to test their protective or compensatory role with respect to the link between at-risk profiles and gambling problems. Four profiles were identified: well-adjusted, internalizing, externalizing, and comorbid. Compared to the well-adjusted profile, the externalizing and comorbid profiles reported more gambling problems at ages 16 and 23, but the internalizing profile did not differ significantly. Various protective and compensatory factors emerged for each profile at both time points. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

76 FR 6815 - Proposed Information Collection, OMB Control Number 1004-NEW

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

... enable the BLM to respond to problems, protect natural and cultural resources, and develop appropriate... personal identifying information in your comment, you should be aware that your entire comment--including your personal identifying information--may be made publicly available at any time. While you can ask us...

Creative Performances and Gifted Education: Studies from Art Education

ERIC Educational Resources Information Center

Thomas, Kerry

2017-01-01

This paper acknowledges that there is widespread support in Gifted Education for students' creative aptitudes to be identified as a domain that includes imagination, originality, fluency, and problem solving. I explore where and when these concepts originated and briefly identify how they are represented in Gifted Education. Then various…

Early childhood risk and resilience factors for behavioural and emotional problems in middle childhood.

PubMed

Cabaj, Jason L; McDonald, Sheila W; Tough, Suzanne C

2014-07-01

Mental disorders in childhood have a considerable health and societal impact but the associated negative consequences may be ameliorated through early identification of risk and protective factors that can guide health promoting and preventive interventions. The objective of this study was to inform health policy and practice through identification of demographic, familial and environmental factors associated with emotional or behavioural problems in middle childhood, and the predictors of resilience in the presence of identified risk factors. A cohort of 706 mothers followed from early pregnancy was surveyed at six to eight years post-partum by a mail-out questionnaire, which included questions on demographics, children's health, development, activities, media and technology, family, friends, community, school life, and mother's health. Although most children do well in middle childhood, of 450 respondents (64% response rate), 29.5% and 25.6% of children were found to have internalising and externalising behaviour problem scores in the lowest quintile on the NSCLY Child Behaviour Scales. Independent predictors for problem behaviours identified through multivariable logistic regression modelling included being male, demographic risk, maternal mental health risk, poor parenting interactions, and low parenting morale. Among children at high risk for behaviour problems, protective factors included high maternal and child self-esteem, good maternal emotional health, adequate social support, good academic performance, and adequate quality parenting time. These findings demonstrate that several individual and social resilience factors can counter the influence of early adversities on the likelihood of developing problem behaviours in middle childhood, thus informing enhanced public health interventions for this understudied life course phase.

USDA Forest Service national protocols for sampling air pollution-sensitive waters

Treesearch

T. J. Sullivan

2012-01-01

The first step in designing a surface water sampling program is identifying one or more problems or questions that require information on water quality. Common water quality problems include nutrient enrichment (from a variety of causes), effects of atmospheric deposition (acidification, eutrophication, toxicity), and effects of major disturbances such as fire or pest...

Teachers' Attitudes toward Reporting Child Sexual Abuse: Problems with Existing Research Leading to New Scale Development

ERIC Educational Resources Information Center

Walsh, Kerryann; Rassafiani, Mehdi; Mathews, Ben; Farrell, Ann; Butler, Des

2010-01-01

This paper details a systematic literature review identifying problems in extant research relating to teachers' attitudes toward reporting child sexual abuse and offers a model for new attitude scale development and testing. Scale development comprised a five-phase process grounded in contemporary attitude theories, including (a) developing the…

Factors Associated with Sexual Behavior Problems in Young Sexually Abused Children.

ERIC Educational Resources Information Center

Hall, Darlene Kordich; Mathews, Fred; Pearce, John

1998-01-01

Analysis of data from the clinical records of 100 sexually abused boys and girls, ages 3-7 years, identified five variables predictive of sexual behavior problems, including sexual arousal of the child during the abuse, perpetrator's use of sadism, a history of physical and emotional abuse, and who the child blames for the abuse. (DB)

Identification of Reading Problems in First Grade within a Response-to-Intervention Framework

ERIC Educational Resources Information Center

Speece, Deborah L.; Schatschneider, Christopher; Silverman, Rebecca; Case, Lisa Pericola; Cooper, David H.; Jacobs, Dawn M.

2011-01-01

Models of Response to Intervention (RTI) include parameters of assessment and instruction. This study focuses on assessment with the purpose of developing a screening battery that validly and efficiently identifies first-grade children at risk for reading problems. In an RTI model, these children would be candidates for early intervention. We…

S.P.I.C.E. Workshop Model: An Approach to Alternative Programs for the Disadvantaged Gifted.

ERIC Educational Resources Information Center

Mitchell, Bruce M.; Dodson, Edward

Major problems associated with subcultural variations in school performance that interfere with the development of special programs for disadvantaged, gifted students are discussed. These problems include the difficulty of identifying gifted minority students by usual testing methods, the nature of programs that may be devised to benefit them, and…

Suggestions for Content Selection and Presentation in High School Computer Textbooks

ERIC Educational Resources Information Center

Lin, Janet Mei-Chuen; Wu, Cheng-Chih

2007-01-01

Based on the findings from reviewing 32 textbooks in the past four years for Taiwan's Ministry of Education, we have identified common problems in the reviewed textbooks and analyzed their inadequacies. Typical problems include the Wintel bias, too much coverage of software application tools and too little of computer science concepts, too many…

Applications of Artificial Intelligence (AI) and Expert Systems for Online Searching.

ERIC Educational Resources Information Center

Hawkins, Donald T.

1988-01-01

Discussion of the online searching process identifies the formulation of a search strategy as the major problem area for users of online systems. Artificial intelligence is suggested as a solution to this problem, and several expert systems for information retrieval are described. An annotated list of 24 items for further reading is included. (23…

Rotordynamic Instability Problems in High-Performance Turbomachinery

NASA Technical Reports Server (NTRS)

1980-01-01

Diagnostic and remedial methods concerning rotordynamic instability problems in high performance turbomachinery are discussed. Instabilities due to seal forces and work-fluid forces are identified along with those induced by rotor bearing systems. Several methods of rotordynamic control are described including active feedback methods, the use of elastometric elements, and the use of hydrodynamic journal bearings and supports.

Participatory approach: from problem identification to setting strategies for increased productivity and sustainability in small scale irrigated agriculture

NASA Astrophysics Data System (ADS)

Habtu, Solomon; Ludi, Eva; Jamin, Jean Yves; Oates, Naomi; Fissahaye Yohannes, Degol

2014-05-01

Practicing various innovations pertinent to irrigated farming at local field scale is instrumental to increase productivity and yield for small holder farmers in Africa. However the translation of innovations from local scale to the scale of a jointly operated irrigation scheme is far from trivial. It requires insight on the drivers for adoption of local innovations within the wider farmer communities. Participatory methods are expected to improve not only the acceptance of locally developed innovations within the wider farmer communities, but to allow also an estimation to which extend changes will occur within the entire irrigation scheme. On such a base, more realistic scenarios of future water productivity within an irrigation scheme, which is operated by small holder farmers, can be estimated. Initial participatory problem and innovation appraisal was conducted in Gumselassa small scale irrigation scheme, Ethiopia, from Feb 27 to March 3, 2012 as part of the EAU4FOOD project funded by EC. The objective was to identify and appraise problems which hinder sustainable water management to enhance production and productivity and to identify future research strategies. Workshops were conducted both at local (Community of Practices) and regional (Learning Practice Alliance) level. At local levels, intensive collaboration with farmers using participatory methods produced problem trees and a "Photo Safari" documented a range of problems that negatively impact on productive irrigated farming. A range of participatory methods were also used to identify local innovations. At regional level a Learning Platform was established that includes a wide range of stakeholders (technical experts from various government ministries, policy makers, farmers, extension agents, researchers). This stakeholder group did a range of exercise as well to identify major problems related to irrigated smallholder farming and already identified innovations. Both groups identified similar problems to productive smallholder irrigation: soil nutrient depletion, salinization, disease and pest resulting from inefficient irrigation practices, infrastructure problems leading to a reduction of the size of the command area and decrease in reservoir volume. The major causes have been poor irrigation infrastructure, poor on-farm soil and water management, prevalence of various crop pests and diseases, lack of inputs and reservoir siltation. On-farm participatory research focusing on soil, crop and water management issues, including technical, institutional and managerial aspects, to identify best performing innovations while taking care of the environment was recommended. Currently, a range of interlinked activities are implemented a multiple scales, combining participatory and scientific approaches towards innovation development and up-scaling of promising technologies and institutional and managerial approaches from local to regional scales. ____________________________ Key words: Irrigation scheme, productivity, innovation, participatory method, Gumselassa, Ethiopia

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders.

PubMed

Horseman, Susan V; Buller, Henry; Mullan, Siobhan; Whay, Helen R

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders

PubMed Central

Horseman, Susan V.; Buller, Henry

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively. PMID:27501387

Healthcare professionals' agreement on clinical relevance of drug-related problems among elderly patients.

PubMed

Bech, Christine Flagstad; Frederiksen, Tine; Villesen, Christine Tilsted; Højsted, Jette; Nielsen, Per Rotbøll; Kjeldsen, Lene Juel; Nørgaard, Lotte Stig; Christrup, Lona Louring

2018-02-01

Background Disagreement among healthcare professionals on the clinical relevance of drug-related problems can lead to suboptimal treatment and increased healthcare costs. Elderly patients with chronic non-cancer pain and comorbidity are at increased risk of drug related problems compared to other patient groups due to complex medication regimes and transition of care. Objective To investigate the agreement among healthcare professionals on their classification of clinical relevance of drug-related problems in elderly patients with chronic non-cancer pain and comorbidity. Setting Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen, Denmark. Method A pharmacist performed medication review on elderly patients with chronic non-cancer pain and comorbidity, identified their drug-related problems and classified these problems in accordance with an existing categorization system. A five-member clinical panel rated the drug-related problems' clinical relevance in accordance with a five-level rating scale, and their agreement was compared using Fleiss' κ. Main outcome measure Healthcare professionals' agreement on clinical relevance of drug related problems, using Fleiss' κ. Results Thirty patients were included in the study. A total of 162 drug related problems were identified, out of which 54% were of lower clinical relevance (level 0-2) and 46% of higher clinical relevance (level 3-4). Only slight agreement (κ = 0.12) was found between the panellists' classifications of clinical relevance using a five-level rating scale. Conclusion The clinical pharmacist identified drug related problems of lower and higher clinical relevance. Poor overall agreement on the severity of the drug related problems was found among the panelists.

Most common problems across health conditions as described by the International Classification of Functioning, Disability, and Health.

PubMed

Ptyushkin, Pavel; Cieza, Alarcos; Stucki, Gerold

2015-09-01

Health conditions are associated with a variety of functional outcomes. Even though functional outcomes are diverse for different health conditions, they can have important commonalities. The aim of this study was to identify the most common problems in functioning across the wide range of health conditions using the International Classification of Functioning (ICF). Existing databases created for the 21 ICF Core Sets studies were descriptively analyzed. These included data collected in 44 countries on 9978 patients with one of 21 health conditions as the main diagnosis. A frequency cutoff of 50% was used to identify the most common problems in functioning when looking at single health conditions and across them. No category was identified as common to all health conditions included in the study. Fifteen most frequent categories were common in 10 to 13 health conditions out of 21. Eleven categories correspond to the list of activities and participation, and four to the list of body functions. These are related to mobility, daily routine, mental functions, intimate relations, employment, and leisure. Some health conditions have more commonalities between each other. The most common problems across health conditions are therefore related to mental functions, mobility, daily life, intimate relations, employment, and leisure. The results contribute toward the identification of the universal set of ICF categories that can be used in clinical practice for the general assessment of functioning.

Resident Evaluation and Remediation: A Comprehensive Approach

PubMed Central

Wu, Jim S.; Siewert, Bettina; Boiselle, Phillip M.

2010-01-01

Background A comprehensive evaluation and remediation program is an essential component of any residency program. The evaluation system should identify problems accurately and early and allow residents with problems to be assigned to a remediation program that effectively deals with them. Elements of a proactive remediation program include a process for outlining deficiencies, providing resources for improvement, communicating clear goals for acceptable performance, and reevaluating performance against these goals. Intervention In recognition of the importance of early detection and prompt remediation of the struggling resident, we sought to develop a multifaceted approach to resident evaluation with the aim of early identification and prompt remediation of difficulties. This article describes our comprehensive evaluation program and remediation program, which uses resources within our radiology department and institutional graduate medical education office. Discussion An effective evaluation system should identify problems accurately and early, whereas a proactive remediation program should effectively deal with issues once they are identified. PMID:21975628

A space-frequency multiplicative regularization for force reconstruction problems

NASA Astrophysics Data System (ADS)

Aucejo, M.; De Smet, O.

2018-05-01

Dynamic forces reconstruction from vibration data is an ill-posed inverse problem. A standard approach to stabilize the reconstruction consists in using some prior information on the quantities to identify. This is generally done by including in the formulation of the inverse problem a regularization term as an additive or a multiplicative constraint. In the present article, a space-frequency multiplicative regularization is developed to identify mechanical forces acting on a structure. The proposed regularization strategy takes advantage of one's prior knowledge of the nature and the location of excitation sources, as well as that of their spectral contents. Furthermore, it has the merit to be free from the preliminary definition of any regularization parameter. The validity of the proposed regularization procedure is assessed numerically and experimentally. It is more particularly pointed out that properly exploiting the space-frequency characteristics of the excitation field to identify can improve the quality of the force reconstruction.

Universal Skills and Competencies for Geoscientists

NASA Astrophysics Data System (ADS)

Mosher, S.

2015-12-01

Geoscience students worldwide face a changing future workforce, but all geoscience work has universal cross-cutting skills and competencies that are critical for success. A recent Geoscience Employers Workshop, and employers' input on the "Future of Undergraduate Geoscience Education" survey, identified three major areas. Geoscience work requires spatial and temporal (3D & 4D) thinking, understanding that the Earth is a system of interacting parts and processes, and geoscience reasoning and synthesis. Thus, students need to be able to solve problems in the context of an open and dynamic system, recognizing that most geoscience problems have no clear, unambiguous answers. Students must learn to manage uncertainty, work by analogy and inference, and make predations with limited data. Being able to visualize and solve problems in 3D, incorporate the element of time, and understand scale is critical. Additionally students must learn how to tackle problems using real data, including understand the problems' context, identify appropriate questions to ask, and determine how to proceed. Geoscience work requires integration of quantitative, technical, and computational skills and the ability to be intellectually flexible in applying skills to new situations. Students need experience using high-level math and computational methods to solve geoscience problems, including probability and statistics to understand risk. Increasingly important is the ability to use "Big Data", GIS, visualization and modeling tools. Employers also agree a strong field component in geoscience education is important. Success as a geoscientist also requires non-technical skills. Because most work environments involve working on projects with a diverse team, students need experience with project management in team settings, including goal setting, conflict resolution, time management and being both leader and follower. Written and verbal scientific communication, as well as public speaking and listening skills, are important. Success also depends on interpersonal skills and professionalism, including business acumen, risk management, ethical conduct, and leadership. A global perspective is increasingly important, including cultural literacy and understanding societal relevance.

Community perceptions of developmental and behavioral problems experienced by children living with epilepsy on the Kenyan coast: A qualitative study.

PubMed

Abubakar, Amina; Kariuki, Symon M; Tumaini, Judith Dzombo; Gona, Joseph; Katana, Khamis; Owen, Jacqueline A Phillips; Newton, Charles R

2015-04-01

Childhood epilepsy is common in Africa. However, there are little data on the developmental and behavioral problems experienced by children living with epilepsy, especially qualitative data that capture community perceptions of the challenges faced by these children. Identifying these perceptions using qualitative approaches is important not only to help design appropriate interventions but also to help adapt behavioral tools that are culturally appropriate. We documented the description of these problems as perceived by parents and teachers of children with or without epilepsy. The study involved 70 participants. Data were collected using in-depth interviews and focus group discussions and were analyzed using NVIVO to identify major themes. Our analysis identified four major areas that are perceived to be adversely affected among children with epilepsy. These included internalizing and externalizing problems such as aggression, temper tantrums, and excessive crying. Additionally, developmental delay, especially cognitive deficits and academic underachievement, was also identified as a major problematic area. There is a need to supplement these findings with quantitative estimates and to develop psychosocial and educational interventions to rehabilitate children with epilepsy who have these difficulties. Copyright © 2015. Published by Elsevier Inc.

Predictive validity of a service-setting-based measure to identify infancy mental health problems: a population-based cohort study.

PubMed

Ammitzbøll, Janni; Thygesen, Lau Caspar; Holstein, Bjørn E; Andersen, Anette; Skovgaard, Anne Mette

2018-06-01

Measures to identify infancy mental health problems are essential to guide interventions and reduce the risk of developmental psychopathology in early years. We investigated a new service-setting-based measure the Copenhagen Infant Mental Health Screening (CIMHS) within the general child health surveillance by community health nurses (CHN). The study population of 2973 infants was assessed by CIMHS at age 9-10 months. A subsample of 416 children was examined at age 1½ years, using parent interviews including the Child Behavior Checklist (CBCL 1½-5), Check List of Autism and Toddlers (CHAT), Infant-Toddler Symptom Checklist (ITSCL), and the Bayley Scales of Infant and Toddler Development (BSID) and observations of behavior, communication, and interaction. Child mental disorders were diagnosed according to ICD-10 and parent-child relationship disorders according to DC:0-3R. Statistical analyses included logistic regression analyses adjusted and weighted to adjust for sampling and bias. CIMHS problems of sleep, feeding and eating, emotions, attention, communication, and language were associated with an up to fivefold increased risk of child mental disorders across the diagnostic spectrum of ICD-10 diagnoses. Homo-type continuity was seen in problems of sleep and feeding and eating being associated with a threefold increased risk of disorders within the same area, OR 3.0 (95% CI 1.6-5.4) and OR 2.7 (95% CI 1.7-4.2), respectively. The sensitivity at high CIMHS problem scores was 32% and specificity 86%. In summary, CIMHS identify a broad range of infants' mental health problems that are amenable to guide intervention within the general child health surveillance.

What do we know about developing patient portals? a systematic literature review.

PubMed

Otte-Trojel, Terese; de Bont, Antoinette; Rundall, Thomas G; van de Klundert, Joris

2016-04-01

Numerous articles have reported on the development of patient portals, including development problems and solutions. We review these articles to inform future patient portal development efforts and to provide a summary of the evidence base that can guide future research. We performed a systematic review of relevant literature to answer 5 questions: (1) What categories of problems related to patient portal development have been defined? (2) What causal factors have been identified by problem analysis and diagnosis? (3) What solutions have been proposed to ameliorate these causal factors? (4) Which proposed solutions have been implemented and in which organizational contexts? (5) Have implemented solutions been evaluated and what learning has been generated? Through searches on PubMed, ScienceDirect and LISTA, we included 109 articles. We identified 5 main problem categories: achieving patient engagement, provider engagement, appropriate data governance, security and interoperability, and a sustainable business model. Further, we identified key factors contributing to these problems as well as solutions proposed to ameliorate them. While about half (45) of the 109 articles proposed solutions, fewer than half of these solutions (18) were implemented, and even fewer (5) were evaluated to generate learning about their effects. Few studies systematically report on the patient portal development processes. As a result, the review does not provide an evidence base for portal development. Our findings support a set of recommendations for advancement of the evidence base: future research should build on existing evidence, draw on principles from design sciences conveyed in the problem-solving cycle, and seek to produce evidence within various different organizational contexts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

What do we know about developing patient portals? a systematic literature review

PubMed Central

de Bont, Antoinette; Rundall, Thomas G; van de Klundert, Joris

2016-01-01

Objective Numerous articles have reported on the development of patient portals, including development problems and solutions. We review these articles to inform future patient portal development efforts and to provide a summary of the evidence base that can guide future research. Materials and Methods We performed a systematic review of relevant literature to answer 5 questions: (1) What categories of problems related to patient portal development have been defined? (2) What causal factors have been identified by problem analysis and diagnosis? (3) What solutions have been proposed to ameliorate these causal factors? (4) Which proposed solutions have been implemented and in which organizational contexts? (5) Have implemented solutions been evaluated and what learning has been generated? Through searches on PubMed, ScienceDirect and LISTA, we included 109 articles. Results We identified 5 main problem categories: achieving patient engagement, provider engagement, appropriate data governance, security and interoperability, and a sustainable business model. Further, we identified key factors contributing to these problems as well as solutions proposed to ameliorate them. While about half (45) of the 109 articles proposed solutions, fewer than half of these solutions (18) were implemented, and even fewer (5) were evaluated to generate learning about their effects. Discussion Few studies systematically report on the patient portal development processes. As a result, the review does not provide an evidence base for portal development. Conclusion Our findings support a set of recommendations for advancement of the evidence base: future research should build on existing evidence, draw on principles from design sciences conveyed in the problem-solving cycle, and seek to produce evidence within various different organizational contexts. PMID:26335985

Use of a latency-based demand assessment to identify potential demands for functional analyses.

PubMed

Call, Nathan A; Miller, Sarah J; Mintz, Joslyn Cynkus; Mevers, Joanna Lomas; Scheithauer, Mindy C; Eshelman, Julie E; Beavers, Gracie A

2016-12-01

Unlike potential tangible positive reinforcers, which are typically identified for inclusion in functional analyses empirically using preference assessments, demands are most often selected arbitrarily or based on caregiver report. The present study evaluated the use of a demand assessment with 12 participants who exhibited escape-maintained problem behavior. Participants were exposed to 10 demands, with aversiveness measured by average latency to the first instance of problem behavior. In subsequent functional analyses, results of a demand condition that included the demand with the shortest latency to problem behavior resulted in identification of an escape function for 11 of the participants. In contrast, a demand condition that included the demand with the longest latency resulted in identification of an escape function for only 5 participants. The implication of these findings is that for the remaining 7 participants, selection of the demand for the functional analysis without using the results of the demand assessment could have produced a false-negative finding. © 2016 Society for the Experimental Analysis of Behavior.

Identifying predictive features in drug response using machine learning: opportunities and challenges.

PubMed

Vidyasagar, Mathukumalli

2015-01-01

This article reviews several techniques from machine learning that can be used to study the problem of identifying a small number of features, from among tens of thousands of measured features, that can accurately predict a drug response. Prediction problems are divided into two categories: sparse classification and sparse regression. In classification, the clinical parameter to be predicted is binary, whereas in regression, the parameter is a real number. Well-known methods for both classes of problems are briefly discussed. These include the SVM (support vector machine) for classification and various algorithms such as ridge regression, LASSO (least absolute shrinkage and selection operator), and EN (elastic net) for regression. In addition, several well-established methods that do not directly fall into machine learning theory are also reviewed, including neural networks, PAM (pattern analysis for microarrays), SAM (significance analysis for microarrays), GSEA (gene set enrichment analysis), and k-means clustering. Several references indicative of the application of these methods to cancer biology are discussed.

Assessing the impact of representational and contextual problem features on student use of right-hand rules

NASA Astrophysics Data System (ADS)

Kustusch, Mary Bridget

2016-06-01

Students in introductory physics struggle with vector algebra and these challenges are often associated with contextual and representational features of the problems. Performance on problems about cross product direction is particularly poor and some research suggests that this may be primarily due to misapplied right-hand rules. However, few studies have had the resolution to explore student use of right-hand rules in detail. This study reviews literature in several disciplines, including spatial cognition, to identify ten contextual and representational problem features that are most likely to influence performance on problems requiring a right-hand rule. Two quantitative measures of performance (correctness and response time) and two qualitative measures (methods used and type of errors made) were used to explore the impact of these problem features on student performance. Quantitative results are consistent with expectations from the literature, but reveal that some features (such as the type of reasoning required and the physical awkwardness of using a right-hand rule) have a greater impact than others (such as whether the vectors are placed together or separate). Additional insight is gained by the qualitative analysis, including identifying sources of difficulty not previously discussed in the literature and revealing that the use of supplemental methods, such as physically rotating the paper, can mitigate errors associated with certain features.

Political Communication Research in the 1980s.

ERIC Educational Resources Information Center

Meadow, Robert G.

1985-01-01

Discusses eight books, including a textbook for undergraduates, that represent the type of research being conducted in the political communication field. Identifies major problems of current research. (PD)

Protocolised approach to end-of-life care in the ICU--the ICU PALCare Pilot Project.

PubMed

Rajamani, A; Barrett, E; Weisbrodt, L; Bourne, J; Palejs, P; Gresham, R; Huang, S

2015-05-01

International literature on end-of-life care in intensive care units (ICUs) supports the use of 'protocol bundles', which is not common practice in our 18-bed adult general ICU in Sydney, New South Wales. We conducted a prospective observational study to identify problems related to end-of-life care practices and to determine whether there was a need to develop protocol bundles. Any ICU patient who had 'withdrawal' of life-sustaining treatment to facilitate a comfortable death was eligible. Exclusion criteria included organ donors, unsuitable family dynamics and lack of availability of research staff to obtain family consent. Process-of-care measures were collected using a standardised form. Satisfaction ratings were obtained using de-identified questionnaire surveys given to the healthcare staff shortly after the withdrawal of therapy and to the families 30 days later. Twenty-three patients were enrolled between June 2011 and July 2012. Survey questionnaires were given to 25 family members and 30 healthcare staff, with a high completion rate (24 family members [96%] and 28 staff [93.3%]). Problems identified included poor documentation of family meetings (39%) and symptom management. Emotional/spiritual support was not offered to families (39.1%) or ICU staff (0%). The overall level of end-of-life care was good. The overwhelming majority of families and healthcare staff were highly satisfied with the care provided. Problems identified related to communication documentation and lack of spiritual/emotional support. To address these problems, targeted measures would be more useful than the adoption of protocol bundles. Alternate models of satisfaction surveys may be needed.

Assessment of alcohol problems using AUDIT in a prison setting: more than an 'aye or no' question

PubMed Central

2011-01-01

Background Alcohol problems are a major UK and international public health issue. The prevalence of alcohol problems is markedly higher among prisoners than the general population. However, studies suggest alcohol problems among prisoners are under-detected, under-recorded and under-treated. Identifying offenders with alcohol problems is fundamental to providing high quality healthcare. This paper reports use of the AUDIT screening tool to assess alcohol problems among prisoners. Methods Universal screening was undertaken over ten weeks with all entrants to one male Scottish prison using the AUDIT standardised screening tool and supplementary contextual questions. The questionnaire was administered by trained prison officers during routine admission procedures. Overall 259 anonymised completed questionnaires were analysed. Results AUDIT scores showed a high prevalence of alcohol problems with 73% of prisoner scores indicating an alcohol use disorder (8+), including 36% having scores indicating 'possible dependence' (20-40). AUDIT scores indicating 'possible dependence' were most apparent among 18-24 and 40-64 year-olds (40% and 56% respectively). However, individual questions showed important differences, with younger drinkers less likely to demonstrate habitual and addictive behaviours than the older age group. Disparity between high levels of harmful/hazardous/dependent drinking and low levels of 'treatment' emerged (only 27% of prisoners with scores indicating 'possible dependence' reported being 'in treatment'). Self-reported associations between drinking alcohol and the index crime were identified among two-fifths of respondents, rising to half of those reporting violent crimes. Conclusions To our knowledge, this is the first study to identify differing behaviours and needs among prisoners with high AUDIT score ranges, through additional analysis of individual questions. The study has identified high prevalence of alcohol use, varied problem behaviours, and links across drinking, crime and recidivism, supporting the argument for more extensive provision of alcohol-focused interventions in prisons. These should be carefully targeted based on initial screening and assessment, responsive, and include care pathways linking prisoners to community services. Finally, findings confirm the value and feasibility of routine use of the AUDIT screening tool in prison settings, to considerably enhance practice in the detection and understanding of alcohol problems, improving on current more limited questioning (e.g. 'yes or no' questions). PMID:22082009

Extraction of a group-pair relation: problem-solving relation from web-board documents.

PubMed

Pechsiri, Chaveevan; Piriyakul, Rapepun

2016-01-01

This paper aims to extract a group-pair relation as a Problem-Solving relation, for example a DiseaseSymptom-Treatment relation and a CarProblem-Repair relation, between two event-explanation groups, a problem-concept group as a symptom/CarProblem-concept group and a solving-concept group as a treatment-concept/repair concept group from hospital-web-board and car-repair-guru-web-board documents. The Problem-Solving relation (particularly Symptom-Treatment relation) including the graphical representation benefits non-professional persons by supporting knowledge of primarily solving problems. The research contains three problems: how to identify an EDU (an Elementary Discourse Unit, which is a simple sentence) with the event concept of either a problem or a solution; how to determine a problem-concept EDU boundary and a solving-concept EDU boundary as two event-explanation groups, and how to determine the Problem-Solving relation between these two event-explanation groups. Therefore, we apply word co-occurrence to identify a problem-concept EDU and a solving-concept EDU, and machine-learning techniques to solve a problem-concept EDU boundary and a solving-concept EDU boundary. We propose using k-mean and Naïve Bayes to determine the Problem-Solving relation between the two event-explanation groups involved with clustering features. In contrast to previous works, the proposed approach enables group-pair relation extraction with high accuracy.

Applying an Evidence-Based Assessment Model to Identify Students at Risk for Perceived Academic Problems following Concussion.

PubMed

Ransom, Danielle M; Burns, Alison R; Youngstrom, Eric A; Vaughan, Christopher G; Sady, Maegan D; Gioia, Gerard A

2016-11-01

The aim of this study was to demonstrate the utility of an evidence-based assessment (EBA) model to establish a multimodal set of tools for identifying students at risk for perceived post-injury academic problems. Participants included 142 students diagnosed with concussion (age: M=14.95; SD=1.80; 59% male), evaluated within 4 weeks of injury (median=16 days). Demographics, pre-injury history, self- and parent-report measures assessing symptom severity and executive functions, and cognitive test performance were examined as predictors of self-reported post-injury academic problems. Latent class analysis categorized participants into "high" (44%) and "low" (56%) levels of self-reported academic problems. Receiver operating characteristic analyses revealed significant discriminative validity for self- and parent-reported symptom severity and executive dysfunction and self-reported exertional response for identifying students reporting low versus high academic problems. Parent-reported symptom ratings [area under the receiver operating characteristic curve (AUC)=.79] and executive dysfunction (AUC=.74), and self-reported ratings of executive dysfunction (AUC=.84), symptoms (AUC=.80), and exertional response (AUC=.70) each classified students significantly better than chance (ps<.001). Hierarchical logistic regression indicated that, of the above, self-reported symptoms and executive dysfunction accounted for the most variance in the prediction of self-reported academic problems. Post-concussion symptom severity and executive dysfunction significantly predict perceived post-injury academic problems. EBA modeling identified the strongest set of predictors of academic challenges, offering an important perspective in the management of concussion by applying traditional strengths of neuropsychological assessment to clinical decision making. (JINS, 2016, 22, 1038-1049).

Epidemiology of childhood conduct problems in Brazil: systematic review and meta-analysis.

PubMed

Murray, Joseph; Anselmi, Luciana; Gallo, Erika Alejandra Giraldo; Fleitlich-Bilyk, Bacy; Bordin, Isabel A

2013-10-01

This study aimed to review evidence on the prevalence of and risk factors for conduct problems in Brazil. We searched electronic databases and contacted Brazilian researchers up to 05/2012. Studies were included in the review if they reported the prevalence of or risk factors for conduct problems, conduct disorder, or oppositional defiant disorder for 100 + Brazilian children aged ≤18 years, systematically sampled in schools or the community. Prevalence rates and sex differences were meta-analysed. Risk factor studies were reviewed one by one. The average prevalence of conduct problems in screening questionnaires was 20.8%, and the average prevalence of conduct disorder/oppositional defiant disorder was 4.1%. There was systematic variation in the results of screening studies according to methodology: recruitment location, informants, instruments, impairment criterion for case definition, and response rates. Risk factors previously identified in high-income countries were mainly replicated in Brazil, including comorbid mental health problems, educational failure, low religiosity, harsh physical punishment and abuse, parental mental health problems, single parent family, and low socioeconomic status. However, boys did not always have higher risk for conduct problems than girls. Studies using screening questionnaires suggest that Brazilian children have higher rates of conduct problems than children in other countries, but diagnostic studies do not show this difference. Risk factors in Brazil were similar to those in high-income countries, apart from child sex. Future research should investigate developmental patterns of antisocial behaviour, employ a variety of research designs to identify causal risk mechanisms, and examine a broader range of risk factors.

Identifying Predictors of Negative Psychological Reactions to Stalking Victimization

ERIC Educational Resources Information Center

Johnson, Matthew C.; Kercher, Glen A.

2009-01-01

Victims of stalking often experience a number of negative psychological problems including such things as fear, symptoms of depression, and anger. However, research on factors that lead to these outcomes is limited. The goal of this study was to first identify distinct subgroups of stalking victims based on measures of psychological problems…

A Scoping Review of Treatments for Older Adults with Substance Use Problems

ERIC Educational Resources Information Center

Mowbray, Orion; Quinn, Adam

2016-01-01

Objectives: To identify effective treatment services for older, substance-using adults, an examination of the evidence associated with interventions for this group is presented. Methods: Using explicit, validated criteria to identify effective interventions, 22 publications were included in a review and were subject to a critical appraisal of…

Cognitive and Linguistic Predictors of Mathematical Word Problems With and Without Irrelevant Information.

PubMed

Wang, Amber Y; Fuchs, Lynn S; Fuchs, Douglas

2016-12-01

The purpose of this study was to identify cognitive and linguistic predictors of word problems with versus without irrelevant information. The sample was 701 2nd-grade students who received no specialized intervention on word problems. In the fall, they were assessed on initial arithmetic and word-problem skill as well as language ability, working memory capacity, and processing speed; in the spring, they were tested on a word-problem measure that included items with versus without irrelevant information. Significant predictors common to both forms of word problems were initial arithmetic and word problem-solving skill as well as language and working memory. Nonverbal reasoning predicted word problems with irrelevant information, but not word problems without irrelevant information. Findings are discussed in terms of implications for intervention and future research.

Assessment of Trauma History and Trauma-Related Problems in Ethnic Minority Child Populations: An INFORMED Approach

ERIC Educational Resources Information Center

de Arellano, Michael A.; Danielson, Carla Kmett

2008-01-01

Youth who experience traumatic events are at risk for a range of negative outcomes, including posttraumatic stress disorder, other anxiety disorders, depression, substance use, and health risk behaviors. It is important to identify valid methods to assess individuals for exposure to traumatic events, as well as the types of problems or symptoms…

Assessing Callous-Unemotional Traits in Preschool Children with Disruptive Behavior Problems Using Peer Reports

ERIC Educational Resources Information Center

Graziano, Paulo A.; Ros, Rosmary; Haas, Sarah; Hart, Katie; Slavec, Janine; Waschbusch, Daniel; Garcia, Alexis

2016-01-01

The goal of this study was to examine the extent to which preschoolers with externalizing behavior problems (EBP) can identify behaviors indicative of callous-unemotional (CU) traits among their peers. Participants for this study included 86 preschool children (69% boys; M[subscript age] = 5.07 years) with at-risk or clinically elevated levels of…

The role of metadata in managing large environmental science datasets. Proceedings

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

Melton, R.B.; DeVaney, D.M.; French, J. C.

1995-06-01

The purpose of this workshop was to bring together computer science researchers and environmental sciences data management practitioners to consider the role of metadata in managing large environmental sciences datasets. The objectives included: establishing a common definition of metadata; identifying categories of metadata; defining problems in managing metadata; and defining problems related to linking metadata with primary data.

The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions.

PubMed

Hors-Fraile, S; Atique, S; Mayer, M A; Denecke, K; Merolli, M; Househ, M

2016-11-10

Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient's feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem.

Exploring Agriculture in America. Instructor Guide and Student Reference.

ERIC Educational Resources Information Center

Humphrey, John Kevin; And Others

This curriculum guide is designed to provide instruction about agriculture for eighth-grade students in Missouri. Lessons included in the curriculum employ a problem-solving instructional approach. Student-oriented activities are included to provide opportunities for experiential learning. Core competencies and key skills are identified in…

Techniques for determining physical zones of influence

DOEpatents

Hamann, Hendrik F; Lopez-Marrero, Vanessa

2013-11-26

Techniques for analyzing flow of a quantity in a given domain are provided. In one aspect, a method for modeling regions in a domain affected by a flow of a quantity is provided which includes the following steps. A physical representation of the domain is provided. A grid that contains a plurality of grid-points in the domain is created. Sources are identified in the domain. Given a vector field that defines a direction of flow of the quantity within the domain, a boundary value problem is defined for each of one or more of the sources identified in the domain. Each of the boundary value problems is solved numerically to obtain a solution for the boundary value problems at each of the grid-points. The boundary problem solutions are post-processed to model the regions affected by the flow of the quantity on the physical representation of the domain.

Postpartum depression: a chronicle of health policy development.

PubMed

Glasser, Saralee

2010-01-01

The current report presents an example of the path taken from identification of a public health problem at the primary health service level, to conducting research documenting the scope of the problem and nature of the risk factors, disseminating the findings, and fostering development and application of relevant policy. The example presented is the case of postpartum depression, an issue with bio-psycho-social implications. Public health nurses identified the problem, prompting epidemiological research. The findings encouraged the Ministry of Health (MOH) to conduct a pilot program for screening and early intervention among pregnant and postpartum women reporting depressive symptoms. Based on the results of the pilot program, the MOH is expanding the program to all Mother-Child Health (MCH) clinics. Israel?s largest Health Maintenance Organization has followed suit and is including this program in its own clinics. This Israeli experience may serve as an instructive example of a locally identified problem evolving into a national policy.

Does language ambiguity in clinical practice justify the introduction of standard terminology? An integrative review.

PubMed

Stallinga, Hillegonda A; ten Napel, Huib; Jansen, Gerard J; Geertzen, Jan H B; de Vries Robbé, Pieter F; Roodbol, Petrie F

2015-02-01

To research the use of ambiguous language in written information concerning patients' functioning and to identify problems resulting from the use of ambiguous language in clinical practice. Many projects that aimed to introduce standard terminology concerning patients' functioning in clinical practice are unsuccessful because standard terminology is rarely used in clinical practice. These projects mainly aim to improve communication by reducing ambiguous language. Considering their lack of success, the validity of the argument that language ambiguity is used in clinical practice is questioned. An integrative literature review. A systematic search of the MEDLINE (1950-2012) and CINAHL (1982-2012) databases was undertaken, including empirical and theoretical literature. The selected studies were critically appraised using a data assessment and extraction form. Seventeen of 767 papers were included in the review and synthesis. The use of ambiguous language in written information concerning patients' functioning was demonstrated. Problems resulting from the use of ambiguous language in clinical practice were not identified. However, several potential problems were suggested, including hindered clinical decision-making and limited research opportunities. The results of this review demonstrated the use of ambiguous language concerning patients' functioning, but health professionals in clinical practice did not experience this issue as a problem. This finding might explain why many projects aimed at introducing standard terminology concerning functioning in clinical practice to solve problems caused by ambiguous language are often unsuccessful. Language ambiguity alone is not a valid argument to justify the introduction of standard terminology. The introduction of standard terminology concerning patients' functioning will only be successful when clinical practice requires the aggregation and reuse of data from electronic patient records for different purposes, including multidisciplinary decision-making and research. © 2014 John Wiley & Sons Ltd.

Automated problem list generation and physicians perspective from a pilot study.

PubMed

Devarakonda, Murthy V; Mehta, Neil; Tsou, Ching-Huei; Liang, Jennifer J; Nowacki, Amy S; Jelovsek, John Eric

2017-09-01

An accurate, comprehensive and up-to-date problem list can help clinicians provide patient-centered care. Unfortunately, problem lists created and maintained in electronic health records by providers tend to be inaccurate, duplicative and out of date. With advances in machine learning and natural language processing, it is possible to automatically generate a problem list from the data in the EHR and keep it current. In this paper, we describe an automated problem list generation method and report on insights from a pilot study of physicians' assessment of the generated problem lists compared to existing providers-curated problem lists in an institution's EHR system. The natural language processing and machine learning-based Watson 1 method models clinical thinking in identifying a patient's problem list using clinical notes and structured data. This pilot study assessed the Watson method and included 15 randomly selected, de-identified patient records from a large healthcare system that were each planned to be reviewed by at least two internal medicine physicians. The physicians created their own problem lists, and then evaluated the overall usefulness of their own problem lists (P), Watson generated problem lists (W), and the existing EHR problem lists (E) on a 10-point scale. The primary outcome was pairwise comparisons of P, W, and E. Six out of the 10 invited physicians completed 27 assessments of P, W, and E, and in process evaluated 732 Watson generated problems and 444 problems in the EHR system. As expected, physicians rated their own lists, P, highest. However, W was rated higher than E. Among 89% of assessments, Watson identified at least one important problem that physicians missed. Cognitive computing systems like this Watson system hold the potential for accurate, problem-list-centered summarization of patient records, potentially leading to increased efficiency, better clinical decision support, and improved quality of patient care. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Developing a quality assurance program for online services.

PubMed Central

Humphries, A W; Naisawald, G V

1991-01-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas. PMID:1909197

Developing a quality assurance program for online services.

PubMed

Humphries, A W; Naisawald, G V

1991-07-01

A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.

Screening accuracy of the parent-completed Ages and Stages Questionnaires - second edition as a broadband screener for motor problems in preschoolers with autism spectrum disorders.

PubMed

Vanvuchelen, Marleen; Van Schuerbeeck, Lise; Braeken, Marijke Aka

2017-01-01

Children with autism spectrum disorders are at risk for motor problems. However, this area is often overlooked in the developmental evaluation in autism diagnostic clinics. An alternative can be to identify children who should receive intensive motor assessment by using a parent-based screener. The aim of this study was to examine whether the Ages and Stages Questionnaires - second edition may be used to identify gross and fine motor problems in children. High-functioning children with autism spectrum disorder (n = 43, 22-54 m) participated in this study. Sensitivity, specificity, predictive values and areas under the receiver operating characteristic curve were calculated by comparing the Ages and Stages Questionnaires - second edition scores to the developmental evaluation of the Peabody Developmental Motor Scale - second edition. The results revealed that both the Ages and Stages Questionnaires - second edition gross and fine motor domain may be used to identify children without motor problems. In contrast, sensitivity analyses revealed the likelihood of under screening motor problems in this population. The Ages and Stages Questionnaires - second edition met only the criteria of a fair to good accuracy to identify poor gross motor (sensitivity = 100%) and below-average fine motor development (sensitivity = 71%) in this sample. Hence, the capacity of the Ages and Stages Questionnaires - second edition to identify motor problems in preschoolers with autism spectrum disorder appears to be limited. It is recommended to include a formal standardized motor test in the diagnostic procedure for all children with autism spectrum disorder. © The Author(s) 2016.

Problems and solutions for patients with fibromyalgia: Building new helping relationships.

PubMed

Montesó-Curto, Pilar; García-Martinez, Montserrat; Romaguera, Sara; Mateu, María Luisa; Cubí-Guillén, María Teresa; Sarrió-Colas, Lidia; Llàdser, Anna Núria; Bradley, Stephen; Panisello-Chavarria, María Luisa

2018-02-01

The aim of this study was to identify the main biological, psychological and sociological problems and potential solutions for patients diagnosed with fibromyalgia by use of Group Problem-Solving Therapy. Group Problem-Solving Therapy is a technique for identifying and solving problems, increasing assertiveness, self-esteem and eliminating negative thoughts. Qualitative phenomenological interpretive design: Group Problem-Solving Therapy sessions conducted with patients suffering fibromyalgia were studied; participants recruited via the Rheumatology Department at a general hospital and associations in Catalonia, Spain with sessions conducted in nearby university setting. The study included 44 people diagnosed with fibromyalgia (43 female, 1 male) from 6 Group Problem-Solving Therapy sessions. Data collected from March-June 2013. A total of 24 sessions were audio recorded, all with prior informed consent. Data were transcribed and then analysed in accordance with established methods of inductive thematic analysis, via a process of reduction to manage and classify data. Five themes were identified: (1) Current problems are often related to historical trauma; (2) There are no "one size fits all" solutions; (3) Fibromyalgia is life-changing; (4) Fibromyalgia is widely misunderstood; (5) Statistically Significant impacts on physical, psychological and social are described. The majority of patients' problems were associated with their previous history and the onset of fibromyalgia; which may be related to trauma in adolescence, early adulthood or later. The solutions provided during the groups appeared to be accepted by the participants. These findings can improve the self-management of fibromyalgia patients by helping to enhance adaptive behaviours and incorporating the female gender approach. © 2017 John Wiley & Sons Ltd.

Child maltreatment and problem gambling: A systematic review.

PubMed

Lane, Wendy; Sacco, Paul; Downton, Katherine; Ludeman, Emilie; Levy, Lauren; Tracy, J Kathleen

2016-08-01

This study systematically reviews research on child maltreatment and risk of gambling problems in adulthood. It also reviews adult problem gamblers' risk of abusing or neglecting their own children. Multiple database searches were conducted using pre-defined search terms related to gambling and child abuse and neglect. We identified 601 unique references and excluded studies if they did not report original research, or did not specifically measure child maltreatment or gambling. Twelve studies that included multivariable analysis of childhood maltreatment exposure and problem gambling were identified. Six of seven studies examining childhood sexual abuse and four of five examining physical abuse showed a significant positive association between abuse and later gambling problems (odds ratios for sexual abuse 2.01-3.65; physical abuse 2.3-2.8). Both studies examining psychological maltreatment and two of three examining neglect identified positive associations with problem gambling. In most studies, risks were reduced or eliminated when controlling for other mental health disorders. The three studies measuring risk of child abuse and neglect among current problem gamblers suggest an increased risk for child physical abuse and medical conditions indicative of neglect although there is a considerable amount of variation among studies. Child abuse is associated with increased risk of gambling problems - gambling treatment providers should ask about maltreatment history as part of their clinical assessment. Problem gamblers may be more likely to physically abuse or neglect their children, but data here are more limited. Child welfare professionals should consider asking questions about parental gambling when assessing family risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

Preschool Teacher Perceptions of Aggressive Behavior

ERIC Educational Resources Information Center

Stein, Misty

2013-01-01

The purpose of this grounded theory qualitative study was to identify teacher perceptions within the classroom of preschool violence and what, if any were the perceived associations between teacher perceptions and the problem of school violence up to and including incarceration in later years. The study included open interview questions for data…

Propeller propulsion system integration: State of technology survey

NASA Technical Reports Server (NTRS)

Miley, S. J.; Vonlavante, E.

1985-01-01

A literature survey was performed to identify and review technical material applicable to the problem area of propeller propulsion system integration. The survey covered only aerodynamic interference aspects of the problem, and was restricted primarily to propeller effects on the airframe. The subject of airframe aerodynamic interference on the propeller was limited to the problem of vibration due to nonuniform inflow. The problem of airframe effects on propeller performance was not included. A total of 1121 references are given. The references are grouped into the subject areas of Aircraft Stability, Propulsive Efficiency, Aerodynamic Interference, Aerodynamic Interference-Propeller Vibration, and Miscellaneous.

A gradient based algorithm to solve inverse plane bimodular problems of identification

NASA Astrophysics Data System (ADS)

Ran, Chunjiang; Yang, Haitian; Zhang, Guoqing

2018-02-01

This paper presents a gradient based algorithm to solve inverse plane bimodular problems of identifying constitutive parameters, including tensile/compressive moduli and tensile/compressive Poisson's ratios. For the forward bimodular problem, a FE tangent stiffness matrix is derived facilitating the implementation of gradient based algorithms, for the inverse bimodular problem of identification, a two-level sensitivity analysis based strategy is proposed. Numerical verification in term of accuracy and efficiency is provided, and the impacts of initial guess, number of measurement points, regional inhomogeneity, and noisy data on the identification are taken into accounts.

Recent advances in reduction methods for nonlinear problems. [in structural mechanics

NASA Technical Reports Server (NTRS)

Noor, A. K.

1981-01-01

Status and some recent developments in the application of reduction methods to nonlinear structural mechanics problems are summarized. The aspects of reduction methods discussed herein include: (1) selection of basis vectors in nonlinear static and dynamic problems, (2) application of reduction methods in nonlinear static analysis of structures subjected to prescribed edge displacements, and (3) use of reduction methods in conjunction with mixed finite element models. Numerical examples are presented to demonstrate the effectiveness of reduction methods in nonlinear problems. Also, a number of research areas which have high potential for application of reduction methods are identified.

Skylab Medical Experiments Altitude Test (SMEAT)

NASA Technical Reports Server (NTRS)

Johnston, R. S. (Compiler)

1973-01-01

The Skylab 56-day environment simulation test provided baseline biomedical data on medical experiments to be included in the Skylab program. Also identified are problems in operating life support systems and medical equipment.

Prenatal Tests

MedlinePlus

... disease (STD) or cervical cancer In a developing child, prenatal tests can: identify treatable health problems that can affect the baby show characteristics of the baby, including size, sex, age, and position in the uterus help determine ...

The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism.

PubMed

Mazefsky, Carla A; Schreiber, Dana R; Olino, Thomas M; Minshew, Nancy J

2014-07-01

This study investigated the association between gastrointestinal symptoms and a broad set of emotional and behavioral concerns in 95 children with high-functioning autism and IQ scores ≥ 80. Gastrointestinal symptoms were assessed via the Autism Treatment Network's Gastrointestinal Symptom Inventory, and data were gathered on autism symptom severity, adaptive behavior, and multiple internalizing and externalizing problems. The majority (61%) of children had at least one reported gastrointestinal symptom. Emotional and behavioral problems were also common but with a high degree of variability. Children with and without gastrointestinal problems did not differ in autism symptom severity, adaptive behavior, or total internalizing or externalizing problem scores. However, participants with gastrointestinal problems had significantly higher levels of affective problems. This finding is consistent with a small body of research noting a relationship between gastrointestinal problems, irritability, and mood problems in autism spectrum disorder. More research to identify the mechanisms underlying this relationship in autism spectrum disorder is warranted. Future research should include a medical assessment of gastrointestinal concerns, longitudinal design, and participants with a range of autism spectrum disorder severity in order to clarify the directionality of this relationship and to identify factors that may impact heterogeneity in the behavioral manifestation of gastrointestinal concerns. © The Author(s) 2013.

Dealing with aggressive behavior within the health care team: a leadership challenge.

PubMed

Hynes, Patricia; Kissoon, Niranjan; Hamielec, Cindy M; Greene, Anne Marie; Simone, Carmine

2006-06-01

During an interdisciplinary Canadian leadership forum [ (click on the Conferences icon)], participants were challenged to develop an approach to a difficult leadership/management situation. In a scenario involving aggressive behavior among health care providers, participants identified that, before responding, an appropriate leader should collect additional information to identify the core problem(s) causing such behavior. Possibilities include stress; lack of clear roles, responsibilities, and standard operating procedures; and, finally, lack of training on important leadership/management skills. As a result of these core problems, several potential solutions are possible, all with potential obstacles to implementation. Additional education around communication and team interaction was felt to be a priority. In summary, clinical leaders probably have a great deal to gain from augmenting their leadership/management skills.

Are Your Students Ready for Anatomy and Physiology? Developing Tools to Identify Students at Risk for Failure

ERIC Educational Resources Information Center

Gultice, Amy; Witham, Ann; Kallmeyer, Robert

2015-01-01

High failure rates in introductory college science courses, including anatomy and physiology, are common at institutions across the country, and determining the specific factors that contribute to this problem is challenging. To identify students at risk for failure in introductory physiology courses at our open-enrollment institution, an online…

Family Support in Prevention Programs for Children at Risk for Emotional/Behavioral Problems

ERIC Educational Resources Information Center

Cavaleri, Mary A.; Olin, S. Serene; Kim, Annie; Hoagwood, Kimberly E.; Burns, Barbara J.

2011-01-01

We conducted a review of empirically based prevention programs to identify prevalence and types of family support services within these programs. A total of 238 articles published between 1990 and 2011 that included a family support component were identified; 37 met criteria for inclusion. Following the Institute of Medicine's typology, prevention…

Correlates of strength training in older rural African American and Caucasian women.

PubMed

Bopp, Melissa; Wilcox, Sara; Oberrecht, Larissa; Kammermann, Sandra; McElmurray, Charles T

2004-01-01

This study examined factors influencing strength training (ST) in two convenience samples of older rural women. Focus group (FG) participants were 23 Caucasian and 16 African American women aged 67.5 +/- 9.2 years. Survey participants were 60 Caucasian and 42 African American women, aged 70.59 +/- 9.21 years. FG participants answered questions about the risks, benefits, and barriers to ST. Survey participants completed measures of demographics, physical activity (including ST), depression and stress, decisional balance for exercise (DBE), barriers to PA, and social support (SS). Regression modeling examined correlates of ST. FG participants identified physical health gains and improved appearance as ST benefits. African American women also included mental health benefits and "feeling good". Both Caucasian and African American groups named physical health problems as risks of ST. Caucasian women identified time constraints, lack of ST knowledge, physical health problems, lack of exercise facilities, and the cost of ST as barriers. African American women cited being "too tired", physical health problems, lack of support, and other family and work responsibilities. The linear regression model explained 23.2% of the variance in hours per week of ST; DBE and family SS were independent positive correlates. This study identified correlates to participation in ST in older rural women and provides a basis for developing ST interventions in this population.

Dissociative identity disorder (DID) in clinical practice - what you don't see may hurt you.

PubMed

Leonard, David; Tiller, John

2016-02-01

To identify problems that interfere with the recognition, diagnosis and management of people with dissociative identity disorder (DID) presenting to psychiatric outpatient and inpatient services and suggest solutions. Problems and suggested solutions associated with clinical presentations and management of people with DID are outlined with references to relevant literature. Problems in the recognition and management of DID are described. These lead to delays in diagnosis and costly, inappropriate management, destructive to services, staff and patients alike. Problems include lack of understanding and experience and scepticism about the disorder, resulting in failure to provide appropriate treatment.Some suggestions to improve recognition and management are included. Better recognition, diagnosis and management of DID will lead to better and more cost effective outcomes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Travel Survey Manual: Appendices

DOT National Transportation Integrated Search

1995-02-01

The primary objectives of this chapter are to provide information on the current physical and operating characteristics of all border crossings, including approaches and egresses, and to identify problems, both physical and operational, that affect t...

Cognitive and Linguistic Predictors of Mathematical Word Problems With and Without Irrelevant Information

PubMed Central

Fuchs, Lynn S.; Fuchs, Douglas

2016-01-01

The purpose of this study was to identify cognitive and linguistic predictors of word problems with versus without irrelevant information. The sample was 701 2nd-grade students who received no specialized intervention on word problems. In the fall, they were assessed on initial arithmetic and word-problem skill as well as language ability, working memory capacity, and processing speed; in the spring, they were tested on a word-problem measure that included items with versus without irrelevant information. Significant predictors common to both forms of word problems were initial arithmetic and word problem-solving skill as well as language and working memory. Nonverbal reasoning predicted word problems with irrelevant information, but not word problems without irrelevant information. Findings are discussed in terms of implications for intervention and future research. PMID:28190942

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

The most common problem facing by the maintenance department: A case Study between Universiti Tun Hussein Onn Malaysia (UTHM) and Universiti Teknologi Malaysia (UTM)

NASA Astrophysics Data System (ADS)

Norazam Yasin, Mohd; Mohamad Zin, Rosli; Halid Abdullah, Abd; Shafiq Mahmad, Muhammad; Fikri Hasmori, Muhammad

2017-11-01

From time to time, the maintenance works become more challenging due to construction of new building and also aging of the existing buildings. University buildings without any exception require proper maintenance services to support their function requirements and this can be considered as major responsibilities to be fulfilled by the maintenance department in the universities. Maintenance department specifically will face various kinds of problems in their operation works and thus this might influence the maintenance work operations itself. This study purposely to identify the common problem facing by the maintenance department and also to examine the current status of the maintenance department. In addition, this study would also propose any suitable approach that could be implemented to overcome the problem facing by the maintenance department. To achieve the objectives of this study, a combination of deep literature study and carrying out a survey is necessary. Literature study aimed to obtain deeper information about this study, meanwhile a survey aimed at identifying the common problem facing by the maintenance department and also to provide the information of the maintenance department’s organization. Several methods will be used in analyzing the data obtained through the survey, including Microsoft Office Excel and also using mean index formula. This study has identified three categories of problem in the maintenance department, which are management problems, human resource problem, and technical problems. Following the findings, several solutions being proposed which can be implemented as the solution to the problem facing. These suggestions have the potential to improve the maintenance department work efficiency, thus could help to increase the department productivity.

The Association Between Serious Mental Health Problems and Violence: Some Common Assumptions and Misconceptions.

PubMed

Ahonen, Lia; Loeber, Rolf; Brent, David A

2017-01-01

The media, the general public, and politicians often emphasize that mental illness is a precursor and a cause of violence, particularly emphasizing an assumed relationship between mental illness, including psychopathy and psychosis, and the use of guns to commit violence. We report which individuals with serious mental health problems have an increased risk to commit violence (including gun violence). Second, we answer the question to what extent serious mental health problems explain most violence and especially gun-related violence. And what is the opinion of experts on these questions? Third, we review which effective screening instrument can help to identify individuals with mental health problems who are at risk to carry a gun and commit violence. For policy makers and legislators, this article points out that most psychiatric disorders are not related to violence, with some exceptions such as schizophrenia and bipolar disorder, and often only in conjunction with substance use. We show that the attributable risk of mental illness to explain violence in general is low. We also emphasize that conduct disorder in late childhood or adolescence is a better predictor of violence than is mental illness at a later age. Empirically based screening methods to identify individuals with mental health problems who are prone to violence appear to have limited utility. Implications are discussed for clinicians and practitioners working in the justice system, researchers, and policy makers.

Parent report measures of infant and toddler social-emotional development: a systematic review.

PubMed

Pontoppidan, Maiken; Niss, Nete K; Pejtersen, Jan H; Julian, Megan M; Væver, Mette S

2017-04-01

Identifying young children at risk for socio-emotional developmental problems at an early stage, to prevent serious problems later in life, is crucial. Therefore, we need high quality measures to identify those children at risk for social-emotional problems who require further evaluation and intervention. To systematically identify parent report measures of infant and toddler (0-24 months) social-emotional development for use in primary care settings. We conducted a systematic review applying a narrative synthesis approach. We searched Medline, PsychInfo, Embase and SocIndex for articles published from 2008 through September 2015 to identify parent-report measures of infant and toddler social-emotional development. Data on the characteristics of the measures, including psychometric data, were collected. Based on 3310 screened articles, we located 242 measures that were screened for eligibility. In all 18 measures of infant and toddler social-emotional development were included. Ten of the measures were developed specifically for measuring social-emotional development, and eight were measures including subscales of social-emotional development. The measures varied with respect to, e.g. the time of publication, number of items, age span, cost and amount of psychometric data available. Several measures of infant and toddler social-emotional development have been developed within the last decade. The majority of psychometric data are available through manuals, not peer-reviewed journals. Although all measures show acceptable reliability, the most comprehensive and psychometrically sound measures are the Ages and Stages Questionnaires: Social-Emotional-2, Infant-Toddler Social and Emotional Assessment, Brief Infant-Toddler Social and Emotional Assessment and Child Behaviour Checklist 1½-5. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pathways and processes of risk in associations among maternal antisocial personality symptoms, interparental aggression, and preschooler's psychopathology.

PubMed

Davies, Patrick T; Sturge-Apple, Melissa L; Cicchetti, Dante; Manning, Liviah G; Vonhold, Sara E

2012-08-01

Two studies examined the nature and processes underlying the joint role of interparental aggression and maternal antisocial personality as predictors of children's disruptive behavior problems. Participants for both studies included a high-risk sample of 201 mothers and their 2-year-old children in a longitudinal, multimethod design. Addressing the form of the interplay between interparental aggression and maternal antisocial personality as risk factors for concurrent and prospective levels of child disruptive problems, the Study 1 findings indicated that maternal antisocial personality was a predictor of the initial levels of preschooler's disruptive problems independent of the effects of interparental violence, comorbid forms of maternal psychopathology, and socioeconomic factors. In attesting to the salience of interparental aggression in the lives of young children, latent difference score analyses further revealed that interparental aggression mediated the link between maternal antisocial personality and subsequent changes in child disruptive problems over a 1-year period. To identify the family mechanisms that account for the two forms of intergenerational transmission of disruptive problems identified in Study 1, Study 2 explored the role of children's difficult temperament, emotional reactivity to interparental conflict, adrenocortical reactivity in a challenging parent-child task, and experiences with maternal parenting as mediating processes. Analyses identified child emotional reactivity to conflict and maternal unresponsiveness as mediators in pathways between interparental aggression and preschooler's disruptive problems. The findings further supported the role of blunted adrenocortical reactivity as an allostatic mediator of the associations between parental unresponsiveness and child disruptive problems.

Maternal well-being and its association to risk of developmental problems in children at school entry

PubMed Central

2010-01-01

Background Children at highest risk of developmental problems benefit from early identification and intervention. Investigating factors affecting child development at the time of transition to school may reveal opportunities to tailor early intervention programs for the greatest effectiveness, social benefit and economic gain. The primary objective of this study was to identify child and maternal factors associated with children who screened at risk of developmental problems at school entry. Methods An existing cohort of 791 mothers who had been followed since early pregnancy was mailed a questionnaire when the children were aged four to six years. The questionnaire included a screening tool for developmental problems, an assessment of the child's social competence, health care utilization and referrals, and maternal factors, including physical health, mental health, social support, parenting morale and sense of competence, and parenting support/resources. Results Of the 491 mothers (62%) who responded, 15% had children who were screened at high risk of developmental problems. Based on a logistic regression model, independent predictors of screening at high risk for developmental problems at age 5 were male gender (OR: 2.3; 95% CI: 1.3, 4.1), maternal history of abuse at pregnancy (OR: 2.4; 95% CI: 1.3, 4.4), and poor parenting morale when the child was 3 years old (OR: 3.9; 95% CI: 2.1, 7.3). A child with all of these risk factors had a 35% predicted probability of screening at high risk of developmental problems, which was reduced to 13% if maternal factors were favourable. Conclusions Risk factors for developmental problems at school entry are related to maternal well being and history of abuse, which can be identified in the prenatal period or when children are preschool age. PMID:20338052

Realizing Improvement through Team Empowerment (RITE): A Team-based, Project-based Multidisciplinary Improvement Program.

PubMed

Larson, David B; Mickelsen, L Jake; Garcia, Kandice

2016-01-01

Performance improvement in a complex health care environment depends on the cooperation of diverse individuals and groups, allocation of time and resources, and use of effective improvement methods. To address this challenge, we developed an 18-week multidisciplinary training program that would also provide a vehicle for effecting needed improvements, by using a team- and project-based model. The program began in the radiology department and subsequently expanded to include projects from throughout the medical center. Participants were taught a specific method for team-based problem solving, which included (a) articulating the problem, (b) observing the process, (c) analyzing possible causes of problems, (d) identifying key drivers, (e) testing and refining interventions, and (f) providing for sustainment of results. Progress was formally reviewed on a weekly basis. A total of 14 teams consisting of 78 participants completed the course in two cohorts; one project was discontinued. All completed projects resulted in at least modest improvement. Mean skill scores increased from 2.5/6 to 4.5/6 (P < .01), and the mean satisfaction score was 4.7/5. Identified keys to success include (a) engagement of frontline staff, (b) teams given authority to make process changes, (c) capable improvement coaches, (d) a physician-director with improvement expertise and organizational authority, (e) capable administrative direction, (f) supportive organizational leaders, (g) weekly progress reviews, (h) timely educational material, (i) structured problem-solving methods, and ( j ) multiple projects working simultaneously. The purpose of this article is to review the program, including the methods and results, and discuss perceived keys to program success. © RSNA, 2016.

Solving the obesity epidemic: voices from the community

PubMed Central

Mama, Scherezade K.; Soltero, Erica G.; Ledoux, Tracey A.; Gallagher, Martina R.; Lee, Rebecca E.

2015-01-01

Science and Community: Ending Obesity Improving Health (S&C) aimed to reduce obesity in Houston by developing community partnerships to identify research priorities and develop a sustainable obesity reduction program. Partnership members were recruited from S&C events and invited to participate in in-depth interviews to gain insight into obesity prevalence, causes, and solutions. Members (n = 22) completed a 60–90-min in-depth interview. The interview guide consisted of 30 questions about pressing health problems in the community, potential solutions to health problems and obesity and how the environment has impacted obesity and health behaviors in the community. Interviewees (n = 12 women and 10 men) were mostly Hispanic/Latino (n = 9) and African American (n = 7). Common problems identified were childhood obesity, balancing a healthy diet and physical inactivity. Interviewees identified obesity as a major problem in their communities and cited access to quality food and physical activity resources as both a problem and a solution. Additional emergent themes focused on solutions, including increasing awareness and education, coordinated efforts among organizations and using an ecologic approach to combat obesity. Community insight gleaned from this study may be used to enhance relevance and sustainability of programs developed to reduce obesity and suggests possible avenues for participatory research and intervention. PMID:24372868

Solving the obesity epidemic: voices from the community.

PubMed

Mama, Scherezade K; Soltero, Erica G; Ledoux, Tracey A; Gallagher, Martina R; Lee, Rebecca E

2014-09-01

"Science and Community: Ending Obesity Improving Health" (S&C) aimed to reduce obesity in Houston by developing community partnerships to identify research priorities and develop a sustainable obesity reduction program. Partnership members were recruited from S&C events and invited to participate in in-depth interviews to gain insight into obesity prevalence, causes, and solutions. Members (n = 22) completed a 60-90-min in-depth interview. The interview guide consisted of 30 questions about pressing health problems in the community, potential solutions to health problems and obesity and how the environment has impacted obesity and health behaviors in the community. Interviewees (n = 12 women and 10 men) were mostly Hispanic/Latino (n = 9) and African American (n = 7). Common problems identified were childhood obesity, balancing a healthy diet and physical inactivity. Interviewees identified obesity as a major problem in their communities and cited access to quality food and physical activity resources as both a problem and a solution. Additional emergent themes focused on solutions, including increasing awareness and education, coordinated efforts among organizations and using an ecologic approach to combat obesity. Community insight gleaned from this study may be used to enhance relevance and sustainability of programs developed to reduce obesity and suggests possible avenues for participatory research and intervention. © 2013 John Wiley & Sons Ltd.

Identifying a Probabilistic Boolean Threshold Network From Samples.

PubMed

Melkman, Avraham A; Cheng, Xiaoqing; Ching, Wai-Ki; Akutsu, Tatsuya

2018-04-01

This paper studies the problem of exactly identifying the structure of a probabilistic Boolean network (PBN) from a given set of samples, where PBNs are probabilistic extensions of Boolean networks. Cheng et al. studied the problem while focusing on PBNs consisting of pairs of AND/OR functions. This paper considers PBNs consisting of Boolean threshold functions while focusing on those threshold functions that have unit coefficients. The treatment of Boolean threshold functions, and triplets and -tuplets of such functions, necessitates a deepening of the theoretical analyses. It is shown that wide classes of PBNs with such threshold functions can be exactly identified from samples under reasonable constraints, which include: 1) PBNs in which any number of threshold functions can be assigned provided that all have the same number of input variables and 2) PBNs consisting of pairs of threshold functions with different numbers of input variables. It is also shown that the problem of deciding the equivalence of two Boolean threshold functions is solvable in pseudopolynomial time but remains co-NP complete.

Maximum likelihood identification and optimal input design for identifying aircraft stability and control derivatives

NASA Technical Reports Server (NTRS)

Stepner, D. E.; Mehra, R. K.

1973-01-01

A new method of extracting aircraft stability and control derivatives from flight test data is developed based on the maximum likelihood cirterion. It is shown that this new method is capable of processing data from both linear and nonlinear models, both with and without process noise and includes output error and equation error methods as special cases. The first application of this method to flight test data is reported for lateral maneuvers of the HL-10 and M2/F3 lifting bodies, including the extraction of stability and control derivatives in the presence of wind gusts. All the problems encountered in this identification study are discussed. Several different methods (including a priori weighting, parameter fixing and constrained parameter values) for dealing with identifiability and uniqueness problems are introduced and the results given. The method for the design of optimal inputs for identifying the parameters of linear dynamic systems is also given. The criterion used for the optimization is the sensitivity of the system output to the unknown parameters. Several simple examples are first given and then the results of an extensive stability and control dervative identification simulation for a C-8 aircraft are detailed.

Analyzing AQP Data to Improve Electronic Flight Bag (EFB) Operations and Training

NASA Technical Reports Server (NTRS)

Seamster, Thomas L.; Kanki, Barbara

2010-01-01

Key points include: Initiate data collection and analysis early in the implementation process. Use data to identify procedural and training refinements. Use a de-identified system to analyze longitudinal data. Use longitudinal I/E data to improve their standardization. Identify above average pilots and crews and use their performance to specify best practices. Analyze below average crew performance data to isolate problems with the training, evaluator standardization and pilot proficiency.

An efficient approach to improve the usability of e-learning resources: the role of heuristic evaluation.

PubMed

Davids, Mogamat Razeen; Chikte, Usuf M E; Halperin, Mitchell L

2013-09-01

Optimizing the usability of e-learning materials is necessary to maximize their potential educational impact, but this is often neglected when time and other resources are limited, leading to the release of materials that cannot deliver the desired learning outcomes. As clinician-teachers in a resource-constrained environment, we investigated whether heuristic evaluation of our multimedia e-learning resource by a panel of experts would be an effective and efficient alternative to testing with end users. We engaged six inspectors, whose expertise included usability, e-learning, instructional design, medical informatics, and the content area of nephrology. They applied a set of commonly used heuristics to identify usability problems, assigning severity scores to each problem. The identification of serious problems was compared with problems previously found by user testing. The panel completed their evaluations within 1 wk and identified a total of 22 distinct usability problems, 11 of which were considered serious. The problems violated the heuristics of visibility of system status, user control and freedom, match with the real world, intuitive visual layout, consistency and conformity to standards, aesthetic and minimalist design, error prevention and tolerance, and help and documentation. Compared with user testing, heuristic evaluation found most, but not all, of the serious problems. Combining heuristic evaluation and user testing, with each involving a small number of participants, may be an effective and efficient way of improving the usability of e-learning materials. Heuristic evaluation should ideally be used first to identify the most obvious problems and, once these are fixed, should be followed by testing with typical end users.

Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions.

PubMed

Lynch, Louise; Long, Maggie; Moorhead, Anne

2018-01-01

International research has identified young men as reluctant to seek help for mental health problems. This research explored barriers and solutions to professional help seeking for mental health problems among young men living in the North West of Ireland. A qualitative approach, using two focus groups with six participants each and five face-to-face interviews, was conducted with men aged 18 to 24 years (total N = 17). Data were analyzed using thematic analysis. Seven key themes of barriers to professional help seeking were identified: "acceptance from peers," "personal challenges," "cultural and environmental influences," "self-medicating with alcohol," "perspectives around seeking professional help," "fear of homophobic responses," and "traditional masculine ideals." Five key themes of solutions to these barriers included "tailored mental health advertising," "integrating mental health into formal education," "education through semiformal support services," "accessible mental health care," and "making new meaning." Interesting findings on barriers include fear of psychiatric medication, fear of homophobic responses from professionals, the legacy of Catholic attitudes, and the genuine need for care. This study offers an in-depth exploration of how young men experience barriers and uniquely offers solutions identified by participants themselves. Youth work settings were identified as a resource for engaging young men in mental health work. Young men can be encouraged to seek help if services and professionals actively address barriers, combining advertising, services, and education, with particular attention and respect to how and when young men seek help and with whom they want to share their problems.

Client-centred assessment and the identification of meaningful treatment goals for individuals with a spinal cord injury

PubMed Central

Donnelly, Catherine; Eng, Janice J; Hall, Jill; Alford, Lindsay; Giachino, Rob; Norton, Kathy; Kerr, Debbie Scott

2011-01-01

Study Design Retrospective analysis. Objectives 1) describe the self-care, productivity and leisure problems identified by individuals with a spinal cord injury during rehabilitation, 2) describe the perceived level of satisfaction and performance with self-care, productivity and leisure activities following a spinal cord injury, 3) quantify the relationship between the Canadian Occupational Performance Measure (COPM), a client-centred, individualized measure of function, and the Functional Independence Measure (FIM). Setting Tertiary rehabilitation centre, spinal cord injury unit, GF Strong Rehabilitation Centre, Vancouver, Canada. Methods Health records from 41 individuals with a SCI admitted between 2000 and 2002 were reviewed. Information was obtained from assessments performed on admission and discharge. Self-care, productivity and leisure problems identified by individuals with a SCI were described and their perceived level of performance and satisfaction was calculated. The relationship between the COPM and the FIM was measured by the Pearson product correlation. Results Self-care goals were identified most frequently (79%) followed by productivity (12%) and leisure (9%) goals. The top three problems identified by individuals with a SCI were functional mobility (including transfers and wheelchair use), dressing and grooming. A fair relationship was found between the COPM and the FIM (r between .351 to .514, p<.05) Conclusions The results highlight the importance of including a client-centred outcome measure in the assessment of individual’s with a SCI. Initial support is provided for use of the COPM in individuals with a SCI. PMID:14993893

A risk assessment methodology for critical transportation infrastructure.

DOT National Transportation Integrated Search

2002-01-01

Infrastructure protection typifies a problem of risk assessment and management in a large-scale system. This study offers a methodological framework to identify, prioritize, assess, and manage risks. It includes the following major considerations: (1...

Construction Boom Seen on Campuses over Next 5 Years.

ERIC Educational Resources Information Center

Evangelauf, Jean

1987-01-01

Campus construction is projected to boom as colleges and universities catch up on deferred maintenance and replace outdated classrooms and laboratories. Severe problems identified include roofs, heating systems, asbestos removal, and electical systems. (LB)

Retention and application of Skylab experiences to future programs. [a postflight review of technical programs.

NASA Technical Reports Server (NTRS)

Gillespie, V. G.; Kelly, R. O.

1974-01-01

The problems encountered and special techniques and procedures developed on the Skylab program are described along with the experiences and practical benefits obtained for dissemination and use on future programs. Three major topics are discussed: electrical problems, mechanical problems, and special techniques. Special techniques and procedures are identified that were either developed or refined during the Skylab program. These techniques and procedures came from all manufacturing and test phases of the Skylab program and include both flight and GSE items from component level to sophisticated spaceflight systems.

Towards a Methodology for Identifying Program Constraints During Requirements Analysis

NASA Technical Reports Server (NTRS)

Romo, Lilly; Gates, Ann Q.; Della-Piana, Connie Kubo

1997-01-01

Requirements analysis is the activity that involves determining the needs of the customer, identifying the services that the software system should provide and understanding the constraints on the solution. The result of this activity is a natural language document, typically referred to as the requirements definition document. Some of the problems that exist in defining requirements in large scale software projects includes synthesizing knowledge from various domain experts and communicating this information across multiple levels of personnel. One approach that addresses part of this problem is called context monitoring and involves identifying the properties of and relationships between objects that the system will manipulate. This paper examines several software development methodologies, discusses the support that each provide for eliciting such information from experts and specifying the information, and suggests refinements to these methodologies.

The Prevalence of Employed Nurses Identified or Enrolled in Substance Use Monitoring Programs

PubMed Central

Monroe, Todd B.; Kenaga, Heidi; Dietrich, Mary S.; Carter, Michael A.; Cowan, Ronald L.

2017-01-01

Background For over 100 years, nurses’ particular work conditions have been anecdotally associated with increases in substance abuse. Reasons include job-related stress and easy access to medications. Current research has suggested that prevalence of nurses with substance use problems is actually similar to, if not less than, that seen in the general population. However, given nurses’ proximity to critical patient care, the potential threat to public health, as well as the current shortage of practitioners and problems related to retention, the lack of research on the effectiveness of the two existing treatment protocols (disciplinary and alternative-to-discipline [ATD]) is a pressing issue of concern to the nursing profession. Objectives The aims of this study were to estimate the 1-year prevalence of employed nurses requiring an intervention for substance use problems in the United States and the 1-year prevalence of nurses enrolled in substance abuse monitoring programs and to compare the sum total of nurses identified in disciplinary and alternative programs with the general population. Methods This was a balanced stratified sampling design study. Measurements included the National Council of State Boards of Nursing 2010 Survey of Regulatory Boards Disciplinary Actions on Nurses, the 2009 annual reports of alternative programs, the 2008 National Sample Survey of Registered Nurses, and the 2009 National Survey on Drug Use and Health. Results The 2009 1-year prevalence of employed nurses identified with substance use problems in the United States and its territories was 17,085 or 0.51% of the employed nursing population. The 1-year prevalence of nurses newly enrolled in substance abuse monitoring programs in the United States and its territories was 12,060 or 0.36%. Although every National Council of State Boards of Nursing jurisdiction has a disciplinary monitoring program, only 73% (n = 43) of these jurisdictions have alternative programs. Despite this, on average, alternative programs had nearly 75% more new enrollees (9,715) when compared with disciplinary programs (2,345). The prevalence of nurses identified with a substance use problem requiring an intervention (and likely treatment) is lower than the prevalence of those who report receiving substance abuse treatment in the general population (0.51% vs. 1.0%). Conclusions The ATD programs potentially have a greater impact on protecting the public than disciplinary programs because ATD programs identify and/or enroll more nurses with substance use problems, thereby initially removing more nurses with substance use problems from direct patient care. PMID:22960589

Aspects of job scheduling

NASA Technical Reports Server (NTRS)

Phillips, K.

1976-01-01

A mathematical model for job scheduling in a specified context is presented. The model uses both linear programming and combinatorial methods. While designed with a view toward optimization of scheduling of facility and plant operations at the Deep Space Communications Complex, the context is sufficiently general to be widely applicable. The general scheduling problem including options for scheduling objectives is discussed and fundamental parameters identified. Mathematical algorithms for partitioning problems germane to scheduling are presented.

Report of the Power Sub systems Panel. [spacecraft instrumentation technology

NASA Technical Reports Server (NTRS)

1979-01-01

Problems in spacecraft power system design, testing, integration, and operation are identified and solutions are defined. The specific technology development problems discussed include substorm and plasma design data, modeling of the power subsystem and components, power system monitoring and degraded system management, rotary joints for transmission of power and signals, nickel cadmium battery manufacturing and application, on-array power management, high voltage technology, and solar arrays.

Defense Analysis: The Decision Process

DTIC Science & Technology

1985-07-01

problems ot resource allocation. Includes chapters on tormulating the problem, the research ettort, evaluation ot alternatives, interpretations of...Economics and Decision Making. He is a graduate of Colgate University (BA, Psychology) and received his Masters degree at the Naval Post Graduate School...Analysis 62 ’, ’The Steps irn Subject iye Aiuslysis 66 " Identify the Factors 66 Discusss the Factors 67 Evaluate Each Factor 67 Summa r y 68 Chapter VII

Weighty Problems: Predictors of Family Physicians Documenting Overweight and Obesity.

PubMed

Cyr, Peggy R; Haskins, Amy E; Holt, Christina; Hanifi, Jasmine

2016-03-01

Documenting obesity on the problem list has been shown to promote action about obesity and overweight, yet a majority of primary care providers do not record obesity on the medical problem list. With this in mind, our objectives were to determine the proportion of physicians' documentation of overweight (OW) or obesity on the problem list in our primary care teaching practice and to identify predictors of physician documentation of OW/obesity. De-identified health records of 6,195 adult patients with BMI ? 25 kg/m2 seen by a family physician over a 2-year period were included. Using multivariate logistic regression, patient age, BMI, gender, race, insurance, comorbidities, number of visits, physician gender or role, and practice site (suburban versus urban) were examined in relation to inclusion of OW/obesity on the medical problem list. Few (21.1%) patients had OW/obesity on their problem list. In the multivariate model, female PCPs were significantly more likely to document OW/obesity (OR=1.39, 95% CI=1.18--1.63) compared to male PCPs, and faculty were 26% more likely to document obesity (95% CI=1.07--1.48) compared to residents. Female patients, those with hypertension, diabetes, hyperlipidemia, and those with six or more visits were significantly more likely to have obesity on their problem lists, while patients with Medicaid were less likely to have obesity recorded. No significant difference was seen by race. Nearly 80% of OW and obese patients were not identified on the problem list. Patient gender, comorbidity, and number of visits were associated with documentation. Future research should examine automatic documentation of OW/obesity on the medical problem list.

The Unintended Consequences of Social Media in Healthcare: New Problems and New Solutions

PubMed Central

Atique, S.; Mayer, M. A.; Denecke, K.; Merolli, M.; Househ, M.

2016-01-01

Summary Objectives Social media is increasingly being used in conjunction with health information technology (health IT). The objective of this paper is to identify some of the undesirable outcomes that arise from this integration and to suggest solutions to these problems. Methodology After a discussion with experts to elicit the topics that should be included in the survey, we performed a narrative review based on recent literature and interviewed multidisciplinary experts from different areas. In each case, we identified and analyzed the unintended effects of social media in health IT. Results Each analyzed topic provided a different set of unintended consequences. Most relevant consequences include lack of privacy with ethical and legal issues, patient confusion in disease management, poor information accuracy in crowdsourcing, unclear responsibilities, misleading and biased information in the prevention and detection of epidemics, and demotivation in gamified health solutions with social components. Conclusions Using social media in healthcare offers several benefits, but it is not exempt of potential problems, and not all of these problems have clear solutions. We recommend careful design of digital systems in order to minimize patient’s feelings of demotivation and frustration and we recommend following specific guidelines that should be created by all stakeholders in the healthcare ecosystem. PMID:27830230

Design-Based Research on the Use of a Tangible User Interface for Geometry Teaching in an Inclusive Classroom

ERIC Educational Resources Information Center

Starcic, Andreja Istenic; Cotic, Mara; Zajc, Matej

2013-01-01

This design-based research study was conducted to identify what importance of a tangible user interface (TUI) can add to teaching and learning. Over a 2-year period, teachers ("n"?=?39) and students ("n"?=?145) participated in the study. The identified problem for investigation was how students, including those with low fine…

Oral health assessment and mouth care for children and young people receiving palliative care. Part one.

PubMed

Sargeant, Stephanie; Chamley, Carol

2013-03-01

This is the first part of two articles exploring oral health problems and treatments for children receiving palliative care, successful management of which can improve considerably the quality of life for this group of children and young people. Part one includes an adapted oral health assessment tool for use in children and young people with complex and palliative healthcare needs that has the potential to help nurses identify and monitor oral health problems and prevent or minimise oral problems from developing. Part two--to be published next month--focuses on basic oral hygiene and the management of specific oral health problems.

Respiratory problems in children with Down syndrome.

PubMed

Pandit, Chetan; Fitzgerald, Dominic A

2012-03-01

Down syndrome is associated with a significant health burden, which is particularly apparent in young children who will frequently present with cardiac and respiratory problems. Respiratory presentations include problems related to structural abnormalities of the airways and lungs, glue ears, recurrent lower respiratory tract infections and obstructive sleep apnoea. These conditions are readily identifiable and able to be treated. An awareness of the breadth of respiratory problems and a plan to monitor patients with Down syndrome for their development has the potential to improve outcomes. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Self report of skin problems among farmworkers in North Carolina.

PubMed

Vallejos, Quirina M; Schulz, Mark R; Quandt, Sara A; Feldman, Steven R; Galvan, Leonardo; Verma, Amit; Fleischer, Alan B; Rapp, Stephen R; Arcury, Thomas A

2008-03-01

This study estimates the prevalence of self-reported skin problems among Latino farmworkers and identifies associated risk factors. The study used a longitudinal surveillance design. Participants were interviewed up to five times and reported skin problems and personal, work, and environment characteristics. Frequencies and counts were calculated for 13 skin problems. Adjusted odds ratios were obtained for six skin problems. More than one-third of participants reported skin problems, including skin and nail fungus; sunburn; bumps, pimples, or acne; calluses; itching; rash; and insect bite. A variety of work and environment factors were associated with higher rates of skin problems. One of the strongest predictors was working in wet clothes or shoes. Programs are needed to educate farmworkers about measures they can take to decrease their risk of skin problems. Changes in work practices and personal protective equipment provided could help decrease the prevalence of skin problems.

Turkish and Moroccan Young Adults in the Netherlands: The Relationship Between Acculturation and Psychological Problems.

PubMed

Özbek, Emel; Bongers, Ilja L; Lobbestael, Jill; van Nieuwenhuizen, Chijs

2015-12-01

This study investigated the relationship between acculturation and psychological problems in Turkish and Moroccan young adults living in the Netherlands. A sample of 131 healthy young adults aged between 18 and 24 years old, with a Turkish or Moroccan background was recruited using snowball sampling. Data on acculturation, internalizing and externalizing problems, beliefs about psychological problems, attributions of psychological problems and barriers to care were collected and analyzed using Latent Class Analysis and multinomial logistic regression. Three acculturation classes were identified in moderately to highly educated, healthy Turkish or Moroccan young adults: integration, separation and diffusion. None of the participants in the sample were marginalized or assimilated. Young adults reporting diffuse acculturation reported more internalizing and externalizing problems than those who were integrated or separated. Separated young adults reported experiencing more practical barriers to care than integrated young adults. Further research with a larger sample, including young adult migrants using mental health services, is required to improve our understanding of acculturation, psychological problems and barriers to care in this population. Including experiences of discrimination in the model might improve our understanding of the relationship between different forms of acculturation and psychological problems.

Questionnaire design from a cross-cultural perspective: an empirical investigation of Koreans and non-Koreans.

PubMed

Willis, Gordon; Zahnd, Elaine

2007-11-01

A persistent challenge to self-report data across racial, ethnic, or cultural groups is the inherent difficulty of attaining cross-cultural comparability of key measures. The current research study investigated the cross-cultural functioning of health-survey questions presented to four groups: (1) Koreans who were monolingual in Korean; (2) non-Korean native speakers of English; (3) bilingual Koreans interviewed in English, and (4) bilingual Koreans interviewed in Korean. This design allowed us to include those likely to be medically underserved, and to assess both linguistic and cultural barriers to collecting health survey data. A total of 36 cognitive interviews were conducted to identify (a) translation problems; (b) problems of cultural adaptation that impede cross-cultural comparability; and (c) generic problems of questionnaire design that affect all groups. An important category of problems was identified that appeared to result from the interaction of respondent and question characteristics. Such problems can best be assessed through explicit consideration of the socio-cultural backgrounds of survey respondents, as opposed to the more usual focus on details of item translation and wording.

[Emotional regulation and motivation in children with ADHD].

PubMed

Høvik, Marie Farstad; Plessen, Kerstin J

2010-12-02

Impaired cognitive control functions have long been regarded as the main problem in the development of Attention-Deficit/Hyperactivity Disorder (ADHD). A more recent model emphasizes the importance of emotional and motivational problems. We have reviewed the evidence for this model, which may have important implications for clinical practice. The article is based on literature identified through a non-systematic search in PubMed. Although limited research was carried out in this topic earlier, studies are currently emerging. Persons with ADHD react differently than controls on tasks that include rewards and on tasks that stress their capacity to regulate emotions. Abnormal signals during examination with electroencephalography (EEG) and anatomical and functional magnetic resonance imaging (fMRI) reflect problems with emotional regulation in patients with ADHD. Neurobiological research supports a model that includes emotional and motivational problems in the development of ADHD. Increased knowledge about emotional and motivational problems may improve treatment of these patients through development of more individually adapted therapy.

Internet gaming addiction, problematic use of the internet, and sleep problems: a systematic review.

PubMed

Lam, Lawrence T

2014-04-01

The effect of problematic use of the Internet on mental health, particularly depression among young people, has been established but without a probable model for the underlying mechanism. In this study, a model is presented to describe possible pathways for the linkage between Internet gaming addiction and depression possibly mediated by sleep problems. A systematic review was conducted to gather epidemiological evidence to support or refute the link between addictive Internet gaming, problematic Internet use, and sleep problems including insomnia and poor sleep quality. Seven studies were identified through a systematic literature search, of these three related to addictive Internet gaming and four on problematic Internet uses and sleep problems. Information was extracted and analysed systematically from each of the studies and tabulated as a summary. Results of the review suggest that additive gaming, particularly massively multiplayer online role-playing games MMORPG, might be associated with poorer quality of sleep. Results further indicated that problematic Internet use was associated with sleep problems including subjective insomnia and poor sleep quality.

Penis Health: Identify and Prevent Problems

MedlinePlus

... might make this condition more likely. Changes in libido. Reduced desire for sex (libido) can be due to several conditions, including a ... or even depression. Significant and abrupt increases in libido, particularly in older men, might be due to ...

Allergies: The Key to Many Childhood Behavior Abnormalities.

ERIC Educational Resources Information Center

Vass, Molly; Rasmussen, Betty

1984-01-01

Describes the role of allergies in childhood behavior problems and discusses the role of school counselors in identifying allergic responses. Includes a list of references and resources on allergies, nutrition, support groups, and environmental care units. (JAC)

Methods to predict seasonal high water table (SHGWT) : final report.

DOT National Transportation Integrated Search

2017-04-03

The research study was sectioned into 5 separate tasks. Task 1 included defining the seasonal high ground water table (SHGWT); describing : methods and techniques used to determine SHGWTs; identify problems associated with estimating SHGWT conditions...

Environment.

ERIC Educational Resources Information Center

White, Gilbert F.

1980-01-01

Presented are perspectives on the emergence of environmental problems. Six major trends in scientific thinking are identified including: holistic approaches to examining environments, life support systems, resource management, risk assessment, streamlined methods for monitoring environmental change, and emphasis on the global framework. (Author/SA)

Political and legal implications of developing and operating a satellite power system

NASA Technical Reports Server (NTRS)

Hazelrigg, G. A., Jr.

1977-01-01

A number of political and legal implications of developing and operating a satellite power system (SPS) are identified and studied in this report. These include the vulnerability of SPS to actions of adversaries, communications impacts, the legality of an SPS in orbit including on-orbit military protection, alleviation of political concerns about deployment and operation of SPS, programmatic planning for SPS and the interaction of SPS with federal regulatory agencies and major departments. In comparing SPS to terrestrial power stations, it is seen that the political problems are neither clearly larger nor clearly smaller--they are clearly different and they are international in nature. If SPS is to become a reality these problems must be dealt with. Five major issues are identified. These must be resolved in order to obtain international acceptance of SPS. However, this study has found no insurmountable obstacles that would clearly prohibit the deployment, operation and protection of an SPS fleet.

The Relationship Between Psychological Distress, Negative Cognitions, and Expectancies on Problem Drinking: Exploring a Growing Problem Among University Students.

PubMed

Obasi, Ezemenari M; Brooks, Jessica J; Cavanagh, Lucia

2016-01-01

Few studies have sought to understand the concurrent relationship between cognitive and affective processes on alcohol use and negative alcohol-related consequences, despite both being identified as predictive risk factors in the college population. More research is needed to understand the relationships between identified factors of problem drinking among this at-risk population. The purpose of this study was to test if the relationship between psychological distress and problem drinking among university students (N = 284; M-age = 19.77) was mediated by negative affect regulation strategies and positive alcohol-related expectancies. Two latent mediation models of problem drinking were tested using structural equation modeling (SEM). The parsimonious three-path mediated latent model was supported by the data, as evidenced by several model fit indices. Furthermore, the alternate saturated model provided similar fit to the data, but contained several direct relationships that were not statistically significant. The relationship between psychological distress and problem drinking was mediated by an extended contributory chain, including negative affect regulation and positive alcohol-related expectancies. Implications for prevention and treatment, as well as future directions, are discussed. © The Author(s) 2015.

Identifying patient safety problems associated with information technology in general practice: an analysis of incident reports.

PubMed

Magrabi, Farah; Liaw, Siaw Teng; Arachi, Diana; Runciman, William; Coiera, Enrico; Kidd, Michael R

2016-11-01

To identify the categories of problems with information technology (IT), which affect patient safety in general practice. General practitioners (GPs) reported incidents online or by telephone between May 2012 and November 2013. Incidents were reviewed against an existing classification for problems associated with IT and the clinical process impacted. 87 GPs across Australia. Types of problems, consequences and clinical processes. GPs reported 90 incidents involving IT which had an observable impact on the delivery of care, including actual patient harm as well as near miss events. Practice systems and medications were the most affected clinical processes. Problems with IT disrupted clinical workflow, wasted time and caused frustration. Issues with user interfaces, routine updates to software packages and drug databases, and the migration of records from one package to another generated clinical errors that were unique to IT; some could affect many patients at once. Human factors issues gave rise to some errors that have always existed with paper records but are more likely to occur and cause harm with IT. Such errors were linked to slips in concentration, multitasking, distractions and interruptions. Problems with patient identification and hybrid records generated errors that were in principle no different to paper records. Problems associated with IT include perennial risks with paper records, but additional disruptions in workflow and hazards for patients unique to IT, occasionally affecting multiple patients. Surveillance for such hazards may have general utility, but particularly in the context of migrating historical records to new systems and software updates to existing systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The prevalence of obesity documentation in Primary Care Electronic Medical Records. Are we acknowledging the problem?

PubMed

Mattar, Ahmed; Carlston, David; Sariol, Glen; Yu, Tongle; Almustafa, Ahmad; Melton, Genevieve B; Ahmed, Adil

2017-01-25

Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI ≥ 30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese.

Adolescents from families of divorce: vulnerability to physiological and psychological disturbances.

PubMed

Thompson, P

1998-03-01

Multiple factors contribute to the vulnerability of adolescents to physiological and psychological disturbances following parental divorce. These include father absence, interparental conflict, economic distress, multiple life stressors, parent adjustment, and short-term crisis. Clinical and societal problems manifested in these vulnerable adolescents are discussed. Systems theory is used to explain this vulnerability of adolescents and to identify appropriate interventions and policies to promote health in this population. Policies recommended include required divorce mediation, early referrals for family and sibling therapy, and school programs to identify and support those most vulnerable.

Research design in end-of-life research: state of science.

PubMed

George, Linda K

2002-10-01

The volume of research on end-of-life care, death, and dying has exploded during the past decade. This article reviews the conceptual and methodological adequacy of end-of-life research to date, focusing on limitations of research to date and ways of improving future research. A systematic search was conducted to identify the base of end-of-life research. Approximately 400 empirical articles were identified and are the basis of this review. Although much has been learned from research to date, limitations in the knowledge base are substantial. The most fundamental problems identified are conceptual and include failure to define dying; neglect of the distinctions among quality of life, quality of death, and quality of end-of-life care. Methodologically, the single greatest problem is the lack of longitudinal studies that cover more than the time period immediately before death. Gaps in the research base include insufficient attention to psychological and spiritual issues, the prevalence of psychiatric disorder and the effectiveness of the treatment of such disorders among dying persons, provider and health system variables, social and cultural diversity, and the effects of comorbidity on trajectories of dying.

Progress in advanced high temperature materials technology

NASA Technical Reports Server (NTRS)

Freche, J. C.; Ault, G. M.

1976-01-01

Significant progress has recently been made in many high temperature material categories pertinent to such applications by the industrial community. These include metal matrix composites, superalloys, directionally solidified eutectics, coatings, and ceramics. Each of these material categories is reviewed and the current state-of-the-art identified, including some assessment, when appropriate, of progress, problems, and future directions.

Problem solving strategies used by RN-to-BSN students in an online problem-based learning course.

PubMed

Oldenburg, Nancy L; Hung, Wei-Chen

2010-04-01

It is essential that nursing students develop the problem solving and critical thinking skills required in the current health care environment. Problem-based learning has been promoted as a way to help students acquire those skills; however, gaps exist in the knowledge base of the strategies used by learners. The purpose of this case study was to gain insight into the problem solving experience of a group of six RN-to-BSN students in an online problem-based learning course. Data, including discussion transcripts, reflective papers, and interview transcripts, were analyzed using a qualitative approach. Students expanded their use of resources and resolved the cases, identifying relevant facts and clinical applications. They had difficulty communicating their findings, establishing the credibility of sources, and offering challenging feedback. Increased support and direction are needed to facilitate the development of problem solving abilities of students in the problem-based learning environment.

[Ethical problems experienced by nurses in primary health care: integrative literature review].

PubMed

Nora, Carlise Rigon Dalla; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida

2015-03-01

The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.

Behavioral health needs and problem recognition by older adults receiving home-based aging services.

PubMed

Gum, Amber M; Petkus, Andrew; McDougal, Sarah J; Present, Melanie; King-Kallimanis, Bellinda; Schonfeld, Lawrence

2009-04-01

Older adults' recognition of a behavioral health need is one of the strongest predictors of their use of behavioral health services. Thus, study aims were to examine behavioral health problems in a sample of older adults receiving home-based aging services, their recognition of behavioral health problems, and covariates of problem recognition. The study design was cross-sectional. Older adults (n = 141) receiving home-based aging services completed interviews that included: Structured Clinical Interview for DSM-IV; Brief Symptom Inventory-18; attitudinal scales of stigma, expectations regarding aging, and thought suppression; behavioral health treatment experience; and questions about recognition of behavioral health problems. Thirty (21.9%) participants received an Axis I diagnosis (depressive, anxiety, or substance); another 17 (12.1%) were diagnosed with an adjustment disorder. Participants were more likely to recognize having a problem if they had an Axis I diagnosis, more distress on the BSI-18, family member or friend with a behavioral health problem, and greater thought suppression. In logistic regression, participants who identified a family member or friend with a behavioral health problem were more likely to identify having a behavioral health problem themselves. Findings suggest that older adults receiving home-based aging services who recognize behavioral health problems are more likely to have a psychiatric diagnosis or be experiencing significant distress, and they are more familiar with behavioral health problems in others. This familiarity may facilitate treatment planning; thus, older adults with behavioral health problems who do not report familiarity of problems in others likely require additional education. (c) 2008 John Wiley & Sons, Ltd.

Large-scale brain network associated with creative insight: combined voxel-based morphometry and resting-state functional connectivity analyses.

PubMed

Ogawa, Takeshi; Aihara, Takatsugu; Shimokawa, Takeaki; Yamashita, Okito

2018-04-24

Creative insight occurs with an "Aha!" experience when solving a difficult problem. Here, we investigated large-scale networks associated with insight problem solving. We recruited 232 healthy participants aged 21-69 years old. Participants completed a magnetic resonance imaging study (MRI; structural imaging and a 10 min resting-state functional MRI) and an insight test battery (ITB) consisting of written questionnaires (matchstick arithmetic task, remote associates test, and insight problem solving task). To identify the resting-state functional connectivity (RSFC) associated with individual creative insight, we conducted an exploratory voxel-based morphometry (VBM)-constrained RSFC analysis. We identified positive correlations between ITB score and grey matter volume (GMV) in the right insula and middle cingulate cortex/precuneus, and a negative correlation between ITB score and GMV in the left cerebellum crus 1 and right supplementary motor area. We applied seed-based RSFC analysis to whole brain voxels using the seeds obtained from the VBM and identified insight-positive/negative connections, i.e. a positive/negative correlation between the ITB score and individual RSFCs between two brain regions. Insight-specific connections included motor-related regions whereas creative-common connections included a default mode network. Our results indicate that creative insight requires a coupling of multiple networks, such as the default mode, semantic and cerebral-cerebellum networks.

Problems related to the integration of fault tolerant aircraft electronic systems

NASA Technical Reports Server (NTRS)

Bannister, J. A.; Adlakha, V.; Triyedi, K.; Alspaugh, T. A., Jr.

1982-01-01

Problems related to the design of the hardware for an integrated aircraft electronic system are considered. Taxonomies of concurrent systems are reviewed and a new taxonomy is proposed. An informal methodology intended to identify feasible regions of the taxonomic design space is described. Specific tools are recommended for use in the methodology. Based on the methodology, a preliminary strawman integrated fault tolerant aircraft electronic system is proposed. Next, problems related to the programming and control of inegrated aircraft electronic systems are discussed. Issues of system resource management, including the scheduling and allocation of real time periodic tasks in a multiprocessor environment, are treated in detail. The role of software design in integrated fault tolerant aircraft electronic systems is discussed. Conclusions and recommendations for further work are included.

Demonstration of Human-Autonomy Teaming Principles

NASA Technical Reports Server (NTRS)

Shively, Robert Jay

2016-01-01

Known problems with automation include lack of mode awareness, automation brittleness, and risk of miscalibrated trust. Human-Autonomy Teaming (HAT) is essential for improving these problems. We have identified some critical components of HAT and ran a part-task study to introduce these components to a ground station that supports flight following of multiple aircraft. Our goal was to demonstrate, evaluate, and refine HAT principles. This presentation provides a brief summary of the study and initial findings.

Identifying Problems Affecting Adult Literacy Training Programs in the Cento Region; Report of the CENTO Seminar on Illiteracy Held in the National Museum, Tehran, Nov. 16-21, 1963.

ERIC Educational Resources Information Center

Luebke, Paul T., Ed.

This volume is the report of the proceedings of a seminar on adult education held in Tehran, Iran. The twelve papers included discuss such topics as adult literacy programs in Iran, literacy in Turkey, adult literacy problems and programs of Pakistan, the purpose of literacy training, defining literacy, planning literacy training programs,…

Music Information Retrieval.

ERIC Educational Resources Information Center

Downie, J. Stephen

2003-01-01

Identifies MIR (Music Information Retrieval) computer system problems, historic influences, current state-of-the-art, and future MIR solutions through an examination of the multidisciplinary approach to MIR. Highlights include pitch; temporal factors; harmonics; tone; editorial, textual, and bibliographic facets; multicultural factors; locating…

33 CFR 332.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... following terms are defined: Adaptive management means the development of a management strategy that... guides modification of those projects to optimize performance. It includes the selection of appropriate... monitoring results to identify potential problems of a compensatory mitigation project and the identification...

Future management strategies for state maintained wetlands and stream mitigation sites.

DOT National Transportation Integrated Search

2008-06-01

This study was to identify existing wetland/stream mitigation sites owned by the Kentucky Transportation Cabinet (KYTC) and assess performance of those sites including problems encountered and maintenance costs. Initial work determined that KYTC Dist...

Using case studies to teach an engineering technology technical writing class

NASA Technical Reports Server (NTRS)

Green, M. M.

1981-01-01

The use of the case method in teaching various technical communication skills is described. Features of the method considered include: solving communication problems, identifying an audience, planning written communications, presenting written communications, and using visual aids.

42 CFR 422.503 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... activities, the furnishing of services, the quality improvement program, and the administrative and... program, including but not limited to reporting potential issues, investigating issues, conducting self... raised, investigating potential compliance problems as identified in the course of self-evaluations and...

Deficiency of Self-Efficacy in Problem-Solving as a Contributory Factor in Family Instability: A Qualitative Study.

PubMed

Pourmovahed, Zahra; Mazloomy Mahmoodabad, Seyed Saied; Zareei Mahmoodabadi, Hassan; Tavangar, Hossein; Yassini Ardekani, Seyed Mojtaba; Vaezi, Ali Akbar

2018-01-01

Objective: Problem-solving ability is one of the most important means of family stability that enables the families to understand their roles, functions, and performances. Self-efficacy deficiency in problem-solving runs through many families. This qualitative study was conducted to investigate and describe how couples solve problems in their families. Method: This study was conducted to detect couples' self-efficacy deficiency in problem-solving using purposive sampling method. Several deep semi-structured interviews based on McMaster model and observations were conducted by nine family therapists and psychiatrists on four couples (eight persons) living in Yazd (Iran).The interviews were performed, audio-recorded, and transcribed verbatim. The analysis was interpreted through directed content analysis methods. Results: Families in Yazd (Iran) made some attempts to solve their problems, but their efforts were not enough, and thus they suffered from self-efficacy deficiency, which included 8 categories. The main theme distilled from the data of 17 participants was self-efficacy deficiency, which included the following categories: avoidance, insolvency, interference from others, ineffective self-treatment, behavioral problems, stubbornness, superficiality, and denial. Conclusion: It is of paramount importance to identify self-efficacy deficiency in families and promote problem- solving programs to increase family stability. In the present study, the main deficiencies in problem-solving were detected.

Hybrid Genetic Algorithm - Local Search Method for Ground-Water Management

NASA Astrophysics Data System (ADS)

Chiu, Y.; Nishikawa, T.; Martin, P.

2008-12-01

Ground-water management problems commonly are formulated as a mixed-integer, non-linear programming problem (MINLP). Relying only on conventional gradient-search methods to solve the management problem is computationally fast; however, the methods may become trapped in a local optimum. Global-optimization schemes can identify the global optimum, but the convergence is very slow when the optimal solution approaches the global optimum. In this study, we developed a hybrid optimization scheme, which includes a genetic algorithm and a gradient-search method, to solve the MINLP. The genetic algorithm identifies a near- optimal solution, and the gradient search uses the near optimum to identify the global optimum. Our methodology is applied to a conjunctive-use project in the Warren ground-water basin, California. Hi- Desert Water District (HDWD), the primary water-manager in the basin, plans to construct a wastewater treatment plant to reduce future septic-tank effluent from reaching the ground-water system. The treated wastewater instead will recharge the ground-water basin via percolation ponds as part of a larger conjunctive-use strategy, subject to State regulations (e.g. minimum distances and travel times). HDWD wishes to identify the least-cost conjunctive-use strategies that control ground-water levels, meet regulations, and identify new production-well locations. As formulated, the MINLP objective is to minimize water-delivery costs subject to constraints including pump capacities, available recharge water, water-supply demand, water-level constraints, and potential new-well locations. The methodology was demonstrated by an enumerative search of the entire feasible solution and comparing the optimum solution with results from the branch-and-bound algorithm. The results also indicate that the hybrid method identifies the global optimum within an affordable computation time. Sensitivity analyses, which include testing different recharge-rate scenarios, pond layouts, and water-supply constraints, indicate that the number of new wells is insensitive to water-supply constraints; however, pumping rates and patterns of the existing wells are sensitive. The locations of new wells are mildly sensitive to the pond layout.

Early risk and protective factors for problem gambling: A systematic review and meta-analysis of longitudinal studies.

PubMed

Dowling, N A; Merkouris, S S; Greenwood, C J; Oldenhof, E; Toumbourou, J W; Youssef, G J

2017-02-01

This systematic review aimed to identify early risk and protective factors (in childhood, adolescence or young adulthood) longitudinally associated with the subsequent development of gambling problems. A systematic search of peer-reviewed and grey literature from 1990 to 2015 identified 15 studies published in 23 articles. Meta-analyses quantified the effect size of 13 individual risk factors (alcohol use frequency, antisocial behaviours, depression, male gender, cannabis use, illicit drug use, impulsivity, number of gambling activities, problem gambling severity, sensation seeking, tobacco use, violence, undercontrolled temperament), one relationship risk factor (peer antisocial behaviours), one community risk factor (poor academic performance), one individual protective factor (socio-economic status) and two relationship protective factors (parent supervision, social problems). Effect sizes were on average small to medium and sensitivity analyses revealed that the results were generally robust to the quality of methodological approaches of the included articles. These findings highlight the need for global prevention efforts that reduce risk factors and screen young people with high-risk profiles. There is insufficient investigation of protective factors to adequately guide prevention initiatives. Future longitudinal research is required to identify additional risk and protective factors associated with problem gambling, particularly within the relationship, community, and societal levels of the socio-ecological model. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Development and validation of the hypoglycaemia problem-solving scale for people with diabetes mellitus

PubMed Central

Juang, Jyuhn-Huarng; Lin, Chia-Hung

2016-01-01

Objective To develop and psychometrically test a new instrument, the hypoglycaemia problem-solving scale (HPSS), which was designed to measure how well people with diabetes mellitus manage their hypoglycaemia-related problems. Methods A cross-sectional survey design approach was used to validate the performance assessment instrument. Patients who had a diagnosis of type 1 or type 2 diabetes mellitus for at least 1 year, who were being treated with insulin and who had experienced at least one hypoglycaemic episode within the previous 6 months were eligible for inclusion in the study. Results A total of 313 patients were included in the study. The initial draft of the HPSS included 28 items. After exploratory factor analysis, the 24-item HPSS consisted of seven factors: problem-solving perception, detection control, identifying problem attributes, setting problem-solving goals, seeking preventive strategies, evaluating strategies, and immediate management. The Cronbach’s α for the total HPSS was 0.83. Conclusions The HPSS was verified as being valid and reliable. Future studies should further test and improve the instrument to increase its effectiveness in helping people with diabetes manage their hypoglycaemia-related problems. PMID:27059292

Development and validation of the hypoglycaemia problem-solving scale for people with diabetes mellitus.

PubMed

Wu, Fei-Ling; Juang, Jyuhn-Huarng; Lin, Chia-Hung

2016-06-01

To develop and psychometrically test a new instrument, the hypoglycaemia problem-solving scale (HPSS), which was designed to measure how well people with diabetes mellitus manage their hypoglycaemia-related problems. A cross-sectional survey design approach was used to validate the performance assessment instrument. Patients who had a diagnosis of type 1 or type 2 diabetes mellitus for at least 1 year, who were being treated with insulin and who had experienced at least one hypoglycaemic episode within the previous 6 months were eligible for inclusion in the study. A total of 313 patients were included in the study. The initial draft of the HPSS included 28 items. After exploratory factor analysis, the 24-item HPSS consisted of seven factors: problem-solving perception, detection control, identifying problem attributes, setting problem-solving goals, seeking preventive strategies, evaluating strategies, and immediate management. The Cronbach's α for the total HPSS was 0.83. The HPSS was verified as being valid and reliable. Future studies should further test and improve the instrument to increase its effectiveness in helping people with diabetes manage their hypoglycaemia-related problems. © The Author(s) 2016.

Workplace problems and solutions for employees with chronic diseases.

PubMed

Varekamp, I; van Dijk, F J H

2010-06-01

While many employees who have a chronic disease manage their jobs well, others are hampered in work performance, experience work-related problems and are at risk for job loss. To identify the practical and psychosocial barriers recognized by employees with chronic disease who experience work-related problems and to examine preferred work accommodations. A questionnaire was sent by mail and completed by current workers who have a chronic disease and experience serious problems at work. One hundred and twenty-two employees participated in this study. On average, they had been ill for 10 years and 44% had more than one disease. The most outstanding work-related problems were psychosocial, including work-home interference and a lack of acceptance of the chronic disease. Performing and finishing work tasks and social relationships with supervisors or colleagues were also felt to be slightly problematic. The most preferred work accommodations included fewer work hours, working from home, a slower work pace and more autonomy in planning work tasks. Almost three-quarters of the respondents were so fatigued that they were at risk of sickness absence or work disability. A chronic physical disease may lead to both practical and psychosocial problems and serious fatigue. Managing psychosocial problems may decrease fatigue.

Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting.

PubMed

Dray, Julia; Bowman, Jenny; Campbell, Elizabeth; Freund, Megan; Wolfenden, Luke; Hodder, Rebecca K; McElwaine, Kathleen; Tremain, Danika; Bartlem, Kate; Bailey, Jacqueline; Small, Tameka; Palazzi, Kerrin; Oldmeadow, Christopher; Wiggers, John

2017-10-01

To examine the effect of universal, school-based, resilience-focused interventions on mental health problems in children and adolescents. Eligible studies were randomized controlled trials (RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015. Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child: 5-10 years; adolescent: 11-18 years), length of follow-up (short: post-≤12 months; long: >12 months), and gender (narrative). A total of 57 included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up, interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. The findings may suggest most promise for using universal resilience-focused interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups, the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains an important area for future research. Systematic Review of Universal Resilience Interventions Targeting Child and Adolescent Mental Health in the School Setting; http://dx.doi.org/10.1186/s13643-015-0172-6; PROSPERO CRD42015025908. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Using Community-Based Participatory Research to Identify Environmental Justice Issues in an Inner-City Community and Inform Urban Planning.

PubMed

Mansyur, Carol Leler; Jeng, Hueiwang Anna; Holloman, Erica; DeBrew, Linwood

2016-01-01

The Southeast CARE Coalition has been using community-based participatory research to examine environmental degradation in the Southeast Community, Newport News, Virginia. A survey was developed to collect assessment data. Up to 66% of respondents were concerned about environmental problems in their community. Those with health conditions were significantly more likely to identify specific environmental problems. The top 5 environmental concerns included coal dust, air quality, crime, water quality, and trash. The community-based participatory research process is building community capacity and participation, providing community input into strategic planning, and empowering community members to take control of environmental justice issues in their community.

The application of remote sensing techniques to selected inter and intra urban data acquisition problems

NASA Technical Reports Server (NTRS)

Horton, F. E.

1970-01-01

The utility of remote sensing techniques to urban data acquisition problems in several distinct areas was identified. This endeavor included a comparison of remote sensing systems for urban data collection, the extraction of housing quality data from aerial photography, utilization of photographic sensors in urban transportation studies, urban change detection, space photography utilization, and an application of remote sensing techniques to the acquisition of data concerning intra-urban commercial centers. The systematic evaluation of variable extraction for urban modeling and planning at several different scales, and the model derivation for identifying and predicting economic growth and change within a regional system of cities are also studied.

The risk factors of laryngeal pathology in Korean adults using a decision tree model.

PubMed

Byeon, Haewon

2015-01-01

The purpose of this study was to identify risk factors affecting laryngeal pathology in the Korean population and to evaluate the derived prediction model. Cross-sectional study. Data were drawn from the 2008 Korea National Health and Nutritional Examination Survey. The subjects were 3135 persons (1508 male and 2114 female) aged 19 years and older living in the community. The independent variables were age, sex, occupation, smoking, alcohol drinking, and self-reported voice problems. A decision tree analysis was done to identify risk factors for predicting a model of laryngeal pathology. The significant risk factors of laryngeal pathology were age, gender, occupation, smoking, and self-reported voice problem in decision tree model. Four significant paths were identified in the decision tree model for the prediction of laryngeal pathology. Those identified as high risk groups for laryngeal pathology included those who self-reported a voice problem, those who were males in their 50s who did not recognize a voice problem, those who were not economically active males in their 40s, and male workers aged 19 and over and under 50 or 60 and over who currently smoked. The results of this study suggest that individual risk factors, such as age, sex, occupation, health behavior, and self-reported voice problem, affect the onset of laryngeal pathology in a complex manner. Based on the results of this study, early management of the high-risk groups is needed for the prevention of laryngeal pathology. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Identifying Children in Middle Childhood Who Are at Risk for Reading Problems.

PubMed

Speece, Deborah L; Ritchey, Kristen D; Silverman, Rebecca; Schatschneider, Christopher; Walker, Caroline Y; Andrusik, Katryna N

2010-06-01

The purpose of this study was to identify and evaluate a universal screening battery for reading that is appropriate for older elementary students in a response to intervention model. Multiple measures of reading and reading correlates were administered to 230 fourth-grade children. Teachers rated children's reading skills, academic competence, and attention. Children were classified as not-at-risk or at-risk readers based on a three-factor model reflecting reading comprehension, word recognition/decoding, and word fluency. Predictors of reading status included group-administered tests of reading comprehension, silent word reading fluency, and teacher ratings of reading problems. Inclusion of individually administered tests and growth estimates did not add substantial variance. The receiver-operator characteristic curve analysis yielded an area under the curve index of 0.90, suggesting this model may both accurately and efficiently screen older elementary students with reading problems.

Alcohol use and cultural change in an indigenous population: a case study from Venezuela.

PubMed

Seale, J Paul; Shellenberger, Sylvia; Rodriguez, Carlos; Seale, Josiah D; Alvarado, Manuel

2002-01-01

To explore the historical and cultural context of problem drinking in a Latin American indigenous population and identify possible areas for intervention. Focus group discussions. Participants reported that prior to 1945, binge drinking and fighting were part of cultural festivals held several times each year. Alcohol was brewed in limited quantities by specially qualified individuals. Limited family violence and injuries resulted. Increasing contact with Western civilization resulted in year-round access to large supplies of commercial alcohol and exposure to alcohol-misusing role models. Increased heavy drinking and decreases in subsistence farming resulted in escalation of problems, including hunger, serious injury, family violence, divorce and legal problems. Communities are beginning to regain control by prohibiting sale of alcohol in villages, sponsoring alcohol-free celebrations, and increasing involvement in religious activities. Though alcohol may cause devastating consequences in cultures in transition, studies of community responses may identify useful strategies for reducing alcohol-related harm.

Drug-related problems and pharmacist interventions in a cohort of patients with asthma and chronic obstructive pulmonary disease.

PubMed

Apikoglu-Rabus, Sule; Yesilyaprak, Gozde; Izzettin, Fikret Vehbi

2016-11-01

Asthma and chronic obstructive pulmonary disease are preventable and treatable chronic airway diseases with high incidence and prevalence. Pharmacists and clinical pharmacy based pharmaceutical care services have positive impact on therapy outcomes. The aim of this study is to describe drug related problems in a cohort of patients with asthma and chronic obstructive pulmonary disease and to assess interventions provided by the pharmacist to address these problems in a community pharmacy. Study population consisted of patients with asthma and chronic obstructive pulmonary disease older than 18 years who visited the study pharmacy during the pre-determined six-month period. The patients whose disease control states were "not fully controlled" were included in our study for further steps. On the first interview, present and potential drug related problems were addressed, interventions were provided. Follow-up interviews were held one month and two months later than the first interview. For the 44 patients with asthma, 59 drug-related problems and 134 causes for these problems were identified. Eighty-four interventions were made to resolve the problems; and 54.2% of the problems were resolved. For the 37 patients with chronic obstructive pulmonary disease, 60 drug-related problems and 128 causes for these problems were identified. Ninety-five interventions were made to resolve the problems; and 63.3% of the problems were resolved. Pharmacists taking part in therapy and management of asthma and chronic obstructive pulmonary disease can help patients be more educated about their disease and medications; and improve disease control and therapy outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluating the effectiveness of a training program that builds teachers’ capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study

PubMed Central

2014-01-01

Background In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers’ ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers’ capability in this area. Methods To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Results Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems alone. At least 50.0% of teachers learned to identify hypothetical cases as problematic and to make the appropriate referral, and 60.0% of teachers who before training could not identify normal adolescence learned to do so. Conclusions The strategy was partially effective but could be improved mainly by extending its duration, and including discussion of actual cases. PMID:24580750

Evaluating the effectiveness of a training program that builds teachers' capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study.

PubMed

Vieira, Marlene A; Gadelha, Ary A; Moriyama, Taís S; Bressan, Rodrigo A; Bordin, Isabel A

2014-02-28

In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers' ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers' capability in this area. To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems alone. At least 50.0% of teachers learned to identify hypothetical cases as problematic and to make the appropriate referral, and 60.0% of teachers who before training could not identify normal adolescence learned to do so. The strategy was partially effective but could be improved mainly by extending its duration, and including discussion of actual cases.

Manufacturing process applications team (MATeam)

NASA Technical Reports Server (NTRS)

Bangs, E. R.; Meyer, J. D.

1978-01-01

Activities of the manufacturing applications team (MATeam) in effecting widespread transfer of NASA technology to aid in the solution of manufacturing problems in the industrial sector are described. During the program's first year of operation, 450 companies, industry associations, and government agencies were contacted, 150 manufacturing problems were documented, and 20 potential technology transfers were identified. Although none of the technology transfers has been commercialized and put in use, several are in the applications engineering phase, and others are in the early stages of implementation. The technology transfer process is described and guidelines used for the preparation of problems statements are included.

BioPreDyn-bench: a suite of benchmark problems for dynamic modelling in systems biology.

PubMed

Villaverde, Alejandro F; Henriques, David; Smallbone, Kieran; Bongard, Sophia; Schmid, Joachim; Cicin-Sain, Damjan; Crombach, Anton; Saez-Rodriguez, Julio; Mauch, Klaus; Balsa-Canto, Eva; Mendes, Pedro; Jaeger, Johannes; Banga, Julio R

2015-02-20

Dynamic modelling is one of the cornerstones of systems biology. Many research efforts are currently being invested in the development and exploitation of large-scale kinetic models. The associated problems of parameter estimation (model calibration) and optimal experimental design are particularly challenging. The community has already developed many methods and software packages which aim to facilitate these tasks. However, there is a lack of suitable benchmark problems which allow a fair and systematic evaluation and comparison of these contributions. Here we present BioPreDyn-bench, a set of challenging parameter estimation problems which aspire to serve as reference test cases in this area. This set comprises six problems including medium and large-scale kinetic models of the bacterium E. coli, baker's yeast S. cerevisiae, the vinegar fly D. melanogaster, Chinese Hamster Ovary cells, and a generic signal transduction network. The level of description includes metabolism, transcription, signal transduction, and development. For each problem we provide (i) a basic description and formulation, (ii) implementations ready-to-run in several formats, (iii) computational results obtained with specific solvers, (iv) a basic analysis and interpretation. This suite of benchmark problems can be readily used to evaluate and compare parameter estimation methods. Further, it can also be used to build test problems for sensitivity and identifiability analysis, model reduction and optimal experimental design methods. The suite, including codes and documentation, can be freely downloaded from the BioPreDyn-bench website, https://sites.google.com/site/biopredynbenchmarks/ .

Seeking a rapprochement between anthropology and the cognitive sciences: a problem-driven approach.

PubMed

Whitehouse, Harvey; Cohen, Emma

2012-07-01

Beller, Bender, and Medin question the necessity of including social anthropology within the cognitive sciences. We argue that there is great scope for fruitful rapprochement while agreeing that there are obstacles (even if we might wish to debate some of those specifically identified by Beller and colleagues). We frame the general problem differently, however: not in terms of the problem of reconciling disciplines and research cultures, but rather in terms of the prospects for collaborative deployment of expertise (methodological and theoretical) in problem-driven research. For the purposes of illustration, our focus in this article is on the evolution of cooperation. Copyright © 2012 Cognitive Science Society, Inc.

Commonalities in Transportation Fire Safety : Regulations, Research and Development, and Data Bases

DOT National Transportation Integrated Search

1980-01-01

This report presents a comprehensive review of current modal fire safety efforts within the U.S. Department of Transportation. Common fire safety problems and modal administration response are identified. Work completed includes a review of modal adm...

Discrepancy Between Preparation and Practice in Teacher Education: An Ecuadorian Study.

ERIC Educational Resources Information Center

Boulianne, Real; Weston, Cynthia

1987-01-01

Survey responses of over 200 graduates regarding the content of a teacher preparation program at a university in Ecuador indicated a significant gap between preparation and practice. Major problems identified included content emphasis and implementation. (Author/CB)

Commercial and Residential Water Damage: The Mold Connection.

ERIC Educational Resources Information Center

Williams, Del

2002-01-01

Describes the problem of toxic mold in residential and commercial property resulting from excess moisture. Includes common sources of unwanted moisture, design and construction flaws, determining the presence of mold, and advice for identifying and hiring reputable mold remediators. (PKP)

Role of the employee assistance program in helping the troubled worker.

PubMed

Fitzgerald, S T; Hammond, S C; Harder, K A

1989-01-01

The worksite has been identified as the most logical setting for providing primary preventive health care efforts that will reduce health care costs. Hazeldon Research Services in their review entitled, "The Cost-Impact of Employee Assistance and Chemical Dependency Treatment Programs," concluded that a significant savings for organizations has been demonstrated by EAP treatment programs. This group also concluded that work remains for service providers, the community, industry, and government to identify the balance between reasonable costs and quality of care. Roman has found that EAPs are becoming more acceptable to management as a means of addressing a broad range of employee problems. In addition, Roman has found that there is recognition by management that many employees have problems that affect job performance. Such problems may include substance abuse, relationship difficulties, absenteeism, and burnout. EAP services have evolved from occupational alcoholism programs to include a broad array of services, and they can be scaled to fit the size and needs of a particular company. Even if only limited services are offered, the EAP must adhere to high standards. Competent employee evaluation and appropriate referrals are necessary in EAPs with even the smallest of scopes.

Severe physical punishment: risk of mental health problems for poor urban children in Brazil

PubMed Central

Duarte, Cristiane S; Peres, Clovis A; Nascimento, Rosimeire; Curto, Bartira M; Paula, Cristiane S

2009-01-01

Abstract Objective To examine the relationship between specific types of child mental health problems and severe physical punishment, in combination with other important known risk factors. Methods We conducted a cross-sectional study in Embu, São Paulo, Brazil, as the Brazilian component of a multicountry survey on abuse in the family environment. From a probabilistic sample of clusters that included all eligible households (women aged 15–49 years with a son or daughter < 18 years of age), we randomly selected one mother–child pair per household (n = 813; attrition rate: 17.6%). This study focused on children aged 6–17 years (n = 480). Child Behaviour Checklist CBCL/6–18 was used to identify children with internalizing problems only, externalizing problems only, and both internalizing and externalizing problems (comorbidity). Severe physical punishment was defined as being hit with an object, being kicked, choked, smothered, burnt, scalded, branded, beaten or threatened with a weapon. We examined other potential correlates from four domains: child (gender, age, ever witnessing marital violence); mother (education, unemployment, anxiety or depression, marital violence); father (absence, drunkenness); and family (socioeconomic status). The WHO Self-Reporting Questionnaire (SRQ-20) was used to identify maternal anxiety or depression (score > 7). Backward logistic regression analysis identified independent correlates and significant interactions. Findings Multivariate modelling showed that severe punishment was an independent correlate of comorbid internalizing and externalizing problems but was not associated with internalizing problems only. It increased the risk of externalizing problems alone only for children and adolescents not exposed to maternal anxiety or depression. Maternal anxiety or depression increased the risk only for children or adolescents not exposed to severe punishment. Conclusion Severe punishment may be related to child mental health problems, with the mechanism depending on the type of problem. Its influence persists in the presence of family stressors such as the father’s absence and maternal anxiety or depression. PMID:19551251

Strategies for Limiting Engineers' Potential Liability for Indoor Air Quality Problems.

PubMed

von Oppenfeld, Rolf R; Freeze, Mark E; Sabo, Sean M

1998-10-01

Engineers face indoor air quality (IAQ) issues at the design phase of building construction as well as during the investigation and mitigation of potential indoor air pollution problems during building operation. IAQ issues that can be identified are "building-related illnesses" that may include problems of volatile organic compounds (VOCs). IAQ issues that cannot be identified are termed "sick building syndrome." Frequently, microorganism-caused illnesses are difficult to confirm. Engineers who provide professional services that directly or indirectly impact IAQ face significant potential liability to clients and third parties when performing these duties. Potential theories supporting liability claims for IAQ problems against engineers include breach of contract and various common law tort theories such as negligence and negligent misrepresentation. Furthermore, an increasing number of federal, state, and local regulations affect IAQ issues and can directly increase the potential liability of engineers. A duty to disclose potential or actual air quality concerns to third parties may apply for engineers in given circumstances. Such a duty may arise from judicial precedent, the Model Guide for Professional Conduct for Engineers, or the Code of Ethics for Engineers. Practical strategies engineers can use to protect themselves from liability include regular training and continuing education in relevant regulatory, scientific, and case law developments; detailed documentation and recordkeeping practices; adequate insurance coverage; contractual indemnity clauses; contractual provisions limiting liability to the scope of work performed; and contractual provisions limiting the extent of liability for engineers' negligence. Furthermore, through the proper use of building materials and construction techniques, an engineer or other design professional can effectively limit the potential for IAQ liability.

Parameter estimation using meta-heuristics in systems biology: a comprehensive review.

PubMed

Sun, Jianyong; Garibaldi, Jonathan M; Hodgman, Charlie

2012-01-01

This paper gives a comprehensive review of the application of meta-heuristics to optimization problems in systems biology, mainly focussing on the parameter estimation problem (also called the inverse problem or model calibration). It is intended for either the system biologist who wishes to learn more about the various optimization techniques available and/or the meta-heuristic optimizer who is interested in applying such techniques to problems in systems biology. First, the parameter estimation problems emerging from different areas of systems biology are described from the point of view of machine learning. Brief descriptions of various meta-heuristics developed for these problems follow, along with outlines of their advantages and disadvantages. Several important issues in applying meta-heuristics to the systems biology modelling problem are addressed, including the reliability and identifiability of model parameters, optimal design of experiments, and so on. Finally, we highlight some possible future research directions in this field.

The Relationship Between Motor Skills, Social Problems, and ADHD Symptomatology: Does It Vary According to Parent and Teacher Report?

PubMed

Goulardins, Juliana B; Rigoli, Daniela; Loh, Pek Ru; Kane, Robert; Licari, Melissa; Hands, Beth; Oliveira, Jorge A; Piek, Jan

2018-06-01

This study investigated the relationship between motor performance; attentional, hyperactive, and impulsive symptoms; and social problems. Correlations between parents' versus teachers' ratings of social problems and ADHD symptomatology were also examined. A total of 129 children aged 9 to 12 years were included. ADHD symptoms and social problems were identified based on Conners' Rating Scales-Revised: L, and the McCarron Assessment of Neuromuscular Development was used to assess motor skills. After controlling for ADHD symptomatology, motor skills remained a significant predictor of social problems in the teacher model but not in the parent model. After controlling for motor skills, inattentive (not hyperactive-impulsive) symptoms were a significant predictor of social problems in the parent model, whereas hyperactive-impulsive (not inattentive) symptoms were a significant predictor of social problems in the teacher model. The findings suggested that intervention strategies should consider the interaction between symptoms and environmental contexts.

SWIFT-Review: a text-mining workbench for systematic review.

PubMed

Howard, Brian E; Phillips, Jason; Miller, Kyle; Tandon, Arpit; Mav, Deepak; Shah, Mihir R; Holmgren, Stephanie; Pelch, Katherine E; Walker, Vickie; Rooney, Andrew A; Macleod, Malcolm; Shah, Ruchir R; Thayer, Kristina

2016-05-23

There is growing interest in using machine learning approaches to priority rank studies and reduce human burden in screening literature when conducting systematic reviews. In addition, identifying addressable questions during the problem formulation phase of systematic review can be challenging, especially for topics having a large literature base. Here, we assess the performance of the SWIFT-Review priority ranking algorithm for identifying studies relevant to a given research question. We also explore the use of SWIFT-Review during problem formulation to identify, categorize, and visualize research areas that are data rich/data poor within a large literature corpus. Twenty case studies, including 15 public data sets, representing a range of complexity and size, were used to assess the priority ranking performance of SWIFT-Review. For each study, seed sets of manually annotated included and excluded titles and abstracts were used for machine training. The remaining references were then ranked for relevance using an algorithm that considers term frequency and latent Dirichlet allocation (LDA) topic modeling. This ranking was evaluated with respect to (1) the number of studies screened in order to identify 95 % of known relevant studies and (2) the "Work Saved over Sampling" (WSS) performance metric. To assess SWIFT-Review for use in problem formulation, PubMed literature search results for 171 chemicals implicated as EDCs were uploaded into SWIFT-Review (264,588 studies) and categorized based on evidence stream and health outcome. Patterns of search results were surveyed and visualized using a variety of interactive graphics. Compared with the reported performance of other tools using the same datasets, the SWIFT-Review ranking procedure obtained the highest scores on 11 out of 15 of the public datasets. Overall, these results suggest that using machine learning to triage documents for screening has the potential to save, on average, more than 50 % of the screening effort ordinarily required when using un-ordered document lists. In addition, the tagging and annotation capabilities of SWIFT-Review can be useful during the activities of scoping and problem formulation. Text-mining and machine learning software such as SWIFT-Review can be valuable tools to reduce the human screening burden and assist in problem formulation.

Faculty Responsibility in Contemporary Society. Proceedings of the American Association of State Colleges and Universities La Sapienza Conference (Rome, Italy, June, 1989).

ERIC Educational Resources Information Center

Wingfield, Clyde J., Ed.

The 10 U.S. papers included in this collection discuss the organization, governance, problems, values, and faculty role of higher education in institutions of higher education in the United States. Major differences are identified in the introduction (Clyde Wingfield), including tendencies for American universities to be more integrated into…

Selection of Representative Models for Decision Analysis Under Uncertainty

NASA Astrophysics Data System (ADS)

Meira, Luis A. A.; Coelho, Guilherme P.; Santos, Antonio Alberto S.; Schiozer, Denis J.

2016-03-01

The decision-making process in oil fields includes a step of risk analysis associated with the uncertainties present in the variables of the problem. Such uncertainties lead to hundreds, even thousands, of possible scenarios that are supposed to be analyzed so an effective production strategy can be selected. Given this high number of scenarios, a technique to reduce this set to a smaller, feasible subset of representative scenarios is imperative. The selected scenarios must be representative of the original set and also free of optimistic and pessimistic bias. This paper is devoted to propose an assisted methodology to identify representative models in oil fields. To do so, first a mathematical function was developed to model the representativeness of a subset of models with respect to the full set that characterizes the problem. Then, an optimization tool was implemented to identify the representative models of any problem, considering not only the cross-plots of the main output variables, but also the risk curves and the probability distribution of the attribute-levels of the problem. The proposed technique was applied to two benchmark cases and the results, evaluated by experts in the field, indicate that the obtained solutions are richer than those identified by previously adopted manual approaches. The program bytecode is available under request.

Ethical problems in nursing management: The views of nurse managers.

PubMed

Aitamaa, Elina; Leino-Kilpi, Helena; Iltanen, Silja; Suhonen, Riitta

2016-09-01

Nurse managers have responsibilities relating to the quality of care, the welfare of the staff and running of the organization. Ethics plays significant role in these responsibilities. Ethical problems are part of daily management, but research in this area is limited. The aim of this study was to identify and describe ethical problems nurse managers encounter in their work to get more detailed and extensive view of these problems. The data consisted of nine interviews with nurse managers at different management levels in primary healthcare and specialized healthcare organizations, and it was analysed by inductive content analysis. Permission to conduct the interviews including ethical approval was given at all participating organizations according to national standards. The respondents were informed about the aim of the study, and voluntary participation, anonymous response and confidentiality were explained to them. Four main categories were found: conflicts in practical situations, lack of appreciation, disregard of problems and experienced inadequacy. Problems could also be divided to patient-related, staff-related, organization-related and other problems. The findings correspond with results from earlier studies but add knowledge of the nature and details of nurse managers' ethical problems. New information is produced related to the ethical problems with nurse managers' own courage, motivation and values. Nurse managers identified a variety of different ethical problems in their work. This information is useful in the development of ethics in nursing management. Further research about the frequency and intensity of nurse managers' ethical problems is needed as well as possible differences in different levels of management. © The Author(s) 2015.

A Qualitative Approach to a Better Understanding of the Problems Underlying Drug Shortages, as Viewed from Belgian, French and the European Union’s Perspectives

PubMed Central

Prokop, Anna; Pilc, Andrzej

2015-01-01

The problem of drug shortages has been reported worldwide, gaining prominence in multiple domains and several countries in recent years. The aim of the study was to analyze, characterise and assess this problem in Belgium and France, while also adopting a wider perspective from the European Union. A qualitative methodological approach was employed, including semi-structured interviews with the representatives of respective national health authorities, pharmaceutical companies and wholesalers, as well as hospital and community pharmacists. The research was conducted in early 2014. Four themes, which were identified through the interviews, were addressed in the paper, i.e. a) defining drug shortages, b) their dynamics and perception, c) their determinants, d) the role of the European and national institutions in coping with the problem. Three groups of determinants of drug shortages were identified throughout this study: manufacturing problems, distribution and supply problems, and problems related to economic aspects. Currently, the Member States of the European Union are striving to resolve the problem very much on their own, although a far more focused and dedicated collaboration may well prove instrumental in coping with drug shortages throughout Europe more effectively. To the best of the authors’ knowledge, this is the first qualitative study to investigate the characteristics, key determinants, and the problem drivers of drug shortages, focusing on this particular group of countries, while also adopting the European Union’s perspective. PMID:25942432

Military veterans with mental health problems: a protocol for a systematic review to identify whether they have an additional risk of contact with criminal justice systems compared with other veterans groups.

PubMed

Taylor, James; Parkes, Tessa; Haw, Sally; Jepson, Ruth

2012-11-06

There is concern that some veterans of armed forces, in particular those with mental health, drug or alcohol problems, experience difficulty returning to a civilian way of life and may subsequently come into contact with criminal justice services and imprisonment. The aim of this review is to examine whether military veterans with mental health problems, including substance use, have an additional risk of contact with criminal justice systems when compared with veterans who do not have such problems. The review will also seek to identify veterans' views and experiences on their contact with criminal justice services, what contributed to or influenced their contact and whether there are any differences, including international and temporal, in incidence, contact type, veteran type, their presenting health needs and reported experiences. In this review we will adopt a methodological model similar to that previously used by other researchers when reviewing intervention studies. The model, which we will use as a framework for conducting a review of observational and qualitative studies, consists of two parallel synthesis stages within the review process; one for quantitative research and the other for qualitative research. The third stage involves a cross study synthesis, enabling a deeper understanding of the results of the quantitative synthesis. A range of electronic databases, including MEDLINE, PsychINFO, CINAHL, will be systematically searched, from 1939 to present day, using a broad range of search terms that cover four key concepts: mental health, military veterans, substance misuse, and criminal justice. Studies will be screened against topic specific inclusion/exclusion criteria and then against a smaller subset of design specific inclusion/exclusion criteria. Data will be extracted for those studies that meet the inclusion criteria, and all eligible studies will be critically appraised. Included studies, both quantitative and qualitative, will then undergo stage-specific analysis and synthesis. The final stage will combine the findings of both syntheses to enable new understandings of why, how, and by how much, military veterans with mental health problems, including problematic drug and alcohol use, come into contact with the criminal justice system.

Veterinary public health capacity in the United States: opportunities for improvement.

PubMed

Jarman, Dwayne W; Liang, Jennifer L; Luce, Richard R; Wright, Jennifer G; Stennies, Gail M; Bisgard, Kristine M

2011-01-01

In 2006, the Association of American Veterinary Medical Colleges reported that the shortage (≥ 1,500) of public health veterinarians is expected to increase tenfold by 2020. In 2008, the Centers for Disease Control and Prevention (CDC) Preventive Medicine Fellows conducted a pilot project among CDC veterinarians to identify national veterinary public health workforce concerns and potential policy strategies. Fellows surveyed a convenience sample (19/91) of public health veterinarians at CDC to identify veterinary workforce recruitment and retention problems faced by federal agencies; responses were categorized into themes. A focus group (20/91) of staff veterinarians subsequently prioritized the categorized themes from least to most important. Participants identified activities to address the three recruitment concerns with the highest combined weight. Participants identified the following three highest prioritized problems faced by federal agencies when recruiting veterinarians to public health: (1) lack of awareness of veterinarians' contributions to public health practice, (2) competitive salaries, and (3) employment and training opportunities. Similarly, key concerns identified regarding retention of public health practice veterinarians included: (1) lack of recognition of veterinary qualifications, (2) competitive salaries, and (3) seamless integration of veterinary and human public health. Findings identified multiple barriers that can affect recruitment and retention of veterinarians engaged in public health practice. Next steps should include replicating project efforts among a national sample of public health veterinarians. A committed and determined long-term effort might be required to sustain initiatives and policy proposals to increase U.S. veterinary public health capacity.

Problematic video game use scale: initial psychometric properties with psychiatrically hospitalized adolescents.

PubMed

Topor, David R; Swenson, Lance P; Liguori, Gina M; Spirito, Anthony; Lowenhaupt, Elizabeth A; Hunt, Jeffrey I

2011-12-01

Excessive video game use among youth has been a growing concern in the United States and elsewhere. The aims of this study are to establish validity of a video game measure in a large adolescent inpatient sample, identify clinical factors underlying problem video game use, and identify associations with measures of psychopathology. Three hundred eighty participants admitted to an adolescent inpatient psychiatric unit between November 2007 and March 2009 were administered a battery of self-report measures, including a questionnaire developed for this study that assessed reinforcers and consequences of past-year video game use (ie, Problematic Video Game Use Scale). Factor analysis was used to identify the underlying structure of behaviors associated with problem video game use. A factor analysis of the Problematic Video Game Use Scale indicated 2 primary factors. One was associated with engaging in problem behaviors that impaired the adolescent's functioning as a result of playing video games and one reflected the reinforcing effects of playing video games. Both factors were associated with measures of psychopathology, although associations were generally stronger for impairment in functioning than for reinforcing effects. Both factors were significantly correlated with self-reported daily video game use (P < .001). Two underlying factors emerged to account for problem video game playing: impairment in functioning and reinforcing effects. Initial evidence of the content validity of the video game measure was established. Findings highlight the importance of assessing video game use among an adolescent population, the factors associated with video game use, and associations with symptoms of psychopathology. Limitations include a common reporter for multiple measures and cross-sectional data that do not allow for causal links to be made. © Copyright 2011 Physicians Postgraduate Press, Inc.

[Medical safety management in the setting of a clinical reference laboratory--risk management efforts in clinical testing].

PubMed

Seki, Akira; Miya, Tetsumasa

2011-03-01

As a result of recurring medical accidents, risk management in the medical setting has been given much attention. The announcement in August, 2000 by the Ministry of Health committee for formulating a standard manual for risk management, of a "Risk management manual formulation guideline" has since been accompanied by the efforts of numerous medical testing facilities to develop such documents. In 2008, ISO/TS 22367:2008 on "Medical laboratories-Reduction of error through risk management and continual improvement" was published. However, at present, risk management within a medical testing facility stresses the implementation of provisional actions in response to a problem after it has occurred. Risk management is basically a planned process and includes "corrective actions" as well as "preventive actions." A corrective action is defined as identifying the root cause of the problem and removing it, and is conducted to prevent the problem from recurring. A preventive action is defined as identifying of the any potential problem and removing it, and is conducted to prevent a problem before it occurs. Presently, I shall report on the experiences of our laboratory regarding corrective and preventive actions taken in response to accidents and incidents, respectively.

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners' perceptions.

PubMed

O'Brien, Doireann; Harvey, Kate; Howse, Jessica; Reardon, Tessa; Creswell, Cathy

2016-10-01

Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available, yet only a minority of children who are affected access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners manage child and adolescent mental health problems and the barriers they face. To ascertain primary care practitioners' perceptions of the barriers that prevent effective management of child and adolescent mental health problems. A systematic review of qualitative and quantitative literature in a primary care setting. A database search of peer-reviewed articles using PsycINFO, MEDLINE(®), Embase, and Web of Science, from inception (earliest 1806) until October 2014, was conducted. Additional studies were identified through hand searches and forward-citation searches. Studies needed to have at least one search term in four categories: primary care, childhood/adolescence, mental health, and barriers. A total of 4151 articles were identified, of which 43 were included (30 quantitative studies and 13 qualitative studies). The majority of the barriers related to identification, management, and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists, and financial restrictions. The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services. © British Journal of General Practice 2016.

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners’ perceptions

PubMed Central

O’Brien, Doireann; Harvey, Kate; Howse, Jessica; Reardon, Tessa; Creswell, Cathy

2016-01-01

Background Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available, yet only a minority of children who are affected access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners manage child and adolescent mental health problems and the barriers they face. Aim To ascertain primary care practitioners’ perceptions of the barriers that prevent effective management of child and adolescent mental health problems. Design and setting A systematic review of qualitative and quantitative literature in a primary care setting. Method A database search of peer-reviewed articles using PsycINFO, MEDLINE®, Embase, and Web of Science, from inception (earliest 1806) until October 2014, was conducted. Additional studies were identified through hand searches and forward-citation searches. Studies needed to have at least one search term in four categories: primary care, childhood/adolescence, mental health, and barriers. Results A total of 4151 articles were identified, of which 43 were included (30 quantitative studies and 13 qualitative studies). The majority of the barriers related to identification, management, and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists, and financial restrictions. Conclusion The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services. PMID:27621291

Surviving Tight Times.

ERIC Educational Resources Information Center

Neugebauer, Roger

2002-01-01

Discusses several strategies recommended by small business experts to help for-profit and non-profit child care centers survive a financial crisis. Strategies include: identifying the source of the problem, monitoring cash flow, reducing or deferring expenditures, expediting regular income and exploring new sources of income, patiently working…

India: From SITE to INSAT.

ERIC Educational Resources Information Center

Chaudhri, M. M.

1986-01-01

Identifies core of India's illiteracy problem and describes use of educational technology to educate rural children. Highlights include descriptions of the Satellite Instructional Television Experiment (SITE) project; motivation behind low-cost educational aids development in rural areas; an educational radio pilot project; and development and…

Special Ed Boondoggle.

ERIC Educational Resources Information Center

Haynes, Richard; Bernard, John; Johannesdottir, Gudrun

1999-01-01

The United States identifies a far larger percentage of students for special-education services than do other developed countries, including Israel, Canada, Germany, France, Britain, Japan, and Korea. Looming behind the U.S. figures are the possibility of lawsuits, mounting paperwork, student discipline problems, lower expectations for student…

Antimatter/HiPAT Support Services

NASA Technical Reports Server (NTRS)

Lewis, Raymond A.

2001-01-01

Techniques were developed for trapping normal matter in the High Performance Antiproton Trap (HiPAT). Situations encountered included discharge phenomena, charge exchange and radial diffusion processes. It is important to identify these problems, since they will also limit the performance in trapping antimatter next year.

The Serial Perplex.

ERIC Educational Resources Information Center

Blackwell, Maree Macon; Chopra, Pearl

The problems associated with the acquisition of periodicals from various sources and different systems used by two University of Alabama libraries for the acquisition, controlling, and recording of serials are described in this report. Sources identified and discussed include local sources and suppliers, direct subscriptions placed with…

End-Users: Dollars but Doubts.

ERIC Educational Resources Information Center

Arnold, Stephen E.

1989-01-01

Identifies existing categories of end users of online information retrieval systems, discusses problems that have been encountered by information providers and customers, and suggests strategies for capturing new end-user markets. Issues discussed include user cordial interfaces, CD-ROM products, ethics involved in information provision, and…

Managing Technology Is Different.

ERIC Educational Resources Information Center

Levinson, Eliot; Grohe, Barbara

2002-01-01

Discusses methods that school superintendents can use to manage technology issues in their schools beyond traditional delegation. Highlights include participation more than delegation to a technology coordinator; identifying the right problems; determining what to make and what to buy; and the need for continual technology funding. (LRW)

The Other Water Pollution

ERIC Educational Resources Information Center

Barton, Kathy

1978-01-01

Nonpoint source pollution, water pollution not released at one specific identifiable point, now accounts for 50 percent of the nation's water pollution problem. Runoff is the primary culprit and includes the following sources: agriculture, mining, hydrologic modifications, and urban runoff. Economics, legislation, practices, and management of this…

Momentum--"Helping Teachers Grow: Confronting Inappropriate Teaching Behavior."

ERIC Educational Resources Information Center

Albrecht, Kay

1989-01-01

Discusses confrontations which lead to growth in day care teachers. The steps of confrontation discussed include: (1) identifying the problem; (2) describing the desired behavior and how it will come about; (3) determining how the successfulness of the change will be measured. (RJC)

Explaining suicide in an urban slum of Mumbai, India: a sociocultural autopsy.

PubMed

Parkar, Shubhangi R; Nagarsekar, Balkrishna; Weiss, Mitchell G

2009-01-01

Health demographic mortality studies use verbal autopsies to identify suicide as a cause of death. Psychological autopsies focus almost exclusively on associated high-risk psychiatric disorders. New approaches considering contextual factors are needed for preventing suicide and promoting mental health. This study examined explanations of suicide reported by surviving family members or close friends with reference to social, cultural, and environmental conditions as well as the challenges of life in the Malavani slum of Mumbai. An EMIC (Explanatory Model Interview Catalog) interview based on a cultural epidemiological framework considered underlying problems, perceived causes, and sociocultural contexts. It was administered to survivors of 76 people who had died by suicide (56.6% women). Accounts of underlying problems typically referred to various aspects of tension (73.7%). Perceived causes often identified multiple factors. The sociocultural contexts of suicide included the victimization of women, the personal and social impact of problem drinking, marital problems, physical health problems, mental tension, possession and sorcery. Women were particularly vulnerable to the impact of problem drinking by a spouse or father. This study demonstrates the value of an approach to sociocultural autopsy examining local contexts and explanations of suicide. Findings highlight needs for both mental health services and culturally sensitive social interventions.

PEDIATRIC MENTAL HEALTH PROBLEMS AND ASSOCIATED BURDEN ON FAMILIES

PubMed Central

Houtrow, Amy J.; Okumura, Megumi J.

2011-01-01

Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children’s Health, 2003 (N=85,116 children aged 3–17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios of mental health problems and family burden were calculated for children by child-, family- and health systems- level characteristics. The prevalence of mental health problems among children aged 3–17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse, and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included White race, severity, older age, higher income, non-two parent family structure, and having a mother with mental health problems. In conclusion, childhood mental health problems are common and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families. PMID:22135697

Usefulness of a single item in a mail survey to identify persons with possible dementia: a new strategy for finding high-risk elders.

PubMed

Brody, Kathleen K; Maslow, Katie; Perrin, Nancy A; Crooks, Valerie; DellaPenna, Richard; Kuang, Daniel

2005-04-01

The objective of this study was to examine the characteristics of elderly persons who responded positively to a question about "severe memory problems" on a mailed health questionnaire yet were missed by the existing health risk algorithm to identify vulnerable elderly persons. A total of 324,471 respondents aged 65 and older completed a primary care health status questionnaire that gathered clinical information to quickly identify members with functional impairment, multiple chronic diseases, and higher medical care needs. The respondents were part of a large, integrated, not-for-profit managed care organization that implemented a model of care for elders using a uniform risk identification method across eight regions. Respondents with severe memory problems were compared to general respondents by morbidity, geriatric syndromes, functional impairments, service utilization, sensory impairments, sociodemographic characteristics, and activities of daily living. Of the respondents, 13,902 persons (4.3%) reported severe memory problems; the existing health risk algorithm missed 47.1% of these. When severe memory problems were included in the risk algorithm, identification increased from 11% to 13%, and risk prevalence by age groups ranged from 4.4% to 40.5%; one third had severe memory problems, a finding that was fairly consistent within age groups (28.4% to 36.5%). A question about severe memory problems should be incorporated into population risk-identification techniques. While false-negative rates are unknown, the false-positive rate of a self-report mail survey appears to be minimal. Persons reporting severe memory problems clearly have multiple comorbidities, higher prevalence of geriatric syndromes, and greater functional and sensory impairments.

Health care barriers and interventions for battered women.

PubMed Central

Loring, M T; Smith, R W

1994-01-01

Family violence is a major public health problem. Battered women present with multiple physical injuries in hospital emergency rooms, clinics, and personal physicians' offices. Yet, they are often not identified as battered and fail to receive appropriate treatment for the nonphysical effects of these events. Instead, only discrete physical injuries are identified. The authors explore the literature to identify barriers in recognizing and treating battered women. These barriers are viewed as a microcosm of the larger public health problem in which battered women fear identifying themselves and often are not recognized by public health professionals. Some barriers pertain to the victims themselves; others can be attributed to the attitudes of medical care providers in emergency rooms, clinics, and private physicians' offices. The many faceted needs of victims require a variety of interventions including medical models, criminal justice intervention systems, and social models for change. Some intervention strategies that are currently being employed in various programs in the United States are described. PMID:8190856

Identifying and treating codeine dependence: a systematic review.

PubMed

Nielsen, Suzanne; MacDonald, Tim; Johnson, Jacinta L

2018-06-04

Codeine dependence is a significant public health problem, motivating the recent rescheduling of codeine in Australia (1 February 2018). To provide information for informing clinical responses, we undertook a systematic review of what is known about identifying and treating codeine dependence. Articles published in English that described people who were codeine-dependent or a clinical approach to treating people who were codeine-dependent, without restriction on year of publication, were reviewed. Articles not including empirical data were excluded. One researcher screened each abstract; two researchers independently reviewed full text articles. Study quality was assessed, and data were extracted with standardised tools. MEDLINE and EMBASE were searched for relevant publications on 22 November 2016. The reference lists of eligible studies were searched to identify further relevant publications. 2150 articles were initially identified, of which 41 were eligible for inclusion in our analysis. Studies consistently reported specific characteristics associated with codeine dependence, including mental health comorbidity and escalation of codeine use attributed to psychiatric problems. Case reports and series described codeine dependence masked by complications associated with overusing simple analgesics and delayed detection. Ten studies described the treatment of codeine dependence. Three reports identified a role for behavioural therapy; the efficacy of CYP inhibitors in a small open label trial was not confirmed in a randomised controlled trial; four case series/chart reviews described opioid agonist therapy and medicated inpatient withdrawal; two qualitative studies identified barriers related to perceptions of codeine-dependent people and treatment providers, and confirmed positive perceptions and treatment outcomes achieved with opioid agonist treatments. Strategies for identifying problematic codeine use are needed. Identifying codeine dependence in clinical settings is often delayed, contributing to serious morbidity. Commonly described approaches for managing codeine dependence include opioid taper, opioid agonist treatment, and psychological therapies. These approaches are consistent with published evidence for pharmaceutical opioid dependence treatment and with broader frameworks for treating opioid dependence. PROSPERO registration: CRD42016052129.

Impact of Pharmacist-Conducted Comprehensive Medication Reviews for Older Adult Patients to Reduce Medication Related Problems.

PubMed

Kiel, Whitney J; Phillips, Shaun W

2017-12-31

Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization. The purpose of this pharmacy resident research study is to examine the impact of pharmacist-conducted geriatric medication reviews to reduce medication-related problems within a leading community health system in southwest Michigan. Furthermore, the study examines type of pharmacist interventions made during medication reviews, acute healthcare utilization, and physician assessment of the pharmacist's value. The study was conducted as a retrospective post-hoc analysis on ambulatory patients who received a CMR by a pharmacist at a primary care practice. Inclusion criteria included patients over 65 years of age with concurrent use of at least five medications who were a recent recipient of a CMR. Exclusion criteria included patients with renal failure, or those with multiple providers involved in primary care. The primary outcome was the difference in number of medication-related problems, as defined by the START and STOPP Criteria (Screening Tool to Alert doctors to Right Treatment/Screening Tool of Older Persons' Prescriptions). Secondary outcomes included hospitalizations, emergency department visits, number and type of pharmacist interventions, acceptance rate of pharmacist recommendations, and assessment of the pharmacist's value by clinic providers. There were a total of 26 patients that received a comprehensive medication review from the pharmacist and were compared to a control group, patients that did not receive a CMR. The average patient age for both groups was 76 years old. A total of 11 medication-related problems in the intervention group patients were identified compared with 24 medication-related problems in the control group ( p -value 0.002). Pharmacist-led comprehensive medication reviews were associated with a statistically significant different in the number of medication-related problems as defined by the START and STOPP criteria.

Comparison of two heuristic evaluation methods for evaluating the usability of health information systems.

PubMed

Khajouei, Reza; Hajesmaeel Gohari, Sadrieh; Mirzaee, Moghaddameh

2018-04-01

In addition to following the usual Heuristic Evaluation (HE) method, the usability of health information systems can also be evaluated using a checklist. The objective of this study is to compare the performance of these two methods in identifying usability problems of health information systems. Eight evaluators independently evaluated different parts of a Medical Records Information System using two methods of HE (usual and with a checklist). The two methods were compared in terms of the number of problems identified, problem type, and the severity of identified problems. In all, 192 usability problems were identified by two methods in the Medical Records Information System. This was significantly higher than the number of usability problems identified by the checklist and usual method (148 and 92, respectively) (p < 0.0001). After removing the duplicates, the difference between the number of unique usability problems identified by the checklist method (n = 100) and usual method (n = 44) was significant (p < 0.0001). Differences between the mean severity of the real usability problems (1.83) and those identified by only one of the methods (usual = 2.05, checklist = 1.74) were significant (p = 0.001). This study revealed the potential of the two HE methods for identifying usability problems of health information systems. The results demonstrated that the checklist method had significantly better performance in terms of the number of identified usability problems; however, the performance of the usual method for identifying problems of higher severity was significantly better. Although the checklist method can be more efficient for less experienced evaluators, wherever usability is critical, the checklist should be used with caution in usability evaluations. Copyright © 2018 Elsevier Inc. All rights reserved.

Pathways to potentially preventable hospitalizations for diabetes and heart failure: a qualitative analysis of patient perspectives.

PubMed

Sentell, Tetine L; Seto, Todd B; Young, Malia M; Vawer, May; Quensell, Michelle L; Braun, Kathryn L; Taira, Deborah A

2016-07-26

Potentially preventable hospitalizations (PPH) for heart failure (HF) and diabetes mellitus (DM) cost the United States over $14 billion annually. Studies about PPH typically lack patient perspectives, especially across diverse racial/ethnic groups with known PPH health disparities. English-speaking individuals with a HF or DM-related PPH (n = 90) at the largest hospital in Hawai'i completed an in-person interview, including open-ended questions on precipitating factors to their PPH. Using the framework approach, two independent coders identified patient-reported factors and pathways to their PPH. Seventy-two percent of respondents were under 65 years, 30 % were female, 90 % had health insurance, and 66 % had previously been hospitalized for the same problem. Patients' stories identified immediate, precipitating, and underlying reasons for the admission. Underlying background factors were critical to understanding why patients had the acute problems necessitating their hospitalizations. Six, non-exclusive, underlying factors included: extreme social vulnerability (e.g., homeless, poverty, no social support, reported by 54 % of respondents); health system interaction issues (e.g., poor communication with providers, 44 %); limited health-related knowledge (42 %); behavioral health issues (e.g., substance abuse, mental illness, 36 %); denial of illness (27 %); and practical problems (e.g., too busy, 6 %). From these findings, we developed a model to understand an individual's pathways to a PPH through immediate, precipitating, and underlying factors, which could help identify potential intervention foci. We demonstrate the model's utility using five examples. In a young, predominately insured population, factors well outside the traditional purview of the hospital, or even clinical medicine, critically influenced many PPH. Patient perspectives were vital to understanding this issue. Innovative partnerships and policies should address these issues, including linkages to social services and behavioral health.

Further evaluation of leisure items in the attention condition of functional analyses.

PubMed

Roscoe, Eileen M; Carreau, Abbey; MacDonald, Jackie; Pence, Sacha T

2008-01-01

Research suggests that including leisure items in the attention condition of a functional analysis may produce engagement that masks sensitivity to attention. In this study, 4 individuals' initial functional analyses indicated that behavior was maintained by nonsocial variables (n = 3) or by attention (n = 1). A preference assessment was used to identify items for subsequent functional analyses. Four conditions were compared, attention with and without leisure items and control with and without leisure items. Following this, either high- or low-preference items were included in the attention condition. Problem behavior was more probable during the attention condition when no leisure items or low-preference items were included, and lower levels of problem behavior were observed during the attention condition when high-preference leisure items were included. These findings suggest how preferred items may hinder detection of behavioral function.

Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review.

PubMed

Vonk-Klaassen, Sylvia M; de Vocht, Hilde M; den Ouden, Marjolein E M; Eddes, Eric Hans; Schuurmans, Marieke J

2016-01-01

Many long-term ostomates are 'out-of-sight' of healthcare, and it is unknown how ostomates deal with ostomy-related problems and how these problems affect their quality of life (QOL). The aim is to examine patient-related studies describing ostomy-related problems and their impact on the perceived QOL of long-term colostomates. The electronic databases PubMed (MEDLINE), CINAHL, Cochrane Library and PsycINFO were systematically searched. All studies were included in which ostomy-specific QOL was measured using validated multidimensional instruments. Of the 6447 citations identified, 14 prevailingly descriptive cross-sectional studies were included. Three different validated multidimensional instruments for measuring QOL in ostomates were used (EORTC C30/CR38, MCOHQOLQO, Stoma QOL Questionnaire). All studies demonstrated that living with a colostomy influences the overall QOL negatively. The ostomy-related problems described included sexual problems, depressive feelings, gas, constipation, dissatisfaction with appearance, change in clothing, travel difficulties, feeling tired and worry about noises. In conclusion, all 14 studies gave an indication of the impact of ostomy-related problems on the perceived QOL and demonstrated that a colostomy influences the QOL negatively. There is a wide range of ostomy-specific QOL scores, and there seem to be higher QOL scores in the studies where the MCOHQOLQO instrument was used. The MCOHQOLQO and the Stoma QOL Questionnaire gave the most detailed information about which ostomy-related problems were experienced. This review adds knowledge about the impact of stoma-related problems on QOL of long-term ostomates, but more research has to be conducted, to detect ostomy-related problems and especially possible care needs.

Joint Occurrence of Pain and Sleep Disturbances in People with Dementia. A Systematic Review.

PubMed

Flo, Elisabeth; Bjorvatn, Bjorn; Corbett, Anne; Pallesen, Stale; Husebo, Bettina S

2017-01-01

Advancing age is associated with high prevalence of pain, sleep problems and dementia. Dementia is frequently accompanied by distressing behavioral and psychological symptoms, including sleep problems. The etiology of sleep problems in dementia is multifactorial. It has been suggested that untreated pain may contribute to sleep problems, and pain treatment has been shown to reduce sleep problems in people with dementia. This systematic review aims to provide an overview of the studies that have investigated the association and/or possible interaction between pain and sleep in dementia. A systematic search was performed in MEDLINE, EMBASE, Cochrane and PsychINFO, including text words and MESH terms covering dementia, pain and sleep. Also, reference lists in the included publications were examined to retrieve publications. Publications had to investigate sleep and pain in relation to dementia to be included in this review. The search produced 1750 independent hits. Out of the 49 publications studied in full text, 11 publications were included. Only one controlled trial was identified and represented the only insights to the possible interactional relationship between pain, sleep and dementia. Pain or pain intensity were related to sleep in 6 of the included studies, while the remaining studies could neither support nor contradict a relationship between sleep and pain in people with dementia. None of the studies employed objective sleep assessment. There is a need for high quality studies investigating the interaction between sleep and pain in people with dementia, using objective sleep measurements and pain assessment suitable for people with dementia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

What Causes Care Coordination Problems? A Case for Microanalysis

PubMed Central

Zachary, Wayne; Maulitz, Russell Charles; Zachary, Drew A.

2016-01-01

Introduction: Care coordination (CC) is an important fulcrum for pursuing a range of health care goals. Current research and policy analyses have focused on aggregated data rather than on understanding what happens within individual cases. At the case level, CC emerges as a complex network of communications among providers over time, crossing and recrossing many organizational boundaries. Micro-level analysis is needed to understand where and how CC fails, as well as to identify best practices and root causes of problems. Coordination Process Diagramming: Coordination Process Diagramming (CPD) is a new framework for representing and analyzing CC arcs at the micro level, separating an arc into its participants and roles, communication structure, organizational structures, and transitions of care, all on a common time line. Conclusion: Comparative CPD analysis across a sample of CC arcs identifies common CC problems and potential root causes, showing the potential value of the framework. The analyses also suggest intervention strategies that could be applied to attack the root causes of CC problems, including organizational changes, education and training, and additional health information technology development. PMID:27563685

A study of aeroelastic and structural dynamic effects in multi-rotor systems with application to hybrid heavy lift vehicles

NASA Technical Reports Server (NTRS)

Friedmann, P. P.

1984-01-01

An aeroelastic model suitable for the study of aeroelastic and structural dynamic effects in multirotor vehicles simulating a hybrid heavy lift vehicle was developed and applied to the study of a number of diverse problems. The analytical model developed proved capable of modeling a number of aeroelastic problems, namely: (1) isolated blade aeroelastic stability in hover and forward flight, (2) coupled rotor/fuselage aeromechanical problem in air or ground resonance, (3) tandem rotor coupled rotor/fuselage problems, and (4) the aeromechanical stability of a multirotor vehicle model representing a hybrid heavy lift airship (HHLA). The model was used to simulate the ground resonance boundaries of a three bladed hingeless rotor model, including the effect of aerodynamic loads, and the theoretical predictions compared well with experimental results. Subsequently the model was used to study the aeromechanical stability of a vehicle representing a hybrid heavy lift airship, and potential instabilities which could occur for this type of vehicle were identified. The coupling between various blade, supporting structure and rigid body modes was identified.

Dealing with complex and ill-structured problems: results of a Plan-Do-Check-Act experiment in a business engineering semester

NASA Astrophysics Data System (ADS)

Riis, Jens Ove; Achenbach, Marlies; Israelsen, Poul; Kyvsgaard Hansen, Poul; Johansen, John; Deuse, Jochen

2017-07-01

Challenged by increased globalisation and fast technological development, we carried out an experiment in the third semester of a global business engineering programme aimed at identifying conditions for training student in dealing with complex and ill-structured problems of forming a new business. As this includes a fuzzy front end, learning cannot be measured in traditional, quantitative terms; therefore, we have explored the use of reflection to convert tacit knowledge to explicit knowledge. The experiment adopted a Plan-Do-Check-Act approach and concluded with developing a plan for new learning initiatives in the subsequent year's semester. The findings conclude that (1) problem-based learning develops more competencies than ordinarily measured at the examination, especially, the social/communication and personal competencies are developed; (2) students are capable of dealing with a complex and ambiguous problem, if properly guided. Four conditions were identified; (3) most students are not conscious of their learning, but are able to reflect if properly encouraged; and (4) improving engineering education should be considered as an organisational learning process.

Stroke survivors' views and experiences on impact of visual impairment.

PubMed

Rowe, Fiona J

2017-09-01

We sought to determine stroke survivors' views on impact of stroke-related visual impairment to quality of life. Stroke survivors with visual impairment, more than 1 year post stroke onset, were recruited. Semistructured biographical narrative interviews were audio-recorded and transcribed verbatim. A thematic approach to analysis of the qualitative data was adopted. Transcripts were systematically coded using NVivo10 software. Thirty-five stroke survivors were interviewed across the UK: 16 females, 19 males; aged 20-75 years at stroke onset. Five qualitative themes emerged: "Formal care," "Symptoms and self," "Adaptations," "Daily life," and "Information." Where visual problems existed, they were often not immediately recognized as part of the stroke syndrome and attributed to other causes such as migraine. Many participants did not receive early vision assessment or treatment for their visual problems. Visual problems included visual field loss, double vision, and perceptual problems. Impact of visual problems included loss in confidence, being a burden to others, increased collisions/accidents, and fear of falling. They made many self-identified adaptations to compensate for visual problems: magnifiers, large print, increased lighting, use of white sticks. There was a consistent lack of support and provision of information about visual problems. Poststroke visual impairment causes considerable impact to daily life which could be substantially improved by simple measures including early formal visual assessment, management and advice on adaptive strategies and self-management options. Improved education about poststroke visual impairment for the public and clinicians could aid earlier diagnosis of visual impairments.

Sentence-Level Attachment Prediction

NASA Astrophysics Data System (ADS)

Albakour, M.-Dyaa; Kruschwitz, Udo; Lucas, Simon

Attachment prediction is the task of automatically identifying email messages that should contain an attachment. This can be useful to tackle the problem of sending out emails but forgetting to include the relevant attachment (something that happens all too often). A common Information Retrieval (IR) approach in analyzing documents such as emails is to treat the entire document as a bag of words. Here we propose a finer-grained analysis to address the problem. We aim at identifying individual sentences within an email that refer to an attachment. If we detect any such sentence, we predict that the email should have an attachment. Using part of the Enron corpus for evaluation we find that our finer-grained approach outperforms previously reported document-level attachment prediction in similar evaluation settings.

An observational study of bullying as a contributing factor in youth suicide in Toronto.

PubMed

Sinyor, Mark; Schaffer, Ayal; Cheung, Amy H

2014-12-01

Bullying has been identified as a potential contributing factor in youth suicide. This issue has been highlighted in recent widely publicized media reports, worldwide, in which deceased youth were bullied. We report on an observational study conducted to determine the frequency of bullying as a contributing factor to youth suicide. Coroner records were reviewed for all suicide deaths in youth aged between 10 and 19 in the city of Toronto from 1998 to 2011. Data abstracted were recent stressors (including bullying), clinical variables, such as the presence of mental illness, demographics, and methods of suicide. Ninety-four youth suicides were included in the study. The mean age was 16.8 years, and 70.2% were male. Bullying was present in 6 deaths (6.4%), and there were no deaths where online or cyberbullying was detected. Bullying was the only identified contributing factor in fewer than 5 deaths. The most common stressors identified were conflict with parents (21.3%), romantic partner problems (17.0%), academic problems (10.6%), and criminal and (or) legal problems (10.6%). Any stressor or mental and (or) physical illness was detected in 78.7% of cases. Depression was detected in 40.4% of cases. Our study highlights the need to view suicide in youth as arising from a complex interplay of various biological, psychological, and social factors of which bullying is only one. It challenges simple cause-and-effect models that may suggest that suicide arises from anyone factor, such as bullying.

Identification of Gambling Problems in Primary Care: Properties of the NODS-CLiP Screening Tool.

PubMed

Cowlishaw, Sean; McCambridge, Jim; Kessler, David

2018-06-25

There are several brief screening tools for gambling that possess promising psychometric properties, but have uncertain utility in generalist healthcare environments which prioritize prevention and brief interventions. This study describes an examination of the National Opinion Research Centre Diagnostic and Statistical Manual of Mental Disorders Screen for Gambling Problems (NODS-CLiP), in comparison with the Problem Gambling Severity Index (PGSI), when used to operationalize gambling problems across a spectrum of severity. Data were obtained from 1058 primary care attendees recruited from 11 practices in England who completed various measures including the NODS-CLiP and PGSI. The performance of the former was defined by estimates of sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs), when PGSI indicators of problem gambling (5+) and any gambling problems (1+), respectively, were reference standards. The NODS-CLiP demonstrated perfect sensitivity for problem gambling, along with high specificity and a NPV, but a low PPV. There was much lower sensitivity when the indicator of any gambling problems was the reference standard, with capture rates indicating only 20% of patients exhibiting low to moderate severity gambling problems (PGSI 1-4) were identified by the NODS-CLiP. The NODS-CLiP performs well when identifying severe cases of problem gambling, but lacks sensitivity for less severe problems and may be unsuitable for settings which prioritize prevention and brief interventions. There is a need for screening measures which are sensitive across the full spectrum of risk and severity, and can support initiatives for improving identification and responses to gambling problems in healthcare settings such as primary care.

Faculty Salary Equity: Issues and Options.

ERIC Educational Resources Information Center

Snyder, Julie K.; And Others

1994-01-01

An approach to identifying and correcting college faculty salary inequities based on gender is presented. Steps include determining whether a problem exists using an objective, legally sound procedure; developing feasible adjustment strategies; and implementing correction and a monitoring process consistent with institutional culture and values.…

A Problem Solving Active-Learning Course in Pharmacotherapy.

ERIC Educational Resources Information Center

Delafuente, Jeffrey C.; And Others

1994-01-01

A third-year pharmacology course in a doctoral pharmacy program that is case based and intended for a large class is described. Aspects discussed include learning objectives, course organization, classroom activities, case selection and design, faculty involvement, grading, and areas identified for improvement. (MSE)

Sustaining Motivation and Productivity during Significant Organizational Change.

ERIC Educational Resources Information Center

Pellak, Mary T.

2001-01-01

Discussion of organizational change and possible negative effects which can impact organizational performance focuses on ways a manager can identify problems with employee motivation and productivity and address them in a supportive manner. Topics include clear expectations, open communication, and recognizing employee efforts. (Author/LRW)

Lifestyles/Personal Health Care in Different Occupations.

ERIC Educational Resources Information Center

Anderson, Stuart A.

1981-01-01

The American Academy of Family Physicians initiated a study to identify and examine certain life-style patterns in representative groups of people. This article presents the responses from teachers, including their perceptions of factors contributing to stress, problems at home, and allocation of time. (WD)

Liquid rocket engine turbines

NASA Technical Reports Server (NTRS)

1974-01-01

Criteria for the design and development of turbines for rocket engines to meet specific performance, and installation requirements are summarized. The total design problem, and design elements are identified, and the current technology pertaining to these elements is described. Recommended practices for achieving a successful design are included.

Determination and analysis of the full-length chicken parvovirus genome.

USDA-ARS?s Scientific Manuscript database

Viral enteric disease in poultry is an ongoing problem in many parts of the world. Many enteric viruses have been identified in turkeys and chickens, including avian astroviruses, rotaviruses, reoviruses, and coronaviruses. Through the application of a molecular screening method targeting particle-a...

Coast Guard: Opportunities Exist to Further Improve Acquisition Management Capabilities

DTIC Science & Technology

2011-04-01

Coast Guard’s significant acquisition challenges, including project challenges in its Deepwater program. GAO’s prior work on the Coast Guard...to defense readiness. We have reported extensively on the Coast Guard’s significant acquisition challenges, including its Deepwater program, which...prior work on the Deepwater acquisition program identified problems in costs, management, and oversight that have led to delivery delays and other

Organisational restructuring/downsizing, OHS regulation and worker health and wellbeing.

PubMed

Quinlan, Michael

2007-01-01

A growing body of international evidence indicates that downsizing and related forms of organisational restructuring are having profound adverse effects on worker safety, health and wellbeing. In particular, evidence links downsizing to poorer mental health outcomes, including bullying and other forms of occupational violence. In Australia federal, state and territory occupational health and safety (OHS) legislation imposes obligations on employers who make changes to the workplace or work processes to identify hazards, undertake risk assessment, consult with employee representatives and take appropriate steps to manage any significant hazards that are identified, including psychosocial hazards. This study shows that while Australian regulators are aware of the problems posed by downsizing they have made only modest efforts to pursue compliance with legislative duties, producing some guidance material that refers to restructuring and workloads and launching a small number of prosecutions. At the same time, there is an increased willingness to address staffing levels and other impacts of downsizing (like working in isolation). Employer and union responses were also examined. The article concludes by identifying a number of initiatives that would enable regulators, unions and employers to address the problems posed by downsizing more effectively.

Web survey of sleep problems associated with early-onset bipolar spectrum disorders.

PubMed

Lofthouse, Nicholas; Fristad, Mary; Splaingard, Mark; Kelleher, Kelly; Hayes, John; Resko, Susan

2008-05-01

As research on sleep difficulties associated with Early-Onset Bipolar Spectrum Disorders (EBSD) is limited, a web-based survey was developed to further explore these problems. 494 parents of 4-to-12 year-olds, identified by parents as being diagnosed with EBSD, completed a web survey about past and current EBSD-related sleep problems. The survey included Children's Sleep Habits Questionnaire (CSHQ) items and sleep problems from the International Classification of Sleep Disorders 2nd edition. Nearly all parents reported some type of past or current EBSD-sleep problem. Most occurred during a worst mood period, particularly with mixed manic-depressive symptoms. Symptoms caused impairments at home, school, or with peers in 96.9% of the sample and across all three contexts in 64.0% of children. Sleep problems were also noted after three-day weekends and Spring and Fall Daylight Savings time changes. Findings, study limitations, and implications for treatment and etiology are discussed.

Internet use and video gaming predict problem behavior in early adolescence.

PubMed

Holtz, Peter; Appel, Markus

2011-02-01

In early adolescence, the time spent using the Internet and video games is higher than in any other present-day age group. Due to age-inappropriate web and gaming content, the impact of new media use on teenagers is a matter of public and scientific concern. Based on current theories on inappropriate media use, a study was conducted that comprised 205 adolescents aged 10-14 years (Md = 13). Individuals were identified who showed clinically relevant problem behavior according to the problem scales of the Youth Self Report (YSR). Online gaming, communicational Internet use, and playing first-person shooters were predictive of externalizing behavior problems (aggression, delinquency). Playing online role-playing games was predictive of internalizing problem behavior (including withdrawal and anxiety). Parent-child communication about Internet activities was negatively related to problem behavior. Copyright © 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

A narrow view: The conceptualization of sexual problems in human sexuality textbooks.

PubMed

Stelzl, Monika; Stairs, Brittany; Anstey, Hannah

2018-02-01

This study examined the ways in which the meaning of 'sexual problems' is constructed and defined in undergraduate human sexuality textbooks. Drawing on feminist and critical discourse frameworks, the dominant as well as the absent/marginalized discourses were identified using critical discourse analysis. Sexual difficulties were largely framed by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Thus, medical discourse was privileged. Alternative conceptualizations and frameworks, such as the New View of Women's Sexual Problems, were included marginally and peripherally. We argue that current constructions of sexuality knowledge reinforce, rather than challenge, existing hegemonic discourses of sexuality.

Problem Gambling and Delinquent Behaviours Among Adolescents: A Scoping Review.

PubMed

Kryszajtys, David T; Hahmann, Tara E; Schuler, Andrée; Hamilton-Wright, Sarah; Ziegler, Carolyn P; Matheson, Flora I

2018-02-22

Despite many studies indicating an association between problem gambling and delinquent behaviours among adolescents, there has been no effort to systematically analyze the state of the literature on this relationship. To fill this gap, we conducted a scoping review of the literature published between 2000 and 2016 on problem gambling and delinquent behaviours among adolescents. We searched twelve databases and reviewed reference lists to identify eligible studies. Search terms included a combination of medical subject headings and keywords for gambling, youth, and delinquency, which were combined with the Boolean operator "AND". 1795 studies were identified through the literature search. Nine studies were eligible for inclusion. All of the studies were conducted in North America, with primarily male participants, and most of the data were cross-sectional. No qualitative studies met the inclusion criteria. Screening tools used to measure problem gambling were inconsistent, making comparisons across studies difficult. We found a consistent moderate to strong association between problem gambling and delinquent behaviour. Only one study presented associations by socio-economic status and none considered gender, sex or ethnic differences. Studies in the review showed that problem gambling is associated with both violent and non-violent behaviours among adolescents. These associations may suggest that problem gambling and delinquent behaviours have common risk factors and reflect a syndrome of risky behaviours best targeted through prevention and treatment that is holistic and considers the context in which the youth is situated. Further research is warranted to better understand the relationship between problem gambling and delinquent behaviours.

Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study.

PubMed

Nguyen, Amanda J; Feo, Concetta; Idrisov, Kyuri; Pintaldi, Giovanni; Lenglet, Annick; Tsatsaeva, Zalina; Bolton, Paul; Bass, Judith

2016-01-01

A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. Amidst substantial reconstruction, periodic violence has contributed to an ongoing atmosphere of insecurity. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling. Data were collected in July 2014. A convenience sample of 59 Chechen adults was asked to Free List all problems affecting people in the area. Four problems were explored further in 19 Key Interviewee (KI) interviews, with respondents identified using snowball sampling. Data analysis was conducted in Russian by the Chechen interviewers. Multiple mental health and psychosocial problems emerged, including 'bad psychological health', 'depression', 'stress and nervous people', and 'problems in the family'. Aggression, 'emotional blowing', and 'not adequate' behavior were frequently reported indicators of these problems, with negative effects on the whole family. Chechens reported seeking help through informal social networks, psychiatric and psychological services, and Islamic Centers. Chechens reported mental health and psychosocial problems similar to those experienced in other post-conflict settings. The description of 'emotional blowing' mirrored prior findings in Chechen asylum seekers and fits within a cluster of cultural concepts of distress featuring anger that has been identified in other conflict-affected populations. Further exploration of the nature and prevalence of this construct, as well as evaluations of interventions aimed at reducing these symptoms, is warranted.

Teaching basic science to optimize transfer.

PubMed

Norman, Geoff

2009-09-01

Basic science teachers share the concern that much of what they teach is soon forgotten. Although some evidence suggests that relatively little basic science is forgotten, it may not appear so, as students commonly have difficulty using these concepts to solve or explain clinical problems: This phenomenon, using a concept learned in one context to solve a problem in a different context, is known to cognitive psychologists as transfer. The psychology literature shows that transfer is difficult; typically, even though students may know a concept, fewer than 30% will be able to use it to solve new problems. However a number of strategies to improve transfer can be adopted at the time of initial teaching of the concept, in the use of exemplars to illustrate the concept, and in practice with additional problems. In this article, we review the literature in psychology to identify practical strategies to improve transfer. Critical review of psychology literature to identify factors that enhance or impede transfer. There are a number of strategies available to teachers to facilitate transfer. These include active problem-solving at the time of initial learning, imbedding the concept in a problem context, using everyday analogies, and critically, practice with multiple dissimilar problems. Further, mixed practice, where problems illustrating different concepts are mixed together, and distributed practice, spread out over time, can result in significant and large gains. Transfer is difficult, but specific teaching strategies can enhance this skill by factors of two or three.

Implementation of basic chemistry experiment based on metacognition to increase problem-solving and build concept understanding

NASA Astrophysics Data System (ADS)

Zuhaida, A.

2018-04-01

Implementation of the experiment have the three aspects of the goal: 1) develop basic skills of experimenting; 2) develop problem-solving skills with a scientific approach; 3) improve understanding of the subject matter. On the implementation of the experiment, students have some weaknesses include: observing, identifying problems, managing information, analyzing, and evaluating. This weakness is included in the metacognition indicator.The objective of the research is to implementation of Basic Chemistry Experiment based on metacognition to increase problem-solving skills and build concept understanding for students of Science Education Department. The method of this research is a quasi- experimental method with pretest-posttest control group design. Problem-solving skills are measured through performance assessments using rubrics from problem solving reports, and results presentation. The conceptual mastery is measured through a description test. The result of the research: (1) improve the problem solving skills of the students with very high category; (2) increase the students’ concept understanding better than the conventional experiment with the result of N-gain in medium category, and (3) increase student's response positively for learning implementation. The contribution of this research is to extend the implementation of practical learning for some subjects, and to improve the students' competence in science.

Discrimination and alcohol-related problems among college students: a prospective examination of mediating effects.

PubMed

Hatzenbuehler, Mark L; Corbin, William R; Fromme, Kim

2011-06-01

Discrimination is a risk factor for health-risk behaviors, including alcohol abuse. Far less is known about the mechanisms through which discrimination leads to alcohol-related problems, particularly during high-risk developmental periods such as young adulthood. The present study tested a mediation model using prospective data from a large, diverse sample of 1539 college students. This model hypothesized that discrimination would be associated with established cognitive (positive alcohol expectancies) and affective (negative affect and coping motives) risk factors for alcohol-related problems, which would account for the prospective association between discrimination and alcohol problems. Structural equation modeling indicated that discrimination was associated cross-sectionally with negative affect and more coping motives for drinking, but not with greater alcohol expectancies. Coping motives mediated the prospective relationship between discrimination and alcohol-related problems. Additionally, results indicated significant indirect effects from discrimination to alcohol-related problems through negative affect and coping motives. These associations were evident for multiple groups confronting status-based discrimination, including women, racial/ethnic minorities, and lesbian/gay/bisexual individuals. This study identified potential affective mechanisms linking discrimination to alcohol-related problems. Results suggest several avenues for prevention and intervention efforts with individuals from socially disadvantaged groups. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions

PubMed Central

Lynch, Louise; Long, Maggie; Moorhead, Anne

2016-01-01

International research has identified young men as reluctant to seek help for mental health problems. This research explored barriers and solutions to professional help seeking for mental health problems among young men living in the North West of Ireland. A qualitative approach, using two focus groups with six participants each and five face-to-face interviews, was conducted with men aged 18 to 24 years (total N = 17). Data were analyzed using thematic analysis. Seven key themes of barriers to professional help seeking were identified: “acceptance from peers,” “personal challenges,” “cultural and environmental influences,” “self-medicating with alcohol,” “perspectives around seeking professional help,” “fear of homophobic responses,” and “traditional masculine ideals.” Five key themes of solutions to these barriers included “tailored mental health advertising,” “integrating mental health into formal education,” “education through semiformal support services,” “accessible mental health care,” and “making new meaning.” Interesting findings on barriers include fear of psychiatric medication, fear of homophobic responses from professionals, the legacy of Catholic attitudes, and the genuine need for care. This study offers an in-depth exploration of how young men experience barriers and uniquely offers solutions identified by participants themselves. Youth work settings were identified as a resource for engaging young men in mental health work. Young men can be encouraged to seek help if services and professionals actively address barriers, combining advertising, services, and education, with particular attention and respect to how and when young men seek help and with whom they want to share their problems. PMID:27365212

Advanced instrumentation: Technology database enhancement, volume 4, appendix G

NASA Technical Reports Server (NTRS)

1991-01-01

The purpose of this task was to add to the McDonnell Douglas Space Systems Company's Sensors Database, including providing additional information on the instruments and sensors applicable to physical/chemical Environmental Control and Life Support System (P/C ECLSS) or Closed Ecological Life Support System (CELSS) which were not previously included. The Sensors Database was reviewed in order to determine the types of data required, define the data categories, and develop an understanding of the data record structure. An assessment of the MDSSC Sensors Database identified limitations and problems in the database. Guidelines and solutions were developed to address these limitations and problems in order that the requirements of the task could be fulfilled.

Alcohol & drug abuse: Revisiting employee assistance programs and substance use problems in the workplace: key issues and a research agenda.

PubMed

Merrick, Elizabeth S Levy; Volpe-Vartanian, Joanna; Horgan, Constance M; McCann, Bernard

2007-10-01

This column describes employee assistance program (EAPs) and identifies key issues for contemporary EAPs. These programs began as occupational alcohol programs and have evolved into more comprehensive resources. To better understand contemporary EAPs, the authors suggest a research agenda that includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs' effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures.

Revisiting Employee Assistance Programs and Substance Use Problems in the Workplace: Key Issues and a Research Agenda

PubMed Central

Levy Merrick, Elizabeth S.; Volpe-Vartanian, Joanna; Horgan, Constance M.; McCann, Bernard

2012-01-01

This column describes employee assistance program (EAPs) and identifies key issues for contemporary EAPs. These programs began as occupational alcohol programs and have evolved into more comprehensive resources. To better understand contemporary EAPs, the authors suggest a research agenda at includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs’ effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures. PMID:17914000

Coping strategies employed by women with endometriosis in a public health-care setting

PubMed Central

Roomaney, Rizwana; Kagee, Ashraf

2015-01-01

This study explored how South African patients attending public health facilities reported coping with endometriosis. A total of 16 women with endometriosis were interviewed, and we explored how participants coped with endometriosis. All interviews were audio-recorded and transcribed. Thematic analysis was used to identify themes. Participants reported employing both problem-focused and emotion-focused strategies to cope with endometriosis. Problem-focused strategies included limiting physical activities, increasing knowledge about endometriosis, scheduling social and work activities around menstrual cycle, engaging in self-management and relying on social support. Emotion-focused coping strategies included accepting the disease, adopting a positive attitude, engaging in self talk and evoking spirituality. PMID:25769875

Models of Invisibility: Rendering Domestic and Other Gendered Violence Visible to Students Through Clinical Law Teaching.

PubMed

MacDowell, Elizabeth L; Cammett, Ann

2016-10-01

The proliferation of university courses about domestic violence includes clinical courses in law schools in which students represent victims in their legal cases. This essay advocates for a broader approach to teaching about the problem. Using examples from their clinic cases, the authors show how teachers can overcome pedagogical challenges and render domestic and other forms of gendered violence, including state and community violence, more visible to students by intentionally raising and placing it within larger frameworks of structural inequality. In this way, students learn to identify and address gendered violence even when it is not the presenting problem. © The Author(s) 2016.

Research Priorities in the Field of Posttraumatic Pain and Disability: Results of a Transdisciplinary Consensus-Generating Workshop

PubMed Central

Elliott, James M.; Lee, Joshua; Loh, Eldon; Schabrun, Siobhan; Siqueira, Walter L.; Corneil, Brian D.; Aal, Bill; Birmingham, Trevor; Brown, Amy; Dickey, James P.; Dixon, S. Jeffrey; Fraser, Douglas D.; Gati, Joseph S.; Gloor, Gregory B.; Good, Gordon; Holdsworth, David; McLean, Samuel A.; Millard, Wanda; Miller, Jordan; Sadi, Jackie; Seminowicz, David A.; Shoemaker, J. Kevin; Siegmund, Gunter P.; Vertseegh, Theodore; Wideman, Timothy H.

2016-01-01

Background. Chronic or persistent pain and disability following noncatastrophic “musculoskeletal” (MSK) trauma is a pervasive public health problem. Recent intervention trials have provided little evidence of benefit from several specific treatments for preventing chronic problems. Such findings may appear to argue against formal targeted intervention for MSK traumas. However, these negative findings may reflect a lack of understanding of the causal mechanisms underlying the transition from acute to chronic pain, rendering informed and objective treatment decisions difficult. The Canadian Institutes of Health Research (CIHR) Institute of Musculoskeletal Health and Arthritis (IMHA) has recently identified better understanding of causal mechanisms as one of three priority foci of their most recent strategic plan. Objectives. A 2-day invitation-only active participation workshop was held in March 2015 that included 30 academics, clinicians, and consumers with the purpose of identifying consensus research priorities in the field of trauma-related MSK pain and disability, prediction, and prevention. Methods. Conversations were recorded, explored thematically, and member-checked for accuracy. Results. From the discussions, 13 themes were generated that ranged from a focus on identifying causal mechanisms and models to challenges with funding and patient engagement. Discussion. Novel priorities included the inclusion of consumer groups in research from the early conceptualization and design stages and interdisciplinary longitudinal studies that include evaluation of integrated phenotypes and mechanisms. PMID:27445598

Problem behaviours and symptom dimensions of psychiatric disorders in adults with intellectual disabilities: An exploratory and confirmatory factor analysis.

PubMed

Melville, Craig A; Johnson, Paul C D; Smiley, Elita; Simpson, Neill; Purves, David; McConnachie, Alex; Cooper, Sally-Ann

2016-08-01

The limited evidence on the relationship between problem behaviours and symptoms of psychiatric disorders experienced by adults with intellectual disabilities leads to conflict about diagnostic criteria and confused treatment. This study examined the relationship between problem behaviours and other psychopathology, and compared the predictive validity of dimensional and categorical models experienced by adults with intellectual disabilities. Exploratory and confirmatory factor analyses appropriate for non-continuous data were used to derive, and validate, symptom dimensions using two clinical datasets (n=457; n=274). Categorical diagnoses were derived using DC-LD. Severity and 5-year longitudinal outcome was measured using a battery of instruments. Five factors/dimensions were identified and confirmed. Problem behaviours were included in an emotion dysregulation-problem behaviour dimension that was distinct from the depressive, anxiety, organic and psychosis dimensions. The dimensional model had better predictive validity than categorical diagnosis. International classification systems should not include problem behaviours as behavioural equivalents in diagnostic criteria for depression or other psychiatric disorders. Investigating the relevance of emotional regulation to psychopathology may provide an important pathway for development of improved interventions. There is uncertainty whether new onset problem behaviours or a change in longstanding problem behaviours should be considered as symptoms of depression or other types of psychiatric disorders in adults with intellectual disabilities. The validity of previous studies was limited by the use of pre-defined, categorical diagnoses or unreliable statistical methods. This study used robust statistical modelling to examine problem behaviours within a dimensional model of symptoms. We found that problem behaviours were included in an emotional dysregulation dimension and not in the dimension that included symptoms that are typical of depression. The dimensional model of symptoms had greater predictive validity than categorical diagnoses of psychiatric disorders. Our findings suggest that problem behaviours are a final common pathway for emotional distress in adults with intellectual disabilities so clinicians should not use a change in problem behaviours as a diagnostic criterion for depression, or other psychiatric disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Dementia Services Mini-Screen: A Simple Method to Identify Patients and Caregivers Needing Enhanced Dementia Care Services

PubMed Central

Borson, Soo; Scanlan, James M.; Sadak, Tatiana; Lessig, Mary; Vitaliano, Peter

2014-01-01

Objective The National Alzheimer’s Plan calls for targeted health system change to improve outcomes for persons with dementia and their family caregivers. We explored whether dementia-specific service needs and gaps could be predicted from simple information that can be readily acquired in routine medical care settings. Method Primary family caregivers for cognitively impaired older adults (n=215) were asked about current stress, challenging patient behaviors, and prior-year needs and gaps in 16 medical and psychosocial services. Demographic data, caregiver stress, and patient clinical features were evaluated in regression analyses to identify unique predictors of service needs and gaps. Results Caregiver stress and patient behavior problems together accounted for an average of 24% of the whole-sample variance in total needs and gaps. Across all analyses, including total, medical, and psychosocial services needs and gaps, all other variables combined (comorbid chronic disease, dementia severity, age, caregiver relationship, and residence) accounted for an accounted for a mean of 3%, with no variable yielding more than 4% in any equation. We combined stress and behavior problem indicators into a simple screen. In early/mild dementia dyads (n=111) typical in primary care settings, the screen identified gaps in total and psychosocial care in 84% and 77%, respectively, of those with high stress/high behavior problems vs. 25% and 23%, respectively, of those with low stress/low behavior problems. Medical care gaps were dramatically higher in high stress/high behavior problem dyads (66%) than all others (12%). Conclusion A simple tool (likely completed in 1–2 minutes) which combines caregiver stress and patient behavior problems, the Dementia Services Mini-Screen, could help clinicians rapidly identify high need, high gap dyads. Health care systems could use it to estimate population needs for targeted dementia services and facilitate their development. PMID:24315560

Battered Agency Syndrome: The Challenge to Agencies Serving Low-Income Communities.

ERIC Educational Resources Information Center

Reed, Diane; Lally, J. Ronald; Quiett, Douglas

Community-based social service agencies working in low-income communities increasingly function with inadequate support and encounter numerous oppressive external and internal conditions that compromise organizational and staff well-being. Working with many such agencies, WestEd identified stressors that included funding problems, unrealistic…

American Viticultural Areas: A Problem in Regional Geography.

ERIC Educational Resources Information Center

Macdonald, Gerald M.; Lemaire, Denyse

1995-01-01

Maintains that growing grapes for winemaking has increased dramatically in the United States. Describes a college class assignment in which students analyzed climate and soil type to identify appropriate viticulture areas. Reports high student interest in the assignment and includes four figures illustrating the approach. (CFR)

Child Abuse and Developmental Disabilities.

ERIC Educational Resources Information Center

Grayson, Joann, Ed.; Bartlette, Don

1992-01-01

Literature indicating high rates of abuse in this population is reviewed, as is literature indicating high rates of developmental disabilities in child victims of abuse. Problems in data collecting practices are noted. Reasons for these children's greater risk for abuse are identified, including child attributes, stress, parent vulnerabilities,…

Development of a Value Inquiry Model in Biology Education.

ERIC Educational Resources Information Center

Jeong, Eun-Young; Kim, Young-Soo

2000-01-01

Points out the rapid advances in biology, increasing bioethical issues, and how students need to make rational decisions. Introduces a value inquiry model development that includes identifying and clarifying value problems; understanding biological knowledge related to conflict situations; considering, selecting, and evaluating each alternative;…

Issues Affecting Cross-Cultural Adaptation of International Graduate Students

ERIC Educational Resources Information Center

Hartshorne, Richard; Baucom, Jennifer

2007-01-01

The purpose of this study was to identify and analyze the adjustment problems encountered by international graduate students enrolled in American universities. Issues of interest included motives for attending graduate school, factors involved in facilitating and constraining the graduate school experience, personality traits that contribute to…

Ten Ways to Infuse Positive Psychology in the Schools

ERIC Educational Resources Information Center

Huebner, Scott

2012-01-01

School professionals, including school psychologists, have often operated from a problem- or deficit-based perspective with a focus on identifying and remediating psychoeducational disorders in children and adolescents. However, positive psychologists have argued that an exclusive focus on deficits does not offer a comprehensive perspective of…

From Workbook to Web: Building an Information Literacy OASIS.

ERIC Educational Resources Information Center

Rosen, Jeff; Castro, Gina M.

2002-01-01

Describes a Web-based information literacy tutorial, OASIS (Online Advancement of Student Information Skills), developed at San Francisco State University. Discussion includes: core competencies identified; design structure and content; planning and marketing; problems and partnerships in the pilot year of OASIS; restructuring the OASIS tutorial;…

Politicians and the Social Studies Curriculum.

ERIC Educational Resources Information Center

Blevins, David R.

1980-01-01

Identifies reasons for legislative interest in social studies including the tendency of legislators to respond positively to organized pressure groups and the belief among legislators that problems can be solved by awareness education. Journal available from The Social Studies Teacher, P.O. Box 189, Ovledo, Florida 32764. (Author/DB)

Identifying pathways for improving household food self-sufficiency outcomes in the hills of Nepal

USDA-ARS?s Scientific Manuscript database

Maintaining and improving food security in mountain regions is an ongoing challenge. There are many facets to the problem, including comparatively high levels of system diversity and crop-livestock integration, challenging terrain and transportation bottlenecks, declining labor availability due to o...

Coping and Suicidality among Homeless Youth

ERIC Educational Resources Information Center

Kidd, Sean A.; Carroll, Michelle R.

2007-01-01

This study examined the impact of coping strategies employed by homeless youth upon suicidal ideation, suicide attempts on the streets, and feeling trapped/helpless. Coping strategies examined in the analysis included problem-focused and avoidant coping, along with several coping strategies identified in previous exploratory qualitative studies.…

Voice problems and depression among adults in the United States.

PubMed

Marmor, Schelomo; Horvath, Keith J; Lim, Kelvin O; Misono, Stephanie

2016-08-01

Prior studies have observed a high prevalence of psychosocial distress, including depression, in patients with voice problems. However, these studies have largely been performed in care-seeking patients identified in tertiary care voice clinics. The objective of this study was to examine the association between depression and voice problems in the U.S. Cross-sectional analysis of National Health Interview Survey (NHIS) data. We identified adult cases reporting a voice problem in the preceding 12 months in the 2012 NHIS. Self-reported demographics and data regarding healthcare visits for voice problems, diagnoses given, severity of the voice problem, and depression symptoms were analyzed. The total weighted sample size was 52,816,364. The presence of depressive symptoms was associated with a nearly two-fold increase (odds ratio = 1.89, 95% confidence interval = 1.21-2.96) in the likelihood of reporting a voice problem in the past year. Patients who reported feeling depressed were less likely to receive care for the voice problem and less likely to report that treatment had helped than those who did not feel depressed. These findings indicate that the co-occurrence of voice problems and depressive symptoms is observed in the general population, not only in care-seeking patients, and that depressive symptoms may influence reported likelihood of receiving voice treatment and effectiveness. This suggests that voice care providers should take mental health symptoms into account when treating patients, and also indicates a need for further investigation. NA. Laryngoscope, 126:1859-1864, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Aspects of emotional functioning following oesophageal cancer surgery in a population-based cohort study.

PubMed

Hellstadius, Ylva; Lagergren, Pernilla; Lagergren, Jesper; Johar, Asif; Hultman, Christina M; Wikman, Anna

2015-01-01

The aim of this study was to establish the proportion of patients reporting emotional problems following oesophagectomy for cancer and identify the risk characteristics for emotional problems. A Swedish population-based cohort study of patients with surgically treated oesophageal cancer was used. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 was used to assess tension, worry, irritation and depressed mood at 6 months and 5 years after surgery. Potential risk characteristics were retrieved from medical notes and data linkages to Swedish health registries. Multivariable logistic regression analyses were performed to examine risk characteristics for poor emotional recovery. Of 401 patients included at 6 months, 49% reported problems with tension, 61% worry, 62% irritation and 63% depressed mood. Of the 140 (35%) patients who completed the 5-year follow-up, 39% reported problems with tension and about half of the patients reported problems with worry, irritation, and depressed mood (49, 45 and 52%, respectively). Squamous cell carcinoma was identified as a risk characteristic for tension (OR 2.15, 95% CI 1.30-3.55), worry (OR 2.02, 95% CI 1.19-3.40) and depressed mood (OR 1.71, 95% CI 1.01-2.90) at 6 months compared with adenocarcinoma. Compared with higher education, lower education was associated with tension (upper secondary schooling: OR 1.97, 95% CI 1.02-3.79 and 9-year compulsory: OR 2.46, 95% CI 1.28-4.74), while non-cohabitating patients were less likely to report problems with worry at 6 months (OR 0.53, 95% CI 0.34-0.84) compared with cohabitating patients. A substantial proportion of patients reports emotional problems following oesophagectomy, and risk characteristics include squamous cell carcinoma histology and low educational level. Copyright © 2014 John Wiley & Sons, Ltd.

Can Classification Tree Analyses Help Improve Decision Making About Treatments for Depression and Anxiety Disorders? A Preliminary Investigation

PubMed Central

Rhodes, Louisa; Naumann, Ulrike M.

2011-01-01

Objective: To identify how decisions about treatment are being made in secondary services for anxiety disorders and depression and, specifically, whether it was possible to predict the decisions to refer for evidence-based treatments. Method: Post hoc classification tree analysis was performed using a sample from an audit on implementation of the National Institute for Health and Clinical Excellence Guidelines for Depression and Anxiety Disorders. The audit was of 5 teams offering secondary care services; they included psychiatrists, psychologists, community psychiatric nurses, social workers, dual-diagnosis workers, and vocational workers. The patient sample included all of those with a primary problem of depression (n = 56) or an anxiety disorder (n = 16) who were offered treatment from February 16 to April 3, 2009. The outcome variable was whether or not evidence-based treatments were offered, and the predictor variables were presenting problem, risk, comorbid problem, social problems, and previous psychiatric history. Results: Treatment decisions could be more accurately predicted for anxiety disorders (93% correct) than for depression (55%). For anxiety disorders, the presence or absence of social problems was a good predictor for whether evidence-based or non–evidence-based treatments were offered; 44% (4/9) of those with social problems vs 100% (6/6) of those without social problems were offered evidence-based treatments. For depression, patients’ risk rating had the largest impact on treatment decisions, although no one variable could be identified as individually predictive of all treatment decisions. Conclusions: Treatment decisions were generally consistent for anxiety disorders but more idiosyncratic for depression, making the development of a decision-making model very difficult for depression. The lack of clarity of some terms in the clinical guidelines and the more complex nature of depression could be factors contributing to this difficulty. Further research is needed to understand the complex nature of decision making with depressed patients. PMID:22295255

Oversight of human participants research: identifying problems to evaluate reform proposals.

PubMed

Emanuel, Ezekiel J; Wood, Anne; Fleischman, Alan; Bowen, Angela; Getz, Kenneth A; Grady, Christine; Levine, Carol; Hammerschmidt, Dale E; Faden, Ruth; Eckenwiler, Lisa; Muse, Carianne Tucker; Sugarman, Jeremy

2004-08-17

The oversight of research involving human participants is widely believed to be inadequate. The U.S. Congress, national commissions, the Department of Health and Human Services, the Institute of Medicine, numerous professional societies, and others are proposing remedies based on the assumption that the main problems are researchers' conflict of interest, lack of institutional review board (IRB) resources, and the volume and complexity of clinical research. Developing appropriate reform proposals requires carefully delineating the problems of the current system to know what reforms are needed. To stimulate a more informed and meaningful debate, we delineate 15 current problems into 3 broad categories. First, structural problems encompass 8 specific problems related to the way the research oversight system is organized. Second, procedural problems constitute 5 specific problems related to the operations of IRB review. Finally, performance assessment problems include 2 problems related to absence of systematic assessment of the outcomes of the oversight system. We critically assess proposed reforms, such as accreditation and central IRBs, according to how well they address these 15 problems. None of the reforms addresses all 15 problems. Indeed, most focus on the procedural problems, failing to address either the structure or the performance assessment problems. Finally, on the basis of the delineation of problems, we outline components of a more effective reform proposal, including bringing all research under federal oversight, a permanent advisory committee to address recurrent ethical issues in clinical research, mandatory single-time review for multicenter research protocols, additional financial support for IRB functions, and a standardized system for collecting and disseminating data on both adverse events and the performance assessment of IRBs.

Gender Differences in the Presentation of Observable Risk Indicators of Problem Gambling.

PubMed

Delfabbro, Paul; Thomas, Anna; Armstrong, Andrew

2018-03-01

In many countries where gambling is legalised, there has been a strong public policy focus on the need for strategies to reduce gambling related harm. These have often included policies requiring staff in gambling venues to identify and/or assist people who might be experiencing gambling-related harm. To facilitate this process, researchers have developed visible behavioural indicators that might be used to profile potentially problematic gambling. Few of these studies have, however, examined whether such indicators or 'warning signs' might differ between men and women. In this study, we describe the results of an analysis of data drawn from 1185 fortnightly gamblers that included 338 problem gamblers as classified by the Problem Gambling Severity Index. Indicators of problem gambling were similar between males and females with a few key exceptions. Indicators reflecting emotional distress were more commonly reported by females with gambling problems, whereas problem gambling males were more likely to display aggressive behaviour towards gambling devices and others in the venue. Amongst males, signs of emotional distress as well as attempts to conceal their presence in venues from others most strongly differentiated between problem and non-problem gamblers. Amongst females, signs of anger, a decline in grooming and those attempts to access credit were the most distinguishing indicators. These findings have implications for the refinement of identification policies and practices.

A critical narrative review of transfer of basic science knowledge in health professions education.

PubMed

Castillo, Jean-Marie; Park, Yoon Soo; Harris, Ilene; Cheung, Jeffrey J H; Sood, Lonika; Clark, Maureen D; Kulasegaram, Kulamakan; Brydges, Ryan; Norman, Geoffrey; Woods, Nicole

2018-06-01

'Transfer' is the application of a previously learned concept to solve a new problem in another context. Transfer is essential for basic science education because, to be valuable, basic science knowledge must be transferred to clinical problem solving. Therefore, better understanding of interventions that enhance the transfer of basic science knowledge to clinical reasoning is essential. This review systematically identifies interventions described in the health professions education (HPE) literature that document the transfer of basic science knowledge to clinical reasoning, and considers teaching and assessment strategies. A systematic search of the literature was conducted. Articles related to basic science teaching at the undergraduate level in HPE were analysed using a 'transfer out'/'transfer in' conceptual framework. 'Transfer out' refers to the application of knowledge developed in one learning situation to the solving of a new problem. 'Transfer in' refers to the use of previously acquired knowledge to learn from new problems or learning situations. Of 9803 articles initially identified, 627 studies were retrieved for full text evaluation; 15 were included in the literature review. A total of 93% explored 'transfer out' to clinical reasoning and 7% (one article) explored 'transfer in'. Measures of 'transfer out' fostered by basic science knowledge included diagnostic accuracy over time and in new clinical cases. Basic science knowledge supported learning - 'transfer in' - of new related content and ultimately the 'transfer out' to diagnostic reasoning. Successful teaching strategies included the making of connections between basic and clinical sciences, the use of commonsense analogies, and the study of multiple clinical problems in multiple contexts. Performance on recall tests did not reflect the transfer of basic science knowledge to clinical reasoning. Transfer of basic science knowledge to clinical reasoning is an essential component of HPE that requires further development for implementation and scholarship. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Depression and associated factors in older adults in South Africa.

PubMed

Peltzer, Karl; Phaswana-Mafuya, Nancy

2013-01-18

Late-life depression is an important public health problem because of its devastating consequences. The study aims to investigate the prevalence and associated factors of self-reported symptom-based depression in a national sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE wave 1) in 2008. We conducted a national population-based cross-sectional study with a probability sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The questionnaire included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements as well as questions on depression symptoms in the past 12 months. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables, and depression. The overall prevalence of symptom-based depression in the past 12 months was 4.0%. In multivariable analysis, functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems) were associated with self-reported depression symptoms in the past 12 months. Self-reported depression in older South Africans seems to be a public health problem calling for appropriate interventions to reduce occurrence. Factors identified to be associated with depression, including functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems), can be used to guide interventions. The identified protective and risk factors can help in formulating public health care policies to improve quality of life among older adults.

The added value of a family-centered approach to optimize infants’ social-emotional development: A quasi-experimental study

PubMed Central

Hielkema, Margriet; Stewart, Roy E.; de Winter, Andrea F.

2017-01-01

Objective Family-centered care (FCC) has been related to positive healthcare outcomes in pediatric care. Our aim was to assess whether an FCC approach also leads to better and earlier identification of social-emotional problems and less child psychosocial problems at age 18 months. Methods In a quasi-experimental study within routine well-child care in the Netherlands, we compared those regions in which an FCC approach was implemented (FCC-JointStart) to those regions with “care-as-usual” (CAU), including all children. In all regions, professionals performed well-child visits (2–18 months) and assessed social-emotional problems, or risks developing these, by rating outcomes of assessments as “not optimal” or as “a problem.” We compared FCC-JointStart and CAU regarding the rates of newly identified (risks for) social-emotional problems, the pace of identification over time, and the child’s psychosocial wellbeing at eighteen months as measured by the Child Behavior Checklist (CBCL). For participants that received extra care, we compared FCC-JointStart and CAU regarding the severity of parent-reported problems. Parents were blinded, professionals were not. Results 5658 parents (68%) agreed to participate in the study. In the FCC-JointStart group, risks were identified more frequently, though differences were small (24.7% versus 22.0%, odds ratio (95%-confidence interval) adjusted for confounders: 1.44 (0.96; 2.18), Phi = .03). Risks were also identified earlier (p = .008), and additional care was provided to more severe cases than in CAU. Effect sizes r ranged from 0.17 (PSBC) to 0.22 (FAD). CBCL scores at 18 months did not differ between groups. Conclusions FFC-JointStart may contribute to more and earlier identification of risks for social-emotional problems and of families that need additional care, but not to fewer child psychosocial problems at age 18 months. Trial registration Netherlands Trial Register NTR2681 PMID:29267270

A qualitative systematic review of published work on disclosure and help-seeking for domestic violence and abuse among women from ethnic minority populations in the UK.

PubMed

Femi-Ajao, Omolade; Kendal, Sarah; Lovell, Karina

2018-03-07

Domestic violence and abuse has been recognised as an international public health problem. However, the pervasiveness of the problem is unknown due in part to underreporting, especially among women from ethnic minority populations. In relation to this group, this review seeks to explore: (1) the barriers to disclosure; (2) the facilitators of help-seeking; and (3) self-perceived impacts of domestic violence. We systematically identified published qualitative studies conducted among women from ethnic minority populations in the UK. Data analysis was completed using thematic analysis approach. 562 papers were identified and eight papers from four studies conducted among women from ethnic minority populations in the UK met the inclusion criteria and were reviewed. Barriers to disclosure include: Immigration status, community influences, problems with language and interpretation, and unsupportive attitudes of staff within mainstream services. Facilitators of help-seeking were: escalation of abuse and safety of children. Self-perceived impact of abuse includes: shame, denial, loss of identity and lack of choice. There is an on-going need for staff from domestic violence services to be aware of the complexities within which women from ethnic minority populations experience domestic violence and abuse.

The James Supportive Care Screening: integrating science and practice to meet the NCCN guidelines for distress management at a Comprehensive Cancer Center.

PubMed

Wells-Di Gregorio, Sharla; Porensky, Emily K; Minotti, Matthew; Brown, Susan; Snapp, Janet; Taylor, Robert M; Adolph, Michael D; Everett, Sherman; Lowther, Kenneth; Callahan, Kelly; Streva, Devita; Heinke, Vicki; Leno, Debra; Flower, Courtney; McVey, Anne; Andersen, Barbara Lee

2013-09-01

Selecting a measure for oncology distress screening can be challenging. The measure must be brief, but comprehensive, capturing patients' most distressing concerns. The measure must provide meaningful coverage of multiple domains, assess symptom and problem-related distress, and ideally be suited for both clinical and research purposes. From March 2006 to August 2012, the James Supportive Care Screening (SCS) was developed and validated in three phases including content validation, factor analysis, and measure validation. Exploratory factor analyses were completed with 596 oncology patients followed by a confirmatory factor analysis with 477 patients. Six factors were identified and confirmed including (i) emotional concerns; (ii) physical symptoms; (iii) social/practical problems; (iv) spiritual problems; (v) cognitive concerns; and (vi) healthcare decision making/communication issues. Subscale evaluation reveals good to excellent internal consistency, test-retest reliability, and convergent, divergent, and predictive validity. Specificity of individual items was 0.90 and 0.87, respectively, for identifying patients with DSM-IV-TR diagnoses of major depression and generalized anxiety disorder. Results support use of the James SCS to quickly detect the most frequent and distressing symptoms and concerns of cancer patients. The James SCS is an efficient, reliable, and valid clinical and research outcomes measure. Copyright © 2013 John Wiley & Sons, Ltd.

Using latent class analysis to identify academic and behavioral risk status in elementary students.

PubMed

King, Kathleen R; Lembke, Erica S; Reinke, Wendy M

2016-03-01

Identifying classes of children on the basis of academic and behavior risk may have important implications for the allocation of intervention resources within Response to Intervention (RTI) and Multi-Tiered System of Support (MTSS) models. Latent class analysis (LCA) was conducted with a sample of 517 third grade students. Fall screening scores in the areas of reading, mathematics, and behavior were used as indicators of success on an end of year statewide achievement test. Results identified 3 subclasses of children, including a class with minimal academic and behavioral concerns (Tier 1; 32% of the sample), a class at-risk for academic problems and somewhat at-risk for behavior problems (Tier 2; 37% of the sample), and a class with significant academic and behavior problems (Tier 3; 31%). Each class was predictive of end of year performance on the statewide achievement test, with the Tier 1 class performing significantly higher on the test than the Tier 2 class, which in turn scored significantly higher than the Tier 3 class. The results of this study indicated that distinct classes of children can be determined through brief screening measures and are predictive of later academic success. Further implications are discussed for prevention and intervention for students at risk for academic failure and behavior problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Framework for characterization. (Revised final report March 1992). Technical pub

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

Ramsay, M.; Boynton, W.; Clark, P.

1992-03-01

The Tampa Bay National Estuary Program (TBNEP) was established in 1990 to develop a comprehensive conservation and management plan, a program to restore and protect Tampa Bay and its resources. The process of identifying the problems of the bay and linking problems to causes is prerequisite to developing the CCMP and is known as characterization. Characterization workshops were held in June and July 1991 to (1) guide the characterization process toward areas of greatest information needs; (2) contribute to the development of a preliminary bay characterization report; and (3) develop a depiction of bay ecosystem components and interrelationships. The workshopsmore » focused on two categories of priority problems: living resources and water quality deterioration. Priority information needs include estuarine seagrasses, low-salinity habitats, and benthic habitats. Refinement of a nitrogen input budget and establishment of cause-effect relationships among nutrient loading dissolved oxygen concentrations and the distribution of seagrass and benthic communities were also identified as priority information needs.« less

Veterinary Public Health Capacity in the United States: Opportunities for Improvement

PubMed Central

Jarman, Dwayne W.; Liang, Jennifer L.; Luce, Richard R.; Wright, Jennifer G.; Stennies, Gail M.; Bisgard, Kristine M.

2011-01-01

Objectives In 2006, the Association of American Veterinary Medical Colleges reported that the shortage (≥1,500) of public health veterinarians is expected to increase tenfold by 2020. In 2008, the Centers for Disease Control and Prevention (CDC) Preventive Medicine Fellows conducted a pilot project among CDC veterinarians to identify national veterinary public health workforce concerns and potential policy strategies. Methods Fellows surveyed a convenience sample (19/91) of public health veterinarians at CDC to identify veterinary workforce recruitment and retention problems faced by federal agencies; responses were categorized into themes. A focus group (20/91) of staff veterinarians subsequently prioritized the categorized themes from least to most important. Participants identified activities to address the three recruitment concerns with the highest combined weight. Results Participants identified the following three highest prioritized problems faced by federal agencies when recruiting veterinarians to public health: (1) lack of awareness of veterinarians' contributions to public health practice, (2) competitive salaries, and (3) employment and training opportunities. Similarly, key concerns identified regarding retention of public health practice veterinarians included: (1) lack of recognition of veterinary qualifications, (2) competitive salaries, and (3) seamless integration of veterinary and human public health. Conclusions Findings identified multiple barriers that can affect recruitment and retention of veterinarians engaged in public health practice. Next steps should include replicating project efforts among a national sample of public health veterinarians. A committed and determined long-term effort might be required to sustain initiatives and policy proposals to increase U.S. veterinary public health capacity. PMID:22043103

Can active learning principles be applied to the bioscience assessments of nursing students? A review of the literature.

PubMed

Bakon, Shannon; Craft, Judy; Christensen, Martin; Wirihana, Lisa

2016-02-01

To explore if active learning principles be applied to nursing bioscience assessments and will this influence student perception of confidence in applying theory to practice? A review of the literature utilising searches of various databases including CINAHL, PUBMED, Google Scholar and Mosby's Journal Index. The literature search identified research from twenty-six original articles, two electronic books, one published book and one conference proceedings paper. Bioscience has been identified as an area that nurses struggle to learn in tertiary institutions and then apply to clinical practice. A number of problems have been identified and explored that may contribute to this poor understanding and retention. University academics need to be knowledgeable of innovative teaching and assessing modalities that focus on enhancing student learning and address the integration issues associated with the theory practice gap. Increased bioscience education is associated with improved patient outcomes therefore by addressing this "bioscience problem" and improving the integration of bioscience in clinical practice there will subsequently be an improvement in health care outcomes. From the literature several themes were identified. First there are many problems with teaching nursing students bioscience education. These include class sizes, motivation, concentration, delivery mode, lecturer perspectives, student's previous knowledge, anxiety, and a lack of confidence. Among these influences the type of assessment employed by the educator has not been explored or identified as a contributor to student learning specifically in nursing bioscience instruction. Second that educating could be achieved more effectively if active learning principles were applied and the needs and expectations of the student were met. Lastly, assessment influences student retention and the student experience and as such assessment should be congruent with the subject content, align with the learning objectives and be used as a stimulus tool for learning. Copyright © 2015 Elsevier Ltd. All rights reserved.

An overview of depression-prone personality traits and the role of interpersonal sensitivity.

PubMed

Boyce, P; Mason, C

1996-02-01

A number of personality styles have been proposed as vulnerability traits to depression. In this paper methodological problems associated with identifying such traits are discussed. These include state effects contaminating personality scales and the issue of depressive heterogeneity. Potential depression-prone personality traits are then discussed, including obsessionality, neuroticism, dependency and cognitive dysfunction. High interpersonal sensitivity as a risk factor to depression is then discussed.

Video Analysis of a Plucked String: An Example of Problem-based Learning

NASA Astrophysics Data System (ADS)

Wentworth, Christopher D.; Buse, Eric

2009-11-01

Problem-based learning is a teaching methodology that grounds learning within the context of solving a real problem. Typically the problem initiates learning of concepts rather than simply being an application of the concept, and students take the lead in identifying what must be developed to solve the problem. Problem-based learning in upper-level physics courses can be challenging, because of the time and financial requirements necessary to generate real data. Here, we present a problem that motivates learning about partial differential equations and their solution in a mathematical methods for physics course. Students study a plucked elastic cord using high speed digital video. After creating video clips of the cord motion under different tensions they are asked to create a mathematical model. Ultimately, students develop and solve a model that includes damping effects that are clearly visible in the videos. The digital video files used in this project are available on the web at http://physics.doane.edu .

How nurses can cope with stress and avoid burnout.

PubMed

Wilkinson, Stephanie

2014-11-01

This article draws on a systematic literature review to identify stressors in emergency and trauma nursing settings, and their potential effects on staff. After a search of relevant databases, six articles were chosen and analysed, and the main causes of stress in the workplace for emergency and trauma nurses were identified. These stressors include work demands and lack of time, lack of managerial support, patient aggression and violence, and staff exposure to traumatic events. Their effects on nurses include burnout, compassion fatigue, somatic complaints, mental health problems and difficulties in life outside work. The article goes on to discuss the implications of the findings on practice.

Lifetime Paid Work and Mental Health Problems among Poor Urban 9-to-13-Year-Old Children in Brazil

PubMed Central

Pires, Ivens H.; Paula, Cristiane S.

2013-01-01

Objective. To verify if emotional/behavioral problems are associated with lifetime paid work in poor urban children, when taking into account other potential correlates. Methods. Cross-sectional study focused on 9-to-13-year-old children (n = 212). In a probabilistic sample of clusters of eligible households (women 15–49 years and son/daughter <18 years), one mother-child pair was randomly selected per household (n = 813; response rate = 82.4%). CBCL/6-18 identified child emotional/behavioral problems. Potential correlates include child gender and age, socioeconomic status/SES, maternal education, parental working status, and family social isolation, among others. Multivariate analysis examined the relationship between emotional/behavioral problems and lifetime paid work in the presence of significant correlates. Findings. All work activities were non-harmful (e.g., selling fruits, helping parents at their small business, and baby sitting). Children with lower SES and socially isolated were more involved in paid work than less disadvantaged peers. Children ever exposed to paid work were four times more likely to present anxiety/depression symptoms at a clinical level compared to non-exposed children. Multivariate modeling identified three independent correlates: child pure internalizing problems, social isolation, and low SES. Conclusion. There is an association between lifetime exposure to exclusively non-harmful paid work activities and pure internalizing problems even when considering SES variability and family social isolation. PMID:24302872

Neighborhood Deprivation during Early Childhood and Conduct Problems in Middle Childhood: Mediation by Aggressive Response Generation.

PubMed

Galán, Chardée A; Shaw, Daniel S; Dishion, Thomas J; Wilson, Melvin N

2017-07-01

The tremendous negative impact of conduct problems to the individual and society has provided the impetus for identifying risk factors, particularly in early childhood. Exposure to neighborhood deprivation in early childhood is a robust predictor of conduct problems in middle childhood. Efforts to identify and test mediating mechanisms by which neighborhood deprivation confers increased risk for behavioral problems have predominantly focused on peer relationships and community-level social processes. Less attention has been dedicated to potential cognitive mediators of this relationship, such as aggressive response generation, which refers to the tendency to generate aggressive solutions to ambiguous social stimuli with negative outcomes. In this study, we examined aggressive response generation, a salient component of social information processing, as a mediating process linking neighborhood deprivation to later conduct problems at age 10.5. Participants (N = 731; 50.5 % male) were drawn from a multisite randomized prevention trial that includes an ethnically diverse and low-income sample of male and female children and their primary caregivers followed prospectively from toddlerhood to middle childhood. Results indicated that aggressive response generation partially mediated the relationship between neighborhood deprivation and parent- and teacher-report of conduct problems, but not youth-report. Results suggest that the detrimental effects of neighborhood deprivation on youth adjustment may occur by altering the manner in which children process social information.

Neighborhood Deprivation during Early Childhood and Conduct Problems in Middle Childhood: Mediation by Aggressive Response Generation

PubMed Central

Shaw, Daniel S.; Dishion, Thomas J.; Wilson, Melvin N.

2018-01-01

The tremendous negative impact of conduct problems to the individual and society has provided the impetus for identifying risk factors, particularly in early childhood. Exposure to neighborhood deprivation in early childhood is a robust predictor of conduct problems in middle childhood. Efforts to identify and test mediating mechanisms by which neighborhood deprivation confers increased risk for behavioral problems have predominantly focused on peer relationships and community-level social processes. Less attention has been dedicated to potential cognitive mediators of this relationship, such as aggressive response generation, which refers to the tendency to generate aggressive solutions to ambiguous social stimuli with negative outcomes. In this study, we examined aggressive response generation, a salient component of social information processing, as a mediating process linking neighborhood deprivation to later conduct problems at age 10.5. Participants (N = 731; 50.5 % male) were drawn from a multisite randomized prevention trial that includes an ethnically diverse and low-income sample of male and female children and their primary caregivers followed prospectively from toddlerhood to middle childhood. Results indicated that aggressive response generation partially mediated the relationship between neighborhood deprivation and parent- and teacher-report of conduct problems, but not youth-report. Results suggest that the detrimental effects of neighborhood deprivation on youth adjustment may occur by altering the manner in which children process social information. PMID:27696324

Lifetime paid work and mental health problems among poor urban 9-to-13-year-old children in Brazil.

PubMed

Bordin, Isabel A; Pires, Ivens H; Paula, Cristiane S

2013-01-01

To verify if emotional/behavioral problems are associated with lifetime paid work in poor urban children, when taking into account other potential correlates. Cross-sectional study focused on 9-to-13-year-old children (n = 212). In a probabilistic sample of clusters of eligible households (women 15-49 years and son/daughter <18 years), one mother-child pair was randomly selected per household (n = 813; response rate = 82.4%). CBCL/6-18 identified child emotional/behavioral problems. Potential correlates include child gender and age, socioeconomic status/SES, maternal education, parental working status, and family social isolation, among others. Multivariate analysis examined the relationship between emotional/behavioral problems and lifetime paid work in the presence of significant correlates. All work activities were non-harmful (e.g., selling fruits, helping parents at their small business, and baby sitting). Children with lower SES and socially isolated were more involved in paid work than less disadvantaged peers. Children ever exposed to paid work were four times more likely to present anxiety/depression symptoms at a clinical level compared to non-exposed children. Multivariate modeling identified three independent correlates: child pure internalizing problems, social isolation, and low SES. There is an association between lifetime exposure to exclusively non-harmful paid work activities and pure internalizing problems even when considering SES variability and family social isolation.

Defining the questions: a research agenda for nontraditional authentication in arms control

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

Hauck, Danielle K; Mac Arthur, Duncan W; Smith, Morag K

Many traditional authentication techniques have been based on hardware solutions. Thus authentication of measurement system hardware has been considered in terms of physical inspection and destructive analysis. Software authentication has implied hash function analysis or authentication tools such as Rose. Continuity of knowledge is maintained through TIDs and cameras. Although there is ongoing progress improving all of these authentication methods, there has been little discussion of the human factors involved in authentication. Issues of non-traditional authentication include sleight-of-hand substitutions, monitor perception vs. reality, and visual diversions. Since monitor confidence in a measurement system depends on the product of their confidencesmore » in each authentication element, it is important to investigate all authentication techniques, including the human factors. This paper will present an initial effort to identify the most important problems that traditional authentication approaches in safeguards have not addressed and are especially relevant to arms control verification. This will include a survey of the literature and direct engagement with nontraditional experts in areas like psychology and human factors. Based on the identification of problem areas, potential research areas will be identified and a possible research agenda will be developed.« less

Teaching History in Russia after the Collapse of the USSR

ERIC Educational Resources Information Center

Volodina, Tatyana

2005-01-01

Dramatic conflicts and ideological changes occurred in Russia during the past decade. They inevitably influenced Russian education, particularly history teaching. A number of problems that have arisen in history education have been identified, including the emergence of new ideological symbols, and inequalities between schools for the rich and…

Business Department Chairperson: An Administrator or a Teacher?

ERIC Educational Resources Information Center

O'Neil, Bryan L.

The responsibilities of the business department chairperson at Castleton State College were assessed. A literature review included the area of organizational structures of academic institutions, and key faculty members and administrators at the college were interviewed to identify the key issues and problems of organizational structures and job…

Education, Assistance and Prevention Program for Chemical Dependency Problems among Pharmacy Students.

ERIC Educational Resources Information Center

Giannetti, Vincent J.; And Others

1990-01-01

Duquesne University (Pennsylvania) has established a chemical dependency peer intervention program with a strong education and prevention focus which involves identifying, motivating, referring for treatment and aftercare monitoring of impaired pharmacy students. The program includes a required student seminar. Student response to the seminar and…

University Spin-Offs in the Commercialization of Research. A Balancing Act.

ERIC Educational Resources Information Center

Rappert, Brian

1997-01-01

Interviews with more than 40 employees of 25 British university spinoff firms, vehicles for moving research into the marketplace, identified differences among sectors (information technology, scientific instruments, and new materials), including diversity in the extent of university control. Overall, these companies do not resolve problems with…

Internationalizing Career Counseling: Emptying Our Cups and Learning from Each Other

ERIC Educational Resources Information Center

Hartung, Paul J.

2005-01-01

The symposium International Perspectives on Career Development included a plenary session that addressed career counseling in a world of limited resources. Panelists representing diverse areas of the world shared their perspectives on career counseling in their countries and the specific problems they faced. They identified common concerns and…

Is there Relevance for Classical French Counterinsurgency in Modern Counterinsurgency

DTIC Science & Technology

2010-12-10

using them effectively in a deliberate manner one part of the country at a time. These four laws identify the heart of the problem in COIN according...information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this...

Identifying and Intervening in Relational Aggression

ERIC Educational Resources Information Center

Raskauskas, Juliana; Stoltz, Ann D.

2004-01-01

Chronic victimization by bullies has been associated with academic failure in adolescence, as well as adjustment difficulties, depression, and suicidal ideation. Relational aggression is a form of bullying that is a problem for adolescent girls. It often takes the form of damaging peer relationships and includes verbal assaults such as teasing or…

Internal Communication Study. 1974-75 Evaluation Report.

ERIC Educational Resources Information Center

Austin Independent School District, TX. Office of Research and Evaluation.

This report attempts to identify some communication problem areas in the Austin Independent School District, based on an open-ended interview questionnaire and a network analysis. Guidelines based on a review of the literature are included for communicators at all levels of the organizational structure. Backup summaries of that review are also…

Rethinking Special Education for a New Century.

ERIC Educational Resources Information Center

Finn, Chester E., Jr., Ed.; Rotherham, Andrew J., Ed.; Hokanson, Charles R., Jr., Ed.

This book scrutinizes the education now being received by 6 million U.S. children with disabilities. It identifies the problems that currently beset special education, analyzes their causes, and suggests solutions. Chapters include: (1) "The Evolution of the Federal Role" (Tyce Palmaffy); (2) "Time To Make Special Education 'Special' Again" (Wade…

Telecommunications for Metropolitan Areas: Opportunities for the 1980's.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Assembly of Engineering.

This report intended for officials responsible for solving metropolitan problems identifies ways that telecommunications could improve the delivery of public services to metropolitan communities during the 1980's. Areas included in this study are delivery of public services to the home, operation of mobile public services, personal security…

Theme Issue: Organizational Communication.

ERIC Educational Resources Information Center

Anapol, Malthon M., Ed.

1978-01-01

The articles in this publication discuss the identity problem of those educated in organizational communication when they face a job market that does not identify specific roles and positions for their specialty. The publication includes an outline for a course in organizational communication and a list of guidelines for the selection of client…

A Committee on Well-Being of Medical Students and House Staff.

ERIC Educational Resources Information Center

Weinstein, Harvey M.

1983-01-01

A committee was established in a university medical center to address socioemotional aspects of medical training and to enhance the learning environment. Problem areas identified for program development included poor communication, stress on self and relationships, need for advocacy, and lack of support for house staff members. (MSE)

Analysis of University Management of Emerging Technologies and Recommendations for Developing Countries

ERIC Educational Resources Information Center

Villa Enciso, Eliana María; Picón Jácome, Edgar; Valencia-Arias, Alejandro; Jiménez Hernández, Claudia Nelcy

2017-01-01

University management seeks to achieve the objectives established by higher education's institutions, including their third mission, which corresponds to the transfer of research results into the industry; in this regard, emerging technologies play an important role to solve problems identified in the industry. Emerging technologies are those…

Elites and Panic: More to Fear than Fear Itself

ERIC Educational Resources Information Center

Clarke, Lee; Chess, Caron

2008-01-01

Attributions of panic are almost exclusively directed at members of the general public. Here, we inquire into the relationships between elites and panic. We review current research and theorizing about panic, including problems of identifying when it has occurred. We propose three relationships: elites fearing panic, elites causing panic and…

Evaluation of a Pre-Treatment Assessment to Select Mand Topographies for Functional Communication Training

ERIC Educational Resources Information Center

Ringdahl, Joel E.; Falcomata, Terry S.; Christensen, Tory J.; Bass-Ringdahl, Sandie M.; Lentz, Alison; Dutt, Anuradha; Schuh-Claus, Jessica

2009-01-01

Recent research has suggested that variables related to specific mand topographies targeted during functional communication training (FCT) can affect treatment outcomes. These include effort, novelty of mands, previous relationships with problem behavior, and preference. However, there is little extant research on procedures for identifying which…

Intersectional Computer-Supported Collaboration in Business Writing: Learning through Challenged Performance

ERIC Educational Resources Information Center

Remley, Dirk

2009-01-01

Carter (2007) identifies four meta-genres associated with writing activities that can help students learn discipline-specific writing skills relative to standards within a given field: these include problem solving, empirical approaches to analysis, selection of sources to use within research, and production of materials that meet accepted…

Confidentiality Revisited: A Response to Manhal-Baugus (1996).

ERIC Educational Resources Information Center

Doyle, Kevin

1998-01-01

Reviews the issues relating to confidentiality raised by Manhal-Baugus (1996), identifies problem areas from the 1996 article, and offers additional information about confidentiality not included in the article. Chemical dependency counselors are urged to consider the federal law covering confidentiality of alcohol- and drug-abuse patient records…

Skills for Today: What We Know about Teaching and Assessing Collaboration

ERIC Educational Resources Information Center

Lai, Emily; DiCerbo, Kristen; Foltz, Peter

2017-01-01

Collaboration is increasingly identified as an important educational outcome, and most models of twenty-first-century skills include collaboration as a key skill (e.g., Griffin, McGaw, & Care, 2012; Pellegrino & Hilton, 2012; OECD PISA Collaborative Problem Solving Expert Working Group, 2013; Trilling & Fadel, 2009). Such widespread…

Parental Depressive Symptoms and Children's Sleep: The Role of Family Conflict

ERIC Educational Resources Information Center

El-Sheikh, Mona; Kelly, Ryan J.; Bagley, Erika J.; Wetter, Emily K.

2012-01-01

Background: We used a multi-method and multi-informant design to identify developmental pathways through which parental depressive symptoms contribute to children's sleep problems. Environmental factors including adult inter-partner conflict and parent-child conflict were considered as process variables of this relation. Methods: An ethnically and…

Mathematics Reform Curricula and Special Education: Identifying Intersections and Implications for Practice

ERIC Educational Resources Information Center

Sayeski, Kristin L.; Paulsen, Kim J.

2010-01-01

In many general education classrooms today, teachers are using "reform" mathematics curricula. These curricula emphasize the application of mathematics in real-life contexts and include such practices as collaborative, group problem solving and student-generated algorithms. Students with learning disabilities in the area of mathematics can…

Emotion Dysregulation as a Mechanism Linking Stress Exposure to Adolescent Aggressive Behavior

ERIC Educational Resources Information Center

Herts, Kate L.; McLaughlin, Katie A.; Hatzenbuehler, Mark L.

2012-01-01

Exposure to stress is associated with a wide range of internalizing and externalizing problems in adolescents, including aggressive behavior. Extant research examining mechanisms underlying the associations between stress and youth aggression has consistently identified social information processing pathways that are disrupted by exposure to…

Equality of Opportunity, Cultural Diversity and Claims for Fairness

ERIC Educational Resources Information Center

Sardoc, Mitja

2016-01-01

The present paper examines some of the tensions, problems and challenges associated with claims for equality of opportunity (the fairness argument). The introductory part identifies three separate forms of justification for public education, including the argument associated with equality of opportunity. Part II examines in detail two questions…

Job-Related Basic Skills. ERIC Digest No. 94.

ERIC Educational Resources Information Center

Kerka, Sandra

Seven job-related basic skills identified as skills employers want are as follows: (1) learning to learn; (2) reading, writing, and computation; (3) oral communication and listening; (4) creative thinking and problem solving; (5) personal management, including self-esteem, goal setting, motivation, and personal and career development; (6) group…

Teaching Students to Become Discriminating Map Users.

ERIC Educational Resources Information Center

Rice, Gwenda H.

1990-01-01

Analyzes the difficulty of depicting a round world on a flat surface by identifying distortions in the traditional Mercator Projection. Questions whether its Eurocentric bias culturally conditions students. Presents other world maps that attempt to resolve more fairly the shape/area problem, including some drawn with computers. Encourages teachers…

Changing Problem Behavior Using Solution Parenting.

ERIC Educational Resources Information Center

Schatz, Mona Struhsaker; Zimmerman, Toni Schindler; Watson, Catherine

Solution parenting is designed to provide both foster parents and caseworkers a new kind of parenting for difficult children and youth in placement. The specialized training program is for those who will teach solution parenting. Objectives for trainees include: (1) identify small, positive behavioral changes; (2) recognize and use pre-existing…

Proceedings of a Conference on Medical Information Systems.

ERIC Educational Resources Information Center

Health Services and Mental Health Administration (DHEW), Bethesda, MD.

The purposes of this conference are: to define the current state of technology; to identify the problems, needs and emerging technology; and to consider alternative computer applications to multiple-facility medical information systems for the delivery of medical care and for health services research. The papers presented include: (1) General…

Courses for Disadvantaged Adults

ERIC Educational Resources Information Center

Brown, Michael Barratt

1976-01-01

Problems and needs of unprepared adult learners are identified and purposes and processes for programs designed to hold them and encourage them on to more systematic study are outlined. Includes description of released time and multi-media programs at Sheffield University Department of Extra Mural Studies for trade unionists and housewives. (JT)

Use of Cognitive Therapy and the Balance Sheet Procedure to Assist Career Decision Making.

ERIC Educational Resources Information Center

O'Hare, Marianne M.

1989-01-01

A balance sheet technique enables counselors to help clients identify and overcome anxiety associated with career decision making. Steps include describing the problem, brainstorming alternatives, listing expected positive and negative outcomes in terms of self and others, seeking information, and choosing alternatives. (SK)

An Introduction to Cost Sharing: Why Good Deeds Do Not Go Unpunished.

ERIC Educational Resources Information Center

Seligman, Richard P.

2000-01-01

Examines the concept of cost sharing between grantor agencies and grantee institutions and identifies problems encountered, including use of cost sharing to leverage funds by both funding agencies and grantee institutions; and various grantee institution costing, accounting, and auditing issues, such as effort reporting, the Cost Accounting…

Using Puppets with Students with Emotional and Behavioral Disorders.

ERIC Educational Resources Information Center

Caputo, Rosario Anthony

1993-01-01

This article suggests ways in which special educators of students with emotional and behavioral disorders can introduce puppets into their classrooms as educational and therapeutic instruments. Puppets are able to help students identify problems and find rational solutions in a nonthreatening situation. Two sample applications are included. (DB)

Functional Analysis and Treatment of Aggression Maintained by Preferred Conversational Topics

ERIC Educational Resources Information Center

Roscoe, Eileen M.; Kindle, Arianne E.; Pence, Sacha T.

2010-01-01

After an initial functional analysis of a participant's aggression showed unclear outcomes, we conducted preference and reinforcer assessments to identify preferred forms of attention that may maintain problem behavior. Next, we conducted an extended functional analysis that included a modified attention condition. Results showed that the…

Minor Anomalies and Behavior in Different Home Environments.

ERIC Educational Resources Information Center

LaVeck, Beverly; And Others

This study presents research findings of a four year study intended to identify infant and family characteristics which, singly or in combination, predict developmental problems during preschool and school years. Predictors included a variety of measures of parental and neonatal biological conditions as well as measures of the quality of the…

Reconstruction of structural damage based on reflection intensity spectra of fiber Bragg gratings

NASA Astrophysics Data System (ADS)

Huang, Guojun; Wei, Changben; Chen, Shiyuan; Yang, Guowei

2014-12-01

We present an approach for structural damage reconstruction based on the reflection intensity spectra of fiber Bragg gratings (FBGs). Our approach incorporates the finite element method, transfer matrix (T-matrix), and genetic algorithm to solve the inverse photo-elastic problem of damage reconstruction, i.e. to identify the location, size, and shape of a defect. By introducing a parameterized characterization of the damage information, the inverse photo-elastic problem is reduced to an optimization problem, and a relevant computational scheme was developed. The scheme iteratively searches for the solution to the corresponding direct photo-elastic problem until the simulated and measured (or target) reflection intensity spectra of the FBGs near the defect coincide within a prescribed error. Proof-of-concept validations of our approach were performed numerically and experimentally using both holed and cracked plate samples as typical cases of plane-stress problems. The damage identifiability was simulated by changing the deployment of the FBG sensors, including the total number of sensors and their distance to the defect. Both the numerical and experimental results demonstrate that our approach is effective and promising. It provides us with a photo-elastic method for developing a remote, automatic damage-imaging technique that substantially improves damage identification for structural health monitoring.

Developmental transitions in presentations of externalizing problems among boys and girls at risk for child maltreatment.

PubMed

Villodas, Miguel T; Litrownik, Alan J; Thompson, Richard; Jones, Deborah; Roesch, Scott C; Hussey, Jon M; Block, Stephanie; English, Diana J; Dubowitz, Howard

2015-02-01

The present study examined the impact of children's maltreatment experiences on the emergence of externalizing problem presentations among children during different developmental periods. The sample included 788 youth and their caregivers who participated in a multisite, prospective study of youth at-risk for maltreatment. Externalizing problems were assessed at ages 4, 8, and 12, and symptoms and diagnoses of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder were assessed at age 14, during interviews with youth and caregivers. Information about maltreatment allegations was coded from official records. Latent transition analysis identified three groups of youth with similar presentations of externalizing problems ("well adjusted," "hyperactive/oppositional," and "aggressive/rule-breaking") and transitions between groups from ages 4, 8, and 12. A "defiant/deceitful" group also emerged at age 12. Girls were generally more likely to present as well adjusted than boys. Children with recent physical abuse allegations had an increased risk for aggressive/rule-breaking presentations during the preschool and preadolescent years, while children with sexual abuse or neglect allegations had lower probabilities of having well-adjusted presentations during middle childhood. These findings indicate that persistently severe aggressive conduct problems, which are related to the most concerning outcomes, can be identified early, particularly among neglected and physically and sexually abused children.

Recreation and procreation: A critical view of sex in the human female.

PubMed

Levin, Roy J

2015-04-01

This review deals critically with many aspects of the functional genital anatomy of the human female in relation to inducing sexual arousal and its relevance to procreation and recreation. Various controversial problems are discussed including: the roles of clitorally versus coitally induced arousal and orgasm in relation to the health of women, the various sites of induction of orgasm and the difficulty women find in specifically identifying them because of "'ambiguity problems" and "genital site pareidolia," the cervix and sexual arousal, why there are so many sites for arousal, why multiple orgasms occur, genital reflexes and coitus, the sites of arousal and their representation in the brain, and identifying aspects and functions of the genitalia with appropriate new nomenclature. © 2014 Wiley Periodicals, Inc.

School Functions in Unaffected Siblings of Youths with Autism Spectrum Disorders.

PubMed

Chien, Yi-Ling; Tu, En-Nien; Gau, Susan Shur-Fen

2017-10-01

This study investigated school functioning among unaffected siblings of youths with autistic spectrum disorder (ASD) and identified the correlates for school maladjustment. We recruited 66 youths with a clinical diagnosis of ASD, aged 8-19, their unaffected siblings and 132 typically developing controls (TD). We found that ASD youths had poorer school functions than unaffected siblings and TD. Unaffected siblings had poorer attitude toward schoolwork and more severe behavioral problems at school than TD. Several associated factors for different scholastic functional domains (i.e., academic performance, attitude toward school work, social interactions, behavioral problems) in the siblings included IQ, autistic traits, inattention/oppositional symptoms, sibling relationships, etc. Our findings suggest the need of assessing school functions in unaffected siblings of ASD. Clinical trial registration identifier: NCT01582256.

Approaches used by employee assistance programs to address perpetration of intimate partner violence.

PubMed

Walters, Jennifer L Hardison; Pollack, Keshia M; Clinton-Sherrod, Monique; Lindquist, Christine H; McKay, Tasseli; Lasater, Beth M

2012-01-01

Employee Assistance Programs (EAPs) are workplace resources available to employees with problems impacting work performance. EAPs are well-positioned to address intimate partner violence (IPV), a major public health problem with workplace impacts. A purposeful sample of 28 EAPs across the United States was surveyed to identify policies and programs to address IPV, including perpetration. Most EAPs did not report having standardized approaches for addressing IPV perpetration. EAPs also described significant barriers to identifying IPV perpetrators, with the majority relying on self-disclosure on the part of the perpetrator when contacting the EAP. These results suggest that many EAPs--even when interacting with employees who present with issues known to correlate with IPV--are missing a potential opportunity to assess and intervene with IPV perpetrators.

Mean-square state and parameter estimation for stochastic linear systems with Gaussian and Poisson noises

NASA Astrophysics Data System (ADS)

Basin, M.; Maldonado, J. J.; Zendejo, O.

2016-07-01

This paper proposes new mean-square filter and parameter estimator design for linear stochastic systems with unknown parameters over linear observations, where unknown parameters are considered as combinations of Gaussian and Poisson white noises. The problem is treated by reducing the original problem to a filtering problem for an extended state vector that includes parameters as additional states, modelled as combinations of independent Gaussian and Poisson processes. The solution to this filtering problem is based on the mean-square filtering equations for incompletely polynomial states confused with Gaussian and Poisson noises over linear observations. The resulting mean-square filter serves as an identifier for the unknown parameters. Finally, a simulation example shows effectiveness of the proposed mean-square filter and parameter estimator.

Contribution of Patient Interviews as Part of a Comprehensive Approach to the Identification of Drug-Related Problems on Geriatric Wards.

PubMed

Stämpfli, Dominik; Boeni, Fabienne; Gerber, Andy; Bättig, Victor A D; Hersberger, Kurt E; Lampert, Markus L

2018-06-19

Inappropriate prescribing is linked to increased risks for adverse drug reactions and hospitalisation. Combining explicit and implicit criteria of inappropriate prescribing with the information obtained in patient interviews seems beneficial with regard to the identification of drug-related problems (DRPs) in hospitalised patients. We aimed to investigate the inclusion of pharmacist interviews as part of medication reviews (including the use of explicit and implicit criteria of inappropriate prescribing) to identify DRPs in older inpatients. Clinical medication reviews were performed on geriatric and associated physical and neurological rehabilitation wards in a regional secondary care hospital. Data from electronic medical records, laboratory data, and current treatment regimens were complemented with a novel structured patient interview performed by a clinical pharmacist. The structured interview questioned patients on administration issues, prescribed medication, self-medication, and allergies. The reviews included the use of current treatment guidelines, the Medication Appropriateness Index, the Screening Tool of Older People's Prescriptions (STOPP, v2), and the Screening Tool to Alert to Right Treatment (START, v2). The potential relevance of the DRPs was estimated using the German version of the CLEO tool. In 110 patients, 595 DRPs were identified, averaging 5.4 per patient (range 0-17). The structured interviews identified 249 DRPs (41.8%), of which 227 were not identified by any other source of information. The majority of DRPs (213/249, i.e. 85.5%) identified by patient interview were estimated to be of minor clinical relevance (i.e. limited adherence, knowledge, quality of life, or satisfaction). We demonstrated that structured patient interviews identified additional DRPs that other sources did not identify. Embedded within a comprehensive approach, the structured patient interviews were needed as data resource for over one-third of all DRPs.

The interaction between gambling activities and modes of access: a comparison of Internet-only, land-based only, and mixed-mode gamblers.

PubMed

Gainsbury, Sally M; Russell, Alex; Blaszczynski, Alex; Hing, Nerilee

2015-02-01

Research suggests that Internet-based gambling includes risk factors that may increase gambling problems. The current study aimed to investigate subgroups of gamblers to identify the potential harms associated with various forms and modes of gambling. An online survey was completed by 4,594 respondents identified as Internet-only (IG), land-based only (LBGs), or mixed-mode (MMG) gamblers based on self-reported gambling behaviour in the last 12months. Results showed significant socio-demographic differences between groups, with the LBGs being the oldest and MMGs the youngest. MMGs engaged in the greatest variety of gambling forms, had the highest average problem gambling severity scores, and were more likely to attribute problems to sports betting than the other groups. IGs were involved in the lowest number of divergent gambling activities, most likely to gamble frequently on sports and races, and attribute problems to these forms. Compared to the other groups, LBs had a higher proportion of problem gamblers than IGs and were most likely to play electronic gaming machines weekly, with this form of gambling contributing to problems at a substantially greater rate. This study confirms the importance of considering gambling involvement across subgroups of Internet or land-based gamblers. There is a need to consider the interaction between forms and modes of gambling to advance our understanding of the potential risk of mode of gambling to contribute to problems. Copyright © 2014 Elsevier Ltd. All rights reserved.

The prevalence of obesity documentation in Primary Care Electronic Medical Records

PubMed Central

Mattar, Ahmed; Carlston, David; Sariol, Glen; Yu, Tongle; Almustafa, Ahmad; Melton, Genevieve B.

2017-01-01

Summary Background Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient’s problem list for patients with eligible body mass indexes (BMI) as contained in the patients’ electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. Method This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. Results Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI ≥ 30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. Conclusion Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese. PMID:28119990

Combating slavery in the 21st century: the role of emergency medicine.

PubMed

Chisolm-Straker, Makini; Richardson, Lynne D; Cossio, Tania

2012-08-01

Human trafficking (HT) victims may present to emergency departments (ED) as patients, but are infrequently identified. To address this issue, we developed and piloted a training intervention for emergency providers on HT and how to identify and treat these patients. Included in the intervention participants were emergency medicine residents, ED attendings, ED nurses, and hospital social workers. Prior to the intervention, 4.8% felt some degree of confidence in their ability to identify and 7.7% to treat a trafficked patient. After the 20-minute intervention, 53.8% felt some degree of confidence in their ability to identify and 56.7% care for this patient population. Because this problem is global, we created a Website that includes an instructive toolkit and an interactive course for self-learning and/or assessment. This intervention will give ED providers the tools they need to assess and treat a patient who might be a victim of human trafficking.

A prospective cohort study identifying risk factors for shoulder injuries in adolescent elite handball players: the Karolinska Handball Study (KHAST) study protocol.

PubMed

Asker, Martin; Waldén, Markus; Källberg, Henrik; Holm, Lena W; Skillgate, Eva

2017-11-22

Handball is a physical contact sport that includes frequent overhead throwing, and this combination leads to a high rate of shoulder injuries. Several factors have been associated with shoulder injuries in overhead athletes, but strong scientific evidence is lacking for most suggested risk factors. We therefore designed the Karolinska Handball Study (KHAST) with the aim to identify risk factors for shoulder injuries in adolescent male and female elite handball players studying at handball-profiled secondary schools in Sweden. Secondary objectives are to investigate whether shoulder function changes during the competition season and whether the physical profile of the players changes during their time in secondary school. Players aged 15 to 19 years were included during the pre-season period of the 2014-2015 and the 2015-2016 seasons. At inclusion, players signed informed consent and filled in a questionnaire regarding playing position, playing level, previous handball experience, history of shoulder problems and athletic identity. Players also completed a detailed test battery at baseline evaluating the shoulder, neck and trunk. Players were then prospectively monitored weekly during the 2014-2015 and/or 2015-2016 competitive seasons regarding injuries and training/match workload. Results from the annual routine physical tests in the secondary school curriculum including bench press, deep squat, hand grip strength, clean lifts, squat jumps, counter movement jumps, <30 m sprints, chins, dips and Cooper's test will be collected until the end of the competitive season 2017-2018. The primary outcome is the incidence of shoulder injuries and shoulder problems. The secondary outcome is the prevalence of shoulder injuries and shoulder problems. Shoulder problems are frequent among handball players and a reduction of these injuries is therefore warranted. However, in order to introduce appropriate preventive measures, a detailed understanding of the underlying risk factors is needed. Our study has a high potential to identify important risk factors for shoulder injuries in adolescent elite handball players owing to a large study sample, a high response rate, data collection during consecutive seasons, and recording of potential confounding factors.

The environmental management problem of Pohorje, Slovenia: A new group approach within ANP - SWOT framework.

PubMed

Grošelj, Petra; Zadnik Stirn, Lidija

2015-09-15

Environmental management problems can be dealt with by combining participatory methods, which make it possible to include various stakeholders in a decision-making process, and multi-criteria methods, which offer a formal model for structuring and solving a problem. This paper proposes a three-phase decision making approach based on the analytic network process and SWOT (strengths, weaknesses, opportunities and threats) analysis. The approach enables inclusion of various stakeholders or groups of stakeholders in particular stages of decision making. The structure of the proposed approach is composed of a network consisting of an objective cluster, a cluster of strategic goals, a cluster of SWOT factors and a cluster of alternatives. The application of the suggested approach is applied to a management problem of Pohorje, a mountainous area in Slovenia. Stakeholders from sectors that are important for Pohorje (forestry, agriculture, tourism and nature protection agencies) who can offer a wide range of expert knowledge were included in the decision-making process. The results identify the alternative of "sustainable development" as the most appropriate for development of Pohorje. The application in the paper offers an example of employing the new approach to an environmental management problem. This can also be applied to decision-making problems in various other fields. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pharmacist review and its impact on Singapore nursing homes

PubMed Central

Chia, Hui Shan; Ho, John Aik Hui; Lim, Bernadette Daolin

2015-01-01

INTRODUCTION There is a high prevalence of polypharmacy and inappropriate medication use in Singapore nursing homes. This study primarily explored the benefits of pharmacist reviews in local nursing homes. The secondary aims were to review the potential cost savings gained from following the pharmacists’ recommendations and to identify the possible risks associated with polypharmacy and inappropriate medication use. METHODS A retrospective period prevalence study was performed. We analysed the pharmacotherapy problems highlighted by pharmacists in three nursing homes and the rate of acceptance of pharmacists’ recommendations. Data was collected in two phases: (a) a one-month pre-setup period, during which 480 patients were reviewed (i.e. one-time review before weekly pharmacist visits); and (b) a six-month post-setup period, during which the 480 patients were reviewed again. Pharmacotherapy problems were classified according to a clinical pharmacist recommendation taxonomy and potential risks were identified. Monthly cost savings were calculated and compared with the monthly costs of pharmacist reviews. RESULTS A total of 392 pharmacotherapy problems were identified, with pharmacist recommendations noted for each problem. Among the 392 recommendations, 236 (60.2%) were accepted. The pharmacotherapy problems were analysed for potential risks, including falls (16.0%) and constipation (13.1%). The acceptance rates were higher during the post-setup period compared to the pre-setup period (p < 0.0001). Total direct acquisition cost savings during the pre- and post-setup periods were SGD 388.30 and SGD 876.69, respectively. CONCLUSION The provision of pharmaceutical care to nursing home residents resulted in improved medication safety and quality of care. PMID:26451051

Driving poststroke: problem identification, assessment use, and interventions offered by canadian occupational therapists.

PubMed

Petzold, Anita; Korner-Bitensky, Nicol; Rochette, Annie; Teasell, Robert; Marshall, Shawn; Perrier, Marie-Josee

2010-01-01

Driving is a key factor in maintaining autonomy and participation in life. Occupational therapists (OTs) are expected to assess individuals who want to resume driving post stroke and to provide retraining where appropriate. Research from the 1980s and 1990s indicated that patients were, for the most part, not being assessed and retrained. However, little is known about current practice management. Thus, this study examined clinicians' management of driving-related issues when treating clients with stroke. We performed a Canadawide telephone survey of 480 OTs providing stroke rehabilitation in both inpatient rehabilitation and community-based settings. Clinicians reported on problems they noted and assessments and interventions they would provide for a "typical patient" described in a vignette that matched their work setting. 20% and 34% of clinicians responding to the inpatient rehabilitation and community-based vignettes, respectively, identified return to driving as a problem. Clinician and work environment variables significantly associated (P < .01) with identifying driving as a potential problem included being male, involvement in university teaching, research conducted in setting, and hosting student placements. The use of driving-specific assessments was under 12%. Less than 6% of clinicians offered driving retraining, and their desired use of retraining was low. Few clinicians identified driving as a problem post stoke, raising concern that patients attempt to drive on their own or never resume driving because of a lack of attention to driving during their rehabilitation. Poststroke driver assessment and retraining is a critical component of poststroke community reintegration that requires greater awareness by clinicians.

A Look to Future Directions in Gene Therapy Research for Monogenic Diseases

PubMed Central

Porteus, Matthew H; Connelly, Jon P; Pruett, Shondra M

2006-01-01

The concept of gene therapy has long appealed to biomedical researchers and clinicians because it promised to treat certain diseases at their origins. In the last several years, there have been several trials in which patients have benefited from gene therapy protocols. This progress, however, has revealed important problems, including the problem of insertional oncogenesis. In this review, which focuses on monogenic diseases, we discuss the problem of insertional oncogenesis and identify areas for future research, such as developing more quantitative assays for risk and efficacy, and ways of minimizing the genotoxic effects of gene therapy protocols, which will be important if gene therapy is to fulfill its conceptual promise. PMID:17009872

Testing a model of depression among Thai adolescents.

PubMed

Vatanasin, Duangjai; Thapinta, Darawan; Thompson, Elaine Adams; Thungjaroenkul, Petsunee

2012-11-01

This predictive correlational study was designed to test a comprehensive model of depression for Thai adolescents. This sample included 800 high school students in Chiang Mai, Thailand. Data were collected using self-reported measures of depression, negative automatic thoughts, effective social problem solving, ineffective social problem solving, rumination, parental care, parental overprotection, and negative life events. Structural equation modeling revealed that negative automatic thoughts, effective and ineffective social problem solving mediated the effects of rumination, negative life events, and parental care and overprotection on adolescent depression. These findings provide new knowledge about identified factors and the mechanisms of their influence on depression among Thai adolescents, which are appropriate for targeting preventive interventions. © 2012 Wiley Periodicals, Inc.

Network Coordinator Report

NASA Technical Reports Server (NTRS)

Himwich, Ed; Strand, Richard

2013-01-01

This report includes an assessment of the network performance in terms of lost observing time for the 2012 calendar year. Overall, the observing time loss was about 12.3%, which is in-line with previous years. A table of relative incidence of problems with various subsystems is presented. The most significant identified causes of loss were electronics rack problems (accounting for about 21.8% of losses), antenna reliability (18.1%), RFI (11.8%), and receiver problems (11.7%). About 14.2% of the losses occurred for unknown reasons. New antennas are under development in the USA, Germany, and Spain. There are plans for new telescopes in Norway and Sweden. Other activities of the Network Coordinator are summarized.

Stochastic correlative firing for figure-ground segregation.

PubMed

Chen, Zhe

2005-03-01

Segregation of sensory inputs into separate objects is a central aspect of perception and arises in all sensory modalities. The figure-ground segregation problem requires identifying an object of interest in a complex scene, in many cases given binaural auditory or binocular visual observations. The computations required for visual and auditory figure-ground segregation share many common features and can be cast within a unified framework. Sensory perception can be viewed as a problem of optimizing information transmission. Here we suggest a stochastic correlative firing mechanism and an associative learning rule for figure-ground segregation in several classic sensory perception tasks, including the cocktail party problem in binaural hearing, binocular fusion of stereo images, and Gestalt grouping in motion perception.

Pre-Surgery Depression and Confidence to Manage Problems Predict Recovery Trajectories of Health and Wellbeing in the First Two Years following Colorectal Cancer: Results from the CREW Cohort Study

PubMed Central

Foster, Claire; Haviland, Joanne; Winter, Jane; Grimmett, Chloe; Chivers Seymour, Kim; Batehup, Lynn; Calman, Lynn; Corner, Jessica; Din, Amy; Fenlon, Deborah; May, Christine M.; Richardson, Alison; Smith, Peter W.

2016-01-01

Purpose This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery. Methods 872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing. Results Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support. Conclusions Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences. PMID:27171174

An Observational Study of Bullying as a Contributing Factor in Youth Suicide in Toronto

PubMed Central

Sinyor, Mark; Schaffer, Ayal; Cheung, Amy H

2014-01-01

Objective Bullying has been identified as a potential contributing factor in youth suicide. This issue has been highlighted in recent widely publicized media reports, worldwide, in which deceased youth were bullied. We report on an observational study conducted to determine the frequency of bullying as a contributing factor to youth suicide. Method: Coroner records were reviewed for all suicide deaths in youth aged between 10 and 19 in the city of Toronto from 1998 to 2011. Data abstracted were recent stressors (including bullying), clinical variables, such as the presence of mental illness, demographics, and methods of suicide. Results: Ninety-four youth suicides were included in the study. The mean age was 16.8 years, and 70.2% were male. Bullying was present in 6 deaths (6.4%), and there were no deaths where online or cyberbullying was detected. Bullying was the only identified contributing factor in fewer than 5 deaths. The most common stressors identified were conflict with parents (21.3%), romantic partner problems (17.0%), academic problems (10.6%), and criminal and (or) legal problems (10.6%). Any stressor or mental and (or) physical illness was detected in 78.7% of cases. Depression was detected in 40.4% of cases. Conclusions: Our study highlights the need to view suicide in youth as arising from a complex interplay of various biological, psychological, and social factors of which bullying is only one. It challenges simple cause-and-effect models that may suggest that suicide arises from any one factor, such as bullying. PMID:25702362

Missed opportunity for alcohol problem prevention among army active duty service members postdeployment.

PubMed

Larson, Mary Jo; Mohr, Beth A; Adams, Rachel Sayko; Wooten, Nikki R; Williams, Thomas V

2014-08-01

We identified to what extent the Department of Defense postdeployment health surveillance program identifies at-risk drinking, alone or in conjunction with psychological comorbidities, and refers service members who screen positive for additional assessment or care. We completed a cross-sectional analysis of 333 803 US Army active duty members returning from Iraq or Afghanistan deployments in fiscal years 2008 to 2011 with a postdeployment health assessment. Alcohol measures included 2 based on self-report quantity-frequency items-at-risk drinking (positive Alcohol Use Disorders Identification Test alcohol consumption questions [AUDIT-C] screen) and severe alcohol problems (AUDIT-C score of 8 or higher)-and another based on the interviewing provider's assessment. Nearly 29% of US Army active duty members screened positive for at-risk drinking, and 5.6% had an AUDIT-C score of 8 or higher. Interviewing providers identified potential alcohol problems among only 61.8% of those screening positive for at-risk drinking and only 74.9% of those with AUDIT-C scores of 8 or higher. They referred for a follow-up visit to primary care or another setting only 29.2% of at-risk drinkers and only 35.9% of those with AUDIT-C scores of 8 or higher. This study identified missed opportunities for early intervention for at-risk drinking. Future research should evaluate the effect of early intervention on long-term outcomes.

The Misidentified Identifiability Problem of Bayesian Knowledge Tracing

ERIC Educational Resources Information Center

Doroudi, Shayan; Brunskill, Emma

2017-01-01

In this paper, we investigate two purported problems with Bayesian Knowledge Tracing (BKT), a popular statistical model of student learning: "identifiability" and "semantic model degeneracy." In 2007, Beck and Chang stated that BKT is susceptible to an "identifiability problem"--various models with different…

Parents' evaluation of developmental status: how well do parents' concerns identify children with behavioral and emotional problems?

PubMed

Glascoe, Frances Page

2003-03-01

This study was undertaken to determine which parental concerns are most associated with significant behavioral/emotional problems and the extent to which parents' concerns can be depended on in the detection of mental health problems. An additional goal is to view how well a recently published screening test relying on parents' concerns, Parents' Evaluation of Developmental Status (PEDS), detects behavioral and emotional problems. Subjects were a national sample of 472 parents and their children (21 months to 8 years old) who were participants in 1 of 2 test standardization and validation studies. Sites included various pediatric settings, public schools, and Head Start programs in 5 diverse geographic locations. Subjects were representative of U.S. demographics in terms of ethnicity, parental level of education, gender, and socioeconomic status. At each site, psychological examiners, educational diagnosticians, or school psychologists recruited families, and obtained informed consent. Examiners disseminated a demographics questionnaire (in English or Spanish) and a developmental screening test that relies on parents' concerns (PEDS). Examiners were blinded to PEDS' scoring and interpretation administered either by interview or in writing, the Eyberg Child Behavior Inventory (ECBI) or the Possible Problems Checklist (PPC), a subtest of the Child Development Inventory that includes items measuring emotional well-being and behavioral self-control. PEDS was used to sort children into risk for developmental disabilities according to various types of parental concern. Those identified as having high or moderate risk were nominated for diagnostic testing or screening followed by developmental and mental health services when indicated. Because their emotional and behavioral needs would have been identified and addressed, these groups were removed from the analysis (N = 177). Of the 295 children who would not have been nominated for further scrutiny on PEDS due to their low risk of developmental problems, 102 had parents with concerns not predictive of developmental disabilities (e.g., behavior, social skills, self-help skills) and 193 had no concerns at all. Of the 295 children, 12% had scores on either the ECBI or the PPC indicative of mental health problems. Two parental concerns were identified through logistic regression as predictive of mental health status: behavior (OR = 4.74, CI = 1.69-13.30); and social skills (OR = 5.76, CI = 2.46-13.50). If one or more of these concerns was present, children had 8.5 times the risk of mental health problems (CI = 3.69-19.71) In children 434 years of age and older, one or both concerns was 87% sensitive and 79% specific to mental health status, figures keeping with standards for screening test accuracy. In young children, the presence of one or both concerns was 68% sensitive and 66% specific to mental health status. The findings suggest that certain parental concerns, if carefully elicited, can be depended on to detect mental health problems when children are 41 years and older and at low risk of developmental problems. For younger children, clinicians should counsel parents in disciplinary techniques, follow up, and if suggestions were not effective, administer a behavioral-emotional screening test such as the Pediatric Symptoms Checklist or the ECBI before making a referral decision.

Logistics: An integral part of cost efficient space operations

NASA Technical Reports Server (NTRS)

Montgomery, Ann D.

1996-01-01

The logistics of space programs and its history within NASA are discussed, with emphasis on manned space flight and the Space Shuttle program. The lessons learned and the experience gained during these programs are reported on. Key elements of logistics are highlighted, and the problems and issues that can be expected to arise in relation to the support of long-term space operations and future space programs, are discussed. Such missions include the International Space Station program and the reusable launch vehicle. Possible solutions to the problems identified are outlined.

Study of systems and techniques for data base management

NASA Technical Reports Server (NTRS)

1976-01-01

Data management areas were studied to identify pertinent problems and issues that will affect future NASA data users in terms of performance and cost. Specific topics discussed include the identifications of potential NASA data users other than those normally discussed, consideration affecting the clustering of minicomputers, low cost computer system for information retrieval and analysis, the testing of minicomputer based data base management systems, ongoing work related to the use of dedicated systems for data base management, and the problems of data interchange among a community of NASA data users.

Effects of motion on jet exhaust noise from aircraft

NASA Technical Reports Server (NTRS)

Chun, K. S.; Berman, C. H.; Cowan, S. J.

1976-01-01

The various problems involved in the evaluation of the jet noise field prevailing between an observer on the ground and an aircraft in flight in a typical takeoff or landing approach pattern were studied. Areas examined include: (1) literature survey and preliminary investigation, (2) propagation effects, (3) source alteration effects, and (4) investigation of verification techniques. Sixteen problem areas were identified and studied. Six follow-up programs were recommended for further work. The results and the proposed follow-on programs provide a practical general technique for predicting flyover jet noise for conventional jet nozzles.

Next generation data harmonization

NASA Astrophysics Data System (ADS)

Armstrong, Chandler; Brown, Ryan M.; Chaves, Jillian; Czerniejewski, Adam; Del Vecchio, Justin; Perkins, Timothy K.; Rudnicki, Ron; Tauer, Greg

2015-05-01

Analysts are presented with a never ending stream of data sources. Often, subsets of data sources to solve problems are easily identified but the process to align data sets is time consuming. However, many semantic technologies do allow for fast harmonization of data to overcome these problems. These include ontologies that serve as alignment targets, visual tools and natural language processing that generate semantic graphs in terms of the ontologies, and analytics that leverage these graphs. This research reviews a developed prototype that employs all these approaches to perform analysis across disparate data sources documenting violent, extremist events.

The role of artificial intelligence techniques in scheduling systems

NASA Technical Reports Server (NTRS)

Geoffroy, Amy L.; Britt, Daniel L.; Gohring, John R.

1990-01-01

Artificial Intelligence (AI) techniques provide good solutions for many of the problems which are characteristic of scheduling applications. However, scheduling is a large, complex heterogeneous problem. Different applications will require different solutions. Any individual application will require the use of a variety of techniques, including both AI and conventional software methods. The operational context of the scheduling system will also play a large role in design considerations. The key is to identify those places where a specific AI technique is in fact the preferable solution, and to integrate that technique into the overall architecture.

Chromosome structures: reduction of certain problems with unequal gene content and gene paralogs to integer linear programming.

PubMed

Lyubetsky, Vassily; Gershgorin, Roman; Gorbunov, Konstantin

2017-12-06

Chromosome structure is a very limited model of the genome including the information about its chromosomes such as their linear or circular organization, the order of genes on them, and the DNA strand encoding a gene. Gene lengths, nucleotide composition, and intergenic regions are ignored. Although highly incomplete, such structure can be used in many cases, e.g., to reconstruct phylogeny and evolutionary events, to identify gene synteny, regulatory elements and promoters (considering highly conserved elements), etc. Three problems are considered; all assume unequal gene content and the presence of gene paralogs. The distance problem is to determine the minimum number of operations required to transform one chromosome structure into another and the corresponding transformation itself including the identification of paralogs in two structures. We use the DCJ model which is one of the most studied combinatorial rearrangement models. Double-, sesqui-, and single-operations as well as deletion and insertion of a chromosome region are considered in the model; the single ones comprise cut and join. In the reconstruction problem, a phylogenetic tree with chromosome structures in the leaves is given. It is necessary to assign the structures to inner nodes of the tree to minimize the sum of distances between terminal structures of each edge and to identify the mutual paralogs in a fairly large set of structures. A linear algorithm is known for the distance problem without paralogs, while the presence of paralogs makes it NP-hard. If paralogs are allowed but the insertion and deletion operations are missing (and special constraints are imposed), the reduction of the distance problem to integer linear programming is known. Apparently, the reconstruction problem is NP-hard even in the absence of paralogs. The problem of contigs is to find the optimal arrangements for each given set of contigs, which also includes the mutual identification of paralogs. We proved that these problems can be reduced to integer linear programming formulations, which allows an algorithm to redefine the problems to implement a very special case of the integer linear programming tool. The results were tested on synthetic and biological samples. Three well-known problems were reduced to a very special case of integer linear programming, which is a new method of their solutions. Integer linear programming is clearly among the main computational methods and, as generally accepted, is fast on average; in particular, computation systems specifically targeted at it are available. The challenges are to reduce the size of the corresponding integer linear programming formulations and to incorporate a more detailed biological concept in our model of the reconstruction.

Modeling, Analyzing, and Mitigating Dissonance Between Alerting Systems

NASA Technical Reports Server (NTRS)

Song, Lixia; Kuchar, James K.

2003-01-01

Alerting systems are becoming pervasive in process operations, which may result in the potential for dissonance or conflict in information from different alerting systems that suggests different threat levels and/or actions to resolve hazards. Little is currently available to help in predicting or solving the dissonance problem. This thesis presents a methodology to model and analyze dissonance between alerting systems, providing both a theoretical foundation for understanding dissonance and a practical basis from which specific problems can be addressed. A state-space representation of multiple alerting system operation is generalized that can be tailored across a variety of applications. Based on the representation, two major causes of dissonance are identified: logic differences and sensor error. Additionally, several possible types of dissonance are identified. A mathematical analysis method is developed to identify the conditions for dissonance originating from logic differences. A probabilistic analysis methodology is developed to estimate the probability of dissonance originating from sensor error, and to compare the relative contribution to dissonance of sensor error against the contribution from logic differences. A hybrid model, which describes the dynamic behavior of the process with multiple alerting systems, is developed to identify dangerous dissonance space, from which the process can lead to disaster. Methodologies to avoid or mitigate dissonance are outlined. Two examples are used to demonstrate the application of the methodology. First, a conceptual In-Trail Spacing example is presented. The methodology is applied to identify the conditions for possible dissonance, to identify relative contribution of logic difference and sensor error, and to identify dangerous dissonance space. Several proposed mitigation methods are demonstrated in this example. In the second example, the methodology is applied to address the dissonance problem between two air traffic alert and avoidance systems: the existing Traffic Alert and Collision Avoidance System (TCAS) vs. the proposed Airborne Conflict Management system (ACM). Conditions on ACM resolution maneuvers are identified to avoid dynamic dissonance between TCAS and ACM. Also included in this report is an Appendix written by Lee Winder about recent and continuing work on alerting systems design. The application of Markov Decision Process (MDP) theory to complex alerting problems is discussed and illustrated with an abstract example system.

Writing testable software requirements

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

Knirk, D.

1997-11-01

This tutorial identifies common problems in analyzing requirements in the problem and constructing a written specification of what the software is to do. It deals with two main problem areas: identifying and describing problem requirements, and analyzing and describing behavior specifications.

A new solution to emulsion liquid membrane problems by non-Newtonian conversion

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

Skelland, A.H.P.; Meng, X.

1996-02-01

Surfactant-stabilized emulsion liquid membrane processes constitute an emerging separation technology that has repeatedly been shown to be highly suited for such diverse separation processes as metal recovery or removal from dilute aqueous solutions; separations in the food industry; removal of organic bases and acids from water; and separation of hydrocarbons. Emulsion liquid membrane separation processes remain excessively vulnerable to one or more of four major problems. Difficulties lie in developing liquid membranes that combine high levels of both stability and permeability with acceptably low levels of swelling and ease of subsequent demulsification for membrane and solute recovery. This article providesmore » a new technique for simultaneously overcoming the first three problems, while identifying physical indications that the proposed solution may have little adverse effect on the fourth problem (demulsification) and may even alleviate it. Numerous benefits of optimized conversion of the membrane phase into suitable non-Newtonian form are identified, their mechanisms outlined, and experimental verifications provided. These include increased stability, retained (or enhanced) permeability, reduced swelling, increased internal phase volume, and increased stirrer speeds. The highly favorable responsiveness of both aliphatic and aromatic membranes to the new technique is demonstrated.« less

[Tacit and explicit knowledge: comparative analysis of the prioritization of maternal health problems in Mexico].

PubMed

Moreno Zegbe, Estephania; Becerril Montekio, Víctor; Alcalde Rabanal, Jacqueline

To identify coincidences and differences in the identification and prioritization of maternal healthcare service problems in Mexico based on the perspective of tacit knowledge and explicit knowledge that may offer evidence that can contribute to attaining the Sustainable Development Goals. Mixed study performed in three stages: 1) systematization of maternal healthcare service problems identified by tacit knowledge (derived from professional experience); 2) identification of maternal healthcare service problems in Latin America addressed by explicit knowledge (scientific publications); 3) comparison between the problems identified by tacit and explicit knowledge. The main problems of maternal health services identified by tacit knowledge are related to poor quality of care, while the predominant problems studied in the scientific literature are related to access barriers to health services. Approximately, 70% of the problems identified by tacit knowledge are also mentioned in the explicit knowledge. Conversely, 70% of the problems identified in the literature are also considered by tacit knowledge. Nevertheless, when looking at the problems taken one by one, no statistically significant similarities were found. The study discovered that the identification of maternal health service problems by tacit knowledge and explicit knowledge is fairly comparable, according to the comparability index used in the study, and highlights the interest of integrating both approaches in order to improve prioritization and decision making towards the Sustainable Development Goals. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Preface of "The Second Symposium on Border Zones Between Experimental and Numerical Application Including Solution Approaches By Extensions of Standard Numerical Methods"

NASA Astrophysics Data System (ADS)

Ortleb, Sigrun; Seidel, Christian

2017-07-01

In this second symposium at the limits of experimental and numerical methods, recent research is presented on practically relevant problems. Presentations discuss experimental investigation as well as numerical methods with a strong focus on application. In addition, problems are identified which require a hybrid experimental-numerical approach. Topics include fast explicit diffusion applied to a geothermal energy storage tank, noise in experimental measurements of electrical quantities, thermal fluid structure interaction, tensegrity structures, experimental and numerical methods for Chladni figures, optimized construction of hydroelectric power stations, experimental and numerical limits in the investigation of rain-wind induced vibrations as well as the application of exponential integrators in a domain-based IMEX setting.

Effects of Methylphenidate on Sleep Functioning in Children with Attention-Deficit/Hyperactivity Disorder.

PubMed

Becker, Stephen P; Froehlich, Tanya E; Epstein, Jeffery N

2016-06-01

To examine the effects of stimulant medication on the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) and identify predictors of sleep problems as a side effect of taking stimulant medication. One hundred sixty-three stimulant-naïve children (72% boys) aged 7 to 11 years diagnosed with ADHD (120 with ADHD predominantly inattentive type, 43 with ADHD combined type) participated in a 4-week, randomized, double-blind, placebo-controlled trial of once-daily (long-acting) methylphenidate (MPH). Parents completed weekly side-effect ratings including an item related to sleep problems. Ten percent of patients had parent-rated sleep problems before the initiation of medication. Rates of parent-rated sleep problems during MPH titration generally increased with increasing MPH dose (placebo: 8%; low dose: 18%; medium dose: 15%; high dose: 25%). Differences emerged between children with (n = 16) or without (n = 147) preexisting sleep problems. Although 23% of children without preexisting sleep problems went on to have sleep problems at the highest MPH dose, only 37.5% of children with preexisting sleep problems still had sleep problems at the highest MPH dose. Lower weight and lower body mass index (BMI) were associated with increased sleep problems during MPH titration. This study demonstrated a general association between increased MPH dose and increased sleep problems in children with ADHD, particularly for children of lower weight/BMI. However, a substantial proportion of children with preexisting sleep difficulties no longer had sleep problems on the highest MPH dose, which may help explain mixed findings reported to date in studies examining the impact of MPH on sleep functioning in children with ADHD and suggests that MPH dose titration should not be avoided solely on the basis of a child's premorbid sleep problems. Future research is needed to replicate and extend these findings to more specific domains of sleep functioning and to identify differences between children with persistent or improved sleep functioning as a result of MPH use.

Obstacles to the discussion of sexual problems in menopausal women: a qualitative study of healthcare providers.

PubMed

Ghazanfarpour, Masoumeh; Khadivzadeh, Talat; Latifnejad Roudsari, Robab; Mehdi Hazavehei, Seyed Mohammad

2017-07-01

The aim of this study was to explore issues that challenge menopausal women in discussions of their sexual problems with a physician. This was done from the perspective of healthcare providers. In a descriptive exploratory qualitative study, using a semi-structured interview and purposive sampling, a sample set of 12 midwives and 13 general practitioners aged 25-70 years were selected in order to elicit meaning behind their experiences about the subject under study. Data analysis was carried out using qualitative content analysis. Results were used to identify a number of obstacles that hindered women from seeking help for sexual problems from GPs and midwives. These obstacles included the following: (1) traditional and cultural beliefs; (2) religious belief; (3) individuals' beliefs and (4) access to services. More research is needed to explore effective strategies to overcome these problems. Impact statement Current knowledge on the subject: In the literature, many reasons have been identified for the unwillingness of Iranian women to discuss their sexual problems with health providers. These include lack of time, feelings of shame and an expectation that a doctor cannot help. However, no qualitative study has addressed barriers held by menopausal women for seeking treatment for sexual problems. The contribution made by the results of this study: The results of this study add to the growing body of research on reasons that determine why most postmenopausal women rarely visit a doctor unless they were in tremendous physical or emotional pain. Also, menopausal women thought that an unmarried health provider would be less understanding about sexual and marital problems and they felt guilty about sharing such issues with them. Patients' opinions on the nature of menopause (a pathological vs. physiological process) affect the way in which the symptoms of menopause and sexual problems are handled by patient. The implications are of these findings for clinical practice and further research: The results of this study can be used to formulate guidelines to cultural sensitivity appropriate to Iranian society.

How learning one category influences the learning of another: intercategory generalization based on analogy and specific stimulus information.

PubMed

Nahinsky, Irwin D; Lucas, Barbara A; Edgell, Stephen E; Overfelt, Joseph; Loeb, Richard

2004-01-01

We investigated the effect of learning one category structure on the learning of a related category structure. Photograph-name combinations, called identifiers, were associated with values of four demographic attributes. Two problems were related by analogous demographic attributes, common identifiers, or both to examine the impact of common identifier, related general characteristics, and the interaction of the two variables in mediating learning transfer from one category structure to another. Problems sharing the same identifier information prompted greater positive transfer than those not sharing the same identifier information. In contrast, analogous defining characteristics in the two problems did not facilitate transfer. We computed correlations between responses to first-problem stimuli and responses to analogous second-problem stimuli for each participant. The analogous characteristics produced a tendency to respond in the same way to corresponding stimuli in the two problems. The results support an alignment between category structures related by analogous defining characteristics, which is facilitated by specific identifier information shared by two category structures.

Nurse Faculty Knowledge of and Confidence in Teaching Genetics/Genomics: Implications for Faculty Development.

PubMed

Donnelly, Mary Katherine; Nersesian, Paula V; Foronda, Cynthia; Jones, Emily L; Belcher, Anne E

The aims of this project were to (1) assess nurse faculty members' knowledge of and confidence in teaching genetics/genomics to nursing students and (2) identify the needs of faculty members to inform a faculty development initiative. Significant knowledge gaps were noted, and more than 50% of respondents indicated that they lacked confidence in teaching genetics/genomics. Strategies to address this problem included identifying champions of genetics/genomics education, use of an educational template, and threading genetics/genomics throughout the curriculum.

Getting a handle on DNFB strategies for boosting performance.

PubMed

2015-03-01

Keeping tabs on DNFB requires a commitment from multiple departments, including clinical documentation, health information management, utilization management, and patient financial services. Monitoring DNFB performance daily, weekly, and monthly can help an organization quickly resolve short-term problems and also identify and respond to more systemic issues. By leveraging historical and comparison data, including performance information from peer organizations, hospitals and health systems can set more realistic targets and further highlight improvement opportunities.

Science educators' perceptions of problems facing science education: A report of five surveys

NASA Astrophysics Data System (ADS)

Gallagher, James Joseph; Yager, Robert E.

Five groups of science educators representing faculty at graduate institutions, graduate students, teachers, supervisors, and leadership conferees were surveyed concerning their perceptions of current problems facing science education. A total of 144 participants provided an average of 4.7 responses. The responses were tabulated using an emergent set of categories that resulted in six major groupings, i.e. conceptual, organizational, teacher; related, student-related, university, and societal. The category with the most problems identified was in the area of conceptual problems. University related problems and organizational problems were the next two most frequently mentioned categories for problems. Specific problems in all categories most often cited include the following:1confusion and uncertainty in goals and objectives;2lack of vision and leadership in schools and universities;3absence of a theoretical base for science education;4poor quality teacher education programs;5inappropriate avenues for continuing education of teachers; limited dialogue between researchers and practitioners; declining enrollments; poor quality teaching and counseling; insufficient programs in science for the wide spectrum of students; and public and parental apathy towards science.

Prediction of employer-employee relationships from sociodemographic variables and social values in Brunei public and private sector workers.

PubMed

Mundia, Lawrence; Mahalle, Salwa; Matzin, Rohani; Nasir Zakaria, Gamal Abdul; Abdullah, Nor Zaiham Midawati; Abdul Latif, Siti Norhedayah

2017-01-01

The purpose of the study was to identify the sociodemographic variables and social value correlates and predictors of employer-employee relationship problems in a random sample of 860 Brunei public and private sector workers of both genders. A quantitative field survey design was used and data were analyzed by correlation and logistic regression. The rationale and justification for using this approach is explained. The main sociodemographic correlates and predictors of employer-employee relationship problems in this study were educational level and the district in which the employee resided and worked. Other correlates, but not necessarily predictors, of employer-employee relationship problems were seeking help from the Bomo (traditional healer); obtaining help from online social networking; and workers with children in the family. The two best and most significant social value correlates and predictors of employer-employee relationship problems included interpersonal communications; and self-regulation and self-direction. Low scorers on the following variables were also associated with high likelihood for possessing employer-employee relationship problems: satisfaction with work achievements; and peace and security, while low scorers on work stress had lower odds of having employer-employee relationship problems. Other significant social value correlates, but not predictors of employer-employee relationship problems were self-presentation; interpersonal trust; peace and security; and general anxiety. Consistent with findings of relevant previous studies conducted elsewhere, there were the variables that correlated with and predicted employer-employee relationship problems in Brunei public and private sector workers. Having identified these, the next step, efforts and priority should be directed at addressing the presenting issues via counseling and psychotherapy with affected employees. Further research is recommended to understand better the problem and its possible solutions.

Prediction of employer–employee relationships from sociodemographic variables and social values in Brunei public and private sector workers

PubMed Central

Mundia, Lawrence; Mahalle, Salwa; Matzin, Rohani; Nasir Zakaria, Gamal Abdul; Abdullah, Nor Zaiham Midawati; Abdul Latif, Siti Norhedayah

2017-01-01

The purpose of the study was to identify the sociodemographic variables and social value correlates and predictors of employer–employee relationship problems in a random sample of 860 Brunei public and private sector workers of both genders. A quantitative field survey design was used and data were analyzed by correlation and logistic regression. The rationale and justification for using this approach is explained. The main sociodemographic correlates and predictors of employer–employee relationship problems in this study were educational level and the district in which the employee resided and worked. Other correlates, but not necessarily predictors, of employer–employee relationship problems were seeking help from the Bomo (traditional healer); obtaining help from online social networking; and workers with children in the family. The two best and most significant social value correlates and predictors of employer–employee relationship problems included interpersonal communications; and self-regulation and self-direction. Low scorers on the following variables were also associated with high likelihood for possessing employer–employee relationship problems: satisfaction with work achievements; and peace and security, while low scorers on work stress had lower odds of having employer–employee relationship problems. Other significant social value correlates, but not predictors of employer–employee relationship problems were self-presentation; interpersonal trust; peace and security; and general anxiety. Consistent with findings of relevant previous studies conducted elsewhere, there were the variables that correlated with and predicted employer–employee relationship problems in Brunei public and private sector workers. Having identified these, the next step, efforts and priority should be directed at addressing the presenting issues via counseling and psychotherapy with affected employees. Further research is recommended to understand better the problem and its possible solutions. PMID:28769597

Barriers and Facilitators for Health Behavior Change among Adults from Multi-Problem Households: A Qualitative Study

PubMed Central

Hogeling, Lette; Spruijt, Renate; Postma, Nathalie; de Vries, Hein

2017-01-01

Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from multi-problem households, as well as to identify ideas for a health promotion program. A qualitative study involving 25 semi-structured interviews was conducted among Dutch adults who received intensive family home care for multi-problem households. Results were discussed with eight social workers in a focus group interview. Data were analyzed using the Framework Method. The results revealed that the main reason for not engaging in sports were the costs. Physical activity was facilitated by physically active (transport to) work and by dog ownership. Respondents who received a food bank package reported this as a barrier for healthy eating. Those with medical conditions such as diabetes indicated that this motivated them to eat healthily. Smokers and former smokers reported that stress was a major barrier for quitting smoking but that medical conditions could motivate them to quit smoking. A reported reason for not using alcohol was having difficult past experiences such as violence and abuse by alcoholics. Mentioned intervention ideas were: something social, an outdoor sports event, cooking classes, a walking group, and children’s activities in nature. Free or cheap activities that include social interaction and reduce stress are in line with the identified barriers and facilitators. Besides these activities, it may be important to influence the target group’s environment by educating social workers and ensuring healthier food bank packages. PMID:29036936

Identification of differences between finite element analysis and experimental vibration data

NASA Technical Reports Server (NTRS)

Lawrence, C.

1986-01-01

An important problem that has emerged from combined analytical/experimental investigations is the task of identifying and quantifying the differences between results predicted by F.E. analysis and results obtained from experiment. The objective of this study is to extend and evaluate the procedure developed by Sidhu for correlation of linear F.E. and modal test data to include structures with viscous damping. The desirability of developing this procedure is that the differences are identified in terms of physical mass, damping, and stiffness parameters instead of in terms of frequencies and modes shapes. Since the differences are computed in terms of physical parameters, locations of modeling problems can be directly identified in the F.E. model. From simulated data it was determined that the accuracy of the computed differences increases as the number of experimentally measured modes included in the calculations is increased. When the number of experimental modes is at least equal to the number of translational degrees of freedom in the F.E. model both the location and magnitude of the differences can be computed very accurately. When the number of modes is less than this amount the location of the differences may be determined even though their magnitudes will be under estimated.

Evaluation of nurse engagement in evidence-based practice.

PubMed

Davidson, Judy E; Brown, Caroline

2014-01-01

The purpose of this project was to explore nurses' willingness to question and change practice. Nurses were invited to report practice improvement opportunities, and participants were supported through the process of a practice change. The project leader engaged to the extent desired by the participant. Meetings proceeded until the participant no longer wished to continue, progress was blocked, or practice was changed. Evaluation of the evidence-based practice change process occurred. Fifteen nurses reported 23 practice improvement opportunities. The majority (12 of 15) preferred to have the project leader review the evidence. Fourteen projects changed practice; 4 were presented at conferences. Multiple barriers were identified throughout the process and included loss of momentum, the proposed change involved other disciplines, and low level or controversial evidence. Practice issues were linked to quality metrics, cost of care, patient satisfaction, regulatory compliance, and patient safety. Active engagement by nurse leaders was needed for a practice change to occur. Participants identified important problems previously unknown to hospital administrators. The majority of nurses preferred involvement in practice change based on clinical problem solving when supported by others to provide literature review and manage the process through committees. Recommendations include supporting a culture that encourages employees to report practice improvement opportunities and provide resources to assist in navigating the identified practice change.

Measuring pain in the context of homelessness

PubMed Central

Matter, Rebecca; Kline, Susan; Cook, Karon F.; Amtmann, Dagmar

2009-01-01

Purpose The primary objective of this study was to inform the development of measures of pain impact appropriate for all respondents, including homeless individuals, so that they can be used in clinical research and practice. The secondary objective was to increase understanding about the unique experience of homeless people with pain. Methods Seventeen homeless individuals with chronic health conditions (often associated with pain) participated in cognitive interviews to test the functioning of 56 pain measurement items and provided information about their experience living with and accessing treatment for pain. Results The most common problems identified with items were that they lacked clarity or were irrelevant in the context of homelessness. Items that were unclear, irrelevant and/or had other identified problems made it difficult for participants to respond. Participants also described multiple ways in which their pain was exacerbated by conditions of homelessness and identified barriers to accessing appropriate treatment. Conclusions Results suggested that the majority of items were problematic for the homeless and require substantial modifications to make the pain impact bank relevant to this population. Additional recommendations include involving homeless in future item bank development, conducting research on the topic of pain and homelessness, and using cognitive interviewing in other types of health disparities research. PMID:19582592

Investigating slips, trips and falls in the New Zealand dairy farming sector.

PubMed

Bentley, Tim; Tappin, David; Moore, Dave; Legg, Stephen; Ashby, Liz; Parker, Richard

2005-06-22

The paper presents findings from 39 detailed follow-up investigations of slips, trips and falls (STF) incurred by individuals working in New Zealand's dairy farming industry. The study sought to identify the key contributory risk factors for STF in this sector to provide evidence to support intervention design, and to determine the effectiveness of the investigative methodology used to achieve these objectives. Findings from the follow-up investigations included an analysis of factors related to the underfoot surface, underfoot hazard and footwear. Of note here was the propensity for STF-involved workers to not see or identify an underfoot hazard due to concurrent visual task distractions, and for workers to use footwear that both lacked effective tread and was unsuitable for the task and underfoot surface. Key latent risk factors and their interactions identified included problems associated with time pressure and related time-saving behaviours and the presence of design errors that, for example, required workers to climb onto equipment to view aspects of the task they were working on. The paper concludes that the potential resource and logistical problems associated with conducting detailed STF investigations are outweighed by the opportunity to collect rich data on key risk factors and their interactions in STF research.

Barriers to Employment Among Social Security Disability Insurance Beneficiaries in the Mental Health Treatment Study.

PubMed

Milfort, Roline; Bond, Gary R; McGurk, Susan R; Drake, Robert E

2015-12-01

This study examined barriers to employment among Social Security Disability Insurance (SSDI) beneficiaries who received comprehensive vocational and mental health services but were not successful in returning to work. This study examined barriers to employment among 430 SSDI beneficiaries with mental disorders who received evidence-based vocational and mental health services for two years but worked less than one month or not at all. Comprehensive care teams, which included employment specialists, made consensus judgments for each participant, identifying the top three barriers to employment from a checklist of 14 common barriers. Teams most frequently identified three barriers to employment: poorly controlled symptoms of mental illness (55%), nonengagement in supported employment (44%), and poorly controlled general medical problems (33%). Other factors were identified much less frequently. Some SSDI beneficiaries, despite having access to comprehensive services, continued to experience psychiatric impairments, difficulty engaging in vocational services, and general medical problems that limited their success in employment.

Applications of neural networks to landmark detection in 3-D surface data

NASA Astrophysics Data System (ADS)

Arndt, Craig M.

1992-09-01

The problem of identifying key landmarks in 3-dimensional surface data is of considerable interest in solving a number of difficult real-world tasks, including object recognition and image processing. The specific problem that we address in this research is to identify the specific landmarks (anatomical) in human surface data. This is a complex task, currently performed visually by an expert human operator. In order to replace these human operators and increase reliability of the data acquisition, we need to develop a computer algorithm which will utilize the interrelations between the 3-dimensional data to identify the landmarks of interest. The current presentation describes a method for designing, implementing, training, and testing a custom architecture neural network which will perform the landmark identification task. We discuss the performance of the net in relationship to human performance on the same task and how this net has been integrated with other AI and traditional programming methods to produce a powerful analysis tool for computer anthropometry.

Consistency and sources of divergence in recommendations on screening with questionnaires for presently experienced health problems or symptoms: a comparison of recommendations from the Canadian Task Force on Preventive Health Care, UK National Screening Committee, and US Preventive Services Task Force.

PubMed

Thombs, Brett D; Saadat, Nazanin; Riehm, Kira E; Karter, Justin Michael; Vaswani, Akansha; Andrews, Bonnie K; Simons, Peter; Cosgrove, Lisa

2017-08-09

Recently, health screening recommendations have gone beyond screening for early-stage, asymptomatic disease to include "screening" for presently experienced health problems and symptoms using self-report questionnaires. We examined recommendations from three major national guideline organizations to determine the consistency of recommendations, identify sources of divergent recommendations, and determine if guideline organizations have identified any direct randomized controlled trial (RCT) evidence for the effectiveness of questionnaire-based screening. We reviewed recommendation statements listed by the Canadian Task Force on Preventive Health Care (CTFPHC), the United Kingdom National Screening Committee (UKNSC), and the United States Preventive Services Task Force (USPSTF) as of 5 September 2016. Eligible recommendations focused on using self-report questionnaires to identify patients with presently experienced health problems or symptoms. Within each recommendation and accompanying evidence review we identified screening RCTs. We identified 22 separate recommendations on questionnaire-based screening, including three CTFPHC recommendations against screening, eight UKNSC recommendations against screening, four USPSTF recommendations in favor of screening (alcohol misuse, adolescent depression, adult depression, intimate partner violence), and seven USPSTF recommendations that did not recommend for or against screening. In the four cases where the USPSTF recommended screening, either the CTFPHC, the UKNSC, or both recommended against. When recommendations diverged, the USPSTF expressed confidence in benefits based on indirect evidence, evaluated potential harms as minimal, and did not consider cost or resource use. CTFPHC and UKNSC recommendations against screening, on the other hand, focused on the lack of direct evidence of benefit and raised concerns about harms to patients and resource use. Of six RCTs that directly evaluated screening interventions, five did not report any statistically significant primary or secondary health outcomes in favor of screening, and one trial reported equivocal results. Only the USPSTF has made any recommendations for screening with questionnaires for presently experienced problems or symptoms. The CTFPHC and UKNSC recommended against screening in all of their recommendations. Differences in recommendations appear to reflect differences in willingness to assume benefit from indirect evidence and different approaches to assessing possible harms and resource consumption. There were no examples in any recommendations of RCTs with direct evidence of improved health outcomes.

Analysis of Feeder Bus Network Design and Scheduling Problems

PubMed Central

Almasi, Mohammad Hadi; Karim, Mohamed Rehan

2014-01-01

A growing concern for public transit is its inability to shift passenger's mode from private to public transport. In order to overcome this problem, a more developed feeder bus network and matched schedules will play important roles. The present paper aims to review some of the studies performed on Feeder Bus Network Design and Scheduling Problem (FNDSP) based on three distinctive parts of the FNDSP setup, namely, problem description, problem characteristics, and solution approaches. The problems consist of different subproblems including data preparation, feeder bus network design, route generation, and feeder bus scheduling. Subsequently, descriptive analysis and classification of previous works are presented to highlight the main characteristics and solution methods. Finally, some of the issues and trends for future research are identified. This paper is targeted at dealing with the FNDSP to exhibit strategic and tactical goals and also contributes to the unification of the field which might be a useful complement to the few existing reviews. PMID:24526890

Venue staff knowledge of their patrons' gambling and problem gambling.

PubMed

Delfabbro, Paul; Borgas, Mignon; King, Daniel

2012-06-01

In several jurisdictions around the world, venue staff are encouraged to make reasonable attempts to determine whether patrons may be experiencing problems associated with their gambling. Although a number of visible indicators and behaviours are recognised as being indicative of gambling problems, no research has investigated how effective staff might be in identifying problem gamblers in venues. The aim of this field test was to examine the level of patron familiarity amongst staff working in small to moderate-sized venues. Patrons (n = 303) were asked to complete a short survey including the Problem Gambling Severity Index and venue staff were asked to describe their knowledge of the same patrons independently. The results showed that patrons rated as more at risk by staff scored significantly higher on the PGSI, but that point-in-time staff ratings were not sufficiently accurate to allow effective identification of problem gamblers. The importance of using accumulated information over multiple sessions as well as technological monitoring of behaviour was emphasised by these results.

Screening for Drinking Problems in the Elderly in Singapore Using the CAGE Questionnaire.

PubMed

Ong, Clarissa Wy; Sagayadevan, Vathsala; Abdin, Edimansyah; Shafie, Saleha Binte; Jeyagurunathan, Anitha; Eng, Goi Khia; Picco, Louisa; Vaingankar, Janhavi; Chong, Siow Ann; Subramaniam, Mythily

2016-10-01

Given that past research on drinking problems has focused primarily on younger samples, the present study sought to examine the prevalence and correlates of alcohol use among the elderly in Singapore. Data were extracted from the Well-being of the Singapore Elderly (WiSE) study, a cross-sectional, epidemiological survey conducted among a nationally representative sample of Singapore residents (n = 2565) aged 60 years and above. Variables assessed include drinking problems, depression and anxiety symptoms, obesity, smoking status, chronic physical disorders and disability. The weighted prevalence of drinking problems (CAGE score ≥2) in our sample was 4.2%. Male sex, Indian ethnicity, and being divorced or separated were associated with a significantly higher likelihood of drinking problems. Participants with drinking problems were also more likely to have subthreshold depression. There were no significant differences in disability among those with drinking problems, those without drinking problems and non-drinkers, after adjusting for demographic variables. Our findings contribute to the body of research that indicates an association between drinking problems and depressive symptoms among the elderly. Thus, screening for depressive symptoms in the elderly with drinking problems may be useful in identifying such comorbidities in order to aid treatment planning.

Infectious diseases in competitive sports.

PubMed

Goodman, R A; Thacker, S B; Solomon, S L; Osterholm, M T; Hughes, J M

1994-03-16

Participation in competitive sports is popular and widely encouraged throughout the United States. Reports of infectious disease outbreaks among competitive athletes and recent publicity regarding infectious disease concerns in sports underscore the need to better characterize the occurrence of these problems. To identify reports of infectious diseases in sports, we performed a comprehensive search of the medical literature (MEDLINE) and newspaper databases in two on-line services (NEXIS and DIALOG PAPERS). Articles selected from the literature review included those describing cases or outbreaks of disease in which exposure to an infectious agent was likely to have occurred during training for competitive sports or during actual competition. Articles from the newspaper review included reports of outbreaks, exposures, or preventive measures that directly or indirectly involved teams or spectators. The literature review identified 38 reports of infectious disease outbreaks or other instances of transmission through person-to-person (24 reports), common-source (nine reports), or airborne (five reports) routes; the newspaper search identified 28 reports. Infectious agents included predominantly viruses but also a variety of fungi and gram-positive and gram-negative bacteria. Our findings indicate that strategies to prevent transmission of infectious diseases in sports must recognize risks at three levels: the individual athlete, the team, and spectators or others who may become exposed to infectious diseases as a result of sports-related activities. Team physicians and others who are responsible for the health of athletes should be especially familiar with the features of infectious diseases that occur in sports and measures for the prevention of these problems.

Using National Health Care Databases and Problem-Based Practice Analysis to Inform Integrated Curriculum Development.

PubMed

Baker, Amy J; Raymond, Mark R; Haist, Steven A; Boulet, John R

2017-04-01

One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals.Selected data from the National Hospital Ambulatory Medical Care Survey: Emergency Department illustrate how instructional materials can be derived from the results of such public-use health care data. Using fever as the reason for visit to the ED, the patient management path is depicted in the form of a case drill-down by exploring the most common diagnoses, blood tests, diagnostic studies, procedures, and medications associated with fever.Although these types of data are quite useful, they should not serve as the sole basis for determining which instructional cases to include. Additional sources of information should be considered to ensure the inclusion of cases that represent infrequent but high-impact problems and those that illustrate fundamental principles that generalize to other cases.

Saturn 1B launch vehicle flight evaluation report, SA-206, Skylab-2

NASA Technical Reports Server (NTRS)

1973-01-01

The performance evaluation of the SA-206 launch vehicle for the Skylab 2 launch is presented. Flight problems are identified, the causes are determined, and recommendations are made for appropriate corrective action. Summaries of launch operations and spacecraft performance are included. The significant events, failures, and anomalies are tabulated.

Saturn 1B launch vehicle flight evaluation report-SA-207: Skylab-3

NASA Technical Reports Server (NTRS)

1973-01-01

The performance evaluation of the SA-207 launch vehicle for the Skylab 3 launch is presented. Flight problems are identified, the causes are determined, and recommendations are made for appropriate corrective action. Summaries of launch operations and spacecraft performance are included. The significant events, failures, and anomalies are tabulated.

How to Identify and Control Water Weeds and Algae.

ERIC Educational Resources Information Center

Applied Biochemists, Inc., Mequon, WI.

Included in this guide to water management are general descriptions of algae, toxic algae, weed problems in lakes, ponds, and canals, and general discussions of mechanical, biological and chemical control methods. In addition, pictures, descriptions, and recommended control methods are given for algae, 6 types of floating weeds, 18 types of…

An Exploration of Factors Influencing Effective Teachers' Decisions to Remain in Urban School Settings

ERIC Educational Resources Information Center

Grizzle, Alison L.

2010-01-01

Existing problems identified in the literature on teacher retention and resilience include (a) a gap in understanding factors influencing urban teacher retention; (b) lack of clarity on multiple factors swaying teachers' decisions to remain despite challenges; (c) overlapping definitions of teacher retention, attrition, and resilience; and (d)…

Learning-Method Choices and Personal Characteristics in Solving a Physical Education Problem

ERIC Educational Resources Information Center

Vincent-Morin, Madeleine; Lafont, Lucile

2005-01-01

The goal of this study was to identify the relationships between the learning choices made by pupils and their personal characteristics, including cognitive style (field dependence--independence), a motivational variable (feeling of self-efficacy), and a cognitive variable (task representation). The participants were 64 twelve-year-old sixth…

Feminist Heuristics: Transforming the Foundation of Food Quality and Safety Assurance Systems

ERIC Educational Resources Information Center

Kimura, Aya Hirata

2012-01-01

Food safety and quality assurance systems have emerged as a key mechanism of food governance in recent years and are also popular among alternative agrofood movements, such as the organic and fair trade movements. Rural sociologists have identified many problems with existing systems, including corporate cooptation, the marginalization of small…

Comparative Legal Services: An Analysis of the Delivery of Legal Services to the Poor in Nations around the World.

ERIC Educational Resources Information Center

Wise, Edward M.

1994-01-01

Asserts that providing poor people equal access to law is a worldwide problem. Identifies and discusses three systems of legal aid services in nations throughout the world. Includes a vocabulary chart and a special section on justice in South Africa. (CFR)

Mandatory Reporting and School Counselors: Reporting Laws, Obstacles, and Solutions

ERIC Educational Resources Information Center

Valkyrie, Karena T.; Creamer, D. Andrew; Vaughn, Leila

2008-01-01

Child abuse and neglect is a serious problem across our nation, and the consequences can be far reaching. Laws were enacted to address child abuse and identify mandatory reporters, including school counselors. In the literature, school counselors regularly report systemic and personal obstacles that influence their compliance with the mandatory…

Genocide: The Ultimate Human Rights Problem.

ERIC Educational Resources Information Center

Charny, Israel W.

1987-01-01

Argues for a more humanistic definition of genocide; one that includes the intentional murder of a group of human beings on the basis of any shared identity. Identifies the Holocaust as the world's major genocidal event but urges recognition of the Armenian, Cambodian, and similar tragedies. Proposes an early-warning organization to monitor and…

Computer planning tools applied to a cable logging research study

Treesearch

Chris B. LeDoux; Penn A. Peters

1985-01-01

Contemporary harvest planning software was used in planning the layout of cable logging units for a production study of the Clearwater Yarder in upstate New York. Planning software, including payload analysis and digital terrain models, allowed researchers to identify layout and yarding problems before the experiment. Analysis of proposed ground profiles pinpointed the...

Work-Integrated Learning and Professional Accreditation Policies: An Environmental Health Higher Education Perspective

ERIC Educational Resources Information Center

Dunn, Louise; Nicholson, Rosemary; Ross, Kirstin; Bricknell, Lisa; Davies, Belinda; Hannelly, Toni; Lampard, Jane-Louise; Murray, Zoe; Oosthuizen, Jacques; Roiko, Anne; Wood, James

2018-01-01

The introduction of a new work-integrated learning (WIL) policy for university environmental health education programs seeking professional accreditation identified a number of problems. This included how to evaluate the acceptability of differing approaches to WIL for course accreditation purposes and a need to develop an agreed understanding of…

Dropout Prevention in Appalachia: Lessons for the Nation.

ERIC Educational Resources Information Center

Campbell Communications, Inc., Bethesda, MD.

The Appalachian Regional Commission (ARC), in its efforts to improve the economy and quality of life in the Appalachian Region, has identified high school dropouts as a major stumbling block to the area's economic growth. Findings of ARC-sponsored research on dropouts include the following: (1) high school dropouts are a serious problem in…

The Point of Creative Frustration and the Creative Process: A New Look at an Old Model.

ERIC Educational Resources Information Center

Sapp, D. David

1992-01-01

This paper offers an extension of Graham Wallas' model of the creative process. It identifies periods of problem solving, incubation, and growth with specific points of initial idea inception, creative frustration, and illumination. Responses to creative frustration are described including denial, rationalization, acceptance of stagnation, and new…

Hawaii Opinion Poll on Public Education (HOPE), 1998.

ERIC Educational Resources Information Center

Hawaii State Dept. of Education, Honolulu. Office of Accountability and School Instructional Support.

The 1998 Hawaii Opinion Poll on Public Education is the fifth to report the public's perceptions of public schools. Three questions included in every report since 1990 ask respondents to grade Hawaii's public schools, whether schools are improving or deteriorating, and to identify the school system's biggest problems. Responses of two subgroups,…

The Role of the Consultant: Content Expert or Process Facilitator?

ERIC Educational Resources Information Center

Schein, Edgar H.

1978-01-01

This triad of consulting models identifies the assumption upon which each rests. The consultant with adequate knowledge and self-insight will understand which model is appropriate to a given situation. The three models include: (1) purchase of expertise; (2) doctor-patient role; and (3) consultation process for problem solving. (Author/MFD)

Pre-Service Classroom Teachers' Proof Schemes in Geometry: A Case Study of Three Pre-Service Teachers

ERIC Educational Resources Information Center

Oflaz, Gülcin; Bulut, Neslihan; Akcakin, Veysel

2016-01-01

Problem Statement: Recent research and evaluation reports show that students are not learning geometry efficiently. One identifier of student understanding related to geometry is teachers' knowledge structures. Understanding what a proof is and writing proofs are essential for success in mathematics. Thus, school mathematics should include proving…

Advanced English as a Second Language for Manufacturing. P.R.I.D.E. People Retraining for Industry Excellence.

ERIC Educational Resources Information Center

Lewandowski, Carol

This workplace skills training course in English as a Second Language (ESL) identifies English problems for nonnative speakers and encourages students to practice speaking, writing, listening, and reading skills using company literature. Introductory material includes course description, objectives, topical outline, and evaluation. The course…

Impedance in School Screening Programs.

ERIC Educational Resources Information Center

Robarts, John T.

1985-01-01

This paper examines the controversy over use of impedance screening in public schools to identify students with hearing problems, including otitis media, a common ear condition in infants and young children. It cites research that questions the value of pure tone screening as a single test and raises critics' objections to the use of impedance,…

Research in Teaching Reading to Disadvantaged Learners: A Critical Review and Evaluation of Research.

ERIC Educational Resources Information Center

Webster, Staten W.

This review of reading research literature deals with three major areas. First, 10 problems that inhibit the educational development of disadvantaged learners are identified and discussed. Secondly, programs designed to aid these students are reviewed. They include reading programs for preschool, elementary school, and secondary school age groups…

Miles Away and Still Caring: A Guide for Long-Distance Caregivers.

ERIC Educational Resources Information Center

American Association of Retired Persons, Washington, DC.

This booklet is designed to assist those who are responsible for coordinating and monitoring from a distance the care of an aging relative. It provides help in identifying problem areas and possible resources for support. It also provides information about creating a network of assistance that includes family, friends, neighbors, and social…

Programmatic Recommendations and Considerations in Assisting School Districts to Serve Vietnamese Children.

ERIC Educational Resources Information Center

Maldonado, Stephen

The seminar reported here focused on identifying the needs and problems of Vietnamese children and adults. These included bilingual education, culture clash, second language programs, and educational differences between Vietnam and the U.S. It was observed that teachers must be prepared to respond to their Vietnamese students according to their…

Creating a Research Agenda in Career Counselling: The Place of Action Theory

ERIC Educational Resources Information Center

Young, Richard A.; Domene, Jose F.

2012-01-01

After identifying historical and current problems in career counselling research, we propose a research agenda based on contextual action theory. This theory has been used as a framework for research in the career field and for general counselling practice. It is advantageous for several reasons including its conceptual basis, its detailed…

Finding Kids with Special Needs: the Background, Development, Field Test and Validation.

ERIC Educational Resources Information Center

Resource Management Systems, Inc., Carmel, CA.

Described are the development of "Findings Kids with Special Needs" (FKSN), a instrument to identify children's learning problems and gifted students; results of field testing with 24,825 children, kindergarten through grade 8, in 110 schools; and validation procedures. Discussed is test construction, including incorporation of 12…

Preaching to the Choir: Are the Commission's Recommendations Already Applied?

ERIC Educational Resources Information Center

Maggino, Filomena; Ruviglioni, Elena

2011-01-01

As we have seen, the Commission's final report outlines a comprehensive framework by defining some guidelines by: (a) identifying the limits of GDP as an indicator of economic performance and social progress, including measurement problems; (b) considering what additional information might be required for the production of more relevant social…

Identifying Diverse Means for Assessing Physical Activity

ERIC Educational Resources Information Center

Perlman, Dana J.; Pearson, Phil

2012-01-01

Physical inactivity is of concern for the majority of age groups within the United States. Limited engagement in physical activity (PA) has been linked with an increased risk for a host of health problems, including but not limited to heart disease, diabetes and cancer. Benefits of PA are widely documented and accepted yet many people, especially…

Decommissioning: Nuclear Power's Missing Link. Worldwatch Paper 69.

ERIC Educational Resources Information Center

Pollock, Cynthia

The processes and associated dilemmas of nuclear power plant decommissioning are reviewed in this publication. Decommissioning involves the clearing up and disposal of a retired nuclear plant and its equipment of such a way as to safeguard the public from the dangers of radioactivity. Related problem areas are identified and include: (1) closure…

Creative Thinking Processes: The Past and the Future

ERIC Educational Resources Information Center

Mumford, Michael D.; McIntosh, Tristan

2017-01-01

For more than one hundred years, students of creativity, including seminal efforts published in the "Journal of Creative Behavior," have sought to identify the key processes people must execute to produce creative problem solutions. In recent years, we have seen a consensual model of key creative thinking processes being accepted by the…

Sleep Patterns of College Students at a Public University

ERIC Educational Resources Information Center

Forquer, LeAnne M.; Camden, Adrian E.; Gabriau, Krista M.; Johnson, C. Merle

2008-01-01

Objective: The authors' purpose in this study was to determine the sleep patterns of college students to identify problem areas and potential solutions. Participants: A total of 313 students returned completed surveys. Methods: A sleep survey was e-mailed to a random sample of students at a North Central university. Questions included individual…

How to Recognize a Quality Technical Education Program.

ERIC Educational Resources Information Center

Doty, Charles R.

Criteria for the evaluation of quality technical educational programs must be identified if follow-up studies are to be effective. Current research shows that problems in the development of such criteria include the tendency to evaluate programs on the basis of organizational structure rather than on the quality of the instructional program…

Methods for conducting systematic reviews of risk factors in low- and middle-income countries.

PubMed

Shenderovich, Yulia; Eisner, Manuel; Mikton, Christopher; Gardner, Frances; Liu, Jianghong; Murray, Joseph

2016-03-15

Rates of youth violence are disproportionately high in many low- and middle-income countries [LMICs] but existing reviews of risk factors focus almost exclusively on high-income countries. Different search strategies, including non-English language searches, might be required to identify relevant evidence in LMICs. This paper discusses methodological issues in systematic reviews aiming to include evidence from LMICs, using the example of a recent review of risk factors for child conduct problems and youth violence in LMICs. We searched the main international databases, such as PsycINFO, Medline and EMBASE in English, as well as 12 regional databases in Arabic, Chinese, English, French, Spanish, Portuguese and Russian. In addition, we used internet search engines and Google Scholar, and contacted over 200 researchers and organizations to identify potentially eligible studies in LMICs. The majority of relevant studies were identified in the mainstream databases, but additional studies were also found through regional databases, such as CNKI, Wangfang, LILACS and SciELO. Overall, 85% of eligible studies were in English, and 15% were reported in Chinese, Spanish, Portuguese, Russian or French. Among eligible studies in languages other than English, two-thirds were identified only by regional databases and one-third was also indexed in the main international databases. There are many studies on child conduct problems and youth violence in LMICs which have not been included in prior reviews. Most research on these subjects in LMICs has been produced in the last two-three decades and mostly in middle-income countries, such as China, Brazil, Turkey, South Africa and Russia. Based on our findings, it appears that many studies of child conduct problems and youth violence in LMICs are reported in English, Chinese, Spanish and Portuguese, but few such studies are published in French, Arabic or Russian. If non-English language searches and screening had not been conducted in the current review, 15% of eligible studies would have been missed. Although there are benefits to non-English language searches and the inclusion of non-English studies in meta-analyses, systematic reviewers also need to consider the resources required to incorporate multi-lingual research.

Proceedings of the First Hanford Separation Science Workshop

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

Not Available

1993-05-01

The First Hanford Separation Science Workshop, sponsored by PNL had two main objectives: (1) assess the applicability of available separation methods for environmental restoration and for minimization, recovery, and recycle of mixed and radioactive mutes; and (2) identify research needs that must be addressed to create new or improved technologies. The information gathered at this workshop not only applies to Hanford but could be adapted to DOE facilities throughout the nation as well. These proceedings have been divided into three components: Background and Introduction to the Problem gives an overview of the history of the Site and the cleanup mission,more » including waste management operations, past disposal practices, current operations, and plans for the future. Also included in this section is a discussion of specific problems concerning the chemistry of the Hanford wastes. Separation Methodologies contains the papers given at the workshop by national experts in the field of separation science regarding the state-of-the-art of various methods and their applicability/adaptability to Hanford. Research Needs identifies further research areas developed in working group sessions. Individual papers are indexed separately.« less

Sleep disturbances among medical students: a global perspective.

PubMed

Azad, Muhammad Chanchal; Fraser, Kristin; Rumana, Nahid; Abdullah, Ahmad Faris; Shahana, Nahid; Hanly, Patrick J; Turin, Tanvir Chowdhury

2015-01-15

Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond that already experienced by modern society. In this global literature review of the medical students' sleep experience, we find that poor sleep is not only common among medical students, but its prevalence is also higher than in non-medical students and the general population. Several factors including medical students' attitudes, knowledge of sleep, and academic demands have been identified as causative factors, but other potential mechanisms are incompletely understood. A better understanding about the etiology of sleep problems in medical trainees is essential if we hope to improve the overall quality of medical students' lives, including their academic performance. Sleep self-awareness and general knowledge appear insufficient in many studied cohorts, so increasing education for students might be one beneficial intervention. We conclude that there is ample evidence for a high prevalence of the problem, and research in this area should now expand towards initiatives to improve general sleep education for medical students, identify students at risk, and target them with programs to improve sleep. © 2015 American Academy of Sleep Medicine.

Selection and application of microbial source tracking tools for water-quality investigations

USGS Publications Warehouse

Stoeckel, Donald M.

2005-01-01

Microbial source tracking (MST) is a complex process that includes many decision-making steps. Once a contamination problem has been defined, the potential user of MST tools must thoroughly consider study objectives before deciding upon a source identifier, a detection method, and an analytical approach to apply to the problem. Regardless of which MST protocol is chosen, underlying assumptions can affect the results and interpretation. It is crucial to incorporate tests of those assumptions in the study quality-control plan to help validate results and facilitate interpretation. Detailed descriptions of MST objectives, protocols, and assumptions are provided in this report to assist in selection and application of MST tools for water-quality investigations. Several case studies illustrate real-world applications of MST protocols over a range of settings, spatial scales, and types of contamination. Technical details of many available source identifiers and detection methods are included as appendixes. By use of this information, researchers should be able to formulate realistic expectations for the information that MST tools can provide and, where possible, successfully execute investigations to characterize sources of fecal contamination to resource waters.

Quality of life in ostomy patients: a qualitative study.

PubMed

Dabirian, Aazam; Yaghmaei, Farideh; Rassouli, Maryam; Tafreshi, Mansoureh Zagheri

2010-12-21

Therapeutic procedures may not only treat disease but also affect patient quality of life. Therefore, quality of life should be measured in order to assess the impact of disease and therapeutic procedures. To identify clients' problems, it is necessary to assess several dimensions of quality of life, including physical, spiritual, economic, and social aspects. In this regard, we conducted a qualitative study to explore quality of life and its dimensions in ostomy patients referred to the Iranian Ostomy Association. Fourteen patients were interviewed about their quality of life dimensions by purposeful sampling. Data were gathered by semistructured interviews and analyzed using the content analysis method. Nine main themes emerged using this approach, including physical problems related to colostomy, impact of colostomy on psychological functioning, social and family relationships, travel, nutrition, physical activity, and sexual function, as well as religious and economic issues. The findings of the study identified a number of challenges in quality of life for patients with ostomy. The results can be used by health care providers to create a supportive environment that promotes better quality of life for their ostomy patients.

Quality of life in ostomy patients: a qualitative study

PubMed Central

Dabirian, Aazam; Yaghmaei, Farideh; Rassouli, Maryam; Tafreshi, Mansoureh Zagheri

2011-01-01

Purpose Therapeutic procedures may not only treat disease but also affect patient quality of life. Therefore, quality of life should be measured in order to assess the impact of disease and therapeutic procedures. To identify clients’ problems, it is necessary to assess several dimensions of quality of life, including physical, spiritual, economic, and social aspects. In this regard, we conducted a qualitative study to explore quality of life and its dimensions in ostomy patients referred to the Iranian Ostomy Association. Methods Fourteen patients were interviewed about their quality of life dimensions by purposeful sampling. Data were gathered by semistructured interviews and analyzed using the content analysis method. Results Nine main themes emerged using this approach, including physical problems related to colostomy, impact of colostomy on psychological functioning, social and family relationships, travel, nutrition, physical activity, and sexual function, as well as religious and economic issues. Conclusion The findings of the study identified a number of challenges in quality of life for patients with ostomy. The results can be used by health care providers to create a supportive environment that promotes better quality of life for their ostomy patients. PMID:21311696

Development of children's internalising and externalising problems from infancy to five years of age.

PubMed

Bayer, Jordana K; Ukoumunne, Obioha C; Mathers, Megan; Wake, Melissa; Abdi, Nadia; Hiscock, Harriet

2012-07-01

Mental health problems are an international public health issue affecting a substantial proportion of youth. This study aimed to identify groups of young children exhibiting distinct internalising and externalising symptom trajectories across early childhood compared to existing norms. Linear regression then identified child, parenting and family predictors from infancy in the development of internalising and externalising behaviours at age 5 years. This consisted of a follow-up of 5-year-old children from a longitudinal, population-based study with earlier surveys having been completed by primary caregivers when the children were aged 7, 12, 18, 24 and 36 months. Five hundred 5-year-olds (68% retention) were included from 733 children recruited at age 6-7 months from routine well-child appointments across six socio-economically diverse government areas in Victoria, Australia. Mothers then completed a further questionnaire when their children reached 5 years of age, repeating the instruments included in previous waves. The primary outcomes were the Child Behavior Checklist (CBCL), 1.5-5 internalising and externalising symptoms (T-scores in relation to norms) and behaviours (raw scores). Across early childhood, three distinct profiles for each of the internalising and externalising symptoms (T-scores) were identified and compared to CBCL norms. Around 20% of this Australian child population exhibited consistently elevated symptoms for each problem. Regarding aetiology, longitudinally the strongest predictors of internalising behaviours at 5 years of age were harsh discipline, maternal stress, having no older siblings, single parenthood and maternal substance misuse. The strongest predictors of externalising behaviours at 5 years of age were male sex, harsh discipline and maternal stress. The predictors explained 22% of the variation in internalising behaviours and 24% of the variation in externalising behaviours at 5 years. Starting as early as the toddler period, effective population approaches to preventing mental health problems are needed. Randomised trials of preventive interventions focused on improving parenting practices and reducing maternal stress are under way.

An investigation into drug-related problems identifiable by commercial medication review software.

PubMed

Curtain, Colin; Bindoff, Ivan; Westbury, Juanita; Peterson, Gregory

2013-01-01

Accredited pharmacists conduct home medicines reviews (HMRs) to detect and resolve potential drug-related problems (DRPs). A commercial expert system, Medscope Review Mentor (MRM), has been developed to assist pharmacists in the detection and resolution of potential DRPs. This study compares types of DRPs identified with the commercial system which uses multiple classification ripple down rules (MCRDR) with the findings of pharmacists. HMR data from 570 reviews collected from accredited pharmacists was entered into MRM and the DRPs were identified. A list of themes describing the main concept of each DRP identified by MRM was developed to allow comparison with pharmacists. Theme types, frequencies, similarity and dissimilarity were explored. The expert system was capable of detecting a wide range of potential DRPs: 2854 themes; compared to pharmacists: 1680 themes. The system identified the same problems as pharmacists in many patient cases. Ninety of 119 types of themes identifiable by pharmacists were also identifiable by software. MRM could identify the same problems in the same patients as pharmacists for 389 problems, resulting in a low overlap of similarity with an averaged Jaccard Index of 0.09. MRM found significantly more potential DRPs than pharmacists. MRM identified a wide scope of DRPs approaching the range of DRPs that were identified by pharmacists. Differences may be associated with system consistency and perhaps human oversight or human selective prioritisation. DRPs identified by the system were still considered relevant even though the system identified a larger number of problems.

Correlates of specific childhood feeding problems.

PubMed

Field, D; Garland, M; Williams, K

2003-01-01

The correlates of specific childhood feeding problems are described to further examine possible predisposing factors for feeding problems. We report our experience with 349 participants evaluated by an interdisciplinary feeding team. A review of records was conducted and each participant was identified as having one or more of five functionally defined feeding problems: food refusal, food selectivity by type, food selectivity by texture, oral motor delays, or dysphagia. The prevalence of predisposing factors for these feeding problems was examined. Predisposing factors included developmental disabilities, gastrointestinal problems, cardiopulmonary problems, neurological problems, renal disease and anatomical anomalies. The frequencies of predisposing factors varied by feeding problem. Differences were found in the prevalence of the five feeding problems among children with three different developmental disabilities: autism, Down syndrome and cerebral palsy. Gastro-oesophageal reflux was the most prevalent condition found among all children in the sample and was the factor most often associated with food refusal. Neurological conditions and anatomical anomalies were highly associated with skill deficits, such as oral motor delays and dysphagia. Specific medical conditions and developmental disabilities are often associated with certain feeding problems. Information concerning predisposing factors of feeding problems can help providers employ appropriate primary, secondary and tertiary prevention measures to decrease the frequency or severity of some feeding problems.

Antecedents of Attention-Deficit/Hyperactivity Disorder symptoms in children born extremely preterm

PubMed Central

Johnson, Samantha; Kochhar, Puja; Hennessy, Enid; Marlow, Neil; Wolke, Dieter; Hollis, Chris

2016-01-01

Objective To investigate antecedents of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in children born extremely preterm (EP; <26 weeks gestation). Method The EPICure Study recruited all babies born EP in the UK and Ireland in March-December 1995. Neurodevelopmental outcomes were assessed at 2.5 (n=283; 90%), 6 (n=160; 78%) and 11 (n=219; 71%) years of age. Parents and teachers completed the Du Paul Rating Scale-IV to assess inattention and hyperactivity/impulsivity symptoms at 11 years. Regression analyses were used to explore the association of neonatal, neurodevelopmental and behavioral outcomes to 6 years with ADHD symptoms at 11 years. Results EP children had significantly more inattention (mean difference 1.2 SD; 95% CI 0.9, 1.5) and hyperactivity/impulsivity (0.5 SD; 0.2, 0.7) than controls, with a significantly greater effect size for inattention than hyperactivity/impulsivity. Significant independent predictors of inattention at 11 years included smaller head circumference, lower IQ and pervasive peer relationship problems at 6 years, and motor development at 2.5 years. In contrast, significant independent predictors of hyperactivity/impulsivity included lower IQ, pervasive conduct problems and ADHD symptoms at 6 years, externalizing problems at 2.5 years and non-white maternal ethnicity. Conclusions EP children are at increased risk for ADHD symptoms, predominantly inattention, for which the antecedents differ by symptom domain. Attention deficits following EP birth were associated with poor brain growth and neurological function. Cognitive and behavioral assessments in early and middle childhood to identify neurodevelopmental and peer relationship problems may be beneficial for identifying EP children at risk for inattention. PMID:27096570

Musculoskeletal injuries description of an under-recognized injury problem among military personnel.

PubMed

Hauret, Keith G; Jones, Bruce H; Bullock, Steven H; Canham-Chervak, Michelle; Canada, Sara

2010-01-01

Although injuries are recognized as a leading health problem in the military, the size of the problem is underestimated when only acute traumatic injuries are considered. Injury-related musculoskeletal conditions are common in this young, active population. Many of these involve physical damage caused by micro-trauma (overuse) in recreation, sports, training, and job performance. The purpose of this analysis was to determine the incidence of injury-related musculoskeletal conditions in the military services (2006) and describe a standardized format in which to categorize and report them. The subset of musculoskeletal diagnoses found to be injury-related in previous military investigations was identified. Musculoskeletal injuries among nondeployed, active duty service members in 2006 were identified from military medical surveillance data. A matrix was used to report and categorize these conditions by injury type and body region. There were 743,547 injury-related musculoskeletal conditions in 2006 (outpatient and inpatient, combined), including primary and nonprimary diagnoses. In the matrix, 82% of injury-related musculoskeletal conditions were classified as inflammation/pain (overuse), followed by joint derangements (15%) and stress fractures (2%). The knee/lower leg (22%), lumbar spine (20%), and ankle/foot (13%) were leading body region categories. When assessing the magnitude of the injury problem in the military services, injury-related musculoskeletal conditions should be included. When these injuries are combined with acute traumatic injuries, there are almost 1.6 million injury-related medical encounters each year. The matrix provides a standardized format to categorize these injuries, make comparisons over time, and focus prevention efforts on leading injury types and/or body regions. Published by Elsevier Inc.

Street floods in Metro Manila and possible solutions.

PubMed

Lagmay, Alfredo Mahar; Mendoza, Jerico; Cipriano, Fatima; Delmendo, Patricia Anne; Lacsamana, Micah Nieves; Moises, Marc Anthony; Pellejera, Nicanor; Punay, Kenneth Niño; Sabio, Glenn; Santos, Laurize; Serrano, Jonathan; Taniza, Herbert James; Tingin, Neil Eneri

2017-09-01

Urban floods from thunderstorms cause severe problems in Metro Manila due to road traffic. Using Light Detection and Ranging (LiDAR)-derived topography, flood simulations and anecdotal reports, the root of surface flood problems in Metro Manila is identified. Majority of flood-prone areas are along the intersection of creeks and streets located in topographic lows. When creeks overflow or when rapidly accumulated street flood does not drain fast enough to the nearest stream channel, the intersecting road also gets flooded. Possible solutions include the elevation of roads or construction of well-designed drainage structures leading to the creeks. Proposed solutions to the flood problem of Metro Manila may avoid paralyzing traffic problems due to short-lived rain events, which according to Japan International Cooperation Agency (JICA) cost the Philippine economy 2.4billionpesos/day. Copyright © 2017. Published by Elsevier B.V.

Comparison of heuristic and cognitive walkthrough usability evaluation methods for evaluating health information systems.

PubMed

Khajouei, Reza; Zahiri Esfahani, Misagh; Jahani, Yunes

2017-04-01

There are several user-based and expert-based usability evaluation methods that may perform differently according to the context in which they are used. The objective of this study was to compare 2 expert-based methods, heuristic evaluation (HE) and cognitive walkthrough (CW), for evaluating usability of health care information systems. Five evaluators independently evaluated a medical office management system using HE and CW. We compared the 2 methods in terms of the number of identified usability problems, their severity, and the coverage of each method. In total, 156 problems were identified using the 2 methods. HE identified a significantly higher number of problems related to the "satisfaction" attribute ( P  = .002). The number of problems identified using CW concerning the "learnability" attribute was significantly higher than those identified using HE ( P  = .005). There was no significant difference between the number of problems identified by HE, based on different usability attributes ( P  = .232). Results of CW showed a significant difference between the number of problems related to usability attributes ( P  < .0001). The average severity of problems identified using CW was significantly higher than that of HE ( P  < .0001). This study showed that HE and CW do not differ significantly in terms of the number of usability problems identified, but they differ based on the severity of problems and the coverage of some usability attributes. The results suggest that CW would be the preferred method for evaluating systems intended for novice users and HE for users who have experience with similar systems. However, more studies are needed to support this finding. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

User Interface Problems of a Nationwide Inpatient Information System: A Heuristic Evaluation.

PubMed

Atashi, Alireza; Khajouei, Reza; Azizi, Amirabbas; Dadashi, Ali

2016-01-01

While studies have shown that usability evaluation could uncover many design problems of health information systems, the usability of health information systems in developing countries using their native language is poorly studied. The objective of this study was to evaluate the usability of a nationwide inpatient information system used in many academic hospitals in Iran. Three trained usability evaluators independently evaluated the system using Nielsen's 10 usability heuristics. The evaluators combined identified problems in a single list and independently rated the severity of the problems. We statistically compared the number and severity of problems identified by HIS experienced and non-experienced evaluators. A total of 158 usability problems were identified. After removing duplications 99 unique problems were left. The highest mismatch with usability principles was related to "Consistency and standards" heuristic (25%) and the lowest related to "Flexibility and efficiency of use" (4%). The average severity of problems ranged from 2.4 (Major problem) to 3.3 (Catastrophe problem). The experienced evaluator with HIS identified significantly more problems and gave higher severities to problems (p<0.02). Heuristic Evaluation identified a high number of usability problems in a widely used inpatient information system in many academic hospitals. These problems, if remain unsolved, may waste users' and patients' time, increase errors and finally threaten patient's safety. Many of them can be fixed with simple redesign solutions such as using clear labels and better layouts. This study suggests conducting further studies to confirm the findings concerning effect of evaluator experience on the results of Heuristic Evaluation.

User Interface Problems of a Nationwide Inpatient Information System: A Heuristic Evaluation

PubMed Central

Atashi, Alireza; Azizi, Amirabbas; Dadashi, Ali

2016-01-01

Summary Introduction While studies have shown that usability evaluation could uncover many design problems of health information systems, the usability of health information systems in developing countries using their native language is poorly studied. The objective of this study was to evaluate the usability of a nationwide inpatient information system used in many academic hospitals in Iran. Material and Methods Three trained usability evaluators independently evaluated the system using Nielsen’s 10 usability heuristics. The evaluators combined identified problems in a single list and independently rated the severity of the problems. We statistically compared the number and severity of problems identified by HIS experienced and non-experienced evaluators. Results A total of 158 usability problems were identified. After removing duplications 99 unique problems were left. The highest mismatch with usability principles was related to “Consistency and standards” heuristic (25%) and the lowest related to “Flexibility and efficiency of use” (4%). The average severity of problems ranged from 2.4 (Major problem) to 3.3 (Catastrophe problem). The experienced evaluator with HIS identified significantly more problems and gave higher severities to problems (p<0.02). Discussion Heuristic Evaluation identified a high number of usability problems in a widely used inpatient information system in many academic hospitals. These problems, if remain unsolved, may waste users’ and patients’ time, increase errors and finally threaten patient’s safety. Many of them can be fixed with simple redesign solutions such as using clear labels and better layouts. This study suggests conducting further studies to confirm the findings concerning effect of evaluator experience on the results of Heuristic Evaluation. PMID:27081409

Youth Top Problems: using idiographic, consumer-guided assessment to identify treatment needs and to track change during psychotherapy.

PubMed

Weisz, John R; Chorpita, Bruce F; Frye, Alice; Ng, Mei Yi; Lau, Nancy; Bearman, Sarah Kate; Ugueto, Ana M; Langer, David A; Hoagwood, Kimberly E

2011-06-01

To complement standardized measurement of symptoms, we developed and tested an efficient strategy for identifying (before treatment) and repeatedly assessing (during treatment) the problems identified as most important by caregivers and youths in psychotherapy. A total of 178 outpatient-referred youths, 7-13 years of age, and their caregivers separately identified the 3 problems of greatest concern to them at pretreatment and then rated the severity of those problems weekly during treatment. The Top Problems measure thus formed was evaluated for (a) whether it added to the information obtained through empirically derived standardized measures (e.g., the Child Behavior Checklist [CBCL; Achenbach & Rescorla, 2001] and the Youth Self-Report [YSR; Achenbach & Rescorla, 2001]) and (b) whether it met conventional psychometric standards. The problems identified were significant and clinically relevant; most matched CBCL/YSR items while adding specificity. The top problems also complemented the information yield of the CBCL/YSR; for example, for 41% of caregivers and 79% of youths, the identified top problems did not correspond to any items of any narrowband scales in the clinical range. Evidence on test-retest reliability, convergent and discriminant validity, sensitivity to change, slope reliability, and the association of Top Problems slopes with standardized measure slopes supported the psychometric strength of the measure. The Top Problems measure appears to be a psychometrically sound, client-guided approach that complements empirically derived standardized assessment; the approach can help focus attention and treatment planning on the problems that youths and caregivers consider most important and can generate evidence on trajectories of change in those problems during treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Delivery of child health services in Indigenous communities: implications for the federal government's emergency intervention in the Northern Territory.

PubMed

Bailie, Ross S; Si, Damin; Dowden, Michelle C; Connors, Christine M; O'Donoghue, Lynette; Liddle, Helen E; Kennedy, Catherine M; Cox, Rhonda J; Burke, Hugh P; Thompson, Sandra C; Brown, Alex D H

2008-05-19

To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children. Cross-sectional baseline audit for a quality improvement intervention. 297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006. Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems. Documentation of delivery of specific clinical examinations (26%-80%) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5%-36%) and enquiry regarding social conditions (3%-11%). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11%-13% of children with identified social problems had an assessment report on file. An action plan was documented for 22% of children with growth faltering and 13% with chronic ear disease; 43% of children with chronic respiratory disease and 31% with developmental delay had an assessment report on file. Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.