CBPR with service providers: arguing a case for engaging practitioners in all phases of research.

PubMed

Spector, Anya Y

2012-03-01

This review synthesizes the literature on CBPR with service providers to identify the benefits to, unique contributions of, and challenges experienced by professional service providers engaged in collaborative research. Service providers benefited by obtaining research-based knowledge to help the communities they serve, gaining research skills, professional relationships, professional development, and new programs. They contributed by informing research aims, designing interventions, conducting recruitment, informing overall study design, and dissemination. Challenges include time, resources, organizational factors, and disconnects between researchers and service providers. Policy and practice implications are explored.

Health Care Provider Accommodations for Patients with Communication Disorders

ERIC Educational Resources Information Center

Burns, Michael I.; Baylor, Carolyn; Dudgeon, Brian J.; Starks, Helene; Yorkston, Kathryn

2017-01-01

Health care providers can experience increased diffculty communicating with adult patients during medical interactions when the patients have communication disorders. Meeting the communication needs of these patients can also create unique challenges for providers. The authors explore Communication Accommodation Theory (H. Giles, 1979) as a guide…

Rotorcraft Health Management Issues and Challenges

NASA Technical Reports Server (NTRS)

Zakrajsek, James J.; Dempsey, Paula J.; Huff, Edward M.; Augustin, Michael; Safa-Bakhsh, Robab; Ephraim, Piet; Grabil, Paul; Decker, Harry J.

2006-01-01

This paper presents an overview of health management issues and challenges that are specific to rotorcraft. Rotorcraft form a unique subset of air vehicles in that their propulsion system is used not only for propulsion, but also serves as the primary source of lift and maneuvering of the vehicle. No other air vehicle relies on the propulsion system to provide these functions through a transmission system with single critical load paths without duplication or redundancy. As such, health management of the power train is a critical and unique part of any rotorcraft health management system. This paper focuses specifically on the issues and challenges related to the dynamic mechanical components in the main power train. This includes the transmission and main rotor mechanisms. This paper will review standard practices used for rotorcraft health management, lessons learned from fielded trials, and future challenges.

Dental care in children with developmental disabilities: attention deficit disorder, intellectual disabilities, and autism.

PubMed

Charles, Jane M

2010-01-01

The Federal government reports that 13% of Americans between birth and 18 years of old meet the definition of a child with special health care needs. These children and young adults present unique challenges for both pediatric and general dentists to provide access to the oral health care system--establishing a treatment plan for those with unique medical, behavioral and dental needs and maintaining oral health over the lifetime. The purpose of this article was to describe the characteristics of 3 common developmental disabilities and the challenges these issues present to the oral health care practitioner.

Social media as a platform for science and health engagement: challenges and opportunities.

PubMed

Dixon, Graham

2016-01-01

Social media has become a major platform for debates on science and health. This commentary argues that while social media can present challenges to communicating important health matters, it can also provide health experts a unique opportunity to engage with and build trust among members of the public.

Boundary-Spanning Actors in Urban 4-H: An Action Research Case Study

ERIC Educational Resources Information Center

David, Victoria Dotson

2014-01-01

Today's Cooperative Extension organization continues to face challenges of providing relevant, quality programming in urban communities. Challenges include the ability to build capacity in Extension's urban youth educators to assess and interpret the unique, variable needs of urban clients and to communicate effectively the identified…

Overcoming the glass ceiling: views from the cellar and the roof.

PubMed

McCrady, Barbara S

2012-12-01

Women's experiences as professionals and behavior therapists have changed considerably in the past 40 years. The author describes early challenges and experiences of discrimination as a young female professional. Although women's opportunities have improved considerably, women still experience unique career challenges and choices. The author provides some suggestions for women's career development.

Veteran family reintegration, primary care needs, and the benefit of the patient-centered medical home model.

PubMed

Hinojosa, Ramon; Hinojosa, Melanie Sberna; Nelson, Karen; Nelson, David

2010-01-01

Men and women returning from the wars in Afghanistan and Iraq face a multitude of difficulties while integrating back into civilian life, but the importance of their veteran status is often overlooked in primary care settings. Family physicians have the potential to be the first line of defense to ensure the well-being of veterans and their families because many will turn to nonmilitary and non-Veterans Affairs providers for health care needs. An awareness of the unique challenges faced by this population is critical to providing care. A patient-centered medical home orientation can help the family physician provide veterans and their families the care they need. Specific recommendations for family physicians include screening their patient population; providing timely care; treating the whole family; and integrating care from multiple disciplines and specialties, providing veterans and families with "one-stop shopping" care. An awareness of the unique challenges faced by veterans and their families translates into better overall outcomes for this population.

Software Assurance Challenges for the Commercial Crew Program

NASA Technical Reports Server (NTRS)

Cuyno, Patrick; Malnick, Kathy D.; Schaeffer, Chad E.

2015-01-01

This paper will provide a description of some of the challenges NASA is facing in providing software assurance within the new commercial space services paradigm, namely with the Commercial Crew Program (CCP). The CCP will establish safe, reliable, and affordable access to the International Space Station (ISS) by purchasing a ride from commercial companies. The CCP providers have varying experience with software development in safety-critical space systems. NASA's role in providing effective software assurance support to the CCP providers is critical to the success of CCP. These challenges include funding multiple vehicles that execute in parallel and have different rules of engagement, multiple providers with unique proprietary concerns, providing equivalent guidance to all providers, permitting alternates to NASA standards, and a large number of diverse stakeholders. It is expected that these challenges will exist in future programs, especially if the CCP paradigm proves successful. The proposed CCP approach to address these challenges includes a risk-based assessment with varying degrees of engagement and a distributed assurance model. This presentation will describe NASA IV&V Program's software assurance support and responses to these challenges.

Air Pollution Monitoring for Communities Grants

EPA Pesticide Factsheets

EPA, through its Science to Achieve Results (STAR) grants program is providing funding to six institutions that will advance air monitoring technology while helping communities address unique air quality challenges.

Taking Care of You: Body, Mind, Spirit--A Unique Stress Management Program That Improves Lifestyle Behaviors

ERIC Educational Resources Information Center

Vetter-Smith, Molly; Massey, Vera; Rellergert, Linda; Wissmann, Mary

2014-01-01

Taking Care of You: Body, Mind, Spirit is a multi-session group program developed by University of Missouri Extension that provides a unique and practical approach to helping adults better managing their stress and bounce back from life's challenges while improving lifestyle behaviors. The program combines mindfulness and a variety of other…

Air Pollution Monitoring for Communities Fact Sheet

EPA Pesticide Factsheets

EPA through its Science to Achieve Results (STAR) grants program is providing funding to six institutions that will advance air monitoring technology while helping communities address unique air quality challenges.

Transition Services for DHH Adolescents and Young Adults with Disabilities: Challenges and Theoretical Frameworks

ERIC Educational Resources Information Center

Luft, Pamela

2015-01-01

Deaf and Hard of Hearing (DHH) adolescents and young adults with disabilities (DWD) are a highly diverse group who may also demonstrate a range of functional limitations. These present unique challenges to professional efforts to provide high-quality transition services. Despite these issues, a majority of this population has cognitive abilities…

Wilderness stewardship challenges in the uKhahlamba Drakensberg Park World Heritage Site

Treesearch

Sonja Krüger

2007-01-01

The location of the uKhahlamba Drakensberg Park wilderness areas along an international border and within a World Heritage Site and Transfrontier Conservation Area, provides unique opportunities and challenges for the stewardship of these areas. Although the wilderness areas were proclaimed more than 30 years ago, wilderness-specific planning, management and monitoring...

Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges

ERIC Educational Resources Information Center

Bennett, Laura; Bates, Michael

2015-01-01

This article provides an overview of the research on targeted violence, including campus violence, and the implications for policy and practice at institutions of higher education. Unique challenges of threat assessment in the community college setting are explored, and an overview of an effective threat assessment policy and team at William…

DUF6 Guide

Science.gov Websites

and the environment. The Guide provides basic information about the properties of uranium compounds understand the unique challenges involved in managing DOE's inventory of depleted UF6 in a safe and efficient

A Model for Designing Library Instruction for Distance Learning

ERIC Educational Resources Information Center

Rand, Angela Doucet

2013-01-01

Providing library instruction in distance learning environments presents a unique set of challenges for instructional librarians. Innovations in computer-mediated communication and advances in cognitive science research provide the opportunity for designing library instruction that meets a variety of student information seeking needs. Using a…

Chemical, Electrical, and Radiation Injuries.

PubMed

Friedstat, Jonathan; Brown, David A; Levi, Benjamin

2017-07-01

This article reviews the unique challenges presented by chemical, electrical, and radiation injuries. The authors discuss pathophysiology and diagnosis of these injuries and provide recommendations for management. Copyright © 2017 Elsevier Inc. All rights reserved.

Orthopaedic nursing in developing nations: A collaboration between the Republic of the Union of Myanmar (Burma) and Australia.

PubMed

Han, Yin Mar; Awng, Nang; Nu, Lahkri Hkawn; Thway, Ni Mya; McLiesh, Paul

2017-11-01

This paper describes a collaboration between orthopaedic nurses in Myanmar (Burma) and Australia. It aims to explores how that collaboration began and how it can grow and has grown. The unique needs and challenges of healthcare delivery in developing nations are discussed. Understanding these unique needs and challenges is vital in tailoring strategies to provide orthopaedic nurses in those countries with resources that are suitable to assist them in providing the highest level of quality care to their patients. The authors hope that this example may inspire other orthopaedic nurses and organisations around the globe to participate in this type of activity with the understanding that it benefits all those involved, nurses from both developed and developing countries, as well as improving patient care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Challenges and opportunities in the care of international patients: clinical and health services issues for academic medical centers.

PubMed

Martin, Don R

2006-02-01

International visitors who travel to the United States for the express purpose of receiving medical care constitute a small, but unique and important, subset of patients in this country. These visitors have traditionally sought care at what are widely regarded as the premier U.S. academic medical centers. Their care may prove challenging due to logistical, medical, language, and cross-cultural issues, and has the potential to distract from the educational and research missions of these medical centers. The author reflects on how one academic medical center, the Johns Hopkins Medical Institutions, has experienced and responded to these challenges. Specific issues include scheduling and evaluation challenges, language and cultural differences, and arranging continuity care. The author concludes that when an institution invests the resources necessary to address these issues, and enlists physicians stimulated by this challenging group of patients, the arrangement is mutually beneficial to the international patients and the institution. Scholarly evaluation of this phenomenon has been virtually nonexistent, due to both the unique niche occupied by these programs and institutional competition for this group of patients. However, collaborative evaluation of international patient programs will provide the opportunity to assess similarities, differences, and effectiveness, benefiting both those providing and those receiving care by improving the appropriateness and quality of care.

Tradition and Culture in the Millennium: Tribal Colleges and Universities. Educational Policy in the 21st Century: Opportunities, Challenges and Solutions

ERIC Educational Resources Information Center

Warner, Linda Sue, Ed.; Gipp, Gerald E., Ed.

2009-01-01

This volume of The David C. Anchin Research Center Series on Educational Policy in the 21st century: Opportunities, Challenges, and Solutions focuses on tribal colleges and universities. As a recent member of higher education community, tribal colleges and universities provide a unique perspective on higher education policy. Policies and…

Top-down Proteomics in Health and Disease: Challenges and Opportunities

PubMed Central

Gregorich, Zachery R.; Ge, Ying

2014-01-01

Proteomics is essential for deciphering how molecules interact as a system and for understanding the functions of cellular systems in human disease; however, the unique characteristics of the human proteome, which include a high dynamic range of protein expression and extreme complexity due to a plethora of post-translational modifications (PTMs) and sequence variations, make such analyses challenging. An emerging “top-down” mass spectrometry (MS)-based proteomics approach, which provides a “bird’s eye” view of all proteoforms, has unique advantages for the assessment of PTMs and sequence variations. Recently, a number of studies have showcased the potential of top-down proteomics for unraveling of disease mechanisms and discovery of new biomarkers. Nevertheless, the top-down approach still faces significant challenges in terms of protein solubility, separation, and the detection of large intact proteins, as well as the under-developed data analysis tools. Consequently, new technological developments are urgently needed to advance the field of top-down proteomics. Herein, we intend to provide an overview of the recent applications of top-down proteomics in biomedical research. Moreover, we will outline the challenges and opportunities facing top-down proteomics strategies aimed at understanding and diagnosing human diseases. PMID:24723472

Structured Ethical Reflection in Practitioner Inquiry: Theory, Pedagogy, and Practice

ERIC Educational Resources Information Center

Stevens, Douglas M.; Brydon-Miller, Mary; Raider-Roth, Miriam

2016-01-01

Practitioner inquiry provides a powerful tool for improving practice and addressing critical issues in classrooms, schools, and broader communities. However, it also raises unique ethical challenges that often go unrecognized and unresolved. Structured Ethical Reflection (SER) provides teacher researchers with a process for identifying core values…

DefenseLink Feature: Military Helps Fight California Wildfires

Science.gov Websites

planes dropping fire retardant on wildfires in southern California face hazards and challenges unique to ' * Sailors Help Victims in Need * Bush Pledges Military Will Continue to Provide Fire Aid | Video

Exploring challenges to telehealth communication by specialists in poison information.

PubMed

Rothwell, Erin; Ellington, Lee; Planalp, Sally; Crouch, Barbara

2012-01-01

The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty managing caller misunderstandings, maintaining distinctive assessments for routine calls, and managing the multifaceted aspects of job stress. The desire for training to enhance telehealth and cultural competency skills was also mentioned, and these findings might provide guidance for the development of training opportunities for telehealth professionals.

Using Quantum Confinement to Uniquely Identify Devices

PubMed Central

Roberts, J.; Bagci, I. E.; Zawawi, M. A. M.; Sexton, J.; Hulbert, N.; Noori, Y. J.; Young, M. P.; Woodhead, C. S.; Missous, M.; Migliorato, M. A.; Roedig, U.; Young, R. J.

2015-01-01

Modern technology unintentionally provides resources that enable the trust of everyday interactions to be undermined. Some authentication schemes address this issue using devices that give a unique output in response to a challenge. These signatures are generated by hard-to-predict physical responses derived from structural characteristics, which lend themselves to two different architectures, known as unique objects (UNOs) and physically unclonable functions (PUFs). The classical design of UNOs and PUFs limits their size and, in some cases, their security. Here we show that quantum confinement lends itself to the provision of unique identities at the nanoscale, by using fluctuations in tunnelling measurements through quantum wells in resonant tunnelling diodes (RTDs). This provides an uncomplicated measurement of identity without conventional resource limitations whilst providing robust security. The confined energy levels are highly sensitive to the specific nanostructure within each RTD, resulting in a distinct tunnelling spectrum for every device, as they contain a unique and unpredictable structure that is presently impossible to clone. This new class of authentication device operates with minimal resources in simple electronic structures above room temperature. PMID:26553435

Addressing the paradox of the team innovation process: A review and practical considerations.

PubMed

Thayer, Amanda L; Petruzzelli, Alexandra; McClurg, Caitlin E

2018-01-01

Facilitating team innovation is paramount to promoting progress in the science, technology, engineering, and math fields, as well as advancing national health, safety, prosperity, and welfare. However, innovation teams face a unique set of challenges due to the novelty and uncertainty that is core to the definition of innovation, as well as the paradoxical nature of idea generation and idea implementation processes. These and other challenges must be overcome for innovation teams to realize their full potential for producing change. The purpose of this review is, thus, to provide insight into the unique context that these teams function within and provide an integrative, evidence-based, and practically useful, organizing heuristic that focuses on the most important considerations for facilitating team innovation. Finally, we provide practical guidance for psychologists, organizations, practitioners, scientists, educators, policymakers, and others who employ teams to produce novel, innovative solutions to today's problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

High Voltage Hybrid Electric Propulsion - Multilayered Functional Insulation System (MFIS) NASA-GRC

NASA Technical Reports Server (NTRS)

Lizcano, M.

2017-01-01

High power transmission cables pose a key challenge in future Hybrid Electric Propulsion Aircraft. The challenge arises in developing safe transmission lines that can withstand the unique environment found in aircraft while providing megawatts of power. High voltage AC, variable frequency cables do not currently exist and present particular electrical insulation challenges since electrical arcing and high heating are more prevalent at higher voltages and frequencies. Identifying and developing materials that maintain their dielectric properties at high voltage and frequencies is crucial.

High Gain Antenna Gimbal for the 2003-2004 Mars Exploration Rover Program

NASA Technical Reports Server (NTRS)

Sokol, Jeff; Krishnan, Satish; Ayari, Laoucet

2004-01-01

The High Gain Antenna Assemblies built for the 2003-2004 Mars Exploration Rover (MER) missions provide the primary communication link for the Rovers once they arrive on Mars. The High Gain Antenna Gimbal (HGAG) portion of the assembly is a two-axis gimbal that provides the structural support, pointing, and tracking for the High Gain Antenna (HGA). The MER mission requirements provided some unique design challenges for the HGAG. This paper describes all the major subsystems of the HGAG that were developed to meet these challenges, and the requirements that drove their design.

Transition Services for DHH Adolescents and Young Adults With Disabilities: Challenges and Theoretical Frameworks.

PubMed

Luft, Pamela

2015-01-01

Deaf and hard of hearing (DHH) adolescents and young adults with disabilities (DWD) are a highly diverse group who may also demonstrate a range of functional limitations. These present unique challenges to professional efforts to provide high-quality transition services. Despite these issues, a majority of this population has cognitive abilities within the typical range, and therefore, their transition expectations should be commensurately high in comparison to those of their DHH peers. Research-based transition practices offer a range of interventions, and although none have been validated with DHH or DWD students, several provide important foundational learning opportunities. Yet their implementation will require modifications with programming and expertise beyond what is available in most school districts. Use of a multilevel, ecological framework and person-centered planning offers systematic strategies for increasing access to transition resources and supports to address these unique needs and lead to successful adulthood.

Auditory and Vestibular Issues Related to Human Spaceflight

NASA Technical Reports Server (NTRS)

Danielson, Richard W.; Wood, Scott J.

2009-01-01

Human spaceflight provides unique opportunities to study human vestibular and auditory systems. This session will discuss 1) vestibular adaptive processes reflected by pronounced perceptual and motor coordination problems during, and after, space missions; 2) vestibular diagnostic and rehabilitative techniques (used to promote recovery after living in altered gravity environments) that may be relevant to treatment of vestibular disorders on earth; and 3) unique acoustical challenges to hearing loss prevention and crew performance during spaceflight missions.

The 4A Metric Algorithm: A Unique E-Learning Engineering Solution Designed via Neuroscience to Counter Cheating and Reduce Its Recidivism by Measuring Student Growth through Systemic Sequential Online Learning

ERIC Educational Resources Information Center

Osler, James Edward

2016-01-01

This paper provides a novel instructional methodology that is a unique E-Learning engineered "4A Metric Algorithm" designed to conceptually address the four main challenges faced by 21st century students, who are tempted to cheat in a myriad of higher education settings (face to face, hybrid, and online). The algorithmic online…

Understanding the Importance of Relationships: Perspective of Children with Intellectual Disabilities, Their Parents, and Nurses in Canada

ERIC Educational Resources Information Center

Aston, Megan; Breau, Lynn; MacLeod, Emily

2014-01-01

Effective and therapeutic relationships between health care providers and clients are important elements for positive health outcomes. Children with intellectual disabilities (IDs) and their parents face unique challenges in establishing relationships with health care providers due to social and institutional stigma and stereotypes associated with…

Guiding Principles for Providing High-Quality Education in Juvenile Justice Secure Care Settings

ERIC Educational Resources Information Center

US Department of Education, 2014

2014-01-01

Providing high-quality education in juvenile justice secure care settings presents unique challenges for the administrators, teachers, and staff who are responsible for the education, rehabilitation, and welfare of youths committed to their care. The United States departments of Education (ED) and Justice (DOJ) recognize that while these…

Safety evaluation of high-speed rail bogie concepts.

DOT National Transportation Integrated Search

2013-10-01

The study defines the basic design concepts required to provide a safe, reliable, high-speed bogie for the next generation PRIIA passenger locomotive. The requirements and conditions for the U.S. market create unique design challenges that currently ...

State transportation policy initiative : a new strategic urban transportation planning process

DOT National Transportation Integrated Search

1995-06-01

Recent legislation and fiscal trends in Florida and nationwide have created a unique combination of constraints and opportunities, providing an impetus for examining the way Florida conducts transportation planning. In response to these challenges, t...

Traffic incident management in hazardous materials spills in incident clearance.

DOT National Transportation Integrated Search

2009-01-01

Hazardous materials spills provide unique challenges to traffic incident clearance. When hazardous materials are present, not only do response personnel have to deal with typical traffic incident issues, they also must deal with potential chemical ha...

Follicular thyroid cancer and Hürthle cell carcinoma: challenges in diagnosis, treatment, and clinical management.

PubMed

Grani, Giorgio; Lamartina, Livia; Durante, Cosimo; Filetti, Sebastiano; Cooper, David S

2018-06-01

Follicular thyroid cancer is the second most common differentiated thyroid cancer histological type and has been overshadowed by its more common counterpart-papillary thyroid cancer-despite its unique biological behaviour and less favourable outcomes. In this Review, we comprehensively review the literature on follicular thyroid cancer to provide an evidence-based guide to the management of these tumours, to highlight the lack of evidence behind guideline recommendations, and to identify changes and challenges over the past decades in diagnosis, prognosis, and treatment. We highlight that correct identification of cancer in indeterminate cytological samples is challenging and ultrasonographic features can be misleading. Despite certain unique aspects of follicular thyroid cancer presentation and prognosis, no specific recommendations exist for follicular thyroid cancer and Hürthle cell carcinoma in evidence-based guidelines. Efforts should be made to stimulate additional research in this field. Copyright © 2018 Elsevier Ltd. All rights reserved.

Challenges Facing a Deaf Family Member Concerning a Loved One’s Dying

PubMed Central

Kehl, Karen A.; Gartner, Constance M.

2010-01-01

Individuals who are Deaf face challenges both similar and unique from those faced by hearing individuals when a family member is dying. This study was guided by the question “What are the challenges faced by a Deaf family member when a loved one is dying?” Methods - This qualitative study is guided by critical theory and an interpretive perspective. Robert, a college-educated older adult who has been Deaf from birth was interviewed in American Sign Language using a death history format. Results – There are challenges for Deaf family members that affect communication with both the dying person and health care professionals. Patient-family communication issues included physical challenges and financial challenges. Lack of cultural competence concerning the Deaf community created challenges communicating with professionals. Decision-making was also a challenge. Conclusions These findings provide a framework for future research concerning the needs of Deaf individuals facing the end of life and provide guidance for clinicians. PMID:19910395

The Use of Video Self-Monitoring Embedded with Mentorship as a Medium to Enhance Experiential Learning Opportunities and Promote Critical Thinking Skills for Educators and Health Science Professionals Working with Children with Autism

ERIC Educational Resources Information Center

Slim-Topdjian, Lina; Pinto Zipp, Genevieve

2016-01-01

The increased prevalence of autism has created an increased challenge for teachers to incorporate specialized teaching strategies to address the unique educational and behavioral challenges facing children diagnosed with autism. Providing teachers with educational training opportunities will promote such learning. In the academic world,…

Changes and Challenges: The Power of Education to Build the World to Which We Aspire. Australian College of Educators (ACE) National Conference Proceedings (Sydney, Australia, September 26-27, 2016)

ERIC Educational Resources Information Center

Ikin, Kerrie, Ed.

2016-01-01

The theme of the 2016 National Conference of the Australian College of Educators (ACE), "Challenges and changes: The power of education to build the world to which we aspire," provided a unique opportunity for education professionals to carefully consider and propose papers, workshops, and poster sessions to stimulate discussion and…

Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions.

PubMed

Muir, Ryan T; Wang, Shelly; Warf, Benjamin C

2016-11-01

OBJECTIVE Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Significant health disparities exist for the treatment of hydrocephalus in developing nations due to a combination of medical, environmental, and socioeconomic factors. This review aims to provide the international neurosurgery community with an overview of the current challenges and future directions of neurosurgical care for children with hydrocephalus in low-income countries. METHODS The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. RESULTS Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. CONCLUSIONS Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

Midwest vision for sustainable fuel production

USDA-ARS?s Scientific Manuscript database

Meeting the challenge of providing 30% of the transportation fuels used in the USA from those developed from biomass will require significant improvements in technology across the supply chain, significant commercial investment in infrastructure, and, because of the unique characteristics of biomass...

You and Health Insurance: Making a Smart Choice for Farm Families

ERIC Educational Resources Information Center

Riportella, Roberta; O'Neill, Barbara

2015-01-01

This article describes and encourages use of a curriculum that was developed for Extension educators to provide farm families with information about the Affordable Care Act (ACA) and the procedure to become certified to use it. It also describes features of the ACA and unique challenges and opportunities that this law provides to farm families,…

Field studies courses open

NASA Astrophysics Data System (ADS)

Fourteen month-long courses combining applied academics with training in field research methodology are being offered this summer by the School for Field Studies. The courses, held in eight countries during May, June, July, and August, provide unique opportunities for participants to work as a team under primitive conditions.‘Our courses bind together the academic challenge of the research problem, the physical challenge of the site itself, and the interpersonal challenge of the expedition team in a dynamic way so that both cognitive and affective learning are accelerated,’ according to Jim Elder, the school's director.

US EPA CSO CAPSTONE REPORT: THE CSO PROBLEM

EPA Science Inventory

The history of combined sewer systems (CSS) and combined sewer overflows (CSOs) in the US provides unique insights into the complex challenge faced in reducing and eliminating their adverse environmental effects. The evolution of the "modern" CSS shows how early urban drainag sys...

Benchmarking neuromorphic vision: lessons learnt from computer vision

PubMed Central

Tan, Cheston; Lallee, Stephane; Orchard, Garrick

2015-01-01

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

Cascabel prescribed fire long-term watershed study: an opportunity to monitor climate change

Treesearch

Gerald Gottfried; Daniel Neary; Peter Ffolliott; Karen Koestner

2012-01-01

Experimental watershed studies can provide answers to new challenges facing land managers and society including the impacts of fires and climate change on upstream and regional hydrology. The Cascabel Watersheds long-term prescribed fire study provides a unique opportunity to monitor climate change because of its location in an oak savanna situated between deserts or...

Parent and Health Care Provider Perspectives Related to Disclosure of Autism Spectrum Disorder in Pediatric Emergency Departments

ERIC Educational Resources Information Center

Muskat, Barbara; Greenblatt, Andrea; Nicholas, David B.; Ratnapalan, Savithiri; Cohen-Silver, Justine; Newton, Amanda S.; Craig, William R.; Kilmer, Christopher; Zwaigenbaum, Lonnie

2016-01-01

Children and youth with autism spectrum disorder presenting in emergency departments face potential cognitive, sensory, and behavioral challenges, and it is crucial for providers to be aware of their unique needs. However, disclosure of a child's autism spectrum disorder can be complex for parental caregivers and is not well understood. This…

Informing Sexual Health Intervention Development in India: Perspectives of Daughters, Mothers, and Service Providers in Mumbai

ERIC Educational Resources Information Center

Adelson, Emiliya; Maitra, Shubhada; Nastasi, Bonnie K.

2017-01-01

In India, girls face many challenges that pose a threat to their sexual health and psychological well-being. The authors explore sexual health from the perspectives of adolescent girls, mothers of adolescent girls, and service providers. Focus groups and interview data were analyzed to understand the unique and shared perspectives of stakeholders.…

International Perspectives on the First-Year Experience in Higher Education. The First-Year Experience Monograph Series No. 52

ERIC Educational Resources Information Center

Nutt, Diane, Ed.; Calderon, Denis, Ed.

2009-01-01

Students around the globe have unique first-year experiences but struggle with many of the same challenges. This monograph focuses on their journeys and provides insights for educators interested in learning about how institutions across the globe provide supports to students dealing with first-year transition issues. Based on the successful…

Promoting Language Development through Movement

ERIC Educational Resources Information Center

Schilling, Tammy; McOmber, Kelly; Mabe, Kathy; Beasley, Bess; Funkhouser, Shari; Martinez, Layvette

2006-01-01

The purpose of this article is to share with educators the broad developmental benefits, specific challenges, and helpful hints regarding outdoor play for preschoolers, particularly those with limited English proficiency (LEP). In this article, the authors found, that physical play provides some unique opportunities for learning, especially for…

Cultural Sensitivity and Challenges in Management of the Transgender Patient With ESRD in Transplantation.

PubMed

Hoch, Deborah Ann; Bulman, Maya; McMahon, Dorn W

2016-03-01

Transgender patients with end-stage renal disease (ESRD) present with specific challenges during the transplant evaluation, perioperative management, and postoperative phase of care. Demographic information, health-care records, chosen name, and gender identity along with documentation of specific health-care needs can become a challenge when gender assigned at birth is incongruent with the patients gender identity. Medical care involves addressing the end-organ disease as well as addressing those aspects of care specific to the transgender patient. This review article provides information on defining transgender, the impact of ESRD, and transgender in the transplant process and considerations in the throughout phases of care. Current recommendations for management of this unique population are provided. © 2016, NATCO.

Modeling and Simulation of Nanoindentation

NASA Astrophysics Data System (ADS)

Huang, Sixie; Zhou, Caizhi

2017-11-01

Nanoindentation is a hardness test method applied to small volumes of material which can provide some unique effects and spark many related research activities. To fully understand the phenomena observed during nanoindentation tests, modeling and simulation methods have been developed to predict the mechanical response of materials during nanoindentation. However, challenges remain with those computational approaches, because of their length scale, predictive capability, and accuracy. This article reviews recent progress and challenges for modeling and simulation of nanoindentation, including an overview of molecular dynamics, the quasicontinuum method, discrete dislocation dynamics, and the crystal plasticity finite element method, and discusses how to integrate multiscale modeling approaches seamlessly with experimental studies to understand the length-scale effects and microstructure evolution during nanoindentation tests, creating a unique opportunity to establish new calibration procedures for the nanoindentation technique.

Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

PubMed

Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

2018-05-09

The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to communicate and advocate more effectively. Rehabilitation professionals can support people with scleroderma by providing them with information on connecting with scleroderma patient organizations or by facilitating local patient support networks.

Asian-American Education: Prospects and Challenges.

ERIC Educational Resources Information Center

Park, Clara C., Ed.; Chi, Marilyn Mei-Ying, Ed.

This book provides teachers with information about the educational needs of Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, and Vietnamese-American children in U.S. public schools. For each group, there are two chapters: one sociocultural and one linguistic. Each documents the unique characteristics of each ethnic group and provides…

Educating Young Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Barton, Erin E.; Harn, Beth

2012-01-01

Every 20 minutes, another child is diagnosed with autism. Are you ready to meet this growing educational challenge? This authoritative guide for practitioners--early interventionists, teachers, school counselors and psychologists--provides practical strategies for addressing the unique needs of children on the autism spectrum and their families.…

The Creative Community College: Leading Change through Innovation

ERIC Educational Resources Information Center

Roueche, John E., Ed.; Richardson, M. Melissa, Ed.; Neal, Phillip W., Ed.; Roueche, Suanne D., Ed.

2008-01-01

This book provides 14 profiles of innovative and transformational leadership at community colleges. The experience and knowledge shared by the contributors demonstrate how community colleges are adapting creatively to rapidly changing economies, technologies, and education standards. Each of the chapters tells a story of unique challenges and…

The conundrum of harmonizing resistance surveillance systems on a global level

USDA-ARS?s Scientific Manuscript database

Surveillance systems, particularly those involving complex data over time, provide unique challenges. They are as varied in design, intent, funding and function as the countries in which they exist. The Centers for Disease Control and Prevention define surveillance as ‘the ongoing systematic colle...

The Revised 2010 Ethical Standards for School Counselors

ERIC Educational Resources Information Center

Huey, Wayne C.

2011-01-01

The American School Counselor Association (ASCA) recently revised its ethical code for professional school counselors, the "Ethical Standards for School Counselors," in 2010. Professional school counselors have a unique challenge in counseling minors in that they provide services in an educational setting. Consequently, school counselors not only…

Lessons Learned: Reflections of a University President

ERIC Educational Resources Information Center

Bowen, William G.

2010-01-01

"Lessons Learned" gives unprecedented access to the university president's office, providing a unique set of reflections on the challenges involved in leading both research universities and liberal arts colleges. In this landmark book, William Bowen, former president of Princeton University and of the Andrew W. Mellon Foundation, and…

V&V of Fault Management: Challenges and Successes

NASA Technical Reports Server (NTRS)

Fesq, Lorraine M.; Costello, Ken; Ohi, Don; Lu, Tiffany; Newhouse, Marilyn

2013-01-01

This paper describes the results of a special breakout session of the NASA Independent Verification and Validation (IV&V) Workshop held in the fall of 2012 entitled "V&V of Fault Management: Challenges and Successes." The NASA IV&V Program is in a unique position to interact with projects across all of the NASA development domains. Using this unique opportunity, the IV&V program convened a breakout session to enable IV&V teams to share their challenges and successes with respect to the V&V of Fault Management (FM) architectures and software. The presentations and discussions provided practical examples of pitfalls encountered while performing V&V of FM including the lack of consistent designs for implementing faults monitors and the fact that FM information is not centralized but scattered among many diverse project artifacts. The discussions also solidified the need for an early commitment to developing FM in parallel with the spacecraft systems as well as clearly defining FM terminology within a project.

Caring for Refugee Youth in the School Setting.

PubMed

Johnson, Jennifer Leigh; Beard, Joyce; Evans, Dena

2017-03-01

Annually, over 80,000 refugees enter the United States as a result of political or religious persecution. Of these, approximately 35% to 40% are children and adolescents. Refugees are faced with challenges associated with living conditions, cultural and social norms, and socioeconomic status due to problems occurring in their homelands. These challenges include but are not limited to malnutrition, communicable disease, questionable immunization status, lack of formal education, sexual abuse, violence, torture, human trafficking, homelessness, poverty, and a lack of access to health care. Moreover, the psychological impact of relocation and the stress of acculturation may perpetuate many of these existing challenges, particularly for refugee youth, with limited or underdeveloped coping skills. School nurses are uniquely poised to support refugee youth in the transition process, improve overall health, and facilitate access to primary health services. The purpose of this article is to provide an overview of the unique refugee experience, examine the key health care needs of the population, and present school nurses with timely and relevant resources to assist in caring for refugee youth.

Low-Power, Chip-Scale, Carbon Dioxide Gas Sensors for Spacesuit Monitoring

NASA Technical Reports Server (NTRS)

Rani, Asha; Shi, Chen; Thomson, Brian; Debnath, Ratan; Wen, Boamei; Motayed, Abhishek; Chullen, Cinda

2018-01-01

N5 Sensors, Inc. through a Small Business Technology Transfer (STTR) contract award has been developing ultra-small, low-power carbon dioxide (CO2) gas sensors, suited for monitoring CO2 levels inside NASA spacesuits. Due to the unique environmental conditions within the spacesuits, such as high humidity, large temperature swings, and operating pressure swings, measurement of key gases relevant to astronaut's safety and health such as(CO2), is quite challenging. Conventional non-dispersive infrared absorption based CO2 sensors present challenges inside the spacesuits due to size, weight, and power constraints, along with the ability to sense CO2 in a high humidity environment. Unique chip-scale, nanoengineered chemiresistive gas-sensing architecture has been developed for this application, which can be operated in a typical space-suite environmental conditions. Unique design combining the selective adsorption properties of the nanophotocatalytic clusters of metal-oxides and metals, provides selective detection of CO2 in high relative humidity conditions. All electronic design provides a compact and low-power solution, which can be implemented for multipoint detection of CO2 inside the spacesuits. This paper will describe the sensor architecture, development of new photocatalytic material for better sensor response, and advanced structure for better sensitivity and shorter response times.

Amorphous Metal Polysulfides: Electrode Materials with Unique Insertion/Extraction Reactions.

PubMed

Sakuda, Atsushi; Ohara, Koji; Fukuda, Katsutoshi; Nakanishi, Koji; Kawaguchi, Tomoya; Arai, Hajime; Uchimoto, Yoshiharu; Ohta, Toshiaki; Matsubara, Eiichiro; Ogumi, Zempachi; Okumura, Toyoki; Kobayashi, Hironori; Kageyama, Hiroyuki; Shikano, Masahiro; Sakaebe, Hikari; Takeuchi, Tomonari

2017-07-05

A unique charge/discharge mechanism of amorphous TiS 4 is reported. Amorphous transition metal polysulfide electrodes exhibit anomalous charge/discharge performance and should have a unique charge/discharge mechanism: neither the typical intercalation/deintercalation mechanism nor the conversion-type one, but a mixture of the two. Analyzing the mechanism of such electrodes has been a challenge because fewer tools are available to examine the "amorphous" structure. It is revealed that the electrode undergoes two distinct structural changes: (i) the deformation and formation of S-S disulfide bonds and (ii) changes in the coordination number of titanium. These structural changes proceed continuously and concertedly for Li insertion/extraction. The results of this study provide a novel and unique model of amorphous electrode materials with significantly larger capacities.

Building a Cadre of Space Professionals With Responsive Lift

DTIC Science & Technology

2003-04-01

doing the impossible is fun. — Walt Disney The current space program at the Academy provides cadets with a unique opportunity for hands-on experience...However, I know proving that a low cost system can be developed and provide a useful capability is a challenge. Hopefully this paper is a start ...launch frequency, and (2) launch cost. For example, to provide USAFA cadets some space mission experience in their academic careers , we must

Managing childhood chronic illness: parent perspectives and implications for parent-provider relationships.

PubMed

Kratz, Lyn; Uding, Nancy; Trahms, Cristine M; Villareale, Nanci; Kieckhefer, Gail M

2009-12-01

When children have special health care needs, parents assume the roles of care coordinator, medical expert, and systems advocate as well as their typical parenting roles. They face many challenges in managing their child's chronic condition in the context of everyday life. Health care providers are uniquely positioned to assist parents in meeting those challenges and to promote parent competency and confidence in their child's care. The data for this analysis were collected during classes for parents of children with chronic conditions who took part in a randomized controlled study of a curriculum's effectiveness. During facilitated discussions, parents discussed challenges they faced and generated strategies they found helpful. Qualitative data analysis revealed dominant themes across subject areas. Challenges included social isolation, strained relationships and ongoing frustrations with health care and educational systems. Helpful strategies focused on being prepared, connecting with peers, becoming an advocate, developing partnerships and caring for one's self. Implications for health care providers include: understanding common challenges parents face; promoting parent-to-parent connections; and building partnerships with parents and their children with special needs.

Enhanced Rescue Lift Capability

NASA Technical Reports Server (NTRS)

Young, Larry A.

2007-01-01

The evolving and ever-increasing demands of emergency response and disaster relief support provided by rotorcraft dictate, among other things, the development of enhanced rescue lift capability for these platforms. This preliminary analysis is first-order in nature but provides considerable insight into some of the challenges inherent in trying to effect rescue using a unique form of robotic rescue device deployed and operated from rotary-wing aerial platforms.

Science and the major racket sports: a review.

PubMed

Lees, Adrian

2003-09-01

The major racket sports include badminton, squash, table tennis and tennis. The growth of sports science and the commercialization of racket sports in recent years have focused attention on improved performance and this has led to a more detailed study and understanding of all aspects of racket sports. The aim here, therefore, is to review recent developments of the application of science to racket sports. The scientific disciplines of sports physiology and nutrition, notational analysis, sports biomechanics, sports medicine, sports engineering, sports psychology and motor skills are briefly considered in turn. It is evident from these reviews that a great deal of scientific endeavour has been applied to racket sports, but this is variable across both the racket sports and the scientific disciplines. A scientific approach has helped to: implement training programmes to improve players' fitness; guide players in nutritional and psychological preparation for play; inform players of the strategy and tactics used by themselves and their opponents; provide insight into the technical performance of skills; understand the effect of equipment on play; and accelerate the recovery from racket-arm injuries. Racket sports have also posed a unique challenge to scientists and have provided vehicles for developing scientific methodology. Racket sports provide a good model for investigating the interplay between aerobic and anaerobic metabolism and the effect of nutrition, heat and fatigue on performance. They have driven the development of mathematical solutions for multi-segment interactions within the racket arm during the performance of shots, which have contributed to our understanding of the mechanisms of both performance and injury. They have provided a unique challenge to sports engineers in relation to equipment performance and interaction with the player. Racket sports have encouraged developments in notational analysis both in terms of analytical procedures and the conceptualization of strategy and tactics. Racket sports have provided a vehicle for investigating fast interceptive actions, hand-eye coordination and perception-action coupling in the field of motor control. In conclusion, science has contributed considerably to our knowledge and understanding of racket sports, and racket sports have contributed to science by providing unique challenges to researchers.

Transforming Teaching Challenges into Learning Opportunities: Interdisciplinary Reflective Collaboration

ERIC Educational Resources Information Center

Callaghan, Ronel

2015-01-01

Teaching in higher education poses unique sets of challenges, especially for academics in the engineering, built sciences and information science education disciplines. This article focuses on how reflective collaboration can support academics in their quest to find unique solutions to challenges in different academic contexts. A reflective…

Anesthetic management during cardiopulmonary bypass: a systematic review.

PubMed

Barry, Aaron E; Chaney, Mark A; London, Martin J

2015-04-01

Cardiopulmonary bypass (CPB) required for cardiac surgery presents unique challenges to the cardiac anesthesiologist responsible for providing the 3 most basic facets of any anesthetic: amnesia, analgesia, and muscle relaxation. Unique pathophysiologic changes during CPB result in pharmacokinetic alterations that impact the serum and tissue concentrations of IV and volatile anesthetics. Similarly, CPB causes pharmacodynamic alterations that impact anesthetic efficacy. The clinical significance of these alterations represents a "moving target" as practice evolves and the technology of CPB circuitry advances. In addition, perfusionists choose, modify, and maintain the CPB circuitry and membrane oxygenator. Thus, their significance may not be fully appreciated by the anesthesiologist. These issues have a profound impact on the anesthetic state of the patient. The delivery and maintenance of anesthesia during CPB present unique challenges. The perfusionist may be directly responsible for the delivery of anesthetic during CPB, a situation unique to the cardiac suite. In addition, monitors of anesthetic depth-assessment of clinical signs, hemodynamic indicators, the bispectral index monitor, end-tidal anesthetic concentration, or twitch monitoring-are often absent, unreliable, or directly impacted by the unique pathophysiology associated with CPB. The magnitude of these challenges is reflected in the higher incidence of intraoperative awareness during cardiac surgery. Further complicating matters are the lack of specific clinical guidelines and varying international policies regarding medical device specifications that add further layers of complexity and introduce practice variability both within institutions and among nations. We performed a systematic survey of the literature to identify where anesthetic practice during CPB is evidence based (or not), identify gaps in the literature to guide future investigations, and explore the implications of evolving surgical practice, perfusion techniques, and national policies that impact amnesia, analgesia, and muscle relaxation during CPB.

Building and strengthening infrastructure for data exchange: lessons from the beacon communities.

PubMed

Torres, Gretchen W; Swietek, Karen; Ubri, Petry S; Singer, Rachel F; Lowell, Kristina H; Miller, Wilhelmine

2014-01-01

The Beacon Community Cooperative Agreement Program supports interventions, including care-delivery innovations, provider performance measurement and feedback initiatives, and tools for providers and consumers to enhance care. Using a learning health system framework, we examine the Beacon Communities' processes in building and strengthening health IT (HIT) infrastructures, specifically successes and challenges in sharing patient information to improve clinical care. In 2010, the Office of the National Coordinator for Health Information Technology (ONC) launched the three-year program, which provided $250 million to 17 Beacon Communities to invest in HIT and health information exchange (HIE) infrastructure. Beacon Communities used this funding to develop and disseminate HIT-enabled quality improvement practices found effective in particular community and practice environments. NORC conducted 7 site visits, November 2012-March 2013, selecting Communities to represent diverse program features. From August-October 2013, NORC held discussions with the remaining 10 Communities. Following each visit or discussion, NORC summarized the information gathered, including transcripts, team observations, and other documents the Community provided, to facilitate a within-Community analysis of context and stakeholders, intervention strategies, enabling factors, and challenges. Although each Community designed and implemented data-sharing strategies in a unique environment, similar challenges and enabling factors emerged across the Beacons. From a learning health system perspective, their strategies to build and strengthen data-sharing infrastructures address the following crosscutting priorities: promoting technical advances and innovations by helping providers adapt EHRs for data exchange and performance measurement with customizable IT and offering technical support to smaller, independent providers; engaging key stakeholders; and fostering transparent governance and stewardship of the infrastructure with neutral conveners. While all the Communities developed or strengthened data-exchange infrastructure, each did this in a unique environment of existing health care market and legal factors. The Communities, however, encountered similar challenges and enabling factors. Organizations undertaking collaborative data sharing, performance measurement and clinical transformation can learn from the Beacon Communities' experience.

Building and Strengthening Infrastructure for Data Exchange: Lessons from the Beacon Communities

PubMed Central

Torres, Gretchen W.; Swietek, Karen; Ubri, Petry S.; Singer, Rachel F.; Lowell, Kristina H.; Miller, Wilhelmine

2014-01-01

Introduction: The Beacon Community Cooperative Agreement Program supports interventions, including care-delivery innovations, provider performance measurement and feedback initiatives, and tools for providers and consumers to enhance care. Using a learning health system framework, we examine the Beacon Communities’ processes in building and strengthening health IT (HIT) infrastructures, specifically successes and challenges in sharing patient information to improve clinical care. Background: In 2010, the Office of the National Coordinator for Health Information Technology (ONC) launched the three-year program, which provided $250 million to 17 Beacon Communities to invest in HIT and health information exchange (HIE) infrastructure. Beacon Communities used this funding to develop and disseminate HIT-enabled quality improvement practices found effective in particular community and practice environments. Methods: NORC conducted 7 site visits, November 2012–March 2013, selecting Communities to represent diverse program features. From August–October 2013, NORC held discussions with the remaining 10 Communities. Following each visit or discussion, NORC summarized the information gathered, including transcripts, team observations, and other documents the Community provided, to facilitate a within-Community analysis of context and stakeholders, intervention strategies, enabling factors, and challenges. Results: Although each Community designed and implemented data-sharing strategies in a unique environment, similar challenges and enabling factors emerged across the Beacons. From a learning health system perspective, their strategies to build and strengthen data-sharing infrastructures address the following crosscutting priorities: promoting technical advances and innovations by helping providers adapt EHRs for data exchange and performance measurement with customizable IT and offering technical support to smaller, independent providers; engaging key stakeholders; and fostering transparent governance and stewardship of the infrastructure with neutral conveners. Conclusion: While all the Communities developed or strengthened data-exchange infrastructure, each did this in a unique environment of existing health care market and legal factors. The Communities, however, encountered similar challenges and enabling factors. Organizations undertaking collaborative data sharing, performance measurement and clinical transformation can learn from the Beacon Communities’ experience. PMID:25848619

Designing Inclusive Learning for Twice Exceptional Students in Minecraft

ERIC Educational Resources Information Center

O'Sullivan, Muireann; Robb, Nigel; Howell, Stephen; Marshall, Kevin; Goodman, Lizbeth

2017-01-01

Twice exceptional learners are intellectually or creatively gifted yet also experience one or more learning difficulties. These students face a unique set of challenges in educational settings. Recommended strategies for accommodating twice exceptional learners focus on--among other things--(1) providing freedom and variety, so that students can…

Charter Schools: Our Challenge, Our Opportunity. Spotlight--Montessori Diversity: Charter Schools.

ERIC Educational Resources Information Center

Kripalani, Lakshmi

2002-01-01

Asserts that charter schools provide unique and rich opportunities for Montessori educators to influence public education. Notes obstacles to establishing Montessori charter schools related to loss of funding for the local school district, the difficulty of Montessori teachers obtaining state certification, testing requirements to show student…

P-glycoprotein Inhibition by the Agricultural Pesticide Propiconazole and Its Hydroxylated Metabolites: Implications for Pesticide-Drug Interactions.

EPA Science Inventory

The human efflux transporter P-glycoprotein (P-gp; MDR1) functions an important cellular defense system against a variety of xenobiotics; however, little information exists on whether environmental chemicals interact with P-gp. Conazoles provide a unique challenge to exposure ass...

P-glycoprotein Inhibition by the Agricultural Pesticide Propiconazole and Its Hydroxylated Metabolites: Implications for Pesticide-Drug Interactions

EPA Science Inventory

The human efflux transporter P-glycoprotein (P-gp, MDR1) functions an important cellular defense system against a variety of xenobiotics; however, little information exists on whether environmental chemicals interact with P-gp. Conazoles provide a unique challenge to exposure ass...

Education News at NASA

NASA Technical Reports Server (NTRS)

2004-01-01

NASA s challenging missions provide unique opportunities for engaging and educating America s youth, the next generation of explorers. Led by Chief Education Officer Dr. Adena Williams Loston, the Agency coordinates education programs for students, faculty, and institutions in order to help inspire and motivate the scientists and engineers of the future.

Ensuring Moral Development in Physical Education

ERIC Educational Resources Information Center

Schwamberger, Benjamin; Wahl-Alexander, Zachary; Ressler, James

2017-01-01

The physical education setting offers a unique opportunity to educate the whole student. It would seem appropriate then, that physical education teachers place strong emphasis on the aspect of moral development and character building, however, this can be a challenging task. To accomplish this, the purpose of this article is to provide strategies…

Establishing Quality Assurance in the South African Context

ERIC Educational Resources Information Center

Strydom, A. H.; Strydom, J. F.

2004-01-01

This paper provides perspectives on the unique challenges and opportunities facing the national auditing and accreditation system in South African higher education. In doing so, the quality assurance contexts of developed countries, Africa and South Africa are considered and the issues of uncertainty and conformity are highlighted. This is…

Inclusion through Work and Productivity for Persons with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Lysaght, Rosemary; Petner-Arrey, Jami; Howell-Moneta, Angela; Cobigo, Virginie

2017-01-01

Background: Employment provides an important avenue to social inclusion for most adults. A range of productivity options exist for persons with intellectual and developmental disabilities (IDD) who wish to work, each offering unique challenges relative to inclusion. Methods: This qualitative study examined the productivity experiences of people…

Literacy Instruction for Young Children with Severe Speech and Physical Impairments: A Systematic Review

ERIC Educational Resources Information Center

Stauter, Donna W.; Myers, Sarah R.; Classen, Audra I.

2017-01-01

Children with severe speech and physical impairment who use augmentative and alternative communication (AAC) present unique challenges in literacy development. Traditional reading instruction has not met these students' needs. Occupational therapy and speech therapy provide supports to mediate limitations to literacy instruction. A systematic…

FHWA and USGS cooperate to provide environmental engineering/science curricula developed for the stochastic empirical loading and dilution model (SELDM) to universities and colleges.

DOT National Transportation Integrated Search

2016-01-01

Managers and engineers at the Federal Highway Administration (FHWA) and State Departments of Transportation (DOTs) indicate that they need researchers, employees, consultants, and regulators who understand the unique challenges involved in managing a...

Families as Partners: Supporting Family Resiliency through Early Intervention

ERIC Educational Resources Information Center

Frantz, Rebecca; Hansen, Sarah Grace; Squires, Jane; Machalicek, Wendy

2018-01-01

Child development occurs within the context of the child's family, neighborhood, and community environment. Early childhood providers support positive outcomes, not only for the children with whom they directly work with but also for their families. Families of children with developmental delays often experience unique challenges. A family…

Trauma to the Pediatric Temporomandibular Joint.

PubMed

Bae, Sam S; Aronovich, Sharon

2018-02-01

Management of pediatric condylar fractures presents a unique challenge because the developing mandible provides limited available bone for fixation and primary teeth preclude the use of typical closed reduction techniques. The available literature is reviewed with regard to closed and open treatment approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

Informed Consent Agreements: Standards of Care for Digital Social Work Practices

ERIC Educational Resources Information Center

Mattison, Marian

2018-01-01

The inclusion of remote digital practices (e-mail, texting, blogging, social media) to deliver social work services raises unique ethical and legal challenges for client and practitioner. Competent care necessitates providing clients with information that would materially affect clients' decisions whether to assume the risks, benefits, and…

Cross-Cultural Simulations in Teacher Education: Developing Empathy and Understanding

ERIC Educational Resources Information Center

Cruz, Barbara C.; Patterson, Jennifer

2005-01-01

Teacher training programs have recognized the importance of preparing future teachers for the unique opportunities and challenges that our multicultural societies and world provide. One method that is useful in sensitizing teachers to issues of diversity is cross-cultural simulations. By using kinesthetic and affective modes of learning,…

Defining Minority Culture for School Psychology Practice and Training in the United States

ERIC Educational Resources Information Center

Lopez, Ruben

2015-01-01

The value of myth busting of common thinking by professional school psychologists and the general public is discussed. The unique service provided by Frisby in challenging closely held assumptions about multiculturalism is described. The problem of a dearth of research supporting multicultural education is reviewed.

Supporting Diverse Young Adolescents: Cooperative Grouping in Inclusive Middle-Level Settings

ERIC Educational Resources Information Center

Miller, Nicole C.; McKissick, Bethany R.; Ivy, Jessica T.; Moser, Kelly

2017-01-01

The middle level classroom presents unique challenges to educators who strive to provide opportunities that acknowledge learner diversity in terms of social, cognitive, physical, and emotional development. This is confounded even further within inclusive middle-school classrooms where the responsibility to differentiate instruction is even more…

Special Educator Evaluation: Cautions, Concerns and Considerations

ERIC Educational Resources Information Center

Semmelroth, Carrie L.; Johnson, Evelyn s.; Allred, Keith W.

2013-01-01

There is currently little consensus on how special education teachers should be evaluated in a way that is effective, fair and responsive to their unique teaching responsibilities. In this paper, we explain several of the current approaches to teacher evaluation under consideration, and then provide an overview of the challenges associated with…

Indian Solar Cities Programme: An Overview of Major Activities and Accomplishments; Preprint

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

Kandt, A.

This paper details the Indian Solar City Programme, provides an overview of one city's Master Plan and implementation progress, describes NREL's support of the Indian Solar City Programme, and outlines synergies and differences between the Indian and American programs including unique challenges and opportunities India is facing.

Online Learning: Cross-Cultural Development in Time Poor Environments

ERIC Educational Resources Information Center

Cameron, Heather; Limberger, Jacqui

2004-01-01

Faced with a unique problem of providing cross-cultural awareness training on a continuing basis, Griffith University, located in Brisbane, Queensland developed an innovative program to meet the challenges it faced. A key strategy in the University's Indigenous Recruitment Strategy was to establish a cross-cultural awareness program sensitising…

Special Educators and Mathematics Phobia: An Initial Qualitative Investigation

ERIC Educational Resources Information Center

Humphrey, Michael; Hourcade, Jack J.

2010-01-01

Special educators are uniquely challenged to be content experts in all curricular areas, including mathematics, because students in their caseloads may require academic instruction in any area. However, special educators with math phobia may be limited in their ability to provide effective instruction to their students with mathematical deficits…

Solutions to Challenges Facing a University Digital Library and Press

PubMed Central

D'Alessandro, Michael P.; Galvin, Jeffrey R.; Colbert, Stephana I.; D'Alessandro, Donna M.; Choi, Teresa A.; Aker, Brian D.; Carlson, William S.; Pelzer, Gay D.

2000-01-01

During the creation of a university digital library and press intended to serve as a medical reference and education tool for health care providers and their patients, six distinct and complex digital publishing challenges were encountered. Over nine years, through a multidisciplinary approach, solutions were devised to the challenges of digital content ownership, management, mirroring, translation, interactions with users, and archiving. The result is a unique, author-owned, internationally mirrored, university digital library and press that serves as an authoritative medical reference and education tool for users around the world. The purpose of this paper is to share the valuable digital publishing lessons learned and outline the challenges facing university digital libraries and presses. PMID:10833161

Challenges in Recruiting Aging Women Holocaust Survivors to a Case Control Study of Breast Cancer.

PubMed

Vin-Raviv, Neomi; Dekel, Rachel; Barchana, Micha; Linn, Shai; Keinan-Boker, Lital

2015-01-01

Older adults are underrepresented in medical research for many reasons, including recruitment difficulties. Recruitment of older adults for research studies is often a time-consuming process and can be more challenging when the study involves older adults with unique exposures to traumatic events and from minority groups. The current article provides a brief overview of (a) challenges encountered while recruiting aging women Holocaust survivors for a case control study and (b) strategies used for meeting those challenges. The case group comprised women Holocaust survivors who were recently diagnosed with breast cancer and the control group comprised healthy women from a Holocaust-survivor community in Israel. Copyright 2015, SLACK Incorporated.

A qualitative analysis of barriers, challenges, and successes in meeting the needs of Hurricane Katrina evacuee families.

PubMed

Legerski, John-Paul; Vernberg, Eric M; Noland, Brian J

2012-12-01

Hurricane Katrina caused many individuals to evacuate to towns and cities throughout the United States. Psychological First Aid (PFA) is a treatment program designed to help clinicians and other disaster relief workers address the needs of adults, youth, and families immediately following disasters. We conducted focus groups with disaster relief and evacuee service providers in the Kansas City Metro Area as an exploratory study to identify their perceptions of the needs of evacuees. Participants identified a number of mental health needs, as well as displacement-related challenges, including loss of social support, material loss, unemployment, and other stressful life events that were secondary to the hurricane. Many of these needs are consistent with principles presented in the PFA manual. We also found that service providers faced unique challenges when attempting to assist evacuees. We discuss implications of these findings for treatment programs and provide suggestions for addressing barriers to care.

Tourette syndrome in children and adolescents: special considerations.

PubMed

Eapen, Valsamma; Crncec, Rudi

2009-12-01

Tourette syndrome (TS) affects people of all ages, with onset in early childhood and continuing through the different stages of the life cycle into adolescence and adults. This review focuses on barriers to diagnosis and challenges in the management of young patients with TS. Barriers to identification occur at multiple levels, including detection in the community setting (including schools), parents' help-seeking behavior, and cultural influences on such behavior, as well as diagnosis by the medical provider. Challenges to management include unfamiliarity of primary care providers, inconsistencies in the diagnosis and management plan, and failure to recognize comorbid conditions, as well as inadequate knowledge and lack of resources to effectively deal with comorbidities. In addition to the complexities posed by pharmacological interactions, there are unique psychosocial challenges experienced by young people with TS and their families. Effective communication and collaboration between families, health care providers, and school personnel, as well as supportive communities, are essential components of comprehensive management.

Intimate Partner Violence and Women with Severe Mental Illnesses: Needs and Challenges from the Perspectives of Behavioral Health and Domestic Violence Service Providers.

PubMed

Van Deinse, Tonya B; Wilson, Amy Blank; Macy, Rebecca J; Cuddeback, Gary S

2018-05-22

Women with severe mental illnesses face high rates of violence victimization, yet little is understood about the unique needs and challenges these women present to the domestic violence and behavioral health agencies that serve them. To help address this knowledge gap, focus groups were conducted with 28 staff members from local behavioral health and domestic violence service agencies. Results from this exploratory study suggest that women with severe mental illnesses who experience intimate partner violence face additional challenges that exacerbate behavioral health and domestic violence issues and put these women at greater risk for continued victimization. DV and behavioral health agency staff experience individual-, provider-, and system-level barriers to serving this high-risk, high-need population. Recommendations and implications for domestic violence and behavioral health providers are discussed.

Visualising the invisible

NASA Astrophysics Data System (ADS)

Laychak, M. B.

2008-06-01

In addition to the optical camera Megacam, the Canada-France-Hawaii Telescope operates a large field infrared camera, Wircam, and a spectrograph/spectropolimeter, Espadons. When these instruments were commissioned, the challenge arose to create educational outreach programmes incorporating the concepts of infrared astronomy and spectroscopy. We integrated spectroscopy into discussions of extrasolar planets and the search for life, two topics routinely requested by teachers for classroom talks. Making the infrared accessible to students provided a unique challenge, one that we met through the implementation and use of webcams modified for infrared use.

Opportunities and challenges of big data for the social sciences: The case of genomic data.

PubMed

Liu, Hexuan; Guo, Guang

2016-09-01

In this paper, we draw attention to one unique and valuable source of big data, genomic data, by demonstrating the opportunities they provide to social scientists. We discuss different types of large-scale genomic data and recent advances in statistical methods and computational infrastructure used to address challenges in managing and analyzing such data. We highlight how these data and methods can be used to benefit social science research. Copyright © 2016 Elsevier Inc. All rights reserved.

Growing Older With HIV/AIDS: New Public Health Challenges

PubMed Central

Cahill, Sean; Valadéz, Robert

2013-01-01

At present, the health care infrastructure is ill-equipped to handle the unique treatment and care needs of HIV-positive older adults. The long-term effects of antiretroviral use are still being discovered and have been associated with a number of comorbidities. Stigma presents challenges for those in need of services and health care, and can significantly affect mental health and treatment adherence. The training of elder service providers and health care providers in meeting the needs of HIV-positive older adults, including gay and transgender people, is needed as the population ages. HIV-related and antigay stigma should be challenged by social marketing campaigns. Continued research and key policy changes could greatly improve health outcomes for HIV-positive elderly persons by increasing access to treatment and support. PMID:23327276

Unique Metabolic Adaptations Dictate Distal Organ-Specific Metastatic Colonization

PubMed Central

Schild, Tanya; Low, Vivien; Blenis, John; Gomes, Ana P.

2018-01-01

Summary Metastases arising from tumors have the proclivity to colonize specific organs, suggesting that they must rewire their biology to meet the demands of the organ colonized, thus altering their primary properties. Each metastatic site presents distinct metabolic challenges to a colonizing cancer cell, ranging from fuel and oxygen availability to oxidative stress. Here, we discuss the organ-specific metabolic adaptations cancer cells must undergo, which provide the ability to overcome the unique barriers to colonization in foreign tissues and establish the metastatic tissue tropism phenotype. PMID:29533780

Framing the Future with Bacteriophages in Agriculture

PubMed Central

Svircev, Antonet; Roach, Dwayne; Castle, Alan

2018-01-01

The ability of agriculture to continually provide food to a growing world population is of crucial importance. Bacterial diseases of plants and animals have continually reduced production since the advent of crop cultivation and animal husbandry practices. Antibiotics have been used extensively to mitigate these losses. The rise of antimicrobial resistant (AMR) bacteria, however, together with consumers’ calls for antibiotic-free products, presents problems that threaten sustainable agriculture. Bacteriophages (phages) are proposed as bacterial population control alternatives to antibiotics. Their unique properties make them highly promising but challenging antimicrobials. The use of phages in agriculture also presents a number of unique challenges. This mini-review summarizes recent development and perspectives of phages used as antimicrobial agents in plant and animal agriculture at the farm level. The main pathogens and their adjoining phage therapies are discussed. PMID:29693561

Distinguishing the Clinical Nurse Specialist From Other Graduate Nursing Roles.

PubMed

Mohr, Lynn D; Coke, Lola A

Today's healthcare environment poses diverse and complex patient care challenges and requires a highly qualified and experienced nursing workforce. To mitigate these challenges are graduate nursing roles, each with a different set of competencies and expertise. With the availability of many different graduate nursing roles, both patients and healthcare professionals can be confused in understanding the benefit of each role. To gain the maximum benefit from each role, it is important that healthcare providers and administrators are able to distinguish the uniqueness of each role to best use the role and develop strategies for effective collaboration and interprofessional interaction. The purpose of this article was to define the role, educational preparation, role differences, and practice competencies for the clinical nurse specialist (CNS), nurse practitioner, clinical nurse leader, and nurse educator/staff development educator roles. A second purpose was to provide role clarity and demonstrate the unique value the CNS brings to the healthcare environment. Using evidence and reviewing role competencies established by varying organizations, each role is presented with similarities and differences among the roles discussed. In addition, collaboration among the identified roles was reviewed, and recommendations were provided for the new and practicing CNSs. Although there are some similarities among the graduate nursing roles such as in educational, licensing, and certification requirements, each role must be understood to gain the full role scope and benefit and glean the anticipated outcomes. Healthcare providers must be aware of the differences in graduate nursing roles, especially in comparing the CNS with other roles to avoid confusion that may lead to roles being underused with a limited job scope. The CNS provides a unique set of services at all system outcome levels and is an essential part of the healthcare team especially in the acute care setting.

Brilliant gamma beams for industrial applications: new opportunities, new challenges

NASA Astrophysics Data System (ADS)

Iancu, V.; Suliman, G.; Turturica, G. V.; Iovea, M.; Daito, I.; Ohgaki, H.; Matei, C.; Ur, C. A.; Balabanski, D. L.

2016-10-01

The Nuclear Physics oriented pillar of the pan-European Extreme Light Infrastructure (ELI-NP) will host an ultra-bright, energy tunable, and quasi-monochromatic gamma-ray beam system in the range of 0.2-19.5 MeV produced by laser-Compton backscattering technique. The applied research program envisioned at ELI-NP targets to use nuclear resonance fluorescence (NRF) and computed tomography to provide new opportunities for industry and society. High sensitivity NRF-based investigations can be successfully applied to safeguard applications and management of radioactive wastes as well as to uncharted fields like cultural heritage and medical imaging. Gamma-ray radioscopy and computed tomography performed at ELI-NP has the potential to achieve high resolution in industrial-sized objects provided the detection challenges introduced by the unique characteristics of the gamma beam are overcome. Here we discuss the foreseen industrial applications that will benefit from the high quality and unique characteristics of ELI-NP gamma beam and the challenges they present. We present the experimental setups proposed to be implemented for this goal, discuss their performance based on analytical calculations and numerical Monte-Carlo simulations, and comment about constrains imposed by the limitation of current scintillator detectors. Several gamma-beam monitoring devices based on scintillator detectors will also be discussed.

NASA Space Flight Vehicle Fault Isolation Challenges

NASA Technical Reports Server (NTRS)

Bramon, Christopher; Inman, Sharon K.; Neeley, James R.; Jones, James V.; Tuttle, Loraine

2016-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle and is scheduled for its first mission in 2017. The goal of the first mission, which will be uncrewed, is to demonstrate the integrated system performance of the SLS rocket and spacecraft before a crewed flight in 2021. SLS has many of the same logistics challenges as any other large scale program. Common logistics concerns for SLS include integration of discrete programs geographically separated, multiple prime contractors with distinct and different goals, schedule pressures and funding constraints. However, SLS also faces unique challenges. The new program is a confluence of new hardware and heritage, with heritage hardware constituting seventy-five percent of the program. This unique approach to design makes logistics concerns such as testability of the integrated flight vehicle especially problematic. The cost of fully automated diagnostics can be completely justified for a large fleet, but not so for a single flight vehicle. Fault detection is mandatory to assure the vehicle is capable of a safe launch, but fault isolation is another issue. SLS has considered various methods for fault isolation which can provide a reasonable balance between adequacy, timeliness and cost. This paper will address the analyses and decisions the NASA Logistics engineers are making to mitigate risk while providing a reasonable testability solution for fault isolation.

Utilizing lean tools to improve value and reduce outpatient wait times in an Indian hospital.

PubMed

Miller, Richard; Chalapati, Nirisha

2015-01-01

This paper aims to demonstrate how lean tools were applied to some unique issues of providing healthcare in a developing country where many patients face challenges not found in developed countries. The challenges provide insight into how lean tools can be utilized to provide similar results across the world. This paper is based on a qualitative case study carried out by a master's student implementing lean at a hospital in India. This paper finds that lean tools such as value-stream mapping and root cause analysis can lead to dramatic reductions in waste and improvements in productivity. The problems of the majority of patients paying for their own healthcare and lacking transportation created scheduling problems that required patients to receive their diagnosis and pay for treatment within a single day. Many additional wastes were identified that were significantly impacting the hospital's ability to provide care. As a result of this project, average outpatient wait times were reduced from 1 hour to 15 minutes along with a significant increase in labor productivity. The results demonstrate how lean tools can increase value to the patients. It also provides are framework that can be utilized for healthcare providers in developed and developing countries to analyze their value streams to reduce waste. This paper is one of the first to address the unique issues of implementing lean to a healthcare setting in a developing country.

Challenges for Multilevel Health Disparities Research in a Transdisciplinary Environment

PubMed Central

Holmes, John H.; Lehman, Amy; Hade, Erinn; Ferketich, Amy K.; Sarah, Gehlert; Rauscher, Garth H.; Abrams, Judith; Bird, Chloe E.

2008-01-01

Numerous factors play a part in health disparities. Although health disparities are manifested at the level of the individual, other contexts should be considered when investigating the associations of disparities with clinical outcomes. These contexts include families, neighborhoods, social organizations, and healthcare facilities. This paper reports on health disparities research as a multilevel research domain from the perspective of a large national initiative. The Centers for Population Health and Health Disparities (CPHHD) program was established by the NIH to examine the highly dimensional, complex nature of disparities and their effects on health. Because of its inherently transdisciplinary nature, the CPHHD program provides a unique environment in which to perform multilevel health disparities research. During the course of the program, the CPHHD centers have experienced challenges specific to this type of research. The challenges were categorized along three axes: sources of subjects and data, data characteristics, and multilevel analysis and interpretation. The CPHHDs collectively offer a unique example of how these challenges are met; just as importantly, they reveal a broad range of issues that health disparities researchers should consider as they pursue transdisciplinary investigations in this domain, particularly in the context of a large team science initiative. PMID:18619398

Teaching Informatics to Prelicensure, RN-to-BSN, and Graduate Level Students.

PubMed

Vottero, Beth

Teaching nursing informatics to students in associate, baccalaureate, RN-BSN, and graduate nursing programs poses challenges for curriculum design, as well as developing appropriate instruction and assessment methods. The current state of nursing informatics education provides opportunities for unique instructional design and assessment techniques. Key course content is provided with suggestions for teaching informatics that focus on leveling for prelicensure, RN-BSN, and graduate nursing programs.

Reptile Soft Tissue Surgery.

PubMed

Di Girolamo, Nicola; Mans, Christoph

2016-01-01

The surgical approach to reptiles can be challenging. Reptiles have unique physiologic, anatomic, and pathologic differences. This may result in frustrating surgical experiences. However, recent investigations provided novel, less invasive, surgical techniques. The purpose of this review was to describe the technical aspects behind soft tissue surgical techniques that have been used in reptiles, so as to provide a general guideline for veterinarians working with reptiles. Copyright © 2016 Elsevier Inc. All rights reserved.

Adolescents in Wartime U.S. Military Families: A Developmental Perspective on Challenges and Resources

PubMed Central

Milburn, Norweeta G.; Lightfoot, Marguerita

2013-01-01

Adolescents in wartime U.S. military families are a unique group of young people who are experiencing the usual milestones of adolescent development, including establishing their identities and becoming autonomous, while they face the challenges of military life such as multiple frequent moves, relocation and parent deployment to combat settings. This paper reviews research on adolescents in wartime U.S. military families, within the context of adolescent development, to identify their behavioral, emotional and academic risk status, and challenges and resources. Recommendations for future research and interventions to foster the healthy development of these adolescents are also provided. PMID:23780722

Resistance to Change among Veteran Teachers: Providing Voice for More Effective Engagement

ERIC Educational Resources Information Center

Snyder, Richard R.

2017-01-01

Effective implementation of change remains a crucial concern for educational leaders in the 21st Century. One of the factors affecting effective implementation of reform is resistance to change. Veteran teachers in particular present unique challenges, and stereotypically the greatest resistance, for effective implementation of change. This study…

Child Skills and Teacher Qualifications: Associations with Elementary Classroom Teachers' Reading Instruction for Struggling Readers

ERIC Educational Resources Information Center

Bratsch-Hines, Mary E.; Vernon-Feagans, Lynne; Varghese, Cheryl; Garwood, Justin

2017-01-01

This study explored the extent to which kindergarten and first grade teachers provided individualized reading instruction to struggling readers during a unique one-on-one reading instruction task. Three outcomes of teachers' instructional strategies were captured: code-focused strategies, meaning-focused strategies, and level of challenge. Child…

Special Education Disabilities and Juvenile Delinquency: A Unique Challenge for School Social Work

ERIC Educational Resources Information Center

Mallett, Christopher A.; Stoddard-Dare, Patricia; Workman-Crewnshaw, Lisa

2011-01-01

In pursuit of their mission to augment the educational process, school social workers provide service to special education students and to youths at risk for juvenile delinquency. This paper builds on previous literature that has looked at the relationship between special education disabilities and youths offending behaviors and delinquency. In…

Psychotropic Medication Management for Youth in State Care: Consent, Oversight, and Policy Considerations

ERIC Educational Resources Information Center

Naylor, Michael W.; Davidson, Christine V.; Ortega-Piron, D. Jean; Bass, Arin; Gutierrez, Alice; Hall, Angela

2007-01-01

The use of psychotropic medications in youth with emotional disturbances in state custody is increasing and presents unique challenges concerning consent and oversight. We examine various means that state child welfare agencies use to provide consent for and oversight of psychotropic medications for children in state custody and describe benefits…

Keeping Sediment and Nutrients out of Streams in Arid/Semi-Arid United States: Application of Low Impact Development/Green Infrastructure Practices

EPA Science Inventory

Climatic and hydrological characteristics in the arid/semi-arid areas create unique challenges to soil, water and biodiversity conservation. These areas are environmentally sensitive, but very valuable for the ecosystems services they provide to society. Some of these areas are...

Universal Design: Supporting Students with Color Vision Deficiency (CVD) in Medical Education

ERIC Educational Resources Information Center

Meeks, Lisa M.; Jain, Neera R.; Herzer, Kurt R.

2016-01-01

Color Vision Deficiency (CVD) is a commonly occurring condition in the general population. For medical students, it has the potential to create unique challenges in the classroom and clinical environments. Few studies have provided medical educators with comprehensive recommendations to assist students with CVD. This article presents a focused…

Literary Education and Digital Learning: Methods and Technologies for Humanities Studies

ERIC Educational Resources Information Center

van Peer, Willie, Ed.; Zyngier, Sonia, Ed.; Viana, Vander, Ed.

2010-01-01

Today's popularization of modern technologies has allowed literature specialists to access an array of new opportunities in the digital medium, which have brought about an equal number of challenges and questions. This book provides insight into the most relevant issues in literary education and digital learning. This unique reference fills a gap…

The Mars Millennium Project.

ERIC Educational Resources Information Center

National Aeronautics and Space Administration, Washington, DC.

The countdown to a new century provides a unique opportunity to engage America's youth in charting a course for the future. The Mars Millennium Project challenges students across the nation to design a community yet to be imagined for the planet Mars. This interdisciplinary learning project aims to encourage K-12 students in classrooms and youth…

Autism Spectrum Disorders: A Research Review for School Counselors

ERIC Educational Resources Information Center

Auger, Richard W.

2013-01-01

The number of students with autism spectrum disorders (ASD) has risen significantly in recent years (CDC, 2012), and students with ASD present unique challenges to schools and school counselors. This article presents a synthesis of recent research literature related to ASD for the purpose of providing school counselors with assistance in…

Research-Based Lessons That Support Student Independent Reading in Social Studies

ERIC Educational Resources Information Center

Swanson, Elizabeth; Reed, Deborah; Vaughn, Sharon

2016-01-01

High school social studies teachers face unique challenges in helping their students learn independently from text in their discipline. In this article, a set of research-based practices that couple independent student reading with high-quality instruction proven to improve content learning for high school nonnative English speakers is provided.…

Civic Orientation in Cultures of Privilege: What Role Do Schools Play?

ERIC Educational Resources Information Center

Ballard, Parissa J.; Caccavale, Laura; Buchanan, Christy M.

2015-01-01

The context of privilege provides unique opportunities and challenges for youth civic development. A mixed-method approach was used to examine links between school-based community service, school climate, and civic orientation among students in cultures of privilege. Surveys completed by students (N = 376) at two private high schools--one with an…

The Effects of Sensitivity to Criticism on Motivation and Performance in Music Students

ERIC Educational Resources Information Center

Atlas, Gordon D.; Taggart, Terry; Goodell, Debra J.

2004-01-01

Music education inherently relies on a process of providing and receiving critical feedback. Students who are very sensitive to criticism, however, may present a unique challenge for the music educator. This study investigated the ways in which sensitivity to criticism affects the educational experience of music students. Nineteen students were…

Cognitive-Behavioral Therapy: Innovations for Cardiopulmonary Patients with Depression and Anxiety

ERIC Educational Resources Information Center

Cully, Jeffrey A.; Paukert, Amber; Falco, Jessica; Stanley, Melinda

2009-01-01

Medically ill patients face unique physical and emotional challenges that place them at increased risk for symptoms of depression and anxiety. Despite high prevalence and significant impact, depression and anxiety are infrequently treated in the medically ill because of a variety of patient, provider, and system factors. The current article…

Using Virtual Technology to Enhance Field Experiences for Pre-Service Special Education Teachers

ERIC Educational Resources Information Center

Billingsley, Glenna M.; Scheuermann, Brenda K.

2014-01-01

Teacher educators of pre-service teachers of students with special needs face challenges in providing the unique knowledge and skills required of highly qualified special education teachers. The emerging use of various forms of virtual technology, however, offers realistic solutions to these problems. This systematic review of literature examines…

Immunostimulatory complexes containing Eimeria tenella antigens and low toxicity plant saponins induce antibody response and provide protection from challenge in broiler chickens

USDA-ARS?s Scientific Manuscript database

Immunostimulating complexes (ISCOMs) are unique multimolecular structures formed by encapsulating antigens, lipids and triterpene saponins and are one of the most successful antigen delivery systems for microbial antigens. In the current study, both the route of administration and the antigen conce...

Pathways, Networks, and Systems: Theory and Experiments

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

Joseph H. Nadeau; John D. Lambris

2004-10-30

The international conference provided a unique opportunity for theoreticians and experimenters to exchange ideas, strategies, problems, challenges, language and opportunities in both formal and informal settings. This dialog is an important step towards developing a deep and effective integration of theory and experiments in studies of systems biology in humans and model organisms.

"Between the Earth and the Skies" The Challenges to Catholic Institution-Building in Pennsylvania’s Croatian Communities, 1894-1924.

DTIC Science & Technology

1998-05-01

religious factors reveals points of divergence between their experience and that of other immigrant groups. An assimilation model developed by Silvano...Tomasi provides the framework for this comparison. The thesis concludes that several unique factors contributed to the anomalous religious

Past and Future Directions in Content Area Literacies

ERIC Educational Resources Information Center

Bean, Tom; O'Brien, David

2013-01-01

In this column, content area literacy scholars Tom Bean and David O'Brien challenge the older "infusion" model of content area literacy with its emphasis on generic strategies. Rather, they argue for and provide examples of projects that draw on the unique dimensions of various disciplines like history, science, and English, particularly in light…

The Trifold Display Board: A Visual and Portable Way to Present Physical Education Class Information

ERIC Educational Resources Information Center

Lavay, Barry; Alexander, Susan; Lawrence, Barbara

2008-01-01

Physical educators at all grade levels often provide instruction in open environments and classrooms without walls, such as gymnasiums, school playgrounds and athletic fields. Open teaching environments present unique challenges when it comes to implementing and displaying class information such as class schedules, routines and procedures, rules…

Health professionals' experiences providing breastfeeding-related care for obese women.

PubMed

Garner, Christine D; Ratcliff, Stephannie L; Devine, Carol M; Thornburg, Loralei L; Rasmussen, Kathleen M

2014-12-01

Obese women are at high risk of early breastfeeding cessation, and health professionals (HPs) have a unique opportunity to provide them with breastfeeding support. Our objective was to describe HPs' experiences providing breastfeeding care for obese women during the prenatal, peripartum, and postpartum periods. In-depth, qualitative interviews were conducted with 34 HPs (including obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. They were recruited from a variety of settings in central New York. Interviews were audio-recorded, transcribed, verified for accuracy, and then analyzed qualitatively. HPs identified obesity in multiple ways, some of which were consistent with standard cutoffs, whereas others implied extreme obesity. Nearly all HPs discussed ways they perceive obese women have challenges with breastfeeding. Some HPs described challenges as specific to obese women (e.g., limited mobility), whereas others described challenges as universal but more likely to occur among obese women (e.g., difficulties positioning the infant to breastfeed). Across professions, HPs described providing breastfeeding care for obese women as requiring more time and physical work and as being more challenging. HPs acknowledged stigma around obesity and discussed treating obese women with dignity and the same as other women. Strategies were suggested for improving breastfeeding support for obese women. HPs identified multiple challenges that obese women encounter with breastfeeding, as well as their own challenges with providing care. Comprehensive strategies are needed to assist obese women with breastfeeding and to alleviate strain on HPs who provide their care.

Bridging the Chasm: Challenges, Opportunities, and Resources for Integrating a Dissemination and Implementation Science Curriculum into Medical Education.

PubMed

Ginossar, Tamar; Heckman, Carolyn J; Cragun, Deborah; Quintiliani, Lisa M; Proctor, Enola K; Chambers, David A; Skolarus, Ted; Brownson, Ross C

2018-01-01

Physicians are charged with implementing evidence-based medicine, yet few are trained in the science of Dissemination and Implementation (D&I). In view of the potential of evidence-based training in D&I to help close the gap between research and practice, the goal of this review is to examine the importance of D&I training in medical education, describe challenges to implementing such training, and provide strategies and resources for building D&I capacity. We conducted (1) a systematic review to identify US-based D&I training efforts and (2) a critical review of additional literature to inform our evaluation of the challenges and opportunities of integrating D&I training in medical education. Out of 269 unique articles reviewed, 11 described US-based D&I training. Although vibrant and diverse training opportunities exist, their capacity is limited, and they are not designed to meet physicians' needs. Synthesis of relevant literature using a critical review approach identified challenges inherent to changing medical education, as well as challenges related to D&I science. Finally, selected strategies and resources are available for facilitating incorporation of D&I training into medical education and overcoming existing challenges. Integrating D&I training in the medical education curriculum, and particularly in residency and fellowship training, holds promise for bridging the chasm between scientific discoveries and improved patient care and outcomes. However, unique challenges should be addressed, including the need for greater evidence.

Understanding the experiences and needs of lesbian, gay, bisexual and trans Australians living with dementia, and their partners.

PubMed

Barrett, Catherine; Crameri, Pauline; Lambourne, Sally; Latham, J R; Whyte, Carolyn

2015-10-01

To outline the experiences and needs of lesbian, gay, bisexual and trans (LGBT) Australians living with dementia - and their partners. In-depth interviews were conducted with LGBT people, their partners and service providers. LGBT people living with dementia experience unique challenges including the failure of some families of origin and service providers to understand and value their sexual orientation or gender identity. The fear of discrimination by service providers results in greater reliance on intimate partners for care and compounds social isolation. The unique experiences of LGBT people with dementia are not well understood. There is a need to recognise historical experiences, including familial relationships, and provide advocacy to ensure sexual and gender rights are not violated. There is also a need to ensure that the experiences and perspectives of LGBT people living with dementia inform the development of services. © 2015 AJA Inc.

User applications unique to mobile satellites

NASA Technical Reports Server (NTRS)

Castiel, David

1990-01-01

As AMSC enters the market with its mobile satellite services, it faces a sophisticated user group that has already experimented with a wide range of communications services, including cellular radio and Ku-band satellite messaging. AMSC's challenge is to define applications unique to the capabilities of its dedicated L band satellite and consistent with the provisions outlined in its FCC license. Through a carefully researched approach to its three main markets (aeronautical, land mobile, and maritime) AMSC is discovering a wellspring of interest in corporate and general aviation, trucking companies, pipeline monitoring and control companies, maritime management firms, telecommunications companies, and government agencies. A general overview is provided of AMSC's FCC license and corporate history, and the specific applications unique to each user group is discussed.

Outdoor physical activity for older people-the senior exercise park: Current research, challenges and future directions.

PubMed

Levinger, Pazit; Sales, Myrla; Polman, Remco; Haines, Terry; Dow, Briony; Biddle, Stuart J H; Duque, Gustavo; Hill, Keith D

2018-03-14

Exercising outdoors provide beneficial effect on mental and physical health for all ages. However, few older people exercise outdoors other than walking. While outdoor gyms have become increasingly common in Australia, limited outdoor exercise equipment specifically designed for older people is available in public spaces. We have set up and evaluated a unique purpose-built outdoor exercise park for older people in the community setting and demonstrated positive physical and well-being outcomes associated with the provision of this unique exercise mode and social programme. This study is a reflective narrative describing this innovative exercise approach and reports challenges associated with establishment of the exercise park, conducting the randomised trial, strategies adopted to address these challenges and recommendations for future implementation of this approach in the community. Many challenges were encountered, including securing appropriate land to locate the exercise park, control of environmental factors for safety (non-slippery ground and equipment) as well as logistics in running the exercise programme itself. Several adjustments in the equipment were also required to ensure safe use by older people. The inclusion of outdoor equipment for older people in public spaces or urban parks is important and careful consideration needs to be taken by local/public authorities to provide access, amenities and safety for all as well as activities to suit all ages. SO WHAT?: Seniors' exercise parks can be installed in public places and may provide an enjoyable and effective approach to engage older individuals in a more active and healthier lifestyle. © 2018 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.

Typhoid toxin provides a window into typhoid fever and the biology of Salmonella Typhi.

PubMed

Galán, Jorge E

2016-06-07

Salmonella Typhi is the cause of typhoid fever, a disease that has challenged humans throughout history and continues to be a major public health concern. Unlike infections with most other Salmonellae, which result in self-limiting gastroenteritis, typhoid fever is a life-threatening systemic disease. Furthermore, in contrast to most Salmonellae, which can infect a broad range of hosts, S. Typhi is a strict human pathogen. The unique features of S. Typhi pathogenesis and its stringent host specificity have been a long-standing puzzle. The discovery of typhoid toxin not only has provided major insight into these questions but also has offered unique opportunities to develop novel therapeutic and prevention strategies to combat typhoid fever.

Typhoid toxin provides a window into typhoid fever and the biology of Salmonella Typhi

PubMed Central

Galán, Jorge E.

2016-01-01

Salmonella Typhi is the cause of typhoid fever, a disease that has challenged humans throughout history and continues to be a major public health concern. Unlike infections with most other Salmonellae, which result in self-limiting gastroenteritis, typhoid fever is a life-threatening systemic disease. Furthermore, in contrast to most Salmonellae, which can infect a broad range of hosts, S. Typhi is a strict human pathogen. The unique features of S. Typhi pathogenesis and its stringent host specificity have been a long-standing puzzle. The discovery of typhoid toxin not only has provided major insight into these questions but also has offered unique opportunities to develop novel therapeutic and prevention strategies to combat typhoid fever. PMID:27222578

Maturing Glycoproteomics Technologies Provide Unique Structural Insights into the N-glycoproteome and Its Regulation in Health and Disease*

PubMed Central

Packer, Nicolle H.; Schulz, Benjamin L.

2016-01-01

The glycoproteome remains severely understudied because of significant analytical challenges associated with glycoproteomics, the system-wide analysis of intact glycopeptides. This review introduces important structural aspects of protein N-glycosylation and summarizes the latest technological developments and applications in LC-MS/MS-based qualitative and quantitative N-glycoproteomics. These maturing technologies provide unique structural insights into the N-glycoproteome and its synthesis and regulation by complementing existing methods in glycoscience. Modern glycoproteomics is now sufficiently mature to initiate efforts to capture the molecular complexity displayed by the N-glycoproteome, opening exciting opportunities to increase our understanding of the functional roles of protein N-glycosylation in human health and disease. PMID:26929216

Phobos Mobility Simulation

NASA Technical Reports Server (NTRS)

Bielski, Paul

2015-01-01

Phobos, the larger of Mars' moons, provides a potential staging location for human exploration of the Martian surface. Its low gravity (about 1/200th of Earth) and lack of atmosphere makes it an attractive destination before a more complex human landing on Mars is attempted. While easier to approach and depart than Mars itself, Phobos provides unique challenges to visiting crews. It is irregularly shaped, so its local gravitational field does not always point straight down with respect to the visible horizon. It is very close to Mars and tidally locked, so the Martian gravity gradient and applied acceleration greatly affect the perceived surface gravity direction and magnitude. This simulation allows the assessment of unique mobility approaches on the surface of Phobos, including hopping in particular.

Heterogeneous electrochemical CO2 reduction using nonmetallic carbon-based catalysts: current status and future challenges

NASA Astrophysics Data System (ADS)

Ma, Tao; Fan, Qun; Tao, Hengcong; Han, Zishan; Jia, Mingwen; Gao, Yunnan; Ma, Wangjing; Sun, Zhenyu

2017-11-01

Electrochemical CO2 reduction (ECR) offers an important pathway for renewable energy storage and fuels production. It still remains a challenge in designing highly selective, energy-efficient, robust, and cost-effective electrocatalysts to facilitate this kinetically slow process. Metal-free carbon-based materials have features of low cost, good electrical conductivity, renewability, diverse structure, and tunability in surface chemistry. In particular, surface functionalization of carbon materials, for example by doping with heteroatoms, enables access to unique active site architectures for CO2 adsorption and activation, leading to interesting catalytic performances in ECR. We aim to provide a comprehensive review of this category of metal-free catalysts for ECR, providing discussions and/or comparisons among different nonmetallic catalysts, and also possible origin of catalytic activity. Fundamentals and some future challenges are also described.

Topical Review: Unique Contributions of Magnetic Resonance Imaging to Pediatric Psychology Research

PubMed Central

Duraccio, Kara M.; Carbine, Kaylie M.; Kirwan, C. Brock

2016-01-01

Objective This review aims to provide a brief introduction of the utility of magnetic resonance imaging (MRI) methods in pediatric psychology research, describe several exemplar studies that highlight the unique benefits of MRI techniques for pediatric psychology research, and detail methods for addressing several challenges inherent to pediatric MRI research. Methods Literature review. Results Numerous useful applications of MRI research in pediatric psychology have been illustrated in published research. MRI methods yield information that cannot be obtained using neuropsychological or behavioral measures. Conclusions Using MRI in pediatric psychology research may facilitate examination of neural structures and processes that underlie health behaviors. Challenges inherent to conducting MRI research with pediatric research participants (e.g., head movement) may be addressed using evidence-based strategies. We encourage pediatric psychology researchers to consider adopting MRI techniques to answer research questions relevant to pediatric health and illness. PMID:26141118

Challenges for Engineering Design, Construction, and Maintenance of Infrastructure in Afghanistan

DTIC Science & Technology

2010-11-01

applied engineering expertise that collectively can solve challenging infra- structure problems. USACE-ERDC’s researchers and engineers are field...Development Center (ERDC) possesses a unique combination of basic research and applied engineering expertise that collectively can solve challenging...restoration, and other projects. The USACE Engineer Research and Development Center (ERDC) possesses a unique combination of basic research and applied

Perceptions of school nurses on the challenges of service provision to ESL students.

PubMed

Whitman, Marilyn V; Davis, Jullet A; Terry, Allison J

2010-04-01

The number of English-as-as second-language (ESL) students in public schools across the country is rising creating unique challenges for school health services with the introduction of new cultures and languages. This study describes the perceptions of school nurses in Alabama schools regarding the challenges they face when communicating with ESL students and their parents. The population consists of school nurses in Alabama public schools. The obtained sample of 1,429 responses is presented and discussed. Urban school nurses were more likely to have access to an interpreter, yet they were more likely to rely on an ESL student to act as a translator when speaking to his/her parents. Kindergarten through elementary school nurses were more likely to witness an increase in ESL students and encounter difficulty communicating with these students and their parents. School nurses have a unique opportunity to engage parents of ESL students in the health of their child, thus it is vital that they be provided with cultural facts and encouraged to use interpreter services to lessen language barriers.

Contextual Challenges to Safe Surgery in a Resource-limited Setting: A Multicenter, Multiprofessional Qualitative Study.

PubMed

Scott, John W; Lin, Yihan; Ntakiyiruta, Georges; Mutabazi, Zeta A; Davis, William Austin; Morris, Megan A; Smink, Douglas S; Riviello, Robert; Yule, Steven

2018-03-01

Safe surgery should be available to all patients, no matter the setting. The purpose of this study was to explore the contextual-specific challenges to safe surgical care encountered by surgeons and surgical teams in many in low- and middle-income countries (LMICs), and to understand the ways in which surgical teams overcome them. Optimal surgical performance is highly complex and requires providers to integrate and communicate information regarding the patient, task, team, and environment to coordinate team-based care that is timely, effective, and safe. Resource limitations common to many LMICs present unique challenges to surgeons operating in these environments, but have never been formally described. Using a grounded theory approach, we interviewed 34 experienced providers (surgeons, anesthetists, and nurses) at the 4 tertiary referral centers in Rwanda, to understand the challenges to safe surgical care and strategies to overcome them. Interview transcripts were coded line-by-line and iteratively analyzed for emerging themes until thematic saturation was reached. Rwandan-described challenges related to 4 domains: physical resources, human resources, overall systems support, and communication/language. The majority of these challenges arose from significant variability in either the quantity or quality of these domains. Surgical providers exhibited examples of resilient strategies to anticipate, monitor, respond to, and learn from these challenges. Resource variability rather than lack of resources underlies many contextual challenges to safe surgical care in a LMIC setting. Understanding these challenges and resilient strategies to overcome them is critical for both LMIC surgical providers and surgeons from HICs working in similar settings.

Behavioral change in rural practice: improving patient motivation in primary care.

PubMed

Clark, Karen; Weir, Christine

2013-01-01

As the disparities in rural healthcare have become better understood, the need to adjust and compensate for these unique challenges becomes a priority. This manuscript suggests three constructs that can be readily integrated into rural care providers' daily work to improve treatment outcomes. Autonomy support, relational support, and competence support are among the motivational constructs discussed with a special consideration for the unique cultural and environmental influences of rural West Virginia residents. The overall objective of this review is to renew the basic tenants of shared decision making as they related to successful behavioral change in primary care.

Care Challenges in the Bathroom: The Views of Professional Care Providers Working in Clients' Homes.

PubMed

King, Emily C; Holliday, Pamela J; Andrews, Gavin J

2018-04-01

In home care, bathroom activities-particularly bathing and toileting-present a unique set of challenges. In this focus group study, professional home care providers identified factors that increase the danger and difficulty of assisting their clients with bathing and toileting. These included small restrictive spaces, a poor fit between available equipment and the environment, a reliance on manual handling techniques (but insufficient space to use optimal body mechanics), attempts to maintain normalcy, and caring for unsteady and unpredictable clients. Specific elements of each activity that care providers found difficult included multitasking to support client stability while performing care below the waist (dressing/undressing, providing perineal care) and helping clients to lift their legs in and out of a bathtub. Participants did not feel that available assistive devices provided enough assistance to reduce the danger and difficulty of these activities.

Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.

PubMed

Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

2015-09-01

Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement.

Stakeholder assessment of comparative effectiveness research needs for Medicaid populations

PubMed Central

Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

2015-01-01

Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement. PMID:26388438

Sink or SLIM: A Local Response to Promote Global Sustainable Change through Education, Partnerships, and Workforce Development

ERIC Educational Resources Information Center

de Roode, Alexander F.; Sakamoto, Clyde M.; Six, Janet

2009-01-01

Maui's unique geographic location, culture, economy, and ecology provide a year-round sustainable living laboratory for the development of sustainable solutions to local and global challenges. Maui Community College's mission, goals, and actions are guided by the Native Hawaiian reverence for the ahupuaa, the traditional land management practice…

Leadership in Social Work: Where Are We?

ERIC Educational Resources Information Center

Sullivan, W. Patrick

2016-01-01

This article provides an overview of the status of leadership in social work, with an emphasis on unique functions and challenges leaders face in the field. Included in this review is a consideration of the concept of leadership as distinct from management, a historical review of the development of leadership as a specialty within social work, and…

Helping Students Cope in an Age of Terrorism: Strategies for School Counselors

ERIC Educational Resources Information Center

Chibbaro, Julia S.; Jackson, C. Marie

2006-01-01

School counselors experience unique challenges as they struggle to provide students with coping skills geared to the outside world including acts of terrorism. School-aged students in the United States are one of the most vulnerable populations in the event of a terrorist act. This article offers a review of the current and most relevant…

Cognitive Skills in the Charitable Giving Decisions of the Elderly

ERIC Educational Resources Information Center

James, Russell N., III

2011-01-01

Charitable giving is a common, and easily measurable, form of prosocial behavior. It may also provide a unique cognitive challenge in that it often requires identifying with the needs of distant others. Using a sample of 331 cognitively normal seniors (mean age of 76), this study examined the relationship between charitable giving and scores on 18…

Aiding Education in Conflict: The Role of International Education Providers Operating in Afghanistan and Pakistan

ERIC Educational Resources Information Center

Harmer, Adele; Stoddard, Abby; DiDomenico, Victoria

2011-01-01

Amid rising violence against civilian aid operations in insecure environments, attacks on the education sector pose a unique set of challenges for international aid actors. In recent years incidents of violence targeting the education sector in Afghanistan and the conflict-affected areas of Pakistan have increased. This article synthesizes recent…

First Year Experience: How We Can Better Assist First-Year International Students in Higher Education

ERIC Educational Resources Information Center

Yan, Zi; Sendall, Patricia

2016-01-01

While many American colleges and universities are providing a First Year Experience (FYE) course or program for their first year students, those programs are not often customized to take into account international students' (IS) unique challenges. Using quantitative and qualitative methods, this study evaluated a FYE course that was customized for…

Whole Brain Learning: The Fine Arts with Students at Risk

ERIC Educational Resources Information Center

Respress, Trinetia; Lutfi, Ghazwan

2006-01-01

Schools are searching for more effective strategies that will enable all students to thrive and succeed. Evidence indicates that the fine arts can provide a unique avenue for reaching challenging students with principles of brain-based learning. This article describes HEARTS, an after-school fine arts program which taps and develops the talents of…

Carving Out Meaningful Spaces for Youth Participation and Engagement in Decision-Making

ERIC Educational Resources Information Center

Finlay, Sarah

2010-01-01

Auckland City Council has one of the longest-standing youth councils in Aotearoa New Zealand. It enables young people to learn about their community, their city and their local government. The process of engaging young people in large cities offers unique challenges for youth councils to reflect the diversity of cities and provide meaningful…

Applying Research in Reading Comprehension to Social Studies Instruction for Middle and High School Students

ERIC Educational Resources Information Center

Swanson, Elizabeth; Wanzek, Jeanne

2014-01-01

Secondary-level content area teachers face unique challenges in helping their students successfully read, understand, and learn content from complex texts in their discipline. In this article, a set of research-based practices designed to provide effective and feasible instruction to improve students' reading and comprehension of text and content…

Developing a Student Respite Provider System for Children with Autism

ERIC Educational Resources Information Center

Openden, Daniel; Symon, Jennifer B.; Koegel, Lynn Kern; Koegel, Robert L.

2006-01-01

Many parents of children with autism and other severe disabilities report heightened levels of stress due to the unique challenges their children present. Respite care is likely to alleviate some of the stress associated with caring for a child with a severe disability. However, it is often difficult for families to identify motivated and…

Information Technology: Unlocking the Door to Differentiation in the 21st Century

ERIC Educational Resources Information Center

Kyburg, Robin M.

2007-01-01

Maria, Sergio, and Steven, whose stories are described in this article, are gifted students whose needs were served through technology. Tapping into the Internet, these students, as well as other learners with varying needs, can be provided with appropriately challenging work that allows them to develop and make unique contributions to the class.…

Psychiatric Rehabilitation of Persons with Co-Occurring Disorders and Corrections Involvement

ERIC Educational Resources Information Center

Bernacchio, Charles; Burker, Eileen J.

2016-01-01

Purpose: Today, the criminal justice system is annually placing more than 300,000 people with severe mental illness (SMI) in prisons and jails which are neither equipped nor staffed to respond to the unique challenges of this population. This article provides a comprehensive overview of the literature that focuses on treating inmates with…

I Thought You Were One of Us! Triumphs and Crisis When Teaching Your Own

ERIC Educational Resources Information Center

Heer, Kal

2015-01-01

Authoritative knowledge produced by white acacemics has forged much of the cannon in educational research. Recently, scholars of color, have been asserting their unique positionalities to conduct research and teach among their own communities. As a result they have provided a challenge to normative privilege whiteness in education. Claims of…

The Impact of Cambridge and the Determination of Fair Use in Educational Settings

ERIC Educational Resources Information Center

Shields, Timothy D.

2016-01-01

The Fair Use exemption to copyright infringement is a difficult concept for those within the legal community because of its unique "case-by-case" application. Without any red line rules, providing guidance to typical users is even more challenging. This paper reviews several recent cases regarding the application of Fair Use and how the…

2012 Survey of States: Successes and Challenges during a Time of Change

ERIC Educational Resources Information Center

Rieke, Rebekah L.; Lazarus, Sheryl S.; Thurlow, Martha L.; Dominguez, Lauren M.

2013-01-01

This report summarizes the thirteenth survey of states by the National Center on Educational Outcomes (NCEO) at the University of Minnesota. Results are presented for 49 states and 6 of the 11 unique states. The purpose of this report is to provide a snapshot of the new initiatives, trends, accomplishments, and emerging issues during this…

Recognising and Developing Urban Teachers: Chartered London Teacher Status

ERIC Educational Resources Information Center

Bubb, Sara; Porritt, Vivienne

2008-01-01

Chartered London Teacher (CLT) status is a unique scheme designed by London Challenge to recognise and reward teachers' achievements and provide a framework for professional development. As well as having the prestige of being a Chartered London Teacher for life, educators receive a one-time payment of 1,000 British pounds from the school budget…

Children with chronic continence problems: the challenges for families.

PubMed

Erickson, David V; Ray, Lynne D

2004-01-01

For families who are raising children with myelomeningocele, bowel and bladder incontinence presents unique challenges for everyday life. The Parenting and Childhood Chronicity model is used to describe the work of raising a child with a chronic condition in 6 areas, including medical care, adapted parenting, dealing with the systems, caring for siblings, maintaining relationships, and personal coping (keeping yourself going). This article provides an overview of the physiologic and developmental challenges inherent in this neural tube defect and illustrates the work that is involved in the child's care and the challenges of maintaining a balance in family life. Clinical implications are discussed, including the setting of appropriate expectations, providing parents with accurate information, ensuring that a focus on continence is not at the expense of other important aspects of the child's functioning, and supporting parents in their interaction with the school system. The medical team, consisting of nursing, urology, nephrology, and psychology working together, can be a strong support for families.

Guide to Cybersecurity, Resilience, and Reliability for Small and Under-Resourced Utilities

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

Ingram, Michael; Martin, Maurice

Small electricity utilities -- those with less than 100 employees or 50,000 meters -- provide essential services to large parts of the United States while facing a number of challenges unique to their mission. For instance, they often serve areas that are sparsely populated, meaning that their per-customer cost to provide service is higher. At the same time, they often serve customers that have moderate or fixed incomes, meaning that they are under strong pressure to keep costs down. This pressure puts them on a strict budget and creates a need for innovative solutions to common problems. Further, their servicemore » areas may include extreme climates, making severe weather events more frequent and their aftermaths more expensive to address. This guide considers challenges that small utilities face while ensuring the reliability, resilience, and cybersecurity of their electric service; approaches to address those challenges using existing guidance documents; ways that the federal government could provide support in these areas.« less

Health Professionals' Experiences Providing Breastfeeding-Related Care for Obese Women

PubMed Central

Ratcliff, Stephannie L.; Devine, Carol M.; Thornburg, Loralei L.; Rasmussen, Kathleen M.

2014-01-01

Abstract Background: Obese women are at high risk of early breastfeeding cessation, and health professionals (HPs) have a unique opportunity to provide them with breastfeeding support. Our objective was to describe HPs' experiences providing breastfeeding care for obese women during the prenatal, peripartum, and postpartum periods. Materials and Methods: In-depth, qualitative interviews were conducted with 34 HPs (including obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. They were recruited from a variety of settings in central New York. Interviews were audio-recorded, transcribed, verified for accuracy, and then analyzed qualitatively. Results: HPs identified obesity in multiple ways, some of which were consistent with standard cutoffs, whereas others implied extreme obesity. Nearly all HPs discussed ways they perceive obese women have challenges with breastfeeding. Some HPs described challenges as specific to obese women (e.g., limited mobility), whereas others described challenges as universal but more likely to occur among obese women (e.g., difficulties positioning the infant to breastfeed). Across professions, HPs described providing breastfeeding care for obese women as requiring more time and physical work and as being more challenging. HPs acknowledged stigma around obesity and discussed treating obese women with dignity and the same as other women. Strategies were suggested for improving breastfeeding support for obese women. Conclusions: HPs identified multiple challenges that obese women encounter with breastfeeding, as well as their own challenges with providing care. Comprehensive strategies are needed to assist obese women with breastfeeding and to alleviate strain on HPs who provide their care. PMID:25347705

Tank-automotive robotics

NASA Astrophysics Data System (ADS)

Lane, Gerald R.

1999-07-01

To provide an overview of Tank-Automotive Robotics. The briefing will contain program overviews & inter-relationships and technology challenges of TARDEC managed unmanned and robotic ground vehicle programs. Specific emphasis will focus on technology developments/approaches to achieve semi- autonomous operation and inherent chassis mobility features. Programs to be discussed include: DemoIII Experimental Unmanned Vehicle (XUV), Tactical Mobile Robotics (TMR), Intelligent Mobility, Commanders Driver Testbed, Collision Avoidance, International Ground Robotics Competition (ICGRC). Specifically, the paper will discuss unique exterior/outdoor challenges facing the IGRC competing teams and the synergy created between the IGRC and ongoing DoD semi-autonomous Unmanned Ground Vehicle and DoT Intelligent Transportation System programs. Sensor and chassis approaches to meet the IGRC challenges and obstacles will be shown and discussed. Shortfalls in performance to meet the IGRC challenges will be identified.

Graphs, matrices, and the GraphBLAS: Seven good reasons

DOE PAGES

Kepner, Jeremy; Bader, David; Buluç, Aydın; ...

2015-01-01

The analysis of graphs has become increasingly important to a wide range of applications. Graph analysis presents a number of unique challenges in the areas of (1) software complexity, (2) data complexity, (3) security, (4) mathematical complexity, (5) theoretical analysis, (6) serial performance, and (7) parallel performance. Implementing graph algorithms using matrix-based approaches provides a number of promising solutions to these challenges. The GraphBLAS standard (istcbigdata.org/GraphBlas) is being developed to bring the potential of matrix based graph algorithms to the broadest possible audience. The GraphBLAS mathematically defines a core set of matrix-based graph operations that can be used to implementmore » a wide class of graph algorithms in a wide range of programming environments. This paper provides an introduction to the GraphBLAS and describes how the GraphBLAS can be used to address many of the challenges associated with analysis of graphs.« less

Canadian Academy of Sport and Exercise Medicine position statement: athletes at high altitude.

PubMed

Koehle, Michael S; Cheng, Ivy; Sporer, Benjamin

2014-03-01

Many sports incorporate training at altitude as a key component of their athlete training plan. Furthermore, many sports are required to compete at high altitude venues. Exercise at high altitude provides unique challenges to the athlete and to the sport medicine clinician working with these athletes. These challenges include altitude illness, alterations in training intensity and performance, nutritional and hydration difficulties, and challenges related to the austerity of the environment. Furthermore, many of the strategies that are typically utilized by visitors to altitude may have implications from an anti-doping point of view.This position statement was commissioned and approved by the Canadian Academy of Sport and Exercise Medicine. The purpose of this statement was to provide an evidence-based, best practices summary to assist clinicians with the preparation and management of athletes and individuals travelling to altitude for both competition and training.

Issues with RNA-seq analysis in non-model organisms: A salmonid example.

PubMed

Sundaram, Arvind; Tengs, Torstein; Grimholt, Unni

2017-10-01

High throughput sequencing (HTS) is useful for many purposes as exemplified by the other topics included in this special issue. The purpose of this paper is to look into the unique challenges of using this technology in non-model organisms where resources such as genomes, functional genome annotations or genome complexity provide obstacles not met in model organisms. To describe these challenges, we narrow our scope to RNA sequencing used to study differential gene expression in response to pathogen challenge. As a demonstration species we chose Atlantic salmon, which has a sequenced genome with poor annotation and an added complexity due to many duplicated genes. We find that our RNA-seq analysis pipeline deciphers between duplicates despite high sequence identity. However, annotation issues provide problems in linking differentially expressed genes to pathways. Also, comparing results between approaches and species are complicated due to lack of standardized annotation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Navigating complex sample analysis using national survey data.

PubMed

Saylor, Jennifer; Friedmann, Erika; Lee, Hyeon Joo

2012-01-01

The National Center for Health Statistics conducts the National Health and Nutrition Examination Survey and other national surveys with probability-based complex sample designs. Goals of national surveys are to provide valid data for the population of the United States. Analyses of data from population surveys present unique challenges in the research process but are valuable avenues to study the health of the United States population. The aim of this study was to demonstrate the importance of using complex data analysis techniques for data obtained with complex multistage sampling design and provide an example of analysis using the SPSS Complex Samples procedure. Illustration of challenges and solutions specific to secondary data analysis of national databases are described using the National Health and Nutrition Examination Survey as the exemplar. Oversampling of small or sensitive groups provides necessary estimates of variability within small groups. Use of weights without complex samples accurately estimates population means and frequency from the sample after accounting for over- or undersampling of specific groups. Weighting alone leads to inappropriate population estimates of variability, because they are computed as if the measures were from the entire population rather than a sample in the data set. The SPSS Complex Samples procedure allows inclusion of all sampling design elements, stratification, clusters, and weights. Use of national data sets allows use of extensive, expensive, and well-documented survey data for exploratory questions but limits analysis to those variables included in the data set. The large sample permits examination of multiple predictors and interactive relationships. Merging data files, availability of data in several waves of surveys, and complex sampling are techniques used to provide a representative sample but present unique challenges. In sophisticated data analysis techniques, use of these data is optimized.

Test Results from a High Power Linear Alternator Test Rig

NASA Technical Reports Server (NTRS)

Birchenough, Arthur G.; Hervol, David S.; Gardner, Brent G.

2010-01-01

Stirling cycle power conversion is an enabling technology that provides high thermodynamic efficiency but also presents unique challenges with regard to electrical power generation, management, and distribution. The High Power Linear Alternator Test Rig (HPLATR) located at the NASA Glenn Research Center (GRC) in Cleveland, OH is a demonstration test bed that simulates electrical power generation from a Stirling engine driven alternator. It implements the high power electronics necessary to provide a well regulated DC user load bus. These power electronics use a novel design solution that includes active rectification and power factor control, active ripple suppression, along with a unique building block approach that permits the use of high voltage or high current alternator designs. This presentation describes the HPLATR, the test program, and the operational results.

Test Results From a High Power Linear Alternator Test Rig

NASA Technical Reports Server (NTRS)

Birchenough, Arthur G.; Hervol, David S.; Gardner, Brent G.

2010-01-01

Stirling cycle power conversion is an enabling technology that provides high thermodynamic efficiency but also presents unique challenges with regard to electrical power generation, management, and distribution. The High Power Linear Alternator Test Rig (HPLATR) located at the NASA Glenn Research Center (GRC) in Cleveland, Ohio is a demonstration test bed that simulates electrical power generation from a Stirling engine driven alternator. It implements the high power electronics necessary to provide a well regulated DC user load bus. These power electronics use a novel design solution that includes active rectification and power factor control, active ripple suppression, along with a unique building block approach that permits the use of high voltage or high current alternator designs. This report describes the HPLATR, the test program, and the operational results.

A unique funding opportunity for public health in Texas.

PubMed

Schlenker, Thomas; Huber, Carol A

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.

Microfluidic and nanofluidic phase behaviour characterization for industrial CO2, oil and gas.

PubMed

Bao, Bo; Riordon, Jason; Mostowfi, Farshid; Sinton, David

2017-08-08

Microfluidic systems that leverage unique micro-scale phenomena have been developed to provide rapid, accurate and robust analysis, predominantly for biomedical applications. These attributes, in addition to the ability to access high temperatures and pressures, have motivated recent expanded applications in phase measurements relevant to industrial CO 2 , oil and gas applications. We here present a comprehensive review of this exciting new field, separating microfluidic and nanofluidic approaches. Microfluidics is practical, and provides similar phase properties analysis to established bulk methods with advantages in speed, control and sample size. Nanofluidic phase behaviour can deviate from bulk measurements, which is of particular relevance to emerging unconventional oil and gas production from nanoporous shale. In short, microfluidics offers a practical, compelling replacement of current bulk phase measurement systems, whereas nanofluidics is not practical, but uniquely provides insight into phase change phenomena at nanoscales. Challenges, trends and opportunities for phase measurements at both scales are highlighted.

REU Programs at Field Research Stations Offer Unique Advantages that may Enhance Retention of Students in STEM Fields.

NASA Astrophysics Data System (ADS)

Kim, D. Y.; Marinelli, R. L.; Heidelberg, K., IV

2014-12-01

Studies have shown that undergraduate participation in research opportunities strengthens the retention of students in STEM fields. Increasing students' confidence levels in their scientific abilities, aiding in the development of their scientific identity, and strengthening their sense of belonging to a scientific community have been cited as important contributing factors. Research field stations offer unique advantages that amplify these benefits by challenging students to plan and work in the field, enhancing networking opportunities with multi-disciplinary professionals from numerous institutions and hierarchical levels, and creating a stronger sense of belonging and comradery within a science community. The USC Wrigley Institute for Environmental Studies' (WIES) Research Experiences for Undergraduates (REU) program is an 8-week program that begins on the main USC campus in Los Angeles and moves to a marine field station on Catalina Island during weeks 2-7, before returning to the mainland to complete the last week of the program. This unique model provides REU students with an opportunity to become integrated into faculty mentors' labs on the main campus, while exposing them to life as a researcher at a field station, both of which contribute significantly to the students' development as a scientist. Here, we present the WIES REU model and include a discussion of benefits and challenges to this unique infrastructure.

A challenging entanglement: health care providers' perspectives on caring for ill and injured tourists on Cozumel Island, Mexico.

PubMed

Hoffman, Leon; Crooks, Valorie A; Snyder, Jeremy

2018-12-01

Despite established knowledge that tourists often fall ill or are injured abroad, little is known about their treatment. The intent of this study was to explore health care professionals' treatment provision experiences on Cozumel Island, Mexico. 13 semi-structured interviews were undertaken with professionals across a number of health care vocations on Cozumel Island. Interviews were transcribed and thematically analysed to determine common challenges faced in the provision of treatment for transnational tourists. Three thematic challenges emerged from the data: human and physical resource deficiencies, medical (mis)perceptions held by patients and complexities surrounding remuneration of care. Health care providers employ unique strategies to mitigate these challenges. Although many of these challenges exist within other touristic and peripheral spaces, we suggest that the challenges experienced by Cozumel Island's health care professionals, and their mitigation strategies, exist as part of a complex entanglement between the island's health care sector and its dominant tourism landscape. We call on tangential tourism services to take a larger role in ensuring the ease of access to, and provision of quality health care services for tourists on Cozumel Island.

Modern Natural Products Drug Discovery and its Relevance to Biodiversity Conservation†

PubMed Central

Kingston, David G. I.

2010-01-01

Natural products continue to provide a diverse and unique source of bioactive lead compounds for drug discovery, but maintaining their continued eminence as source compounds is challenging in the face of the changing face of the pharmaceutical industry and the changing nature of biodiversity prospecting brought about by the Convention of Biodiversity. This review provides an overview of some of these challenges, and suggests ways in which they can be addressed so that natural products research can remain a viable and productive route to drug discovery. Results from International Cooperative Biodiversity Groups (ICBGs) working in Madagascar, Panama, and Suriname are used as examples of what can be achieved when biodiversity conservation is linked to drug discovery. PMID:21138324

Business of biosimilars - 14th annual conference (October 15-17, 2013 - Boston, Massachusetts, USA).

PubMed

Bourgoin, A

2013-12-01

Competition in the biological market offers a new set of opportunities and challenges within the healthcare industry. Biosimilars, like generic small-molecule drugs, can provide cost savings and increase patient access, while also promoting innovation. While large molecule manufacturers face many challenges unique to complex therapeutics, it is becoming clear that the commercialization of biosimilars shares many of the same hurdles as the generics market. The 14th Annual Business of Biosimilars Conference provided quality presentations from industry leaders regarding many commercial considerations for stakeholders interested in entering the biosimilars market. Opportunities to network with industry experts were offered, with over 120 attendees. Copyright 2013 Prous Science, S.A.U. or its licensors. All rights reserved.

Quantitative Approaches to Group Research: Suggestions for Best Practices

ERIC Educational Resources Information Center

McCarthy, Christopher J.; Whittaker, Tiffany A.; Boyle, Lauren H.; Eyal, Maytal

2017-01-01

Rigorous scholarship is essential to the continued growth of group work, yet the unique nature of this counseling specialty poses challenges for quantitative researchers. The purpose of this proposal is to overview unique challenges to quantitative research with groups in the counseling field, including difficulty in obtaining large sample sizes…

Use of the nominal group technique to identify stakeholder priorities and inform survey development: an example with informal caregivers of people with scleroderma.

PubMed

Rice, Danielle B; Cañedo-Ayala, Mara; Turner, Kimberly A; Gumuchian, Stephanie T; Malcarne, Vanessa L; Hagedoorn, Mariët; Thombs, Brett D

2018-03-02

The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment surveys. The objective was to demonstrate the use of NGT discussions to develop survey items on (1) challenges experienced by informal caregivers of people living with systemic sclerosis (SSc) and (2) preferences for support services. Three NGT groups were conducted. In each group, participants generated lists of challenges and preferred formats for support services. Participants shared items, and a master list was compiled, then reviewed by participants to remove or merge overlapping items. Once a final list of items was generated, participants independently rated challenges on a scale from 1 (not at all important) to 10 (extremely important) and support services on a scale from 1 (not at all likely to use) to 10 (very likely to use). Lists generated in the NGT discussions were subsequently reviewed and integrated into a single list by research team members. SSc patient conferences held in the USA and Canada. Informal caregivers who previously or currently were providing care for a family member or friend with SSc. A total of six men and seven women participated in the NGT discussions. Mean age was 59.8 years (SD=12.6). Participants provided care for a partner (n=8), parent (n=1), child (n=2) or friend (n=2). A list of 61 unique challenges was generated with challenges related to gaps in information, resources and support needs identified most frequently. A list of 18 unique support services was generated; most involved online or in-person delivery of emotional support and educational material about SSc. The NGT was an efficient method for obtaining survey items directly from SSc caregivers on important challenges and preferences for support services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mother-Daughter Dyad Recruitment and Cancer Intervention Challenges in an African American Sample

PubMed Central

Mosavel, Maghboeba; Ports, Katie; Leighton-Herrmann, Ellyn

2014-01-01

Developing an effective youth-based health messaging intervention for African American women, who remain disparately impacted by cancer, presents unique challenges. This paper reports on the challenges with recruiting familial dyads from predominantly low-income, African American neighborhoods, as well as the challenges associated with designing and implementing an upward-directed cancer screening intervention. We developed and pilot tested an educational workshop that provided adolescents with cancer screening information to share with their mother or female relative. Data from follow-up interviews and focus groups, as well as observation records regarding implementation obstacles highlight important lessons learned. The use of familial dyads as well as issues of access posed challenges for recruitment and follow-up. Workshop-related challenges stemmed from the approach, content and length. Finally, personal and environmental factors presented barriers to adolescent message delivery and adult follow-through. By identifying these challenges, we hope to influence and enable the future development of effective adolescent-initiated health messaging interventions. PMID:25489496

50TH Project Air Force, 1946 - 1996.

DTIC Science & Technology

1996-01-01

the study results challenged current doctrine on the uses of airpower by suggesting...FORCE gives us a unique opportunity to reflect on past achieve- ments and the legacy they provide for the future. The essays in this volume offer a...montage of per- sonal perspectives on that legacy. While they do not present a comprehensive history they help us grasp the significance of

Who Seeks "Cita Con El Doctor"? Twelve Years of Spanish-Language Radio Program Targeting U.S. Latinos

ERIC Educational Resources Information Center

Ramirez, A. Susana; Graff, Kaitlin; Nelson, David; Galica, Kasia; Leyva, Bryan; Banegas, Mateo; Huerta, Elmer

2015-01-01

Purpose: Spanish-dominant Latinos make up 13% of the U.S. population, and this group is poorer and faces multiple threats to health compared with the general population. Additionally, Spanish speakers face challenges accessing health information that is often not available in Spanish. This study provides a descriptive epidemiology of a unique,…

A Tangled Web of Terms: The Overlap and Unique Contribution of Involvement, Engagement, and Integration to Understanding College Student Success

ERIC Educational Resources Information Center

Wolf-Wendel, Lisa; Ward, Kelly; Kinzie, Jillian

2009-01-01

Established theories and constructs long associated with student success, including involvement, engagement, and integration, provide common language and a body of knowledge to inform understanding of the challenges currently facing higher education. This paper examines how the theories and terms have evolved, explores how the terms are currently…

Availability of Diagnostic and Treatment Services for Acute Stroke in Frontier Counties in Montana and Northern Wyoming

ERIC Educational Resources Information Center

Okon, Nicholas J.; Rodriguez, Daniel V.; Dietrich, Dennis W.; Oser, Carrie S.; Blades, Lynda L.; Burnett, Anne M.; Russell, Joseph A.; Allen, Martha J.; Chasson, Linda; Helgerson, Steven D.; Gohdes, Dorothy; Harwell, Todd S.

2006-01-01

Context: Rapid diagnosis and treatment of ischemic stroke can lead to improved patient outcomes. Hospitals in rural and frontier counties, however, face unique challenges in providing diagnostic and treatment services for acute stroke. Purpose: The aim of this study was to assess the availability of key diagnostic technology and programs for acute…

Supporting New Special Education Teachers: How Online Resources and Web 2.0 Technologies Can Help

ERIC Educational Resources Information Center

Billingsley, Bonnie; Israel, Maya; Smith, Sean

2011-01-01

New special education teachers (SETs) face some typical challenges as well as ones that are specific to their particular work settings. Providing support that addresses teachers' unique needs is important for increasing their effectiveness, helping them make a smooth entry into teaching, and reducing their stress and turnover. Nearly 20 years ago,…

Behavioral toxicology: Stimulating challenges for a growing discipline

USGS Publications Warehouse

Little, Edward E.

1990-01-01

Since the early 1970s, contaminants have been shown to affect virtually every aspect of behavior in terrestrial and aquatic organisms. Behavior inte- grates many cellular processes and is essential to the viability of the organism, the population and the community. Therefore, observations of behavior provide a unique toxicological perspective - one that links the biochemical and ecological conse- quences of environmental contamination.

Wood-based Tri-Axial Sandwich Composite Materials: Design, Fabrication, Testing, Modeling and Application

Treesearch

Jinghao Li; John F. Hunt; Shaoqin Gong; Zhiyong Cai

2014-01-01

As the demand for sustainable materials increases, there are unique challenges and opportunities to develop light-weight green composites materials for a wide range of applications. Thus wood-based composite materials from renewable forests may provide options for some niche applications while helping to protect our environment. In this paper, the wood-based tri-axial...

The NASA integrated test facility and its impact on flight research

NASA Technical Reports Server (NTRS)

Mackall, D. A.; Pickett, M. D.; Schilling, L. J.; Wagner, C. A.

1988-01-01

The Integrated Test Facility (ITF), being built at NASA Ames-Dryden Flight Research Facility, will provide new test capabilities for emerging research aircraft. An overview of the ITF and the challenges being addressed by this unique facility are outlined. The current ITF capabilities, being developed with the X-29 Forward Swept Wing Program, are discussed along with future ITF activities.

Infantry Small-Unit Mountain Operations

DTIC Science & Technology

2011-02-01

expended to traverse it.  Unique sustainment solutions. Sustainment in a mountain environment is a challenging and time-consuming process . Terrain...a particular environment during the intelligence preparation of the battlefield (IPB) process and provide the analysis to the company. The IPB...consists of a four-step process that includes—  Defining the operational environment.  Describing environmental effects on operations.  Evaluating the

Eleventh annual Warren K. Sinclair keynote address-science, radiation protection and NCRP: building on the past, looking to the future.

PubMed

Bushberg, Jerrold T

2015-02-01

The many reports and other authoritative documents developed and published by the National Council on Radiation Protection and Measurements (NCRP) have been of great service to the nation and the radiation protection community since its Congressional charter was signed into law 50 y ago. There will be a continuing need for NCRP to identify the principles upon which radiation protection is to be based and to provide guidance on best practices for the practical application of those principles for the many beneficial uses of radiation in society. The unique and invaluable resource that is NCRP is in large part due to the selfless dedication and numerous contributions of its Council and scientific committee members. The multidisciplinary composition of these leading experts and their collective input on complex questions provide a unique synergy that results in a comprehensive and well-balanced approach to addressing current and future radiation protection challenges. Subsequent articles in these proceedings covering a broad range of relevant topics will review sentinel accomplishments of the past as well as current work and future challenges that are in keeping with NCRP's mission to advance the science of radiation protection in the public interest.

Biotechnological Applications of Marine Enzymes From Algae, Bacteria, Fungi, and Sponges.

PubMed

Parte, S; Sirisha, V L; D'Souza, J S

Diversity is the hallmark of all life forms that inhabit the soil, air, water, and land. All these habitats pose their unique inherent challenges so as to breed the "fittest" creatures. Similarly, the biodiversity from the marine ecosystem has evolved unique properties due to challenging environment. These challenges include permafrost regions to hydrothermal vents, oceanic trenches to abyssal plains, fluctuating saline conditions, pH, temperature, light, atmospheric pressure, and the availability of nutrients. Oceans occupy 75% of the earth's surface and harbor most ancient and diverse forms of organisms (algae, bacteria, fungi, sponges, etc.), serving as an excellent source of natural bioactive molecules, novel therapeutic compounds, and enzymes. In this chapter, we introduce enzyme technology, its current state of the art, unique enzyme properties, and the biocatalytic potential of marine algal, bacterial, fungal, and sponge enzymes that have indeed boosted the Marine Biotechnology Industry. Researchers began exploring marine enzymes, and today they are preferred over the chemical catalysts for biotechnological applications and functions, encompassing various sectors, namely, domestic, industrial, commercial, and healthcare. Next, we summarize the plausible pros and cons: the challenges encountered in the process of discovery of the potent compounds and bioactive metabolites such as biocatalysts/enzymes of biomedical, therapeutic, biotechnological, and industrial significance. The field of Marine Enzyme Technology has recently assumed importance, and if it receives further boost, it could successfully substitute other chemical sources of enzymes useful for industrial and commercial purposes and may prove as a beneficial and ecofriendly option. With appropriate directions and encouragement, marine enzyme technology can sustain the rising demand for enzyme production while maintaining the ecological balance, provided any undesired exploitation of the marine ecosystem is avoided. © 2017 Elsevier Inc. All rights reserved.

Pain management in the geriatric population.

PubMed

Borsheski, Robert; Johnson, Quinn L

2014-01-01

Pain is a highly prevalent and clinically important problem in the elderly. Unfortunately, due to difficulties in assessing pain in geriatric patients, the complexities of multiple comorbidities, and the high prevalence of polypharmacy, many practitioners are reluctant to treat pain aggressively in this unique patient population. Safe and effective treatment therefore, requires a working knowledge of the physiologic changes associated with aging, the challenges of accurately assessing pain, the unique effects of common therapeutic agents upon the elderly as well as the importance of adjunctive therapies. The following review is intended to provide the practitioner with practical knowledge for safer and more effective treatment of pain.

Evolution of Wholesale Electricity Market Design with Increasing Levels of Renewable Generation

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

Ela, E.; Milligan, M.; Bloom, A.

2014-09-01

Variable generation such as wind and photovoltaic solar power has increased substantially in recent years. Variable generation has unique characteristics compared to the traditional technologies that supply energy in the wholesale electricity markets. These characteristics create unique challenges in planning and operating the power system, and they can also influence the performance and outcomes from electricity markets. This report focuses on two particular issues related to market design: revenue sufficiency for long-term reliability and incentivizing flexibility in short-term operations. The report provides an overview of current design and some designs that have been proposed by industry or researchers.

Collusion-resistant multimedia fingerprinting: a unified framework

NASA Astrophysics Data System (ADS)

Wu, Min; Trappe, Wade; Wang, Z. Jane; Liu, K. J. Ray

2004-06-01

Digital fingerprints are unique labels inserted in different copies of the same content before distribution. Each digital fingerprint is assigned to an inteded recipient, and can be used to trace the culprits who use their content for unintended purposes. Attacks mounted by multiple users, known as collusion attacks, provide a cost-effective method for attenuating the identifying fingerprint from each coluder, thus collusion poses a reeal challenge to protect the digital media data and enforce usage policies. This paper examines a few major design methodologies for collusion-resistant fingerprinting of multimedia, and presents a unified framework that helps highlight the common issues and the uniqueness of different fingerprinting techniques.

The Space Shuttle

NASA Technical Reports Server (NTRS)

Moffitt, William L.

2003-01-01

As missions have become increasingly more challenging over the years, the most adaptable and capable element of space shuttle operations has proven time and again to be human beings. Human space flight provides unique aspects of observation. interaction and intervention that can reduce risk and improve mission success. No other launch vehicle - in development or in operation today - can match the space shuttle's human space flight capabilities. Preserving U.S. leadership in human space flight requires a strategy to meet those challenges. The ongoing development of next generation vehicles, along with upgrades to the space shuttle, is the most effective means for assuring our access to space.

Spermatic cord dedifferentiated liposarcoma presenting as a recurrent inguinal hernia.

PubMed

Crigger, Chad; Barnard, John; Zaslau, Stanley; Vos, Jeffrey A

2016-12-01

Paratesticular sarcomas are a rare entity and provide a unique clinical challenge due to their slow growing, often painless natural course. Adding to this challenge is the complex anatomy of the scrotum that allows these masses to mimic other conditions, including inguinal hernia, cysts, or fluid collections. We report such a case and our approach to an 83-year-old male with dedifferentiated liposarcoma of the spermatic cord with a history of inguinal hernia. In doing so, we highlight the need for thorough evaluation of scrotal masses and the management of these rare, though well-described, tumors.

Information technology challenges of biodiversity and ecosystems informatics

USGS Publications Warehouse

Schnase, J.L.; Cushing, J.; Frame, M.; Frondorf, A.; Landis, E.; Maier, D.; Silberschatz, A.

2003-01-01

Computer scientists, biologists, and natural resource managers recently met to examine the prospects for advancing computer science and information technology research by focusing on the complex and often-unique challenges found in the biodiversity and ecosystem domain. The workshop and its final report reveal that the biodiversity and ecosystem sciences are fundamentally information sciences and often address problems having distinctive attributes of scale and socio-technical complexity. The paper provides an overview of the emerging field of biodiversity and ecosystem informatics and demonstrates how the demands of biodiversity and ecosystem research can advance our understanding and use of information technologies.

Challenges and Strategies for Breeding Resistance in Capsicum annuum to the Multifarious Pathogen, Phytophthora capsici

PubMed Central

Barchenger, Derek W.; Lamour, Kurt H.; Bosland, Paul W.

2018-01-01

Phytophthora capsici is the most devastating pathogen for chile pepper production worldwide and current management strategies are not effective. The population structure of the pathogen is highly variable and few sources of widely applicable host resistance have been identified. Recent genomic advancements in the host and the pathogen provide important insights into the difficulties reported by epidemiological and physiological studies published over the past century. This review highlights important challenges unique to this complex pathosystem and suggests strategies for resistance breeding to help limit losses associated with P. capsici. PMID:29868083

Uses of duckweed

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

Hillman, W.S.; Culley, D.D. Jr.

1978-07-01

Among the various approaches to improving present technologies for waste-water treatment, several involve the use of plants, which can remove pollutants and provide materials useful as animal feeds or energy sources. Various aquatic plants are being proposed in such approaches, and the duckweeds in particular, an essentially unique group of higher aquatic plants, might be especially advantageous in such systems. Although this article focuses on only this one group of plants, it can nevertheless provide an introduction to issues that are both scientifically challenging and existentially inescapable.

Strong Interaction Studies with PANDA at FAIR

NASA Astrophysics Data System (ADS)

Schönning, Karin

2016-10-01

The Facility for Antiproton and Ion Research (FAIR) in Darmstadt, Germany, provides unique possibilities for a new generation of nuclear-, hadron- and atomic physics experiments. The future PANDA experiment at FAIR will offer a broad physics programme with emphasis on different aspects of hadron physics. Understanding the strong interaction in the perturbative regime remains one of the greatest challenges in contemporary physics and hadrons provide several important keys. In these proceedings, PANDA will be presented along with some high-lights of the planned physics programme.

Pastoral Care and Counseling with Military Families.

PubMed

Moon, Zachary

2016-06-01

The complex human experience of military service and the stress suffered by millions of military families each time a loved one deploys present unique challenges and opportunities in providing pastoral care and counseling. War and military service impact many facets of our society, as well as generational and interpersonal relationships. This article speaks to both academic and practitioner communities, and provides a vision for effective pastoral care and counseling with military families drawing on resources from family systems theory. © The Author(s) 2016.

Silyl Ketene Imines: Highly Versatile Nucleophiles for Catalytic, Asymmetric Synthesis

PubMed Central

Denmark, Scott E.; Wilson, Tyler W.

2012-01-01

This Minireview provides an overview on the development of silyl ketene imines and their recent applications in catalytic, enantioselective reactions. The unique structure of the ketene imine allows a diverse range of reactivity patterns and provides solutions to existing challenges in the enantioselective construction of quaternary stereogenic carbon centers and cross-benzoin adducts. A variety of reactions for which silyl ketene imines have been applied are presented with an overall goal of inspiring new uses for these underutilized nucleophiles. PMID:22968901

Robust Optical Recognition of Cursive Pashto Script Using Scale, Rotation and Location Invariant Approach

PubMed Central

Ahmad, Riaz; Naz, Saeeda; Afzal, Muhammad Zeshan; Amin, Sayed Hassan; Breuel, Thomas

2015-01-01

The presence of a large number of unique shapes called ligatures in cursive languages, along with variations due to scaling, orientation and location provides one of the most challenging pattern recognition problems. Recognition of the large number of ligatures is often a complicated task in oriental languages such as Pashto, Urdu, Persian and Arabic. Research on cursive script recognition often ignores the fact that scaling, orientation, location and font variations are common in printed cursive text. Therefore, these variations are not included in image databases and in experimental evaluations. This research uncovers challenges faced by Arabic cursive script recognition in a holistic framework by considering Pashto as a test case, because Pashto language has larger alphabet set than Arabic, Persian and Urdu. A database containing 8000 images of 1000 unique ligatures having scaling, orientation and location variations is introduced. In this article, a feature space based on scale invariant feature transform (SIFT) along with a segmentation framework has been proposed for overcoming the above mentioned challenges. The experimental results show a significantly improved performance of proposed scheme over traditional feature extraction techniques such as principal component analysis (PCA). PMID:26368566

A Comprehensive Study on the Internet of Underwater Things: Applications, Challenges, and Channel Models †

PubMed Central

Wu, Geng-De; Huang, Chun-Ju

2017-01-01

The Internet of Underwater Things (IoUT) is a novel class of Internet of Things (IoT), and is defined as the network of smart interconnected underwater objects. IoUT is expected to enable various practical applications, such as environmental monitoring, underwater exploration, and disaster prevention. With these applications, IoUT is regarded as one of the potential technologies toward developing smart cities. To support the concept of IoUT, Underwater Wireless Sensor Networks (UWSNs) have emerged as a promising network system. UWSNs are different from the traditional Territorial Wireless Sensor Networks (TWSNs), and have several unique properties, such as long propagation delay, narrow bandwidth, and low reliability. These unique properties would be great challenges for IoUT. In this paper, we provide a comprehensive study of IoUT, and the main contributions of this paper are threefold: (1) we introduce and classify the practical underwater applications that can highlight the importance of IoUT; (2) we point out the differences between UWSNs and traditional TWSNs, and these differences are the main challenges for IoUT; and (3) we investigate and evaluate the channel models, which are the technical core for designing reliable communication protocols on IoUT. PMID:28640220

A Comprehensive Study on the Internet of Underwater Things: Applications, Challenges, and Channel Models.

PubMed

Kao, Chien-Chi; Lin, Yi-Shan; Wu, Geng-De; Huang, Chun-Ju

2017-06-22

The Internet of Underwater Things (IoUT) is a novel class of Internet of Things (IoT), and is defined as the network of smart interconnected underwater objects. IoUT is expected to enable various practical applications, such as environmental monitoring, underwater exploration, and disaster prevention. With these applications, IoUT is regarded as one of the potential technologies toward developing smart cities. To support the concept of IoUT, Underwater Wireless Sensor Networks (UWSNs) have emerged as a promising network system. UWSNs are different from the traditional Territorial Wireless Sensor Networks (TWSNs), and have several unique properties, such as long propagation delay, narrow bandwidth, and low reliability. These unique properties would be great challenges for IoUT. In this paper, we provide a comprehensive study of IoUT, and the main contributions of this paper are threefold: (1) we introduce and classify the practical underwater applications that can highlight the importance of IoUT; (2) we point out the differences between UWSNs and traditional TWSNs, and these differences are the main challenges for IoUT; and (3) we investigate and evaluate the channel models, which are the technical core for designing reliable communication protocols on IoUT.

Expanding the foundation for personalized medicine: implications and challenges for dentistry.

PubMed

Garcia, I; Kuska, R; Somerman, M J

2013-07-01

Personalized medicine aims to individualize care based on a person's unique genetic, environmental, and clinical profile. Dentists and physicians have long recognized variations between and among patients, and have customized care based on each individual's health history, environment, and behavior. However, the sequencing of the human genome in 2003 and breakthroughs in regenerative medicine, imaging, and computer science redefined "personalized medicine" as clinical care that takes advantage of new molecular tools to facilitate highly precise health care based on an individual's unique genomic and molecular characteristics. Major investments in science bring a new urgency toward realizing the promise of personalized medicine; yet, many challenges stand in the way. In this article, we present an overview of the opportunities and challenges that influence the oral health community's full participation in personalized medicine. We highlight selected research advances that are solidifying the foundation of personalized oral health care, elaborate on their impact on dentistry, and explore obstacles toward their adoption into practice. It is our view that now is the time for oral health professionals, educators, students, researchers, and patients to engage fully in preparations for the arrival of personalized medicine as a means to provide quality, customized, and effective oral health care for all.

Implementation and Challenges of Direct Acoustic Dosing into Cell-Based Assays.

PubMed

Roberts, Karen; Callis, Rowena; Ikeda, Tim; Paunovic, Amalia; Simpson, Carly; Tang, Eric; Turton, Nick; Walker, Graeme

2016-02-01

Since the adoption of Labcyte Echo Acoustic Droplet Ejection (ADE) technology by AstraZeneca in 2005, ADE has become the preferred method for compound dosing into both biochemical and cell-based assays across AstraZeneca research and development globally. The initial implementation of Echos and the direct dosing workflow provided AstraZeneca with a unique set of challenges. In this article, we outline how direct Echo dosing has evolved over the past decade in AstraZeneca. We describe the practical challenges of applying ADE technology to 96-well, 384-well, and 1536-well assays and how AstraZeneca developed and applied software and robotic solutions to generate fully automated and effective cell-based assay workflows. © 2015 Society for Laboratory Automation and Screening.

Academic-correctional health partnerships: preparing the correctional health workforce for the changing landscape-focus group research results.

PubMed

Hale, Janet Fraser; Haley, Heather-Lyn; Jones, Judy L; Brennan, Allyson; Brewer, Arthur

2015-01-01

Providing health care in corrections is challenging. Attracting clinicians can be equally challenging. The future holds a shortage of nurses and primary care physicians. We have a unique opportunity, now, to develop and stabilize our workforce, create a positive image, and enhance quality before the health care landscape changes even more dramatically. Focus groups were conducted with 22 correctional health care professionals divided into three groups: physicians (6), nurses (4), and nurse practitioners/physician assistants (12). Content focused on curricular themes, but additional themes emerged related to recruitment and retention. This article describes recruitment challenges, strategic themes identified, and the proposed initiatives to support a stable, high-quality correctional health workforce. © The Author(s) 2014.

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

PubMed Central

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Objectives Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. Methods This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. Results The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Conclusions Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services. PMID:26405800

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services.

The volunteer anesthetist: a personal view.

PubMed

Brown, S T

2000-08-01

The most common opportunities for nurse anesthetists to be involved in volunteer anesthesia overseas are usually on a surgical team to provide direct care for selected types of patients or to be involved in teaching local anesthesia providers. The challenges are numerous and unique in each setting. Sharing of knowledge, directly as an instructor or indirectly as a provider, provides for a great impact on health care delivery in many emerging nations. The anesthesia provider who is working to deliver care in another country must consider many variables before taking on such a venture. The type of surgical team or teaching assignment one accepts will determine the type of preparation that must be done before departing. In addition to the many organizational items, one should consider some personal issues as well. Lost wages, transportation costs, and lodging expenses are often paid for by the volunteer. Time away from one's family may also be a consideration. Health care, such as updated immunizations, must be attended to before to departure. Volunteers must be able to provide good care in less than ideal situations, and often with much less equipment and medications than are available in the United States. A review of some of the issues that one should consider before deciding to be a volunteer are outlined in this article. The nurse anesthetist who successfully anticipates and deals with the challenges of volunteer anesthesia will be rewarded with an intense degree of personal satisfaction. The ability to give back to the profession and those who would otherwise not have access to one's skills or knowledge produces a sense of accomplishment that is unique.

A concept for performance management for Federal science programs

USGS Publications Warehouse

Whalen, Kevin G.

2017-11-06

The demonstration of clear linkages between planning, funding, outcomes, and performance management has created unique challenges for U.S. Federal science programs. An approach is presented here that characterizes science program strategic objectives by one of five “activity types”: (1) knowledge discovery, (2) knowledge development and delivery, (3) science support, (4) inventory and monitoring, and (5) knowledge synthesis and assessment. The activity types relate to performance measurement tools for tracking outcomes of research funded under the objective. The result is a multi-time scale, integrated performance measure that tracks individual performance metrics synthetically while also measuring progress toward long-term outcomes. Tracking performance on individual metrics provides explicit linkages to root causes of potentially suboptimal performance and captures both internal and external program drivers, such as customer relations and science support for managers. Functionally connecting strategic planning objectives with performance measurement tools is a practical approach for publicly funded science agencies that links planning, outcomes, and performance management—an enterprise that has created unique challenges for public-sector research and development programs.

A brief introduction to the military workplace culture.

PubMed

Redmond, S A; Wilcox, S L; Campbell, S; Kim, A; Finney, K; Barr, K; Hassan, A M

2015-01-01

Military culture and workplace are areas of interest for researchers across disciplines. However, few publications on military culture exist. The purpose of this article is to introduce general concepts regarding the structure and culture of the United States Military and discuss how this creates challenges for reintegrating into the civilian world. Topics that will be covered in this article include an overview of the Department of Defense (DoD) and Department of Veterans Affairs (VA), socialization to military culture, the unique features of the military as a workplace, the cultural experiences of military personnel reintegrating back into the community, and the challenges faced by military members and their spouses. The provided information on military culture will expand military cultural competency so that civilian employers can enhance their ability to create supportive workplaces for veterans and military spouses during times of transition and reintegration. The unique characteristics of the military culture should be understood by those who work with or plan to work with military populations.

Mapping Multiplex Hubs in Human Functional Brain Networks

PubMed Central

De Domenico, Manlio; Sasai, Shuntaro; Arenas, Alex

2016-01-01

Typical brain networks consist of many peripheral regions and a few highly central ones, i.e., hubs, playing key functional roles in cerebral inter-regional interactions. Studies have shown that networks, obtained from the analysis of specific frequency components of brain activity, present peculiar architectures with unique profiles of region centrality. However, the identification of hubs in networks built from different frequency bands simultaneously is still a challenging problem, remaining largely unexplored. Here we identify each frequency component with one layer of a multiplex network and face this challenge by exploiting the recent advances in the analysis of multiplex topologies. First, we show that each frequency band carries unique topological information, fundamental to accurately model brain functional networks. We then demonstrate that hubs in the multiplex network, in general different from those ones obtained after discarding or aggregating the measured signals as usual, provide a more accurate map of brain's most important functional regions, allowing to distinguish between healthy and schizophrenic populations better than conventional network approaches. PMID:27471443

Consanguinity in Saudi Arabia: a unique opportunity for pediatric kidney research.

PubMed

Kari, Jameela A; Bockenhauer, Detlef; Stanescu, Horia; Gari, Mamdooh; Kleta, Robert; Singh, Ajay K

2014-02-01

Identification of disease-related genes is a critical step in understanding the molecular basis of disease and developing targeted therapies. The genetic study of diseases occurring in the offspring of consanguineous unions is a powerful way to discover new disease genes. Pediatric nephrology provides an excellent example because ∼70% of cases of kidney disease in childhood are congenital with a likely genetic basis. This percentage is likely to be even higher in countries with a high consanguinity rate, such as the Kingdom of Saudi Arabia. However, there are a number of challenges, such as cultural, legal, and religious restrictions, that should be appreciated before carrying out genetic research in a tradition-bound country. In this article, we discuss the background, opportunities, and challenges involved with this unique opportunity to conduct studies of such genetic disorders. Keys to success include collaboration and an understanding of local traditions and laws. Copyright © 2014 National Kidney Foundation, Inc. All rights reserved.

Topical Review: Unique Contributions of Magnetic Resonance Imaging to Pediatric Psychology Research.

PubMed

Jensen, Chad D; Duraccio, Kara M; Carbine, Kaylie M; Kirwan, C Brock

2016-03-01

This review aims to provide a brief introduction of the utility of magnetic resonance imaging (MRI) methods in pediatric psychology research, describe several exemplar studies that highlight the unique benefits of MRI techniques for pediatric psychology research, and detail methods for addressing several challenges inherent to pediatric MRI research. Literature review. Numerous useful applications of MRI research in pediatric psychology have been illustrated in published research. MRI methods yield information that cannot be obtained using neuropsychological or behavioral measures. Using MRI in pediatric psychology research may facilitate examination of neural structures and processes that underlie health behaviors. Challenges inherent to conducting MRI research with pediatric research participants (e.g., head movement) may be addressed using evidence-based strategies. We encourage pediatric psychology researchers to consider adopting MRI techniques to answer research questions relevant to pediatric health and illness. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Unique Funding Opportunity for Public Health in Texas

PubMed Central

Schlenker, Thomas; Huber, Carol A.

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the “Triple Aim” goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation. PMID:25423061

Visualizing the BEC-BCS crossover in a two-dimensional Fermi gas: Pairing gaps and dynamical response functions from ab initio computations

NASA Astrophysics Data System (ADS)

Vitali, Ettore; Shi, Hao; Qin, Mingpu; Zhang, Shiwei

2017-12-01

Experiments with ultracold atoms provide a highly controllable laboratory setting with many unique opportunities for precision exploration of quantum many-body phenomena. The nature of such systems, with strong interaction and quantum entanglement, makes reliable theoretical calculations challenging. Especially difficult are excitation and dynamical properties, which are often the most directly relevant to experiment. We carry out exact numerical calculations, by Monte Carlo sampling of imaginary-time propagation of Slater determinants, to compute the pairing gap in the two-dimensional Fermi gas from first principles. Applying state-of-the-art analytic continuation techniques, we obtain the spectral function and the density and spin structure factors providing unique tools to visualize the BEC-BCS crossover. These quantities will allow for a direct comparison with experiments.

USGS Science: Addressing Our Nation's Challenges

USGS Publications Warehouse

Larson, Tania M.

2009-01-01

With 6.6 billion people already living on Earth, and that number increasing every day, human influence on our planet is ever more apparent. Changes to the natural world combined with increasing human demands threaten our health and safety, our national security, our economy, and our quality of life. As a planet and a Nation, we face unprecedented challenges: loss of critical and unique ecosystems, the effects of climate change, increasing demand for limited energy and mineral resources, increasing vulnerability to natural hazards, the effects of emerging diseases on wildlife and human health, and growing needs for clean water. The time to respond to these challenges is now, but policymakers and decisionmakers face difficult choices. With competing priorities to balance, and potentially serious - perhaps irreversible - consequences at stake, our leaders need reliable scientific information to guide their decisions. As the Nation's earth and natural science agency, the USGS monitors and conducts scientific research on natural hazards and resources and how these elements and human activities influence our environment. Because the challenges we face are complex, the science needed to better understand and deal with these challenges must reflect the complex interplay among natural and human systems. With world-class expertise in biology, geology, geography, hydrology, geospatial information, and remote sensing, the USGS is uniquely capable of conducting the comprehensive scientific research needed to better understand the interdependent interactions of Earth's systems. Every day, the USGS helps decisionmakers to minimize loss of life and property, manage our natural resources, and protect and enhance our quality of life. This brochure provides examples of the challenges we face and how USGS science helps decisionmakers to address these challenges.

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

Neeley, James R.; Jones, James V.; Watson, Michael D.; Bramon, Christopher J.; Inman, Sharon K.; Tuttle, Loraine

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle and is scheduled for its first mission in 2017. The goal of the first mission, which will be uncrewed, is to demonstrate the integrated system performance of the SLS rocket and spacecraft before a crewed flight in 2021. SLS has many of the same logistics challenges as any other large scale program. Common logistics concerns for SLS include integration of discreet programs geographically separated, multiple prime contractors with distinct and different goals, schedule pressures and funding constraints. However, SLS also faces unique challenges. The new program is a confluence of new hardware and heritage, with heritage hardware constituting seventy-five percent of the program. This unique approach to design makes logistics concerns such as commonality especially problematic. Additionally, a very low manifest rate of one flight every four years makes logistics comparatively expensive. That, along with the SLS architecture being developed using a block upgrade evolutionary approach, exacerbates long-range planning for supportability considerations. These common and unique logistics challenges must be clearly identified and tackled to allow SLS to have a successful program. This paper will address the common and unique challenges facing the SLS programs, along with the analysis and decisions the NASA Logistics engineers are making to mitigate the threats posed by each.

A statistical framework for multiparameter analysis at the single-cell level.

PubMed

Torres-García, Wandaliz; Ashili, Shashanka; Kelbauskas, Laimonas; Johnson, Roger H; Zhang, Weiwen; Runger, George C; Meldrum, Deirdre R

2012-03-01

Phenotypic characterization of individual cells provides crucial insights into intercellular heterogeneity and enables access to information that is unavailable from ensemble averaged, bulk cell analyses. Single-cell studies have attracted significant interest in recent years and spurred the development of a variety of commercially available and research-grade technologies. To quantify cell-to-cell variability of cell populations, we have developed an experimental platform for real-time measurements of oxygen consumption (OC) kinetics at the single-cell level. Unique challenges inherent to these single-cell measurements arise, and no existing data analysis methodology is available to address them. Here we present a data processing and analysis method that addresses challenges encountered with this unique type of data in order to extract biologically relevant information. We applied the method to analyze OC profiles obtained with single cells of two different cell lines derived from metaplastic and dysplastic human Barrett's esophageal epithelium. In terms of method development, three main challenges were considered for this heterogeneous dynamic system: (i) high levels of noise, (ii) the lack of a priori knowledge of single-cell dynamics, and (iii) the role of intercellular variability within and across cell types. Several strategies and solutions to address each of these three challenges are presented. The features such as slopes, intercepts, breakpoint or change-point were extracted for every OC profile and compared across individual cells and cell types. The results demonstrated that the extracted features facilitated exposition of subtle differences between individual cells and their responses to cell-cell interactions. With minor modifications, this method can be used to process and analyze data from other acquisition and experimental modalities at the single-cell level, providing a valuable statistical framework for single-cell analysis.

A Case Study of the Approach to Teaching and to Technology of Three New Teachers in an Alternative Teacher Certification Program

ERIC Educational Resources Information Center

O'Connor, Eileen A.

2007-01-01

The Master of Arts in Teaching program at Empire State College, a new alternative teacher certification program focused on bringing career-changing adults to high-needs schools, provides a unique opportunity to understand the challenges facing new teachers, in their content area and in their use of technology. This article describes aspects of…

Cultivating the Understanding of a Catholic University's Mission and the Principles of Catholic Social Teaching through a Faculty Service-Learning Experience

ERIC Educational Resources Information Center

Guiry, Michael

2012-01-01

The challenge for faculty teaching in Catholic business schools is how to integrate the University's mission and identity as well as the principles of Catholic Social Teaching (CST) into business school courses. Such integration is necessary if Catholic business schools are to provide students with a unique educational experience. This article…

The Educational Professional: The Educational Experiences that Enhanced and Impeded the Academic Outcome of Youth in Foster Care

ERIC Educational Resources Information Center

Chisholm, Gloria

2010-01-01

A child in foster care is often categorized as a student at risk for school failure. However, children in foster care face a unique challenge in that most have been involuntarily separated from their biological parent and/or family. The schools must work in collaboration with the child to provide the necessary supports to achieve better…

Livermore Accelerator Source for Radionuclide Science (LASRS)

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

Anderson, Scott; Bleuel, Darren; Johnson, Micah

The Livermore Accelerator Source for Radionuclide Science (LASRS) will generate intense photon and neutron beams to address important gaps in the study of radionuclide science that directly impact Stockpile Stewardship, Nuclear Forensics, and Nuclear Material Detection. The co-location of MeV-scale neutral and photon sources with radiochemical analytics provides a unique facility to meet current and future challenges in nuclear security and nuclear science.

The Value of Clinical Teachers for EMR Implementations and Conversions

PubMed Central

Pantaleoni, J.L.; Longhurst, C.A.

2015-01-01

Summary Effective physician training is an essential aspect of EMR implementation. However, it can be challenging to find instructors who can present the material in a clinically relevant manner. The authors describe a unique physician-training program, utilizing medical students as course instructors. This approach resulted in high learner satisfaction rates and provided significant cost-savings compared to alternative options. PMID:25848414

"It's Not Like a Job Now; It's Part of Me": Exploring African Women's Experiences in the Irish Childcare Sector

ERIC Educational Resources Information Center

Garrity, Sheila; McGrath, Brian

2011-01-01

A small-scale qualitative research study was recently carried out in the West of Ireland to explore the experiences of African childminders who had established new childcare services. The intention of the study was to explore the issues, concerns and challenges of this group of providers given their unique position as recently settled, ethnic…

Cervical cancer data and data systems in limited-resource settings: Challenges and opportunities.

PubMed

Drummond, Jennifer L; Were, Martin C; Arrossi, Silvina; Wools-Kaloustian, Kara

2017-07-01

Appropriate collection and use of health information is critical to the planning, scaling up, and improvement of cervical cancer programs. The health information systems implementation landscape is unique to each country; however, systems serving cervical cancer programs in low-resource settings share characteristics that present common challenges. In response, many programs have taken innovative approaches to generating the quality information needed for decision making. Recent advances in health information technology also provide feasible solutions to challenges. This article draws from the experiences of the authors and from current literature to describe outstanding challenges and promising practices in the implementation of cervical cancer data systems, and to make recommendations for next steps. Recommendations include engaging all stakeholders-including providers, program managers, implementing partners, and donors-in promoting national, district, and community information systems; building on existing systems and processes, as well as introducing new technologies; and evolving data collection and data systems as programs advance. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Future implications of eHealth interventions for chronic pain management in underserved populations.

PubMed

DeMonte, Colette M; DeMonte, William D; Thorn, Beverly E

2015-01-01

Many underserved communities, especially those in rural settings, face unique challenges that make high quality healthcare less accessible. The implementation of eHealth technologies has become a potentially valuable option to disseminate interventions. The authors' work in rural Alabama Federally Qualified Health Centers provide insights into the access to technology as well as the likelihood of utilizing eHealth technology in underserved communities. This paper will review current challenges related to digital dissemination of behavioral health interventions for chronic pain. Two major concerns are the lack of technological resources and the lack of appropriate materials for patients who may have low levels of reading, health and/or digital literacy. We will propose some recommendations to address common barriers faced by those providing care.

Responsibility for quality improvement and patient safety: hospital board and medical staff leadership challenges.

PubMed

Goeschel, Christine A; Wachter, Robert M; Pronovost, Peter J

2010-07-01

Concern about the quality and safety of health care persists, 10 years after the 1999 Institute of Medicine report To Err is Human. Despite growing awareness of quality and safety risks, and significant efforts to improve, progress is difficult to measure. Hospital leaders, including boards and medical staffs, are accountable to improve care, yet they often address this duty independently. Shared responsibility for quality and patient safety improvement presents unique challenges and unprecedented opportunities for boards and medical staffs. To capitalize on the pressure to improve, both groups may benefit from a better understanding of their synergistic potential. Boards should be educated about the quality of care provided in their institutions and about the challenges of valid measurement and accurate reporting. Boards strengthen their quality oversight capacity by recruiting physicians for vacant board seats. Medical staff members strengthen their role as hospital leaders when they understand the unique duties of the governing board. A quality improvement strategy rooted in synergistic efforts by the board and the medical staff may offer the greatest potential for safer care. Such a mutually advantageous approach requires a clear appreciation of roles and responsibilities and respect for differences. In this article, we review these responsibilities, describe opportunities for boards and medical staffs to collaborate as leaders, and offer recommendations for how boards and medical staff members can address the challenges of shared responsibility for quality of care.

Student Service Members/Veterans on Campus: Challenges for Reintegration

PubMed Central

Borsari, Brian; Yurasek, Ali; Miller, Mary Beth; Murphy, James G.; McDevitt-Murphy, Meghan E.; Martens, Matthew P.; Darcy, Monica G.; Carey, Kate B.

2016-01-01

Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a meaningful career and financial stability. Evidence suggests that student service members/Veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts to facilitate their retention and academic performance. With a focus on SSM/Vs attending colleges and universities, we obtained 57 peer-reviewed and 73 grey literature records published between 2001 and 2015. The current SSM/V literature contains an abundance of grey literature, and the empirical research tends to be limited by cross-sectional design and small sample sizes. SSM/Vs encounter significant personal and environmental challenges when transitioning from the military to college campuses. A variety of services have been developed to address the needs of the SSM/V population, but the efficacy of these services remains largely unknown. In conclusion, there is a clear need to provide education to faculty, students and staff regarding the experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engagement in mental health services would also be beneficial, as would improved availability of and SSM/V access to academic support. All future programs designed to address the unique challenges of SSM/Vs in the academic environment should also be systematically implemented and evaluated. PMID:28206804

NordicWelfAir - Understanding the link between Air pollution and Distribution of related Health Impacts and Welfare in the Nordic countries

NASA Astrophysics Data System (ADS)

Brandt, Jørgen

2017-04-01

Air pollution has serious impacts on human health, wellbeing and welfare. The main challenge is to understand how to regulate air pollution in an optimal way both on global and local scales. Linking the detailed information of the spatio-temporal distribution of air pollution levels and the chemical composition of the atmospheric particles with register data for mortality and morbidity, we have a unique opportunity in the Nordic countries to gain new understanding of the various health impacts from different kinds of air pollution from different kind of sources. This will provide the basic understanding needed for policy making of strategies to optimally reduce the air pollution challenge and to assess the related impacts on the distribution of health impacts and related societal costs and welfare. The large interdisciplinary NordicWelfAir project (http://nordicwelfair.au.dk), funded by NordForsk, will take advantage of the unique Nordic data. The results from the project will be used in both a Nordic as well as global perspective to improve the health and welfare by finding the optimal solutions to societal and public health challenges from air pollution through high-quality research. The results from the research in this project have the potential to act as new international standards in our understanding of health impacts from air pollution for different population groups due to the possibility to integrate the unique data and knowledge of air pollution, register, health, socio-economics, and welfare research in the Nordic countries in a highly interdisciplinary project. The study will provide a Nordic contribution to international research on the topics of environmental equality and justice within the area of air quality related risks, amenities and wellbeing. Acknowledgements This project is funded by NordForsk under the Nordic Programme on Health and Welfare. Project #75007: Understanding the link between air pollution and distribution of related health impacts and welfare in the Nordic countries (http://NordicWelfAir.au.dk).

Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

PubMed

Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger

2013-05-01

To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.

Responsibilities of the Occupational and Environmental Medicine Provider in the Treatment and Prevention of Climate Change-Related Health Problems.

PubMed

Perkison, William B; Kearney, Gregory D; Saberi, Pouné; Guidotti, Tee; McCarthy, Ronda; Cook-Shimanek, Margaret; Pensa, Mellisa A; Nabeel, Ismail

2018-02-01

: Workers are uniquely susceptible to the health hazards imposed by environmental changes. Occupational and environmental medicine (OEM) providers are at the forefront of emerging health issues pertaining to working populations including climate change, and must be prepared to recognize, respond to, and mitigate climate change-related health effects in workers. This guidance document from the American College of Occupational and Environmental Medicine focuses on North American workers health effects that may occur as a result of climate change and describes the responsibilities of the OEM provider in responding to these health challenges.

System Definition of the James Webb Space Telescope (JWST) Integrated Science Instrument Module (ISIM)

NASA Technical Reports Server (NTRS)

Lundquist, Ray; Aymergen, Cagatay; VanCampen, Julie; Abell, James; Smith, Miles; Driggers, Phillip

2008-01-01

The Integrated Science Instrument Module (ISIM) for the James Webb Space Telescope (JWST) provides the critical functions and the environment for the four science instruments on JWST. This complex system development across many international organizations presents unique challenges and unique solutions. Here we describe how the requirement flow has been coordinated through the documentation system, how the tools and processes are used to minimize impact to the development of the affected interfaces, how the system design has matured, how the design review process operates, and how the system implementation is managed through reporting to ensure a truly world class scientific instrument compliment is created as the final product.

Barriers to Addressing Adolescent Substance Use: Perceptions of New York School-Based Health Center Providers.

PubMed

Harris, Brett; Shaw, Benjamin; Lawson, Hal; Sherman, Barry

2016-02-01

Adolescent substance use is associated with chronic health conditions, accidents, injury, and school-related problems, including dropping out. Schools have the potential to provide students with substance use prevention and intervention services, albeit with confidentiality challenges. School-based health centers (SBHCs) provide confidentiality, positioning them as ideal settings to provide substance use prevention and intervention. This study identified program directors' and clinicians' barriers to addressing adolescent substance use in SBHCs. Between May and June 2013, an electronic survey was distributed to all 162 New York State SBHC program directors and clinicians serving middle and high school students. The most prevalent perceived barriers to discussing substance use with students were time constraints (43%), the belief that students are not honest about their use (43%), and clinicians' lack of training (28%). Both directors and clinicians identified challenges in getting students to return for additional sessions to address their use, and they also indicated that confidentiality was a treatment referral barrier. This study identified timely opportunities that may be leveraged and unique challenges that may be overcome with targeted dissemination, training, and technical assistance efforts to enable directors and clinicians to routinely address substance use in SBHCs. © 2016, American School Health Association.

Correctional nursing: a study protocol to develop an educational intervention to optimize nursing practice in a unique context.

PubMed

Almost, Joan; Gifford, Wendy A; Doran, Diane; Ogilvie, Linda; Miller, Crystal; Rose, Don N; Squires, Mae

2013-06-21

Nurses are the primary healthcare providers in correctional facilities. A solid knowledge and expertise that includes the use of research evidence in clinical decision making is needed to optimize nursing practice and promote positive health outcomes within these settings. The institutional emphasis on custodial care within a heavily secured, regulated, and punitive environment presents unique contextual challenges for nursing practice. Subsequently, correctional nurses are not always able to obtain training or ongoing education that is required for broad scopes of practice. The purpose of the proposed study is to develop an educational intervention for correctional nurses to support the provision of evidence-informed care. A two-phase mixed methods research design will be used. The setting will be three provincial correctional facilities. Phase one will focus on identifying nurses' scope of practice and practice needs, describing work environment characteristics that support evidence-informed practice and developing the intervention. Semi-structured interviews will be completed with nurses and nurse managers. To facilitate priorities for the intervention, a Delphi process will be used to rank the learning needs identified by participants. Based on findings, an online intervention will be developed. Phase two will involve evaluating the acceptability and feasibility of the intervention to inform a future experimental design. The context of provincial correctional facilities presents unique challenges for nurses' provision of care. This study will generate information to address practice and learning needs specific to correctional nurses. Interventions tailored to barriers and supports within specific contexts are important to enable nurses to provide evidence-informed care.

Economic evaluations of point of care testing strategies for active tuberculosis.

PubMed

Zwerling, Alice; Dowdy, David

2013-06-01

Point of care (POC) diagnostics are often hailed as having the potential to transform tuberculosis (TB) control efforts. However, POC testing is better conceptualized as a system of diagnosis and treatment, not simply a test that can provide rapid, deployable results. Economic evaluations may help decision makers allocate scarce resources for TB control, but evaluations of POC testing face unique challenges that include evaluating the full diagnostic system, incorporating implementation costs, translating diagnostic results into health and accounting for downstream treatment costs. For economic evaluations to reach their full potential as decision-making tools for POC testing in TB, these challenges must be understood and addressed.

Nanotechnology: Opportunities and Challenges

NASA Technical Reports Server (NTRS)

Meyyappan, Meyya

2003-01-01

Nanotechnology seeks to exploit novel physical, chemical, biological, mechanical, electrical, and other properties, which arise primarily due to the nanoscale nature of certain materials. A key example is carbon nanotubes (CNTs) which exhibit unique electrical and extraordinary mechanical properties and offer remarkable potential for revolutionary applications in electronics devices, computing, and data storage technology, sensors, composites, nanoelectromechanical systems (NEMS), and as tip in scanning probe microscopy (SPM) for imaging and nanolithography. Thus the CNT synthesis, characterization, and applications touch upon all disciplines of science and engineering. This presentation will provide an overview and progress report on this and other major research candidates in Nanotechnology and address opportunities and challenges ahead.

Insights from Parents about Caring for a Child with Birth Defects

PubMed Central

Lemacks, Jodi; Fowles, Kristin; Mateus, Amanda; Thomas, Kayte

2013-01-01

Birth defects affect 1 in 33 babies. Having a child with a birth defect impacts the whole family. Parents of children who have birth defects face unique challenges and desire to make life better for their kids. They also want to help to prevent birth defects in the future. Some of the challenges parents face involve communication with healthcare professionals, quality of life issues, creating awareness and advocating for research and funding, finding resources and support, and helping teens transition to appropriate, specialized adult care. This paper addresses these issues and their sub-issues, provides examples, and makes suggestions for improvement and research. PMID:23965922

Bringing Person- and Family-Centred Care Alive in Home, Community and Long-Term Care Organizations.

PubMed

Bender, Danielle; Holyoke, Paul

2016-01-01

It is now more important than ever for person- and family-centred care (PFCC) to be at the forefront of program and service design and delivery; yet, to date, very little guidance is available to assist home, community and long-term care (LTC) organizations to operationalize this concept and overcome inherent challenges. This article provides a list of practical strategies for healthcare leaders to promote and support a culture shift towards PFCC in their organizations and identifies and addresses five common concerns. The unique opportunities and challenges for practicing PFCC in home, community and LTC settings are also discussed.

Monogenic Mouse Models of Autism Spectrum Disorders: Common Mechanisms and Missing Links

PubMed Central

Hulbert, Samuel W.; Jiang, Yong-hui

2016-01-01

Autism Spectrum Disorders (ASDs) present unique challenges in the fields of genetics and neurobiology because of the clinical and molecular heterogeneity underlying these disorders. Genetic mutations found in ASD patients provide opportunities to dissect the molecular and circuit mechanisms underlying autistic behaviors using animal models. Ongoing studies of genetically modified models have offered critical insight into possible common mechanisms arising from different mutations, but links between molecular abnormalities and behavioral phenotypes remain elusive. The challenges encountered in modeling autism in mice demand a new analytic paradigm that integrates behavioral analysis with circuit-level analysis in genetically modified models with strong construct validity. PMID:26733386

A Survey of Routing Protocols in Wireless Body Sensor Networks

PubMed Central

Bangash, Javed Iqbal; Abdullah, Abdul Hanan; Anisi, Mohammad Hossein; Khan, Abdul Waheed

2014-01-01

Wireless Body Sensor Networks (WBSNs) constitute a subset of Wireless Sensor Networks (WSNs) responsible for monitoring vital sign-related data of patients and accordingly route this data towards a sink. In routing sensed data towards sinks, WBSNs face some of the same routing challenges as general WSNs, but the unique requirements of WBSNs impose some more constraints that need to be addressed by the routing mechanisms. This paper identifies various issues and challenges in pursuit of effective routing in WBSNs. Furthermore, it provides a detailed literature review of the various existing routing protocols used in the WBSN domain by discussing their strengths and weaknesses. PMID:24419163

A survey of routing protocols in wireless body sensor networks.

PubMed

Bangash, Javed Iqbal; Abdullah, Abdul Hanan; Anisi, Mohammad Hossein; Khan, Abdul Waheed

2014-01-13

Wireless Body Sensor Networks (WBSNs) constitute a subset of Wireless Sensor Networks (WSNs) responsible for monitoring vital sign-related data of patients and accordingly route this data towards a sink. In routing sensed data towards sinks, WBSNs face some of the same routing challenges as general WSNs, but the unique requirements of WBSNs impose some more constraints that need to be addressed by the routing mechanisms. This paper identifies various issues and challenges in pursuit of effective routing in WBSNs. Furthermore, it provides a detailed literature review of the various existing routing protocols used in the WBSN domain by discussing their strengths and weaknesses.

Addressing challenging behaviour in children with Down syndrome: the use of applied behaviour analysis for assessment and intervention.

PubMed

Feeley, Kathleen M; Jones, Emily A

2006-09-01

Children with Down syndrome are at an increased risk for engaging in challenging behaviour that may be part of a behavioural phenotype characteristic of Down syndrome. The methodology of applied behaviour analysis has been demonstrated effective with a wide range of challenging behaviours, across various disabilities. Applications to children with Down syndrome and the examination of behaviourally based strategies to specifically address the unique characteristics of children with Down syndrome are limited. However, there are several studies in which a subset of the participants did have Down syndrome. A handful of these studies are reviewed within the context of functional behaviour assessment and Positive Behavioural Supports. Drawing from these studies and the behavioural literature, as well as the authors' clinical experience and research, suggestions regarding early intervention for challenging behaviour with children with Down syndrome are provided.

Optical identification using imperfections in 2D materials

NASA Astrophysics Data System (ADS)

Cao, Yameng; Robson, Alexander J.; Alharbi, Abdullah; Roberts, Jonathan; Woodhead, Christopher S.; Noori, Yasir J.; Bernardo-Gavito, Ramón; Shahrjerdi, Davood; Roedig, Utz; Fal'ko, Vladimir I.; Young, Robert J.

2017-12-01

The ability to uniquely identify an object or device is important for authentication. Imperfections, locked into structures during fabrication, can be used to provide a fingerprint that is challenging to reproduce. In this paper, we propose a simple optical technique to read unique information from nanometer-scale defects in 2D materials. Imperfections created during crystal growth or fabrication lead to spatial variations in the bandgap of 2D materials that can be characterized through photoluminescence measurements. We show a simple setup involving an angle-adjustable transmission filter, simple optics and a CCD camera can capture spatially-dependent photoluminescence to produce complex maps of unique information from 2D monolayers. Atomic force microscopy is used to verify the origin of the optical signature measured, demonstrating that it results from nanometer-scale imperfections. This solution to optical identification with 2D materials could be employed as a robust security measure to prevent counterfeiting.

Older Adult Spouses with Multiple Chronic Conditions: Challenges, Rewards, and Coping Strategies.

PubMed

Peacock, Shelley; Sethi, Bharati; Williams, Allison; Duggleby, Wendy; Bayly, Melanie; Swindle, Jenny; Ploeg, Jenny; Markle-Reid, Maureen

2017-06-01

There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne's interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.

DCE-MRI, DW-MRI, and MRS in Cancer: Challenges and Advantages of Implementing Qualitative and Quantitative Multi-parametric Imaging in the Clinic

PubMed Central

Winfield, Jessica M.; Payne, Geoffrey S.; Weller, Alex; deSouza, Nandita M.

2016-01-01

Abstract Multi-parametric magnetic resonance imaging (mpMRI) offers a unique insight into tumor biology by combining functional MRI techniques that inform on cellularity (diffusion-weighted MRI), vascular properties (dynamic contrast-enhanced MRI), and metabolites (magnetic resonance spectroscopy) and has scope to provide valuable information for prognostication and response assessment. Challenges in the application of mpMRI in the clinic include the technical considerations in acquiring good quality functional MRI data, development of robust techniques for analysis, and clinical interpretation of the results. This article summarizes the technical challenges in acquisition and analysis of multi-parametric MRI data before reviewing the key applications of multi-parametric MRI in clinical research and practice. PMID:27748710

Reducing Structural Weight and Increasing Protection in Simple Structures Subjected to Blast Loads

DTIC Science & Technology

2014-08-12

centric vehicle structures that make the operation of the vehicle both comfortable and safe for the soldiers. Furthermore, a lighter weight vehicle...supporting forces. Therefore, a key design challenge is to develop lightweight occupant-centric vehicle structures that can provide high levels of...protection against explosive threats. In this paper, concepts for using materials, damping and other mechanisms to design structures with unique dynamic

Aging in the United States: Opportunities and Challenges for Otolaryngology-Head and Neck Surgery.

PubMed

Chiu, Brandon L; Pinto, Jayant M

2018-05-17

The number of Americans over the age of 65 has been growing much faster than the overall population's growth rate. These changes can be largely attributed to the improvement in life expectancy. This demographic shift yields a unique and exciting opportunity to provide both expedient and cost-efficient care to a growing patient population. Copyright © 2018 Elsevier Inc. All rights reserved.

The rationale for fundamental research in space biology - Introduction and background

NASA Technical Reports Server (NTRS)

Halstead, T. W.; Krauss, R. W.

1992-01-01

An overview is presented of the concept and development of SSF and the unique opportunities offered by SSF to take advantage of the greater space, the increased power, and especially the long duration of the station for a cascade of innovative experiments in fundamental science. It is emphasized that this space environment will provide new dimensions for approaching some of the most challenging problems still facing modern biology.

Understanding the Experiences and Needs of South Asian Families Caring for a Child with Learning Disabilities in the United Kingdom: An Experiential-Contextual Framework

ERIC Educational Resources Information Center

Heer, Kuljit; Rose, John; Larkin, Michael

2012-01-01

The prevalence of learning disabilities amongst South Asian communities in the United Kingdom is thought to be almost three times higher than in any other community. Despite this, service utilisation amongst this group remains low and working cross-culturally can pose unique challenges for service providers. The experiences of South Asian families…

Tribometer for Ultra-Harsh Environments

DTIC Science & Technology

2006-05-01

of this cermet (oxide and metal) provide unique opportunity and challenges and thus was selected as a material to test the tribometer. The...NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON a . REPORT b. ABSTRACT c. THIS PAGE 17. LIMITATION OF ABSTRACT Standard Form 298...Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a

Orthostatic hypotension: pathophysiology, assessment, treatment and the paradox of supine hypertension.

PubMed

Chisholm, Peter; Anpalahan, Mahesan

2017-04-01

Both hypertension and orthostatic hypotension (OH) are strongly age-associated and are common management problems in older people. However, unlike hypertension, management of OH has unique challenges with few well-established treatments. Not infrequently, they both coexist, further compounding the management. This review provides comprehensive information on OH, including pathophysiology, diagnostic workup and treatment, with a view to provide a practical guide to its management. Special references are made to patients with supine hypertension and postprandial hypotension and older hypertensive patients. © 2016 Royal Australasian College of Physicians.

Assessment of Ethanol Trends on the ISS

NASA Technical Reports Server (NTRS)

Perry, Jay; Carter, Layne; Kayatin, Matthew; Gazda, Daniel; McCoy, Torin; Limero, Thomas

2016-01-01

The International Space Station (ISS) Environmental Control and Life Support System (ECLSS) provides a working environment for six crewmembers through atmosphere revitalization and water recovery systems. In the last year, elevated ethanol levels have presented a unique challenge for the ISS ECLSS. Ethanol is monitored on the ISS by the Air Quality Monitor (AQM). The source of this increase is currently unknown. This paper documents the credible sources for the increased ethanol concentration, the monitoring provided by the AQM, and the impact on the atmosphere revitalization and water recovery systems.

Virtual reality in medical education and assessment

NASA Technical Reports Server (NTRS)

Sprague, Laurie A.; Bell, Brad; Sullivan, Tim; Voss, Mark; Payer, Andrew F.; Goza, Stewart Michael

1994-01-01

The NASA Johnson Space Center (JSC)/LinCom Corporation, the University of Texas Medical Branch at Galveston (UTMB), and the Galveston Independent School District (GISD) have teamed up to develop a virtual visual environment display (VIVED) that provides a unique educational experience using virtual reality (VR) technologies. The VIVED end product will be a self-contained educational experience allowing students a new method of learning as they interact with the subject matter through VR. This type of interface is intuitive and utilizes spatial and psychomotor abilities which are now constrained or reduced by the current two dimensional terminals and keyboards. The perpetual challenge to educators remains the identification and development of methodologies which conform the learners abilities and preferences. The unique aspects of VR provide an opportunity to explore a new educational experience. Endowing medical students with an understanding of the human body poses some difficulty challenges. One of the most difficult is to convey the three dimensional nature of anatomical structures. The ideal environment for addressing this problem would be one that allows students to become small enough to enter the body and travel through it - much like a person walks through a building. By using VR technology, this effect can be achieved; when VR is combined with multimedia technologies, the effect can be spectacular.

Utilization of targeted near-infrared molecular imaging to improve pulmonary metastasectomy of osteosarcomas

NASA Astrophysics Data System (ADS)

Predina, Jarrod D.; Newton, Andrew; Deshpande, Charuhas; Low, Philip; Singhal, Sunil

2018-01-01

Pulmonary metastasectomy for osteosarcoma provides a select group of patients an opportunity for long-term survival and possible cure. Unfortunately, a complete metastasectomy is challenging due an inability to accurately identify lesions that lay below the threshold of preoperative imaging or intraoperative visual and tactile inspection. Growing evidence suggests that osteosarcomas express a number of unique molecular markers, including the folate receptor alpha. In this case report, we describe the application of a folate receptor-targeted, near-infrared optical contrast agent (OTL38) to improve osteosarcoma localization during minimally invasive pulmonary resection. In addition to localizing preoperatively identified lesions, this technology helped identify additional disease that was undetected on preoperative imaging or with traditional intraoperative techniques. This report marks the first successful utilization of a molecular imaging probe useful for osteosarcomas. This technology may provide a unique approach to improve pulmonary metastasectomy of osteosarcomas.

Stretchable silicon nanoribbon electronics for skin prosthesis.

PubMed

Kim, Jaemin; Lee, Mincheol; Shim, Hyung Joon; Ghaffari, Roozbeh; Cho, Hye Rim; Son, Donghee; Jung, Yei Hwan; Soh, Min; Choi, Changsoon; Jung, Sungmook; Chu, Kon; Jeon, Daejong; Lee, Soon-Tae; Kim, Ji Hoon; Choi, Seung Hong; Hyeon, Taeghwan; Kim, Dae-Hyeong

2014-12-09

Sensory receptors in human skin transmit a wealth of tactile and thermal signals from external environments to the brain. Despite advances in our understanding of mechano- and thermosensation, replication of these unique sensory characteristics in artificial skin and prosthetics remains challenging. Recent efforts to develop smart prosthetics, which exploit rigid and/or semi-flexible pressure, strain and temperature sensors, provide promising routes for sensor-laden bionic systems, but with limited stretchability, detection range and spatio-temporal resolution. Here we demonstrate smart prosthetic skin instrumented with ultrathin, single crystalline silicon nanoribbon strain, pressure and temperature sensor arrays as well as associated humidity sensors, electroresistive heaters and stretchable multi-electrode arrays for nerve stimulation. This collection of stretchable sensors and actuators facilitate highly localized mechanical and thermal skin-like perception in response to external stimuli, thus providing unique opportunities for emerging classes of prostheses and peripheral nervous system interface technologies.

Bringing nanomedicines to market: regulatory challenges, opportunities, and uncertainties.

PubMed

Nijhara, Ruchika; Balakrishnan, Krishna

2006-06-01

Scientists and entrepreneurs who contemplate developing nanomedicine products face several unique challenges in addition to many of the traditional hurdles of product development. In this review we analyze the major physicochemical, biologic and functional characteristics of several nanomedicine products on the market and explore the question of what made them unique. What made them successful? We also focus on the regulatory challenges faced by nanomedicine product developers. Based on these analyses, we propose the factors that are most likely to contribute to the success of nanomedicine products.

Challenges in international medicine: ethical dilemmas, unanticipated consequences, and accepting limitations.

PubMed

Iserson, Kenneth V; Biros, Michelle H; James Holliman, C

2012-06-01

While personal and organizational challenges occur in every area of health care, practitioners of international medicine face unique problems and dilemmas that are rarely discussed in training programs. Health professions schools, residency and fellowship programs, nongovernmental organizations (NGOs), and government programs have a responsibility to make those new to international medicine aware of the special circumstances that they may face and to provide methods for understanding and dealing with these circumstances. Standard "domestic" approaches to such challenges may not work in international medicine, even though these challenges may appear to be similar to those faced in other clinical settings. How should organizations ensure that well-meaning health intervention efforts do not cause adverse unintended sequelae? How should an individual balance respect for cultural uniqueness and local mores that may profoundly differ from his or her own beliefs, with the need to remain a moral agent true to one's self? When is acceptance the appropriate response to situations in which limitations of resources seem to preclude any good solution? Using a case-based approach, the authors discuss issues related to the four major international medicine domains: clinical practice (postdisaster response, resource limitations, standards of care), medical systems and systems development (prehospital care, wartime casualties, sustainable change, cultural awareness), teaching (instruction and local resources, professional preparation), and research (questionable funded studies, clinical trials, observational studies). It is hoped that this overview may help prepare those involved with international medicine for the challenges and dilemmas they may face and help frame their responses to these situations. © 2012 by the Society for Academic Emergency Medicine.

Extended-Range Forecasts at Climate Prediction Center: Current Status and Future Plans

NASA Astrophysics Data System (ADS)

Kumar, A.

2016-12-01

Motivated by a user need to provide forecast information on extended-range time-scales (i.e., weeks 2-4), in recent years Climate Prediction Center (CPC) has made considerable efforts towards developing and testing the feasibility for developing the required forecasts. The forecasts targeting this particular time-scale face a unique challenge in that while the forecast skill due to atmospheric initial conditions is small (because of rapid decay in the memory associated with the atmospheric initial conditions), short time averages for which forecasts are made do not benefit from skill associated with anomalous boundary conditions either. Despite these challenges, CPC has embarked on providing an experimental outlook for weeks 3-4 average. The talk will summarize the current status of CPC's current suite of extended-range forecast products, and further, will discuss some future plans.

Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One.

PubMed

Castelli Dransart, Dolores Angela

2017-06-01

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.

Atypical Dopamine Uptake Inhibitors that Provide Clues About Cocaine's Mechanism at the Dopamine Transporter

NASA Astrophysics Data System (ADS)

Hauck Newman, Amy; Katz, Jonathan L.

The dopamine transporter (DAT) has been a primary target for cocaine abuse/addiction medication discovery. However predicted addiction liability and limited clinical evaluation has provided a formidable challenge for development of these agents for human use. The unique and atypical pharmacological profile of the benztropine (BZT) class of dopamine uptake inhibitors, in preclinical models of cocaine effects and abuse, has encouraged further development of these agents. Moreover, in vivo studies have challenged the original DAT hypothesis and demonstrated that DAT occupancy and subsequent increases in dopamine produced by BZT analogues are significantly delayed and long lasting, as compared to cocaine. These important and distinctive elements are critical to the lack of abuse liability among BZT analogues, and improve their potential for development as treatments for cocaine abuse and possibly other neuropsychiatric disorders.

The Electric Power System of the International Space Station: A Platform for Power Technology Development

NASA Technical Reports Server (NTRS)

Gietl, Eric B.; Gholdston, Edward W.; Manners, Bruce A.; Delventhal, Rex A.

2000-01-01

The electrical power system developed for the International Space Station represents the largest space-based power system ever designed and, consequently, has driven some key technology aspects and operational challenges. The full U.S.-built system consists of a 160-Volt dc primary network, and a more tightly regulated 120-Volt dc secondary network. Additionally, the U.S. system interfaces with the 28-Volt system in the Russian segment. The international nature of the Station has resulted in modular converters, switchgear, outlet panels, and other components being built by different countries, with the associated interface challenges. This paper provides details of the architecture and unique hardware developed for the Space Station, and examines the opportunities it provides for further long-term space power technology development, such as concentrating solar arrays and flywheel energy storage systems.

Moral experience and ethical challenges in an emergency department in Pakistan: emergency physicians' perspectives.

PubMed

Zafar, Waleed

2015-04-01

Emergency departments (ED) are often stressful environments posing unique ethical challenges-issues that primarily raise moral rather than clinical concerns-in patient care. Despite this, there are very few reports of what emergency physicians find ethically challenging in their everyday work. Emergency medicine (EM) is a relatively young but rapidly growing specialty that is gaining acceptance worldwide. The aim of this study was to explore the perspectives of EM residents and physicians regarding the common ethical challenges they face during patient care in one of only two academic EM departments in Pakistan. These challenges could then be addressed in residents' training and departmental practice guidelines. A qualitative research design was employed and in-depth interviews were conducted with ED physicians. Participants were encouraged to think of specific examples from their work, to highlight the particular ethical concerns raised and to describe in detail the process by which those concerns were addressed or left unresolved. Transcripts were analysed using grounded theory methods. Thirteen participants were interviewed and they described four key challenges: how to provide highest quality care with limited resources; how to be truthful to patients; what to do when it is not possible to provide or continue treatment to patients; and when (and when not) to offer life-sustaining treatments. Participants' accounts provided important insights into how physicians tried to resolve these challenges in the 'local moral world' of an ED in Pakistan. The study highlights the need for developing systematic and contextually appropriate mechanisms for resolving common ethical challenges in the EDs and for training residents in moral problem solving. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Probability and surprisal in auditory comprehension of morphologically complex words.

PubMed

Balling, Laura Winther; Baayen, R Harald

2012-10-01

Two auditory lexical decision experiments document for morphologically complex words two points at which the probability of a target word given the evidence shifts dramatically. The first point is reached when morphologically unrelated competitors are no longer compatible with the evidence. Adapting terminology from Marslen-Wilson (1984), we refer to this as the word's initial uniqueness point (UP1). The second point is the complex uniqueness point (CUP) introduced by Balling and Baayen (2008), at which morphologically related competitors become incompatible with the input. Later initial as well as complex uniqueness points predict longer response latencies. We argue that the effects of these uniqueness points arise due to the large surprisal (Levy, 2008) carried by the phonemes at these uniqueness points, and provide independent evidence that how cumulative surprisal builds up in the course of the word co-determines response latencies. The presence of effects of surprisal, both at the initial uniqueness point of complex words, and cumulatively throughout the word, challenges the Shortlist B model of Norris and McQueen (2008), and suggests that a Bayesian approach to auditory comprehension requires complementation from information theory in order to do justice to the cognitive cost of updating probability distributions over lexical candidates. Copyright © 2012 Elsevier B.V. All rights reserved.

Manufacturing and metrology for IR conformal windows and domes

NASA Astrophysics Data System (ADS)

Ferralli, Ian; Blalock, Todd; Brunelle, Matt; Lynch, Timothy; Myer, Brian; Medicus, Kate

2017-05-01

Freeform and conformal optics have the potential to dramatically improve optical systems by enabling systems with fewer optical components, reduced aberrations, and improved aerodynamic performance. These optical components differ from standard components in their surface shape, typically a non-symmetric equation based definition, and material properties. Traditional grinding and polishing tools are unable to handle these freeform shapes. Additionally, standard metrology tools cannot measure these surfaces. Desired substrates are typically hard ceramics, including poly-crystalline alumina or aluminum oxynitride. Notwithstanding the challenges that the hardness provides to manufacturing, these crystalline materials can be highly susceptible to grain decoration creating unacceptable scatter in optical systems. In this presentation, we will show progress towards addressing the unique challenges of manufacturing conformal windows and domes. Particular attention is given to our robotic polishing platform. This platform is based on an industrial robot adapted to accept a wide range of tooling and parts. The robot's flexibility has provided us an opportunity to address the unique challenges of conformal windows. Slurries and polishing active layers can easily be changed to adapt to varying materials and address grain decoration. We have the flexibility to change tool size and shape to address the varying sizes and shapes of conformal optics. In addition, the robotic platform can be a base for a deflectometry-based metrology tool to measure surface form error. This system, whose precision is independent of the robot's positioning accuracy, will allow us to measure optics in-situ saving time and reducing part risk. In conclusion, we will show examples of the conformal windows manufactured using our developed processes.

The Challenges of Career and Technical Education Concurrent Enrollment: An Administrative Perspective

ERIC Educational Resources Information Center

Haag, Patricia W.

2015-01-01

Career and technical education concurrent enrollment may pose unique challenges in programming and enrollment for program administrators, and this chapter describes the experiences and challenges of a CTE concurrent enrollment administrator.

Motivational and psychological correlates of bodybuilding dependence

PubMed Central

EMINI, NEIM N.; BOND, MALCOLM J.

2014-01-01

Abstract Background and aims: Exercise may become physically and psychologically maladaptive if taken to extremes. One example is the dependence reported by some individuals who engage in weight training. The current study explored potential psychological, motivational, emotional and behavioural concomitants of bodybuilding dependence, with a particular focus on motives for weight training. Using a path analysis paradigm, putative causal models sought to explain associations among key study variables. Methods: A convenience sample of 101 men aged between 18 and 67 years was assembled from gymnasia in Adelaide, South Australia. Active weight trainers voluntarily completed a questionnaire that included measures of bodybuilding dependence (social dependency, training dependency, and mastery), anger, hostility and aggression, stress and motivations for weight training. Results: Three motives for weight training were identified: mood control, physique anxiety and personal challenge. Of these, personal challenge and mood control were the most directly salient to dependence. Social dependency was particularly relevant to personal challenge, whereas training dependency was associated with both personal challenge and mood control. Mastery demonstrated a direct link with physique anxiety, thus reflecting a unique component of exercise dependence. Conclusions: While it was not possible to determine causality with the available data, the joint roles of variables that influence, or are influenced by, bodybuilding dependence are identified. Results highlight unique motivations for bodybuilding and suggest that dependence could be a result of, and way of coping with, stress manifesting as aggression. A potential framework for future research is provided through the demonstration of plausible causal linkages among these variables. PMID:25317342

Motivational and psychological correlates of bodybuilding dependence.

PubMed

Emini, Neim N; Bond, Malcolm J

2014-09-01

Exercise may become physically and psychologically maladaptive if taken to extremes. One example is the dependence reported by some individuals who engage in weight training. The current study explored potential psychological, motivational, emotional and behavioural concomitants of bodybuilding dependence, with a particular focus on motives for weight training. Using a path analysis paradigm, putative causal models sought to explain associations among key study variables. A convenience sample of 101 men aged between 18 and 67 years was assembled from gymnasia in Adelaide, South Australia. Active weight trainers voluntarily completed a questionnaire that included measures of bodybuilding dependence (social dependency, training dependency, and mastery), anger, hostility and aggression, stress and motivations for weight training. Three motives for weight training were identified: mood control, physique anxiety and personal challenge. Of these, personal challenge and mood control were the most directly salient to dependence. Social dependency was particularly relevant to personal challenge, whereas training dependency was associated with both personal challenge and mood control. Mastery demonstrated a direct link with physique anxiety, thus reflecting a unique component of exercise dependence. While it was not possible to determine causality with the available data, the joint roles of variables that influence, or are influenced by, bodybuilding dependence are identified. RESULTS highlight unique motivations for bodybuilding and suggest that dependence could be a result of, and way of coping with, stress manifesting as aggression. A potential framework for future research is provided through the demonstration of plausible causal linkages among these variables.

Student service members/veterans on campus: Challenges for reintegration.

PubMed

Borsari, Brian; Yurasek, Ali; Miller, Mary Beth; Murphy, James G; McDevitt-Murphy, Meghan E; Martens, Matthew P; Darcy, Monica G; Carey, Kate B

2017-01-01

Many returning OIF/OEF/OND Veterans are seeking higher education in an effort to develop a meaningful career and financial stability. Evidence suggests that student service members/veterans (SSM/Vs) are experiencing less academic success than other students. The purpose of this review is to identify the unique challenges of SSM/Vs and evaluate current campus efforts to facilitate their retention and academic performance. With a focus on SSM/Vs attending colleges and universities, we obtained 57 peer-reviewed and 73 gray literature records published between 2001 and 2015. The current SSM/V literature contains an abundance of gray literature, and the empirical research tends to be limited by cross-sectional design and small sample sizes. SSM/Vs encounter significant personal and environmental challenges when transitioning from the military to college campuses. A variety of services have been developed to address the needs of the SSM/V population, but the efficacy of these services remains largely unknown. In conclusion, there is a clear need to provide education to faculty, students, and staff regarding the experiences of SSM/Vs. Efforts to enhance screening for, availability of, and SSM/V engagement in mental health services would also be beneficial, as would improved availability of and SSM/V access to academic support. All future programs designed to address the unique challenges of SSM/Vs in the academic environment should also be systematically implemented and evaluated. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Constructibility Challenges for Perimeter Control Blasting and Slope Development in Shale and Other "Weak" Rocks

NASA Astrophysics Data System (ADS)

Scarpato, D. J.

2016-02-01

Slope construction in shale can present some interesting challenges for geotechnical design engineers and contractors alike. There are challenges that can be expected and designed for; however, all too frequently, such challenges manifest themselves as "surprises" in the field. Common constructibility challenges can include drill hole deviation during drilling for controlled blasting; and, excavation slope instability arising from inconsistent perimeter control drilling. Drill hole deviation results from the cumulative effects from both drilling mechanics and rock mass conditions. Once a hole has initiated the deviation trajectory, it is difficult to rectify drill steel position. Although such challenges are not necessarily unique to shale, they are often exacerbated by weak, weathered and transversely isotropic nature of bedrock conditions. All too often, the working assumption is that shale is "soft" and easily excavatable; however, this blanket assumption can prove to be costly. This paper is intended to provide design professionals and contractors with the practical considerations needed to avoid the "surprises" associated with drill hole deviation, and minimize the potential for costly claims.

Biopsychosocial Challenges and Needs of Young African American Women with Triple-Negative Breast Cancer.

PubMed

Bollinger, Sarah

2018-05-01

Triple-negative breast cancer (TNBC) is a subtype of breast cancer known to have poorer prognoses and lower survival rates compared with other types of breast cancer. In addition, TNBC is overrepresented in premenopausal African American women. Using grounded theory as the qualitative methodological approach, the present article elucidates unique biopsychosocial challenges and needs of young African American women with TNBC. A study group of six women with TNBC and a comparison group of six women with estrogen receptor-positive breast cancer were interviewed longitudinally over three time points throughout the cancer treatment trajectory. Major themes that were unique to the study group of women with TNBC include (a) longer, more aggressive treatment trajectories; (b) more difficult struggles with feminine identity; (c) the presence of fertility and parenting issues; (d) higher burdens of care; (e) barriers to separation and individuation as a maturation milestone; and (f) feeling out of place compared with peers. These themes provide a foundation to inform how social workers care for this underserved group of women.

Ground test challenges in the development of the Space Shuttle orbiter auxiliary power unit

NASA Technical Reports Server (NTRS)

Chaffee, N. H.; Lance, R. J.; Weary, D. P.

1984-01-01

A conventional aircraft hydraulic system design approach was selected to provide fluid power for the Space Shuttle Orbiter. Developing the power unit, known as the Auxiliary Power Unit (APU), to drive the hydraulic pumps presented a major technological challenge. A small, high speed turbine drive unit powered by catalytically decomposed hydrazine and operating in the pulse mode was selected to meet the requirement. Because of limitations of vendor test facilities, significant portions of the development, flight qualification, and postflight anomaly testing of the Orbiter APU were accomplished at the Johnson Space Center (JSC) test facilities. This paper discusses the unique requirements of attitude, gravity forces, pressure profiles, and thermal environments which had to be satisfied by the APU, and presents the unique test facility and simulation techniques employed to meet the ground test requirements. In particular, the development of the zero-g lubrication system, the development of necessary APU thermal control techniques, the accomplishment of integrated systems tests, and the postflight investigation of the APU lube oil cooler behavior are discussed.

Quality, Safety and Patient Centered Care--A Dream Come True in the Mountains of Northern Pakistan. An Award winning project of "2015 Quality, Safety & Patient Centered Care Award" at, Chicago USA.

PubMed

Jassani, Kashif; Essani, Rozina Roshan; Abbas, Syed Nadeem Husain

2016-01-01

Northern Pakistan remains very challenging terrain due to harsh weather all year round presenting an infrastructura, human resource and supply chain challenge of its own. Many times the facility had to move to different locations on emergency and ad hoc basis due to landslides, earthquakes affecting continuity of care. Providing quality healthcare to often resource constraint hard-to-reach areas has always been AKHS,P's unique forte. Breaking barriers for catchment population to access quality healthcare, AKHS,P embarked on an initiative of implementing, achieving and sustaining ISO 9001:2008 Quality Management System international standards certification. This article shares the unique experience of AKHS,P in achieving and sustaining ISO 9001:2008 International Quality Management System Certification. After untiring efforts and the hard work of ground staff; AKHS,P achieved ISO 9001:2008 International Quality Management System Certification as well as 1st Surveillance Audit which itself proved that AKHS,P sustained quality systems and ensured continuous quality improvement in the Mountains of Northern Pakistan.

The Need for an Aerospace Pharmacy Residency

NASA Technical Reports Server (NTRS)

Bayuse, T.; Schuyler, C.; Bayuse, Tina M.

2007-01-01

This viewgraph poster presentation reviews the rationale for a call for a new program in residency for aerospace pharmacy. Aerospace medicine provides a unique twist on traditional medicine, and a specialty has evolved to meet the training for physicians, and it is becoming important to develop such a program for training in pharmacy designed for aerospace. The reasons for this specialist training are outlined and the challenges of developing a program are reviewed.

Developing a Cognitive Model of Expert Performance for Ship Navigation Maneuvers in an Intelligent Tutoring System

DTIC Science & Technology

2010-03-01

nature of ship navigation and the requirements for the intelligent tutor presented unique challenges for development. This paper describes how the...the context of improving training. 1. Project Overview The Conning Officer Virtual Environment (COVE) is a ship-handling simulation system used...Corporation, 2009), is used to provide students with ship-handling training without the cost or risk to equipment of at-sea exercises. One downside

Dental Calculus and the Evolution of the Human Oral Microbiome.

PubMed

Warinner, Christina

2016-07-01

Characterizing the evolution of the oral microbiome is a challenging, but increasingly feasible, task. Recently, dental calculus has been shown to preserve ancient biomolecules from the oral microbiota, host tissues and diet for tens of thousands of years. As such, it provides a unique window into the ancestral oral microbiome. This article reviews recent advancements in ancient dental calculus research and emerging insights into the evolution and ecology of the human oral microbiome.

To friend or not to friend: the use of social media in clinical oncology.

PubMed

Wiener, Lori; Crum, Caroline; Grady, Christine; Merchant, Melinda

2012-03-01

Online social networking has replaced more traditional methods of personal and professional communication in many segments of society today. The wide reach and immediacy of social media facilitate dissemination of knowledge in advocacy and cancer education, but the usefulness of social media in personal relationships between patients and providers is still unclear. Although professional guidelines regarding e-mail communication may be relevant to social media, the inherent openness in social networks creates potential boundary and privacy issues in the provider-patient context. This commentary seeks to increase provider awareness of unique issues and challenges raised by the integration of social networking into oncology communications.

Multispectral and hyperspectral advanced characterization of soldier's camouflage equipment

NASA Astrophysics Data System (ADS)

Farley, Vincent; Kastek, Mariusz; Chamberland, Martin; PiÄ tkowski, Tadeusz; Lagueux, Philippe; Dulski, Rafał; Trzaskawka, Piotr

2013-05-01

The requirements for soldier camouflage in the context of modern warfare are becoming more complex and challenging given the emergence of novel infrared sensors. There is a pressing need for the development of adapted fabrics and soldier camouflage devices to provide efficient camouflage in both the visible and infrared spectral ranges. The Military University of Technology has conducted an intensive project to develop new materials and fabrics to further improve the camouflage efficiency of soldiers. The developed materials shall feature visible and infrared properties that make these unique and adapted to various military context needs. This paper presents the details of an advanced measurement campaign of those unique materials where the correlation between multispectral and hyperspectral infrared measurements is performed.

Multispectral and hyperspectral advanced characterization of soldier's camouflage equipment

NASA Astrophysics Data System (ADS)

Lagueux, Philippe; Kastek, Mariusz; Chamberland, Martin; PiÄ tkowski, Tadeusz; Farley, Vincent; Dulski, Rafał; Trzaskawka, Piotr

2013-10-01

The requirements for soldier camouflage in the context of modern warfare are becoming more complex and challenging given the emergence of novel infrared sensors. There is a pressing need for the development of adapted fabrics and soldier camouflage devices to provide efficient camouflage in both the visible and infrared spectral ranges. The Military University of Technology has conducted an intensive project to develop new materials and fabrics to further improve the camouflage efficiency of soldiers. The developed materials shall feature visible and infrared properties that make these unique and adapted to various military context needs. This paper presents the details of an advanced measurement campaign of those unique materials where the correlation between multispectral and hyperspectral infrared measurements is performed.

Tendon Tissue Engineering: Progress, Challenges, and Translation to the Clinic

PubMed Central

Shearn, Jason T.; Kinneberg, Kirsten R.C.; Dyment, Nathaniel A.; Galloway, Marc T.; Kenter, Keith; Wylie, Christopher; Butler, David L.

2013-01-01

The tissue engineering field has made great strides in understanding how different aspects of tissue engineered constructs (TECs) and the culture process affect final tendon repair. However, there remain significant challenges in developing strategies that will lead to a clinically effective and commercially successful product. In an effort to increase repair quality, a better understanding of normal development, and how it differs from adult tendon healing, may provide strategies to improve tissue engineering. As tendon tissue engineering continues to improve, the field needs to employ more clinically relevant models of tendon injury such as degenerative tendons. We need to translate successes to larger animal models to begin exploring the clinical implications of our treatments. By advancing the models used to validate our TECs, we can help convince our toughest customer, the surgeon, that our products will be clinically efficacious. As we address these challenges in musculoskeletal tissue engineering, the field still needs to address the commercialization of products developed in the laboratory. TEC commercialization faces numerous challenges because each injury and patient is unique. This review aims to provide tissue engineers with a summary of important issues related to engineering tendon repairs and potential strategies for producing clinically successful products. PMID:21625053

Physics, Physicists and Revolutionary Capabilities for the Intelligence Community

NASA Astrophysics Data System (ADS)

Porter, Lisa

2009-05-01

Over the past several decades, physicists have made seminal contributions to technological capabilities that have enabled the U.S. intelligence community to provide unexpected and unparalleled information to our nation's decision makers and help dispel the cloud of uncertainty they face in dealing with crises and challenges around the world. As we look to the future, we recognize that the ever-quickening pace of changes in the world and the threats we must confront demand continued innovation and improvement in the capabilities needed to provide the information on which our leaders depend. This talk will focus on some of the major technological challenges that the intelligence community faces in the coming years, and the many ways that physicists can help to overcome those challenges. The potential impact of physicists on the future capabilities of the US intelligence community is huge. In addition to the more obvious and direct impact through research in areas ranging from novel sensors to quantum information science, the unique approach physicists bring to a problem can also have an indirect but important effect by influencing how challenges in areas ranging from cybersecurity to advanced analytics are approached and solved. Several examples will be given.

The logistics of an inpatient dermatology service.

PubMed

Rosenbach, Misha

2017-03-01

Inpatient dermatology represents a unique challenge as caring for hospitalized patients with skin conditions is different from most dermatologists' daily outpatient practice. Declining rates of inpatient dermatology participation are often attributed to a number of factors, including challenges navigating the administrative burdens of hospital credentialing, acclimating to different hospital systems involving potential alternate electronic medical records systems, medical-legal concerns, and reimbursement concerns. This article aims to provide basic guidelines to help dermatologists establish a presence as a consulting physician in the inpatient hospital-based setting. The emphasis is on identifying potential pitfalls, problematic areas, and laying out strategies for tackling some of the challenges of inpatient dermatology including balancing financial concerns and optimizing reimbursements, tracking data and developing a plan for academic productivity, optimizing workflow, and identifying metrics to document the impact of an inpatient dermatology consult service. ©2017 Frontline Medical Communications.

Financial stability in biobanking: unique challenges for disease-focused foundations and patient advocacy organizations.

PubMed

Bromley, Russell L

2014-10-01

In the last decade, many disease-focused foundations and patient advocacy organizations that support biomedical research have created patient registries and biobanks. This article reviews the motivations behind the creation of those biobanks and how they are different from biobanks sponsored by government or industry. It also discusses some of the different funding models being employed by these organizations. Finally, it highlights some of the unique challenges faced by disease-focused foundations and advocacy organizations that sponsor biobanks, and how they are overcoming those challenges to achieve both financial and operational sustainability.

Programmatic and economic challenges for commercial space processing

NASA Astrophysics Data System (ADS)

Overfelt, Tony; Watkins, John

1997-01-01

The International Space Station is the largest cooperative space project in history and is likely to be industry's most viable access to the low-g environment for long duration materials processing experiments. Such access will provide unique and competitive research capabilities to industry if private sector entities can commercially utilize the Space Station for their industrial projects. Although ``commercial utilization'' implies a variety of things to different people, the key industrial issues are frequent, reliable, and economical access to space as well as protection of private sector intellectual property rights. This paper discusses how these key issues will influence the programmatic and economic challenges for commercial space processing in the future Space Station era.

Meeting the challenge of interpretation: Hearing the voices of people with intellectual and developmental disability through I-Poems.

PubMed

Corby, Deirdre; Taggart, Laurence; Cousins, Wendy

2018-06-01

Including the inner perspectives of people who have intellectual disability can pose methodological challenges to qualitative researchers. This article explains how the Listening Guide was applied as an additional step in the analysis during a study which used hermeneutic interviews with people with intellectual disability as the sole method of data collection. An argument is made for the systematic application of the guide with a focus on the use of I-Poems. This article advances qualitative methodological approaches and concludes that this method of drawing attention to the participants' own voices provides a unique basis for interpreting interviews and tasks researchers to examine the use of the Listening Guide.

Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges.

PubMed

Mustafa, Reem A; Wiercioch, Wojtek; Cheung, Adrienne; Prediger, Barbara; Brozek, Jan; Bossuyt, Patrick; Garg, Amit X; Lelgemann, Monika; Büehler, Diedrich; Schünemann, Holger J

2017-12-01

In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

Transition of Suomi National Polar-Orbiting Partnership (S-NPP) Data Products for Operational Weather Forecasting Applications

NASA Technical Reports Server (NTRS)

Smith, Matthew R.; Molthan, Andrew L.; Fuell, Kevin K.; Jedlovec, Gary J.

2012-01-01

SPoRT is a team of NASA/NOAA scientists focused on demonstrating the utility of NASA and future NOAA data and derived products on improving short-term weather forecasts. Work collaboratively with a suite of unique products and selected WFOs in an end-to-end transition activity. Stable funding from NASA and NOAA. Recognized by the science community as the "go to" place for transitioning experimental and research data to the operational weather community. Endorsed by NWS ESSD/SSD chiefs. Proven paradigm for transitioning satellite observations and modeling capabilities to operations (R2O). SPoRT s transition of NASA satellite instruments provides unique or higher resolution data products to complement the baseline suite of geostationary data available to forecasters. SPoRT s partnership with NWS WFOs provides them with unique imagery to support disaster response and local forecast challenges. SPoRT has years of proven experience in developing and transitioning research products to the operational weather community. SPoRT has begun work with CONUS and OCONUS WFOs to determine the best products for maximum benefit to forecasters. VIIRS has already proven to be another extremely powerful tool, enhancing forecasters ability to handle difficult forecasting situations.

NCCN Oncology Risk Evaluation and Mitigation Strategies White Paper: Recommendations for Stakeholders.

PubMed

Johnson, Philip E; Dahlman, George; Eng, Kirby; Garg, Rekha; Gottlieb, Scott; Hoffman, James M; Howell, Peyton; Jahanzeb, Mohammad; Johnson, Shirley; Mackler, Emily; Rubino, Mark; Sarokhan, Brenda; Marc Stewart, F; Tyler, Tim; Vose, Julie M; Weinstein, Sharon; Li, Edward C; Demartino, Jessica

2010-09-01

REMS are a particularly important issue for oncology and the National Comprehensive Cancer Network (NCCN). A disproportionate number of drugs with complex REMS are used in patients with cancer or hematologic disorders. REMS policies and processes within oncology may act as a model for other clinical areas. A breadth of experience and access to a wide knowledge base exists within oncology that will ensure appropriate development and consideration of the practical implications of REMS. NCCN is uniquely positioned to assume a leadership role in this process given its status as the arbiter of high-quality cancer care based on its world-leading institutions and clinicians. Notwithstanding the potential benefits, the successful design, implementation, and analysis of the FDA's recent requirement for REMS for some high-risk drugs and biologics will present significant challenges for stakeholders, including patients, providers, cancer centers, manufacturers, payors, health information technology vendors, and regulatory agencies. To provide guidance to these stakeholders regarding REMS challenges, the NCCN assembled a work group comprised of thought leaders from NCCN Member Institutions and other outside experts. The Work Group identified challenges across the REMS spectrum, including the areas of standardization, development and assessment of REMS programs, medication guides, provider knowledge and impact on prescribing, provider burden and compensation, and incorporation of REMS into clinical practice.

Challenges of Using Methadone in the Indian Pain and Palliative Care Practice.

PubMed

Viswanath, Vidya; Palat, Gayatri; Chary, Srini; Broderick, Ann

2018-01-01

Palliative care providers across India lobbied to gain access to methadone for pain relief and this has finally been achieved. Palliative care activists will count on the numerous strengths for introducing methadone in India, including the various national and state government initiatives that have been introduced recognizing the importance of palliative care as a specialty in addition to improving opioid accessibility and training. Adding to the support are the Non-Governmental Organizations (NGOs), the medical fraternity and the international interactive and innovative programs such as the Project Extension for Community Health Outcome. As compelling as the need for methadone is, many challenges await. This article outlines the challenges of procuring methadone and also discusses the challenges specific to methadone. Balancing the availability and diversion in a setting of opioid phobia, implementing the amended laws to improve availability and accessibility in a country with diverse health-care practices are the major challenges in implementing methadone for relief of pain. The unique pharmacology of the drug requires meticulous patient selection, vigilant monitoring, and excellent communication and collaboration with a multidisciplinary team and caregivers. The psychological acceptance of the patient, the professional training of the team and the place where care is provided are also challenges which need to be overcome. These challenges could well be the catalyst for a more diligent and vigilant approach to opioid prescribing practices. Start low, go slow could well be the way forward with caregiver education to prescribe methadone safely in the Indian palliative care setting.

Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

PubMed

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

2016-12-01

School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

Vagal Reactivity and Affective Adjustment in Infants during Interaction Challenges.

ERIC Educational Resources Information Center

Bazhenova, Olga V.; Plonskaia, Oxana; Porges, Stephen W.

2001-01-01

Evaluated respiratory sinus arrhythmia (RSA) and heart period in 5-month-olds during interaction challenges. Found that during object-mediated challenge, RSA increases were uniquely related to positive engagement. During person-mediated challenge, subjects showed more complex integration of autonomic and behavioral responses such that only infants…

Technology Challenges in Small UAV Development

NASA Technical Reports Server (NTRS)

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

2005-01-01

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

Laboratory Information Systems in Molecular Diagnostics: Why Molecular Diagnostics Data are Different.

PubMed

Lee, Roy E; Henricks, Walter H; Sirintrapun, Sahussapont J

2016-03-01

Molecular diagnostic testing presents new challenges to information management that are yet to be sufficiently addressed by currently available information systems for the molecular laboratory. These challenges relate to unique aspects of molecular genetic testing: molecular test ordering, informed consent issues, diverse specimen types that encompass the full breadth of specimens handled by traditional anatomic and clinical pathology information systems, data structures and data elements specific to molecular testing, varied testing workflows and protocols, diverse instrument outputs, unique needs and requirements of molecular test reporting, and nuances related to the dissemination of molecular pathology test reports. By satisfactorily addressing these needs in molecular test data management, a laboratory information system designed for the unique needs of molecular diagnostics presents a compelling reason to migrate away from the current paper and spreadsheet information management that many molecular laboratories currently use. This paper reviews the issues and challenges of information management in the molecular diagnostics laboratory.

Robust QRS peak detection by multimodal information fusion of ECG and blood pressure signals.

PubMed

Ding, Quan; Bai, Yong; Erol, Yusuf Bugra; Salas-Boni, Rebeca; Zhang, Xiaorong; Hu, Xiao

2016-11-01

QRS peak detection is a challenging problem when ECG signal is corrupted. However, additional physiological signals may also provide information about the QRS position. In this study, we focus on a unique benchmark provided by PhysioNet/Computing in Cardiology Challenge 2014 and Physiological Measurement focus issue: robust detection of heart beats in multimodal data, which aimed to explore robust methods for QRS detection in multimodal physiological signals. A dataset of 200 training and 210 testing records are used, where the testing records are hidden for evaluating the performance only. An information fusion framework for robust QRS detection is proposed by leveraging existing ECG and ABP analysis tools and combining heart beats derived from different sources. Results show that our approach achieves an overall accuracy of 90.94% and 88.66% on the training and testing datasets, respectively. Furthermore, we observe expected performance at each step of the proposed approach, as an evidence of the effectiveness of our approach. Discussion on the limitations of our approach is also provided.

BOLD magnetic resonance imaging in nephrology

PubMed Central

Hall, Michael E; Jordan, Jennifer H; Juncos, Luis A; Hundley, W Gregory; Hall, John E

2018-01-01

Magnetic resonance (MR) imaging, a non-invasive modality that provides anatomic and physiologic information, is increasingly used for diagnosis of pathophysiologic conditions and for understanding renal physiology in humans. Although functional MR imaging methods were pioneered to investigate the brain, they also offer powerful techniques for investigation of other organ systems such as the kidneys. However, imaging the kidneys provides unique challenges due to potential complications from contrast agents. Therefore, development of non-contrast techniques to study kidney anatomy and physiology is important. Blood oxygen level-dependent (BOLD) MR is a non-contrast imaging technique that provides functional information related to renal tissue oxygenation in various pathophysiologic conditions. Here we discuss technical considerations, clinical uses and future directions for use of BOLD MR as well as complementary MR techniques to better understand renal pathophysiology. Our intent is to summarize kidney BOLD MR applications for the clinician rather than focusing on the complex physical challenges that functional MR imaging encompasses; however, we briefly discuss some of those issues. PMID:29559807

Ares-I-X Stability and Control Flight Test: Analysis and Plans

NASA Technical Reports Server (NTRS)

Brandon, Jay M.; Derry, Stephen D.; Heim, Eugene H.; Hueschen, Richard M.; Bacon, Barton J.

2008-01-01

The flight test of the Ares I-X vehicle provides a unique opportunity to reduce risk of the design of the Ares I vehicle and test out design, math modeling, and analysis methods. One of the key features of the Ares I design is the significant static aerodynamic instability coupled with the relatively flexible vehicle - potentially resulting in a challenging controls problem to provide adequate flight path performance while also providing adequate structural mode damping and preventing adverse control coupling to the flexible structural modes. Another challenge is to obtain enough data from the single flight to be able to conduct analysis showing the effectiveness of the controls solutions and have data to inform design decisions for Ares I. This paper will outline the modeling approaches and control system design to conduct this flight test, and also the system identification techniques developed to extract key information such as control system performance (gain/phase margins, for example), structural dynamics responses, and aerodynamic model estimations.

Composite Resection of Tumors of the Rostral Maxilla and Dorsolateral Muzzle Utilizing an Upper Lip-Sparing, Combined Approach in Dogs.

PubMed

Thomson, Amy E; Soukup, Jason W

2018-01-01

Tumors of the rostral maxilla that involve both the oral mucosa and the dermis or subdermis of the dorsolateral muzzle provide unique challenges for the oromaxillofacial surgeon. Traditionally described approaches to such lesions may involve an intraoral incision that extends and involves the upper lip to envelope the involved dermis of the dorsolateral muzzle. However, such an approach unnecessarily resects upper lip tissue resulting in a large defect that likely requires advanced skin flaps or grafts for reconstruction. Such flaps are technically challenging and introduce potential for significance postoperative complications. In this article, we provide a detailed description a combined intra- and extraoral approach that allows for composite resection of tumors of the rostral maxilla that also involve the dorsolateral muzzle. The described technique allows for excellent intraoperative visualization and provides a superior cosmetic outcome that minimizes postoperative complications. In addition, we describe our experience utilizing the technique in three clinical cases.

Composite Resection of Tumors of the Rostral Maxilla and Dorsolateral Muzzle Utilizing an Upper Lip-Sparing, Combined Approach in Dogs

PubMed Central

Thomson, Amy E.; Soukup, Jason W.

2018-01-01

Tumors of the rostral maxilla that involve both the oral mucosa and the dermis or subdermis of the dorsolateral muzzle provide unique challenges for the oromaxillofacial surgeon. Traditionally described approaches to such lesions may involve an intraoral incision that extends and involves the upper lip to envelope the involved dermis of the dorsolateral muzzle. However, such an approach unnecessarily resects upper lip tissue resulting in a large defect that likely requires advanced skin flaps or grafts for reconstruction. Such flaps are technically challenging and introduce potential for significance postoperative complications. In this article, we provide a detailed description a combined intra- and extraoral approach that allows for composite resection of tumors of the rostral maxilla that also involve the dorsolateral muzzle. The described technique allows for excellent intraoperative visualization and provides a superior cosmetic outcome that minimizes postoperative complications. In addition, we describe our experience utilizing the technique in three clinical cases. PMID:29616231

Communicating NASA's Knowledge: A Report of the Communicate Knowledge Process Team

NASA Technical Reports Server (NTRS)

1998-01-01

NASA has a unique charter in the Space Act of 1958 to 'provide for the widest practicable and appropriate dissemination of information concerning its activities and the results thereof.' As NASA approaches the new millennium, Government legislation and regulations, budgetary reductions that have necessitated downsizing the workforce, an emphasis on measurable results from Government agencies, and technological communications breakthroughs have provided the impetus for NASA to reexamine the way it communicates the knowledge that it generates. NASA has been challenged to manage knowledge as a resource that we owe to the American people.

SBML and CellML translation in antimony and JSim.

PubMed

Smith, Lucian P; Butterworth, Erik; Bassingthwaighte, James B; Sauro, Herbert M

2014-04-01

The creation and exchange of biologically relevant models is of great interest to many researchers. When multiple standards are in use, models are more readily used and re-used if there exist robust translators between the various accepted formats. Antimony 2.4 and JSim 2.10 provide translation capabilities from their own formats to SBML and CellML. All provided unique challenges, stemming from differences in each format's inherent design, in addition to differences in functionality. Both programs are available under BSD licenses; Antimony from http://antimony.sourceforge.net/and JSim from http://physiome.org/jsim/. lpsmith@u.washington.edu.

International Space Station Passive Thermal Control System Analysis, Top Ten Lessons-Learned

NASA Technical Reports Server (NTRS)

Iovine, John

2011-01-01

The International Space Station (ISS) has been on-orbit for over 10 years, and there have been numerous technical challenges along the way from design to assembly to on-orbit anomalies and repairs. The Passive Thermal Control System (PTCS) management team has been a key player in successfully dealing with these challenges. The PTCS team performs thermal analysis in support of design and verification, launch and assembly constraints, integration, sustaining engineering, failure response, and model validation. This analysis is a significant body of work and provides a unique opportunity to compile a wealth of real world engineering and analysis knowledge and the corresponding lessons-learned. The analysis lessons encompass the full life cycle of flight hardware from design to on-orbit performance and sustaining engineering. These lessons can provide significant insight for new projects and programs. Key areas to be presented include thermal model fidelity, verification methods, analysis uncertainty, and operations support.

Terra Mission Operations: Launch to the Present (and Beyond)

NASA Technical Reports Server (NTRS)

Kelly, Angelita; Moyer, Eric; Mantziaras, Dimitrios; Case, Warren

2014-01-01

The Terra satellite, flagship of NASA's long-term Earth Observing System (EOS) Program, continues to provide useful earth science observations well past its 5-year design lifetime. This paper describes the evolution of Terra operations, including challenges and successes and the steps taken to preserve science requirements and prolong spacecraft life. Working cooperatively with the Terra science and instrument teams, including NASA's international partners, the mission operations team has successfully kept the Terra operating continuously, resolving challenges and adjusting operations as needed. Terra retains all of its observing capabilities (except Short Wave Infrared) despite its age. The paper also describes concepts for future operations. This paper will review the Terra spacecraft mission successes and unique spacecraft component designs that provided significant benefits extending mission life and science. In addition, it discusses special activities as well as anomalies and corresponding recovery efforts. Lastly, it discusses future plans for continued operations.

Coming of age: health-care challenges of an ageing population in Israel.

PubMed

Dwolatzky, Tzvi; Brodsky, Jenny; Azaiza, Faisal; Clarfield, A Mark; Jacobs, Jeremy M; Litwin, Howard

2017-06-24

Although Israel is still young in years, with relatively high birth rates and older people (individuals aged 65 years or older) constituting only about 11% of its population, the absolute number of older people is growing rapidly. Life expectancy is high, and increasing numbers of people are living to advanced old age (older than 85 years). A wide spectrum of geriatric care is provided within a universal system providing health services to all citizens. Community and institutional care is available, and many innovative programmes are being developed. The unique demographic characteristics of the ageing society in Israel reflect cultural and multiethnic diversity, in addition to a high rate of immigration of older people. To meet the growing challenges, address disparities, and search for innovation will require planning and development of adequate services at the highest level. Copyright © 2017 Elsevier Ltd. All rights reserved.

Dissolution DNP for in vivo preclinical studies

NASA Astrophysics Data System (ADS)

Comment, Arnaud

2016-03-01

The tremendous polarization enhancement afforded by dissolution dynamic nuclear polarization (DNP) can be taken advantage of to perform preclinical in vivo molecular and metabolic imaging. Following the injection of molecules that are hyperpolarized via dissolution DNP, real-time measurements of their biodistribution and metabolic conversion can be recorded. This technology therefore provides a unique and invaluable tool for probing cellular metabolism in vivo in animal models in a noninvasive manner. It gives the opportunity to follow and evaluate disease progression and treatment response without requiring ex vivo destructive tissue assays. Although its considerable potential has now been widely recognized, hyperpolarized magnetic resonance by dissolution DNP remains a challenging method to implement for routine in vivo preclinical measurements. The aim of this article is to provide an overview of the current state-of-the-art technology for preclinical applications and the challenges that need to be addressed to promote it and allow its wider dissemination in the near future.

Effect of temperature and radiation damage on the local atomic structure of elemental plutonium and related compounds

DOE PAGES

Booth, Corwin H.; Olive, Daniel Thomas

2016-10-26

This focused review provides an overview and a framework for understanding local structure in metallic plutonium (especially the metastable fcc δ-phase alloyed with Ga) as it relates to self-irradiation damage. Of particular concern is the challenge of understanding self-irradiation damage in plutonium-bearing materials where theoretical challenges of the unique involvement of the 5f electrons in bonding limit the efficacy of molecular dynamics simulations and experimental challenges of working with radioactive material have limited the ability to confirm the results of such simulations and to further push the field forward. The main concentration is on extended X-ray absorption fine-structure measurements ofmore » -phase Pu, but the scope is broadened to include certain studies on plutonium intermetallics and oxides insofar as they inform the physics of damage and healing processes in elemental Pu. Here, the studies reviewed here provide insight into lattice distortions and their production, damage annealing and defect migration, and the importance of understanding and controlling sample morphology when interpreting such experiments.« less

Multifunctional Cellular Materials Based on 2D Nanomaterials: Prospects and Challenges.

PubMed

Qiu, Ling; He, Zijun; Li, Dan

2018-01-01

Recent advances in emerging 2D nanomaterial-based cellular materials (2D-CMs) open up new opportunities for the development of next generation cellular solids with exceptional properties. Herein, an overview of the current research status of 2D-CMs is provided and their future opportunities are highlighted. First, the unique features of 2D nanomaterials are introduced to illustrate why these nanoscale building blocks are promising for the development of novel cellular materials and what the new features of 2D nanoscale building blocks can offer when compared to their 0D and 1D counterparts. An in-depth discussion on the structure-property relationships of 2D-CMs is then provided, and the remarkable functions that can be achieved by engineering their cellular architecture are highlighted. Additionally, the use of 2D-CMs to tackle key challenges in different practical applications is demonstrated. In conclusion, a personal perspective on the challenges and future research directions of 2D-CMs is given. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The safety of methadone hydrochloride.

PubMed

Swegle, John M; Wensel, David D

2008-01-01

Methadone is an interesting analgesic for multiple reasons. The unique properties of the agent, low cost and widespread availability have led to increases in methadone prescribing. Despite advantages, methadone is challenging to work with, particularly in patients with high opioid requirements. Recent concerns regarding cardiac arrhythmias and respiratory depression have led to changes in the labeling of methadone. This editorial highlights some of these concerns and provides some recommendations for the appropriate use of methadone in the setting of pain.

Challenges of Big Data Analysis.

PubMed

Fan, Jianqing; Han, Fang; Liu, Han

2014-06-01

Big Data bring new opportunities to modern society and challenges to data scientists. On one hand, Big Data hold great promises for discovering subtle population patterns and heterogeneities that are not possible with small-scale data. On the other hand, the massive sample size and high dimensionality of Big Data introduce unique computational and statistical challenges, including scalability and storage bottleneck, noise accumulation, spurious correlation, incidental endogeneity, and measurement errors. These challenges are distinguished and require new computational and statistical paradigm. This article gives overviews on the salient features of Big Data and how these features impact on paradigm change on statistical and computational methods as well as computing architectures. We also provide various new perspectives on the Big Data analysis and computation. In particular, we emphasize on the viability of the sparsest solution in high-confidence set and point out that exogeneous assumptions in most statistical methods for Big Data can not be validated due to incidental endogeneity. They can lead to wrong statistical inferences and consequently wrong scientific conclusions.

Considerations for Life Science experimentation on the Space Shuttle.

PubMed

Souza, K A; Davies, P; Rossberg Walker, K

1992-10-01

The conduct of Life Science experiments aboard the Shuttle Spacelab presents unaccustomed challenges to scientists. Not only is one confronted with the challenge of conducting an experiment in the unique microgravity environment of a orbiting spacecraft, but there are also the challenges of conducing experiments remotely, using equipment, techniques, chemicals, and materials that may differ from those standardly used in ones own laboratory. Then there is the question of "controls." How does one study the effects of altered gravitational fields on biological systems and control for other variables like vibration, acceleration, noise, temperature, humidity, and the logistics of specimen transport? Typically, the scientist new to space research has neither considered all of these potential problems nor has the data at hand with which to tackle the problems. This paper will explore some of these issues and provide pertinent data from recent Space Shuttle flights that will assist the new as well as the experienced scientist in dealing with the challenges of conducting research under spaceflight conditions.

Using Qualitative Methods to Evaluate a Family Behavioral Intervention for Type 1 Diabetes

PubMed Central

Herbert, Linda Jones; Sweenie, Rachel; Kelly, Katherine Patterson; Holmes, Clarissa; Streisand, Randi

2013-01-01

Introduction The objectives of this study were to qualitatively evaluate a dyadic adolescent-parent type 1 diabetes (T1D) program developed to prevent deterioration in diabetes care among adolescents with T1D and provide recommendations for program refinement. Method Thirteen adolescent-parent dyads who participated in the larger RCT, the TeamWork Project, were interviewed regarding their perceptions of their participation in the program and current T1D challenges. Interviews were transcribed and coded to establish broad themes. Results Adolescents and parents thought the TeamWork Project sessions were helpful and taught them new information. Five themes catalog findings from the qualitative interviews: TeamWork content, TeamWork structure, transition of responsibility, current and future challenges, and future intervention considerations. Discussion Addressing T1D challenges as a parent-adolescent dyad via a behavioral clinic program is helpful to families during adolescence. Findings highlight the utility of qualitative evaluation to tailor interventions for the unique challenges related to pediatric chronic illness. PMID:24269281

Considerations for Life Science experimentation on the Space Shuttle

NASA Technical Reports Server (NTRS)

Souza, K. A.; Davies, P.; Rossberg Walker, K.

1992-01-01

The conduct of Life Science experiments aboard the Shuttle Spacelab presents unaccustomed challenges to scientists. Not only is one confronted with the challenge of conducting an experiment in the unique microgravity environment of a orbiting spacecraft, but there are also the challenges of conducing experiments remotely, using equipment, techniques, chemicals, and materials that may differ from those standardly used in ones own laboratory. Then there is the question of "controls." How does one study the effects of altered gravitational fields on biological systems and control for other variables like vibration, acceleration, noise, temperature, humidity, and the logistics of specimen transport? Typically, the scientist new to space research has neither considered all of these potential problems nor has the data at hand with which to tackle the problems. This paper will explore some of these issues and provide pertinent data from recent Space Shuttle flights that will assist the new as well as the experienced scientist in dealing with the challenges of conducting research under spaceflight conditions.

Photonics on the Mission to Mars

NASA Technical Reports Server (NTRS)

Watson, Michael D.

2013-01-01

Human missions to Mars present some unique challenges for photonics devices. These devices will have exposure to many different space environments. During assembly they will be exposed to the Earth orbiting environment. Upon departure they will need to function through the Earth's Van Allen Radiation Belt. While the general interplanetary environment is less challenging than the radiation belt, they will operate in this environment for 18 months, subject to sudden saturation from solar flares. These components must continue to function properly through these saturation events presenting quite a challenge to photonic components, both optical and electronic. At Mars, the orbital environment is more benign than the Earth's. Components used as part of the landing vehicles must also deal with the pervasive dust environment for 3 - 6 months. These assembly and mission execution environments provide every form of space environmental challenges to photonic components. This paper will briefly discuss each environment and the expectations on the components for successful operation over the life of the mission.

Challenges of Big Data Analysis

PubMed Central

Fan, Jianqing; Han, Fang; Liu, Han

2014-01-01

Big Data bring new opportunities to modern society and challenges to data scientists. On one hand, Big Data hold great promises for discovering subtle population patterns and heterogeneities that are not possible with small-scale data. On the other hand, the massive sample size and high dimensionality of Big Data introduce unique computational and statistical challenges, including scalability and storage bottleneck, noise accumulation, spurious correlation, incidental endogeneity, and measurement errors. These challenges are distinguished and require new computational and statistical paradigm. This article gives overviews on the salient features of Big Data and how these features impact on paradigm change on statistical and computational methods as well as computing architectures. We also provide various new perspectives on the Big Data analysis and computation. In particular, we emphasize on the viability of the sparsest solution in high-confidence set and point out that exogeneous assumptions in most statistical methods for Big Data can not be validated due to incidental endogeneity. They can lead to wrong statistical inferences and consequently wrong scientific conclusions. PMID:25419469

Oral Pre-Exposure Prophylaxis (PrEP) for Prevention of HIV in Serodiscordant Heterosexual Couples in the United States: Opportunities and Challenges

PubMed Central

Myers, Julie E.; Kurth, Ann E.; Cohen, Stephanie E.; Mannheimer, Sharon B.; Simmons, Janie; Pouget, Enrique R.; Trabold, Nicole; Haberer, Jessica E.

2014-01-01

Abstract Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP—injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US. PMID:25045996

An invisible student population: Accommodating and serving college students with lupus.

PubMed

Agarwal, Neelam; Kumar, Vinod

2017-01-01

Systemic Lupus Erythematosus (SLE), or lupus, is a chronic autoimmune disorder. Individuals with lupus face unique psychosocial and emotional challenges such as living with the unpredictability of the disease, symptoms such as fatigue, pain and depression, anxiety, cognitive problems, and coping with stress. This article attempts to shed light on the role that lupus plays in the lives of college students in their academics and other unique psychosocial needs. The author uses a single case study method based on the lived experience of a student with lupus. The method adopted is used as a means to provide anecdotal information about specific areas to consider when providing services to students living with this condition. Findings from this one case study identified some of the accommodations available to help students in higher education that may even vary for two students with same diagnosis of lupus. The paper presents some of the innovative strategies that can be used by practitioners while working with these students in higher education. These strategies can provide helpful support for students with lupus with the recommended academic accommodations.

Comparison of the 1996 and 2001 census data for Aboriginal and non-Aboriginal workers in health care occupations.

PubMed

Lecompte, Emily; Baril, Mireille

2008-01-01

To meet the unique health needs of Aboriginal peoples (First Nations, Inuit and Métis), it is important to increase and encourage Aboriginal representation in health care. One Federal initiative, the Aboriginal Health Human Resource Initiative (AHHRI) at Health Canada, focuses on: (1) increasing the number of Aboriginal people working in health careers; (2) adapting health care educational curricula to support the development of cultural competencies; and (3) improving the retention of health care workers in Aboriginal communities. A health care system that focuses on understanding the unique challenges, concerns, and needs of Aboriginal people can better respond to this specific population, which suffers disproportionately from ill health in comparison to their non-Aboriginal counterparts. This report examines the supply of Aboriginal health care providers in Canada, based on geographic region, area of residence, Aboriginal identity, and occupation. Findings are drawn from the 1996 and 2001 censuses from Statistics Canada. Quantitative results provide a greater understanding of labour force characteristics of First Nation, Inuit, Métis, and non-Aboriginal health providers.

NASA Langley Atmospheric Science Data Center (ASDC) Experience with Aircraft Data

NASA Astrophysics Data System (ADS)

Perez, J.; Sorlie, S.; Parker, L.; Mason, K. L.; Rinsland, P.; Kusterer, J.

2011-12-01

Over the past decade the NASA Langley ASDC has archived and distributed a variety of aircraft mission data sets. These datasets posed unique challenges for archiving from the rigidity of the archiving system and formats to the lack of metadata. The ASDC developed a state-of-the-art data archive and distribution system to serve the atmospheric sciences data provider and researcher communities. The system, called Archive - Next Generation (ANGe), is designed with a distributed, multi-tier, serviced-based, message oriented architecture enabling new methods for searching, accessing, and customizing data. The ANGe system provides the ease and flexibility to ingest and archive aircraft data through an ad hoc workflow or to develop a new workflow to suit the providers needs. The ASDC will describe the challenges encountered in preparing aircraft data for archiving and distribution. The ASDC is currently providing guidance to the DISCOVER-AQ (Deriving Information on Surface Conditions from Column and Vertically Resolved Observations Relevant to Air Quality) Earth Venture-1 project on developing collection, granule, and browse metadata as well as supporting the ADAM (Airborne Data For Assessing Models) site.

JPSS Preparations at the Satellite Proving Ground for Marine, Precipitation, and Satellite Analysis

NASA Astrophysics Data System (ADS)

Folmer, M. J.; Berndt, E.; Clark, J.; Orrison, A.; Kibler, J.; Sienkiewicz, J. M.; Nelson, J. A., Jr.; Goldberg, M.

2016-12-01

The National Oceanic and Atmospheric Administration (NOAA) Satellite Proving Ground (PG) for Marine, Precipitation, and Satellite Analysis (MPS) has been demonstrating and evaluating Suomi National Polar-orbiting Partnership (S-NPP) products along with other polar-orbiting satellite platforms in preparation for the Joint Polar Satellite System - 1 (JPSS-1) launch in March 2017. The first S-NPP imagery was made available to the MPS PG during the evolution of Hurricane Sandy in October 2012 and has since been popular in operations. Since this event the MPS PG Satellite Liaison has been working with forecasters on ways to integrate single-channel and multispectral imagery from the Visible Infrared Imaging Radiometer Suite (VIIRS), the Moderate Resolution Imaging Spectroradiometer (MODIS), and the Advanced Very High Resolution Radiometer (AVHRR)into operations to complement numerical weather prediction and geostationary satellite savvy National Weather Service (NWS) National Centers. Additional unique products have been introduced to operations to address specific forecast challenges, including the Cooperative Institute for Research in the Atmosphere (CIRA) Layered Precipitable Water, the National Environmental Satellite, Data, and Information Service (NESDIS) Snowfall Rate product, NOAA Unique Combined Atmospheric Processing System (NUCAPS) Soundings, ozone products from the Atmospheric Infrared Sounder (AIRS), Cross-track Infrared Sounder/Advanced Technology Microwave Sounder (CrIS/ATMS), and Infrared Atmospheric Sounding Interferometer (IASI). In addition, new satellite domains have been created to provide forecasters at the NWS Ocean Prediction Center and Weather Prediction Center with better quality imagery at high latitudes. This has led to research projects that are addressing forecast challenges such as tropical to extratropical transition and explosive cyclogenesis. This presentation will provide examples of how the MPS PG has been introducing and integrating these products into operations to help solve these forecast challenges.

Exploration Challenges: Transferring Ground Repair Techniques to Space Flight Application

NASA Technical Reports Server (NTRS)

McLemore, Carole A.; Kennedy, James P.; Rose, Frederick A.; Evans, Brian W.

2007-01-01

Fulfilling NASA's Vision for Space Exploration will demand an extended presence in space at distances from our home planet that exceed our current experience in space logistics and maintenance. The ability to perform repairs in lieu of the customary Orbital Replacement Unit (ORU) process where a faulty part is replaced will be elevated from contingency to routine to sustain operations. The use and cost effectiveness of field repairs for ground based operations in industry and the military have advanced with the development of technology in new materials, new repair techniques and new equipment. The unique environments, accessibility constraints and Extra Vehicular Activity (EVA) issues of space operations will require extensive assessment and evolution of these technologies to provide an equivalent and expected level of assurance to mission success. Challenges include the necessity of changes in design philosophy and policy, extremes in thermal cycling, disruptive forces (such as static charge and wind entrainment) on developed methods for control of materials, dramatically increased volatility of chemicals for cleaning and other compounds due to extremely low pressures, the limits imposed on dexterity and maneuverability by current EVA equipment and practices, and the necessity of unique verification methodology. This paper describes these challenges in and discusses the effects on the established ground techniques for repair. The paper also describes the leading repair methodology candidates and their beneficial attributes for resolving these issues with the evolution of technology.

The mountains hold things in: the use of community research review work groups to address cancer disparities in Appalachia.

PubMed

Hutson, Sadie P; Dorgan, Kelly A; Phillips, Amber N; Behringer, Bruce

2007-11-01

To review regional findings about cancer disparities with grass roots community leaders in Appalachia and to identify perspectives about what makes the cancer experience unique in Appalachia. A community-based participatory approach that includes focus-group methodology. Work groups gathered in well-known community locations in northeastern Tennessee and southwestern Virginia. 22 lay adult community members (12 in Tennessee and 10 in Virginia), all of whom had a personal and community interest in cancer and were reputed as informal community leaders. Work groups engaged in a series of five sequential sessions designed to (a) review regional data about cancer disparities and identify perspectives about what makes the cancer experience unique in Appalachia, (b) promote dialogue between the work group members and healthcare providers to identify methods for improved collaboration, and (c) integrate the work group with regional efforts of the states' comprehensive cancer control plans. Four major themes emerged from the focus group sessions with each work group: cancer storytelling, cancer collectivism, healthcare challenges, and cancer expectations. The community research review work groups proved to be a successful method to disseminate information about regional cancer disparities. Study findings provide a unique foundation so that healthcare providers and researchers can begin to address cancer disparities in the Appalachian region. Nurses are in key positions to partner with trusted community leaders to address disparities across the cancer continuum in Appalachia.

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

Michael Viola, J. Edwards, T. Brown, L. Dudek, R. Ellis, P. Heitzenroeder, R. Strykowsky and Michael Cole

The National Compact Stellarator Experiment (NCSX) was a collaborative effort between ORNL and PPPL. PPPL provided the assembly techniques with guidance from ORNL to meet design criteria. The individual vacuum vessel segments, modular coils, trim coils, and toroidal field coils components were delivered to the Field Period Assembly (FPA) crew who then would complete the component assemblies and then assemble the final three field period assemblies, each consisting of two sets of three modular coils assembled over a 120o vacuum vessel segment with the trim coils and toroidal field coils providing the outer layer. The requirements for positioning the modularmore » coils were found to be most demanding. The assembly tolerances required for accurate positioning of the field coil windings in order to generate sufficiently accurate magnetic fields strained state of the art techniques in metrology and alignment and required constant monitoring of assembly steps with laser trackers, measurement arms, and photogrammetry. The FPA activities were being performed concurrently while engineering challenges were being resolved. For example, it was determined that high friction electrically isolated shims were needed between the modular coil interface joints and low distortion welding was required in the nose region of those joints. This took months of analysis and development yet the assembly was not significantly impacted because other assembly tasks could be performed in parallel with ongoing assembly tasks as well as tasks such as advance tooling setup preparation for the eventual welding tasks. The crew technicians developed unique, accurate time saving techniques and tooling which provided significant cost and schedule savings. Project management displayed extraordinary foresight and every opportunity to gain advanced knowledge and develop techniques was taken advantage of. Despite many risk concerns, the cost and schedule performance index was maintained nearly 1.0 during the assembly phase until project cancellation. In this paper, the assembly logic, the engineering challenges, solutions to those challenges and some of the unique and clever assembly techniques, will be presented.« less

Hydrogel scaffolds for tissue engineering: Progress and challenges

PubMed Central

El-Sherbiny, Ibrahim M.; Yacoub, Magdi H.

2013-01-01

Designing of biologically active scaffolds with optimal characteristics is one of the key factors for successful tissue engineering. Recently, hydrogels have received a considerable interest as leading candidates for engineered tissue scaffolds due to their unique compositional and structural similarities to the natural extracellular matrix, in addition to their desirable framework for cellular proliferation and survival. More recently, the ability to control the shape, porosity, surface morphology, and size of hydrogel scaffolds has created new opportunities to overcome various challenges in tissue engineering such as vascularization, tissue architecture and simultaneous seeding of multiple cells. This review provides an overview of the different types of hydrogels, the approaches that can be used to fabricate hydrogel matrices with specific features and the recent applications of hydrogels in tissue engineering. Special attention was given to the various design considerations for an efficient hydrogel scaffold in tissue engineering. Also, the challenges associated with the use of hydrogel scaffolds were described. PMID:24689032

Engineering of the LISA Pathfinder mission—making the experiment a practical reality

NASA Astrophysics Data System (ADS)

Warren, Carl; Dunbar, Neil; Backler, Mike

2009-05-01

LISA Pathfinder represents a unique challenge in the development of scientific spacecraft—not only is the LISA Test Package (LTP) payload a complex integrated development, placing stringent requirements on its developers and the spacecraft, but the payload also acts as the core sensor and actuator for the spacecraft, making the tasks of control design, software development and system verification unusually difficult. The micro-propulsion system which provides the remaining actuation also presents substantial development and verification challenges. As the mission approaches the system critical design review, flight hardware is completing verification and the process of verification using software and hardware simulators and test benches is underway. Preparation for operations has started, but critical milestones for LTP and field effect electric propulsion (FEEP) lie ahead. This paper summarizes the status of the present development and outlines the key challenges that must be overcome on the way to launch.

Patients as Patches: Ecology and Epidemiology in Healthcare Environments.

PubMed

Lofgren, Eric T; Egizi, Andrea M; Fefferman, Nina H

2016-12-01

The modern healthcare system involves complex interactions among microbes, patients, providers, and the built environment. It represents a unique and challenging setting for control of the emergence and spread of infectious diseases. We examine an extension of the perspectives and methods from ecology (and especially urban ecology) to address these unique issues, and we outline 3 examples: (1) viewing patients as individual microbial ecosystems; (2) the altered ecology of infectious diseases specifically within hospitals; and (3) ecosystem management perspectives for infection surveillance and control. In each of these cases, we explore the accuracy and relevance of analogies to existing urban ecological perspectives, and we demonstrate a few of the potential direct uses of this perspective for altering research into the control of healthcare-associated infections. Infect Control Hosp Epidemiol. 2016;1507-1512.

Dynamic high energy density plasma environments at the National Ignition Facility for nuclear science research

NASA Astrophysics Data System (ADS)

Cerjan, Ch J.; Bernstein, L.; Berzak Hopkins, L.; Bionta, R. M.; Bleuel, D. L.; Caggiano, J. A.; Cassata, W. S.; Brune, C. R.; Frenje, J.; Gatu-Johnson, M.; Gharibyan, N.; Grim, G.; Hagmann, Chr; Hamza, A.; Hatarik, R.; Hartouni, E. P.; Henry, E. A.; Herrmann, H.; Izumi, N.; Kalantar, D. H.; Khater, H. Y.; Kim, Y.; Kritcher, A.; Litvinov, Yu A.; Merrill, F.; Moody, K.; Neumayer, P.; Ratkiewicz, A.; Rinderknecht, H. G.; Sayre, D.; Shaughnessy, D.; Spears, B.; Stoeffl, W.; Tommasini, R.; Yeamans, Ch; Velsko, C.; Wiescher, M.; Couder, M.; Zylstra, A.; Schneider, D.

2018-03-01

The generation of dynamic high energy density plasmas in the pico- to nano-second time domain at high-energy laser facilities affords unprecedented nuclear science research possibilities. At the National Ignition Facility (NIF), the primary goal of inertial confinement fusion research has led to the synergistic development of a unique high brightness neutron source, sophisticated nuclear diagnostic instrumentation, and versatile experimental platforms. These novel experimental capabilities provide a new path to investigate nuclear processes and structural effects in the time, mass and energy density domains relevant to astrophysical phenomena in a unique terrestrial environment. Some immediate applications include neutron capture cross-section evaluation, fission fragment production, and ion energy loss measurement in electron-degenerate plasmas. More generally, the NIF conditions provide a singular environment to investigate the interplay of atomic and nuclear processes such as plasma screening effects upon thermonuclear reactivity. Achieving enhanced understanding of many of these effects will also significantly advance fusion energy research and challenge existing theoretical models.

Using Professional Organizations to Prepare the Behavioral Health Workforce to Respond to the Needs of Pediatric Populations Impacted by Health-Related Disasters: Guiding Principles and Challenges.

PubMed

Sprang, Ginny; Silman, Miriam

2015-12-01

Behavioral health professional organizations are in the unique role of aggregating and disseminating information to their membership before, during, and after health-related disasters to promote the integration of behavioral health services into the public health disaster response plan. This article provides a set of 5 principles to direct this undertaking that are based on the current literature and previous evaluation of the online guidance provided by 6 prominent behavioral health professional organizations. These principles use a strengths-based approach to prioritize resilience; underscore the importance of context, collaboration, and coordination; recognize the unique needs of pediatric populations; and guide ongoing training and content development in the area of biopsychosocial responses to health-related disasters. Recognizing important innovations and strides made by the behavioral health organizations noted in a previous study, this article recommends additional areas in which behavioral health professional organizations can contribute to overall pandemic disaster preparedness and response efforts.

The use of social media for campus safety.

PubMed

Haupt, Brittany; Kapucu, Naim; Morgan, Jeffrey

As public safety communication evolved, each disaster or emergency presented unique challenges for emergency managers and others response to disasters. Yet, a foundational focus is the timely dissemination of accurate information to keep communities informed and able to prepare, mitigate, respond, and recover. For the campus community, the increase in bomb threats, active shooter incidents, and geographic-based natural disasters call for the discovery of reliable and cost-effective solutions for emergency information management. Social media is becoming a critical asset in this endeavor. This article examines the evolution of public safety communication, the unique setting of the campus community, and social media's role in campus disaster resilience. In addition, an exploratory study was done to better understand the perception of social media use for public safety within the campus community. The findings provide practical recommendations for campus emergency management professions; however, future research is needed to provide specific, actionable ways to achieve these goals as well as understand how diverse universities utilize a variety of platforms.

Developing Smartphone Apps for Education, Outreach, Science, and Engineering

NASA Astrophysics Data System (ADS)

Weatherwax, A. T.; Fitzsimmons, Z.; Czajkowski, J.; Breimer, E.; Hellman, S. B.; Hunter, S.; Dematteo, J.; Savery, T.; Melsert, K.; Sneeringer, J.

2010-12-01

The increased popularity of mobile phone apps provide scientists with a new avenue for sharing and distributing data and knowledge with colleagues, while also providing meaningful education and outreach products for consumption by the general public. Our initial development of iPhone and Android apps centered on the distribution of exciting auroral images taken at the South Pole for education and outreach purposes. These portable platforms, with limited resources when compared to computers, presented a unique set of design and implementation challenges that we will discuss in this presentation. For example, the design must account for limited memory; screen size; processing power; battery life; and potentially high data transport costs. Some of these unique requirements created an environment that enabled undergraduate and high-school students to participate in the creation of these apps. Additionally, during development it became apparent that these apps could also serve as data analysis and engineering tools. Our presentation will further discuss our plans to use apps not only for Education and Public Outreach, but for teaching, science and engineering.

Enabling full-field physics-based optical proximity correction via dynamic model generation

NASA Astrophysics Data System (ADS)

Lam, Michael; Clifford, Chris; Raghunathan, Ananthan; Fenger, Germain; Adam, Kostas

2017-07-01

As extreme ultraviolet lithography becomes closer to reality for high volume production, its peculiar modeling challenges related to both inter and intrafield effects have necessitated building an optical proximity correction (OPC) infrastructure that operates with field position dependency. Previous state-of-the-art approaches to modeling field dependency used piecewise constant models where static input models are assigned to specific x/y-positions within the field. OPC and simulation could assign the proper static model based on simulation-level placement. However, in the realm of 7 and 5 nm feature sizes, small discontinuities in OPC from piecewise constant model changes can cause unacceptable levels of edge placement errors. The introduction of dynamic model generation (DMG) can be shown to effectively avoid these dislocations by providing unique mask and optical models per simulation region, allowing a near continuum of models through the field. DMG allows unique models for electromagnetic field, apodization, aberrations, etc. to vary through the entire field and provides a capability to precisely and accurately model systematic field signatures.

To Friend or Not to Friend: The Use of Social Media in Clinical Oncology

PubMed Central

Wiener, Lori; Crum, Caroline; Grady, Christine; Merchant, Melinda

2012-01-01

Online social networking has replaced more traditional methods of personal and professional communication in many segments of society today. The wide reach and immediacy of social media facilitate dissemination of knowledge in advocacy and cancer education, but the usefulness of social media in personal relationships between patients and providers is still unclear. Although professional guidelines regarding e-mail communication may be relevant to social media, the inherent openness in social networks creates potential boundary and privacy issues in the provider-patient context. This commentary seeks to increase provider awareness of unique issues and challenges raised by the integration of social networking into oncology communications. PMID:23077437

Discovering eHealth Technology: An Innovative Interprofessional Graduate Student Learning Experience.

PubMed

Estes, Krista; Gilliam, Eric; Knapfel, Sarah; Lee, Chanmi; Skiba, Diane

2016-01-01

The use of eHealth has grown in recent years and is projected to continue to increase exponentially. In order to empower and prepare advanced practice providers to integrate eHealth into their clinical practice, curricular changes need to occur. The iTEAM grant provides a unique opportunity to prepare advanced practice disciplines to provide collaborative care using eHealth. Through the integration of a simulated telehealth using a standardized patient, Doctor of Pharmacy and Advanced Practice Registered Nursing students learned how to apply health information technology and coordinate care in an interprofessional manner. Opportunities and challenges to guide future efforts to integrate eHealth-learning experiences into the curriculum are identified.

High-Pressure Gaseous Burner (HPGB) Facility Completed for Quantitative Laser Diagnostics Calibration

NASA Technical Reports Server (NTRS)

Nguyen, Quang-Viet

2002-01-01

A gas-fueled high-pressure combustion facility with optical access, which was developed over the last 2 years, has just been completed. The High Pressure Gaseous Burner (HPGB) rig at the NASA Glenn Research Center can operate at sustained pressures up to 60 atm with a variety of gaseous fuels and liquid jet fuel. The facility is unique as it is the only continuous-flow, hydrogen-capable, 60-atm rig in the world with optical access. It will provide researchers with new insights into flame conditions that simulate the environment inside the ultra-high-pressure-ratio combustion chambers of tomorrow's advanced aircraft engines. The facility provides optical access to the flame zone, enabling the calibration of nonintrusive optical diagnostics to measure chemical species and temperature. The data from the HPGB rig enables the validation of numerical codes that simulate gas turbine combustors, such as the National Combustor Code (NCC). The validation of such numerical codes is often best achieved with nonintrusive optical diagnostic techniques that meet these goals: information-rich (multispecies) and quantitative while providing good spatial and time resolution. Achieving these goals is a challenge for most nonintrusive optical diagnostic techniques. Raman scattering is a technique that meets these challenges. Raman scattering occurs when intense laser light interacts with molecules to radiate light at a shifted wavelength (known as the Raman shift). This shift in wavelength is unique to each chemical species and provides a "fingerprint" of the different species present. The facility will first be used to gather a comprehensive data base of laser Raman spectra at high pressures. These calibration data will then be used to quantify future laser Raman measurements of chemical species concentration and temperature in this facility and other facilities that use Raman scattering.

Surrogate pregnancy: a guide for Canadian prenatal health care providers

PubMed Central

Reilly, Dan R.

2007-01-01

Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks ofsurrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support. PMID:17296962

Surrogate pregnancy: a guide for Canadian prenatal health care providers.

PubMed

Reilly, Dan R

2007-02-13

Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks of surrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support.

Life Support Requirements and Challenges for NASA's Constellation Program

NASA Technical Reports Server (NTRS)

Carasquillo, Robyn

2007-01-01

NASA's Constellation Program, which includes the mission objectives of establishing a permanently-manned lunar Outpost, and the exploration of Mars, poses new and unique challenges for human life support systems that will require solutions beyond the Shuttle and International Space Station state of the art systems. In particular, the requirement to support crews for 210 days duration at the lunar outpost with limited resource resupply capability wilt require closed-loop regenerative life support systems with minimal expendables. Planetary environmental conditions such as lunar dust and extreme temperatures, as well as the capability to support frequent and extended-duration EVA's will be particularly challenging. This presentation will summarize the key program and mission life support requirements for the Constellation Program and the unique challenges they present for technology and architecture development.

New Strategies and Challenges in Lung Proteomics and Metabolomics. An Official American Thoracic Society Workshop Report.

PubMed

Bowler, Russell P; Wendt, Chris H; Fessler, Michael B; Foster, Matthew W; Kelly, Rachel S; Lasky-Su, Jessica; Rogers, Angela J; Stringer, Kathleen A; Winston, Brent W

2017-12-01

This document presents the proceedings from the workshop entitled, "New Strategies and Challenges in Lung Proteomics and Metabolomics" held February 4th-5th, 2016, in Denver, Colorado. It was sponsored by the National Heart Lung Blood Institute, the American Thoracic Society, the Colorado Biological Mass Spectrometry Society, and National Jewish Health. The goal of this workshop was to convene, for the first time, relevant experts in lung proteomics and metabolomics to discuss and overcome specific challenges in these fields that are unique to the lung. The main objectives of this workshop were to identify, review, and/or understand: (1) emerging technologies in metabolomics and proteomics as applied to the study of the lung; (2) the unique composition and challenges of lung-specific biological specimens for metabolomic and proteomic analysis; (3) the diverse informatics approaches and databases unique to metabolomics and proteomics, with special emphasis on the lung; (4) integrative platforms across genetic and genomic databases that can be applied to lung-related metabolomic and proteomic studies; and (5) the clinical applications of proteomics and metabolomics. The major findings and conclusions of this workshop are summarized at the end of the report, and outline the progress and challenges that face these rapidly advancing fields.

Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research.

PubMed

Tuthill, Emily L; Chan, Jessica; Butler, Lisa M

2015-01-01

Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Health-care providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant-feeding counseling. However, rates of EBF at 6 months of age are suboptimal. HCPs are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant-feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching, and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant-feeding counseling in the prevention of mother-to-child transmission (PMTCT) of HIV programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant-feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful, and responsive to the needs of both HCPs and mothers.

Longitudinal Multiple Sclerosis Lesion Segmentation: Resource & Challenge

PubMed Central

Carass, Aaron; Roy, Snehashis; Jog, Amod; Cuzzocreo, Jennifer L.; Magrath, Elizabeth; Gherman, Adrian; Button, Julia; Nguyen, James; Prados, Ferran; Sudre, Carole H.; Cardoso, Manuel Jorge; Cawley, Niamh; Ciccarelli, Olga; Wheeler-Kingshott, Claudia A. M.; Ourselin, Sébastien; Catanese, Laurence; Deshpande, Hrishikesh; Maurel, Pierre; Commowick, Olivier; Barillot, Christian; Tomas-Fernandez, Xavier; Warfield, Simon K.; Vaidya, Suthirth; Chunduru, Abhijith; Muthuganapathy, Ramanathan; Krishnamurthi, Ganapathy; Jesson, Andrew; Arbel, Tal; Maier, Oskar; Handels, Heinz; Iheme, Leonardo O.; Unay, Devrim; Jain, Saurabh; Sima, Diana M.; Smeets, Dirk; Ghafoorian, Mohsen; Platel, Bram; Birenbaum, Ariel; Greenspan, Hayit; Bazin, Pierre-Louis; Calabresi, Peter A.; Crainiceanu, Ciprian M.; Ellingsen, Lotta M.; Reich, Daniel S.; Prince, Jerry L.; Pham, Dzung L.

2017-01-01

In conjunction with the ISBI 2015 conference, we organized a longitudinal lesion segmentation challenge providing training and test data to registered participants. The training data consisted of five subjects with a mean of 4.4 time-points, and test data of fourteen subjects with a mean of 4.4 time-points. All 82 data sets had the white matter lesions associated with multiple sclerosis delineated by two human expert raters. Eleven teams submitted results using state-of-the-art lesion segmentation algorithms to the challenge, with ten teams presenting their results at the conference. We present a quantitative evaluation comparing the consistency of the two raters as well as exploring the performance of the eleven submitted results in addition to three other lesion segmentation algorithms. The challenge presented three unique opportunities: 1) the sharing of a rich data set; 2) collaboration and comparison of the various avenues of research being pursued in the community; and 3) a review and refinement of the evaluation metrics currently in use. We report on the performance of the challenge participants, as well as the construction and evaluation of a consensus delineation. The image data and manual delineations will continue to be available for download, through an evaluation website1 as a resource for future researchers in the area. This data resource provides a platform to compare existing methods in a fair and consistent manner to each other and multiple manual raters. PMID:28087490

Introduction to the special section from recent Association of Psychologists in Academic Health Centers (APAHC) programs.

PubMed

Klepac, Robert K; Dixon, Kim E

2010-12-01

The Association of Psychologists in Academic Health Centers (APAHC) offers programming at the annual American Psychological Association (APA) conventions as well as periodic APAHC conferences. Participants from academic health centers across the country convened in St. Louis, Missouri, October 15-17, 2009, for the 4th National Conference of the Association of Psychologists in Academic Health Centers (APAHC). The title of the conference was ''Psychologists in Academic Health Centers: Facing Tomorrow's Challenges to AHC Programs and Careers.'' Efforts were made to include topics relevant to academic health center (AHC) practice including the unique challenges of working in AHCs and issues pertinent to the different stages of AHC careers. To facilitate networking, opportunities for discussion among conferees and presenters with shared interests and concerns were provided throughout the conference. This paper introduces the special section of JCPMS dedicated to the conference and provides a brief overview of its development and organization. Articles selected for inclusion represent a sampling of the four conference themes: (1) challenges to AHC programs, (2) staying current in critical clinical areas, (3) professional issues and challenges, and (4) challenges to developing careers. Post-conference evaluation data are presented as evidence of the need for further conferences with similar foci. The programming offered by APAHC at the APA convention in San Diego in 2010 built on the themes offered at the 2009 APAHC conference.

Systems engineering for very large systems

NASA Technical Reports Server (NTRS)

Lewkowicz, Paul E.

1993-01-01

Very large integrated systems have always posed special problems for engineers. Whether they are power generation systems, computer networks or space vehicles, whenever there are multiple interfaces, complex technologies or just demanding customers, the challenges are unique. 'Systems engineering' has evolved as a discipline in order to meet these challenges by providing a structured, top-down design and development methodology for the engineer. This paper attempts to define the general class of problems requiring the complete systems engineering treatment and to show how systems engineering can be utilized to improve customer satisfaction and profit ability. Specifically, this work will focus on a design methodology for the largest of systems, not necessarily in terms of physical size, but in terms of complexity and interconnectivity.

Systems engineering for very large systems

NASA Astrophysics Data System (ADS)

Lewkowicz, Paul E.

Very large integrated systems have always posed special problems for engineers. Whether they are power generation systems, computer networks or space vehicles, whenever there are multiple interfaces, complex technologies or just demanding customers, the challenges are unique. 'Systems engineering' has evolved as a discipline in order to meet these challenges by providing a structured, top-down design and development methodology for the engineer. This paper attempts to define the general class of problems requiring the complete systems engineering treatment and to show how systems engineering can be utilized to improve customer satisfaction and profit ability. Specifically, this work will focus on a design methodology for the largest of systems, not necessarily in terms of physical size, but in terms of complexity and interconnectivity.

Can the impact on health of a government policy designed to create more liveable neighbourhoods be evaluated? An overview of the RESIDential Environment Project.

PubMed

Giles-Corti, Billie; Knuiman, Matthew; Pikora, Terri J; Van Neil, Kimberly; Timperio, Anna; Bull, Fiona C L; Shilton, Trevor; Bulsara, Max

2007-01-01

There is growing interest in the impact of community design on the health of residents. In 1998, the Western Australian Government began a trial of new subdivision design codes (i.e. Liveable Neighbourhoods Community Design Code) aimed at creating pedestrian-friendly neighbourhoods to increase walking, cycling and public transport use. The trial provided a unique opportunity for a natural experiment to evaluate the impact of a government planning policy on residents. Nevertheless, evaluations of this kind present a number of methodological challenges in obtaining the highest quality evidence possible. This paper describes the RESIDential Environment Project's study design and discusses how various methodological challenges were overcome.

The future of HIV prevention: prospects for an effective anti-HIV microbicide.

PubMed

Nuttall, Jeremy; Romano, Joseph; Douville, Karen; Galbreath, Caroline; Nel, Annaléne; Heyward, William; Mitchnick, Mark; Walker, Saul; Rosenberg, Zeda

2007-03-01

Topical microbicides are self-administered products for prevention of HIV transmission, and they present one of the most promising strategies for combating the HIV-AIDS epidemic. The development of microbicides is a long and complicated process, with many hurdles that are unique to this class of product, including challenges in product design, in the conduct and design of clinical trials, and in obtaining licensure of a new class of products intended for use almost exclusively in developing countries. Once they have been registered, there are additional challenges to the marketing and distribution of microbicides. An overview of the types of microbicide currently in development, and a summary of the issues and the approaches being taken to address them, are provided.

Multigenerational Challenges: Team-Building for Positive Clinical Workforce Outcomes

PubMed

Moore, Jill M; Everly, Marcee; Bauer, Renee

2016-05-31

Patient acuity in hospital settings continues to increase, and there is greater emphasis on patient outcomes. The current nursing workforce is comprised of four distinct generational cohorts that include veterans, baby boomers, millennials, and generation Xers. Each group has unique characteristics that add complexity to the workforce and this can add challenges to providing optimal patient care. Team building is one strategy to increase mutual understanding, communication, and respect, and thus potentially improve patient outcomes. In this article, we first briefly define generational cohorts by characteristics, and discuss differing expectations for work/life balance and potential negative outcomes. Our discussion offers team building strategies for positive outcomes, a case scenario, and concludes with resources for team building and organizational opportunities.

The key to successful management of STS operations: An integrated production planning system

NASA Technical Reports Server (NTRS)

Johnson, W. A.; Thomasen, C. T.

1985-01-01

Space Transportation System operations managers are being confronted with a unique set of challenges as a result of increasing flight rates, the demand for flight manifest/production schedule flexibility and an emphasis on continued cost reduction. These challenges have created the need for an integrated production planning system that provides managers with the capability to plan, schedule, status and account for an orderly flow of products and services across a large, multi-discipline organization. With increased visibility into the end-to-end production flow for individual and parallel missions in process, managers can assess the integrated impact of changes, identify and measure the interrelationships of resource, schedule, and technical performance requirements and prioritize productivity enhancements.

Individual Therapy With a Child of Divorced Parents.

PubMed

Jordan, Pauline H

2016-05-01

This article reviews the literature on divorce as a risk factor in children's psychological development; describes common themes expressed by children presenting in treatment; and highlights the unique challenges for the child therapist working with a child of divorce, particularly those with high parental conflict and court involvement. Then, using a case example, the article describes therapeutic strategies and a treatment structure that, consistent with the ethical guidelines of the American Psychological Association (2010), focuses on developing and maintaining the therapeutic relationship to support the psychological growth of the child. Finally, the article discusses the ethical challenges inherent in providing therapeutic intervention for this type of child and the implications for this type of therapeutic approach. © 2016 Wiley Periodicals, Inc.

Generating a Reduced Gravity Environment on Earth

NASA Technical Reports Server (NTRS)

Dungan, Larry K.; Cunningham, Tom; Poncia, Dina

2010-01-01

Since the 1950s several reduced gravity simulators have been designed and utilized in preparing humans for spaceflight and in reduced gravity system development. The Active Response Gravity Offload System (ARGOS) is the newest and most realistic gravity offload simulator. ARGOS provides three degrees of motion within the test area and is scalable for full building deployment. The inertia of the overhead system is eliminated by an active motor and control system. This presentation will discuss what ARGOS is, how it functions, and the unique challenges of interfacing to the human. Test data and video for human and robotic systems will be presented. A major variable in the human machine interaction is the interface of ARGOS to the human. These challenges along with design solutions will be discussed.

Mesial frontal lobe epilepsy.

PubMed

Unnwongse, Kanjana; Wehner, Tim; Foldvary-Schaefer, Nancy

2012-10-01

Mesial frontal lobe epilepsies can be divided into epilepsies arising from the anterior cingulate gyrus and those of the supplementary sensorimotor area. They provide diagnostic challenges because they often lack lateralizing or localizing features on clinical semiology and interictal and ictal scalp electroencephalographic (EEG) recordings. A number of unique semiologic features have been described over the last decade in patients with mesial frontal lobe epilepsy (FLE). There are few reports of applying advanced neurophysiologic techniques such as electrical source imaging, magnetoencephalography, EEG/functional magnetic resonance imaging, or analysis of high-frequency oscillations in patients with mesial FLE. Despite these diagnostic challenges, it seems that patients with mesial FLE benefit from epilepsy surgery to the same extent or even better than patients with FLE do, as a whole.

Autonomous indoor wayfinding for individuals with cognitive impairments

PubMed Central

2010-01-01

Background A challenge to individuals with cognitive impairments in wayfinding is how to remain oriented, recall routines, and travel in unfamiliar areas in a way relying on limited cognitive capacity. While people without disabilities often use maps or written directions as navigation tools or for remaining oriented, this cognitively-impaired population is very sensitive to issues of abstraction (e.g. icons on maps or signage) and presents the designer with a challenge to tailor navigation information specific to each user and context. Methods This paper describes an approach to providing distributed cognition support of travel guidance for persons with cognitive disabilities. A solution is proposed based on passive near-field RFID tags and scanning PDAs. A prototype is built and tested in field experiments with real subjects. The unique strength of the system is the ability to provide unique-to-the-user prompts that are triggered by context. The key to the approach is to spread the context awareness across the system, with the context being flagged by the RFID tags and the appropriate response being evoked by displaying the appropriate path guidance images indexed by the intersection of specific end-user and context ID embedded in RFID tags. Results We found that passive RFIDs generally served as good context for triggering navigation prompts, although individual differences in effectiveness varied. The results of controlled experiments provided more evidence with regard to applicabilities of the proposed autonomous indoor wayfinding method. Conclusions Our findings suggest that the ability to adapt indoor wayfinding devices for appropriate timing of directions and standing orientation will be particularly important. PMID:20840786

Immigrant to Canada, newcomer to childhood cancer: a qualitative study of challenges faced by immigrant parents.

PubMed

Klassen, Anne F; Gulati, Sonia; Watt, Lisa; Banerjee, Ananya T; Sung, Lillian; Klaassen, Robert J; Dix, David; Poureslami, Iraj M; Shaw, Nicola

2012-05-01

Given the increasing numbers of immigrant families in Canada, it is imperative that healthcare providers (HCPs) understand the caregiving experiences of immigrant family caregivers. Our study aimed to explore any special challenges faced by immigrant parents of children with cancer and to identify supportive factors. A constructivist grounded theory approach was used. Participants included 50 first generation Chinese and South Asian parents of children with cancer who were at least six months post-diagnosis. Recruitment took place at six Canadian pediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi. Analysis involved coding and the use of the constant comparison method. Interviewing continued until no new themes emerged. While immigrant parents described many challenges faced by any parent of a child with cancer, the context of being an immigrant made certain experiences particularly challenging. Parents described challenges in the following areas: managing caregiving demand and financial strain, accessing support from others, and interfacing with the healthcare system. Parents described receiving a range of practical, emotional, social and informational support from extended family, their workplace, other cancer families, community organizations and HCPs. Our study addresses an important gap in the research literature by providing practical insight into the experiences of immigrant family caregivers. Our findings may help to inform the development of pediatric oncology policies and programs in ways that respond to the unique needs and challenges of culturally and linguistically diverse families. Copyright © 2011 John Wiley & Sons, Ltd.

A challenging entanglement: health care providers’ perspectives on caring for ill and injured tourists on Cozumel Island, Mexico

PubMed Central

Crooks, Valorie A.; Snyder, Jeremy

2018-01-01

ABSTRACT Purpose: Despite established knowledge that tourists often fall ill or are injured abroad, little is known about their treatment. The intent of this study was to explore health care professionals’ treatment provision experiences on Cozumel Island, Mexico. Methods: 13 semi-structured interviews were undertaken with professionals across a number of health care vocations on Cozumel Island. Interviews were transcribed and thematically analysed to determine common challenges faced in the provision of treatment for transnational tourists. Results: Three thematic challenges emerged from the data: human and physical resource deficiencies, medical (mis)perceptions held by patients and complexities surrounding remuneration of care. Health care providers employ unique strategies to mitigate these challenges. Conclusion: Although many of these challenges exist within other touristic and peripheral spaces, we suggest that the challenges experienced by Cozumel Island’s health care professionals, and their mitigation strategies, exist as part of a complex entanglement between the island’s health care sector and its dominant tourism landscape. We call on tangential tourism services to take a larger role in ensuring the ease of access to, and provision of quality health care services for tourists on Cozumel Island. PMID:29869593

Enhancing astronaut performance using sensorimotor adaptability training

PubMed Central

Bloomberg, Jacob J.; Peters, Brian T.; Cohen, Helen S.; Mulavara, Ajitkumar P.

2015-01-01

Astronauts experience disturbances in balance and gait function when they return to Earth. The highly plastic human brain enables individuals to modify their behavior to match the prevailing environment. Subjects participating in specially designed variable sensory challenge training programs can enhance their ability to rapidly adapt to novel sensory situations. This is useful in our application because we aim to train astronauts to rapidly formulate effective strategies to cope with the balance and locomotor challenges associated with new gravitational environments—enhancing their ability to “learn to learn.” We do this by coupling various combinations of sensorimotor challenges with treadmill walking. A unique training system has been developed that is comprised of a treadmill mounted on a motion base to produce movement of the support surface during walking. This system provides challenges to gait stability. Additional sensory variation and challenge are imposed with a virtual visual scene that presents subjects with various combinations of discordant visual information during treadmill walking. This experience allows them to practice resolving challenging and conflicting novel sensory information to improve their ability to adapt rapidly. Information obtained from this work will inform the design of the next generation of sensorimotor countermeasures for astronauts. PMID:26441561

Enhancing astronaut performance using sensorimotor adaptability training.

PubMed

Bloomberg, Jacob J; Peters, Brian T; Cohen, Helen S; Mulavara, Ajitkumar P

2015-01-01

Astronauts experience disturbances in balance and gait function when they return to Earth. The highly plastic human brain enables individuals to modify their behavior to match the prevailing environment. Subjects participating in specially designed variable sensory challenge training programs can enhance their ability to rapidly adapt to novel sensory situations. This is useful in our application because we aim to train astronauts to rapidly formulate effective strategies to cope with the balance and locomotor challenges associated with new gravitational environments-enhancing their ability to "learn to learn." We do this by coupling various combinations of sensorimotor challenges with treadmill walking. A unique training system has been developed that is comprised of a treadmill mounted on a motion base to produce movement of the support surface during walking. This system provides challenges to gait stability. Additional sensory variation and challenge are imposed with a virtual visual scene that presents subjects with various combinations of discordant visual information during treadmill walking. This experience allows them to practice resolving challenging and conflicting novel sensory information to improve their ability to adapt rapidly. Information obtained from this work will inform the design of the next generation of sensorimotor countermeasures for astronauts.

A proposed legal framework for addressing privacy for patient controlled health records in pediatrics.

PubMed

Bourgeois, Fabienne; Taylor, Patrick; Mandl, Kenneth

2006-01-01

Patient controlled health records(PCHRs) provide widespread and flexible access to integrated medical information. Unique legal challenges arise where the patient is a minor. Variations in laws and statutes concerning minor's rights to privacy and confidentiality, and institutions' local interpretations of them, need to be integrated in the principles governing PCHRs. We propose a legal framework to guide the development of access policies for PCHRs to ensure appropriate privacy and confidentiality protection surrounding minors.

Innovation and wound healing.

PubMed

Harding, Keith

2015-04-01

Innovation in medicine requires unique partnerships between academic research, biotech or pharmaceutical companies, and health-care providers. While innovation in medicine has greatly increased over the past 100 years, innovation in wound care has been slow, despite the fact that chronic wounds are a global health challenge where there is a need for technical, process and social innovation. While novel partnerships between research and the health-care system have been created, we still have much to learn about wound care and the wound-healing processes.

Mechanically controllable break junctions for molecular electronics.

PubMed

Xiang, Dong; Jeong, Hyunhak; Lee, Takhee; Mayer, Dirk

2013-09-20

A mechanically controllable break junction (MCBJ) represents a fundamental technique for the investigation of molecular electronic junctions, especially for the study of the electronic properties of single molecules. With unique advantages, the MCBJ technique has provided substantial insight into charge transport processes in molecules. In this review, the techniques for sample fabrication, operation and the various applications of MCBJs are introduced and the history, challenges and future of MCBJs are discussed. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Aiding the Eye, Watching the Brain: James Weiland, IEEE Fellow, explores the unique challenges of retinal prostheses.

PubMed

Grifantini, Kristina

2017-01-01

The retina is a sophisticated neural network that provides humans with high-resolution vision. And for those who suffer from retinal disease or deterioration, particularly age-related macular degeneration (the leading cause of blindness among people over the age of 50 in the United States), a better understanding of how to stimulate the retina or completely override its path to the area of the brain that processes vision may offer hope to restore sight.

Falcon: A Temporal Visual Analysis System

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

Steed, Chad A.

2016-09-05

Flexible visible exploration of long, high-resolution time series from multiple sensor streams is a challenge in several domains. Falcon is a visual analytics approach that helps researchers acquire a deep understanding of patterns in log and imagery data. Falcon allows users to interactively explore large, time-oriented data sets from multiple linked perspectives. Falcon provides overviews, detailed views, and unique segmented time series visualizations with multiple levels of detail. These capabilities are applicable to the analysis of any quantitative time series.

Technology-based Interventions for Preventing and Treating Substance Use Among Youth

PubMed Central

Marsch, Lisa A.; Borodovsky, Jacob T.

2017-01-01

Summary Preventing or mitigating substance use among youth generally involves three different intervention frameworks: universal prevention, selective prevention, and treatment. Each of these levels of intervention poses unique therapeutic and implementation challenges. Technology-based interventions provide solutions to many of these problems by delivering evidence-based interventions in a consistent and cost-effective manner. This article summarizes the current state of the science of technology-based interventions for preventing substance use initiation and mitigating substance use and associated consequences among youth. PMID:27613350

Institute for Sustainable Energy

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

Agrawal, Ajay

2016-03-28

Alternate fuels offer unique challenges and opportunities as energy source for power generation, vehicular transportation, and industrial applications. Institute for Sustainable Energy (ISE) at UA conducts innovative research to utilize the complex mix of domestically-produced alternate fuels to achieve low-emissions, high energy-efficiency, and fuel-flexibility. ISE also provides educational and advancement opportunities to students and researchers in the energy field. Basic research probing the physics and chemistry of alternative fuels has generated practical concepts investigated in a burner and engine test platforms.

International Student Mental Health

ERIC Educational Resources Information Center

Prieto-Welch, Susan L.

2016-01-01

This chapter describes the mental health status of international students in institutions of higher education, unique challenges these students face and their impact on mental health, and suggestions for ways to address these challenges.

Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.

PubMed

Gloyd, Stephen; Wagenaar, Bradley H; Woelk, Godfrey B; Kalibala, Samuel

2016-01-01

HIV programme data from routine health information systems (RHIS) and personal health information (PHI) provide ample opportunities for secondary data analysis. However, these data pose unique opportunities and challenges for use in health system monitoring, along with process and impact evaluations. Analyses focused on retrospective case reviews of four of the HIV-related studies published in this JIAS supplement. We identify specific opportunities and challenges with respect to the secondary analysis of RHIS and PHI data. Challenges working with both HIV-related RHIS and PHI included missing, inconsistent and implausible data; rapidly changing indicators; systematic differences in the utilization of services; and patient linkages over time and different data sources. Specific challenges among RHIS data included numerous registries and indicators, inconsistent data entry, gaps in data transmission, duplicate registry of information, numerator-denominator incompatibility and infrequent use of data for decision-making. Challenges specific to PHI included the time burden for busy providers, the culture of lax charting, overflowing archives for paper charts and infrequent chart review. Many of the challenges that undermine effective use of RHIS and PHI data for analyses are related to the processes and context of collecting the data, excessive data requirements, lack of knowledge of the purpose of data and the limited use of data among those generating the data. Recommendations include simplifying data sources, analysis and reporting; conducting systematic data quality audits; enhancing the use of data for decision-making; promoting routine chart review linked with simple patient tracking systems; and encouraging open access to RHIS and PHI data for increased use.

Programmable self-assembly of three-dimensional nanostructures from 10,000 unique components

NASA Astrophysics Data System (ADS)

Ong, Luvena L.; Hanikel, Nikita; Yaghi, Omar K.; Grun, Casey; Strauss, Maximilian T.; Bron, Patrick; Lai-Kee-Him, Josephine; Schueder, Florian; Wang, Bei; Wang, Pengfei; Kishi, Jocelyn Y.; Myhrvold, Cameron; Zhu, Allen; Jungmann, Ralf; Bellot, Gaetan; Ke, Yonggang; Yin, Peng

2017-12-01

Nucleic acids (DNA and RNA) are widely used to construct nanometre-scale structures with ever increasing complexity, with possible application in fields such as structural biology, biophysics, synthetic biology and photonics. The nanostructures are formed through one-pot self-assembly, with early kilodalton-scale examples containing typically tens of unique DNA strands. The introduction of DNA origami, which uses many staple strands to fold one long scaffold strand into a desired structure, has provided access to megadalton-scale nanostructures that contain hundreds of unique DNA strands. Even larger DNA origami structures are possible, but manufacturing and manipulating an increasingly long scaffold strand remains a challenge. An alternative and more readily scalable approach involves the assembly of DNA bricks, which each consist of four short binding domains arranged so that the bricks can interlock. This approach does not require a scaffold; instead, the short DNA brick strands self-assemble according to specific inter-brick interactions. First-generation bricks used to create three-dimensional structures are 32 nucleotides long, consisting of four eight-nucleotide binding domains. Protocols have been designed to direct the assembly of hundreds of distinct bricks into well formed structures, but attempts to create larger structures have encountered practical challenges and had limited success. Here we show that DNA bricks with longer, 13-nucleotide binding domains make it possible to self-assemble 0.1-1-gigadalton, three-dimensional nanostructures from tens of thousands of unique components, including a 0.5-gigadalton cuboid containing about 30,000 unique bricks and a 1-gigadalton rotationally symmetric tetramer. We also assembled a cuboid that contains around 10,000 bricks and about 20,000 uniquely addressable, 13-base-pair ‘voxels’ that serves as a molecular canvas for three-dimensional sculpting. Complex, user-prescribed, three-dimensional cavities can be produced within this molecular canvas, enabling the creation of shapes such as letters, a helicoid and a teddy bear. We anticipate that with further optimization of structure design, strand synthesis and assembly procedure even larger structures could be accessible, which could be useful for applications such as positioning functional components.

Self-Healing Technologies for Wiring and Surfaces in Aerospace and Deep Space Exploration Applications

NASA Technical Reports Server (NTRS)

Williams, Martha Kay; Gibson, Tracy L.; Jolley, Scott T.; Caraccio-Meier, Anne Joan

2017-01-01

Self-healing technologies have been identified as critical technology gaps for future exploration. NASA and KSC have been working in this area for multiple years with established intellectual property; however, there are many challenges that remain in this area of research. How do we mimic what the body does so naturally when we as NASA have unique requirements? We have been investigating several mechanisms for self-healing: microencapsulation with a healant core to fill in voids in the case of mechanical puncture and flowable (or sealable)systems that have inherent chemical properties that allow the materials to flow back together when cut or damaged. The microcapsules containing healant have to be durable and robust, must be able to take high temperatures to meet NASA unique requirements, provide good capillary flow of the healant, and be small in diameters to fill in damage voids in thin films or surfaces. Sealable systems have to flow in a range of temperatures and yet be lightweight and chemically resistant. The systems currently being developed are based on polyimide and polyurethane matrices and have been studied for use in high performance wiring systems, inflatable systems, and habitation structures. Self-healing or self-sealing capability would significantly reduce maintenance requirements and increase the safety and reliability performance of critical systems. Advances in these self-healing technologies and some of the unique challenges needed to be overcome in order to incorporate a self-healing mechanism into wiring or thin films systems will be addressed.

Sustainable Approaches for Materials Management in Remote, Economically Challenged Areas of the Pacific

EPA Science Inventory

Remote, economically challenged areas in the Commonwealth of the Northern Marianas Islands (CNMI) and American Samoa in the US Pacific island territories face unique challenges with respect to solid waste management. These islands are remote and isolated, with some islands suppo...

Bringing Wellness to Schools: Opportunities and Challenges to Mental Health Integration in School Health Centers

PubMed Central

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.

2016-01-01

Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895

Challenges of Pre- and Post-Test Counseling for Orthodox Jewish Individuals in the Premarital Phase.

PubMed

Rose, E; Schreiber-Agus, N; Bajaj, K; Klugman, S; Goldwaser, T

2016-02-01

The Jewish community has traditionally taken ownership of its health, and has taken great strides to raise awareness about genetic issues that affect the community, such as Tay-Sachs disease and Hereditary Breast and Ovarian Cancer syndrome. Thanks in part to these heightened awareness efforts, many Orthodox Jewish individuals are now using genetics services as they begin to plan their families. Due to unique cultural and religious beliefs and perceptions, the Orthodox Jewish patients who seek genetic counseling face many barriers to a successful counseling session, and often seek the guidance of programs such as the Program for Jewish Genetic Health (PJGH). In this article, we present clinical vignettes from the PJGH's clinical affiliate, the Reproductive Genetics practice at the Montefiore Medical Center. These cases highlight unique features of contemporary premarital counseling and screening within the Orthodox Jewish Community, including concerns surrounding stigma, disclosure, "marriageability," the use of reproductive technologies, and the desire to include a third party in decision making. Our vignettes demonstrate the importance of culturally-sensitive counseling. We provide strategies and points to consider when addressing the challenges of pre- and post-test counseling as it relates to genetic testing in this population.

p21-activated kinase inhibitors.

PubMed

Rudolph, Joachim; Crawford, James J; Hoeflich, Klaus P; Chernoff, Jonathan

2013-01-01

The p21-activated kinases (PAKs) are Ser/Thr kinases in the STE20 kinase family with important roles in regulating cytoskeletal organization, cell migration, and signaling. The PAK enzyme family comprises six members subdivided into two groups: Group I, represented by PAK1, 2, and 3, and Group II, represented by PAK 4, 5, and 6, based on sequence and structural homology. Individual PAK isoforms were found to be overexpressed and amplified in a variety of human cancers, and in vitro and in vivo studies using genetically engineered systems as well as small-molecule tool compounds have suggested therapeutic utility of PAKs as oncology targets. The identification of potent and kinome-selective ATP-competitive PAK inhibitors has proven challenging, likely caused by the openness and unique plasticity of the ATP-binding site of PAK enzymes. Progress in achieving increased kinase selectivity has been achieved with certain inhibitors but at the expense of increased molecular weight. Allosteric inhibitors, such as IPA-3, leverage the unique Group I PAK autoregulatory domain for selective inhibition, and this approach might provide an outlet to evade the kinase selectivity challenges observed with ATP-competitive PAK inhibitors. © 2013 Elsevier Inc. All rights reserved.

Regioselective Reactions for Programmable Resveratrol Oligomer Synthesis

PubMed Central

Snyder, Scott A.; Gollner, Andreas; Chiriac, Maria I.

2011-01-01

Although much attention has been devoted to resveratrol, a unique polyphenol produced by plants throughout the world and credited as potentially being responsible for the so-called “French paradox” given its broad spectrum activity, the hundreds of oligomeric materials derived from it have been largely ignored despite their similarly high biochemical potential. Challenges in achieving their isolation in quantity from natural sources, coupled with an inability to rationally prepare them in the laboratory, are the main culprits. Here we show that a programmable, controlled, and potentially scaleable synthesis of the resveratrol family is possible through a unique three-stage design. These efforts required novel tactics coupled with strategy- and reagent-guided functionalizations to differentiate two distinct cores possessing multiple sites with the same and/or similar reactivity, ultimately leading to five higher-order natural products. We anticipate that this work 1) demonstrates that challenging, positionally-selective functionalizations of complex materials are possible where biosynthetic studies have indicated otherwise, 2) provides materials and tools to finally unlock the full biochemical potential of the family, particularly from the standpoint of activity and drug-property optimization, and 3) affords an intellectual framework to potentially access other oligomeric families controllably. PMID:21697944

Challenging the Metallothionein (MT) Gene of Biomphalaria glabrata: Unexpected Response Patterns Due to Cadmium Exposure and Temperature Stress.

PubMed

Niederwanger, Michael; Dvorak, Martin; Schnegg, Raimund; Pedrini-Martha, Veronika; Bacher, Katharina; Bidoli, Massimo; Dallinger, Reinhard

2017-08-11

Metallothioneins (MTs) are low-molecular-mass, cysteine-rich, metal binding proteins. In most animal species, they are involved in metal homeostasis and detoxification, and provide protection from oxidative stress. Gastropod MTs are highly diversified, exhibiting unique features and adaptations like metal specificity and multiplications of their metal binding domains. Here, we show that the MT gene of Biomphalaria glabrata , one of the largest MT genes identified so far, is composed in a unique way. The encoding for an MT protein has a three-domain structure and a C-terminal, Cys-rich extension. Using a bioinformatic approach involving structural and in silico analysis of putative transcription factor binding sites (TFBs), we found that this MT gene consists of five exons and four introns. It exhibits a regulatory promoter region containing three metal-responsive elements (MREs) and several TFBs with putative involvement in environmental stress response, and regulation of gene expression. Quantitative real-time polymerase chain reaction (qRT-PCR) data indicate that the MT gene is not inducible by cadmium (Cd) nor by temperature challenges (heat and cold), despite significant Cd uptake within the midgut gland and the high Cd tolerance of metal-exposed snails.

Challenging the Metallothionein (MT) Gene of Biomphalaria glabrata: Unexpected Response Patterns Due to Cadmium Exposure and Temperature Stress

PubMed Central

Dvorak, Martin; Schnegg, Raimund; Pedrini-Martha, Veronika; Bacher, Katharina; Bidoli, Massimo; Dallinger, Reinhard

2017-01-01

Metallothioneins (MTs) are low-molecular-mass, cysteine-rich, metal binding proteins. In most animal species, they are involved in metal homeostasis and detoxification, and provide protection from oxidative stress. Gastropod MTs are highly diversified, exhibiting unique features and adaptations like metal specificity and multiplications of their metal binding domains. Here, we show that the MT gene of Biomphalaria glabrata, one of the largest MT genes identified so far, is composed in a unique way. The encoding for an MT protein has a three-domain structure and a C-terminal, Cys-rich extension. Using a bioinformatic approach involving structural and in silico analysis of putative transcription factor binding sites (TFBs), we found that this MT gene consists of five exons and four introns. It exhibits a regulatory promoter region containing three metal-responsive elements (MREs) and several TFBs with putative involvement in environmental stress response, and regulation of gene expression. Quantitative real-time polymerase chain reaction (qRT-PCR) data indicate that the MT gene is not inducible by cadmium (Cd) nor by temperature challenges (heat and cold), despite significant Cd uptake within the midgut gland and the high Cd tolerance of metal-exposed snails. PMID:28800079

Bridging the Gap Between Research and Practice: Implementation Science.

PubMed

Olswang, Lesley B; Prelock, Patricia A

2015-12-01

This article introduces implementation science, which focuses on research methods that promote the systematic application of research findings to practice. The narrative defines implementation science and highlights the importance of moving research along the pipeline from basic science to practice as one way to facilitate evidence-based service delivery. This review identifies challenges in developing and testing interventions in order to achieve widespread adoption in practice settings. A framework for conceptualizing implementation research is provided, including an example to illustrate the application of principles in speech-language pathology. Last, the authors reflect on the status of implementation research in the discipline of communication sciences and disorders. The extant literature highlights the value of implementation science for reducing the gap between research and practice in our discipline. While having unique principles guiding implementation research, many of the challenges and questions are similar to those facing any investigators who are attempting to design valid and reliable studies. This article is intended to invigorate interest in the uniqueness of implementation science among those pursuing both basic and applied research. In this way, it should help ensure the discipline's knowledge base is realized in practice and policy that affects the lives of individuals with communication disorders.

Coupling of Large Amplitude Inversion with Other States

NASA Astrophysics Data System (ADS)

Pearson, John; Yu, Shanshan

2016-06-01

The coupling of a large amplitude motion with a small amplitude vibration remains one of the least well characterized problems in molecular physics. Molecular inversion poses a few unique and not intuitively obvious challenges to the large amplitude motion problem. In spite of several decades of theoretical work numerous challenges in calculation of transition frequencies and more importantly intensities persist. The most challenging aspect of this problem is that the inversion coordinate is a unique function of the overall vibrational state including both the large and small amplitude modes. As a result, the r-axis system and the meaning of the K-quantum number in the rotational basis set are unique to each vibrational state of large or small amplitude motion. This unfortunate reality has profound consequences to calculation of intensities and the coupling of nearly degenerate vibrational states. The case of NH3 inversion and inversion through a plane of symmetry in alcohols will be examined to find a general path forward.

Unique Approach to Dental Management of Children with Hearing Impairment.

PubMed

Renahan, Navanith; Varma, R Balagopal; Kumaran, Parvathy; Xavier, Arun M

2017-01-01

The number of deaf children has dramatically increased in the past few decades. These children present to the pediatric dentist a unique set of challenges mostly pertaining to the establishment of communication with them. There have been very few attempts in the past to break down these challenges and formulate a strategy on how to manage them effectively. This is a case report of a child who was successfully managed using two different modes of communication. Finally, the advantages and disadvantages are mentioned, and a common strategy incorporating the positives of both the methods has been devised. Renahan N, Varma RB, Kumaran P, Xavier AM. Unique Approach to Dental Management of Children with Hearing Impairment. Int J Clin Pediatr Dent 2017;10(1):107-110.

Opioid addiction, diversion, and abuse in chronic and cancer pain.

PubMed

Kata, Vijay; Novitch, Matthew B; Jones, Mark R; Anyama, Best O; Helander, Erik M; Kaye, Alan D

2018-06-01

The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties. We explore behavioral interventions, provider education, alternative pain management techniques, postmarketing surveillance, and abuse-deterrent formulas as emerging methods to counteract opioid abuse in these populations.

Exploring Race Based Differences in Patterns of Life-Course Criminality

PubMed Central

Markowitz, Michael W.; Salvatore, Christopher

2013-01-01

A persistent issue facing criminologists is the challenge of developing theoretical models that provide comprehensive explanations of the onset and persistence of criminality. One promising theory to develop over the last 30 years has been life-course theory. Using multivariate analysis of variance the main question posed in this research, do elements of social development shape the trajectory of persistent offending in a race-neutral fashion, or are the dynamics shaping life-course criminality unique for people of color, was examined. The results provide a number of useful insights into the relationship between race, life-course transition factors, and longitudinal patterns of criminality. PMID:23436952

Imaging metabolic heterogeneity in cancer.

PubMed

Sengupta, Debanti; Pratx, Guillem

2016-01-06

As our knowledge of cancer metabolism has increased, it has become apparent that cancer metabolic processes are extremely heterogeneous. The reasons behind this heterogeneity include genetic diversity, the existence of multiple and redundant metabolic pathways, altered microenvironmental conditions, and so on. As a result, methods in the clinic and beyond have been developed in order to image and study tumor metabolism in the in vivo and in vitro regimes. Both regimes provide unique advantages and challenges, and may be used to provide a picture of tumor metabolic heterogeneity that is spatially and temporally comprehensive. Taken together, these methods may hold the key to appropriate cancer diagnoses and treatments in the future.

Medical Operational Challenges in the Expedition 16 Landing and Recovery

NASA Technical Reports Server (NTRS)

Moynihan, S.; Johnston, S. L.; Ilcus, L. S.; Shevchenko, V.

2009-01-01

On April 19, 2008 the crew of Expedition 16 left the International Space Station and returned to earth via their Soyuz TMA-11 capsule after 192 days on orbit. Their capsule experienced the second consecutive and third ballistic reentry in the last 10 TMA recoveries and landed approximately 260 miles (420 km) from the prime landing site. Issues: The purpose of this presentation will be to describe, not only the typical medical operational challenges faced by Flight Surgeons recovering a long duration crew from space, but also address the unique challenges that existed with the Expedition 16 landing and crew recovery. Nominal Soyuz recovery challenges include remote recovery sites with crew exposures to sleep shifting and fatigue, dehydration, hypothermia and hyperthermia, and rotational, sustained, and impact g-forces. These environmental factors coupled with the patho-physiologic neuro-vestibular and orthostatic intolerance changes that occur secondary to the crews reintroduction into the earth s gravity field will be detailed. Additional challenges that were unique to this expedition included a ballistic reentry with higher g-loads, the presence of fire outside of the capsule on landing, a contingency medical event of a ground support personnel, and loss of communications with the crew just prior to landing and during recovery operations. Conclusions: In spite of these unique challenges the Russian Search and Rescue Forces and Medical Support personnel along with U.S. Medical Support performed well together. Possible improvements in training and coordination will be discussed.

Supporting Middle School Students Whose Parents Are Deployed: Challenges and Strategies for Schools

ERIC Educational Resources Information Center

Williams, Brenda

2013-01-01

Middle school students from military families face unique challenges, especially when their parents are deployed. Among the challenges they experience are frequent relocations; issues that affect academic achievement; uncertainty; and changes in roles, responsibilities, and relationships at home. Reunification involves issues of the returning…

Essential Tensions in Interdisciplinary Scholarship: Navigating Challenges in Affect, Epistemologies, and Structure in Environment-Society Research Centers

ERIC Educational Resources Information Center

Turner, V. Kelly; Benessaiah, Karina; Warren, Scott; Iwaniec, David

2015-01-01

Scholars have enumerated unique challenges to collaborative interdisciplinary research, many of which evade prescriptive solutions. Some of these challenges can be understood as "essential tensions," necessary and persistent contradictory imperatives in the scientific process. Drawing from interviews with internationally renowned…

Student Media Production to Meet Challenges in Climate Change Science Education

ERIC Educational Resources Information Center

Rooney-Varga, Juliette N.; Brisk, Angelica Allende; Adams, Elizabeth; Shuldman, Elizabeth; Rath, Kenneth

2014-01-01

While the need for effective climate change education is growing, this area of geoscience also poses unique educational challenges. These challenges include the politicization of climate change, the psychological and affective responses it elicits, and common misconceptions, which can all create barriers to learning. Here, we present an…

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

Bramon, Chris; Neeley, James R.; Jones, James V.; Watson, Michael D.; Inman, Sharon K.; Tuttle, Loraine

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle in development and is scheduled for its first mission in 2017. SLS has many of the same logistics challenges as any other large scale program. However, SLS also faces unique challenges. This presentation will address the SLS challenges, along with the analysis and decisions to mitigate the threats posed by each.

Multi-kernel aggregation of local and global features in long-wave infrared for detection of SWAT teams in challenging environments

NASA Astrophysics Data System (ADS)

Arya, Ankit S.; Anderson, Derek T.; Bethel, Cindy L.; Carruth, Daniel

2013-05-01

A vision system was designed for people detection to provide support to SWAT team members operating in challenging environments such as low-to-no light, smoke, etc. When the vision system is mounted on a mobile robot platform: it will enable the robot to function as an effective member of the SWAT team; to provide surveillance information; to make first contact with suspects; and provide safe entry for team members. The vision task is challenging because SWAT team members are typically concealed, carry various equipment such as shields, and perform tactical and stealthy maneuvers. Occlusion is a particular challenge because team members operate in close proximity to one another. An uncooled electro-opticaljlong wav e infrared (EO/ LWIR) camera, 7.5 to 13.5 m, was used. A unique thermal dataset was collected of SWAT team members from multiple teams performing tactical maneuvers during monthly training exercises. Our approach consisted of two stages: an object detector trained on people to find candidate windows, and a secondary feature extraction, multi-kernel (MK) aggregation and classification step to distinguish between SWAT team members and civilians. Two types of thermal features, local and global, are presented based on ma ximally stable extremal region (MSER) blob detection. Support vector machine (SVM) classification results of approximately [70, 93]% for SWAT team member detection are reported based on the exploration of different combinations of visual information in terms of training data.

A unique fluoride nanocontainer: porous molecular capsules can accommodate an unusually high number of "rather labile" fluoride anions.

PubMed

Garai, Somenath; Rubčić, Mirta; Bögge, Hartmut; Haupt, Erhard T K; Gouzerh, Pierre; Müller, Achim

2015-05-11

The present work refers to the challenging issue of fluoride anion recognition/binding in water by taking advantage of the unique possibilities offered by the porous molecular nanocontainers of the {Mo132} Keplerate type allowing the study of a variety of new phenomena. Reaction of the highly reactive carbonate-type capsule with aqueous HF results in the release of carbon dioxide and integration of an unprecedentedly large number of fluoride anions--partly as coordinated ligands at both the pentagonal units and the linkers, partly as a disordered water/fluoride assembly inside the cavity. The internal assembly and some of the fluoride ligands are easily released, which provides interesting options for future studies regarding coordination chemistry and catalysis under confined conditions. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Silk fibroin as biomaterial for bone tissue engineering.

PubMed

Melke, Johanna; Midha, Swati; Ghosh, Sourabh; Ito, Keita; Hofmann, Sandra

2016-02-01

Silk fibroin (SF) is a fibrous protein which is produced mainly by silkworms and spiders. Its unique mechanical properties, tunable biodegradation rate and the ability to support the differentiation of mesenchymal stem cells along the osteogenic lineage, have made SF a favorable scaffold material for bone tissue engineering. SF can be processed into various scaffold forms, combined synergistically with other biomaterials to form composites and chemically modified, which provides an impressive toolbox and allows SF scaffolds to be tailored to specific applications. This review discusses and summarizes recent advancements in processing SF, focusing on different fabrication and functionalization methods and their application to grow bone tissue in vitro and in vivo. Potential areas for future research, current challenges, uncertainties and gaps in knowledge are highlighted. Silk fibroin is a natural biomaterial with remarkable biomedical and mechanical properties which make it favorable for a broad range of bone tissue engineering applications. It can be processed into different scaffold forms, combined synergistically with other biomaterials to form composites and chemically modified which provides a unique toolbox and allows silk fibroin scaffolds to be tailored to specific applications. This review discusses and summarizes recent advancements in processing silk fibroin, focusing on different fabrication and functionalization methods and their application to grow bone tissue in vitro and in vivo. Potential areas for future research, current challenges, uncertainties and gaps in knowledge are highlighted. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Healthcare e-commerce: connecting with patients.

PubMed

Joslyn, J S

2001-01-01

Electronically connecting with patients is a challenging frontier at which technical hurdles are probably exceeded by political, legal, and other barriers. The rise of consumerism, however, compels a response focused more on revenue and strategic advantage than on pure cost savings. Among the difficulties faced by providers is choosing among various models of connectivity and component function. Emerging models include "free-floating" personal medical records largely independent of the office-based physician, systems with compatible and intertwined physician and consumer relationships using an application services provider office practice system, and systems that connect patients and providers through e-mail, office triage, prescription refills, scheduling, and so on. This article discusses these and other combinations of technology that significantly overcome the barriers involved and that may be woven together to provide solutions uniquely suited to various competitive situations.

Flexible manufacturing system handbook. Volume 1: Executive summary

NASA Astrophysics Data System (ADS)

1983-02-01

Flexible Manufacturing Systems (FMSs) represent a relatively new strategy to increase productivity. The technology is especially attractive for manufacturers who produce in the middle ranges of production volumes, neither mass production nor one of a kind. Today's unpredictable market environment demands low-cost solutions that provide quick product start-up, adaptability and responsiveness to changes in demand, and the capacity to easily resurrect out-of-production designs. In many instances, FMSs provide a direct hardware/software solution to this threefold management challenge. The adoption of FMS technology requires that one address many questions beforehand. This handbook provides a methodical approach to answering these questions. But it is not a cookbook; it cannot be. Each application of FMS technology is unique, therefore, the guidelines presented are fairly general.

Cultural diversity and mental health.

PubMed

Gopalkrishnan, Narayan; Babacan, Hurriyet

2015-12-01

Cultural diversity and its impact on mental health has become an increasingly important issue in a globalised world where the interactions between cultures continue to grow exponentially. This paper presents critical areas in which culture impacts on mental health, such as how health and illness are perceived, coping styles, treatment-seeking patterns, impacts of history, racism, bias and stereotyping, gender, family, stigma and discrimination. While cultural differences provide a number of challenges to mental health policy and practice they also provide a number of opportunities to work in unique and effective ways towards positive mental health. Ethno-specific approaches to mental health that incorporate traditional and community-based systems can provide new avenues for working with culturally diverse populations. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Veterinary Compounding: Regulation, Challenges, and Resources

PubMed Central

Davidson, Gigi

2017-01-01

The spectrum of therapeutic need in veterinary medicine is large, and the availability of approved drug products for all veterinary species and indications is relatively small. For this reason, extemporaneous preparation, or compounding, of drugs is commonly employed to provide veterinary medical therapies. The scope of veterinary compounding is broad and focused primarily on meeting the therapeutic needs of companion animals and not food-producing animals in order to avoid human exposure to drug residues. As beneficial as compounded medical therapies may be to animal patients, these therapies are not without risks, and serious adverse events may occur from poor quality compounds or excipients that are uniquely toxic when administered to a given species. Other challenges in extemporaneous compounding for animals include significant regulatory variation across the global veterinary community, a relative lack of validated compounding formulas for use in animals, and poor adherence by compounders to established compounding standards. The information presented in this article is intended to provide an overview of the current landscape of compounding for animals; a discussion on associated benefits, risks, and challenges; and resources to aid compounders in preparing animal compounds of the highest possible quality. PMID:28075379

Targeting Translational Successes through CANSORT-SCI: Using Pet Dogs To Identify Effective Treatments for Spinal Cord Injury.

PubMed

Moore, Sarah A; Granger, Nicolas; Olby, Natasha J; Spitzbarth, Ingo; Jeffery, Nick D; Tipold, Andrea; Nout-Lomas, Yvette S; da Costa, Ronaldo C; Stein, Veronika M; Noble-Haeusslein, Linda J; Blight, Andrew R; Grossman, Robert G; Basso, D Michele; Levine, Jonathan M

2017-06-15

Translation of therapeutic interventions for spinal cord injury (SCI) from laboratory to clinic has been historically challenging, highlighting the need for robust models of injury that more closely mirror the human condition. The high prevalence of acute, naturally occurring SCI in pet dogs provides a unique opportunity to evaluate expeditiously promising interventions in a population of animals that receive diagnoses and treatment clinically in a manner similar to persons with SCI, while adhering to National Institutes of Health guidelines for scientific rigor and transparent reporting. In addition, pet dogs with chronic paralysis are often maintained long-term by their owners, offering a similarly unique population for study of chronic SCI. Despite this, only a small number of studies have used the clinical dog model of SCI. The Canine Spinal Cord Injury Consortium (CANSORT-SCI) was recently established by a group of veterinarians and basic science researchers to promote the value of the canine clinical model of SCI. The CANSORT-SCI group held an inaugural meeting November 20 and 21, 2015 to evaluate opportunities and challenges to the use of pet dogs in SCI research. Key challenges identified included lack of familiarity with the model among nonveterinary scientists and questions about how and where in the translational process the canine clinical model would be most valuable. In light of these, we review the natural history, outcome, and available assessment tools associated with canine clinical SCI with emphasis on their relevance to human SCI and the translational process.

Challenges and unmet needs in basal insulin therapy: lessons from the Asian experience

PubMed Central

Chan, Wing Bun; Chen, Jung Fu; Goh, Su-Yen; Vu, Thi Thanh Huyen; Isip-Tan, Iris Thiele; Mudjanarko, Sony Wibisono; Bajpai, Shailendra; Mabunay, Maria Aileen; Bunnag, Pongamorn

2017-01-01

Basal insulin therapy can improve glycemic control in people with type 2 diabetes. However, timely initiation, optimal titration, and proper adherence to prescribed basal insulin regimens are necessary to achieve optimal glycemic control. Even so, glycemic control may remain suboptimal in a significant proportion of patients. Unique circumstances in Asia (eg, limited resources, management of diabetes primarily in nonspecialist settings, and patient populations that are predominantly less educated) coupled with the limitations of current basal insulin options (eg, risk of hypoglycemia and dosing time inflexibility) amplify the challenge of optimal basal insulin therapy in Asia. Significant progress has been made with long-acting insulin analogs (insulin glargine 100 units/mL and insulin detemir), which provide longer coverage and less risk of hypoglycemia over intermediate-acting insulin (Neutral Protamine Hagedorn insulin). Furthermore, recent clinical evidence suggests that newer long-acting insulin analogs, new insulin glargine 300 units/mL and insulin degludec, may address some of the unmet needs of current basal insulin options in terms of risk of hypoglycemia and dosing time inflexibility. Nevertheless, more can be done to overcome barriers to basal insulin therapy in Asia, through educating both patients and physicians, developing better patient support models, and improving accessibility to long-acting insulin analogs. In this study, we highlight the unique challenges associated with basal insulin therapy in Asia and, where possible, propose strategies to address the unmet needs by drawing on clinical experiences and perspectives in Asia. PMID:29276400

ISO 50001 for US Commercial Buildings - Current Status and Opportunities

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

Liu, Jingjing; Sheaffer, Paul

''ISO 50001: 2011 Energy management systems – Requirements with guidance for use'' is a voluntary International Standard which provides organizations a proven framework to manage energy and continuously improve their energy performance. Implementing ISO 50001 in the commercial building sector has its unique opportunities and challenges in comparison with the industrial sector. The energy footprint of a portfolio of commercial buildings can be just as significant as a large industrial facility in comparison. There are many energy-saving opportunities in commercial buildings that can be addressed without capital investments, and the perceived risks for making energy improvements can be lower thanmore » in the industrial sector. In addition, the energy-consuming systems in commercial buildings are limited in types and have many similarities across buildings, which makes it much easier to standardize many ISO 50001 required processes, 5 procedures and documents to simplify implementation. There are also some sector-unique challenges, such as less familiar with ISO systems and the certification process. Another challenge arises from the complexity in some buildings’ ownership, tenancy, and O&M responsibilities. This whitepaper discusses these opportunities and issues in detail. The paper also recommends the characteristics of organizations in the commercial building sector that can benefit the most from adopting the ISO 50001 standard – namely the “suitable market”. Eight segments (education, food sales, retail, inpatient health care, hospitality, office buildings, laboratories and data centers) within the commercial building sector are highlighted.« less

Challenges and unmet needs in basal insulin therapy: lessons from the Asian experience.

PubMed

Chan, Wing Bun; Chen, Jung Fu; Goh, Su-Yen; Vu, Thi Thanh Huyen; Isip-Tan, Iris Thiele; Mudjanarko, Sony Wibisono; Bajpai, Shailendra; Mabunay, Maria Aileen; Bunnag, Pongamorn

2017-01-01

Basal insulin therapy can improve glycemic control in people with type 2 diabetes. However, timely initiation, optimal titration, and proper adherence to prescribed basal insulin regimens are necessary to achieve optimal glycemic control. Even so, glycemic control may remain suboptimal in a significant proportion of patients. Unique circumstances in Asia (eg, limited resources, management of diabetes primarily in nonspecialist settings, and patient populations that are predominantly less educated) coupled with the limitations of current basal insulin options (eg, risk of hypoglycemia and dosing time inflexibility) amplify the challenge of optimal basal insulin therapy in Asia. Significant progress has been made with long-acting insulin analogs (insulin glargine 100 units/mL and insulin detemir), which provide longer coverage and less risk of hypoglycemia over intermediate-acting insulin (Neutral Protamine Hagedorn insulin). Furthermore, recent clinical evidence suggests that newer long-acting insulin analogs, new insulin glargine 300 units/mL and insulin degludec, may address some of the unmet needs of current basal insulin options in terms of risk of hypoglycemia and dosing time inflexibility. Nevertheless, more can be done to overcome barriers to basal insulin therapy in Asia, through educating both patients and physicians, developing better patient support models, and improving accessibility to long-acting insulin analogs. In this study, we highlight the unique challenges associated with basal insulin therapy in Asia and, where possible, propose strategies to address the unmet needs by drawing on clinical experiences and perspectives in Asia.

Algorithms and Array Design Criteria for Robust Imaging in Interferometry

NASA Astrophysics Data System (ADS)

Kurien, Binoy George

Optical interferometry is a technique for obtaining high-resolution imagery of a distant target by interfering light from multiple telescopes. Image restoration from interferometric measurements poses a unique set of challenges. The first challenge is that the measurement set provides only a sparse-sampling of the object's Fourier Transform and hence image formation from these measurements is an inherently ill-posed inverse problem. Secondly, atmospheric turbulence causes severe distortion of the phase of the Fourier samples. We develop array design conditions for unique Fourier phase recovery, as well as a comprehensive algorithmic framework based on the notion of redundant-spaced-calibration (RSC), which together achieve reliable image reconstruction in spite of these challenges. Within this framework, we see that classical interferometric observables such as the bispectrum and closure phase can limit sensitivity, and that generalized notions of these observables can improve both theoretical and empirical performance. Our framework leverages techniques from lattice theory to resolve integer phase ambiguities in the interferometric phase measurements, and from graph theory, to select a reliable set of generalized observables. We analyze the expected shot-noise-limited performance of our algorithm for both pairwise and Fizeau interferometric architectures and corroborate this analysis with simulation results. We apply techniques from the field of compressed sensing to perform image reconstruction from the estimates of the object's Fourier coefficients. The end result is a comprehensive strategy to achieve well-posed and easily-predictable reconstruction performance in optical interferometry.

Sample Returns Missions in the Coming Decade

NASA Technical Reports Server (NTRS)

Desai, Prasun N.; Mitcheltree, Robert A.; Cheatwood, F. McNeil

2000-01-01

In the coming decade, several missions will attempt to return samples to Earth from varying parts of the solar system. These samples will provide invaluable insight into the conditions present during the early formation of the solar system, and possibly give clues to how life began on Earth. A description of five sample return missions is presented (Stardust, Genesis, Muses-C. Mars Sample Return, and Comet Nucleus Sample Return). An overview of each sample return mission is given, concentrating particularly on the technical challenges posed during the Earth entry, descent, and landing phase of the missions. Each mission faces unique challenges in the design of an Earth entry capsule. The design of the entry capsule must address the aerodynamic, heating, deceleration, landing, and recovery requirements for the safe return of samples to Earth.

A Domain Description Language for Data Processing

NASA Technical Reports Server (NTRS)

Golden, Keith

2003-01-01

We discuss an application of planning to data processing, a planning problem which poses unique challenges for domain description languages. We discuss these challenges and why the current PDDL standard does not meet them. We discuss DPADL (Data Processing Action Description Language), a language for describing planning domains that involve data processing. DPADL is a declarative, object-oriented language that supports constraints and embedded Java code, object creation and copying, explicit inputs and outputs for actions, and metadata descriptions of existing and desired data. DPADL is supported by the IMAGEbot system, which we are using to provide automation for an ecological forecasting application. We compare DPADL to PDDL and discuss changes that could be made to PDDL to make it more suitable for representing planning domains that involve data processing actions.

Stardust Interstellar Preliminary Examination II: Curating the Interstellar Dust Collector, Picokeystones, and Sources of Impact Tracks

NASA Technical Reports Server (NTRS)

Frank, David R.; Westphal, Andrew J.; Zolensky, Michael E.; Gainsforth, Zack; Butterworth, Anna L.; Bastien, Ronald K.; Allen, Carlton; Anderson, David; Bechtel, Hans A.; Sandford, Scott A.

2013-01-01

We discuss the inherent difficulties that arise during "ground truth" characterization of the Stardust interstellar dust collector. The challenge of identifying contemporary interstellar dust impact tracks in aerogel is described within the context of background spacecraft secondaries and possible interplanetary dust particles and beta-meteoroids. In addition, the extraction of microscopic dust embedded in aerogel is technically challenging. Specifically, we provide a detailed description of the sample preparation techniques developed to address the unique goals and restrictions of the Interstellar Preliminary Exam. These sample preparation requirements and the scarcity of candidate interstellar impact tracks exacerbate the difficulties. We also illustrate the role of initial optical imaging with critically important examples, and summarize the overall processing of the collection to date.

Bird Strike Risk for Space Launch Vehicles

NASA Technical Reports Server (NTRS)

Hales, Christy; Czech, Matthew

2017-01-01

Within seconds after liftoff of the Space Shuttle during mission STS-114, a turkey vulture impacted the vehicle's external tank. The contact caused no apparent damage to the shuttle, but the incident led NASA to consider the potential consequences of bird strikes during a shuttle launch. The environment at Kennedy Space Center provides unique bird strike challenges due to the Merritt Island National Wildlife Refuge and the Atlantic Flyway bird migration routes. This presentation will outline an approach for estimating risk resulting from bird strikes to space launch vehicles. The migration routes, types of birds present, altitudes of those birds, exposed area of the launch vehicle, and its capability to withstand impacts all affect the risk due to bird strike. Lessons learned, challenges over lack of data, and significant risk contributors will be discussed.

Exploring the Experiences of Deportation and Reintegration of Aging Deported Men in Trinidad and Tobago.

PubMed

Boodram, Cheryl-Ann Sarita

2018-01-01

Older deported men in Trinidad and Tobago face unique challenges in reintegrating into life after deportation. This qualitative study examined the intersection of aging and deportation to identify factors that affect the reintegration experiences of aging deported men. Qualitative interviews were conducted with 16 deported men over the age of 50 and were analyzed using the constant comparison method. Findings show that reintegration was influenced by complex intrapersonal, subsistence, and social challenges. The findings in this study point to the need to expand social support networks available to aging deported men and provide greater opportunities for them to meet their economic and subsistence needs, and the need to strengthen strategies to reduce the stigma and discrimination associated with aging deported populations.

Development and Execution of End-of-Mission Operations Case Study of the UARS and ERBS End-of-Mission Plans

NASA Technical Reports Server (NTRS)

Hughes, John; Marius, Julio L.; Montoro, Manuel; Patel, Mehul; Bludworth, David

2006-01-01

This Paper is a case study of the development and execution of the End-of-Mission plans for the Earth Radiation Budget Satellite (ERBS) and the Upper Atmosphere Research Satellite (UARS). The goals of the End-of-Mission Plans are to minimize the time the spacecraft remains on orbit and to minimize the risk of creating orbital debris. Both of these Missions predate the NASA Management Instructions (NMI) that directs missions to provide for safe mission termination. Each spacecrafts had their own unique challenges, which required assessing End-of-Mission requirements versus spacecraft limitations. Ultimately the End-of- Mission operations were about risk mitigation. This paper will describe the operational challenges and the lessons learned executing these End-of-Mission Plans

Conceptual Challenges and Directions for Social Neuroscience

PubMed Central

Adolphs, Ralph

2010-01-01

Social neuroscience has been enormously successful and is making major contributions to fields ranging from psychiatry to economics. Yet deep and interesting conceptual challenges abound. Is social information processing domain specific? Is it universal or susceptible to individual differences and effects of culture? Are there uniquely human social cognitive abilities? What is the “social brain,” and how do we map social psychological processes onto it? Animal models together with fMRI and other cognitive neuroscience approaches in humans are providing an unprecedented level of detail and many surprising results. It may well be that social neuroscience in the near future will give us an entirely new view of who we are, how we evolved, and what might be in store for the future of our species. PMID:20346753

Exploring the Experiences of Deportation and Reintegration of Aging Deported Men in Trinidad and Tobago

PubMed Central

Boodram, Cheryl-Ann Sarita

2018-01-01

Older deported men in Trinidad and Tobago face unique challenges in reintegrating into life after deportation. This qualitative study examined the intersection of aging and deportation to identify factors that affect the reintegration experiences of aging deported men. Qualitative interviews were conducted with 16 deported men over the age of 50 and were analyzed using the constant comparison method. Findings show that reintegration was influenced by complex intrapersonal, subsistence, and social challenges. The findings in this study point to the need to expand social support networks available to aging deported men and provide greater opportunities for them to meet their economic and subsistence needs, and the need to strengthen strategies to reduce the stigma and discrimination associated with aging deported populations. PMID:29399601

Employee health surveillance in the health care industry.

PubMed

Hood, Joyce; Larrañaga, Michael

2007-10-01

This article provides an overview of the fundamental and inherent challenges in developing a health surveillance program for a health care facility. These challenges are similar to those facing individuals responsible for developing health surveillance programs for multiple industries because several "mini-industries" exist within hospitals. Hazards can range from those that are regulated by the Occupational Safety and Health Administration to those that are unregulated but pose a threat to health care workers. Occupational hazards that are unique to the health care industry also exist. A health surveillance program can be developed with focused assessment and a strong occupational safety and health program. Implementation can occur within a health care setting with the buy-in of the many stakeholders involved, especially supervisors managing departments where chemical and other hazards are present.

Delimiting family in syntheses of research on childhood chronic conditions and family life.

PubMed

Knafl, Kathleen; Leeman, Jennifer; Havill, Nancy; Crandell, Jamie; Sandelowski, Margarete

2015-03-01

Synthesis of family research presents unique challenges to investigators who must delimit what will be included as a family study in the proposed review. In this paper, the authors discuss the conceptual and pragmatic challenges of conducting systematic reviews of the literature on the intersection between family life and childhood chronic conditions. A proposed framework for delimiting the family domain of interest is presented. The framework addresses both topical salience and level of relevance and provides direction to future researchers, with the goal of supporting the overall quality of family research synthesis efforts. For users of synthesis studies, knowledge of how investigators conceptualize the boundaries of family research is important contextual information for understanding the limits and applicability of the results. © 2014 Family Process Institute.

The conduct of practice-based research in community clinics compared to private practices: similarities, differences, and challenges

PubMed Central

Gillette, Jane; Cunha-Cruz, Joana; Gilbert, Ann; Speed-McIntyre, Pollene; Zhou, Lingmei; DeRouen, Timothy

2013-01-01

Practice-based research should be performed in all practice settings if the results are to be applied to all settings. However, some practice settings, such as community clinics, have unique features that may make the conduct of such research more challenging. The purpose of this article is to describe and compare the similarities and unique challenges related to conducting research in community clinics compared to private practices within the Northwest Practice-Based REsearch Collaborative in Evidence-Based DENTistry (PRECEDENT) network. Information was obtained from meetings with general dentists, a survey of general dentists (N = 253), and a clinical examination and record review of a systemic random sample of patients visiting community clinics and private practices. (N = 1903)—all part of a dental practice-based research network. The processes of conducting research, the dentist and patient sociodemographic characteristics, the prevalence of oral diseases, and the dental treatments received in community clinics and private practices were compared. Both community clinics and private practices have the clinical treatment of the patients as their priority and have time constraints on research. The processes of research training, obtaining informed consent, and collecting, transmitting, and securely maintaining research data are also similar. The patient populations and treatment needs differ substantially between community clinics and private practices, with a higher prevalence of dental caries and higher restorative treatment needs in the community clinic patients. The process of study participant selection and follow-up for research and the dentist and staff work arrangements also vary between the two practice settings. Although community clinic patients and their dental healthcare providers have different research needs and challenges than their counterparts in private practice, practice-based research can be successfully PMID:25429251

Experiences of registered nurses who supervise international nursing students in the clinical and classroom setting: an integrative literature review.

PubMed

Newton, Louise; Pront, Leeanne; Giles, Tracey M

2016-06-01

To examine the literature reporting the experiences and perceptions of registered nurses who supervise international nursing students in the clinical and classroom setting. Nursing education relies on clinical experts to supervise students during classroom and clinical education, and the quality of that supervision has a significant impact on student development and learning. Global migration and internationalisation of nursing education have led to increasing numbers of registered nurses supervising international nursing students. However, a paucity of relevant literature limits our understanding of these experiences. An integrative literature review. Comprehensive database searches of CINAHL, Informit, PubMed, Journals@Ovid, Findit@flinders and Medline were undertaken. Screening of 179 articles resulted in 10 included for review. Appraisal and analysis using Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) five stage integrative review recommendations was undertaken. This review highlighted some unique challenges for registered nurses supervising international nursing students. Identified issues were, a heightened sense of responsibility, additional pastoral care challenges, considerable time investments, communication challenges and cultural differences between teaching and learning styles. It is possible that these unique challenges could be minimised by implementing role preparation programmes specific to international nursing student supervision. Further research is needed to provide an in-depth exploration of current levels of preparation and support to make recommendations for future practice, education and policy development. An awareness of the specific cultural learning needs of international nursing students is an important first step to the provision of culturally competent supervision for this cohort of students. There is an urgent need for education and role preparation for all registered nurses supervising international nursing students, along with adequate recognition of the additional time required to effectively supervise these students. © 2016 John Wiley & Sons Ltd.

Challenges for Novice School Leaders: Facing Today's Issues in School Administration

ERIC Educational Resources Information Center

Beam, Andrea P.; Claxton, Russell L.; Smith, Samuel J.

2016-01-01

Challenges for novice school leaders evolve as information is managed differently and as societal and regulatory expectations change. This study addresses unique challenges faced by practicing school administrators (n = 159) during their first three years in a school leadership position. It focuses on their perceptions, how perceptions of present…

Showing Your Students You Care: Seeing the Individual Trees in the Classroom Forest

ERIC Educational Resources Information Center

Philipp, Randolph A.; Thanheiser, Eva

2010-01-01

Teaching is a complex profession, and although every context is unique, teachers face common challenges. The authors have identified two challenges that nearly every teacher encounters: (1) managing a classroom of students; and (2) addressing the needs of individual students. Although these are not teachers' only challenges, the authors highlight…

Postsecondary Strengths, Challenges, and Supports Experienced by Foster Care Alumni College Graduates

ERIC Educational Resources Information Center

Salazar, Amy M.; Jones, Kevin R.; Emerson, John C.; Mucha, Lauren

2016-01-01

Young people transitioning from foster care to college experience unique identities and circumstances that make being successful in college especially challenging. We used qualitative survey data from 248 college graduates who were formerly in foster care to explore the strengths, challenges, and supports they experienced while in college that…

Understanding Diversity of English Language Learners: Identification of ELLs and ELLs with Disabilities

ERIC Educational Resources Information Center

Wang, Charity

2014-01-01

English Language Learners (ELLs) are one of the fastest growing student populations throughout the country. With ELLs come unique challenges schools must navigate to best serve these students. One challenge is the identification of these students and proper placement and service within ELL programs offered by schools. Another challenge is…

Ethical Challenges of Military Social Workers Serving in a Combat Zone

ERIC Educational Resources Information Center

Simmons, Catherine A.; Rycraft, Joan R.

2010-01-01

Often faced with ethical challenges that may appear extraordinary, military social workers comprise a distinctive subgroup of the social work profession. From the unique paradigms in which they practice their craft, obvious questions about how military social workers address the ethical challenges inherent to their wartime mission arise. Using a…

NASA Space Flight Vehicle Fault Isolation Challenges

NASA Technical Reports Server (NTRS)

Neeley, James R.; Jones, James V.; Bramon, Christopher J.; Inman, Sharon K.; Tuttle, Loraine

2016-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle in development and is scheduled for its first mission in 2018.SLS has many of the same logistics challenges as any other large scale program. However, SLS also faces unique challenges related to testability. This presentation will address the SLS challenges for diagnostics and fault isolation, along with the analyses and decisions to mitigate risk..

Family-centered maternity care for deaf refugees: the patient-centered medical home in action.

PubMed

Balachandra, Shirish K; Carroll, Jennifer K; Fogarty, Colleen T; Finigan, Elizabeth G

2009-12-01

The intersection of 2 underserved populations-refugees and deaf individuals-presents novel challenges to health care systems and has not been described previously. A patient-centered medical home (PCMH) is uniquely equipped to provide outstanding primary care to disadvantaged groups. As an illustrative case study, we present our experience applying principles of the PCMH to address an extremely challenging clinical situation: providing high-quality maternity care to a recently immigrated Vietnamese refugee couple lacking formal language skills. We describe how enhanced access, continuity, coordination, and cultural appropriateness can facilitate favorable outcomes in even daunting circumstances. By collaborating with multiple interpreters, the health center staff, and the extended family, we effectively mobilized an expanded system of care to ensure informed consent and shared decision making, ultimately culminating in a successful labor and vaginal delivery. Through organizational and individual commitment to the tenets of the PCMH, we demonstrate the particular strengths of family medicine training sites in caring for similar patients and families with complex cultural and linguistic barriers to care.

A midwifery-led in-hospital birth center within an academic medical center: successes and challenges.

PubMed

Perdion, Karen; Lesser, Rebecca; Hirsch, Jennifer; Barger, Mary; Kelly, Thomas F; Moore, Thomas R; Lacoursiere, D Yvette

2013-01-01

The University of California San Diego Community Women's Health Program (CWHP) has emerged as a successful and sustainable coexistence model of women's healthcare. The cornerstone of this midwifery practice is California's only in-hospital birth center. Located within the medical center, this unique and physically separate birth center has been the site for more than 4000 births. With 10% cesarean delivery and 98% breast-feeding rates, it is an exceptional example of low-intervention care. Integrating this previously freestanding birth center into an academic center has brought trials of mistrust and ineffectual communication. Education, consistent leadership, and development of multidisciplinary guidelines aided in overcoming these challenges. This collaborative model provides a structure in which residents learn to be respectful consultants and appreciate differences in medical practice. The CWHP and its Birth Center illustrates that through persistence and flexibility a collaborative model of maternity services can flourish and not only positively influence new families but also future generations of providers.

Lower body negative pressure as a tool for research in aerospace physiology and military medicine

NASA Technical Reports Server (NTRS)

Convertino, V. A.

2001-01-01

Lower body negative pressure (LBNP) has been extensively used for decades in aerospace physiological research as a tool to investigate cardiovascular mechanisms that are associated with or underlie performance in aerospace and military environments. In comparison with clinical stand and tilt tests, LBNP represents a relatively safe methodology for inducing highly reproducible hemodynamic responses during exposure to footward fluid shifts similar to those experienced under orthostatic challenge. By maintaining an orthostatic challenge in a supine posture, removal of leg support (muscle pump) and head motion (vestibular stimuli) during LBNP provides the capability to isolate cardiovascular mechanisms that regulate blood pressure. LBNP can be used for physiological measurements, clinical diagnoses and investigational research comparisons of subject populations and alterations in physiological status. The applications of LBNP to the study of blood pressure regulation in spaceflight, groundbased simulations of low gravity, and hemorrhage have provided unique insights and understanding for development of countermeasures based on physiological mechanisms underlying the operational problems.

Treating clients with Asperger’s syndrome and autism

PubMed Central

2013-01-01

Asperger’s syndrome (AS) is a form of autism spectrum disorder (ASD) affecting many individuals today. Although neurobiological correlates for AS have been identified, like many ASDs, AS is not completely understood. AS as a distinct disorder is also not universally accepted and in the DSM-5 AS is not considered a separate nosological entity. In contrast to some other ASDs, individuals with AS are commonly characterized by having standard or higher than average intelligence, yet difficulties in social skills and communication can present challenges for these individuals in everyday functioning. Counseling a person with AS or autism presents a unique challenge for the mental health care provider. We have compiled this review consisting of some recent ideas regarding counseling the client with AS with the goal of providing some clinical insights and practical clues. Although the focus of the present paper is largely on AS, many of these strategies could also apply to individuals with high-functioning autism (HFA). PMID:24020859

A new paradigm for quarantine and public health activities at land borders: opportunities and challenges.

PubMed

Waterman, Stephen H; Escobedo, Miguel; Wilson, Todd; Edelson, Paul J; Bethel, Jeffrey W; Fishbein, Daniel B

2009-01-01

The Institute of Medicine (IOM) report Quarantine Stations at Ports of Entry: Protecting the Public's Health focused almost exclusively on U.S. airports and seaports, which served 106 million entries in 2005. IOM concluded that the primary function of these quarantine stations (QSs) should shift from providing inspection to providing strategic national public health leadership. The large expanse of our national borders, large number of crossings, sparse federal resources, and decreased regulation regarding conveyances crossing these borders make land borders more permeable to a variety of threats. To address the health challenges related to land borders, the QSs serving such borders must assume unique roles and partnerships to achieve the strategic leadership and public health research roles envisioned by the IOM. In this article, we examine how the IOM recommendations apply to the QSs that serve the land borders through which more than 319 million travelers, immigrants, and refugees entered the U.S. in 2005.

Psychosocial health challenges of the elderly in Nigeria: a narrative review.

PubMed

Animasahun, Victor J; Chapman, Helena J

2017-06-01

Globally, national health systems are challenged to build successful aging models to prepare for biomedical, psychological and social changes. The integral component of psychosocial health in overall quality of life and well-being, however, is underscored and requires greater focus. Changing demographics in Nigeria, in addition to cultural considerations and absence of a social security system, present unique challenges to elderly. We aimed to review the literature that describes the current situation and challenges in psychosocial health status in the elderly in Nigeria and provide recommendations that promote health and well-being during the aging process. Four primary factors affect psychosocial health status of elderly Nigerians, namely: changes in family dynamics, increased demand for healthcare services, increased economic stress, and decreased functional independence. Like other developing countries, the Nigerian national system faces similar challenges in preparing a national framework that can maximize coverage to citizens in the midst of demographic changes in aging. By focusing on five target areas such as the educational system, health services, community-based initiatives, local or regional policies and national strategies, current framework in Nigeria can be modified to prepare for changing demographics in aging.

Unique research challenges for high-speed civil transports

NASA Technical Reports Server (NTRS)

Jackson, Charlie M., Jr.; Morris, E. K., Jr.

1988-01-01

Market growth and technological advances are expected to lead to a generation of long-range transports that cruise at supersonic or even hypersonic speeds. Current NASA/industry studies will define the market windows in terms of time frame, Mach number, and technology requirements for these aircraft. Initial results indicate that, for the years 2000 to 2020, economically attractive vehicles could have a cruise speed up to Mach 6. The resulting research challenges are unique. They must be met with technologies that will produce commercially successful and environmentally compatible vehicles where none have existed. Several important areas of research were identified for the high-speed civil transports. Among these are sonic boom, takeoff noise, thermal management, lightweight structures with long life, unique propulsion concepts, unconventional fuels, and supersonic laminar flow.

Unique research challenges for high-speed civil transports

NASA Technical Reports Server (NTRS)

Jackson, Charlie M., Jr.; Morris, Charles E. K., Jr.

1987-01-01

Market growth and technological advances are expected to lead to a generation of long-range transports that cruise at supersonic or even hypersonic speeds. Current NASA/industry studies will define the market windows in terms of time frame, Mach number, and technology requirements for these aircraft. Initial results indicate that, for the years 2000 to 2020, economically attractive vehicles could have a cruise speed up to Mach 6. The resulting research challenges are unique. They must be met with technologies that will produce commercially successful and environmentally compatible vehicles where none have existed. Several important areas of research were identified for the high-speed civil transports. Among these are sonic boom, takeoff noise, thermal management, lightweight structures with long life, unique propulsion concepts, unconventional fuels, and supersonic laminar flow.

Spleen transcriptome response to infection with avian pathogenic Escherichia coli in broiler chickens

PubMed Central

2011-01-01

Background Avian pathogenic Escherichia coli (APEC) is detrimental to poultry health and its zoonotic potential is a food safety concern. Regulation of antimicrobials in food-production animals has put greater focus on enhancing host resistance to bacterial infections through genetics. To better define effective mechanism of host resistance, global gene expression in the spleen of chickens, harvested at two times post-infection (PI) with APEC, was measured using microarray technology, in a design that will enable investigation of effects of vaccination, challenge, and pathology level. Results There were 1,101 genes significantly differentially expressed between severely infected and non-infected groups on day 1 PI and 1,723 on day 5 PI. Very little difference was seen between mildly infected and non-infected groups on either time point. Between birds exhibiting mild and severe pathology, there were 2 significantly differentially expressed genes on day 1 PI and 799 on day 5 PI. Groups with greater pathology had more genes with increased expression than decreased expression levels. Several predominate immune pathways, Toll-like receptor, Jak-STAT, and cytokine signaling, were represented between challenged and non-challenged groups. Vaccination had, surprisingly, no detectible effect on gene expression, although it significantly protected the birds from observable gross lesions. Functional characterization of significantly expressed genes revealed unique gene ontology classifications during each time point, with many unique to a particular treatment or class contrast. Conclusions More severe pathology caused by APEC infection was associated with a high level of gene expression differences and increase in gene expression levels. Many of the significantly differentially expressed genes were unique to a particular treatment, pathology level or time point. The present study not only investigates the transcriptomic regulations of APEC infection, but also the degree of pathology associated with that infection. This study will allow for greater discovery into host mechanisms for disease resistance, providing targets for marker assisted selection and advanced drug development. PMID:21951686

Spleen transcriptome response to infection with avian pathogenic Escherichia coli in broiler chickens.

PubMed

Sandford, Erin E; Orr, Megan; Balfanz, Emma; Bowerman, Nate; Li, Xianyao; Zhou, Huaijun; Johnson, Timothy J; Kariyawasam, Subhashinie; Liu, Peng; Nolan, Lisa K; Lamont, Susan J

2011-09-27

Avian pathogenic Escherichia coli (APEC) is detrimental to poultry health and its zoonotic potential is a food safety concern. Regulation of antimicrobials in food-production animals has put greater focus on enhancing host resistance to bacterial infections through genetics. To better define effective mechanism of host resistance, global gene expression in the spleen of chickens, harvested at two times post-infection (PI) with APEC, was measured using microarray technology, in a design that will enable investigation of effects of vaccination, challenge, and pathology level. There were 1,101 genes significantly differentially expressed between severely infected and non-infected groups on day 1 PI and 1,723 on day 5 PI. Very little difference was seen between mildly infected and non-infected groups on either time point. Between birds exhibiting mild and severe pathology, there were 2 significantly differentially expressed genes on day 1 PI and 799 on day 5 PI. Groups with greater pathology had more genes with increased expression than decreased expression levels. Several predominate immune pathways, Toll-like receptor, Jak-STAT, and cytokine signaling, were represented between challenged and non-challenged groups. Vaccination had, surprisingly, no detectible effect on gene expression, although it significantly protected the birds from observable gross lesions. Functional characterization of significantly expressed genes revealed unique gene ontology classifications during each time point, with many unique to a particular treatment or class contrast. More severe pathology caused by APEC infection was associated with a high level of gene expression differences and increase in gene expression levels. Many of the significantly differentially expressed genes were unique to a particular treatment, pathology level or time point. The present study not only investigates the transcriptomic regulations of APEC infection, but also the degree of pathology associated with that infection. This study will allow for greater discovery into host mechanisms for disease resistance, providing targets for marker assisted selection and advanced drug development.

The Cambia Sojourns Scholars Leadership Program: Conversations with Emerging Leaders in Palliative Care.

PubMed

Cruz-Oliver, Dulce M; Bernacki, Rachelle; Cooper, Zara; Grudzen, Corita; Izumi, Seiko; Lafond, Deborah; Lam, Daniel; LeBlanc, Thomas W; Tjia, Jennifer; Walter, Jennifer

2017-08-01

There is a pressing workforce shortage and leadership scarcity in palliative care to adequately meet the demands of individuals with serious illness and their families. To address this gap, the Cambia Health Foundation launched its Sojourns Scholars Leadership Program in 2014, an initiative designed to identify, cultivate, and advance the next generation of palliative care leaders. This report intends to summarize the second cohort of Sojourns Scholars' projects and their reflection on their leadership needs. This report summarizes the second cohort of sojourns scholars' project and their reflection on leadership needs. After providing a written reflection on their own projects, the second cohort participated in a group interview (fireside chat) to elicit their perspectives on barriers and facilitators in providing palliative care, issues facing leadership in palliative care in the United States, and lessons from personal and professional growth as leaders in palliative care. They analyzed the transcript of the group interview using qualitative content analysis methodology. Three themes emerged from descriptions of the scholars' project experience: challenges in palliative care practice, leadership strategies in palliative care, and three lessons learned to be a leader were identified. Challenges included perceptions of palliative care, payment and policy, and workforce development. Educating and collaborating with other clinicians and influencing policy change are important strategies used to advance palliative care. Time management, leading team effort, and inspiring others are important skills that promote effectiveness as a leader. Emerging leaders have a unique view of conceptualizing contemporary palliative care and shaping the future. Providing comprehensive, coordinated care that is high quality, patient and family centered, and readily available depends on strong leadership in palliative care. The Cambia Scholars Program represents a unique opportunity.

Nutrition in Space: Benefits on Earth

NASA Technical Reports Server (NTRS)

Smith, Scott M.

2006-01-01

History has often proven the criticality for adequate nutrition to ensure expedition success. Space exploration will be no different, with the exception of the certainty that food will not be found along the journey. Ensuring the health and safety of astronauts is critical and nutrition will serve several functions to that end. Nutritional assessment of International Space Station (ISS) crewmembers not only serves to evaluate the nutritional health of individuals, but also allows a better understanding of how space flight affects nutritional requirements, and how nutrition can serve in mitigating the negative effects of weightlessness on the human. Available data suggest that the nutritional status of astronauts is compromised during and after flight. Inadequate dietary intake and subsequent weight loss are often considered hallmarks of space flight, although exceptions to this do exist, and provide hope. However, beyond energy intake, specific nutrient issues also exist. Several vitamins, including D and folate, are affected in space travelers. Hematological and antioxidant defense systems are impacted, with increased iron storage, and increased markers of oxidative damage. Bone loss during space flight remains a critical challenge. Ground-based studies have proven that nutrition is a potent modulator of the bone response to simulated weightlessness. Protein and sodium are two nutrients which tend to exacerbate bone resorption and loss, likely mediated through acid base balance. Defining nutrient requirements, and being able to provide and maintain those nutrients on exploration missions, will be critical for maintaining crew member health. Both flight and ground-based research provide a unique situation, one where healthy individuals are put in a unique and challenging environment. A full understanding of the role of nutrition during space flight will not only enhance crew health and safety during flight, but will also expand our understanding of the role of nutrition in health of those remaining on Earth.

Athletic Trainer Services in Public and Private Secondary Schools.

PubMed

Pike, Alicia M; Pryor, Riana R; Vandermark, Lesley W; Mazerolle, Stephanie M; Casa, Douglas J

2017-01-01

 The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored.  To compare the level of AT services in public and private secondary schools.  Concurrent mixed-methods study.  Public and private secondary schools in the United States.  A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).  School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.  A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.  Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.

Athletic Trainer Services in Public and Private Secondary Schools

PubMed Central

Pike, Alicia M.; Pryor, Riana R.; Vandermark, Lesley W.; Mazerolle, Stephanie M.; Casa, Douglas J.

2017-01-01

Context: The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored. Objective: To compare the level of AT services in public and private secondary schools. Design: Concurrent mixed-methods study. Setting: Public and private secondary schools in the United States. Patients or Other Participants: A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private). Main Outcome Measure(s): School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis. Results: A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators. Conclusions: Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector. PMID:28157403

CHILDREN'S HEALTH AND THE ENVIRONMENT: PUBLIC HEALTH ISSUES AND CHALLENGES FOR RISK ASSESSMENT

EPA Science Inventory

Infants and children are not little adults. They are uniquely vulnerable to environmental toxicants. To protect infants and children against toxicants, the National Research Council in 1993 called for development of an approach to risk assessment that considers children's unique...

Strategies for Increasing Academic Achievement in Higher Education

ERIC Educational Resources Information Center

Ensign, Julene; Woods, Amelia Mays

2014-01-01

Higher education today faces unique challenges. Decreasing student engagement, increasing diversity, and limited resources all contribute to the issues being faced by students, educators, and administrators alike. The unique characteristics and expectations that students bring to their professional programs require new methods of addressing…

Children's Health and the Environment: Public Health Issues and Challenges for Risk Assessment

EPA Science Inventory

Infants and children are not little adults. They are uniquely vulnerable to environmental toxicants. To protect infants and children against toxicants, the National Research Council in 1993 called for development of an approach to risk assessment that considers children's unique...

Regulatory Considerations in the Design and Manufacturing of Implantable 3D‐Printed Medical Devices

PubMed Central

Morrison, Robert J.; Kashlan, Khaled N.; Flanangan, Colleen L.; Wright, Jeanne K.; Green, Glenn E.; Hollister, Scott J.

2015-01-01

Abstract Three‐dimensional (3D) printing, or additive manufacturing, technology has rapidly penetrated the medical device industry over the past several years, and innovative groups have harnessed it to create devices with unique composition, structure, and customizability. These distinctive capabilities afforded by 3D printing have introduced new regulatory challenges. The customizability of 3D‐printed devices introduces new complexities when drafting a design control model for FDA consideration of market approval. The customizability and unique build processes of 3D‐printed medical devices pose unique challenges in meeting regulatory standards related to the manufacturing quality assurance. Consistent material powder properties and optimal printing parameters such as build orientation and laser power must be addressed and communicated to the FDA to ensure a quality build. Postprinting considerations unique to 3D‐printed devices, such as cleaning, finishing and sterilization are also discussed. In this manuscript we illustrate how such regulatory hurdles can be navigated by discussing our experience with our group's 3D‐printed bioresorbable implantable device. PMID:26243449

Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Terblanche, Deon; Jalkanen, Liisa

2013-04-01

Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities Deon E. Terblanche and Liisa Jalkanen dterblanche@wmo.int ljalkanen@wmo.int World Meteorological Organization, Geneva, Switzerland The 21st Century could amongst others, become known as the century in which our species has evolved from Homo sapiens to Homo urbanus. By now the urban population has surpassed the rural population and the rate of urbanization will continue at such a pace that by 2050 urban dwellers could outnumber their rural counterpart by more than two to one. Most of this growth in urban population will occur in developing countries and along coastal areas. Urbanization is to a large extent the outcome of humans seeking a better life through improved opportunities presented by high-density communities. Megacities and large urban complexes provide more job opportunities and social structures, better transport and communication links and a relative abundance of physical goods and services when compared to most rural areas. Unfortunately these urban complexes also present numerous social and environmental challenges. Urban areas differ from their surroundings by morphology, population density, and with high concentration of industrial activities, energy consumption and transport. They also pose unique challenges to atmospheric modelling and monitoring and create a multi-disciplinary spectrum of potential threats, including air pollution, which need to be addressed in an integrated way. These areas are also vulnerable to the changing climate and its implications to sea-level and extreme events, air quality and related health impacts. Many urban activities are significantly impacted by weather events that would not be considered to be of high impact in less densely populated areas. For instance, moderate precipitation events can cause flooding and landslides as modified urban catchments generally have higher run-off to rainfall ratios than their more pristine rural counterparts. The urban environment also provides numerous opportunities. One example being the better use of weather and environmental predictions to proactively optimize the functioning of the urban environment in terms of the use of energy, goods and services. Another is the providing of air quality forecasting services to benefit the health of the population. To address the challenges and opportunities facing megacities and large urban complexes, WMO has established the Global Atmosphere Watch (GAW) Urban Research Meteorology and Environment (GURME). Air pollution questions in urban areas, in particular megacities, is the main focus, building observational and modelling capabilities in developing countries through pilot projects and transfer of scientific expertise. GURME contributes to improving capabilities to handle meteorological and related features of air pollution by addressing end-to-end aspects of air quality, linking observational capabilities with the needs of chemical weather prediction, with the goal of providing high quality air quality services. Using examples from around the world but with specific reference to Africa, the unique challenges and opportunities related to megacities and large urban complexes, as perceived by the World Meteorological Organization (WMO) are highlighted.

The Gynecologist Has a Unique Role in Providing Oncofertility Care to Young Cancer Patients

PubMed Central

Duncan, Francesca E; Jozefik, Jennifer K; Kim, Alison M; Hirshfeld-Cytron, Jennifer; Woodruff, Teresa K

2011-01-01

Facing a cancer diagnosis at any age is devastating. However, young cancer patients have the added burden that life-preserving cancer treatments, including surgery, chemotherapy, and radiotherapy, may compromise their future fertility. The possibility of reproductive dysfunction as a consequence of cancer treatment has a negative impact on the quality of life of cancer survivors. The field of oncofertility, which merges the clinical specialties of oncology and reproductive endocrinology, was developed to explore and expand fertility preservation options and to better manage the reproductive status of cancer patients. Fertility preservation for females has proved to be a particular challenge because mature female gametes are rare and difficult to acquire. The purpose of this article is to provide the gynecologist with a comprehensive overview of how cancer treatments affect the female reproductive axis, delineate the diverse fertility preservation options that are currently available or being developed for young women, and describe current measures of ovarian reserve that can be used pre- and post-cancer treatment. As a primary care provider, the gynecologist will likely interact with patients throughout the cancer care continuum. Thus, the gynecologist is in a unique position to join the oncofertility team in providing young cancer patients with up-to-date fertility preservation information and referrals to specialists. PMID:21927621

Advancing solar energy forecasting through the underlying physics

NASA Astrophysics Data System (ADS)

Yang, H.; Ghonima, M. S.; Zhong, X.; Ozge, B.; Kurtz, B.; Wu, E.; Mejia, F. A.; Zamora, M.; Wang, G.; Clemesha, R.; Norris, J. R.; Heus, T.; Kleissl, J. P.

2017-12-01

As solar power comprises an increasingly large portion of the energy generation mix, the ability to accurately forecast solar photovoltaic generation becomes increasingly important. Due to the variability of solar power caused by cloud cover, knowledge of both the magnitude and timing of expected solar power production ahead of time facilitates the integration of solar power onto the electric grid by reducing electricity generation from traditional ancillary generators such as gas and oil power plants, as well as decreasing the ramping of all generators, reducing start and shutdown costs, and minimizing solar power curtailment, thereby providing annual economic value. The time scales involved in both the energy markets and solar variability range from intra-hour to several days ahead. This wide range of time horizons led to the development of a multitude of techniques, with each offering unique advantages in specific applications. For example, sky imagery provides site-specific forecasts on the minute-scale. Statistical techniques including machine learning algorithms are commonly used in the intra-day forecast horizon for regional applications, while numerical weather prediction models can provide mesoscale forecasts on both the intra-day and days-ahead time scale. This talk will provide an overview of the challenges unique to each technique and highlight the advances in their ongoing development which come alongside advances in the fundamental physics underneath.

The space shuttle ascent vehicle aerodynamic challenges configuration design and data base development

NASA Technical Reports Server (NTRS)

Dill, C. C.; Young, J. C.; Roberts, B. B.; Craig, M. K.; Hamilton, J. T.; Boyle, W. W.

1985-01-01

The phase B Space Shuttle systems definition studies resulted in a generic configuration consisting of a delta wing orbiter, and two solid rocket boosters (SRB) attached to an external fuel tank (ET). The initial challenge facing the aerodynamic community was aerodynamically optimizing, within limits, this configuration. As the Shuttle program developed and the sensitivities of the vehicle to aerodynamics were better understood the requirements of the aerodynamic data base grew. Adequately characterizing the vehicle to support the various design studies exploded the size of the data base to proportions that created a data modeling/management challenge for the aerodynamicist. The ascent aerodynamic data base originated primarily from wind tunnel test results. The complexity of the configuration rendered conventional analytic methods of little use. Initial wind tunnel tests provided results which included undesirable effects from model support tructure, inadequate element proximity, and inadequate plume simulation. The challenge to improve the quality of test results by determining the extent of these undesirable effects and subsequently develop testing techniques to eliminate them was imposed on the aerodynamic community. The challenges to the ascent aerodynamics community documented are unique due to the aerodynamic complexity of the Shuttle launch. Never before was such a complex vehicle aerodynamically characterized. The challenges were met with innovative engineering analyses/methodology development and wind tunnel testing techniques.

The impact of aging physiology in critical care.

PubMed

Walker, Mandi; Spivak, Mark; Sebastian, Mary

2014-03-01

Aging physiology greatly impacts care delivery in the geriatric patient population. Consideration should be given to addressing the patient-specific needs regarding the systemic changes seen in the aging patient. Each major body system presents its own unique challenges to the critical care practitioner, and a comprehensive understanding of these changes is necessary to effectively care for this patient population. This article summarizes these changes and provides key points for the practitioner to consider when caring for the aging patient in the critical care arena. Copyright © 2014 Elsevier Inc. All rights reserved.

Sheep (Ovis aries) as a Model for Cardiovascular Surgery and Management before, during, and after Cardiopulmonary Bypass

PubMed Central

DiVincenti, Louis; Westcott, Robin; Lee, Candice

2014-01-01

Because of its similarity to humans in important respects, sheep (Ovis aries) are a common animal model for translational research in cardiovascular surgery. However, some unique aspects of sheep anatomy and physiology present challenges to its use in these complicated experiments. In this review, we discuss relevant anatomy and physiology of sheep and discuss management before, during, and after procedures requiring cardiopulmonary bypass to provide a concise source of information for veterinarians, technicians, and researchers developing and implementing protocols with this model. PMID:25255065

Total knee arthroplasty in a patient with diastrophic dwarfism.

PubMed

Crowley, Robin L; Haas, Richard E

2010-10-01

Diastrophic dwarfism is an autosomal recessive disease that predominantly occurs in the Finnish population (1 in 33,000) but has been known to occur worldwide. Affected patients present with multiple cartilaginous anomalies and early degeneration of weight-bearing joints. Once past infancy, life expectancy is favorable and patients may undergo multiple surgical procedures throughout their lifetime to repair .or replace affected joints. The characteristic short trunk of these patients in addition to scoliosis, cervical kyphosis, and involvement of articular cartilages can create unique ventilation and airway challenges for anesthesia providers involved in their care.

Transosseous fixation of pediatric displaced mandibular fractures with polyglactin resorbable suture--a simplified technique.

PubMed

Chandan, Sanjay; Halli, Rajshekhar; Joshi, Samir; Chhabaria, Gaurav; Setiya, Sneha

2013-11-01

Management of pediatric mandibular fractures presents a unique challenge to surgeons in terms of its numerous variations compared to adults. Both conservative and open methods have been advocated with their obvious limitations and complications. However, conservative modalities may not be possible in grossly displaced fractures, which necessitate the open method of fixation. We present a novel and simplified technique of transosseous fixation of displaced pediatric mandibular fractures with polyglactin resorbable suture, which provides adequate stability without any interference with tooth buds and which is easy to master.

Review on open source operating systems for internet of things

NASA Astrophysics Data System (ADS)

Wang, Zhengmin; Li, Wei; Dong, Huiliang

2017-08-01

Internet of Things (IoT) is an environment in which everywhere and every device became smart in a smart world. Internet of Things is growing vastly; it is an integrated system of uniquely identifiable communicating devices which exchange information in a connected network to provide extensive services. IoT devices have very limited memory, computational power, and power supply. Traditional operating systems (OS) have no way to meet the needs of IoT systems. In this paper, we thus analyze the challenges of IoT OS and survey applicable open source OSs.

Boundaries & adolescents in residental teatment settings: what clinicians need to know.

PubMed

Bunner, Karen; Yonge, Olive

2006-09-01

Working with adolescents in psychiatric treatment settings poses unique challenges related to boundaries. Staff are typically from a range of disciplines, and some are from nonregulated professions. Three potential boundary-crossing areas are touching, gift giving, and self-disclosure. To enhance quality of care, staff needs an orientation aimed at boundary education, including the concepts of transference and countertransference; an atmosphere of safety to discuss their observations of themselves and others; to be willing to provide feedback; and a sound knowledge base of adolescent growth and development.

Remediation of water and wastewater by using engineered nanomaterials: A review.

PubMed

Bishoge, Obadia K; Zhang, Lingling; Suntu, Shaldon L; Jin, Hui; Zewde, Abraham A; Qi, Zhongwei

2018-05-12

Nanotechnology is currently a fast-rising socioeconomic and political knowledge-based technology owing to the unique characteristics of its engineered nanomaterials. This branch of technology is useful for water and wastewater remediation. Many scientists and researchers have been conducting different studies and experiments on the applications of engineered nanomaterials at the local to international level. This review mainly aims to provide a current overview of existing knowledge on engineered nanomaterials and their applications in water and wastewater remediation. Furthermore, the present risks and challenges of nanotechnology are examined.

Smart Electronic Textiles.

PubMed

Weng, Wei; Chen, Peining; He, Sisi; Sun, Xuemei; Peng, Huisheng

2016-05-17

This Review describes the state-of-the-art of wearable electronics (smart textiles). The unique and promising advantages of smart electronic textiles are highlighted by comparing them with the conventional planar counterparts. The main kinds of smart electronic textiles based on different functionalities, namely the generation, storage, and utilization of electricity, are then discussed with an emphasis on the use of functional materials. The remaining challenges are summarized together with important new directions to provide some useful clues for the future development of smart electronic textiles. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Community-based water-quality monitoring in the Yukon River Basin and the Kuskokwim Watershed

USGS Publications Warehouse

Herman-Mercer, Nicole M.

2013-01-01

The unique partnership between the USGS and the YRITWC provides mutual benefits by fostering outreach efforts that have been essential for community empowerment and by generating scientific data for prohibitively large and remote regions that would be challenging for USGS scientists to sample as robustly alone. The addition of a new partnership with the KRWC to create a community-based monitoring program will only increase these benefits by growing the spatial extent of data collection and empowering more people to take charge of important science in their own backyard.

A Profession Without Limits: The Changing Role of Reference Librarians.

PubMed

Sullo, Elaine; Gomes, Alexandra W

2016-01-01

Reference librarians, specifically those working in academic health sciences environments, have expanded their roles and taken on new and unique responsibilities. While librarians at The George Washington University's Himmelfarb Health Sciences Library continue to provide traditional reference services, they have gone beyond their comfort zone in many cases to become involved in activities that are outside of the librarian's established role. This article describes the current roles of Himmelfarb's reference librarians, as well as the way these librarians prepared for these roles and addressed the associated challenges.

Designing Mission Operations for the Gravity Recovery and Interior Laboratory Mission

NASA Technical Reports Server (NTRS)

Havens, Glen G.; Beerer, Joseph G.

2012-01-01

NASA's Gravity Recovery and Interior Laboratory (GRAIL) mission, to understand the internal structure and thermal evolution of the Moon, offered unique challenges to mission operations. From launch through end of mission, the twin GRAIL orbiters had to be operated in parallel. The journey to the Moon and into the low science orbit involved numerous maneuvers, planned on tight timelines, to ultimately place the orbiters into the required formation-flying configuration necessary. The baseline GRAIL mission is short, only 9 months in duration, but progressed quickly through seven very unique mission phases. Compressed into this short mission timeline, operations activities and maneuvers for both orbiters had to be planned and coordinated carefully. To prepare for these challenges, development of the GRAIL Mission Operations System began in 2008. Based on high heritage multi-mission operations developed by NASA's Jet Propulsion Laboratory and Lockheed Martin, the GRAIL mission operations system was adapted to meet the unique challenges posed by the GRAIL mission design. This paper describes GRAIL's system engineering development process for defining GRAIL's operations scenarios and generating requirements, tracing the evolution from operations concept through final design, implementation, and validation.

SiglecF+Gr1hi eosinophils are a distinct subpopulation within the lungs of allergen-challenged mice

PubMed Central

Percopo, Caroline M.; Brenner, Todd A.; Ma, Michelle; Kraemer, Laura S.; Hakeem, Reem M. A.; Lee, James J.; Rosenberg, Helene F.

2017-01-01

Although eosinophils as a group are readily identified by their unique morphology and staining properties, flow cytometry provides an important means for identification of subgroups based on differential expression of distinct surface Ags. Here, we characterize an eosinophil subpopulation defined by high levels of expression of the neutrophil Ag Gr1 (CD45+CD11c−SiglecF+Gr1hi). SiglecF+Gr1hi eosinophils, distinct from the canonical SiglecF+Gr1− eosinophil population, were detected in allergen-challenged wild-type and granule protein-deficient (EPX−/− and MBP-1−/−) mice, but not in the eosinophil-deficient ΔdblGATA strain. In contrast to Gr1+ neutrophils, which express both cross-reacting Ags Ly6C and Ly6G, SiglecF+Gr1hi eosinophils from allergen-challenged lung tissue are uniquely Ly6G+. Although indistinguishable from the more-numerous SiglecF+Gr1− eosinophils under light microscopy, FACS-isolated populations revealed prominent differences in cytokine contents. The lymphocyte-targeting cytokines CXCL13 and IL-27 were identified only in the SiglecF+Gr1hi eosinophil population (at 3.9 and 4.8 pg/106 cells, respectively), as was the prominent proinflammatory mediator IL-13 (72 pg/106 cells). Interestingly, bone marrow-derived (SiglecF+), cultured eosinophils include a more substantial Gr1+ subpopulation (∼50%); Gr1+ bmEos includes primarily a single Ly6C+ and a smaller, double-positive (Ly6C+Ly6G+) population. Taken together, our findings characterize a distinct SiglecF+Gr1hi eosinophil subset in lungs of allergen-challenged, wild-type and granule protein-deficient mice. SiglecF+Gr1hi eosinophils from wild-type mice maintain a distinct subset of cytokines, including those active on B and T lymphocytes. These cytokines may facilitate eosinophil-mediated immunomodulatory responses in the allergen-challenged lung as well as in other distinct microenvironments. PMID:27531929

SiglecF+Gr1hi eosinophils are a distinct subpopulation within the lungs of allergen-challenged mice.

PubMed

Percopo, Caroline M; Brenner, Todd A; Ma, Michelle; Kraemer, Laura S; Hakeem, Reem M A; Lee, James J; Rosenberg, Helene F

2017-01-01

Although eosinophils as a group are readily identified by their unique morphology and staining properties, flow cytometry provides an important means for identification of subgroups based on differential expression of distinct surface Ags. Here, we characterize an eosinophil subpopulation defined by high levels of expression of the neutrophil Ag Gr1 (CD45 + CD11c - SiglecF + Gr1 hi ). SiglecF + Gr1 hi eosinophils, distinct from the canonical SiglecF + Gr1 - eosinophil population, were detected in allergen-challenged wild-type and granule protein-deficient (EPX -/- and MBP-1 -/- ) mice, but not in the eosinophil-deficient ΔdblGATA strain. In contrast to Gr1 + neutrophils, which express both cross-reacting Ags Ly6C and Ly6G, SiglecF + Gr1 hi eosinophils from allergen-challenged lung tissue are uniquely Ly6G + Although indistinguishable from the more-numerous SiglecF + Gr1 - eosinophils under light microscopy, FACS-isolated populations revealed prominent differences in cytokine contents. The lymphocyte-targeting cytokines CXCL13 and IL-27 were identified only in the SiglecF + Gr1 hi eosinophil population (at 3.9 and 4.8 pg/10 6 cells, respectively), as was the prominent proinflammatory mediator IL-13 (72 pg/10 6 cells). Interestingly, bone marrow-derived (SiglecF + ), cultured eosinophils include a more substantial Gr1 + subpopulation (∼50%); Gr1 + bmEos includes primarily a single Ly6C + and a smaller, double-positive (Ly6C + Ly6G + ) population. Taken together, our findings characterize a distinct SiglecF + Gr1 hi eosinophil subset in lungs of allergen-challenged, wild-type and granule protein-deficient mice. SiglecF + Gr1 hi eosinophils from wild-type mice maintain a distinct subset of cytokines, including those active on B and T lymphocytes. These cytokines may facilitate eosinophil-mediated immunomodulatory responses in the allergen-challenged lung as well as in other distinct microenvironments. © Society for Leukocyte Biology.

Electroluminescence and electrical degradation of insulating polymers at electrode interfaces under divergent fields

NASA Astrophysics Data System (ADS)

Zhang, Shuai; Li, Qi; Hu, Jun; Zhang, Bo; He, Jinliang

2018-04-01

Electrical degradation of insulating polymers at electrode interfaces is an essential factor in determining long-term reliability. A critical challenge is that the exact mechanism of degradation is not fully understood, either experimentally or theoretically, due to the inherent complex processes. Consequently, in this study, we investigate electroluminescence (EL) at the interface of an electrode and insulator, and determine the relationship between EL and electrical degradation. Using a tip-plate electrode structure, the unique features of EL under a highly divergent field are investigated. The voltage type (alternating or direct current), the polymer matrix, and the time of pressing are also investigated separately. A study of EL from insulators under a divergent field is provided, and the relationship between EL spectra and degradation is discussed. It is shown that EL spectra under a divergent field have unique characteristics compared with EL spectra from polymer films under a uniform field and the most obvious one is the UV emission. The results obtained in the current investigation bring us a step closer to understanding the process of electrical degradation and provide a potential way to diagnose insulator defects.

Dynamic high energy density plasma environments at the National Ignition Facility for nuclear science research

DOE PAGES

Cerjan, Ch J.; Bernstein, L.; Hopkins, L. Berzak; ...

2017-08-16

We present the generation of dynamic high energy density plasmas in the pico- to nano-second time domain at high-energy laser facilities affords unprecedented nuclear science research possibilities. At the National Ignition Facility (NIF), the primary goal of inertial confinement fusion research has led to the synergistic development of a unique high brightness neutron source, sophisticated nuclear diagnostic instrumentation, and versatile experimental platforms. These novel experimental capabilities provide a new path to investigate nuclear processes and structural effects in the time, mass and energy density domains relevant to astrophysical phenomena in a unique terrestrial environment. Some immediate applications include neutron capturemore » cross-section evaluation, fission fragment production, and ion energy loss measurement in electron-degenerate plasmas. More generally, the NIF conditions provide a singular environment to investigate the interplay of atomic and nuclear processes such as plasma screening effects upon thermonuclear reactivity. Lastly, achieving enhanced understanding of many of these effects will also significantly advance fusion energy research and challenge existing theoretical models.« less

Delivering free healthcare to rural Central Appalachia population: the case of the Health Wagon.

PubMed

Gardner, T; Gavaza, P; Meade, P; Adkins, D M

2012-01-01

Central Appalachia residents present unique healthcare challenges. This vulnerable population faces poor health status and low access to health care. 'The Health Wagon' was established to innovatively enhance access to health care for the poor and marginalized rural population of Central Appalachia. This article describes the operations of the Health Wagon, a full mobile medical clinic, in delivering free health care to those in rural Southwest Virginia in Central Appalachia. The Health Wagon provides a wide range of comprehensive healthcare services, such as acute and chronic disease management, laboratory and diagnostic services, medication assistance, dental and eye care and specialty clinics for marginalized, poor and disenfranchised patients living in the mountains of that region. In 2009, a total of 157 clinics were provided and 2900 patients were seen (3165 patient encounters) in addition to 268 telemedicine specialty consultations at no cost to the patients. The work of the Health Wagon has broken down a financial barrier to healthcare access and offers unique and profound opportunities to improve health and expand health care in rural Central Appalachia.

Essential Role of Lymph Nodes in Contact Hypersensitivity Revealed in Lymphotoxin-α–Deficient Mice

PubMed Central

Rennert, Paul D.; Hochman, Paula S.; Flavell, Richard A.; Chaplin, David D.; Jayaraman, Sundararajan; Browning, Jeffrey L.; Fu, Yang-Xin

2001-01-01

Lymph nodes (LNs) are important sentinal organs, populated by circulating lymphocytes and antigen-bearing cells exiting the tissue beds. Although cellular and humoral immune responses are induced in LNs by antigenic challenge, it is not known if LNs are essential for acquired immunity. We examined immune responses in mice that lack LNs due to genetic deletion of lymphotoxin ligands or in utero blockade of membrane lymphotoxin. We report that LNs are absolutely required for generating contact hypersensitivity, a T cell–dependent cellular immune response induced by epicutaneous hapten. We show that the homing of epidermal Langerhans cells in response to hapten application is specifically directed to LNs, providing a cellular basis for this unique LN function. In contrast, the spleen cannot mediate contact hypersensitivity because antigen-bearing epidermal Langerhans cells do not access splenic white pulp. Finally, we formally demonstrate that LNs provide a unique environment essential for generating this acquired immune response by reversing the LN defect in lymphotoxin-α−/− mice, thereby restoring the capacity for contact hypersensitivity. PMID:11390430

Microwave remote sensing from space

NASA Technical Reports Server (NTRS)

Carver, K. R.; Elachi, C.; Ulaby, F. T.

1985-01-01

Spaceborne microwave remote sensors provide perspectives of the earth surface and atmosphere which are of unique value in scientific studies of geomorphology, oceanic waves and topography, atmospheric water vapor and temperatures, vegetation classification and stress, ice types and dynamics, and hydrological characteristics. Microwave radars and radiometers offer enhanced sensitivities to the geometrical characteristics of the earth's surface and its cover, to water in all its forms - soil and vegetation moisture, ice, wetlands, oceans, and atmospheric water vapor, and can provide high-resolution imagery of the earth's surface independent of cloud cover or sun angle. A brief review of the historical development and principles of active and passive microwave remote sensing is presented, with emphasis on the unique characteristics of the information obtainable in the microwave spectrum and the value of this information to global geoscientific studies. Various spaceborne microwave remote sensors are described, with applications to geology, planetology, oceanography, glaciology, land biology, meteorology, and hydrology. A discussion of future microwave remote sensor technological developments and challenges is presented, along with a summary of future missions being planned by several countries.

Tsunami overview.

PubMed

Morrow, Robert C; Llewellyn, D Mark

2006-10-01

Historically, floods and tsunamis have caused relatively few severe injuries; an exception to that tendency followed the great Andaman Island-Sumatra earthquake and tsunami of 2004. More than 280,000 people died, the coastal plains were massively scoured, and more than 1 million individuals were made homeless by the quake and resulting tsunami, which affected a 10-nation region around the Indian Ocean. This destruction overwhelmed local resources and called forth an unprecedented, prolonged, international response. The USNS Mercy deployed on a unique mission and rendered service to the people and government of Indonesia. This introduction provides background on the nature and extent of the damage, conditions upon arrival of the hospital ship 5 weeks after the initial destruction, and the configuration of professionals aboard (officers and sailors of the U.S. Navy, civilian volunteers from Project HOPE, officers of the U.S. Public Health Service, and officers and civilian mariners of the Military Sealift Command). Constraints on the mission provide context for the other articles of this issue that document and comment on the activities, challenges, methods, and accomplishments of this unique mission's "team of teams," performing humanitarian assistance and disaster relief in the Pacific theater.

The Translational Genomics Core at Partners Personalized Medicine: Facilitating the Transition of Research towards Personalized Medicine

PubMed Central

Blau, Ashley; Brown, Alison; Mahanta, Lisa; Amr, Sami S.

2016-01-01

The Translational Genomics Core (TGC) at Partners Personalized Medicine (PPM) serves as a fee-for-service core laboratory for Partners Healthcare researchers, providing access to technology platforms and analysis pipelines for genomic, transcriptomic, and epigenomic research projects. The interaction of the TGC with various components of PPM provides it with a unique infrastructure that allows for greater IT and bioinformatics opportunities, such as sample tracking and data analysis. The following article describes some of the unique opportunities available to an academic research core operating within PPM, such the ability to develop analysis pipelines with a dedicated bioinformatics team and maintain a flexible Laboratory Information Management System (LIMS) with the support of an internal IT team, as well as the operational challenges encountered to respond to emerging technologies, diverse investigator needs, and high staff turnover. In addition, the implementation and operational role of the TGC in the Partners Biobank genotyping project of over 25,000 samples is presented as an example of core activities working with other components of PPM. PMID:26927185

The Translational Genomics Core at Partners Personalized Medicine: Facilitating the Transition of Research towards Personalized Medicine.

PubMed

Blau, Ashley; Brown, Alison; Mahanta, Lisa; Amr, Sami S

2016-02-26

The Translational Genomics Core (TGC) at Partners Personalized Medicine (PPM) serves as a fee-for-service core laboratory for Partners Healthcare researchers, providing access to technology platforms and analysis pipelines for genomic, transcriptomic, and epigenomic research projects. The interaction of the TGC with various components of PPM provides it with a unique infrastructure that allows for greater IT and bioinformatics opportunities, such as sample tracking and data analysis. The following article describes some of the unique opportunities available to an academic research core operating within PPM, such the ability to develop analysis pipelines with a dedicated bioinformatics team and maintain a flexible Laboratory Information Management System (LIMS) with the support of an internal IT team, as well as the operational challenges encountered to respond to emerging technologies, diverse investigator needs, and high staff turnover. In addition, the implementation and operational role of the TGC in the Partners Biobank genotyping project of over 25,000 samples is presented as an example of core activities working with other components of PPM.

Semi-transparent solar cells

NASA Astrophysics Data System (ADS)

Sun, J.; Jasieniak, J. J.

2017-03-01

Semi-transparent solar cells are a type of technology that combines the benefits of visible light transparency and light-to-electricity conversion. One of the biggest opportunities for such technologies is in their integration as windows and skylights within energy-sustainable buildings. Currently, such building integrated photovoltaics (BIPV) are dominated by crystalline silicon based modules; however, the opaque nature of silicon creates a unique opportunity for the adoption of emerging photovoltaic candidates that can be made truly semi-transparent. These include: amorphous silicon-, kesterite-, chalcopyrite-, CdTe-, dye-sensitized-, organic- and perovskite- based systems. For the most part, amorphous silicon has been the workhorse in the semi-transparent solar cell field owing to its established, low-temperature fabrication processes. Excitement around alternative classes, particularly perovskites and the inorganic candidates, has recently arisen because of the major efficiency gains exhibited by these technologies. Importantly, each of these presents unique opportunities and challenges within the context of BIPV. This topic review provides an overview into the broader benefits of semi-transparent solar cells as building-integrated features, as well as providing the current development status into all of the major types of semi-transparent solar cells technologies.

Dynamic high energy density plasma environments at the National Ignition Facility for nuclear science research

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

Cerjan, Ch J.; Bernstein, L.; Hopkins, L. Berzak

We present the generation of dynamic high energy density plasmas in the pico- to nano-second time domain at high-energy laser facilities affords unprecedented nuclear science research possibilities. At the National Ignition Facility (NIF), the primary goal of inertial confinement fusion research has led to the synergistic development of a unique high brightness neutron source, sophisticated nuclear diagnostic instrumentation, and versatile experimental platforms. These novel experimental capabilities provide a new path to investigate nuclear processes and structural effects in the time, mass and energy density domains relevant to astrophysical phenomena in a unique terrestrial environment. Some immediate applications include neutron capturemore » cross-section evaluation, fission fragment production, and ion energy loss measurement in electron-degenerate plasmas. More generally, the NIF conditions provide a singular environment to investigate the interplay of atomic and nuclear processes such as plasma screening effects upon thermonuclear reactivity. Lastly, achieving enhanced understanding of many of these effects will also significantly advance fusion energy research and challenge existing theoretical models.« less

Cryogenic Vibrational Spectroscopy Provides Unique Fingerprints for Glycan Identification.

PubMed

Masellis, Chiara; Khanal, Neelam; Kamrath, Michael Z; Clemmer, David E; Rizzo, Thomas R

2017-10-01

The structural characterization of glycans by mass spectrometry is particularly challenging. This is because of the high degree of isomerism in which glycans of the same mass can differ in their stereochemistry, attachment points, and degree of branching. Here we show that the addition of cryogenic vibrational spectroscopy to mass and mobility measurements allows one to uniquely identify and characterize these complex biopolymers. We investigate six disaccharide isomers that differ in their stereochemistry, attachment point of the glycosidic bond, and monosaccharide content, and demonstrate that we can identify each one unambiguously. Even disaccharides that differ by a single stereogenic center or in the monosaccharide sequence order show distinct vibrational fingerprints that would clearly allow their identification in a mixture, which is not possible by ion mobility spectrometry/mass spectrometry alone. Moreover, this technique can be applied to larger glycans, which we demonstrate by distinguishing isomeric branched and linear pentasaccharides. The creation of a database containing mass, collision cross section, and vibrational fingerprint measurements for glycan standards should allow unambiguous identification and characterization of these biopolymers in mixtures, providing an enabling technology for all fields of glycoscience. Graphical Abstract ᅟ.

Physiological and Psychological Challenges of Increasing Physical Activity and Exercise in Patients at Risk of Diabetic Foot Ulcers: A Critical Review

PubMed Central

Crews, Ryan T.; Schneider, Kristin L.; Yalla, Sai V.; Reeves, Neil D.; Vileikyte, Loretta

2017-01-01

Obesity and a sedentary lifestyle are common challenges among individuals at risk of diabetic foot ulcers (DFUs). While substantial research exists on physical activity interventions in adults with diabetes, those at greatest risk for foot ulceration were often excluded or not well-represented. Both at-risk patients and their clinicians may be hesitant to increase physical activity due to their perception of DFU risks. Physical activity is not contraindicated for those at risk of DFU, yet patients at risk present with unique barriers to initiating increases in physical activity. This review focuses upon the physiological and psychological challenges of increasing physical activity and exercise in patients at risk of DFUs. Offloading, diabetic peripheral neuropathy, depression, pain, self-efficacy and social support, DFU risk-specific beliefs and emotions, and research to date on exercise interventions in this population are all discussed. Additionally, recommendations for implementing and researching physical activity interventions for individuals at risk for DFU are provided. PMID:27155091

Global Forum: Spine Research and Training in Underserved, Low and Middle-Income, Culturally Unique Communities: The World Spine Care Charity Research Program's Challenges and Facilitators.

PubMed

Brady, O'Dane; Nordin, Margareta; Hondras, Maria; Outerbridge, Geoff; Kopansky-Giles, Deborah; Côté, Pierre; da Silva, Sophia; Ford, Timothy; Eberspaecher, Stefan; Acaroğlu, Emre; Mmopelwa, Tiro; Hurwitz, Eric L; Haldeman, Scott

2016-12-21

The World Spine Care (WSC), established by volunteers from 5 continents, is dedicated to providing sustainable, evidence-based spine care to individuals and communities in low and middle-income countries consistent with available health-care resources and integrated within the local culture. The research committee approves and oversees the WSC's collaborative research and training projects worldwide and serves to create a sustainable research community for underserved populations focused on preventing disability from spinal disorders. The purpose of this article is to describe 4 projects overseen by the WSC research committee and to discuss several challenges and specific facilitators that allowed successful completion of initiatives. These novel projects, which involved establishing spine surgery expertise and data collection in the WSC clinics and surrounding communities, all met their aims. This was achieved by overcoming language and resource challenges, adapting to local customs, and taking time to build mutual respect and to nurture relationships with local investigators and stakeholders.

Measurement and Instrumentation Challenges at X-ray Free Electron Lasers

NASA Astrophysics Data System (ADS)

Feng, Yiping

2015-03-01

X-ray Free Electron Laser sources based on the Self Amplified Spontaneous Emission process are intrinsically chaotic, giving rise to pulse-to-pulse fluctuations in all physical properties, including intensity, position and pointing, spatial and temporal profiles, spectral content, timing, and coherence. These fluctuations represents special challenges to users whose experiments are designed to reveal small changes in the underlying physical quantities, which would otherwise be completely washed out without using the proper diagnostics tools. Due to the X-ray FEL's unique characteristics such as the unprecedented peak power and nearly full spatial coherence, there are many technical challenges in conceiving and implementing these devices that are highly transmissive, provide sufficient signal-to-noise ratio, and most importantly work in the single-shot mode. Portions of this research were carried out at the Linac Coherent Light Source (LCLS) at the SLAC National Accelerator Laboratory. LCLS is an Office of Science User Facility operated for the U.S. Department of Energy Office of Science by Stanford Univ.

Applications of Single-Cell Sequencing for Multiomics.

PubMed

Xu, Yungang; Zhou, Xiaobo

2018-01-01

Single-cell sequencing interrogates the sequence or chromatin information from individual cells with advanced next-generation sequencing technologies. It provides a higher resolution of cellular differences and a better understanding of the underlying genetic and epigenetic mechanisms of an individual cell in the context of its survival and adaptation to microenvironment. However, it is more challenging to perform single-cell sequencing and downstream data analysis, owing to the minimal amount of starting materials, sample loss, and contamination. In addition, due to the picogram level of the amount of nucleic acids used, heavy amplification is often needed during sample preparation of single-cell sequencing, resulting in the uneven coverage, noise, and inaccurate quantification of sequencing data. All these unique properties raise challenges in and thus high demands for computational methods that specifically fit single-cell sequencing data. We here comprehensively survey the current strategies and challenges for multiple single-cell sequencing, including single-cell transcriptome, genome, and epigenome, beginning with a brief introduction to multiple sequencing techniques for single cells.

Gravitational wave astronomy: needle in a haystack.

PubMed

Cornish, Neil J

2013-02-13

A worldwide array of highly sensitive ground-based interferometers stands poised to usher in a new era in astronomy with the first direct detection of gravitational waves. The data from these instruments will provide a unique perspective on extreme astrophysical objects, such as neutron stars and black holes, and will allow us to test Einstein's theory of gravity in the strong field, dynamical regime. To fully realize these goals, we need to solve some challenging problems in signal processing and inference, such as finding rare and weak signals that are buried in non-stationary and non-Gaussian instrument noise, dealing with high-dimensional model spaces, and locating what are often extremely tight concentrations of posterior mass within the prior volume. Gravitational wave detection using space-based detectors and pulsar timing arrays bring with them the additional challenge of having to isolate individual signals that overlap one another in both time and frequency. Promising solutions to these problems will be discussed, along with some of the challenges that remain.

The Challenge of Separating Effects of Simultaneous Education Projects on Student Achievement

ERIC Educational Resources Information Center

Ma, Xin; Ma, Lingling

2009-01-01

When multiple education projects operate in an overlapping or rear-ended manner, it is always a challenge to separate unique project effects on schooling outcomes. Our analysis represents a first attempt to address this challenge. A three-level hierarchical linear model (HLM) was presented as a general analytical framework to separate program…

Patient Communication in Health Care Settings: new Opportunities for Augmentative and Alternative Communication.

PubMed

Blackstone, Sarah W; Pressman, Harvey

2016-01-01

Delivering quality health care requires effective communication between health care providers and their patients. In this article, we call on augmentative and alternative communication (AAC) practitioners to offer their knowledge and skills in support of a broader range of patients who confront communication challenges in health care settings. We also provide ideas and examples about ways to prepare people with complex communication needs for the inevitable medical encounters that they will face. We argue that AAC practitioners, educators, and researchers have a unique role to play, important expertise to share, and an extraordinary opportunity to advance the profession, while positively affecting patient outcomes across the health care continuum for a large number of people.

X-Ray Spectroscopy of Photoionized Plasmas

NASA Technical Reports Server (NTRS)

Kallman, Tim

2008-01-01

Spectroscopy allows study of sources on small spatial scales, and can provide detailed diagnostic information about elemental abundances, temperature, density and gas dynamics. For compact sources such as accreting black holes in active galactic nuclei (AGN) and X-ray binaries X-ray spectra provide truly unique insight. Observations using Chandra and XMM have revealed components of gas in these systems which were previously unknown or poorly studied. Interpretation of these data presents modeling and analysis challenges, and requires an understanding of atomic physics, ionization and spectrum formation in a radiation-dominated environment. In this talk I will discuss examples, and how they have contributed to our understanding of accreting sources and the nearby gas.

U.S. Geological Survey water-resource monitoring activities in support of the Wyoming Landscape Conservation Initiative

USGS Publications Warehouse

Soileau, Suzanna; Miller, Kirk

2013-01-01

The quality of the Nation’s water resources are vital to the health and well-being of both our communities and the natural landscapes we value. The U.S. Geological Survey investigates the occurrence, quantity, quality, distribution, and movement of surface water and groundwater and provides this information to engineers, scientists, managers, educators, and the general public. This information also supplements current (2013) and historical water data provided by the National Water Information System. The U.S. Geological Survey collects and shares data nationwide, but how those data are used is often site specific; this variety of data assists natural-resource managers in addressing unique, local, and regional challenges.

Size matters: gold nanoparticles in targeted cancer drug delivery

PubMed Central

Dreaden, Erik C; Austin, Lauren A; Mackey, Megan A; El-Sayed, Mostafa A

2013-01-01

Cancer is the current leading cause of death worldwide, responsible for approximately one quarter of all deaths in the USA and UK. Nanotechnologies provide tremendous opportunities for multimodal, site-specific drug delivery to these disease sites and Au nanoparticles further offer a particularly unique set of physical, chemical and photonic properties with which to do so. This review will highlight some recent advances, by our laboratory and others, in the use of Au nanoparticles for systemic drug delivery to these malignancies and will also provide insights into their rational design, synthesis, physiological properties and clinical/preclinical applications, as well as strategies and challenges toward the clinical implementation of these constructs moving forward. PMID:22834077

HIV in Indian MSM: reasons for a concentrated epidemic & strategies for prevention.

PubMed

Thomas, Beena; Mimiaga, Matthew J; Kumar, Senthil; Swaminathan, Soumya; Safren, Steven A; Mayer, Kenneth H

2011-12-01

Men who have sex with men (MSM) in India are disproportionately likely to be HIV-infected, and face distinct psychosocial challenges. Understanding the unique socio-cultural issues of MSM in India and how they relate to HIV risk could maximize the utility of future prevention efforts. This review discusses: (i) the importance of addressing co-occurring mental health issues, such as depression, which may interfere with MSM's ability to benefit from traditional risk reduction counselling, (ii) reducing HIV-related stigma among health providers, policymakers and the lay public, and (iii) the role for non-governmental organizations that work with the community to play in providing culturally relevant HIV prevention programmes for MSM.

Biology and Systematics of Echinococcus.

PubMed

Thompson, R C A

2017-01-01

The biology of Echinococcus, the causative agent of echinococcosis (hydatid disease) is reviewed with emphasis on the developmental biology of the adult and metacestode stages of the parasite. Major advances include determining the origin, structure and functional activities of the laminated layer and its relationship with the germinal layer; and the isolation, in vitro establishment and characterization of the multipotential germinal cells. Future challenges are to identify the mechanisms that provide Echinococcus with its unique developmental plasticity and the nature of activities at the parasite-host interface, particularly in the definitive host. The revised taxonomy of Echinococcus is presented and the solid nomenclature it provides will be essential in understanding the epidemiology of echinococcosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Role of Stem Cell Therapeutics in Wound Healing: Current Understanding and Future Directions.

PubMed

Sorice, Sarah; Rustad, Kristine C; Li, Alexander Y; Gurtner, Geoffrey C

2016-09-01

Chronic wounds present unique challenges for healthcare providers as they place patients at increased risk for various morbidities and mortality. Advances in wound care technology have expanded the treatment options available for wound management, but few products fully address the underlying core deficiencies responsible for the development of poorly healing wounds. In the future, addressing these derangements will undoubtedly play a key role in the treatment of these patients. Broad enthusiasm has surrounded the field of stem cell biology, which has shown great promise in repairing damaged tissues across numerous disease phenotypes. In this review, we provide a comprehensive review of the literature and evaluate the present landscape of wound therapeutics while discussing the rationales and allure behind stem cell-based products. We further propose 2 challenges that remain as new stem cell-based therapies are being developed and as this technology moves toward clinical translation. Given the relatively young age of this newer technology in wound healing, numerous challenges continue to surround its effective use including identifying the ideal population of stem cells to use and determining the optimal cell delivery method. However, significant forward progress has been made, with several clinical trials beginning to demonstrate reliable clinical benefit. The upward trajectory of stem cell technologies provides an exciting opportunity to positively impact patient outcomes through the controlled application of regenerative cell-based therapy.

International Students at Community Colleges: Challenges and Opportunities for This Unique Segment of U.S. Higher Education

ERIC Educational Resources Information Center

Jennings, Ross

2017-01-01

In unprecedented numbers, American community colleges are seeking to boost their recruitment and retention of international students. This chapter uncovers the challenges and opportunities based on successful experiences in community college efforts.

Recent progress in plasma-assisted synthesis and modification of 2D materials

NASA Astrophysics Data System (ADS)

Han, Zhao Jun; Murdock, Adrian T.; Seo, Dong Han; Bendavid, Avi

2018-07-01

Plasma represents an important technique for both the synthesis and modification of two-dimensional (2D) materials, owing to the unique plasma-material interactions which can enable effective energy transfer at the nanoscale. Non-equilibrium and non-thermal plasma techniques have been widely applied on various 2D materials, including graphene, silicene, germanene, phosphorene, hexagonal boron nitride (h-BN), and transition metal dichalcogenides such as MoS2 and WS2. Here, we review the recent progress in plasma-assisted synthesis and modification (e.g. functionalisation, doping and etching) of 2D materials and discuss the potential applications of this unique branch of 2D materials. Challenges and future research opportunities in the relevant research field are also discussed. The primary aim of this Review is to provide a better understanding of the plasma-assisted processes and to promote the utilization of 2D materials for advanced electronic, optoelectronic, sensing and energy storage applications.

Cubesats: Cost-effective science and technology platforms for emerging and developing nations

NASA Astrophysics Data System (ADS)

Woellert, Kirk; Ehrenfreund, Pascale; Ricco, Antonio J.; Hertzfeld, Henry

2011-02-01

The development, operation, and analysis of data from cubesats can promote science education and spur technology utilization in emerging and developing nations. This platform offers uniquely low construction and launch costs together with a comparative ubiquity of launch providers; factors that have led more than 80 universities and several emerging nations to develop programs in this field. Their small size and weight enables cubesats to “piggyback” on rocket launches and accompany orbiters travelling to Moon and Mars. It is envisaged that constellations of cubesats will be used for larger science missions. We present a brief history, technology overview, and summary of applications in science and industry for these small satellites. Cubesat technical success stories are offered along with a summary of pitfalls and challenges encountered in both developed and emerging nations. A discussion of economic and public policy issues aims to facilitate the decision-making process for those considering utilization of this unique technology.

Synthetic Immunology: Hacking Immune Cells to Expand Their Therapeutic Capabilities.

PubMed

Roybal, Kole T; Lim, Wendell A

2017-04-26

The ability of immune cells to survey tissues and sense pathologic insults and deviations makes them a unique platform for interfacing with the body and disease. With the rapid advancement of synthetic biology, we can now engineer and equip immune cells with new sensors and controllable therapeutic response programs to sense and treat diseases that our natural immune system cannot normally handle. Here we review the current state of engineered immune cell therapeutics and their unique capabilities compared to small molecules and biologics. We then discuss how engineered immune cells are being designed to combat cancer, focusing on how new synthetic biology tools are providing potential ways to overcome the major roadblocks for treatment. Finally, we give a long-term vision for the use of synthetic biology to engineer immune cells as a general sensor-response platform to precisely detect disease, to remodel disease microenvironments, and to treat a potentially wide range of challenging diseases.