40 CFR 86.614-84 - Hearings on suspension, revocation, and voiding of certificates of conformity.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and law relied upon in support of the position taken on each issue, with specific page references to... on any issue; (10) To take or cause depositions to be taken whenever the ends of justice would be... stipulations and admissions, receive requests and order depositions to be taken, identify disputed issues of...

Critical Issues in Evaluating National-Level Health Data Warehouses in LMICs: Kenya Case Study.

PubMed

Gesicho, Milka B; Babic, Ankica; Were, Martin C

2017-01-01

Low-Middle-Income-Countries (LMICs) are beginning to adopt national health data warehousing (NHDWs) for making strategic decisions and for improving health outcomes. Given the numerous challenges likely to be faced in establishment of NHDWs by LMICs, it is prudent that evaluations are done in relation to the data warehouses (DWs), in order to identify and mitigate critical issues that arise. When critic issues are not identified, DWs are prone to suboptimal implementation with compromised outcomes. Despite the fact that several publications exist on evaluating DWs, evaluations specific to health data warehouses are scanty, with almost none evaluating NHDWs more so in LMICs. This paper uses a systematic approach guided by an evaluation framework to identify critical issues to be considered in evaluating Kenya's NHDW.

Important Clinical Rehabilitation Principles Unique to People with Non-traumatic Spinal Cord Dysfunction.

PubMed

New, Peter Wayne; Eriks-Hoogland, Inge; Scivoletto, Giorgio; Reeves, Ronald K; Townson, Andrea; Marshall, Ruth; Rathore, Farooq A

2017-01-01

Background: Non-traumatic spinal cord dysfunction (SCDys) is caused by a large range of heterogeneous etiologies. Although most aspects of rehabilitation for traumatic spinal cord injury and SCDys are the same, people with SCDys have some unique rehabilitation issues. Purpose: This article presents an overview of important clinical rehabilitation principles unique to SCDys. Methods: Electronic literature search conducted (January 2017) using MEDLINE and Embase (1990-2016) databases for publications regarding SCDys. The focus of the literature search was on identifying publications that present suggestions regarding the clinical rehabilitation of SCDys. Results: The electronic search of MEDLINE and Embase identified no relevant publications, and the publications included were from the authors' libraries. A number of important clinical rehabilitation principles unique to people with SCDys were identified, including classification issues, general rehabilitation issues, etiology-specific issues, and a role for the rehabilitation physician as a diagnostic clinician. The classification issues were regarding the etiology of SCDys and the International Standards for Neurological Classification of Spinal Cord Injury. The general rehabilitation issues were predicting survival, improvement, and rehabilitation outcomes; admission to spinal rehabilitation units, including selection decision issues; participation in rehabilitation; and secondary health conditions. The etiology-specific issues were for SCDys due to spinal cord degeneration, tumors, and infections. Conclusions: Although there are special considerations regarding the rehabilitation of people with SCDys, such as the potential for progression of the underlying condition, functional improvement is typically significant with adequate planning of rehabilitation programs and special attention regarding the clinical condition of patients with SCDys.

Establishing usability heuristics for heuristics evaluation in a specific domain: Is there a consensus?

PubMed

Hermawati, Setia; Lawson, Glyn

2016-09-01

Heuristics evaluation is frequently employed to evaluate usability. While general heuristics are suitable to evaluate most user interfaces, there is still a need to establish heuristics for specific domains to ensure that their specific usability issues are identified. This paper presents a comprehensive review of 70 studies related to usability heuristics for specific domains. The aim of this paper is to review the processes that were applied to establish heuristics in specific domains and identify gaps in order to provide recommendations for future research and area of improvements. The most urgent issue found is the deficiency of validation effort following heuristics proposition and the lack of robustness and rigour of validation method adopted. Whether domain specific heuristics perform better or worse than general ones is inconclusive due to lack of validation quality and clarity on how to assess the effectiveness of heuristics for specific domains. The lack of validation quality also affects effort in improving existing heuristics for specific domain as their weaknesses are not addressed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ethics in Government.

ERIC Educational Resources Information Center

Update on Law-Related Education, 1990

1990-01-01

Presents a lesson developed by the Center for Civic Education giving secondary students the opportunity to explore ethical issues in government from the perspective of corrective justice. Outlines role plays and other class activities based on a fictitious ethics scandal involving bribery. Identifies specific questions to be asked on issues of…

The Teacher/Scientist: From Trainer to Educator.

ERIC Educational Resources Information Center

Ellerbrock, Michael J.

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

Research Priorities in Networking and Communications.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC.

A workshop focused on major research issues in networking and communications. This report defines the context for research priorities and initiatives and deals with issues in networking and communications. Fifteen major research priorities and four research specific initiatives were identified by participants as areas that should be pursued over…

Cultural and Contextual Issues in Exemplar Research

ERIC Educational Resources Information Center

King, Pamela Ebstyne; Oakes Mueller, Ross A.; Furrow, James

2013-01-01

This chapter specifically addresses how exemplar methods are especially relevant to examining cultural and contextual issues. Cross-cultural, cultural, and indigenous psychologies are discussed in order to highlight how studying actual exemplars in their unique and complex developmental contexts has the potential to identify themes that either…

Legal Issues in Experiential Education. PANEL Resource Paper #3.

ERIC Educational Resources Information Center

Goldstein, Michael B.

Legal issues relevant to experiential learning are identified to help program administrators know when to seek expert assistance and advice. Much of the law of experiential learning is based on specific statutory provisions and decisions. The student involved in experiential learning may assume certain learning outcomes very different from those…

77 FR 52315 - North Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... the final rule; Getting the nuts and bolts in place for implementation; Planned outreach and education... version will be posted at http://www.alaskafisheries.noaa.gov/npfmc/ . Although non-emergency issues not... formal action during these meetings. Actions will be restricted to those issues specifically identified...

Approach to implementing a DICOM network: incorporate both economics and workflow adaptation

NASA Astrophysics Data System (ADS)

Beaver, S. Merritt; Sippel-Schmidt, Teresa M.

1995-05-01

This paper describes an approach to aide in the decision-making process for the justification and design of a digital image and information management system. It identifies key technical and clinical issues that need to be addressed by a healthcare institution during this process. Some issues identified here are very controversial and may take months or years for a department to determine solutions which meet their specific staffing, financial, and technical needs.

Quality Control Review of the Defense Contract Management Agency Internal Review Audit Function

DTIC Science & Technology

2013-04-18

DMI-2011-001, “Audit of DCMA Telework Program,” November 29, 2011, we identified issues with independence. For the Audit of DCMA Telework Program...and Audit of DCMA Telework Program, we identified issues with audit planning. Specifically, we found that both audits did not include documentation...of fraud risks had been performed during audit planning. For the audit of the DCMA Telework Program, steps were added to the audit program to

Rural Information Needs.

ERIC Educational Resources Information Center

Fowler, Dave

1989-01-01

Examines the information needs of rural populations by identifying eight national issues and interpreting these as requests made to rural county agents. Four groups of rural information users are identified, and information needs specific to each group and that cross over all groups are discussed. (CLB)

Public health and terrorism preparedness: cross-border issues.

PubMed

Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra

2005-01-01

On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the "Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable." The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review.

PubMed

Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

2016-01-01

When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care. To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner. A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis. The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories. The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure.

The Full Spectrum of Clinical Ethical Issues in Kidney Failure. Findings of a Systematic Qualitative Review

PubMed Central

Kahrass, Hannes; Strech, Daniel; Mertz, Marcel

2016-01-01

Background When treating patients with kidney failure, unavoidable ethical issues often arise. Current clinical practice guidelines some of them, but lack comprehensive information about the full range of relevant ethical issues in kidney failure. A systematic literature review of such ethical issues supports medical professionalism in nephrology, and offers a solid evidential base for efforts that aim to improve ethical conduct in health care. Aim To identify the full spectrum of clinical ethical issues that can arise for patients with kidney failure in a systematic and transparent manner. Method A systematic review in Medline (publications in English or German between 2000 and 2014) and Google Books (with no restrictions) was conducted. Ethical issues were identified by qualitative text analysis and normative analysis. Results The literature review retrieved 106 references that together mentioned 27 ethical issues in clinical care of kidney failure. This set of ethical issues was structured into a matrix consisting of seven major categories and further first and second-order categories. Conclusions The systematically-derived matrix helps raise awareness and understanding of the complexity of ethical issues in kidney failure. It can be used to identify ethical issues that should be addressed in specific training programs for clinicians, clinical practice guidelines, or other types of policies dealing with kidney failure. PMID:26938863

A comparison of ethical issues in nursing practice across nursing units.

PubMed

Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun

2014-08-01

The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.

Army Command and Control Study-82 (ACCS-82). Volume III. Annexes.

DTIC Science & Technology

1979-09-30

specific issues identified by the group as requiring resolution in order to acompLish the study objective (Vol I, Chap 7). Recommendations are organized...Volume I, have been approved with the following modifications: a. Organizational Issue 1. The Army Readiness and Mobilization Region concept, described...in Volume IV, is the approved organizational alternative. b. Organizational Issue 3. The activation of one additional CONUS headquarters is

What Are the Issues Confronting Infertile Women? A Qualitative and Quantitative Approach

ERIC Educational Resources Information Center

Hammerli, Katja; Znoj, Hansjorg; Berger, Thomas

2010-01-01

Infertility is a stressful experience, yet little is known about the specific issues confronting infertile women. In the present study, researchers sought to identify themes important to infertile women and examine possible associations with mental health levels. Using qualitative content analysis, researchers analyzed the email messages of 57…

What Do We Know about Early Sport Specialization? Not Much!

ERIC Educational Resources Information Center

Baker, Joseph; Cobley, Stephen; Fraser-Thomas, Jessica

2009-01-01

In November 2005, the International Olympic Committee's Medical Commission issued a statement on "Training the elite child athlete" recommending that "more scientific research be done to better identify the parameters of training the elite child athlete". This paper focuses on a specific issue related to training the child athlete: early…

How to Conduct a Good Meta-Analysis in Gifted Education

ERIC Educational Resources Information Center

Steenbergen-Hu, Saiying; Olszewski-Kubilius, Paula

2016-01-01

This methodological brief introduces basic procedures and issues for conducting a high-quality meta-analysis in gifted education. Specifically, we discuss issues such as how to select a topic and formulate research problems, search for and identify qualified studies, code studies and extract data, choose and calculate effect sizes, analyze data,…

Identification and Characterization of Key Human Performance Issues and Research in the Next Generation Air Transportation System (NextGen)

NASA Technical Reports Server (NTRS)

Lee, Paul U.; Sheridan, Tom; Poage, james L.; Martin, Lynne Hazel; Jobe, Kimberly K.

2010-01-01

This report identifies key human-performance-related issues associated with Next Generation Air Transportation System (NextGen) research in the NASA NextGen-Airspace Project. Four Research Focus Areas (RFAs) in the NextGen-Airspace Project - namely Separation Assurance (SA), Airspace Super Density Operations (ASDO), Traffic Flow Management (TFM), and Dynamic Airspace Configuration (DAC) - were examined closely. In the course of the research, it was determined that the identified human performance issues needed to be analyzed in the context of NextGen operations rather than through basic human factors research. The main gaps in human factors research in NextGen were found in the need for accurate identification of key human-systems related issues within the context of specific NextGen concepts and better design of the operational requirements for those concepts. By focusing on human-system related issues for individual concepts, key human performance issues for the four RFAs were identified and described in this report. In addition, mixed equipage airspace with components of two RFAs were characterized to illustrate potential human performance issues that arise from the integration of multiple concepts.

Ethically-based clinical decision-making in physical therapy: process and issues.

PubMed

Finch, Elspeth; Geddes, E Lynne; Larin, Hélène

2005-01-01

The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

PubMed

Meadows, Andrew B; Maine, Lucinda L; Keyes, Elizabeth K; Pearson, Kathy; Finstuen, Kenn

2005-01-01

To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. Delphi method for executive decision making. Civilian pharmacy profession. 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

A comparison between findings from the DREEM questionnaire and that from qualitative interviews.

PubMed

Denz-Penhey, Harriet; Murdoch, J Campbell

2009-10-01

The Rural Clinical School of Western Australia educates one quarter of all Western Australian medical students in their first clinical year in rural settings. As part of a comprehensive evaluation programme students give feedback regularly. To identify if the Dundee Ready Education Environment Measurement (DREEM) data could be used qualitatively and descriptively to determine specific problems from the data alone despite the small numbers at some sites. The DREEM questionnaire was administered on the same day as qualitative interviews were undertaken. The qualitative interviews were analysed thematically first and then compared with findings from DREEM. Each major (student related) evaluation issue identified by the qualitative interviews was also identified by the DREEM questionnaire analysis. When the DREEM study was undertaken in the Rural Clinical School of Western Australia there was no real expectation that it would provide sufficient information to identify issues picked up in the extensive and time consuming qualitative study. About half of the work undertaken by the qualitative evaluation, that of the experiences of the students at the site, was picked up by the DREEM questionnaire in a much shorter time frame and at less cost of staff time and resources. The DREEM questionnaire can be used qualitatively to assess very specific issues relating to each of the subscales. These findings extend the use of DREEM from quantitative and statistically significant research to qualitative meaning-filled interpretations. The issues then need to be addressed sensitively.

Improved E-ELT subsystem and component specifications, thanks to M1 test facility

NASA Astrophysics Data System (ADS)

Dimmler, M.; Marrero, J.; Leveque, S.; Barriga, Pablo; Sedghi, B.; Kornweibel, N.

2014-07-01

During the last 2 years ESO has operated the "M1 Test Facility", a test stand consisting of a representative section of the E-ELT primary mirror equipped with 4 complete prototype segment subunits including sensors, actuators and control system. The purpose of the test facility is twofold: it serves to study and get familiar with component and system aspects like calibration, alignment and handling procedures and suitable control strategies on real hardware long before the primary mirror (hereafter M1) components are commissioned. Secondly, and of major benefit to the project, it offered the possibility to evaluate component and subsystem performance and interface issues in a system context in such detail, that issues could be identified early enough to feed back into the subsystem and component specifications. This considerably reduces risk and cost of the production units and allows refocusing the project team on important issues for the follow-up of the production contracts. Experiences are presented in which areas the results of the M1 Test Facility particularly helped to improve subsystem specifications and areas, where additional tests were adopted independent of the main test facility. Presented are the key experiences of the M1 Test Facility which lead to improved specifications or identified the need for additional testing outside of the M1 Test Facility.

Collaborativeness as the Core of Professional Learning Communities beyond Culture and Context: Evidence from Canada, Finland, and Israel

ERIC Educational Resources Information Center

Jäppinen, Aini-Kristiina; Leclerc, Martine; Tubin, Dorit

2016-01-01

Professional learning communities (PLC) have been widely accepted as effective with respect to good atmosphere, adequate leadership practices, and functional working practices. However, the outcomes for school improvement depend on case-specific issues. To identify less culturally and contextually bound issues in 3 PLC settings in Canada, Finland,…

National Technology Standards for K-12 Schools: A Case Study of Unresolved Issues in Public Relations

ERIC Educational Resources Information Center

Mullen, Carol A.; Kealy, William A.; Sullivan, Ashley

2004-01-01

This article addresses an important need--the dissemination of information relating to technology as a public relations tool--and the associated exigency for administrator and teacher technology training. Specifically, we identify the increased expectations for the performance of school leaders and teachers, as well as unresolved issues in public…

Dimensional Integration of Assessment Outcomes with Intervention Services for Children with Specific Learning Disabilities

ERIC Educational Resources Information Center

Decker, Scott

2012-01-01

This article reviews critical issues with integrating different procedures for identifying children with specific learning disabilities permitted in the federal regulations of the 2004 Individual With Disabilities Education Act 2004. Theoretical differences between behavioral approaches that focus on recording behavioral responses based on…

Teacher Motivation and Retention in High School Special Education

ERIC Educational Resources Information Center

Lawrence, Matthew Daniel

2017-01-01

The purpose of this study was to identify the best motivational tools for recruiting high-quality high school special education teachers; and to identify effective techniques and strategies to facilitate those individuals' experiencing career longevity within the profession. This study also sought to highlight the specific issues that actively…

10 CFR 35.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... nuclear pharmacist means a pharmacist who— (1) Meets the requirements in §§ 35.55(a) and 35.59; or (2) Is identified as an authorized nuclear pharmacist on— (i) A specific license issued by the Commission or...; or (3) Is identified as an authorized nuclear pharmacist by a commercial nuclear pharmacy that has...

10 CFR 35.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... nuclear pharmacist means a pharmacist who— (1) Meets the requirements in §§ 35.55(a) and 35.59; or (2) Is identified as an authorized nuclear pharmacist on— (i) A specific license issued by the Commission or...; or (3) Is identified as an authorized nuclear pharmacist by a commercial nuclear pharmacy that has...

10 CFR 35.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... nuclear pharmacist means a pharmacist who— (1) Meets the requirements in §§ 35.55(a) and 35.59; or (2) Is identified as an authorized nuclear pharmacist on— (i) A specific license issued by the Commission or...; or (3) Is identified as an authorized nuclear pharmacist by a commercial nuclear pharmacy that has...

10 CFR 35.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... nuclear pharmacist means a pharmacist who— (1) Meets the requirements in §§ 35.55(a) and 35.59; or (2) Is identified as an authorized nuclear pharmacist on— (i) A specific license issued by the Commission or...; or (3) Is identified as an authorized nuclear pharmacist by a commercial nuclear pharmacy that has...

10 CFR 35.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... nuclear pharmacist means a pharmacist who— (1) Meets the requirements in §§ 35.55(a) and 35.59; or (2) Is identified as an authorized nuclear pharmacist on— (i) A specific license issued by the Commission or...; or (3) Is identified as an authorized nuclear pharmacist by a commercial nuclear pharmacy that has...

11 CFR 106.6 - Allocation of expenses between federal and non-federal activities by separate segregated funds...

Code of Federal Regulations, 2013 CFR

2013-01-01

... public communications—(1) Costs to be allocated. Separate segregated funds and nonconnected committees... issue, without mentioning a specific candidate; and (iv) Public communications that refer to a political... identified Federal candidates; (iii) Public communications that refer to one or more clearly identified...

11 CFR 106.6 - Allocation of expenses between federal and non-federal activities by separate segregated funds...

Code of Federal Regulations, 2014 CFR

2014-01-01

... public communications—(1) Costs to be allocated. Separate segregated funds and nonconnected committees... issue, without mentioning a specific candidate; and (iv) Public communications that refer to a political... identified Federal candidates; (iii) Public communications that refer to one or more clearly identified...

11 CFR 106.6 - Allocation of expenses between federal and non-federal activities by separate segregated funds...

Code of Federal Regulations, 2012 CFR

2012-01-01

... public communications—(1) Costs to be allocated. Separate segregated funds and nonconnected committees... issue, without mentioning a specific candidate; and (iv) Public communications that refer to a political... identified Federal candidates; (iii) Public communications that refer to one or more clearly identified...

The role of universities in energy and environmental R & D: An extended outline

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

Drucker, H.

1995-12-31

Issues related to university research and development roles in energy and environmental areas are very briefly outlined in the paper. Fundamental issues discussed include basic versus applied science, and applied science versus technology development. Some specific issues appropriate for university research are identified, such as desulfurizing coal and managing mixed wastes in groundwater. The Plant Biotechnology consortium is described as a model that builds on university strengths in basic and applied technology.

Identification of Crew-Systems Interactions and Decision Related Trends

NASA Technical Reports Server (NTRS)

Jones, Sharon Monica; Evans, Joni K.; Reveley, Mary S.; Withrow, Colleen A.; Ancel, Ersin; Barr, Lawrence

2013-01-01

NASA Vehicle System Safety Technology (VSST) project management uses systems analysis to identify key issues and maintain a portfolio of research leading to potential solutions to its three identified technical challenges. Statistical data and published safety priority lists from academic, industry and other government agencies were reviewed and analyzed by NASA Aviation Safety Program (AvSP) systems analysis personnel to identify issues and future research needs related to one of VSST's technical challenges, Crew Decision Making (CDM). The data examined in the study were obtained from the National Transportation Safety Board (NTSB) Aviation Accident and Incident Data System, Federal Aviation Administration (FAA) Accident/Incident Data System and the NASA Aviation Safety Reporting System (ASRS). In addition, this report contains the results of a review of safety priority lists, information databases and other documented references pertaining to aviation crew systems issues and future research needs. The specific sources examined were: Commercial Aviation Safety Team (CAST) Safety Enhancements Reserved for Future Implementation (SERFIs), Flight Deck Automation Issues (FDAI) and NTSB Most Wanted List and Open Recommendations. Various automation issues taxonomies and priority lists pertaining to human factors, automation and flight design were combined to create a list of automation issues related to CDM.

Leading Online: An Autoethnography Focused on Leading an Instructional Focus on Student Learning in an Online School

ERIC Educational Resources Information Center

Lancaster, Sally Ann

2012-01-01

The purpose in writing this autoethnography was to describe, analyze and interpret one leader's experience in leading a group of online teachers. I specifically wanted to identify the characteristics of an online learning environment that triggered teachers to focus on management issues rather than instructional learning issues; that is what…

A formative evaluation of problem-based learning as an instructional strategy in a medical laboratory technician course

NASA Astrophysics Data System (ADS)

Nelson, Diane Patricia

2002-09-01

This study is a formative evaluation of problem-based learning as an effective course delivery strategy in a second year introductory Medical Laboratory Technician discipline-specific hematology course. This strategy can serve two purposes in this type of course: discipline specific content knowledge and process skills learning. A needs study identified that students required additional workplace skills as they entered the clinical internship. Students tested well on the national registry examinations, discipline-specific content knowledge, but group process skills needed improvement in the areas of collaboration, communication, and critical reasoning. Problem-based learning was identified as an change intervention to help provide these skills. A search of the literature revealed that the Baker College cultural and physical environment would support this intervention. Twelve cases were written, situated in a clinical laboratory environment, addressing learning issues identified in a modified Delphi survey of laboratory personnel e.g. fiscal responsibility, turn-around time, invasiveness of laboratory techniques, and holistic view of healthcare environment. A hematology class of 13 students received the intervention. The cases were structured to proceed from instructor-centered (guided) learning issues to learner-centered learning issues. Observations of the in-group collaboration processes were documented, as well as oral presentations and critical reasoning, with students given periodic feedback on these skills. Student surveys provided data about satisfaction, attitude to PBL process, and self-efficacy. Multiple choice discipline-specific content examinations were given and compared with classes from the previous four years. The study found that students receiving the PBL treatment scored as well as or better than students from previous years on traditional multiple choice exams. Recall questions showed positive significance and application/analysis questions showed no significance from previous years. Clinical correlations end-of-case evaluations addressing the issues of thoroughness of investigation, supporting evidence, accuracy of information, order and clarity of thought showed positive improvement across the intervention, as did the PBL processes of in-group collaboration skills, teamwork skills, and presentation skills. By the end of the intervention, students expressed preference for student-centered learning issues.

Applied Ethics and eHealth: Principles, Identity, and RFID

NASA Astrophysics Data System (ADS)

Whitehouse, Diane; Duquenoy, Penny

The social and ethical implications of contemporary technologies are becoming an issue of steadily growing importance. This paper offers an overview in terms of identity and the field of ethics, and explores how these apply to eHealth in both theory and practice. The paper selects a specific circumstance in which these ethical issues can be explored. It focuses particularly on radio-frequency identifiers (RFID). It ends by discussing ethical issues more generally, and the practice of ethical consideration.

Portfolio Standards and the Promotion of Combined Heat And Power

EPA Pesticide Factsheets

This paper presents the basic portfolio standard design approaches, identifies key CHP-related issues for policymakers to consider, and provides state-specific information on existing standards allowing for CHP.

Identifying critical issues in recreation planning and management: improving the management-research partnership

Treesearch

John H. Schomaker; David W. Lime

1988-01-01

The "nominal group" process is a proven technique to systematically arrive at a consensus about critical information needs in recreation planning and management. Using this process, 41 managers who attended a 1983 conference on river management identified 114 specific information needs grouped under 11 general questions. Clearly, some concerns of...

Identity Management Systems in Healthcare: The Issue of Patient Identifiers

NASA Astrophysics Data System (ADS)

Soenens, Els

According to a recent recommendation of the European Commission, now is the time for Europe to enhance interoperability in eHealth. Although interoperability of patient identifiers seems promising for matters of patient mobility, patient empowerment and effective access to care, we see that today there is indeed a considerable lack of interoperability in the field of patient identification. Looking from a socio-technical rather than a merely technical point of view, one can understand the fact that the development and implementation of an identity management system in a specific healthcare context is influenced by particular social practices, affected by socio-economical history and the political climate and regulated by specific data protection legislations. Consequently, the process of making patient identification in Europe more interoperable is a development beyond semantic and syntactic levels. In this paper, we gives some examples of today’s patient identifier systems in Europe, discuss the issue of interoperability of (unique) patient identifiers from a socio-technical point of view and try not to ignore the ‘privacy side’ of the story.

Issue Paper on the Environmental Chemistry of Metals

EPA Pesticide Factsheets

EPA has identified three types of regulatory risk assessments where information regarding speciation of metals is useful and desirable: national hazard/risk ranking and characterization, site-specific assessments, and National Regulatory Assessments.

32 CFR 1801.42 - Right of appeal and appeal procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COUNTERINTELLIGENCE CENTER PUBLIC RIGHTS UNDER THE PRIVACY ACT OF 1974 Action On Privacy Act Administrative Appeals... identify the documents or portions of documents at issue with specificity, provide the desired amending...

Can the EVIDEM Framework Tackle Issues Raised by Evaluating Treatments for Rare Diseases: Analysis of Issues and Policies, and Context-Specific Adaptation.

PubMed

Wagner, Monika; Khoury, Hanane; Willet, Jacob; Rindress, Donna; Goetghebeur, Mireille

2016-03-01

The multiplicity of issues, including uncertainty and ethical dilemmas, and policies involved in appraising interventions for rare diseases suggests that multicriteria decision analysis (MCDA) based on a holistic definition of value is uniquely suited for this purpose. The objective of this study was to analyze and further develop a comprehensive MCDA framework (EVIDEM) to address rare disease issues and policies, while maintaining its applicability across disease areas. Specific issues and policies for rare diseases were identified through literature review. Ethical and methodological foundations of the EVIDEM framework v3.0 were systematically analyzed from the perspective of these issues, and policies and modifications of the framework were performed accordingly to ensure their integration. Analysis showed that the framework integrates ethical dilemmas and issues inherent to appraising interventions for rare diseases but required further integration of specific aspects. Modification thus included the addition of subcriteria to further differentiate disease severity, disease-specific treatment outcomes, and economic consequences of interventions for rare diseases. Scoring scales were further developed to include negative scales for all comparative criteria. A methodology was established to incorporate context-specific population priorities and policies, such as those for rare diseases, into the quantitative part of the framework. This design allows making more explicit trade-offs between competing ethical positions of fairness (prioritization of those who are worst off), the goal of benefiting as many people as possible, the imperative to help, and wise use of knowledge and resources. It also allows addressing variability in institutional policies regarding prioritization of specific disease areas, in addition to existing uncertainty analysis available from EVIDEM. The adapted framework measures value in its widest sense, while being responsive to rare disease issues and policies. It provides an operationalizable platform to integrate values, competing ethical dilemmas, and uncertainty in appraising healthcare interventions.

Not Quite like a Honeymoon: Charting the First 24 Months of Sino-Foreign Educational Programmes

ERIC Educational Resources Information Center

Willis, Mike; Kennedy, Rowan

2009-01-01

There is now a large range of studies that have considered various aspects and issues of Sino-foreign university collaboration--which remains a vexed and contentious issue. The aim of the present study is to identify the specific steps a group of Sino-foreign educational alliances took over their first two years--as viewed by Chinese and foreign…

Key issues concerning environmental enrichment for laboratory-held fish species.

PubMed

Williams, T D; Readman, G D; Owen, S F

2009-04-01

An improved knowledge and understanding of the fundamental biological requirements is needed for many of the species of fish held in captivity and, without this knowledge it is difficult to determine the optimal conditions for laboratory culture. The aim of this paper is to review the key issues concerning environmental enrichment for laboratory-held fish species and identify where improvements are required. It provides background information on environmental enrichment, describes enrichment techniques currently used in aquatic ecotoxicology studies, identifies potential restrictions in their use and discusses why more detailed and species-specific guidance is needed.

DNAPL SITE EVALUATION - Project Summary

EPA Science Inventory

Dense nonaqueous-phase liquids (DNAPLs), especially chlorinated solvents, are among the most prevalent subsurface contaminants identified in ground-water supplies and at waste disposal sites. There are several site-characterization issues specific to DNAPL sites including (a) the...

7 CFR 1486.206 - What is the Quick Response Marketing Fund?

Code of Federal Regulations, 2010 CFR

2010-01-01

... Marketing Fund must identify specific market access issues that also face time constraints. Application... responsiveness to time-sensitive marketing problems or opportunities, such as a change in an import regime or the...

30 CFR 227.301 - What are a State's responsibilities if it performs audits?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Audit Strategy, which MMS will develop in consultation with States having delegated audit authority; (c) Agree to undertake special audit initiatives MMS identifies targeting specific royalty issues, such as...

32 CFR 1901.42 - Right of appeal and appeal procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGENCY PUBLIC RIGHTS UNDER THE PRIVACY ACT OF 1974 Action on Privacy Act Administrative Appeals § 1901.42.... All appeals must identify the documents or portions of documents at issue with specificity, provide...

Mastering the Diversity Challenge: Easy On-the-Job Applications for Measurable Results.

ERIC Educational Resources Information Center

Lebo, Fern

This book provides practical, step-by-step guidelines and gives important reasons why managing diversity is good for overall business. It identifies issues specific to designated groups and provides effective techniques for creating a level playing field, as well as specific on-the-job applications for running meetings, building a team, opening…

Chemical genomics: characterizing target pathways for bioactive compounds using the endomembrane trafficking network.

PubMed

Rodriguez-Furlán, Cecilia; Hicks, Glenn R; Norambuena, Lorena

2014-01-01

The plant endomembrane trafficking system is a highly complex set of processes. This complexity presents a challenge for its study. Classical plant genetics often struggles with loss-of-function lethality and gene redundancy. Chemical genomics allows overcoming many of these issues by using small molecules of natural or synthetic origin to inhibit specific trafficking proteins thereby affecting the processes in a tunable and reversible manner. Bioactive chemicals identified by high-throughput phenotype screens must be characterized in detail starting with understanding of the specific trafficking pathways affected. Here, we describe approaches to characterize bioactive compounds that perturb vesicle trafficking. This should equip researchers with practical knowledge on how to identify endomembrane-specific trafficking pathways that may be perturbed by specific compounds and will help to eventually identify molecular targets for these small molecules.

Identifying and Supporting English Learner Students with Learning Disabilities: Key Issues in the Literature and State Practice. REL 2015-086

ERIC Educational Resources Information Center

Burr, Elizabeth; Haas, Eric; Ferriere, Karen

2015-01-01

While the literature on learning disabilities and on second-language acquisition is relatively extensive within the field of education, less is known about the specific characteristics and representation of English learner students with learning disabilities. Because there are no definitive resources and processes for identifying and determining…

The full spectrum of ethical issues in dementia care: systematic qualitative review.

PubMed

Strech, Daniel; Mertz, Marcel; Knüppel, Hannes; Neitzke, Gerald; Schmidhuber, Martina

2013-06-01

Integrating ethical issues in dementia-specific training material, clinical guidelines and national strategy plans requires an unbiased awareness of all the relevant ethical issues. To determine systematically and transparently the full spectrum of ethical issues in clinical dementia care. We conducted a systematic review in Medline (restricted to English and German literature published between 2000 and 2011) and Google books (with no restrictions). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in clinical dementia care. The literature review retrieved 92 references that together mentioned a spectrum of 56 ethical issues in clinical dementia care. The spectrum was structured into seven major categories that consist of first- and second-order categories for ethical issues. The systematically derived spectrum of ethical issues in clinical dementia care presented in this paper can be used as training material for healthcare professionals, students and the public for raising awareness and understanding of the complexity of ethical issues in dementia care. It can also be used to identify ethical issues that should be addressed in dementia-specific training programmes, national strategy plans and clinical practice guidelines. Further research should evaluate whether this new genre of systematic reviews can be applied to the identification of ethical issues in other cognitive and somatic diseases. Also, the practical challenges in addressing ethical issues in training material, guidelines and policies need to be evaluated.

Adapting the coping in deliberation (CODE) framework: a multi-method approach in the context of familial ovarian cancer risk management.

PubMed

Witt, Jana; Elwyn, Glyn; Wood, Fiona; Rogers, Mark T; Menon, Usha; Brain, Kate

2014-11-01

To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. We performed a systematic literature search to identify issues important to women during deliberations about RRSO. Three focus groups with patients (most were pre-menopausal and untested for genetic mutations) and 11 interviews with health professionals were conducted to determine which issues mattered in the UK context. Data were used to adapt the generic CODE framework. The literature search yielded 49 relevant studies, which highlighted various issues and coping options important during deliberations, including mutation status, risks of surgery, family obligations, physician recommendation, peer support and reliable information sources. Consultations with UK stakeholders confirmed most of these factors as pertinent influences on deliberations. Questions in the generic framework were adapted to reflect the issues and coping options identified. The generic CODE framework was readily adapted to a specific preference-sensitive medical decision, showing that deliberations and coping are linked during deliberations about RRSO. Adapted versions of the CODE framework may be used to develop tailored decision support methods and materials in order to improve patient-centred care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

Gauglitz, Phillip A.; Bontha, Jagannadha R.; Daniel, Richard C.

The Hanford Waste Treatment and Immobilization Plant (WTP) is currently being designed and constructed to pretreat and vitrify a large portion of the waste in the 177 underground waste storage tanks at the Hanford Site. A number of technical issues related to the design of the pretreatment facility (PTF) of the WTP have been identified. These issues must be resolved prior to the U.S. Department of Energy (DOE) Office of River Protection (ORP) reaching a decision to proceed with engineering, procurement, and construction activities for the PTF. One of the issues is Technical Issue T1 - Hydrogen Gas Release frommore » Vessels (hereafter referred to as T1). The focus of T1 is identifying controls for hydrogen release and completing any testing required to close the technical issue. In advance of selecting specific controls for hydrogen gas safety, a number of preliminary technical studies were initiated to support anticipated future testing and to improve the understanding of hydrogen gas generation, retention, and release within PTF vessels. These activities supported the development of a plan defining an overall strategy and approach for addressing T1 and achieving technical endpoints identified for T1. Preliminary studies also supported the development of a test plan for conducting testing and analysis to support closing T1. Both of these plans were developed in advance of selecting specific controls, and in the course of working on T1 it was decided that the testing and analysis identified in the test plan were not immediately needed. However, planning activities and preliminary studies led to significant technical progress in a number of areas. This report summarizes the progress to date from the preliminary technical studies. The technical results in this report should not be used for WTP design or safety and hazards analyses and technical results are marked with the following statement: “Preliminary Technical Results for Planning – Not to be used for WTP Design or Safety Analyses.”« less

A theoretical framework for psychiatric nursing practice.

PubMed

Onega, L L

1991-01-01

Traditionally, specific theoretical frameworks which are congruent with psychiatric nursing practice have been poorly articulated. The purpose of this paper is to identify and discuss a philosophical base, a theoretical framework, application to psychiatric nursing, and issues related to psychiatric nursing knowledge development and practice. A philosophical framework that is likely to be congruent with psychiatric nursing, which is based on the nature of human beings, health, psychiatric nursing and reality, is identified. Aaron Antonovsky's Salutogenic Model is discussed and applied to psychiatric nursing. This model provides a helpful way for psychiatric nurses to organize their thinking processes and ultimately improve the health care services that they offer to their clients. Goal setting and nursing interventions using this model are discussed. Additionally, application of the use of Antonovsky's model is made to nursing research areas such as hardiness, uncertainty, suffering, empathy and literary works. Finally, specific issues related to psychiatric nursing are addressed.

Substance abuse prevention intervention research with Hispanic populations.

PubMed

Castro, Felipe González; Barrera, Manuel; Pantin, Hilda; Martinez, Charles; Felix-Ortiz, Maria; Rios, Rebeca; Lopez, Vera A; Lopez, Cristy

2006-09-01

Selected studies with specific relevance to substance abuse prevention interventions with Hispanic youth and families were examined to identify prior findings and emerging issues that may guide the design of future substance abuse prevention intervention research and its implementation with Hispanic populations. The origins of prevention research and role of risk and protective factors are examined, including culturally-specific risk and protective factors for Hispanic populations. Correlational studies, non-experimental interventions, and randomized controlled trials were examined for the period of 1974-2003. The literature search yielded 15 articles selected for this review that exhibited adequate methodological rigor. An added search for more recent studies identified three additional articles, for a total of 18 prevention intervention articles that were reviewed. Theoretical and methodological issues and recommendations are presented for future research aimed at improving the efficacy and effectiveness of future prevention intervention studies and their cultural relevance for Hispanic populations.

Report of sampling and analysis results, Addison Army housing units, Addison, Illinois. Final report

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

Not Available

1990-09-01

The objectives of this sampling and analysis effort include further characterization of environmental contamination identified in an enhanced preliminary assessment carried out in 1989. The specific activities performed at this site were identification, evaluation of the condition, and collection of samples from specific suspected asbestos-containing materials, including floor tiles, pipe run and pipe fitting insulation, dust in the ductwork, and exterior siding, where present. These evaluation were necessary to clarify potential environmental issues identified in the earlier report, prior to the sale or realignment of the property.

Preparing students for the ethical challenges on international health electives: A systematic review of the literature on educational interventions.

PubMed

Rahim, Anika; Knights Née Jones, Felicity; Fyfe, Molly; Alagarajah, Janagan; Baraitser, Paula

2016-09-01

International health electives pose specific ethical challenges for students travelling from to low and middle income countries. We undertook a systematic review of the literature on interventions to prepare students to identify ethical issues addressed, educational approaches and to collate evidence on the effectiveness of different strategies. We searched nine electronic databases of peer-reviewed literature and identified grey literature through key word searches; supplemented through citation mapping and expert consultation. Articles that described ethical training conducted by universities or professional bodies were included for review. We reviewed forty-four full text articles. Ten sources of published literature and seven sources of grey literature met our inclusion criteria. We identified thirteen ethical situations that students should be prepared to manage and eight generic skills to support this process. Most interventions were delivered before the elective, used case studies or guidelines. Some suggested ethical principles or a framework for analysis of ethical issues. Only two papers evaluated the intervention described. Our paper collates a small but growing body of work on education to prepare students to manage ethical issues. Ethical training should have elements that are delivered before, during and after the elective. Interventions should include case studies covering thirteen ethical issues identified here, linked to ethical principles and a process for responding to ethical issues. We suggest that evaluations of interventions are an important area for future research.

A geospatial approach to identify water quality issues for National Wildlife Refuges in Oregon and Washington

USGS Publications Warehouse

Hinck, Jo Ellen; Chojnacki, Kimberly; Finger, Susan E.; Linder, Greg; Kilbride, Kevin

2011-01-01

Many National Wildlife Refuges (Refuges) have impaired water quality resulting from historic and current land uses, upstream sources, and aerial pollutant deposition. Competing duties limit the time available for Refuge staff to identify and evaluate potential water quality issues. As a result, water quality–related issues may not be resolved until a problem has already arisen. This study developed a geospatial approach for identifying and prioritizing water quality issues affecting natural resources (including migratory birds and federally listed species) within Refuge boundaries. We assessed the location and status of streams pursuant to the Clean Water Act in relation to individual Refuges in Oregon and Washington, United States. Although twelve Refuges in Oregon (60%) and eight Refuges in Washington (40%) were assessed under the Clean Water Act, only 12% and 3% of total Refuge stream lengths were assessed, respectively. Very few assessed Refuge streams were not designated as impaired (0% in Oregon, 1% in Washington). Despite the low proportions of stream lengths assessed, most Refuges in Oregon (70%) and Washington (65%) are located in watersheds with approved total maximum daily loads. We developed summaries of current water quality issues for individual Refuges and identified large gaps for Refuge-specific water quality data and habitat utilization by sensitive species. We conclude that monitoring is warranted on many Refuges to better characterize water quality under the Clean Water Act.

Dependability and performability analysis

NASA Technical Reports Server (NTRS)

Trivedi, Kishor S.; Ciardo, Gianfranco; Malhotra, Manish; Sahner, Robin A.

1993-01-01

Several practical issues regarding specifications and solution of dependability and performability models are discussed. Model types with and without rewards are compared. Continuous-time Markov chains (CTMC's) are compared with (continuous-time) Markov reward models (MRM's) and generalized stochastic Petri nets (GSPN's) are compared with stochastic reward nets (SRN's). It is shown that reward-based models could lead to more concise model specifications and solution of a variety of new measures. With respect to the solution of dependability and performability models, three practical issues were identified: largeness, stiffness, and non-exponentiality, and a variety of approaches are discussed to deal with them, including some of the latest research efforts.

A Descriptive Study of the Retention of Secondary Trade and Industrial Teachers in Kansas

ERIC Educational Resources Information Center

Su, Sho-Hsien; Dainty, Julie D.; Sandford, Brian A.; Townsend, Donald; Belcher, Gregory G.

2011-01-01

Teacher retention is an important issue which can influence the delivery of quality education. However, only a few factors have been identified in the area of career and technical education that may influence teacher retention. The purpose of this study was to identify specific factors that may influence the retention of trade and industrial…

Information Science Panel joint meeting with Imaging Science Panel

NASA Technical Reports Server (NTRS)

1982-01-01

Specific activity in information extraction science (taken to include data handling) is needed to: help identify the bounds of practical missions; identify potential data handling and analysis scenarios; identify the required enabling technology; and identify the requirements for a design data base to be used by the disciplines in determining potential parameters for future missions. It was defined that specific analysis topics were a function of the discipline involved, and therefore no attempt was made to define any specific analysis developments required. Rather, it was recognized that a number of generic data handling requirements exist whose solutions cannot be typically supported by the disciplines. The areas of concern were therefore defined as: data handling aspects of system design considerations; enabling technology for data handling, with specific attention to rectification and registration; and enabling technology for analysis. Within each of these areas, the following topics were addressed: state of the art (current status and contributing factors); critical issues; and recommendations for research and/or development.

Spacecraft Habitable Volume: Results of an Interdisciplinary Workshop

NASA Technical Reports Server (NTRS)

Fitts, David J.; Connolly, Janis; Howard, Robert

2011-01-01

NASA's Human Exploration Framework Team posed the question: "Is 80 cubic meters per person of habitable volume acceptable for a proposed Deep Space Habitat?" The goal of the workshop was to address the "net habitable volume" necessary for long-duration human spaceflight missions and identify design and psychological issues and mitigations. The objectives were: (1) Identify psychological factors -- i.e., "stressors" -- that impact volume and layout specifications for long duration missions (2) Identify mitigation strategies for stressors, especially those that can be written as volume design specifications (3) Identify a forward research roadmap -- i.e., what future work is needed to define and validate objective design metrics? (4) Provide advisories on the human factors consequences of poor net habitable volume allocation and layout design.

Addressing uncertainty in vulnerability assessments [Chapter 5

Treesearch

Linda Joyce; Molly Cross; Evan Girvatz

2011-01-01

This chapter addresses issues and approaches for dealing with uncertainty specifically within the context of conducting climate change vulnerability assessments (i.e., uncertainties related to identifying and modeling the sensitivities, levels of exposure, and adaptive capacity of the assessment targets).

Construction loads experienced by plastic composite ties.

DOT National Transportation Integrated Search

2014-07-01

Damage to plastic composite ties during handling and track installation has been reported by a number of railroads. Results from : a survey conducted to identify specific handling issues were used to develop field and laboratory tests to measure the ...

Liability risk sharing regime for U.S. commercial space transportation : study and analysis

DOT National Transportation Integrated Search

2002-04-01

The Federal Aviation Administration of the Department of Transportation (DOT), in cooperation with interested federal agencies, has performed a study and analysis of seven issues specifically identified in the Space Competitiveness Act, and provides ...

Traffic Operations Control For Older Drivers And Pedestrians: Summary Report

DOT National Transportation Integrated Search

1996-07-01

The purpose of this investigation was to determine which intersection operational characteristics could be altered to accommodate age-related changes. Two key drivers issues were examined in order to identify the specific older driver problems and th...

A tool to determine financial impact of adverse events in health care: healthcare quality calculator.

PubMed

Yarbrough, Wendell G; Sewell, Andrew; Tickle, Erin; Rhinehardt, Eric; Harkleroad, Rod; Bennett, Marc; Johnson, Deborah; Wen, Li; Pfeiffer, Matthew; Benegas, Manny; Morath, Julie

2014-12-01

Hospital leaders lack tools to determine the financial impact of poor patient outcomes and adverse events. To provide health-care leaders with decision support for investments to improve care, we created a tool, the Healthcare Quality Calculator (HQCal), which uses institution-specific financial data to calculate impact of poor patient outcomes or quality improvement on present and future margin. Excel and Web-based versions of the HQCal were based on a cohort study framework and created with modular components including major drivers of cost and reimbursement. The Healthcare Quality Calculator (HQCal) compares payment, cost, and profit/loss for patients with and without poor outcomes or quality issues. Cost and payment information for groups with and without quality issues are used by the HQCal to calculate profit or loss. Importantly, institution-specific payment and cost data are used to calculate financial impact and attributable cost associated with poor patient outcomes, adverse events, or quality issues. Because future cost and reimbursement changes can be forecast, the HQCal incorporates a forward-looking component. The flexibility of the HQCal was demonstrated using surgical site infections after abdominal surgery and postoperative surgical airway complications. The Healthcare Quality Calculator determines financial impact of poor patient outcomes and the benefit of initiatives to improve quality. The calculator can identify quality issues that would provide the largest financial benefit if improved; however, it cannot identify specific interventions. The calculator provides a tool to improve transparency regarding both short- and long-term financial consequences of funding, or failing to fund, initiatives to close gaps in quality or improve patient outcomes.

Teaching ethics to engineers: ethical decision making parallels the engineering design process.

PubMed

Bero, Bridget; Kuhlman, Alana

2011-09-01

In order to fulfill ABET requirements, Northern Arizona University's Civil and Environmental engineering programs incorporate professional ethics in several of its engineering courses. This paper discusses an ethics module in a 3rd year engineering design course that focuses on the design process and technical writing. Engineering students early in their student careers generally possess good black/white critical thinking skills on technical issues. Engineering design is the first time students are exposed to "grey" or multiple possible solution technical problems. To identify and solve these problems, the engineering design process is used. Ethical problems are also "grey" problems and present similar challenges to students. Students need a practical tool for solving these ethical problems. The step-wise engineering design process was used as a model to demonstrate a similar process for ethical situations. The ethical decision making process of Martin and Schinzinger was adapted for parallelism to the design process and presented to students as a step-wise technique for identification of the pertinent ethical issues, relevant moral theories, possible outcomes and a final decision. Students had greatest difficulty identifying the broader, global issues presented in an ethical situation, but by the end of the module, were better able to not only identify the broader issues, but also to more comprehensively assess specific issues, generate solutions and a desired response to the issue.

Package leaflets of the most consumed medicines in Portugal: safety and regulatory compliance issues. A descriptive study.

PubMed

Pires, Carla; Vigário, Marina; Cavaco, Afonso

2015-01-01

Package leaflets are necessary for safe use of medicines. The aims of the present study were: 1) to assess the compliance between the content of the package leaflets and the specifications of the pharmaceutical regulations; and 2) to identify potential safety issues for patients. Qualitative descriptive study, involving all the package leaflets of branded medicines from the three most consumed therapeutic groups in Portugal, analyzed in the Department of Pharmacoepidemiology, School of Pharmacy, University of Lisbon. A checklist validated through an expert consensus process was used to gather the data. The content of each package leaflet in the sample was classified as compliant or non-compliant with compulsory regulatory issues (i.e. stated dosage and descriptions of adverse reactions) and optional regulatory issues (i.e. adverse reaction frequency, symptoms and procedures in cases of overdose). A total of 651 package leaflets were identified. Overall, the package leaflets were found to be compliant with the compulsory regulatory issues. However, the optional regulatory issues were only addressed in around half of the sample of package leaflets, which made it possible to identify some situations of potentially compromised drug safety. Ideally, the methodologies for package leaflet approval should be reviewed and optimized as a way of ensuring the inclusion of the minimum essential information for safe use of medicines.

77 FR 18247 - Request for Comments on Issues of Privacy and Access With Regard to Human Genome Sequence Data

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... regards genomic information and evolving notions of privacy, as evidenced and influenced by social media.... Undertaking these duties, the Commission seeks to identify and examine specific bioethical, legal, and social...

Funding Drives Service Decisions: A Moral Dilemma.

ERIC Educational Resources Information Center

Huebner, K. M.; Luxton, L.

1990-01-01

The 1990 Josephine L. Taylor Leadership Institute addressed the theme "Funding Drives Service Decisions: A Moral Dilemma." Institute participants identified specific dilemmas related to legislation, funding, and placement issues in education and rehabilitation of visually handicapped individuals. Participants subsequently generated solutions in…

Professional Development in International Schools; Issues of Inclusion Identified by a Group of International School Teaching Assistants

ERIC Educational Resources Information Center

Tarry, Estelle; Cox, Anna

2014-01-01

With the growth in numbers of teaching assistants (TAs) in the UK, it has been identified through research carried out on behalf of the Council of British International Schools (COBIS) research that TAs in British international schools have specific and unmet training needs. Following the development of a course for TAs in international contexts,…

Specificity and Engagement: Increasing ELSI s Relevance to Nano Scientists

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

Shumpert, Barry L.; Wolfe, Amy K.; Bjornstad, David J.

Scholars studying the ethical, legal, and social issues (ELSI) associated with emerging technologies maintain the importance of considering these issues throughout the research and development cycle, even during the earliest stages of basic research. Embedding these considerations within the scientific process requires communication between ELSI scholars and the community of physical scientists who are conducting that basic research. We posit that this communication can be effective on a broad scale only if it links societal issues directly to characteristics of the emerging technology that are relevant to the physical and natural scientists involved in research and development. In this article,more » we examine nano-ELSI literature from 2003 to 2010 to discern the degree to which it makes these types of explicit connections. We find that, while the literature identifies a wide range of issues of societal concern, it generally does so in a non-specific manner. It neither links societal issues to particular forms or characteristics of widely divergent nanotechnologies nor to any of the many potential uses to which those nanotechnologies may be put. We believe that these kinds of specificity are essential to those engaged in nano-scale research. We also compare the literature-based findings to observations from interviews we conducted with nanoscientists and conclude that ELSI scholars should add technical- and application-related forms of specificity to their work and their writings to enhance effectiveness and impact in communicating with one important target audience members of the nanoscale science community.« less

Readiness Review of BWXT for Fabrication of AGR-5/6/7 TRISO Particles

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

Marshall, Douglas William; Sharp, Michelle Tracy

2016-02-01

INL readiness review assessment of BWXT readiness to commence fabrication of low-enriched TRISO coated fuel particles for the AGR-5/6/7 irradiation experiments. BWXT self-identified equipment issues preventing operation. INL identified two findings. The first was that disposition codes had not been assigned and documented on BWXT forms to ensure that off-specification materials could not be used in the fabrication of TRISO particles. The second was that chemical purity specifications were not reliably passed on to chemical suppliers, which resulted in the receipt of one acetylene cylinder with suspect impurity levels.

On Being "Attractive" With Resistant Clients.

ERIC Educational Resources Information Center

Miller, Mark J.; Wells, Don

1990-01-01

Calls client resistance a frequent occurrence within the helping profession. Defines client resistance, provides a brief review of related literature, and offers counselor attractiveness as one way of addressing the issue. Identifies attractive counselor behaviors and attitudes and presents case study illustrating specific attractive counselor…

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

PubMed

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

2016-01-01

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

Sulfate Salts in Gasoline and Ethanol Fuels -- Historical Perspective and Analysis of Available Data

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

McCormick, Robert L.; Alleman, Teresa; Yanowitz, Janet

This report reviews the chemistry of sulfate salts dissolved in ethanol and gasoline, potential sources of sulfate salts in ethanol and gasoline, the history of consumer vehicle issues with sulfate salt deposits in the early 2000s, and the corresponding changes to the denatured fuel ethanol specification. Recommendations for future research are provided. During a period of rapid market expansion in 2004-05, issues were reported with vehicles running on E10 provided by certain suppliers in some markets. It was commonly believed that these vehicle problems were caused by sulfate salts precipitating from the fuel. Investigators identified sodium sulfate, and in onemore » case also ammonium sulfate, as the predominate salts found in the engines. Several stakeholders believed the issue was excess sulfate ions in the ethanol portion of the E10, and in 2005 the ASTM specification for ethanol (D4806) was modified to include a 4-part per million (ppm) limit on sulfate ions. While there have been no further reports of consumer vehicle issues, the recently approved increase of ethanol in gasoline from 10 to 15 volume percent has resulted in renewed interest in the sulfate ion concentration in fuel ethanol. This report reviews published data on the solubility of sulfate salts in ethanol. The possible sources of sulfate anions and charge balancing cations (such as sodium) in fuel ethanol and petroleum derived blendstocks are discussed. Examination of historical information on the consumer vehicle issues that occurred in 2004-2005 reveals that a source of sodium or ammonium ions, required for the formation of the observed insoluble salts, was never identified. Recommendations for research to better understand sulfate salt solubility issues in ethanol, hydrocarbon blendstocks, and ethanol-gasoline blends are presented.« less

Staff Training on the Use of Health Information Systems: What Do We Know?

PubMed

Bygholm, Ann

2018-01-01

Staff training is acknowledged as an important activity when implementing health information systems (HISs). This paper reviews the literature on staff training in connection with HIS implementation. The aim is to identify critical issues to reflect on when planning or evaluating this type of training. Searches were conducted in three research databases, resulting in 423 hits. Sixty-four papers were retrieved for more detailed examination, and 12 papers were selected for analysis. The analysis focused on the content, organization and pedagogical approach. In general, the review revealed minor primarily descriptive studies focused on aspects of staff training rather than strategies for staff training. The review revealed specific agreed-upon issues that are considered important for the success of the training. The issues identified are transfer of knowledge and skills is not enough, ongoing training is important, training should be related to practice and address individual learning needs, and super-users are important facilitators.

Feasibility study of shared-ride auto transit. Final report

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

Kocur, G.; Zaelke, D.; Neumann, L.

1977-09-01

The report examines the feasibility of the implementation of shared-ride auto transit (SRAT), which is an innovative approach for increasing auto occupancy in rural and urban areas. The report focuses on operational concepts, potential usage, legal and regulatory issues, and institutional issues. Formulation of the SRAT concept was motivated by several concerns, such as: (1) energy conservation; (2) transit service to areas unable to economically justify conventional transit services, and to travel disadvantaged groups; (3) transit service replacement to achieve greater efficiency and to reduce transit deficits; (4) provision of inexpensive transit service; and (5) the increase of safety andmore » reliability of hitchhiking. Four case study sites (Boulder, Colorado; Boston, Massachusetts; Portland, Oregon; and Tidewater, Virginia), were used to identify the specific institutional issues likely to impact SRAT implementation for that site, and to identify the opportunities for designing, implementing and operating SRAT in a variety of institutional settings.« less

Adapt Design: A Methodology for Enabling Modular Design for Mission Specific SUAS

DTIC Science & Technology

2016-08-24

ADAPT DESIGN: A METHODOLOGY FOR ENABLING MODULAR DESIGN FOR MISSION SPECIFIC SUAS Zachary C. Fisher David Locascio K. Daniel Cooksey...vehicle’s small scale. This paper considers a different approach to SUAS design aimed at addressing this issue. In this approach, a hybrid modular and...Two types of platforms have been identified: scalable platforms where variants are produced by varying scalable design variables, and modular

Environmental Technological Education in a Developing Country--Libya.

ERIC Educational Resources Information Center

Walters, A. H.; And Others

1981-01-01

Presents an overview of environmental and developmental issues and concerns of Libya focusing on water resources, agriculture, and industrialization. Identifies the need for an environmental program coordinated by a council and for environmental technological education programs and materials specifically designed for Libyan students. (DC)

Erectable space platform for space sciences and applications

NASA Technical Reports Server (NTRS)

1979-01-01

The specific objectives of the study were to: (1) identify a viable conceptual design for the service module/platform; (2) assess the technology issues that must be faced in planning development; and (3) prepare an initial plan for bringing critical technologies up to acceptable levels.

Long-Term Pavement Performance Ohio SPS-1 and SPS-2 Dynamic Load Response Data Processing

DOT National Transportation Integrated Search

2015-03-01

The dynamic load response (DLR) Study Team reinterpreted 4,290 Ohio Specific Pavement Studies (SPS)-1 (asphalt concrete pavements) raw traces and 9,240 Ohio SPS-2 (portland cement concrete pavements) raw traces, correcting the data issues identified ...

24 CFR 58.15 - Tiering.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the issues addressed in the broader review. The broader review should identify and evaluate those... consideration. The broader review should also establish the policy, standard or process to be followed in the site specific review. The Finding of No Significant Impact (FONSI) with respect to the broader...

24 CFR 58.15 - Tiering.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the issues addressed in the broader review. The broader review should identify and evaluate those... consideration. The broader review should also establish the policy, standard or process to be followed in the site specific review. The Finding of No Significant Impact (FONSI) with respect to the broader...

24 CFR 58.15 - Tiering.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the issues addressed in the broader review. The broader review should identify and evaluate those... consideration. The broader review should also establish the policy, standard or process to be followed in the site specific review. The Finding of No Significant Impact (FONSI) with respect to the broader...

24 CFR 58.15 - Tiering.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the issues addressed in the broader review. The broader review should identify and evaluate those... consideration. The broader review should also establish the policy, standard or process to be followed in the site specific review. The Finding of No Significant Impact (FONSI) with respect to the broader...

24 CFR 58.15 - Tiering.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the issues addressed in the broader review. The broader review should identify and evaluate those... consideration. The broader review should also establish the policy, standard or process to be followed in the site specific review. The Finding of No Significant Impact (FONSI) with respect to the broader...

A Categorical Content Analysis of Highly Cited Literature Related to Trends and Issues in Special Education.

PubMed

Arden, Sarah V; Pentimonti, Jill M; Cooray, Rochana; Jackson, Stephanie

2017-07-01

This investigation employs categorical content analysis processes as a mechanism to examine trends and issues in a sampling of highly cited (100+) literature in special education journals. The authors had two goals: (a) broadly identifying trends across publication type, content area, and methodology and (b) specifically identifying articles with disaggregated outcomes for students with learning disabilities (LD). Content analyses were conducted across highly cited (100+) articles published during a 20-year period (1992-2013) in a sample ( n = 3) of journals focused primarily on LD, and in one broad, cross-categorical journal recognized for its impact in the field. Results indicated trends in the article type (i.e., commentary and position papers), content (i.e., reading and behavior), and methodology (i.e., small proportions of experimental and quasi-experimental designs). Results also revealed stability in the proportion of intervention research studies when compared to previous analyses and a decline in the proportion of those that disaggregated data specifically for students with LD.

Nutrition labelling is a trade policy issue: lessons from an analysis of specific trade concerns at the World Trade Organization.

PubMed

Thow, Anne Marie; Jones, Alexandra; Hawkes, Corinna; Ali, Iqra; Labonté, Ronald

2017-01-12

Interpretive nutrition labels provide simplified nutrient-specific text and/or symbols on the front of pre-packaged foods, to encourage and enable consumers to make healthier choices. This type of labelling has been proposed as part of a comprehensive policy response to the global epidemic of non-communicable diseases. However, regulation of nutrition labelling falls under the remit of not just the health sector but also trade. Specific Trade Concerns have been raised at the World Trade Organization's Technical Barriers to Trade Committee regarding interpretive nutrition labelling initiatives in Thailand, Chile, Indonesia, Peru and Ecuador. This paper presents an analysis of the discussions of these concerns. Although nutrition labelling was identified as a legitimate policy objective, queries were raised regarding the justification of the specific labelling measures proposed, and the scientific evidence for effectiveness of such measures. Concerns were also raised regarding the consistency of the measures with international standards. Drawing on policy learning theory, we identified four lessons for public health policy makers, including: strategic framing of nutrition labelling policy objectives; pro-active policy engagement between trade and health to identify potential trade issues; identifying ways to minimize potential 'practical' trade concerns; and engagement with the Codex Alimentarius Commission to develop international guidance on interpretative labelling. This analysis indicates that while there is potential for trade sector concerns to stifle innovation in nutrition labelling policy, care in how interpretive nutrition labelling measures are crafted in light of trade commitments can minimize such a risk and help ensure that trade policy is coherent with nutrition action. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Processes and Challenges in Identifying Learning Disabilities among Students Who Are English Language Learners in Three New York State Districts. Issues & Answers. REL 2010-No. 085

ERIC Educational Resources Information Center

Sanchez, Maria Teresa; Parker, Caroline; Akbayin, Bercem; McTigue, Anna

2010-01-01

Using interviews with district and school personnel and documents from state and district web sites in three districts in New York State, the study examines practices for identifying learning disabilities among students who are English language learners and the challenges that arise. Specifically, two research questions guided the project: (1)…

Investigating the Fundamental Scientific Issues Affecting the Long-term Geologic Storage of Carbon Dioxide

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

Spangler, Lee; Cunningham, Alfred; Barnhart, Elliot

2014-12-19

The Zero Emissions Research and Technology (ZERT) collaborative was formed to address basic science and engineering knowledge gaps relevant to geologic carbon sequestration. The original funding round of ZERT (ZERT I) identified and addressed many of these gaps. ZERT II has focused on specific science and technology areas identified in ZERT I that showed strong promise and needed greater effort to fully develop.

Privacy and ethics in pediatric environmental health research-part II: protecting families and communities.

PubMed

Fisher, Celia B

2006-10-01

In pediatric environmental health research, information about family members is often directly sought or indirectly obtained in the process of identifying child risk factors and helping to tease apart and identify interactions between genetic and environmental factors. However, federal regulations governing human subjects research do not directly address ethical issues associated with protections for family members who are not identified as the primary "research participant." Ethical concerns related to family consent and privacy become paramount as pediatric environmental health research increasingly turns to questions of gene-environment interactions. In this article I identify issues arising from and potential solutions for the privacy and informed consent challenges of pediatric environmental health research intended to adequately protect the rights and welfare of children, family members, and communities. I first discuss family members as secondary research participants and then the specific ethical challenges of longitudinal research on late-onset environmental effects and gene-environment interactions. I conclude with a discussion of the confidentiality and social risks of recruitment and data collection of research conducted within small or unique communities, ethnic minority populations, and low-income families. The responsible conduct of pediatric environmental health research must be conceptualized as a goodness of fit between the specific research context and the unique characteristics of subjects and other family stakeholders.

An Investigation of Joint Service Acquisition Logistics Issues/Problems and Automated Joint Program Support.

DTIC Science & Technology

1984-09-01

Management Information System (ALMIS) to address them. Literature was surveyed and problems were summarized and developed into a questionnaire. Structured interviews were then conducted with over 100 different Air Force and civilian upper and middle JSAP managers. Many general and specific problems and issues were identified and validated using statistical and qualitative methods. General use of ALMIS to address certain joint service problem areas was confirmed. Potential use and desirable capabilities for ALMIS were also determined. Recommendations for ALMIS

Business Process Modelling is an Essential Part of a Requirements Analysis. Contribution of EFMI Primary Care Working Group.

PubMed

de Lusignan, S; Krause, P; Michalakidis, G; Vicente, M Tristan; Thompson, S; McGilchrist, M; Sullivan, F; van Royen, P; Agreus, L; Desombre, T; Taweel, A; Delaney, B

2012-01-01

To perform a requirements analysis of the barriers to conducting research linking of primary care, genetic and cancer data. We extended our initial data-centric approach to include socio-cultural and business requirements. We created reference models of core data requirements common to most studies using unified modelling language (UML), dataflow diagrams (DFD) and business process modelling notation (BPMN). We conducted a stakeholder analysis and constructed DFD and UML diagrams for use cases based on simulated research studies. We used research output as a sensitivity analysis. Differences between the reference model and use cases identified study specific data requirements. The stakeholder analysis identified: tensions, changes in specification, some indifference from data providers and enthusiastic informaticians urging inclusion of socio-cultural context. We identified requirements to collect information at three levels: micro- data items, which need to be semantically interoperable, meso- the medical record and data extraction, and macro- the health system and socio-cultural issues. BPMN clarified complex business requirements among data providers and vendors; and additional geographical requirements for patients to be represented in both linked datasets. High quality research output was the norm for most repositories. Reference models provide high-level schemata of the core data requirements. However, business requirements' modelling identifies stakeholder issues and identifies what needs to be addressed to enable participation.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas.

PubMed

Impoinvil, Daniel E; Ahmad, Sajjad; Troyo, Adriana; Keating, Joseph; Githeko, Andrew K; Mbogo, Charles M; Kibe, Lydiah; Githure, John I; Gad, Adel M; Hassan, Ali N; Orshan, Laor; Warburg, Alon; Calderón-Arguedas, Olger; Sánchez-Loría, Victoria M; Velit-Suarez, Rosanna; Chadee, Dave D; Novak, Robert J; Beier, John C

2007-10-01

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas

PubMed Central

Impoinvil, Daniel E.; Ahmad, Sajjad; Troyo, Adriana; Keating, Joseph; Githeko, Andrew K.; Mbogo, Charles M; Kibe, Lydiah; Githure, John I.; Gad, Adel M.; Hassan, Ali N.; Orshan, Laor; Warburg, Alon; Calderón-Arguedas, Olger; Sánchez-Loría, Victoria M.; Velit-Suarez, Rosanna; Chadee, Dave D.; Novak, Robert J.; Beier, John C.

2007-01-01

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site’s biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying “best practices” for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission. PMID:17316882

Crew Factors in Flight Operations. 11; A Survey of Fatigue Factors in Regional Airline Operations

NASA Technical Reports Server (NTRS)

Co, Elizabeth L.; Gregory, Kevin B.; Johnson, Julie M.; Rosekind, Mark R.

1999-01-01

This report is the eleventh in a series on the physiological effects of flight operations on flight crews. A 119-question survey was completed by 1,424 flight crewmembers from 26 regional carriers to identify factors contributing to fatigue in regional airline operations. Eighty-nine percent of crewmembers identified fatigue as a moderate or serious concern with 88% reporting that it was a common occurrence and 92% reporting that, when it occurs, fatigue represents a moderate or serious safety issue. However, 86% reported they received no company training addressing fatigue issues. Identified fatigue factors included multiple flight segments, scheduling considerations, varying regulations, and others. The two most commonly cited fatigue factors regarded flying multiple (more than four) segments. Scheduling factors accounted for nine of the ten most common recommendations to reduce fatigue in regional operations. Differing requirements among regulations were cited as contributing to fatigue. Other identified factors were the flight deck environment, automation, and diet. The data suggested specific recommendations, including education of industry personnel about fatigue issues and examination of scheduling practices. Education plays a critical role in any effort to address fatigue. Analyzing scheduling practices and identifying potential improvements may result in reduced fatigue as well as other benefits to operations.

Human Health Risk Assessment of Pharmaceuticals in Water: Issues and Challenges Ahead

PubMed Central

Kumar, Arun; Chang, Biao; Xagoraraki, Irene

2010-01-01

This study identified existing issues related to quantitative pharmaceutical risk assessment (QPhRA, hereafter) for pharmaceuticals in water and proposed possible solutions by analyzing methodologies and findings of different published QPhRA studies. Retrospective site-specific QPhRA studies from different parts of the world (U.S.A., United Kingdom, Europe, India, etc.) were reviewed in a structured manner to understand different assumptions, outcomes obtained and issues, identified/addressed/raised by the different QPhRA studies. Till date, most of the published studies have concluded that there is no appreciable risk to human health during environmental exposures of pharmaceuticals; however, attention is still required to following identified issues: (1) Use of measured versus predicted pharmaceutical concentration, (2) Identification of pharmaceuticals-of-concern and compounds needing special considerations, (3) Use of source water versus finished drinking water-related exposure scenarios, (4) Selection of representative exposure routes, (5) Valuation of uncertainty factors, and (6) Risk assessment for mixture of chemicals. To close the existing data and methodology gaps, this study proposed possible ways to address and/or incorporation these considerations within the QPhRA framework; however, more research work is still required to address issues, such as incorporation of short-term to long-term extrapolation and mixture effects in the QPhRA framework. Specifically, this study proposed a development of a new “mixture effects-related uncertainty factor” for mixture of chemicals (i.e., mixUFcomposite), similar to an uncertainty factor of a single chemical, within the QPhRA framework. In addition to all five traditionally used uncertainty factors, this uncertainty factor is also proposed to include concentration effects due to presence of different range of concentration levels of pharmaceuticals in a mixture. However, further work is required to determine values of all six uncertainty factors and incorporate them to use during estimation of point-of-departure values within the QPhRA framework. PMID:21139869

Review on the Role of Planetary Factors on Habitability.

PubMed

Kereszturi, A; Noack, L

2016-11-01

In this work various factors on the habitability were considered, focusing on conditions irrespective of the central star's radiation, to see the role of specific planetary body related effects. These so called planetary factors were evaluated to identify those trans-domain issues where important information is missing but good chance exit to be filled by new knowledge that might be gained in the next decade(s). Among these strategic knowledge gaps, specific issues are listed, like occurrence of radioactive nucleides in star forming regions, models to estimate the existence of subsurface liquid water from bulk parameters plus evolutionary context of the given system, estimation on the existence of redox gradient depending on the environment type etc. These issues require substantial improvement of modelling and statistical handling of various cases, as "planetary environment types". Based on our current knowledge it is probable that subsurface habitability is at least as frequent, or more frequent than surface habitability. Unfortunately it is more difficult from observations to infer conditions for subsurface habitability, but specific argumentation might help with indirect ways, which might result in new methods to approach habitability in general.

An Independent Scientific Assessment of Well Stimulation in California Volume II

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

Jane C.S. Long; Laura C. Feinstein; Corinne E. Bachmann

This study is issued in three volumes. Volume I, issued in January 2015, describes how well stimulation technologies work, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II, the present volume, discusses how well stimulation could affect water, atmosphere, seismic activity, wildlife and vegetation, and human health. Volume II reviews available data, and identifies knowledge gaps and alternative practices that could avoid or mitigate these possible impacts. Volume III, also issued in July 2015, presents case studies that assess environmental issues and qualitative risksmore » for specific geographic regions. A final Summary Report summarizes key findings, conclusions and recommendations of all three volumes.« less

Indexes of severity: conceptual development.

PubMed Central

Krischer, J P

1979-01-01

A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose. PMID:468553

Enhancing international medical graduates' communication: the contribution of applied linguistics.

PubMed

Dahm, Maria R; Yates, Lynda; Ogden, Kathryn; Rooney, Kim; Sheldon, Brooke

2015-08-01

International medical graduates (IMGs) make up one-third of the Australian medical workforce. Those from non-English-language backgrounds can face cultural and communication barriers, yet linguistic support is variable and medical educators are often required to provide feedback on both medical and communication issues. However, some communication difficulties may be very specific to the experiences of IMGs as second language users. This interdisciplinary study combines perspectives from applied linguistics experts and clinical educators to address IMGs' difficulties from multiple dimensions and to enhance feedback quality. Five video-recorded patient encounters with five IMGs were collected at Launceston General Hospital. Three clinical educators gave quantitative and qualitative feedback using the Rating Instrument for Clinical Consulting Skills, and two applied linguistics experts analysed the data for language, pragmatic and communication difficulties. The comparison of the educators' language-related feedback with linguistic analyses of the same interactions facilitated the exploration of differences in the difficulties identified by the two expert groups. Although the clinical educators were able to use their tacit intuitive understanding of communication issues to identify IMG difficulties, they less frequently addressed the underlying issues or suggested specific remedies in their feedback. This pilot study illustrates the effectiveness of interdisciplinary collaboration in highlighting the specific discourse features contributing to IMG communication difficulties and thus assists educators in deconstructing their intuitive knowledge. The authors suggest that linguistic insights can therefore improve communications training by assisting educators to provide more targeted feedback. © 2015 John Wiley & Sons Ltd.

Master Plan for Data Processing Services, 1988-1993. Report.

ERIC Educational Resources Information Center

Connecticut Regional Community Colleges, Hartford. Board of Trustees.

Developed in accordance with a legislative mandate, this master plan for Connecticut's regional community colleges provides baseline data on the current status of data processing; identifies issues, trends, and constraints; and sets forth specific plans for computing activities and services within the community college system. Introductory…

"Cultural Responsiveness": A Framework for Re-Thinking Students' Interculturality through Study Abroad

ERIC Educational Resources Information Center

Giovanangeli, Angela; Oguro, Susan

2016-01-01

While intercultural competence is commonly a goal of university study abroad programmes, debates around criteria for assessing this competence have highlighted the challenges in appropriately identifying students' intercultural learning in relation to specific university programmes. To overcome these issues, this research moves beyond…

32 CFR 1801.4 - Suggestions and complaints.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CENTER PUBLIC RIGHTS UNDER THE PRIVACY ACT OF 1974 General § 1801.4 Suggestions and complaints. NACIC welcomes suggestions or complaints with regard to its administration of the Privacy Act. Letters of suggestion or complaint should identify the specific purpose and the issues for consideration. NACIC will...

Transition from School to Adulthood for Young People with Disabilities.

ERIC Educational Resources Information Center

Inge, Katherine J., Ed.

1992-01-01

This newsletter issue provides rehabilitation professionals with various information pieces concerning transition from school to adulthood for young people with disabilities. An introduction identifies specific challenges in transition programming and stresses the goal of fully integrating young people with disabilities as interdependent parts of…

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

Wood, Richard Thomas; Ewing, Paul D.

The U.S. Nuclear Regulatory Commission’s (NRC’s) regulations in Part 50, “Domestic Licensing of Production and Utilization Facilities,” of Title 10 of the Code of Federal Regulations (10 CFR Part 50) state that structures, systems, and components important to safety in a nuclear power plant are to be designed to accommodate the effects of environmental conditions (i.e., remain functional under all postulated service conditions) and that design control measures such as testing are to be used to check the adequacy of design. Regulatory Guide (RG) 1.180 was developed to provide guidance to licensees and applicants on methods acceptable to the NRCmore » staff for complying with the NRC’s regulations on design, installation, and testing practices for addressing the effects of electromagnetic and radio-frequency interference (EMI/RFI) and power surges on safety-related instrumentation and control (I&C) systems. The first revision of RG 1.180 was issued in January 2000 and a second revision was issued in October 2003*. The second revision differed from the first revision in endorsing Military Standard (MIL-STD)-461E and the International Electrotechnical Commission (IEC) Standard (Std) 61000 series of EMI/RFI test methods, extending the guidance to cover signal line testing, incorporating frequency ranges where portable communications devices are experiencing increasing use, and relaxing the operating envelopes (test levels) when experience and confirmatory research warranted. It also offered exemptions from specific test criteria based on technical considerations such as plant conditions and the intended location of the safety-related I&C equipment. Since the last revision, new requirements have been identified, associated RGs have been created and updated, and additional industry guidance has been developed. Additionally, the operational environment has changed with the increase in wireless communication technology for both personal (smartphone) and industrial (remote I&C) purposes. Also, specific concerns and issues with testing methods and methodologies have been identified that must be addressed. Further, most of the standards that serve as the basis for the RG have been revised. Therefore, the NRC’s Office of Regulatory Research has contracted with Oak Ridge National Laboratory (ORNL) to incorporate new information and resolve the identified issues under NRC-HQ-60-14-D-0015, “Update to RG 1.180, Revision 2, Guidelines for Evaluating Electromagnetic and Radio-Frequency Interference in Safety-Related Instrumentation and Control Systems.” The ultimate goal of this project is to provide NRC the technical basis for developing and publishing a new revision of the RG. The focus of Task 4 was for ORNL to identify and address any new or additional EMI/RFI issues that could potentially impact the EMC of I&C systems. More specifically, ORNL was to evaluate the impact of any new issue on safety equipment in their local environments and then determine whether the issues should be included and discussed in the revision to RG 1.180 that is currently under way.« less

Ethics guidelines, health research and Indigenous Australians.

PubMed

Anderson, Ian; Griew, Robert; McAullay, Daniel

2003-02-01

In this paper we overview the findings of a literature review that was undertaken to guide the revision of the Guidelines on Ethical Matters in Aboriginal and Torres Strait Islander Health Research (NH&MRC, 1991). The literature reviewed, in general, supported the development of specific research guidelines for Aboriginal and Torres Strait Islander contexts. The findings of this review were analysed thematically, and a number of key issues were identified for consideration in the review process. We present a summary of these key issues. In the final section of the paper we consider in more detail two of the key issues raised in the review process (the assessment of relevance or benefit of proposed research; and the process of consultation and negotiation of collective consent) in order to critically consider how these issue should be engaged in revised guidelines. On the basis of this analysis, it is our contention that specific guidelines on key issues are limited to the extent to which they can anticipate all possible research contexts. In order to address this problem, and guide researchers, guidelines should also explicitly outline the values, from an Aboriginal and Torres Islander perspective that are foundational to an ethical research process.

The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

PubMed

Allott, Kelly; Lloyd, Susan

2009-07-01

Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

A comparative study of electric power distribution systems for spacecraft

NASA Technical Reports Server (NTRS)

Stuart, Thomas A.; King, Roger J.

1990-01-01

The electric power distribution systems for spacecraft are compared concentrating on two interrelated issues: the choice between dc and high frequency ac, and the converter/inverter topology to be used at the power source. The relative merits of dc and ac distribution are discussed. Specific converter and inverter topologies are identified and analyzed in detail for the purpose of detailed comparison. Finally, specific topologies are recommended for use in dc and ac systems.

“We make choices we think are going to save us”: Debate and stance identification for online breast cancer CAM discussions

PubMed Central

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-01-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients’ conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients’ stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members’ stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients’ opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work. PMID:28967000

"We make choices we think are going to save us": Debate and stance identification for online breast cancer CAM discussions.

PubMed

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-04-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients' conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients' stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members' stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients' opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work.

Ethical issues in medical research in the developing world: a report on a meeting organised by Fondation Mérieux.

PubMed

Perrey, Christophe; Wassenaar, Douglas; Gilchrist, Shawn; Ivanoff, Bernard

2009-08-01

This paper reports on a multidisciplinary meeting held to discuss ethical issues in medical research in the developing world. Many studies, including clinical trials, are conducted in developing countries with a high burden of disease. Conditions under which this research is conducted vary because of differences in culture, public health, political, legal and social contexts specific to these countries. Research practices, including standards of care for participants, may vary as a result. It is therefore not surprising that ethical issues emerge. This meeting sought to identify and discuss these issues from the perspectives of the many actors in such research, including community representatives, with a view to finding ethical and pragmatic solutions to these issues. Dialogue between these actors was also promoted, with a view to identifying the need to develop such dialogue in future. Drawing from the experiences of the speakers, the colloquium attempted to outline some answers to several key questions characterising the field today. Experiences related to epidemiologic research, vaccine trials, drug trials, diagnostic tests and to some fundamental ethical issues in health research. Speakers were from different countries, disciplines and professions. The meeting provided a forum for consultation and debate between different ethics actors. Both encouraging findings and challenges emerged.

Ethical issues identified by obstetrics and gynecology learners through a novel ethics curriculum.

PubMed

Mejia, Rachel B; Shinkunas, Laura A; Ryan, Ginny L

2015-12-01

Obstetrics and gynecology (ob/gyn) is fraught with bioethical issues, the professional significance of which may vary based on clinical experience. Our objective was to utilize our novel ethics curriculum to identify ethics and professionalism issues highlighted by ob/gyn learners and to compare responses between learner levels to further inform curricular development. We introduced an integrated and dynamic ob/gyn ethics and professionalism curriculum and mixed methods analysis of 181 resulting written reflections (case observation and assessments) from third-year medical students and from first- to fourth-year ob/gyn residents. Content was compared by learner level using basic thematic analysis and summary statistics. Within the 7 major ethics and professionalism domains, learners wrote most frequently about miscellaneous ob/gyn issues such as periviability and abortion (22% of students, 20% of residents) and problematic treatment decisions (20% of students, 19% of residents) rather than professional duty, communication, justice, student-/resident-specific issues, or quality of care. The most commonly discussed ob/gyn area by both learner groups was obstetrics rather than gynecology, gynecologic oncology, or reproductive endocrinology and infertility, although residents were more likely to discuss obstetrics-related concerns than students (65% vs 48%; P = .04) and students wrote about gynecologic oncology-related concerns more frequently than residents (25% vs 6%; P = .002). In their reflections, sources of ethical value (eg, the 4 classic ethics principles, professional guidelines, and consequentialism) were cited more frequently and in greater number by students than by residents (82% of students cited at least 1 source of ethical value vs 65% of residents; P = .01). Residents disagreed more frequently with the ethical propriety of clinical management than did students (67% vs 43%; P = .005). Our study introduces an innovative and dynamic approach to an ob/gyn ethics and professionalism curriculum that highlights important learner-identified ethics and professionalism issues both specific to ob/gyn and common to clinical medicine. Findings will help ob/gyn educators best utilize and refine this flexible curriculum such that it is appropriately focused on topics relevant to each learner level. Copyright © 2015 Elsevier Inc. All rights reserved.

Ethical issues in newer assisted reproductive technologies: A view from Nigeria.

PubMed

Fadare, J O; Adeniyi, A A

2015-12-01

Infertility is a prevalent condition in many developing countries with significant physical and psychosocial implications. The aim of this study is to discuss briefly the ethics of newer assisted reproductive technology (ART) with special emphasis on the peculiarities in Nigeria. MEDLINE and Google Scholar were searched for English-language articles from January 1990 to July 2014 using the search terms "ethics of ART AND Nigeria," "ethical issues in in vitro fertilization AND Nigeria." Using the above search phrases, a total of 43 articles were retrieved out of which only 5 dealt specifically with the subject matter. The core ethical issues found in the reviewed literature are listed in [Table 1]. Inequitable access to ART due to its high cost, lack of regulatory body, safety of the procedure, and fate of the embryos were the main themes identified from the papers. Surrogacy, sex selection, and gamete donation were additional relevant ethical issues. There is an urgent need for stakeholders in developing countries to formulate cultural and context-specific guidelines to help address some of these ethical dilemmas.

Ethical management in the constitution of a European database for leukodystrophies rare diseases.

PubMed

Duchange, Nathalie; Darquy, Sylviane; d'Audiffret, Diane; Callies, Ingrid; Lapointe, Anne-Sophie; Loeve, Boris; Boespflug-Tanguy, Odile; Moutel, Grégoire

2014-09-01

The EU LeukoTreat program aims to connect, enlarge and improve existing national databases for leukodystrophies (LDs) and other genetic diseases affecting the white matter of the brain. Ethical issues have been placed high on the agenda by pairing the participating LD expert research teams with experts in medical ethics and LD patient families and associations. The overarching goal is to apply core ethics principles to specific project needs and ensure patient rights and protection in research addressing the context of these rare diseases. This paper looks at how ethical issues were identified and handled at project management level when setting up an ethics committee. Through a work performed as a co-construction between health professionals, ethics experts, and patient representatives, we expose the major ethical issues identified. The committee acts as the forum for tackling specific issues tied to data sharing and patient participation: the thin line between care and research, the need for a charter establishing the commitments binding health professionals and the information items to be delivered. Ongoing feedback on the database, including delivering global results in a broad-audience format, emerged as a key recommendation. Information should be available to all patients in the partner countries developing the database and should be scaled to different patient profiles. This work led to a number of recommendations for ensuring transparency and optimizing the partnership between scientists and patients. Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

What shapes research impact on policy? Understanding research uptake in sexual and reproductive health policy processes in resource poor contexts

PubMed Central

2011-01-01

Assessing the impact that research evidence has on policy is complex. It involves consideration of conceptual issues of what determines research impact and policy change. There are also a range of methodological issues relating to the question of attribution and the counter-factual. The dynamics of SRH, HIV and AIDS, like many policy arenas, are partly generic and partly issue- and context-specific. Against this background, this article reviews some of the main conceptualisations of research impact on policy, including generic determinants of research impact identified across a range of settings, as well as the specificities of SRH in particular. We find that there is scope for greater cross-fertilisation of concepts, models and experiences between public health researchers and political scientists working in international development and research impact evaluation. We identify aspects of the policy landscape and drivers of policy change commonly occurring across multiple sectors and studies to create a framework that researchers can use to examine the influences on research uptake in specific settings, in order to guide attempts to ensure uptake of their findings. This framework has the advantage that distinguishes between pre-existing factors influencing uptake and the ways in which researchers can actively influence the policy landscape and promote research uptake through their policy engagement actions and strategies. We apply this framework to examples from the case study papers in this supplement, with specific discussion about the dynamics of SRH policy processes in resource poor contexts. We conclude by highlighting the need for continued multi-sectoral work on understanding and measuring research uptake and for prospective approaches to receive greater attention from policy analysts. PMID:21679384

Resettlement: A Cultural and Psychological Crisis.

ERIC Educational Resources Information Center

Hulewat, Phyllis

1996-01-01

The stages of resettlement and need to integrate past cultural experience into their new life are similar for all immigrants. Describes stages of resettlement and basic elements needed to manage the resettlement process. Three specific groups of clients are identified, and case management methods are presented for dealing with issues raised by…

In Search of Vigilance: The Problem of Iatrogenically Created Psychological Phenomena

ERIC Educational Resources Information Center

Hancock, P. A.

2013-01-01

To what extent are identified psychological processes created in laboratories? The present work addresses this issue with reference to one particular realm of behavior: vigilance. Specifically, I argue that the classic vigilance decrement function can be viewed more realistically and advantageously as an "invigilant" increment function. Rather…

Identifying Dust Emission "Hot Spots" in the Southern Plains Region of New Mexico, Oklahoma and Texas : Effect of Blowing Dust on Highway

DOT National Transportation Integrated Search

2017-12-30

Windblown dust poses a significant hazard to highway safety. Dust contributes to chain-reaction traffic accidents every year in the southwestern US, however, no known studies have specifically investigated this issue in New Mexico, Oklahoma, and Texa...

Individual Stress Management Coursework in Canadian Teacher Preparation Programs

ERIC Educational Resources Information Center

Harris, Gregory E.

2011-01-01

Teacher stress is a significant issue facing the teaching profession. The current paper explores individual stress management as a viable option to address stress in this profession. Specifically, Canadian teacher education programs are examined to identify the prevalence of pre-service teacher education courses focused on individual stress…

Theme Issue: Organizational Communication.

ERIC Educational Resources Information Center

Anapol, Malthon M., Ed.

1978-01-01

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

Unresolved Childhood Sexual Abuse: Are Older Adults Affected?

ERIC Educational Resources Information Center

Allers, Christopher T.; And Others

1992-01-01

Presents case studies and discussions regarding 3 observed characteristics of unresolved childhood sexual abuse in adult survivors over 65 years of age. Specifically, chronic depression, elder abuse, and misdiagnosis of residual abuse trauma as dementia or mental illness are compared to parallel issues identified by researchers working with…

Objectives and Contents of the Educational Activity Oriented Toward the Small Child.

ERIC Educational Resources Information Center

Walczyna, Jadwiga

This paper emphasizes the importance of educational activities for small children and discusses the issues and problems associated with choice of educational objectives and activity content. Three factors which influence the formation of educational objectives are identified: (1) tradition, (2) specific character of socio-economic conditions in…

Blended Delivery and Online Assessment: Scaffolding Student Reflections in Work-Integrated Learning

ERIC Educational Resources Information Center

Larkin, Ingrid; Beatson, Amanda

2014-01-01

This paper documents a teaching innovation addressing the challenges of embedding and assessing reflective practice in work-integrated learning, specifically marketing internships. We identify four issues relating to this problem: lack of knowledge or skill for reflection, limitations of physical journals, facilitation of different forms of…

Critical Issues in the Delivery of Local Government Services in Rural America.

ERIC Educational Resources Information Center

Doeksen, Gerald A.; Peterson, Janet

Technological changes, an increase in demand for quality community services, and environmental controls have created conditions of continual change in the delivery of rural services. This report summarizes economic theory on community service delivery, reviews economic literature on specific community services, and identifies research gaps and…

What Is Postmodernism and How Is It Relevant to Engaged Pedagogy?

ERIC Educational Resources Information Center

Cosgrove, Lisa

2004-01-01

This article identifies some of the advantages of using a postmodern approach in the psychology classroom. A postmodern pedagogical stance has special relevance for faculty who teach abnormal psychology insofar as postmodernism encourages reflexivity and increases students' awareness of social justice issues. The author provides specific ideas for…

SUMMARY REPORT OF THE MEETING ON DEVELOPMENT OF A METALS ASSESSMENT FRAMEWORK

EPA Science Inventory

Under the auspices of the Agency's Science Policy Council, the Agency is embarking on the development of an assessment framework for metals. The first step in the process is formulation of an Action Plan that will identify key scientific issues specific to metals and metal compou...

Teaching with a Closed Mind: The Threat of Censorship in the Social Studies Classroom.

ERIC Educational Resources Information Center

Russell, Kenneth W.

1990-01-01

Traces the history of censorship. Examines the current censorship controversy, focusing on the conflict over censorship in the schools. Discusses organizations concerned with censorship issues and identifies specific instances of censorship in the social studies. Outlines censorship tactics, and presents positive reactions to take toward…

Navy Nuclear Aircraft Carrier (CVN) Homeporting at Mayport: Background and Issues for Congress

DTIC Science & Technology

2009-09-23

at http://www.defenselink.mil/releases/release.aspx?releaseid= 12600 . 2 The Navy has not identified which specific CVN it would transfer, and a CVN...Determine Aircraft Carrier Homeporting In Mayport,” available online at http://www.defenselink.mil/releases/release.aspx?releaseid= 12600 . 7Although

Mental Health and Students at Risk

ERIC Educational Resources Information Center

Goodwin, Alan B.

2016-01-01

This chapter addresses issues pertaining to students who are at risk, possibly due to a psychological disability. Some of the challenges institutions of higher education confront in addressing at-risk students' struggles are identified, with specific focus placed on risk management and evolving legal mandates. No content is intended to represent…

Climate change and food safety: an emerging issue with special focus on Europe.

PubMed

Miraglia, M; Marvin, H J P; Kleter, G A; Battilani, P; Brera, C; Coni, E; Cubadda, F; Croci, L; De Santis, B; Dekkers, S; Filippi, L; Hutjes, R W A; Noordam, M Y; Pisante, M; Piva, G; Prandini, A; Toti, L; van den Born, G J; Vespermann, A

2009-05-01

According to general consensus, the global climate is changing, which may also affect agricultural and livestock production. The potential impact of climate change on food security is a widely debated and investigated issue. Nonetheless, the specific impact on safety of food and feed for consumers has remained a less studied topic. This review therefore identifies the various food safety issues that are likely to be affected by changes in climate, particularly in Europe. Amongst the issues identified are mycotoxins formed on plant products in the field or during storage; residues of pesticides in plant products affected by changes in pest pressure; trace elements and/or heavy metals in plant products depending on changes in their abundance and availability in soils; polycyclic aromatic hydrocarbons in foods following changes in long-range atmospheric transport and deposition into the environment; marine biotoxins in seafood following production of phycotoxins by harmful algal blooms; and the presence of pathogenic bacteria in foods following more frequent extreme weather conditions, such as flooding and heat waves. Research topics that are amenable to further research are highlighted.

Experimentation and evaluation of advanced integrated system concepts

NASA Astrophysics Data System (ADS)

Ross, M.; Garrigus, K.; Gottschalck, J.; Rinearson, L.; Longee, E.

1980-09-01

This final report examines the implementation of a time-phased test bed for experimentation and evaluation of advanced system concepts relative to the future Defense Switched Network (DSN). After identifying issues pertinent to the DSN, a set of experiments which address these issues are developed. Experiments are ordered based on their immediacy and relative importance to DSN development. The set of experiments thus defined allows requirements for a time phased implementation of a test bed to be identified, and several generic test bed architectures which meet these requirements are examined. Specific architecture implementations are costed and cost/schedule profiles are generated as a function of experimental capability. The final recommended system consists of two separate test beds: a circuit switch test bed, configured around an off-the-shelf commercial switch, and directed toward the examination of nearer term and transitional issues raised by the evolving DSN; and a packet/hybrid test bed, featuring a discrete buildup of new hardware and software modules, and directed toward examination of the more advanced integrated voice and data telecommunications issues and concepts.

Toward a Method for Exposing and Elucidating Ethical Issues with Human Cognitive Enhancement Technologies.

PubMed

Hofmann, Bjørn

2017-04-01

To develop a method for exposing and elucidating ethical issues with human cognitive enhancement (HCE). The intended use of the method is to support and facilitate open and transparent deliberation and decision making with respect to this emerging technology with great potential formative implications for individuals and society. Literature search to identify relevant approaches. Conventional content analysis of the identified papers and methods in order to assess their suitability for assessing HCE according to four selection criteria. Method development. Amendment after pilot testing on smart-glasses. Based on three existing approaches in health technology assessment a method for exposing and elucidating ethical issues in the assessment of HCE technologies was developed. Based on a pilot test for smart-glasses, the method was amended. The method consists of six steps and a guiding list of 43 questions. A method for exposing and elucidating ethical issues in the assessment of HCE was developed. The method provides the ground work for context specific ethical assessment and analysis. Widespread use, amendments, and further developments of the method are encouraged.

Women's health: periodontitis and its relation to hormonal changes, adverse pregnancy outcomes and osteoporosis.

PubMed

Krejci, Charlene B; Bissada, Nabil F

2012-01-01

To examine the literature with respect to periodontitis and issues specific to women's health, namely, hormonal changes, adverse pregnancy outcomes and osteoporosis. The literature was evaluated to review reported associations between periodontitis and genderspecific issues, namely, hormonal changes, adverse pregnancy outcomes and osteoporosis. Collectively, the literature provided a large body of evidence that supports various associations between periodontitis and hormonal changes, adverse pregnancy outcomes and osteoporosis; however, certain shortcomings were noted with respect to biases involving definitions, sample sizes and confounding variables. Specific cause and effect relationships could not be delineated at this time and neither could definitive treatment interventions. Future research must include randomised controlled trials with consistent definitions, adequate controls and sufficiently large sample sizes in order to clarify specific associations, identify cause and effect relationships, define treatment options and determine treatment interventions which will lessen the untoward effects on the at-risk populations.

Energy information data base: report number codes

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

None

1979-09-01

Each report processed by the US DOE Technical Information Center is identified by a unique report number consisting of a code plus a sequential number. In most cases, the code identifies the originating installation. In some cases, it identifies a specific program or a type of publication. Listed in this publication are all codes that have been used by DOE in cataloging reports. This compilation consists of two parts. Part I is an alphabetical listing of report codes identified with the issuing installations that have used the codes. Part II is an alphabetical listing of installations identified with codes eachmore » has used. (RWR)« less

Structural dynamics technology research in NASA: Perspective on future needs

NASA Technical Reports Server (NTRS)

1979-01-01

The perspective of a NASA ad hoc study group on future research needs in structural dynamics within the aerospace industry is presented. The common aspects of the design process across the industry are identified and the role of structural dynamics is established through a discussion of various design considerations having their basis in structural dynamics. The specific structural dynamics issues involved are identified and assessed as to their current technological status and trends. Projections of future requirements based on this assessment are made and areas of research to meet them are identified.

Facilities removal working group

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

NONE

This working group`s first objective is to identify major economic, technical, and regulatory constraints on operator practices and decisions relevant to offshore facilities removal. Then, the group will try to make recommendations as to regulatory and policy adjustments, additional research, or process improvements and/or technological advances, that may be needed to improve the efficiency and effectiveness of the removal process. The working group will focus primarily on issues dealing with Gulf of Mexico platform abandonments. In order to make the working group sessions as productive as possible, the Facilities Removal Working Group will focus on three topics that address amore » majority of the concerns and/or constraints relevant to facilities removal. The three areas are: (1) Explosive Severing and its Impact on Marine Life, (2) Pile and Conductor Severing, and (3) Deep Water Abandonments This paper will outline the current state of practice in the offshore industry, identifying current regulations and specific issues encountered when addressing each of the three main topics above. The intent of the paper is to highlight potential issues for panel discussion, not to provide a detailed review of all data relevant to the topic. Before each panel discussion, key speakers will review data and information to facilitate development and discussion of the main issues of each topic. Please refer to the attached agenda for the workshop format, key speakers, presentation topics, and panel participants. The goal of the panel discussions is to identify key issues for each of the three topics above. The working group will also make recommendations on how to proceed on these key issues.« less

The early development phases of a European Organisation for Research and Treatment of Cancer (EORTC) module to assess patient reported outcomes (PROs) in women undergoing breast reconstruction.

PubMed

Thomson, H J; Winters, Z E; Brandberg, Y; Didier, F; Blazeby, J M; Mills, J

2013-03-01

A comprehensive evaluation of breast reconstruction (BRR) surgery includes measurement of patient reported outcomes (PROs). There is, however, a lack of validated BRR-specific PRO measures (PROMs) that adequately assess relevant issues. This study is developing a European Organisation for Research and Treatment of Cancer (EORTC) questionnaire/module specific for PROs in BRR to supplement the cancer-core and breast cancer EORTC questionnaires, respectively: the QLQ-C30 and QLQ-BR23. Phases I and II of questionnaire development followed EORTC guidelines including a systematic literature review to identify all potential 'issues' (concepts relevant to PROs) and semi-structured interviews with 89 patients and 9 European multi-disciplinary health care professionals (HCPs) (Sweden, Italy and the United Kingdom [UK]). Interviewers asked participants the 'relevance' of outcomes identified in the literature and captured additional 'issues' of importance. The literature search and interviews of patients and HCPs yielded 69 issues relating to BRR operationalised into 31 provisional items (single questions) for the module, which was conceptualised to contain five scales: treatment/surgery related symptoms (affecting the shoulder, arm and reconstructed breast), body image, sexuality, cosmetic outcomes (pertaining to three areas: breast, donor site and nipple) and overall satisfaction. The provisional development of the EORTC BRR module has 31 items addressing issues of importance to patients as well as HCPs. Further international testing is underway as a UK National Cancer Research Network trial to ensure that this PROM will be psychometrically and clinically robust and applicable for use in clinical trials, cohort studies, national audit and clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ethical and methodological issues in research with Sami experiencing disability.

PubMed

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.

Exploring work-related issues on corporate sustainability.

PubMed

Brunoro, C M; Bolis, I; Sznelwar, L I

2015-01-01

In a research project about work-related issues and corporate sustainability conducted in Brazil, the goal was to better understand how work-related issues were addressed in the corporate context. Particularly, there are some specific initiatives that serve as guides to organizational decisions, which make their performance indicators for the context of corporate sustainability. 1) To explore the presence of work-related issues and their origins in corporate sustainability approach, analyzing a) corporate disclosures; b) sustainability guidelines that are identified as relevant in corporate disclosures; c) documents that are related to sustainable development and also identified as key-documents for these guidelines and initiatives. 2) To present the activity-centered ergonomics and psychodynamics of work contributions to work-related issues in a corporate sustainability approach. An exploratory study based on multiple sources of evidence that were performed from 2012 to 2013, including interviews with companies that engaged in corporate sustainability and document analysis using the content analysis approach. Work-related issues have been presented since the earliest sustainable development documents. It is feasible to construct an empirical framework for work-related issues and corporate sustainability approaches. 1) Although some authors argue that corporate sustainability has its roots based only on the environmental dimension, there is strong empirical evidence showing that social dimension aspects such as work-related issues have been present since the beginning. 2) Some indicators should be redesigned to more precisely translate the reality of some workplaces, particularly those indicators related to organizational design and mental health.

Bayesian SEM for Specification Search Problems in Testing Factorial Invariance.

PubMed

Shi, Dexin; Song, Hairong; Liao, Xiaolan; Terry, Robert; Snyder, Lori A

2017-01-01

Specification search problems refer to two important but under-addressed issues in testing for factorial invariance: how to select proper reference indicators and how to locate specific non-invariant parameters. In this study, we propose a two-step procedure to solve these issues. Step 1 is to identify a proper reference indicator using the Bayesian structural equation modeling approach. An item is selected if it is associated with the highest likelihood to be invariant across groups. Step 2 is to locate specific non-invariant parameters, given that a proper reference indicator has already been selected in Step 1. A series of simulation analyses show that the proposed method performs well under a variety of data conditions, and optimal performance is observed under conditions of large magnitude of non-invariance, low proportion of non-invariance, and large sample sizes. We also provide an empirical example to demonstrate the specific procedures to implement the proposed method in applied research. The importance and influences are discussed regarding the choices of informative priors with zero mean and small variances. Extensions and limitations are also pointed out.

Dementia in Latin America

PubMed Central

Parra, Mario A.; Baez, Sandra; Allegri, Ricardo; Nitrini, Ricardo; Lopera, Francisco; Slachevsky, Andrea; Custodio, Nilton; Lira, David; Piguet, Olivier; Kumfor, Fiona; Huepe, David; Cogram, Patricia; Bak, Thomas; Manes, Facundo

2018-01-01

The demographic structure of Latin American countries (LAC) is fast approaching that of developing countries, and the predicted prevalence of dementia in the former already exceeds the latter. Dementia has been declared a global challenge, yet regions around the world show differences in both the nature and magnitude of such a challenge. This article provides evidence and insights on barriers which, if overcome, would enable the harmonization of strategies to tackle the dementia challenge in LAC. First, we analyze the lack of available epidemiologic data, the need for standardizing clinical practice and improving physician training, and the existing barriers regarding resources, culture, and stigmas. We discuss how these are preventing timely care and research. Regarding specific health actions, most LAC have minimal mental health facilities and do not have specific mental health policies or budgets specific to dementia. In addition, local regulations may need to consider the regional context when developing treatment and prevention strategies. The support needed nationally and internationally to enable a smooth and timely transition of LAC to a position that integrates global strategies is highlighted. We focus on shared issues of poverty, cultural barriers, and socioeconomic vulnerability. We identify avenues for collaboration aimed to study unique populations, improve valid assessment methods, and generate opportunities for translational research, thus establishing a regional network. The issues identified here point to future specific actions aimed at tackling the dementia challenge in LAC. PMID:29305437

Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing 'what matters most' to identify culture-specific aspects of stigma.

PubMed

Yang, Lawrence Hsin; Thornicroft, Graham; Alvarado, Ruben; Vega, Eduardo; Link, Bruce George

2014-04-01

While stigma measurement across cultures has assumed growing importance in psychiatric epidemiology, it is unknown to what extent concepts arising from culture have been incorporated. We utilize a formulation of culture-as the everyday interactions that 'matter most' to individuals within a cultural group-to identify culturally-specific stigma dynamics relevant to measurement. A systematic literature review from January 1990 to September 2012 was conducted using PsycINFO, Medline and Google Scholar to identify articles studying: (i) mental health stigma-related concepts; (ii) ≥ 1 non-Western European cultural group. From 5292 abstracts, 196 empirical articles were located. The vast majority of studies (77%) utilized adaptations of existing Western-developed stigma measures to new cultural groups. Extremely few studies (2.0%) featured quantitative stigma measures derived within a non-Western European cultural group. A sizeable amount (16.8%) of studies employed qualitative methods to identify culture-specific stigma processes. The 'what matters most' perspective identified cultural ideals of the everyday activities that comprise 'personhood' of 'preserving lineage' among specific Asian groups, 'fighting hard to overcome problems and taking advantage of immigration opportunities' among specific Latino-American groups, and 'establishing trust among religious institutions due to institutional discrimination' among African-American groups. These essential cultural interactions shaped culture-specific stigma manifestations. Mixed method studies (3.6%) corroborated these qualitative results. Quantitatively-derived, culturally-specific stigma measures were lacking. Further, the vast majority of qualitative studies on stigma were conducted without using stigma-specific frameworks. We propose the 'what matters most' approach to address this key issue in future research.

Privacy and Ethics in Pediatric Environmental Health Research—Part II: Protecting Families and Communities

PubMed Central

Fisher, Celia B.

2006-01-01

Background In pediatric environmental health research, information about family members is often directly sought or indirectly obtained in the process of identifying child risk factors and helping to tease apart and identify interactions between genetic and environmental factors. However, federal regulations governing human subjects research do not directly address ethical issues associated with protections for family members who are not identified as the primary “research participant.” Ethical concerns related to family consent and privacy become paramount as pediatric environmental health research increasingly turns to questions of gene–environment interactions. Objectives In this article I identify issues arising from and potential solutions for the privacy and informed consent challenges of pediatric environmental health research intended to adequately protect the rights and welfare of children, family members, and communities. Discussion I first discuss family members as secondary research participants and then the specific ethical challenges of longitudinal research on late-onset environmental effects and gene–environment interactions. I conclude with a discussion of the confidentiality and social risks of recruitment and data collection of research conducted within small or unique communities, ethnic minority populations, and low-income families. Conclusions The responsible conduct of pediatric environmental health research must be conceptualized as a goodness of fit between the specific research context and the unique characteristics of subjects and other family stakeholders. PMID:17035154

Pharmacy executives: leadership issues and associated skills, knowledge, and abilities in the U.S. Department of Defense.

PubMed

Meadows, Andrew B; Finstuen, Kenn; Hudak, Ronald P

2003-01-01

To identify the issues or problems that current and aspiring U.S. Department of Defense (DoD) pharmacy executives will face in the future and to define the skills, knowledge, and abilities (SKAs) required to successfully address these issues. Delphi method for executive decision making. DoD. Ninety-three pharmacists serving in the military grades of lieutenant colonel/commander and colonel/captain, as well as pharmacists selected for promotion to those grades. iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants identified five major issues believed to be of greatest importance to pharmacy executives and reported specific SKAs that might be needed to successfully manage those issues. An expert panel sorted these issues into meaningful domains, then provided an appropriate title for each domain. Round 2--on a 7-point scale, respondents rated the SKA items according to their assessment of how much a future DoD pharmacy executive would need each SKA. Response rates were 44.1% and 46.2% for Delphi rounds 1 and 2, respectively. The first round generated 62 unique issues facing pharmacy executives. The expert panel reviewed and sorted the issues into eight domains and selected an appropriate title for each domain. The domains identified by the panel were human resources, pharmacy operations/business practices, information management and technology, financial resources, formulary management, drug therapy management, pharmacy benefit management, and leadership. During round 2, 73.3% of the top 15 rated SKAs came from the drug therapy management, leadership, and formulary management domains. The three highest-rated SKAs were "ability to see the big picture," "ability to build strong relations with medical staffs," and "skills in both writing and verbal communication." The issues facing future DoD pharmacy executives will require them to expand their clinical abilities as well as their ability to collaborate and communicate with other professionals.

An exploratory survey on the views of European tissue engineers concerning the ethical issues of tissue engineering research.

PubMed

Trommelmans, Leen; Selling, Joseph; Dierickx, Kris

2009-09-01

We present the first exploratory survey about the views of tissue engineers on the ethical issues of tissue engineering (TE), conducted among participants of a large European TE consortium. We analyzed the topics for which ethical guidance is necessary and the preferred dissemination channels, which are relevant issues and goals of clinical trials with human tissue-engineered products, and which information is to be given to trial participants. The need for comprehensive, specific ethical guidance of TE is a first key finding of this survey. Second, it becomes clear that little clarity exists on some crucial issues in the setup and conduct of clinical trials in TE. Identifying the unique features of TE and their repercussions for the ethical conduct of TE research and therapy is necessary. Third, prospective trial participants are to be informed about a wide variety of issues before taking part in the trial.

Obtaining subjects' consent to publish identifying personal information: current practices and identifying potential issues.

PubMed

Yoshida, Akiko; Dowa, Yuri; Murakami, Hiromi; Kosugi, Shinji

2013-11-25

In studies publishing identifying personal information, obtaining consent is regarded as necessary, as it is impossible to ensure complete anonymity. However, current journal practices around specific points to consider when obtaining consent, the contents of consent forms and how consent forms are managed have not yet been fully examined. This study was conducted to identify potential issues surrounding consent to publish identifying personal information. Content analysis was carried out on instructions for authors and consent forms developed by academic journals in four fields (as classified by Journal Citation Reports): medicine general and internal, genetics and heredity, pediatrics, and psychiatry. An online questionnaire survey of editors working for journals that require the submission of consent forms was also conducted. Instructions for authors were reviewed for 491 academic journals (132 for medicine general and internal, 147 for genetics and heredity, 100 for pediatrics, and 112 for psychiatry). Approximately 40% (203: 74 for medicine general and internal, 31 for genetics and heredity, 58 for pediatrics, and 40 for psychiatry) stated that subject consent was necessary. The submission of consent forms was required by 30% (154) of the journals studied, and 10% (50) provided their own consent forms for authors to use. Two journals mentioned that the possible effects of publication on subjects should be considered. Many journal consent forms mentioned the difficulties in ensuring complete anonymity of subjects, but few addressed the study objective, the subjects' right to refuse consent and the withdrawal of consent. The main reason for requiring the submission of consent forms was to confirm that consent had been obtained. Approximately 40% of journals required subject consent to be obtained. However, differences were observed depending on the fields. Specific considerations were not always documented. There is a need to address issues around the study objective, subjects' right to refuse consent and the withdrawal of consent. Whether responsibility for ensuring that the consent form has been signed lies with publishers also needs to be discussed.

Distributed photovoltaic systems: Utility interface issues and their present status

NASA Technical Reports Server (NTRS)

Hassan, M.; Klein, J.

1981-01-01

Major technical issues involving the integration of distributed photovoltaics (PV) into electric utility systems are defined and their impacts are described quantitatively. An extensive literature search, interviews, and analysis yielded information about the work in progress and highlighted problem areas in which additional work and research are needed. The findings from the literature search were used to determine whether satisfactory solutions to the problems exist or whether satisfactory approaches to a solution are underway. It was discovered that very few standards, specifications, or guidelines currently exist that will aid industry in integrating PV into the utility system. Specific areas of concern identified are: (1) protection, (2) stability, (3) system unbalance, (4) voltage regulation and reactive power requirements, (5) harmonics, (6) utility operations, (7) safety, (8) metering, and (9) distribution system planning and design.

Workshop on Assurance for Autonomous Systems for Aviation

NASA Technical Reports Server (NTRS)

Brat, Guillaume; Davies, Misty; Giannakopoulou, Dimitra; Neogi, Natasha

2016-01-01

This report describes the workshop on Assurance for Autonomous Systems for Aviation that was held in January 2016 in conjunction with the SciTech 2016 conference held in San Diego, CA. The workshop explored issues related to assurance for autonomous systems and also the idea of trust in these systems. Specifically, we focused on discussing current practices for assurance of autonomy, identifying barriers specific to autonomy as related to assurance as well as operational scenarios demonstrating the need to address the barriers. Furthermore, attention was given to identifying verification techniques that may be applicable to autonomy, as well as discussing new research directions needed to address barriers, thereby involving potential shifts in current practices.

Socio-Praxis Preferences in Teacher Preparation for Child Sexual Abuse and Its Mandatory Reporting

ERIC Educational Resources Information Center

Goldman, Juliette D. G.; Grimbeek, Peter

2015-01-01

Child abuse and neglect, particularly child sexual abuse, is a pastoral care issue that deeply concerns all education professionals. The literature strongly supports specific training for pre-service teachers about child sexual abuse and its mandatory reporting, although few studies identify how such training should be academically structured.…

Engaging Women in Computer Science and Engineering: Promising Practices for Promoting Gender Equity in Undergraduate Research Experiences

ERIC Educational Resources Information Center

Kim, Karen A.; Fann, Amy J.; Misa-Escalante, Kimberly O.

2011-01-01

Building on research that identifies and addresses issues of women's underrepresentation in computing, this article describes promising practices in undergraduate research experiences that promote women's long-term interest in computer science and engineering. Specifically, this article explores whether and how REU programs include programmatic…

Identifying Research Priorities for School Improvement in the Developing World

ERIC Educational Resources Information Center

Read, Robyn; Fernandez-Hermosilla, Magdalena; Anderson, Stephen; Mundy, Karen

2016-01-01

This paper discusses a research agenda setting project conducted for an international non-governmental organization which aims to help create a regionally relevant, high-quality knowledge base on key education issues of policy and practice. Specifically, we illustrate how our team adapted the Child Health and Nutrition Research Initiative (CHRNI)…

Leisure Counseling. Searchlight Plus: Relevant Resources in High Interest Areas. No 48+.

ERIC Educational Resources Information Center

Loesch, Larry

This information analysis paper reviews the literature on leisure counseling, identified by a computer search of the ERIC data base from November 1966 through December 1979. The introduction highlights specific issues and trends, including the changing views and importance of leisure, changes in the nature and functions of leisure, and the…

Yesterday's Conservationists: How Were They Educated about the Outdoors and the Environment?

ERIC Educational Resources Information Center

Place, Greg S.

2016-01-01

The purpose of this study was to investigate the effects of early-life educational experiences on the development of environmental attitudes among historical conservation individuals. Five key individuals who were active in conservation and environmental issues were identified in this study. Specifically, the goal was to discover what caused…

Effective Practices and Structures for Middle Grades Education. Policy Issues.

ERIC Educational Resources Information Center

Mac Iver, Douglas

This document draws upon theory and research about early adolescence and about the effects of middle grades structures and practices on student outcomes. The purpose is to identify specific problem areas and promising innovations that should be considered by policymakers as they establish guidelines for the restructuring of education in the middle…

Retention and Access Issues Affecting Black Women Attending Predominantly White Institutions

ERIC Educational Resources Information Center

De War, Joshua J.

2009-01-01

This study examined the self-reported experiences of Black, female, undergraduate students at a small, predominantly White, Midwestern college in the United States in order to identify factors affecting retention. Specific attention was paid to how participants perceived the effects of personal and institutional factors in relation to their…

Using Paired Comparisons to Assess Maslow's Hierarchy of Needs.

ERIC Educational Resources Information Center

Strong, Lisa L.; Fiebert, Martin S.

Past studies which have examined need levels have identified individuals as functioning at specific need levels without an adequate assessment of the intensity of each need or a clear comparison with other need levels. To address these issues, a self-report inventory using a modified paired comparison format was developed to assess need potencies…

76 FR 54507 - Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

... design estimates. Analyses performed under the Generic Issue program (GIP) indicated the need to evaluate... Examination of External Events (IPEEE) for Severe Accident Vulnerabilities,'' (ADAMS Accession No. ML031150485) to request that each licensee identify and report to the NRC all plant- specific vulnerabilities to...

Towards Next Generation Activity-Based Learning Systems

ERIC Educational Resources Information Center

Sampson, Demetrios G.; Karampiperis, Pythagoras

2006-01-01

The need for e-learning systems that support a diverse set of pedagogical requirements has been identified as an important issue in web-based education. Until now, significant research and development effort has been devoted to aiming towards web-based educational systems tailored to specific pedagogical approaches. The most advanced of them are…

Collins Center Update. Volume 14, Issue 3, April-June 2012

DTIC Science & Technology

2012-06-01

2012 leaders must weigh the risks associated with these operations. Recent media reports of the ‘ Duqu ’, ‘Flame’, and ‘Stuxnet’ malware high- light...cyberspace operation was depen- dent upon intelligence, provided by the ‘ Duqu ’ and ‘Flame’ malware, to identify specific systems in the Natanz uranium

77 FR 65215 - In the Matter of Licensee Identified in Attachment 1 and all Other Persons Who Obtain Safeguards...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

... a computing environment that has adequate computer security controls in place to prevent... NRC intends to issue a security Order to this Licensee in the near future. The Order will require compliance with specific Additional Security Measures to enhance the security for certain radioactive...

PATHOGEN RISK ASSESSMENT FOR LAND APPLICATION OF MUNICIPAL SLUDGE, VOLUME II: USER'S MANUAL

EPA Science Inventory

Section 405 of the Clean Water Act requires the U.S. EPA to develop and issue regulations that identify: 1) uses for sludge including disposal; 2) specific factors (including costs) to be taken into account in determining the measures and practices applicable for each use or disp...

PATHOGEN RISK ASSESSMENT FOR LAND APPLICATION OF MUNICIPAL SLUDGE VOLUME I: METHODOLOGY AND COMPUTER MODEL

EPA Science Inventory

Section 405 of the Clean Water Act requires the U.S. EPA to develop and issue regulations that identify: 1) uses for sludge including disposal; 2) specific factors (including costs) to be taken into account in determining the measures and practices applicable for each use or disp...

Correlates of Self Esteem in Adolescents with Spina Bifida.

ERIC Educational Resources Information Center

Eckart, M. L.

The study examined correlates of self-esteem in 54 adolescents and young adults (ages 12-22) with spina bifida. Core issues identified were the relationships of global self-esteem and perceived competencies in specific areas, perceptions of control, and identification with the physically handicapped. Relationships of self-esteem to age, gender,…

Where Are We Now? Learning Progressions and Formative Assessment

ERIC Educational Resources Information Center

Gotwals, Amelia Wenk

2018-01-01

In this commentary, I consider the three empirical studies in this special issue based on two main aspects: (a) the nature of the learning progressions and (b) what formative assessment practice(s) were investigated. Specifically, I describe differences among the learning progressions in terms of scope and grain size. I also identify three…

Employer-Sponsored Child Care Models and Related Issues.

ERIC Educational Resources Information Center

Renfroe, Martha Lou

This study was designed to describe the different models of Employer-Sponsored Child Care (ESCC) available to employers and child care professionals. Examples of specific child care programs sponsored by employers are described, and five ESCC models are identified: on-site and off-site centers for a single employer, off-site centers for multiple…

Predicting Stereotype Threat, Test Anxiety, and Cognitive Ability Test Performance: An Examination of Three Models

ERIC Educational Resources Information Center

Sawyer, Jr., Thomas P.; Hollis-Sawyer, Lisa A.

2005-01-01

As the classroom and workplace, among other contexts, become more diverse in their population characteristics, the need to be aware of specific factors impacting testing outcome issues correspondingly increases. The focus in this study, among other purposes, was to identify possible interactions between examinee's individual-difference…

75 FR 76254 - Official Performance and Procedural Requirements for Grain Weighing Equipment and Related Grain...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... requirements of the 2008 edition of the National Institute of Standards and Technology (NIST) Handbook 44, ``Specifications, Tolerances, and Other Technical Requirements for Weighing and Measuring Devices,'' (NIST Handbook... identified as ``NIST Handbook 44 IBF Comments,'' making reference to the date and page number of this issue...

[Operation/Maintenance of Fiber Placement Machine

NASA Technical Reports Server (NTRS)

Pelham, L.; Dillard, T.

2000-01-01

NASA contract NAS8-39749 was completed in January 2000. The contract period of performance covered six (6) years and included basic program technical support as required by NASA with up to thirty (30) different technical directives identified and issued by NASA for specific Advanced Composite Technology tasks during the course of the contract.

Municipal Decision-Making Factors Relative to Cable Television Ownership.

ERIC Educational Resources Information Center

Clayton, Richard E., Ed.

A study was made to identify and provide information and factors which should be taken into consideration by a municipality in its development of policy regarding the ownership, franchising, and ordinance issues involved in cable television. Since the report discusses Southern California activities, specifically those of the San Gabriel Valley, it…

Navy Nuclear Aircraft Carrier (CVN) Homeporting at Mayport: Background and Issues for Congress

DTIC Science & Technology

2009-06-19

available online at http://www.defenselink.mil/releases/release.aspx?releaseid= 12600 . 2 The Navy has not identified which specific CVN it would...releaseid= 12600 . 7Although the Navy states that the CVN based at Yokosuka is forward deployed to Yokosuka, the ship is commonly referred to as being

Navy Nuclear Aircraft Carrier (CVN) Homeporting at Mayport: Background and Issues for Congress

DTIC Science & Technology

2009-07-17

releaseid= 12600 . 2 The Navy has not identified which specific CVN it would transfer, and a CVN transferred to Mayport could come from any of the...available online at http://www.defenselink.mil/releases/release.aspx?releaseid= 12600 . 7Although the Navy states that the CVN based at Yokosuka is

Can You Show You Are a Good Lecturer?

ERIC Educational Resources Information Center

Wood, Leigh N.; Harding, Ansie

2007-01-01

Measurement of the quality of teaching activities is becoming increasingly important since universities are rewarding performance in terms of promotion, awards and bonuses and research is no longer the only key performance indicator. Good teaching is not easy to identify and measure. This paper specifically deals with the issue of good teaching in…

Vision 2000 Conference Report (Alexandria, Virginia, July 21-24, 1994).

ERIC Educational Resources Information Center

National Council for Agricultural Education, Alexandria, VA.

Representatives of 11 organizations playing a leading role in agricultural education (AE) attended a conference to discuss their vision of AE in the year 2000. During the conference, the issues of greatest concern to AE were prioritized, specific strategies/solutions to accomplish each priority were identified, an action plan to achieve desired…

Convinced, ambivalent or annoyed: Tyrolean ski tourism stakeholders and their perceptions of climate change.

PubMed

Trawöger, Lisa

2014-02-01

Its focus on snow-dependent activities makes Alpine winter tourism especially sensitive to climate change. Stakeholder risk perceptions are a key factor in adaptation to climate change because they fundamentally drive or constrain stakeholder action. This paper examines climate change perceptions of winter tourism stakeholders in Tyrol (Austria). Using a qualitative approach, expert interviews were conducted. Four opinion categories reflecting different attitudes toward climate change issues were identified: convinced planners , annoyed deniers , ambivalent optimists , convinced wait-and-seers . Although the findings generally indicate a growing awareness of climate change, this awareness is mainly limited to perceiving the issue as a global phenomenon. Awareness of regional and branch-specific consequences of climate change that lead to a demand for action could not be identified. Current technical strategies, like snowmaking, are not primarily climate-induced. At present, coping with climate change is not a priority for risk management. The findings point out the importance of gaining and transferring knowledge of regional and branch-specific consequences of climate change in order to induce action at the destination level.

Convinced, ambivalent or annoyed: Tyrolean ski tourism stakeholders and their perceptions of climate change☆

PubMed Central

Trawöger, Lisa

2014-01-01

Its focus on snow-dependent activities makes Alpine winter tourism especially sensitive to climate change. Stakeholder risk perceptions are a key factor in adaptation to climate change because they fundamentally drive or constrain stakeholder action. This paper examines climate change perceptions of winter tourism stakeholders in Tyrol (Austria). Using a qualitative approach, expert interviews were conducted. Four opinion categories reflecting different attitudes toward climate change issues were identified: convinced planners, annoyed deniers, ambivalent optimists, convinced wait-and-seers. Although the findings generally indicate a growing awareness of climate change, this awareness is mainly limited to perceiving the issue as a global phenomenon. Awareness of regional and branch-specific consequences of climate change that lead to a demand for action could not be identified. Current technical strategies, like snowmaking, are not primarily climate-induced. At present, coping with climate change is not a priority for risk management. The findings point out the importance of gaining and transferring knowledge of regional and branch-specific consequences of climate change in order to induce action at the destination level. PMID:27064520

Long-term outcomes of adults with features of VACTERL association

PubMed Central

Raam, Manu S.; Pineda-Alvarez, Daniel E.; Hadley, Donald W.; Solomon, Benjamin D.

2010-01-01

VACTERL association involves the presence of specific congenital, multi-organ malformations that tend to co-occur. Clinical and research efforts typically center on pediatric patients, and there is a scarcity of information in the literature regarding VACTERL-related issues and outcomes in adulthood. We describe here 11 adults with features of VACTERL association ascertained through our research study on the condition. In our cohort of adult patients, approximately 25% of medically significant malformations that are component features of VACTERL association, including 40% of vertebral, 50% of cardiac, and 50% of renal anomalies, were not identified during childhood. Additionally, medical sequelae of many of the primary malformations identified in infancy or early childhood persist or are first reported in adulthood. These sequelae can involve challenging medical and surgical management in adulthood. As most adults with VACTERL association are not specifically followed for VACTERL-related issues, a more uniform diagnostic work-up and a low threshold for investigation of medical sequelae of the primary disorder may enhance the quality of clinical management in these patients. PMID:20888933

Ethical learning on international medical electives: a case-based analysis of medical student learning experiences.

PubMed

Bowsher, Gemma; Parry-Billings, Laura; Georgeson, Anna; Baraitser, Paula

2018-04-11

Students on international medical electives face complex ethical issues when undertaking clinical work. The variety of elective destinations and the culturally specific nature of clinical ethical issues suggest that pre-elective preparation could be supplemented by in-elective support. An online, asynchronous, case-based discussion was piloted to support ethical learning on medical student electives. We developed six scenarios from elective diaries to stimulate peer-facilitated discussions during electives. We evaluated the transcripts to assess whether transformative, experiential learning took place, assessing specifically for indications that 1) critical reflection, 2) reflective action and 3) reflective learning were taking place. We also completed a qualitative thematic content analysis of the discussions. Of forty-one extended comments, nine responses showed evidence of transformative learning (Mezirow stage three). The thematic analysis identified five themes: adopting a position on ethical issues without overt analysis; presenting issues in terms of their effects on students' ability to complete tasks; describing local contexts and colleagues as "other"; difficulty navigating between individual and structural issues, and overestimation of the impact of individual action on structures and processes. Results suggest a need to: frame ethical learning on elective so that it builds on earlier ethical programmes in the curriculum, and encourages students to adopt structured approaches to complex ethical issues including cross-cultural negotiation and to enhance global health training within the curriculum.

Automatic Multi-sensor Data Quality Checking and Event Detection for Environmental Sensing

NASA Astrophysics Data System (ADS)

LIU, Q.; Zhang, Y.; Zhao, Y.; Gao, D.; Gallaher, D. W.; Lv, Q.; Shang, L.

2017-12-01

With the advances in sensing technologies, large-scale environmental sensing infrastructures are pervasively deployed to continuously collect data for various research and application fields, such as air quality study and weather condition monitoring. In such infrastructures, many sensor nodes are distributed in a specific area and each individual sensor node is capable of measuring several parameters (e.g., humidity, temperature, and pressure), providing massive data for natural event detection and analysis. However, due to the dynamics of the ambient environment, sensor data can be contaminated by errors or noise. Thus, data quality is still a primary concern for scientists before drawing any reliable scientific conclusions. To help researchers identify potential data quality issues and detect meaningful natural events, this work proposes a novel algorithm to automatically identify and rank anomalous time windows from multiple sensor data streams. More specifically, (1) the algorithm adaptively learns the characteristics of normal evolving time series and (2) models the spatial-temporal relationship among multiple sensor nodes to infer the anomaly likelihood of a time series window for a particular parameter in a sensor node. Case studies using different data sets are presented and the experimental results demonstrate that the proposed algorithm can effectively identify anomalous time windows, which may resulted from data quality issues and natural events.

Energy Efficiency Collaboratives

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

Li, Michael; Bryson, Joe

2015-09-01

Collaboratives for energy efficiency have a long and successful history and are currently used, in some form, in more than half of the states. Historically, many state utility commissions have used some form of collaborative group process to resolve complex issues that emerge during a rate proceeding. Rather than debate the issues through the formality of a commission proceeding, disagreeing parties are sent to discuss issues in a less-formal setting and bring back resolutions to the commission. Energy efficiency collaboratives take this concept and apply it specifically to energy efficiency programs—often in anticipation of future issues as opposed to reactingmore » to a present disagreement. Energy efficiency collaboratives can operate long term and can address the full suite of issues associated with designing, implementing, and improving energy efficiency programs. Collaboratives can be useful to gather stakeholder input on changing program budgets and program changes in response to performance or market shifts, as well as to provide continuity while regulators come and go, identify additional energy efficiency opportunities and innovations, assess the role of energy efficiency in new regulatory contexts, and draw on lessons learned and best practices from a diverse group. Details about specific collaboratives in the United States are in the appendix to this guide. Collectively, they demonstrate the value of collaborative stakeholder processes in producing successful energy efficiency programs.« less

Technology transfer

NASA Technical Reports Server (NTRS)

Handley, Thomas

1992-01-01

The requirements for a successful technology transfer program and what such a program would look like are discussed. In particular, the issues associated with technology transfer in general, and within the Jet Propulsion Laboratory (JPL) environment specifically are addressed. The section on background sets the stage, identifies the barriers to successful technology transfer, and suggests actions to address the barriers either generally or specifically. The section on technology transfer presents a process with its supporting management plan that is required to ensure a smooth transfer process. Viewgraphs are also included.

A standard satellite control reference model

NASA Technical Reports Server (NTRS)

Golden, Constance

1994-01-01

This paper describes a Satellite Control Reference Model that provides the basis for an approach to identify where standards would be beneficial in supporting space operations functions. The background and context for the development of the model and the approach are described. A process for using this reference model to trace top level interoperability directives to specific sets of engineering interface standards that must be implemented to meet these directives is discussed. Issues in developing a 'universal' reference model are also identified.

Feasibility study for early removal of HEU from CPP-651-Phase II

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

Smith, C.V.; Henry, R.; Milligan, C.

1997-09-01

A two-phase feasibility study was initiated in late 1996 to identify a way to expedite the removal of SNM from the CPP-651 vault. The first phase of this study provided preliminary information that appeared promising, but needed additional detailed planning and evaluate to validate the concepts and conclusions. The focus of Phase 2 was to provide the validation via resource-loaded schedules and more detailed cost estimates. Section 1 describes the purpose and objectives of the Phase 2 tasks and the programmatic drivers that influence related CPP-651 high-enriched uranium (HEU) management issues. Section 2 identifies the evaluation criteria and methodology andmore » the transfer issues and barriers preventing shipment. Section 3 provides site-specific background information for the CPP-651 facility and the Idaho National Engineering and Environmental Laboratory (INEEL) and describes the development of the basic material removal schedule, the proposed base case plan for removal of SNM, and the proposed HEU material management/shipping issues and strategies. Section 4 identifies the proposed options for accelerated removal of SNM and how they were evaluated via detailed scheduling, resource histograms, and cost analysis. Section 5 summarizes principal tasks for implementing this plan and other related HEU CPP-651 management issues that require continued planning efforts to assure successful implementation of this proposed early removal strategy.« less

Gender in health technology assessment: pilot study on agency approaches.

PubMed

Panteli, Dimitra; Zentner, Annette; Storz-Pfennig, Philipp; Busse, Reinhard

2011-07-01

Gender as a social construct is a recognized health determinant. Because best practice in reporting health technology assessment (HTA) clearly specifies the need to appraise a technology's social impact within the target population, the extent to which gender issues are taken into account in HTA production is of interest, not only in light of equitable practices but also for reasons of effectiveness. The aim of this study is to provide a first assessment of the degree of gender sensitivity shown by HTA agencies around the world today. The Web sites of sixty HTA agencies were analyzed. The consideration of gender aspects was specifically looked for in each agency's general mission statement, its priority setting process, and its methodological approach. Additionally, specific gender-oriented initiatives not belonging to any of the aforementioned categories were identified. Of the sixty agencies, less than half mention a commitment to addressing the social implication of health technologies. Only fifteen institutions make information on their priority setting principles available on their Web sites and gender was an issue in two of those cases. Data on methodology were obtainable online from 18 agencies, two of which mentioned gender issues explicitly. Finally, gender-oriented initiatives were identified by thirteen agencies. A gender-sensitive approach is apparently rarely adopted in current HTA production. Exceptional practices and relevant tools do exist and could serve as examples to be promoted by international collaborative networks.

Neuropsychological issues in military deployments: lessons observed in the DoD Gulf War Illnesses Research Program.

PubMed

Friedl, Karl E; Grate, Stephen J; Proctor, Susan P

2009-04-01

The U.S. Department of Defense invested $150 M to investigate undiagnosed Gulf War Illnesses (GWI) and twice that amount in post hoc clinical management. No new disease syndrome was identified, but the research produced new understanding and awareness of important psychosocial and neurotoxicological interactions that represented a difficult and relatively untapped frontier in biomedical research, especially concerning chronic multisymptom illnesses. Some specific Gulf War issues such as effects of depleted uranium, Leishmania diagnosis and treatment, and pesticide and prophylactic drug interactions have been intensively investigated; remaining priorities for further investigation include: markers of neurologic change (e.g., neuroimaging, neuropsychological testing), interactions between psychological resilience and neurotoxicity, structure-function relationships of neurotoxins with neurodegenerative disease potential, and predictors of individual susceptibility. The primary conclusions from the program are that no specific neurotoxic chemical has been identified that explains the chronic multisymptom illness observed but wellness of service members in future deployments may be better sustained based on continuing research on preexposure health baselining, fitness and health-damaging behaviors, and stress resilience. The many scientific discoveries and accomplishments of the GWI research effort have advanced military medical science, provided a solid basis on which to build future protections against health and performance risks to the warfighter, and improved the ability to respond to future deployment health issues.

Yarning about fall prevention: community consultation to discuss falls and appropriate approaches to fall prevention with older Aboriginal and Torres Strait Islander people.

PubMed

Lukaszyk, Caroline; Coombes, Julieann; Turner, Norma Jean; Hillmann, Elizabeth; Keay, Lisa; Tiedemann, Anne; Sherrington, Cathie; Ivers, Rebecca

2017-08-01

Fall related injury is an emerging issue for older Indigenous people worldwide, yet few targeted fall prevention programs are currently available for Indigenous populations. In order to inform the development of a new Aboriginal-specific fall prevention program in Australia, we conducted community consultation with older Aboriginal people to identify perceptions and beliefs about falls, and to identify desired program elements. Yarning Circles were held with Aboriginal and Torres Strait Islander people aged 45 years and over. Each Yarning Circle was facilitated by an Aboriginal researcher who incorporated six indicative questions into each discussion. Questions explored the impact of falls on Yarning Circle participants, their current use of fall prevention services and investigated Yarning Circle participant's preferences regarding the design and mode of delivery of a fall prevention program. A total of 76 older Aboriginal people participated in ten Yarning Circles across six sites in the state of New South Wales. Participants associated falls with physical disability, a loss of emotional well-being and loss of connection to family and community. Many participants did not use existing fall prevention services due to a lack of availability in their area, having no referral provided by their GP and/or being unaware of fall prevention programs in general. Program elements identified as important by participants were that it be Aboriginal-specific, group-based, and on-going, with the flexibility to be tailored to specific communities, with free transport provided to and from the program. Older Aboriginal people reported falls to be a priority health issue, with a significant impact on their health and well-being. Few older Aboriginal people accessed prevention programs, suggesting there is an important need for targeted Aboriginal-specific programs. A number of important program elements were identified which if incorporated into prevention programs, may help to address the rising burden of falls.

The B4 school check behaviour measures: findings from the Hawke's Bay evaluation.

PubMed

Hedley, Cath; Thompson, Shona; Morris Matthews, Kay; Pentecost, Mandy; Wivell, Judy; Frost, Ariana Stockdale; Morris, Helen

2012-11-01

The Before (B4) School Check is a free health and development check delivered by specifically trained nurses to four year old children throughout New Zealand, aimed to identify and address any health, behavioural, social or developmental concerns that could affect a child's ability to get the most benefit from school. Reported here are the results of an evaluation of the B4 School Checks in Hawke's Bay, focusing specifically on children assessed at the 84 School Check with behaviour issues as determined by the Strengths and Difficulties Questionnaire (SDQ). Health Hawke's Bay (HHB) records were reviewed to understand the number and demographics of the children assessed with behaviour issues at the B4 School Checks up to 31 August 2011, and the interventions to which they were referred. Telephone Interviews were conducted with 36 parents/caregivers of these children to address the questions, what difference did the B4 School Check make to children assessed with behaviour issues and what aspects of the B4 School Check delivery contributed to successful outcomes for these children? Results showed that child behaviour issues in Hawke's Bay were identified in more boys than girls and concentrated in more deprived families. Māori children were represented in numbers disproportional to the regional population. The majority of referrals for child behaviour directed parents/caregivers to non-governmental organisations for family support and parenting programmes. Thematic analysis was applied to the qualitative data derived from the interviews with parents/caregivers and results indicated high levels of satisfaction with the B4 School Check for behaviour and the referred outcomes. Implications for nursing practice arise from these findings in that they identify factors which contribute to what does and does not work well for achieving successful outcomes from the B4 School Check for behaviour.

Ethical and methodological issues in research with Sami experiencing disability.

PubMed

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.

Ethical and methodological issues in research with Sami experiencing disability

PubMed Central

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability. PMID:27396747

Ethical Issues in mHealth Research Involving Persons Living with HIV/AIDS and Substance Abuse

PubMed Central

Labrique, Alain B.; Kirk, Gregory D.; Westergaard, Ryan P.; Merritt, Maria W.

2013-01-01

We aim to raise awareness and stimulate dialogue among investigators and research ethics committees regarding ethical issues that arise specifically in the design and conduct of mHealth research involving persons living with HIV/AIDS and substance abuse. Following a brief background discussion of mHealth research in general, we offer a case example to illustrate the characteristics of mHealth research involving people living with HIV/AIDS and substance abuse. With reference to a well-established systematic general ethical framework for biomedical research with human participants, we identify a range of ethical issues that have particular salience for the protection of participants in mHealth research on HIV/AIDS and substance abuse. PMID:24171110

The philosophy of scientific experimentation: a review

PubMed Central

2009-01-01

Practicing and studying automated experimentation may benefit from philosophical reflection on experimental science in general. This paper reviews the relevant literature and discusses central issues in the philosophy of scientific experimentation. The first two sections present brief accounts of the rise of experimental science and of its philosophical study. The next sections discuss three central issues of scientific experimentation: the scientific and philosophical significance of intervention and production, the relationship between experimental science and technology, and the interactions between experimental and theoretical work. The concluding section identifies three issues for further research: the role of computing and, more specifically, automating, in experimental research, the nature of experimentation in the social and human sciences, and the significance of normative, including ethical, problems in experimental science. PMID:20098589

Drug samples in dermatology: special considerations and recommendations for the future.

PubMed

Alikhan, Ali; Sockolov, Mary; Brodell, Robert T; Feldman, Steven R

2010-06-01

The use of drug samples is a controversial issue in medicine. We sought to determine the pros and cons of drug sampling, and how drug sampling in general medicine differs from dermatology. Literature searches were conducted on PubMed, Google, and Yahoo!. Articles were found pertaining to drug sampling in general, and for dermatology specifically. Numerous pros and cons for drug sampling were found in the literature search. We divided these by cost-related issues, such as the industry-wide cost of sampling and the use of sampling to assist the underinsured and poor, and quality of care issues, such as adherence, patient education, and safety considerations. Articles also suggested that dermatology may differ from general medicine as topical treatments have fewer side effects, are more complicated to use, and come in different vehicles. We identified few studies specifically focused on issues relevant to sampling in dermatology. There are strong arguments for and against drug sampling involving both cost and quality of care issues. Dermatology-specific medications clearly differ from oral medications in several regards. We ultimately conclude that the benefits of drug sampling outweigh the risks, but give recommendations on how drug sampling can be done ethically and effectively, including limiting personal use, not selling samples, properly documenting sample release, teaching patients about proper use, teaching students and residents ethical use of samples, working with pharmaceutical representatives in an ethical manner, prescribing the drug that is best for the patient, and securing samples appropriately to prevent theft and misuse. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

The Real Guide to Grad School. What You Better Know Before You Choose Humanities & Social Sciences.

ERIC Educational Resources Information Center

Clark, Robert E., Ed.; Palattella, John, Ed.

This guide to selecting a graduate school in the humanities and social science fields focuses on the individual disciplines; identifies "standard-bearing" institutions, as well as good but lesser known ones; and reviews specific intellectual issues within various disciplines as they relate to graduate school choice. After an introductory chapter,…

Functioning at the Edge of Knowledge: A Study of Learning Processes in New Product Development

ERIC Educational Resources Information Center

Doos, Marianne; Wilhelmson, Lena; Backlund, Thomas; Dixon, Nancy

2005-01-01

Purpose: In the telecommunication industry, companies gain a competitive edge through the competence of their employees, making issues of learning critical. The study aims to identify specific learning processes necessary when working at the edge both of one's own knowledge and of that of the branch. Design/methodology/approach: This research…

Urban Forest Health Needs Assessment Survey: Results and Recommendations

Treesearch

Jill D. Pokorny

1998-01-01

The survey was designed to query urban forestry professionals in the 20 northeastern and Midwest States and the District of Columbia, which are served by the Northeastern Area, to learn about their attitudes toward the general issue of urban forest health, identify specific training and information needs in the area of urban tree health management, and discover...

Private Feelings, Public Expressions: Professional Jealousy and the Moral Practice of Teaching

ERIC Educational Resources Information Center

Chen, Yen-Hsin; Kristjansson, Kristjan

2011-01-01

This paper explores the issue of personal factors that impinge upon education. More specifically, it addresses professional jealousy among teachers and how it affects the moral practice of teaching. Our focus is teachers' emotions in general and teachers' jealousies in particular, in the context of the ideal of the moral teacher. We identify and…

NCRVE Change Agent. Shaping the Future of Vocational Education. Volume 4, 1994.

ERIC Educational Resources Information Center

NCRVE Change Agent, 1994

1994-01-01

The first of four issues in this volume consists of four review articles. "Tech Prep Quality" reviews a guide to total quality management and tech prep. "Specific, Ocean to Ocean" reviews a publication that identifies 10 preliminary plans for implementing tech prep. "...No Single Option" is about a monograph that evaluates tech prep and other…

Describing, Analysing and Judging Language Codes in Cinematic Discourse

ERIC Educational Resources Information Center

Richardson, Kay; Queen, Robin

2012-01-01

In this short commentary piece, the authors stand back from many of the specific details in the seven papers which constitute the special issue, and offer some observations which attempt to identify and assess points of similarity and difference amongst them, under a number of different general headings. To the extent that the "sociolinguistics of…

Issues and Challenges Identified in the Development of a Broad Multidisciplinary Work Integrated Learning Package

ERIC Educational Resources Information Center

Sutherland, Karen; Symmons, Mark

2013-01-01

Work integrated learning (WIL) units can be discipline specific and constructed for majors or degrees with a strong vocational orientation. This paper describes an undergraduate unit with its genesis in a public relations internship. The original unit enjoyed strong support from industry partners and was instrumental in many graduates securing…

Public Support for Successful Instructional Practices for At-Risk Students.

ERIC Educational Resources Information Center

Hilliard, Asa G., III

It is possible for at-risk students to perform at demanding academic levels, and their achievement can be improved dramatically in a relatively short time. Effective ways to teach at-risk children have already been identified; no new research is needed. This report covers the following specific issues related to educating high-risk students. It…

Assessing Reading Comprehension in Adolescent Low Achievers: Subskills Identification and Task Specificity

ERIC Educational Resources Information Center

van Steensel, Roel; Oostdam, Ron; van Gelderen, Amos

2013-01-01

On the basis of a validation study of a new test for assessing low-achieving adolescents' reading comprehension skills--the SALT-reading--we analyzed two issues relevant to the field of reading test development. Using the test results of 200 seventh graders, we examined the possibility of identifying reading comprehension subskills and the effects…

The Chief Performance Officer in Education. Solutions. Issue No. 3

ERIC Educational Resources Information Center

Nafziger, Dean

2013-01-01

A performance management system can help the state education agency (SEA) become more intentional about what it does and does not do, how work is done, and when to change course. Performance management does not define goals or identify specific strategies, but it puts in place systems that enable learning and adaptation to drive improvement and…

Campylobacter jejuni host tissue tropism: a consequence of its low-carb lifestyle?

PubMed

Thompson, Stuart A; Gaynor, Erin C

2008-11-13

Mechanisms underlying virulence properties of Campylobacter jejuni have historically been difficult to identify. In this issue of Cell Host & Microbe, Hofreuter et al. (2008) show that C. jejuni's ability to metabolize glutamine, glutathione, and asparagine affects its ability to colonize specific host tissues. These findings reflect the emerging theme of bacterial physiology directly impacting pathogenesis.

Closing the Theory-Practice Gap: Physical Education Students' Use of Jigsaw Learning in a Secondary School

ERIC Educational Resources Information Center

O'Leary, Nick; Wattison, Nicole; Edwards, Toni; Bryan, Kate

2015-01-01

Recognising that the theory-practice gap remains problematic in the preparation of physical education (PE) teachers, this study sought to explore three undergraduate students use of jigsaw learning teaching gymnastics during a secondary school placement. Specifically, the research attempted to identify those issues that arose using this learning…

Educator, Planner and Advocate: Higher Education for Adults in the New Millennium

ERIC Educational Resources Information Center

Plageman, Paula

2011-01-01

The purpose of this article is to identify an issue that impacts individuals and institutions on a seemingly individual basis but collectively affects numerous program participants and their communities. Specifically, this article is about the tension between the need to provide student support service programming with the need to advocate for the…

Cultural Adaptations of the "Strengthening Families Programme 10-14" in the US Pacific Northwest: A Qualitative Evaluation

ERIC Educational Resources Information Center

Roulette, Jennifer W; Hill, Laura G; Diversi, Marcelo; Overath, Renee

2017-01-01

Objective: Most reports of adaptations to evidence-based prevention programmes for delivery to specific cultural groups describe formal adaptation procedures. In this paper, we report on how practitioners identify and manage issues of perceived cultural mismatch when delivering a scripted, evidence-based intervention. Design: We used grounded…

Shifting Challenges in Teacher-Education Research and Accreditation: Lessons Learned from Limitations on Studying Program Impact

ERIC Educational Resources Information Center

Contopidis, Ellen; DaBoll-Lavoie, Kathleen; Dunn, Kerry; Darling, Deana; Wieczorek, Kim

2017-01-01

A critical issue in educator preparation is how to ascertain if program graduates are sufficiently prepared to be effective through the acquisition of meaningful evidence of graduates' impact on their students. Challenges to proving specific impact of educator-preparation programs on student learning include identifying and following program…

Navy Nuclear Aircraft Carrier (CVN) Homeporting at Mayport: Background and Issues for Congress

DTIC Science & Technology

2009-12-23

releaseid= 12600 . 2 The Navy has not identified which specific CVN it would transfer, and a CVN transferred to Mayport could come from any of the...Mayport,” available online at http://www.defenselink.mil/releases/release.aspx?releaseid= 12600 . 7Although the Navy states that the CVN based at Yokosuka

Principles for Practice with Substance-Abusing Pregnant Women: A Framework Based on the Five Social Work Intervention Roles

ERIC Educational Resources Information Center

Sun, An-Pyng

2004-01-01

The author discusses components essential to pregnancy-specific substance abuse treatment, based on a review of the literature. Elements and issues related to substance abuse during pregnancy are identified under the five social work intervention roles: teacher, broker, clinician, mediator, and advocate. The concepts and approaches presented in…

Ethical issues with service animals.

PubMed

Wenthold, Nora; Savage, Teresa A

2007-01-01

The beneficial aspects of canines who provide services to people with disabilities have resulted in an explosion of a category of dogs that are bred and/or trained just for service purposes. Over the past 30 years, the role of most service dogs has become more prominent and more demanding. There are also concerns as to the well-being of these animals and questions regarding realistic expectations of them. The purpose of this article is to explore the utilization of service dogs in a rehabilitation health care setting. More specifically, ethical issues that are pertinent to the service dog's role will be identified and resolutions recommended.

Influence Map Methodology for Evaluating Systemic Safety Issues

NASA Technical Reports Server (NTRS)

2008-01-01

"Raising the bar" in safety performance is a critical challenge for many organizations, including Kennedy Space Center. Contributing-factor taxonomies organize information about the reasons accidents occur and therefore are essential elements of accident investigations and safety reporting systems. Organizations must balance efforts to identify causes of specific accidents with efforts to evaluate systemic safety issues in order to become more proactive about improving safety. This project successfully addressed the following two problems: (1) methods and metrics to support the design of effective taxonomies are limited and (2) influence relationships among contributing factors are not explicitly modeled within a taxonomy.

Translating supportability requirements into design reality

NASA Astrophysics Data System (ADS)

Buche, J.; Cohen, I.

1986-10-01

This paper explores some of the principal issues in the integration of supportability into the design process. Roles of the contractor's design, supportability and management specialists and their government counterparts are discussed as they relate to logistics influence in design. Methods and processes by which weapon system logistics and readiness requirements are established, assessed, allocated to system elements and translated into specific design features are described. Tradeoff consideration, an approach to effective tradeoff criteria, and the progress of supportability issues through the program phases are identified with particular emphasis on the necessity for developing and maintaining an effective audit trail.

Health issues of female foreign domestic workers: a systematic review of the scientific and gray literature.

PubMed

Malhotra, Rahul; Arambepola, Chandima; Tarun, Samiksha; de Silva, Vijitha; Kishore, Jugal; Østbye, Truls

2013-01-01

Although the number of female foreign domestic workers (FDWs) is increasing worldwide, little is known about their health issues. To systematically review the literature on health issues of female FDWs to ascertain the problems studied, identify limitations, and suggest future research and policy implications. A systematic database (PubMed, EBSCO Host, and Google Scholar) and bibliographic search identified the English-language scientific and gray literature published during 1990-2012 addressing health issues of female FDWs living with the family of the employer, using qualitative and/or quantitative research methods. Studies in which female FDWs constituted less than half of the participants were excluded. The health issues studied and identified were adverse work conditions and associated health problems (such as physical, verbal, and sexual abuse at the workplace, caregiving tasks associated with musculoskeletal strain, and chemical exposure associated with respiratory difficulty), mental health (psychotic, neurotic, and mood disorders), infectious diseases (most of the studies were on intestinal parasitic infections), and health knowledge/attitudes/practices (most of the studies were in context of sexual and reproductive health). Most of the studies were medical record reviews or questionnaire-based surveys utilizing convenience sampling or qualitative interviews/focus group discussions. Female FDWs face numerous health problems. Studies on representative, possibly longitudinal, samples of female FDWs focusing on specific health conditions are needed to better understand the epidemiology of such conditions. Concerted efforts through the governments of both labor-sending and host countries are required to improve the health, work conditions, and safety of this vulnerable group of women.

Lay and professional stakeholder involvement in scoping palliative care issues: Methods used in seven European countries.

PubMed

Brereton, Louise; Ingleton, Christine; Gardiner, Clare; Goyder, Elizabeth; Mozygemba, Kati; Lysdahl, Kristin Bakke; Tummers, Marcia; Sacchini, Dario; Leppert, Wojciech; Blaževičienė, Aurelija; van der Wilt, Gert Jan; Refolo, Pietro; De Nicola, Martina; Chilcott, James; Oortwijn, Wija

2017-02-01

Stakeholders are people with an interest in a topic. Internationally, stakeholder involvement in palliative care research and health technology assessment requires development. Stakeholder involvement adds value throughout research (from prioritising topics to disseminating findings). Philosophies and understandings about the best ways to involve stakeholders in research differ internationally. Stakeholder involvement took place in seven countries (England, Germany, Italy, Lithuania, the Netherlands, Norway and Poland). Findings informed a project that developed concepts and methods for health technology assessment and applied these to evaluate models of palliative care service delivery. To report on stakeholder involvement in the INTEGRATE-HTA project and how issues identified informed project development. Using stakeholder consultation or a qualitative research design, as appropriate locally, stakeholders in seven countries acted as 'advisors' to aid researchers' decision making. Thematic analysis was used to identify key issues across countries. A total of 132 stakeholders (82 professionals and 50 'lay' people) aged ⩾18 participated in individual face-to-face or telephone interviews, consultation meetings or focus groups. Different stakeholder involvement methods were used successfully to identify key issues in palliative care. A total of 23 issues common to three or more countries informed decisions about the intervention and comparator of interest, sub questions and specific assessments within the health technology assessment. Stakeholders, including patients and families undergoing palliative care, can inform project decision making using various involvement methods according to the local context. Researchers should consider local understandings about stakeholder involvement as views of appropriate and feasible methods vary. Methods for stakeholder involvement, especially consultation, need further development.

Patient complaints as a means to improve quality of hospital care. Results of a qualitative content analysis

PubMed

Hoffmann, Susanne; Dreher-Hummel, Thomas; Dollinger, Claudia; Frei, Irena Anna

2018-04-01

Background: Many hospitals have defined procedures for a complaint management. A systematic analysis of patient complaints helps to identify similar complaints and patterns so that targeted improvement measures can be derived (Gallagher & Mazor, 2015). Aim: Our three-month, nurse-led practice development project aimed 1) to identify complaints regarding communication issues, 2) to systemise and prioritise complaints regarding communication issues, and 3) to derive clinic-specific recommendations for improvement. Method: We analysed 273 complaints of patients documented by the quality management (secondary data analysis). Using content analysis and applying the coding taxonomy for inpatient complaints by Reader, Gillespie and Roberts (2014), we distinguished communication-related complaints. By further inductive differentiation of these complaints, we identified patterns and prioritised fields of action. Results: We identified 186 communication-related complaints divided into 16 subcategories. For each subcategory, improvement interventions were derived, discussed and prioritised. Conclusions: Thus, patient complaints provided an excellent opportunity for reflection and workplace learning for nurses. The analysis gave impulse to exemplify the subject “person-centered care” for nurses.

Gap analysis of cultural and religious needs of hospitalized patients.

PubMed

Davidson, Judy E; Boyer, Merri Lynn; Casey, Debra; Matzel, Stephen Chavez; Walden, Chaplain David

2008-01-01

Identify patient and family needs specifically related to an in-hospital birth or death. This study aimed to perform a gap analysis between identified needs and current hospital practice, services, and resources. With the IRB approval, and purposive sampling using the demographics of a community hospital plus subgroups from problematic cases. Twenty-two semistructured interviews were audiotaped, and 6 lectures and 2 panel discussions were videotaped. Transcriptions were distributed to the research team and manually coded for gaps between current practices versus stated needs. Group process was used to form consensus regarding findings. The following subgroups were targeted: Muslim, Baha'i, Catholic, Protestant, Jewish, Buddhist, Mormon, Jehovah's Witness, Latino, Filipino, Chinese, African American. Gaps in available resources, such as prayer books, rugs, and compasses, were identified. Knowledge gaps included many issues such as the Muslim preference for decreasing sedatives at end of life to be able to recite the sacred prayer while dying. Practice issues such as respecting plain-clothed clergy, the impact of "rule-orientation" on family needs, and the universal need to call clergy early were identified.

Exploring the quality of life issues in people with retinal diseases: a qualitative study.

PubMed

Prem Senthil, Mallika; Khadka, Jyoti; Gilhotra, Jagjit Singh; Simon, Sumu; Pesudovs, Konrad

2017-01-01

The lack of an appropriate retina-specific patient-reported outcome instrument restricts the understanding of the full impact of hereditary retinal diseases and other less common but potentially blinding acquired retinal diseases such as, vascular occlusions, epiretinal membrane, macular hole, central serous retinopathy and other vitreoretinopathies on quality of life. This study aims to explore the quality of life issues in people with hereditary retinal diseases and acquired retinal diseases to develop disease-specific patient-reported outcome instruments. A qualitative research methodology to understand the lived experiences of people with retinal diseases was carried out. Data were collected through semistructured interviews. The coding, aggregation and theme development was carried out using the NVivo -10 software. Seventy-nine interviews were conducted with participants with hereditary retinal diseases ( n  = 32; median age = 57 years) and acquired retinal diseases ( n  = 47; median age = 73 years). We identified nine quality of life themes (domains) relevant to people with retinal diseases. Difficulty in performing important day-to-day activities (activity limitation) was the most prominent quality of life issue in the hereditary retinal diseases group whereas concerns about health, disease outcome and personal safety (health concerns) was the most prominent quality of life issue in the acquired retinal diseases group. Participants with hereditary retinal diseases had more issues with social interaction (social well-being), problems with mobility and orientation (mobility), and effect on work and finance (economic) than participants with acquired retinal diseases. On the contrary, participants with acquired retinal diseases reported more inconveniences (conveniences) than participants with hereditary retinal diseases, which were mostly attributed to treatment. Participants with hereditary retinal diseases were coping better compared to participants with acquired retinal diseases. Our study found that participants with both hereditary and acquired retinal diseases are living with myriad of disease-specific quality of life issues. Many of these issues are completely different and unique to each disease group. Hence, these group of diseases would need separate patient-reported outcome instruments to capture the disease-specific quality of life impacts.

Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

PubMed

Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

2018-02-01

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting ethical principles. © 2017 John Wiley & Sons Ltd.

Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases.

PubMed

Meyer, Diane; Kirk Sell, Tara; Schoch-Spana, Monica; Shearer, Matthew P; Chandler, Hannah; Thomas, Erin; Rose, Dale A; Carbone, Eric G; Toner, Eric

2018-05-01

The domestic response to the West Africa Ebola virus disease (EVD) epidemic from 2014-2016 provides a unique opportunity to distill lessons learned about health sector planning and operations from those individuals directly involved. This research project aimed to identify and integrate these lessons into an actionable checklist that can improve health sector resilience to future high-consequence infectious disease (HCID) events. Interviews (N = 73) were completed with individuals involved in the domestic EVD response in 4 cities (Atlanta, Dallas, New York, and Omaha), and included individuals who worked in academia, emergency management, government, health care, law, media, and public health during the response. Interviews were transcribed and analyzed qualitatively. Two focus groups were then conducted to expand on themes identified in the interviews. Using these themes, an evidence-informed checklist was developed and vetted for completeness and feasibility by an expert advisory group. Salient themes identified included health care facility issues-specifically identifying assessment and treatment hospitals, isolation and treatment unit layout, waste management, community relations, patient identification, patient isolation, limitations on treatment, laboratories, and research considerations-and health care workforce issues-specifically psychosocial impact, unit staffing, staff training, and proper personal protective equipment. The experiences of those involved in the domestic Ebola response provide critical lessons that can help strengthen resilience of health care systems and improve future responses to HCID events. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Factors Associated With Utilization of Cardiac Rehabilitation Among Patients With Ischemic Heart Disease in the Veterans Health Administration: A QUALITATIVE STUDY.

PubMed

Schopfer, David W; Priano, Susan; Allsup, Kelly; Helfrich, Christian D; Ho, P Michael; Rumsfeld, John S; Forman, Daniel E; Whooley, Mary A

2016-01-01

Cardiac rehabilitation (CR) programs reduce morbidity and mortality in patients with ischemic heart disease but are vastly underutilized in the United States, including the Veterans Health Administration (VA) Healthcare System. Numerous barriers affecting utilization have been identified in other health care systems, but the specific factors affecting Veterans are unknown. We sought to identify barriers and facilitators associated with utilization of CR in VA facilities. We performed a qualitative study of 56 VA patients, providers, and CR program managers at 30 VA facilities across the United States. We conducted semistructured interviews with key informants to explore their attitudes and knowledge toward CR. Interviews were conducted until thematic saturation occurred. Analyses using grounded theory to identify key themes were conducted using the qualitative data analysis package ATLAS.ti. We identified 6 themes as barriers and 5 as facilitators. The most common barriers to participation in CR were patient transportation issues (68%), lack of patient willingness to participate (41%), and no access to a nearby VA hospital with a CR program (30%). The most common facilitators were involvement of a dedicated provider or "clinical champion" (50%), provider knowledge of or experience with CR (48%), and patient desire for additional medical support (32%). Our findings suggest that addressing access issues and educating and activating providers on CR may increase utilization of CR programs. Targeting these specific factors may improve utilization of CR programs.

Using primary care electronic health record data for comparative effectiveness research: experience of data quality assessment and preprocessing in The Netherlands.

PubMed

Huang, Yunyu; Voorham, Jaco; Haaijer-Ruskamp, Flora M

2016-07-01

Details of data quality and how quality issues were solved have not been reported in published comparative effectiveness studies using electronic health record data. We developed a conceptual framework of data quality assessment and preprocessing and apply it to a study comparing angiotensin-converting enzyme inhibitors with angiotensin receptor blockerss on renal function decline in diabetes patients. The framework establishes a line of thought to identify and act on data issues. The core concept is to evaluate whether data are fit-for-use for research tasks. Possible quality problems are listed through specific signal detections, and verified whether they are true problems. Optimal solutions are selected for the identified problems. This framework can be used in observational studies to improve validity of results.

HIV infection risk factors among male-to-female transgender persons: a review of the literature.

PubMed

De Santis, Joseph P

2009-01-01

Male-to-female (MTF) transgender women experience a host of psychosocial issues such as discrimination, stigmatization, and marginalization. These challenges often limit economic opportunities, affect mental health, and may place members of this population at an increased risk for HIV infection. This report presents a review of the literature that focuses on risk factors for HIV infection specific to the MTF population. Factors including needle sharing and substance abuse, high-risk sexual behaviors, commercial sex work, health care access, lack of knowledge regarding HIV transmission, violence, stigma and discrimination, and mental health issues have been identified in the literature as risk factors for the acquisition of HIV infection by members of this population. Implications for care provided to MTF transgender persons are presented, and suggestions for future research are identified.

"It still haunts me whether we did the right thing": a qualitative analysis of free text survey data on the bereavement experiences and support needs of family caregivers.

PubMed

Harrop, Emily; Morgan, Fiona; Byrne, Anthony; Nelson, Annmarie

2016-11-08

Research suggests that there may be bereavement experiences and support needs which are specific to family caregivers providing end of life care (EoLC), although this remains an under-researched area. This paper focuses on themes relating to bereavement which were derived from an analysis of free text survey responses collected in a research priority setting exercise for palliative and EoLC. The priority setting exercise involved a public survey, designed to generate research priorities. Rather than identify research topics, many people instead described their experiences and raised more general questions relating to palliative and end of life care. To explore these experiences and perspectives a supplementary thematic analysis was conducted on the survey responses. 1403 respondents took part, including patients, current and bereaved carers, health and social care professionals, volunteers and members of the public. Several grief issues were identified, which seem specific to the experiences of family caregivers. Responses demonstrated a relationship between death experiences, feelings of guilt and bereavement outcomes for some family caregivers, as well as caregiver experiences of a "void" created by the withdrawal of professional support after death. Communication and support needs were also identified by participants. This analysis provides further evidence of some of the specific effects that caring for a loved one at the end of life can have on bereavement experiences. Finding ways of improving communication around the time of death and effective follow up approaches post death could help to address some of these issues.

Influence of medical journal press releases on the quality of associated newspaper coverage: retrospective cohort study.

PubMed

Schwartz, Lisa M; Woloshin, Steven; Andrews, Alice; Stukel, Therese A

2012-01-27

To determine whether the quality of press releases issued by medical journals can influence the quality of associated newspaper stories. Retrospective cohort study of medical journal press releases and associated news stories. We reviewed consecutive issues (going backwards from January 2009) of five major medical journals (Annals of Internal Medicine, BMJ, Journal of the National Cancer Institute, JAMA, and New England Journal of Medicine) to identify the first 100 original research articles with quantifiable outcomes and that had generated any newspaper coverage (unique stories ≥100 words long). We identified 759 associated newspaper stories using Lexis Nexis and Factiva searches, and 68 journal press releases using Eurekalert and journal website searches. Two independent research assistants assessed the quality of journal articles, press releases, and a stratified random sample of associated newspaper stories (n=343) by using a structured coding scheme for the presence of specific quality measures: basic study facts, quantification of the main result, harms, and limitations. Proportion of newspaper stories with specific quality measures (adjusted for whether the quality measure was present in the journal article's abstract or editor note). We recorded a median of three newspaper stories per journal article (range 1-72). Of 343 stories analysed, 71% reported on articles for which medical journals had issued press releases. 9% of stories quantified the main result with absolute risks when this information was not in the press release, 53% did so when it was in the press release (relative risk 6.0, 95% confidence interval 2.3 to 15.4), and 20% when no press release was issued (2.2, 0.83 to 6.1). 133 (39%) stories reported on research describing beneficial interventions. 24% mentioned harms (or specifically declared no harms) when harms were not mentioned in the press release, 68% when mentioned in the press release (2.8, 1.1 to 7.4), and 36% when no press release was issued (1.5, 0.49 to 4.4). 256 (75%) stories reported on research with important limitations. 16% reported any limitations when limitations were not mentioned in the press release, 48% when mentioned in the press release (3.0, 1.5 to 6.2), and 21% if no press release was issued (1.3, 0.50 to 3.6). High quality press releases issued by medical journals seem to make the quality of associated newspaper stories better, whereas low quality press releases might make them worse.

Influence of medical journal press releases on the quality of associated newspaper coverage: retrospective cohort study

PubMed Central

Schwartz, Lisa M; Andrews, Alice; Stukel, Therese A

2012-01-01

Objective To determine whether the quality of press releases issued by medical journals can influence the quality of associated newspaper stories. Design Retrospective cohort study of medical journal press releases and associated news stories. Setting We reviewed consecutive issues (going backwards from January 2009) of five major medical journals (Annals of Internal Medicine, BMJ, Journal of the National Cancer Institute, JAMA, and New England Journal of Medicine) to identify the first 100 original research articles with quantifiable outcomes and that had generated any newspaper coverage (unique stories ≥100 words long). We identified 759 associated newspaper stories using Lexis Nexis and Factiva searches, and 68 journal press releases using Eurekalert and journal website searches. Two independent research assistants assessed the quality of journal articles, press releases, and a stratified random sample of associated newspaper stories (n=343) by using a structured coding scheme for the presence of specific quality measures: basic study facts, quantification of the main result, harms, and limitations. Main outcome Proportion of newspaper stories with specific quality measures (adjusted for whether the quality measure was present in the journal article’s abstract or editor note). Results We recorded a median of three newspaper stories per journal article (range 1-72). Of 343 stories analysed, 71% reported on articles for which medical journals had issued press releases. 9% of stories quantified the main result with absolute risks when this information was not in the press release, 53% did so when it was in the press release (relative risk 6.0, 95% confidence interval 2.3 to 15.4), and 20% when no press release was issued (2.2, 0.83 to 6.1). 133 (39%) stories reported on research describing beneficial interventions. 24% mentioned harms (or specifically declared no harms) when harms were not mentioned in the press release, 68% when mentioned in the press release (2.8, 1.1 to 7.4), and 36% when no press release was issued (1.5, 0.49 to 4.4). 256 (75%) stories reported on research with important limitations. 16% reported any limitations when limitations were not mentioned in the press release, 48% when mentioned in the press release (3.0, 1.5 to 6.2), and 21% if no press release was issued (1.3, 0.50 to 3.6). Conclusion High quality press releases issued by medical journals seem to make the quality of associated newspaper stories better, whereas low quality press releases might make them worse. PMID:22286507

NASA Presentation to TechAmerica G12 Committee

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Sampson, Michael J.

2011-01-01

This slide presentation reviews some of the actions that NASA is taking to address the issue of counterfeit electronic parts. While the emphasis is on electronic parts, the vision is broad enough to include materials and software. The effort includes coordination with other agencies, to identify and with the Government-Industry Data Exchange Program (GIDEP). An interim GIDEP Policy for suspected counterfeits was instituted. NASA's recommendation to the policy was for identification of the supplier and suggests allowing access to that information by government only. The issues with the General MIL specification, the testing requirements for radiation issues, the continuing development of Class Y standards for electronic equipment, status of package case isolation tests needed for 750 and 883,enhancement of 750 Internal Visual Inspection are reviewed. Further issues with consistent ESD control conditions across commodities, test methods, humidity limits, etc are briefly reviewed. The cost benefit analysis of film versus Real time radiography are also reviewed.

Strategic planning for post-disaster temporary housing.

PubMed

Johnson, Cassidy

2007-12-01

Temporary housing programmes suffer from excessively high cost, late delivery, poor location, improper unit designs and other inherent issues. These issues can be attributed in part to a prevalence of ad hoc tactical planning, rather than pre-disaster strategic planning, for reconstruction undertaken by governments and non-governmental organisations (NGOs) in the chaotic post-disaster environment. An analysis of the process and outcomes from six case studies of temporary housing programmes after disasters in Turkey and Colombia in 1999, Japan in 1995, Greece in 1986, Mexico in 1985, and Italy in 1976 yields information about the extent to which strategic planning is employed in temporary housing programmes, as well as common issues in temporary housing. Based on an understanding of these common issues, this paper proposes a framework for strategic planning for temporary housing that identifies organisational designs and available resources for temporary housing before the disaster, but allows modifications to fit the specific post-disaster situation.

Money Matters: Recommendations for Financial Stress Research in Occupational Health Psychology.

PubMed

Sinclair, Robert R; Cheung, Janelle H

2016-08-01

Money is arguably the most important resource derived from work and the most important source of stress for contemporary employees. A substantial body of research supports the relationship between access to financial resources and health and well-being, both at individual and aggregated (e.g. national) levels of analysis. Yet, surprisingly little occupational health psychology research has paid attention to financial issues experienced specifically by those in the labour force. With these issues in mind, the overarching goal of the present paper was to address conceptual and measurement issues in the study of objective and subjective aspects of financial stress and review several assessment options available to occupational health psychology researchers for both aspects of financial stress. Where appropriate, we offer guidance to researchers about choices among various financial stress measures and identify issues that require further research attention. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Implementation Issues for Departure Planning Systems

NASA Technical Reports Server (NTRS)

Hansman, R. John; Feron, Eric; Clarke, John-Paul; Odoni, Amedeo

1999-01-01

The objective of the proposed effort is to investigate issues associated with the design and implementation of decision aiding tools to assist in improving the departure process at congested airports. This effort follows a preliminary investigation of potential Departure Planning approaches and strategies, which identified potential benefits in departure efficiency, and also in reducing the environmental impact of aircraft in the departure queue. The preliminary study bas based, in large part, on observations and analysis of departure processes at Boston, Logan airport. The objective of this follow-on effort is to address key implementation issues and to expand the observational base to include airports with different constraints and traffic demand. Specifically, the objectives of this research are to: (1) Expand the observational base to include airports with different underlying operational dynamics. (2) Develop prototype decision aiding algorithms/approaches and assess potential benefits. and (3) Investigate Human Machine Integration (HMI) issues associated with decision aids in tower environments.

Halal authenticity issues in meat and meat products.

PubMed

Nakyinsige, Khadijah; Man, Yaakob Bin Che; Sazili, Awis Qurni

2012-07-01

In the recent years, Muslims have become increasingly concerned about the meat they eat. Proper product description is very crucial for consumers to make informed choices and to ensure fair trade, particularly in the ever growing halal food market. Globally, Muslim consumers are concerned about a number of issues concerning meat and meat products such as pork substitution, undeclared blood plasma, use of prohibited ingredients, pork intestine casings and non-halal methods of slaughter. Analytical techniques which are appropriate and specific have been developed to deal with particular issues. The most suitable technique for any particular sample is often determined by the nature of the sample itself. This paper sets out to identify what makes meat halal, highlight the halal authenticity issues that occur in meat and meat products and provide an overview of the possible analytical methods for halal authentication of meat and meat products. Copyright © 2012 Elsevier Ltd. All rights reserved.

Solution-focused conversations: a new therapeutic strategy in well child health nursing telephone consultations.

PubMed

Polaschek, Linda; Polaschek, Nick

2007-07-01

This paper is a report of a study to explore well child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. Well child nurses (health visitors) in some services provide a separate telephone consultation service for parents who need immediate advice or are unable to visit the clinic. As well as purely physical issues suggesting infant pathology, these consultations address a range of other concerns relating to parenting and child behaviour. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of well child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognize the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of well child telenurses. Solution-focused conversation is a suitable approach for the single, relatively short, interactions involved in telephone nursing. Other communication strategies could be appropriate for nurses in different clinical situations.

The retention of the older nursing workforce: a literature review exploring factors which influence the retention and turnover of older nurses.

PubMed

Moseley, Amanda; Jeffers, Lesley; Paterson, Jan

2008-08-01

In an era of nursing shortages and increased health care demands, it is important to explore factors which contribute to the retention of nursing staff, especially older nurses who contribute a wealth of knowledge and experience to their employing organization. This literature review explored the factors that influence older nurses to leave an organization or to retire early and identified a number of key issues which can influence this decision. These included the need to respect and recognise the achievements of older staff, specific managerial characteristics which influence staff retention, the importance of empowerment and autonomy, the valuing of expertise, the provision of challenges, creating a sense of community within an organization, the importance of education and peer development, the impact of work demands and environment, the influence of flexible working and shift options and the issue of adequate financial reimbursement. From this review, a variety of recommendations have been generated which it is hoped will help to inform the creation of policies and practices that specifically address the issue of retention of older nursing staff.

Development of Reliable Life Support Systems

NASA Technical Reports Server (NTRS)

Carter, Layne

2017-01-01

The life support systems on the International Space Station (ISS) are the culmination of an extensive effort encompassing development, design, and test to provide the highest possible confidence in their operation on ISS. Many years of development testing are initially performed to identify the optimum technology and the optimum operational approach. The success of this development program depends on the accuracy of the system interfaces. The critical interfaces include the specific operational environment, the composition of the waste stream to be processed and the quality of the product. Once the development program is complete, a detailed system schematic is built based on the specific design requirements, followed by component procurement, assembly, and acceptance testing. A successful acceptance test again depends on accurately simulating the anticipated environment on ISS. The ISS Water Recovery System (WRS) provides an excellent example of where this process worked, as well as lessons learned that can be applied to the success of future missions. More importantly, ISS has provided a test bed to identify these design issues. Mechanical design issues have included an unreliable harmonic drive train in the Urine Processor's fluids pump, and seals in the Water Processor's Catalytic Reactor with insufficient life at the operational temperature. Systems issues have included elevated calcium in crew urine (due to microgravity effect) that resulted in precipitation at the desired water recovery rate, and the presence of an organosilicon compound (dimethylsilanediol) in the condensate that is not well removed by the water treatment process. Modifications to the WRS to address these issues are either complete (and now being evaluated on ISS) or are currently in work to insure the WRS has the required reliability before embarking on a mission to Mars.

Cancer and the LGBTQ Population: Quantitative and Qualitative Results from an Oncology Providers’ Survey on Knowledge, Attitudes, and Practice Behaviors

PubMed Central

Tamargo, Christina L.; Sanchez, Julian A.

2017-01-01

Background: Despite growing social acceptance, the LGBTQ population continues to face barriers to healthcare including fear of stigmatization by healthcare providers, and providers’ lack of knowledge about LGBTQ-specific health issues. This analysis focuses on the assessment of quantitative and qualitative responses from a subset of providers who identified as specialists that treat one or more of the seven cancers that may be disproportionate in LGBTQ patients. Methods: A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. Results: Oncology providers specializing in seven cancer types had poor knowledge of LGBTQ-specific health needs, with fewer than half of the surveyed providers (49.5%) correctly answering knowledge questions. Most providers had overall positive attitudes toward LGBTQ patients, with 91.7% agreeing they would be comfortable treating this population, and would support education and/or training on LGBTQ-related cancer health issues. Conclusion: Results suggest that despite generally positive attitudes toward the LGBTQ population, oncology providers who treat cancer types most prevalent among the population, lack knowledge of their unique health issues. Knowledge and practice behaviors may improve with enhanced education and training on this population’s specific needs. PMID:28991160

Cancer and the LGBTQ Population: Quantitative and Qualitative Results from an Oncology Providers' Survey on Knowledge, Attitudes, and Practice Behaviors.

PubMed

Tamargo, Christina L; Quinn, Gwendolyn P; Sanchez, Julian A; Schabath, Matthew B

2017-10-07

Despite growing social acceptance, the LGBTQ population continues to face barriers to healthcare including fear of stigmatization by healthcare providers, and providers' lack of knowledge about LGBTQ-specific health issues. This analysis focuses on the assessment of quantitative and qualitative responses from a subset of providers who identified as specialists that treat one or more of the seven cancers that may be disproportionate in LGBTQ patients. A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. Oncology providers specializing in seven cancer types had poor knowledge of LGBTQ-specific health needs, with fewer than half of the surveyed providers (49.5%) correctly answering knowledge questions. Most providers had overall positive attitudes toward LGBTQ patients, with 91.7% agreeing they would be comfortable treating this population, and would support education and/or training on LGBTQ-related cancer health issues. Results suggest that despite generally positive attitudes toward the LGBTQ population, oncology providers who treat cancer types most prevalent among the population, lack knowledge of their unique health issues. Knowledge and practice behaviors may improve with enhanced education and training on this population's specific needs.

Resource utilization in home health care: results of a prospective study.

PubMed

Trisolini, M G; Thomas, C P; Cashman, S B; Payne, S M

1994-01-01

Resource utilization in home health care has become an issue of concern due to rising costs and recent initiatives to develop prospective payment systems for home health care. A number of issues remain unresolved for the development of prospective reimbursement in this sector, including the types of variables to be included as payment variables and appropriate measures of resource use. This study supplements previous work on home health case-mix by analyzing the factors affecting one aspect of resource use for skilled nursing visits--visit length--and explores the usefulness of several specially collected variables which are not routinely available in administrative records. A data collection instrument was developed with a focus group of skilled nurses, identifying a range of variables hypothesized to affect visit length. Five categories of variables were studied using multiple regression analysis: provider-related; patient's socio-economic status; patient's clinical status; patient's support services; and visit-specific. The final regression model identifies 9 variables which significantly affect visit time. Five of the 9 are visit-specific variables, a significant finding since these are not routinely collected. Case-mix systems which include visit time as a measure of resource use will need to investigate visit-specific variables, as this study indicates they could have the largest influence on visit time. Two other types of resources used in home health care, supplies and security drivers, were also investigated in less detail.

A mixed methods approach to adapting health-related quality of life measures for use in routine oncology clinical practice.

PubMed

Harley, Clare; Takeuchi, Elena; Taylor, Sally; Keding, Ada; Absolom, Kate; Brown, Julia; Velikova, Galina

2012-04-01

The current study reviewed and adapted existing health-related quality of life (HRQoL) instruments for use in routine clinical practice delivering outpatient chemotherapy for colorectal, breast and gynaecological cancers. 564 (288 gynaecological, 208 breast and 68 colorectal) outpatient consultations of 141 patients were audio-recorded and analysed to identify discussed issues. Issues were ranked from most to least commonly discussed within each disease group. Existing HRQoL instruments were evaluated against these lists and best fitting items entered into cancer-specific item banks. Item banks were evaluated during semi-structured interviews by twenty-one oncologists (13 consultants and 8 specialist registrars), four clinical nurse specialists and thirty patients, from breast, gynaecological and colorectal cancer practices. Pilot questionnaires were completed by 448 (145 breast, 148 gynaecological and 155 colorectal) patients attending outpatient clinics. Item selection and scale reliability was explored using descriptive data and psychometric methods alongside qualitative patient and clinician ratings. Each questionnaire includes five physical and three psychosocial function scales each with good internal consistency reliability (α > 0.70) plus disease-specific individual-symptom items identified as useful in clinical practice. Three cancer-specific health-related quality of life measures were developed for use in routine clinical practice. Initial analyses suggest good clinical utility and acceptable psychometric properties for the new instruments.

Opioid Analgesics.

PubMed

Jamison, Robert N; Mao, Jianren

2015-07-01

Chronic pain is an international health issue of immense importance that is influenced by both physical and psychological factors. Opioids are useful in treating chronic pain but have accompanying complications. It is important for clinicians to understand the basics of opioid pharmacology, the benefits and adverse effects of opioids, and related problematic issues of tolerance, dependence, and opioid-induced hyperalgesia. In this article, the role of psychiatric comorbidity and the use of validated assessment tools to identify individuals who are at the greatest risk for opioid misuse are discussed. Additionally, interventional treatment strategies for patients with chronic pain who are at risk for opioid misuse are presented. Specific behavioral interventions designed to improve adherence with prescription opioids among persons treated for chronic pain, such as frequent monitoring, periodic urine screens, opioid therapy agreements, opioid checklists, and motivational counseling, are also reviewed. Use of state-sponsored prescription drug monitoring programs is also encouraged. Areas requiring additional investigation are identified, and the future role of abuse-deterrent opioids and innovative technology in addressing issues of opioid therapy and pain are presented. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Evaluation of speech errors in Putonghua speakers with cleft palate: a critical review of methodology issues.

PubMed

Jiang, Chenghui; Whitehill, Tara L

2014-04-01

Speech errors associated with cleft palate are well established for English and several other Indo-European languages. Few articles describing the speech of Putonghua (standard Mandarin Chinese) speakers with cleft palate have been published in English language journals. Although methodological guidelines have been published for the perceptual speech evaluation of individuals with cleft palate, there has been no critical review of methodological issues in studies of Putonghua speakers with cleft palate. A literature search was conducted to identify relevant studies published over the past 30 years in Chinese language journals. Only studies incorporating perceptual analysis of speech were included. Thirty-seven articles which met inclusion criteria were analyzed and coded on a number of methodological variables. Reliability was established by having all variables recoded for all studies. This critical review identified many methodological issues. These design flaws make it difficult to draw reliable conclusions about characteristic speech errors in this group of speakers. Specific recommendations are made to improve the reliability and validity of future studies, as well to facilitate cross-center comparisons.

Ethical Perspective on Quality of Care: The Nature of Ethical Dilemmas Identified by New Graduate and Experienced Speech Pathologists

ERIC Educational Resources Information Center

Kenny, Belinda J.; Lincoln, Michelle; Blyth, Katrina; Balandin, Susan

2009-01-01

Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and…

Identifying the Criteria for Planning the Selection and Succession of a CIO: A Phenomenological Study

ERIC Educational Resources Information Center

Williamson, Charles E.

2010-01-01

Many challenges face CIOs in their management of IT systems; yet, very little research is available regarding the issues and constraints associated with their role. CIO leadership is still a subject of inquiry for those with aspirations to pursue such a position. The specific problem of the current qualitative phenomenological study concerned the…

Management Strategies for Positive Mental Health Outcomes: What Early Childhood Administrators Need to Know

ERIC Educational Resources Information Center

Green, Beth; Everhart, Maria C.; Gordon, Lynwood; Friesen, Barbara

2004-01-01

The focus of this training is on understanding ways to design and implement an overall mental health strategy in your program. The authors are not going to talk about specific intervention strategies, such as how to deal with challenging behavior in the classroom, or how to identify and screen children with possible mental health issues. Instead,…

Goals 2000 and the Role of the National Education Standards and Improvement Council.

ERIC Educational Resources Information Center

Mulcahy, D. G.

The National Education Standards and Improvement Council (NESIC) was established in the Goals 2000: Educate America Act. One of NESIC's duties is to identify areas in which specific educational standards ought to be developed. Several complex issues arise in carrying out this duty, such as: the need for standards in such non-content areas as…

Targeting Therapy Resistance: When Glutamine Catabolism Becomes Essential.

PubMed

Lukey, Michael J; Katt, William P; Cerione, Richard A

2018-05-14

Identifying contexts in which cancer cells become addicted to specific nutrients is critical for developing targeted metabolic therapies. In this issue of Cancer Cell, Momcilovic et al. report that suppressed glycolysis following mTOR inhibition is countered by adaptive glutamine catabolism in lung squamous cell carcinoma, sensitizing tumors to glutaminase inhibition. Copyright © 2018 Elsevier Inc. All rights reserved.

Toward Increasing Professionalism in Public Relations: An Activity-Specific System for Categorizing Practitioners.

ERIC Educational Resources Information Center

Brownell, Mark A.; Niebauer, Walter E., Jr.

To develop a method of categorizing public relations practitioners according to a hierarchy of professionalism which would also identify what training is needed to raise those in lower levels to higher levels, a study surveyed 93 Iowa practitioners listed in the 1986-87 Public Relations Society of America Register Issue. Response rate was 66% and…

Assessment Issues in Languages for Specific Purposes

ERIC Educational Resources Information Center

O'Sullivan, Barry

2012-01-01

While Grosse and Voght (1991) set out a well-considered overview of LSP and identified areas in need of development, they limited their observations on the topic of assessment to a short section devoted to what they called the "proficiency movement." While it is true that they really did not have a lot to report on at the time they wrote their…

Application of Matrix Outcome Mapping to Constructively Align Program Outcomes and Course Outcomes in Higher Education

ERIC Educational Resources Information Center

Mazouz, Abdelkader; Crane, Keenan

2013-01-01

Establishing a link between Course Learning Outcomes (LOs) and Program Outcomes (POs) while assessing the course contents and delivery are among the most challenging issues in Higher Education. In the present study two forms were generated based on specific Course Learning Outcomes identified in the syllabus at the beginning of the teaching term:…

A primer on systematic reviews in toxicology.

PubMed

Hoffmann, Sebastian; de Vries, Rob B M; Stephens, Martin L; Beck, Nancy B; Dirven, Hubert A A M; Fowle, John R; Goodman, Julie E; Hartung, Thomas; Kimber, Ian; Lalu, Manoj M; Thayer, Kristina; Whaley, Paul; Wikoff, Daniele; Tsaioun, Katya

2017-07-01

Systematic reviews, pioneered in the clinical field, provide a transparent, methodologically rigorous and reproducible means of summarizing the available evidence on a precisely framed research question. Having matured to a well-established approach in many research fields, systematic reviews are receiving increasing attention as a potential tool for answering toxicological questions. In the larger framework of evidence-based toxicology, the advantages and obstacles of, as well as the approaches for, adapting and adopting systematic reviews to toxicology are still being explored. To provide the toxicology community with a starting point for conducting or understanding systematic reviews, we herein summarized available guidance documents from various fields of application. We have elaborated on the systematic review process by breaking it down into ten steps, starting with planning the project, framing the question, and writing and publishing the protocol, and concluding with interpretation and reporting. In addition, we have identified the specific methodological challenges of toxicological questions and have summarized how these can be addressed. Ultimately, this primer is intended to stimulate scientific discussions of the identified issues to fuel the development of toxicology-specific methodology and to encourage the application of systematic review methodology to toxicological issues.

Use of digital media technology for primary prevention of STIs/HIV in youth.

PubMed

Chávez, Noé Rubén; Shearer, Lee S; Rosenthal, Susan L

2014-10-01

The relevant literature was reviewed to identify issues in research evaluating digital media technology (DMT) interventions for the primary prevention of STIs/HIV in adolescents and young adults. A literature search with relevant key terms was conducted in PubMed, for articles with studies that included: (a) participants between 11-29 years; (b) use of one or more of the following forms of DMT: interactive digital video or CD-ROM, computer, text messaging, or Internet; (c) evaluation of an STI/HIV primary prevention intervention; and (d) use of a cognitive, psychosocial, behavioral, or biological outcome. Twenty-nine studies were identified and included in the review. Based on the review of these studies, 7 main issues were discussed and recommendations for improving future research were offered. The 7 main issues were: (a) need for a balance between universal application and specific sub-group focus, (b) lack of a developmental framework, (c) challenge of applying DMT in resource limited contexts, (d) rapidly changing nature of DMT, (e) lack of biological outcomes, (f) lack of comparison/control groups to assess the impact of DMT, and (g) limited temporal follow-up. There is increasing literature evaluating the effectiveness of DMT for preventing STIs/HIV among adolescents and young adults. A careful consideration of 7 main issues identified in the literature can improve the design and evaluation of these interventions and enhance our understanding of their effectiveness. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: findings from Australia’s living with diabetes cohort study

PubMed Central

2013-01-01

Background While factors associated with health-related quality of life for people with chronic diseases including diabetes are well researched, far fewer studies have investigated measures of disease-specific quality of life. The purpose of this study is to assess the impact of complications and comorbidities on diabetes-specific quality of life in a large population-based cohort of type 2 diabetic patients. Methods The Living with Diabetes Study recruited participants from the National Diabetes Services Scheme in Australia. Data were collected via a mailed self-report questionnaire. Diabetes-specific quality of life was measured using the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire. The analyses are for 3609 patients with type 2 diabetes. Regression models with adjustment for control variables investigated the association of complications and comorbidities with diabetes-specific quality of life. Next, the most parsimonious model for diabetes-specific quality of life after controlling for important covariates was examined. Results The expected associations with better diabetes-specific quality of life were evident, such as increased income, not on insulin, better glycaemic control and older age. However, being single and having been diagnosed with cancer were also associated with better ADDQoL. Additionally, poorer diabetes-specific quality of life was strongly sensitive to the presence of diabetes complications and mental health conditions such as depression, anxiety and schizophrenia. These relationships persisted after adjustment for gender, age, duration of diabetes, treatment regimen, sampling region and other treatment and socio-demographic variables. Conclusions A greater appreciation of the complexities of diabetes-specific quality of life can help tailor disease management and self-care messages given to patients. Attention to mental health issues may be as important as focusing on glycaemic control and complications. Therefore clinicians’ ability to identify and mange mental health issues and/or refer patients is critical to improving patients’ diabetes-specific quality of life. PMID:24131673

Pharmacy faculty workplace issues: findings from the 2009-2010 COD-COF Joint Task Force on Faculty Workforce.

PubMed

Desselle, Shane P; Peirce, Gretchen L; Crabtree, Brian L; Acosta, Daniel; Early, Johnnie L; Kishi, Donald T; Nobles-Knight, Dolores; Webster, Andrew A

2011-05-10

Many factors contribute to the vitality of an individual faculty member, a department, and an entire academic organization. Some of the relationships among these factors are well understood, but many questions remain unanswered. The Joint Task Force on Faculty Workforce examined the literature on faculty workforce issues, including the work of previous task forces charged by the American Association of Colleges of Pharmacy (AACP). We identified and focused on 4 unique but interrelated concepts: organizational culture/climate, role of the department chair, faculty recruitment and retention, and mentoring. Among all 4 resides the need to consider issues of intergenerational, intercultural, and gender dynamics. This paper reports the findings of the task force and proffers specific recommendations to AACP and to colleges and schools of pharmacy.

Security Vulnerability Profiles of NASA Mission Software: Empirical Analysis of Security Related Bug Reports

NASA Technical Reports Server (NTRS)

Goseva-Popstojanova, Katerina; Tyo, Jacob P.; Sizemore, Brian

2017-01-01

NASA develops, runs, and maintains software systems for which security is of vital importance. Therefore, it is becoming an imperative to develop secure systems and extend the current software assurance capabilities to cover information assurance and cybersecurity concerns of NASA missions. The results presented in this report are based on the information provided in the issue tracking systems of one ground mission and one flight mission. The extracted data were used to create three datasets: Ground mission IVV issues, Flight mission IVV issues, and Flight mission Developers issues. In each dataset, we identified the software bugs that are security related and classified them in specific security classes. This information was then used to create the security vulnerability profiles (i.e., to determine how, why, where, and when the security vulnerabilities were introduced) and explore the existence of common trends. The main findings of our work include:- Code related security issues dominated both the Ground and Flight mission IVV security issues, with 95 and 92, respectively. Therefore, enforcing secure coding practices and verification and validation focused on coding errors would be cost effective ways to improve mission's security. (Flight mission Developers issues dataset did not contain data in the Issue Category.)- In both the Ground and Flight mission IVV issues datasets, the majority of security issues (i.e., 91 and 85, respectively) were introduced in the Implementation phase. In most cases, the phase in which the issues were found was the same as the phase in which they were introduced. The most security related issues of the Flight mission Developers issues dataset were found during Code Implementation, Build Integration, and Build Verification; the data on the phase in which these issues were introduced were not available for this dataset.- The location of security related issues, as the location of software issues in general, followed the Pareto principle. Specifically, for all three datasets, from 86 to 88 the security related issues were located in two to four subsystems.- The severity levels of most security issues were moderate, in all three datasets.- Out of 21 primary security classes, five dominated: Exception Management, Memory Access, Other, Risky Values, and Unused Entities. Together, these classes contributed from around 80 to 90 of all security issues in each dataset. This again proves the Pareto principle of uneven distribution of security issues, in this case across CWE classes, and supports the fact that addressing these dominant security classes provides the most cost efficient way to improve missions' security. The findings presented in this report uncovered the security vulnerability profiles and identified the common trends and dominant classes of security issues, which in turn can be used to select the most efficient secure design and coding best practices compiled by the part of the SARP project team associated with the NASA's Johnson Space Center. In addition, these findings provide valuable input to the NASA IVV initiative aimed at identification of the two 25 CWEs of ground and flight missions.

Identifying emerging issues in forestry as a tool for research planning.

Treesearch

Hans M. Gregersen; Allen L. Lundgren; Pamela J. Jakes; David N. Bengston

1989-01-01

A Delphi exercise is used to identify emerging issues in National Forest management and use, the relative importance of the issues, and barriers to resolving issues. USDA Forest Service managers agree on the importance of the 11 issues identified; however, researchers and National Forest managers do not always agree on the importance of issues or barriers.

A systematic review of patient reported outcome measures (PROMs) used in child and adolescent burn research.

PubMed

Griffiths, C; Armstrong-James, L; White, P; Rumsey, N; Pleat, J; Harcourt, D

2015-03-01

Patient reported outcome measures (PROMs) can identify important information about patient needs and therapeutic progress. The aim of this review was to identify the PROMs that are being used in child and adolescent burn care and to determine the quality of such scales. Computerised and manual bibliographic searches of Medline, Social Sciences Index, Cinahl, Psychinfo, Psycharticles, AMED, and HAPI, were used to identify English-language articles using English-language PROMs from January 2001 to March 2013. The psychometric quality of the PROMs was assessed. 23 studies met the entry criteria and identified 32 different PROMs (31 generic, 1 burns-specific). Overall, the psychometric quality of the PROMs was low; only two generic scales (the Perceived Stigmatisation Questionnaire and the Social Comfort Scale) and only one burns-specific scale (the Children Burn Outcomes Questionnaire for children aged 5-18) had psychometric evidence relevant to this population. The majority of PROMs did not have psychometric evidence for their use with child or adolescent burn patients. To appropriately identify the needs and treatment progress of child and adolescent burn patients, new burns-specific PROMs need to be developed and validated to reflect issues that are of importance to this population. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Health-related quality of life of cranial WHO grade I meningioma patients: are current questionnaires relevant?

PubMed

Zamanipoor Najafabadi, Amir H; Peeters, Marthe C M; Lobatto, Daniel J; Broekman, Marieke L D; Smith, Timothy R; Biermasz, Nienke R; Peerdeman, Saskia M; Peul, Wilco C; Taphoorn, Martin J B; van Furth, Wouter R; Dirven, Linda

2017-11-01

The clinical relevance of Health-Related Quality of Life (HRQoL) in meningioma patients has been increasingly acknowledged in recent years. Various questionnaires have been used. However, almost none of these questionnaires has been particularly developed for and/or validated in this patient group. Therefore, the aim of this study was to assess the relevance and comprehensiveness of existing HRQoL questionnaires used in meningioma research and to assess the agreement between patients and health care professionals (HCPs) on the most relevant and important HRQoL issues. A systematic literature search, following the PRISMA statement, was conducted to identify all HRQoL questionnaires used in meningioma research. Semi-structured interviews were organized with patients and HCPs to (1) assess the relevance of all issues covered by the questionnaires (score 0-3: not relevant-highly relevant), (2) assess the ten most important issues, and (3) identify new relevant HRQoL issues. Fourteen different questionnaires were found in the literature, comprising 140 unique issues. Interviews were conducted with 20 patients (median age 57, 71% female) and 10 HCPs (4 neurosurgeons, 2 neurologists, 2 radiotherapists, 1 rehabilitation specialist, 1 neuropsychologist; median experience 13 years). Meningioma patients rated 17-80% of the issues in each of the questionnaires as relevant, HCPs 90-100%. Patients and HCPs agreed on the relevance of only 49 issues (35%, Cohen's kappa: 0.027). Both patients and HCPs considered lack of energy the most important issue. Patients and HCPs suggested five additional relevant issues not covered by current HRQoL questionnaires. Existing HRQoL questionnaires currently used in meningioma patients do not fully cover all relevant issues to these patients. Agreement between patients and HCPs on the relevance of issues was poor. Both findings support the need to develop and validate a meningioma-specific HRQoL questionnaire.

Ethical questions must be considered for electronic health records.

PubMed

Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

2012-09-01

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

A challenge-response endoscopic sinus surgery specific checklist as an add-on to standard surgical checklist: an evaluation of potential safety and quality improvement issues.

PubMed

Sommer, Doron D; Arbab-Tafti, Sadaf; Farrokhyar, Forough; Tewfik, Marc; Vescan, Allan; Witterick, Ian J; Rotenberg, Brian; Chandra, Rakesh; Weitzel, Erik K; Wright, Erin; Ramakrishna, Jayant

2018-02-27

The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist. Although endoscopic sinus surgery is generally considered a safe procedure, avoidable complications and potential safety concerns continue to occur. The WHO surgical checklist does not directly address certain surgery-specific issues, which may be of particular relevance for endoscopic sinus surgery. This prospective observational pilot study monitored compliance with and compared the occurrence of safety and equipment issues before and after implementation of the checklist. Forty-seven consecutive endoscopic surgeries were audited; the first 8 without the checklist and the following 39 with the checklist. The checklist was compiled by evaluating the patient journey, utilizing the available literature, expert consensus, and finally reevaluation with audit type cases. The final checklist was developed with all relevant stakeholders involved in a Delphi method. Implementing this specific surgical checklist in 39 cases at our institution, allowed us to identify and rectify 35 separate instances of potentially unsafe, improper or inefficient preoperative setup. These incidents included issues with labeling of topical vasoconstrictor or injectable anesthetics (3, 7.7%) and availability, function and/or position of video monitors (2, 5.1%), endoscope (6, 15.4%), microdebrider (6, 15.4%), bipolar cautery (6, 15.4%), and suctions (12, 30.8%). The design and integration of this checklist for endoscopic sinus surgery, has helped improve efficiency and patient safety in the operating room setting. © 2018 ARS-AAOA, LLC.

Deep Learning in Medical Image Analysis

PubMed Central

Shen, Dinggang; Wu, Guorong; Suk, Heung-Il

2016-01-01

The computer-assisted analysis for better interpreting images have been longstanding issues in the medical imaging field. On the image-understanding front, recent advances in machine learning, especially, in the way of deep learning, have made a big leap to help identify, classify, and quantify patterns in medical images. Specifically, exploiting hierarchical feature representations learned solely from data, instead of handcrafted features mostly designed based on domain-specific knowledge, lies at the core of the advances. In that way, deep learning is rapidly proving to be the state-of-the-art foundation, achieving enhanced performances in various medical applications. In this article, we introduce the fundamentals of deep learning methods; review their successes to image registration, anatomical/cell structures detection, tissue segmentation, computer-aided disease diagnosis or prognosis, and so on. We conclude by raising research issues and suggesting future directions for further improvements. PMID:28301734

Software reuse issues affecting AdaNET

NASA Technical Reports Server (NTRS)

Mcbride, John G.

1989-01-01

The AdaNet program is reviewing its long-term goals and strategies. A significant concern is whether current AdaNet plans adequately address the major strategic issues of software reuse technology. The major reuse issues of providing AdaNet services that should be addressed as part of future AdaNet development are identified and reviewed. Before significant development proceeds, a plan should be developed to resolve the aforementioned issues. This plan should also specify a detailed approach to develop AdaNet. A three phased strategy is recommended. The first phase would consist of requirements analysis and produce an AdaNet system requirements specification. It would consider the requirements of AdaNet in terms of mission needs, commercial realities, and administrative policies affecting development, and the experience of AdaNet and other projects promoting the transfer software engineering technology. Specifically, requirements analysis would be performed to better understand the requirements for AdaNet functions. The second phase would provide a detailed design of the system. The AdaNet should be designed with emphasis on the use of existing technology readily available to the AdaNet program. A number of reuse products are available upon which AdaNet could be based. This would significantly reduce the risk and cost of providing an AdaNet system. Once a design was developed, implementation would proceed in the third phase.

Barriers to education of overseas doctors in paediatrics: a qualitative study in South Yorkshire.

PubMed

Mahajan, J; Stark, P

2007-03-01

To explore the factors that may influence the progress of doctors who come from the Indian subcontinent to train in paediatrics in the UK. Overseas doctors training in paediatrics in Rotherham, Sheffield and Doncaster participated in the study. Focus groups were used to collect data; two focus groups, each with 4-5 participants, were conducted at 6-week intervals. Semistructured, one-to-one interviews were conducted to add more understanding and depth to issues highlighted in the focus groups. The focus groups and interviews were audiotaped; the tapes were transcribed and data were analysed using the Grounded Theory; open codes were formed and concepts identified using microanalysis, and initial theories were built. Lack of information about the National Health Service (NHS)/Royal Colleges, inappropriate communication skills, difficulties in team working, difficulties in preparing for Royal College examinations, visa and job hunting, and social and cultural isolation were identified as major barriers. Problems arose not only from difficulties with language but also from use of local and colloquial words, different accents and difficulty in communicating sensitive issues. Lack of understanding of role in teams and difficulties in working in multiprofessional setting all contributed to the problems. Cultural differences inside and outside the workplace, and social isolation were also highlighted. Induction programmes, mentoring, awareness of the issues within the teams, and courses in communication specifically directed at overseas doctors were identified as means to overcome these barriers. Several intercultural factors were identified that could act as barriers to the progress of overseas doctors training in paediatrics in the UK. Increased awareness of these factors within the teams would be the first step in resolving some of the issues.

Mathematical Learning Disabilities in Special Populations: Phenotypic Variation and Cross-Disorder Comparisons

PubMed Central

Dennis, Maureen; Berch, Daniel B.; Mazzocco, Michèle M.M.

2011-01-01

What is mathematical learning disability (MLD)? The reviews in this special issue adopt different approaches to defining the construct of MLD. Collectively, they demonstrate the current status of efforts to establish a consensus definition and the challenges faced in this endeavor. In this commentary, we reflect upon the proposed pathways to mathematical learning difficulties and disabilities presented across the reviews. Specifically we consider how each of the reviews contributes to identifying the MLD phenotype by specifying the range of assets and deficits in mathematics, identifying sources of individual variation, and characterizing the natural progression of MLD over the life course. We show how principled comparisons across disorders address issues about the cognitive and behavioral co-morbidities of MLD, and whether commonalities in brain dysmorphology are associated with common mathematics performance profiles. We project the status of MLD research ten years hence with respect to theoretical gains, advances in methodology, and principled intervention studies. PMID:19213019

Evidence-based Heuristics for Evaluating Demands on eHealth Literacy and Usability in a Mobile Consumer Health Application.

PubMed

Monkman, Helen; Griffith, Janessa; Kushniruk, Andre W

2015-01-01

Heuristic evaluations have proven to be valuable for identifying usability issues in systems. Commonly used sets of heuritics exist; however, they may not always be the most suitable, given the specific goal of the analysis. One such example is seeking to evaluate the demands on eHealth literacy and usability of consumer health information systems. In this study, eight essential heuristics and three optional heuristics subsumed from the evidence on eHealth/health literacy and usability were tested for their utility in assessing a mobile blood pressure tracking application (app). This evaluation revealed a variety of ways the design of the app could both benefit and impede users with limited eHealth literacy. This study demonstrated the utility of a low-cost, single evaluation approach for identifying both eHealth literacy and usability issues based on existing evidence in the literature.

14 CFR 91.1017 - Amending program manager's management specifications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

14 CFR 91.1017 - Amending program manager's management specifications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... proposed amendment. (2) The Flight Standards District Office that issued the program manager's management... presented, the Flight Standards District Office that issued the program manager's management specifications... Standards District Office that issued the program manager's management specifications issues an amendment of...

Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica.

PubMed

Johnston, Rory; Crooks, Valorie A; Ormond, Meghann

2015-07-04

Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua's previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context. Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua's framework to identify overlapping and divergent issues. Many of the issues identified in Pocock and Phua's policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework. The framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework's design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism's development or how the specific impacts of the practice are likely to unfold.

Obtaining subjects’ consent to publish identifying personal information: current practices and identifying potential issues

PubMed Central

2013-01-01

Background In studies publishing identifying personal information, obtaining consent is regarded as necessary, as it is impossible to ensure complete anonymity. However, current journal practices around specific points to consider when obtaining consent, the contents of consent forms and how consent forms are managed have not yet been fully examined. This study was conducted to identify potential issues surrounding consent to publish identifying personal information. Methods Content analysis was carried out on instructions for authors and consent forms developed by academic journals in four fields (as classified by Journal Citation Reports): medicine general and internal, genetics and heredity, pediatrics, and psychiatry. An online questionnaire survey of editors working for journals that require the submission of consent forms was also conducted. Results Instructions for authors were reviewed for 491 academic journals (132 for medicine general and internal, 147 for genetics and heredity, 100 for pediatrics, and 112 for psychiatry). Approximately 40% (203: 74 for medicine general and internal, 31 for genetics and heredity, 58 for pediatrics, and 40 for psychiatry) stated that subject consent was necessary. The submission of consent forms was required by 30% (154) of the journals studied, and 10% (50) provided their own consent forms for authors to use. Two journals mentioned that the possible effects of publication on subjects should be considered. Many journal consent forms mentioned the difficulties in ensuring complete anonymity of subjects, but few addressed the study objective, the subjects’ right to refuse consent and the withdrawal of consent. The main reason for requiring the submission of consent forms was to confirm that consent had been obtained. Conclusion Approximately 40% of journals required subject consent to be obtained. However, differences were observed depending on the fields. Specific considerations were not always documented. There is a need to address issues around the study objective, subjects’ right to refuse consent and the withdrawal of consent. Whether responsibility for ensuring that the consent form has been signed lies with publishers also needs to be discussed. PMID:24267590

Muscle dysmorphia: methodological issues, implications for research.

PubMed

Suffolk, Mark T; Dovey, Terence M; Goodwin, Huw; Meyer, Caroline

2013-01-01

Muscle dysmorphia is a male-dominated, body image-related psychological condition. Despite continued investigation, contention surrounds the nosological status of this disorder. The aim of this article was to review the literature on muscle dysmorphia to provide a qualitative account of methodological issues that may inhibit our understanding. Key areas relating to non-standardized participant groups, measuring instruments, and terminology were identified as potentially inhibiting symptom coherence and diagnostic reliability. New measuring instruments validated with clinical samples and carefully described participant groups, standardized terminology, and a greater emphasis on prospective longitudinal research with specific sub groups of the weight training community would be of interest to the field.

Autism genetics: Methodological issues and experimental design.

PubMed

Sacco, Roberto; Lintas, Carla; Persico, Antonio M

2015-10-01

Autism is a complex neuropsychiatric disorder of developmental origin, where multiple genetic and environmental factors likely interact resulting in a clinical continuum between "affected" and "unaffected" individuals in the general population. During the last two decades, relevant progress has been made in identifying chromosomal regions and genes in linkage or association with autism, but no single gene has emerged as a major cause of disease in a large number of patients. The purpose of this paper is to discuss specific methodological issues and experimental strategies in autism genetic research, based on fourteen years of experience in patient recruitment and association studies of autism spectrum disorder in Italy.

Teamwork in high-risk environments analogous to space

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.

1990-01-01

Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

High-rise housing in the city of Samara: the first steps on the path to sustainable development

NASA Astrophysics Data System (ADS)

Vavilova, Tatiana Ya.; Makeeva, Elena Yu.

2018-03-01

This paper outlines theoretical background of high-rise housing and discusses its design experience. It particularly focuses on environmental, social and economic aspects which are among crucial sustainable development issues. The authors dwell upon the implementation of innovative solutions that meet principles and goals of sustainable development and take construction objects built in Samara (which is one of the largest metropolises in Russia) as an example. The research also investigates the quality of project designs and reveals techniques corresponding to the "green standards". It considers the issues of practicing high-rise building construction in specific urban conditions and identifies unresolved architectural problems.

Manned Mars mission environmental control and life support subsystem

NASA Technical Reports Server (NTRS)

Hueter, Uwe

1986-01-01

A specific design is not presented, but the general philosophy regarding potential Environmental Control/Life Support System (ECLSS) requirements, concepts, issues, and technology needs are discussed. The focus is on a manned Mars mission occurring in the late 1990's. Discussions on the Trans-Mars Vehicle, the Mars Excursion Module (MEM), and a Martian base facility are covered. The functions, performance requirements, and design loads of a typical ECLSS are listed, and the issues and technology briefly discussed. Several ECLSS concepts and options are identified, and comparative weights and volumes are provided for these. Several aspects of the space station ECLSS are contrasted with the Mars element ECLSS.

Development of the European Organisation for Research and Treatment of Cancer quality of life questionnaire module for older people with cancer: The EORTC QLQ-ELD15.

PubMed

Johnson, Colin; Fitzsimmons, Deborah; Gilbert, Jacqueline; Arrarras, Juan-Ignacio; Hammerlid, Eva; Bredart, Anne; Ozmen, Mahir; Dilektasli, Evren; Coolbrandt, Anne; Kenis, Cindy; Young, Teresa; Chow, Edward; Venkitaraman, Ramachandran; Howse, Frances; George, Steve; O'Connor, Steve; Yadegarfar, Ghasem

2010-08-01

There is a lack of instruments that focus on the specific health-related quality of life (HRQOL) issues that affect older people with cancer. The aim of this study was to develop a HRQOL questionnaire module to supplement the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire, the EORTC QLQ-C30 for older (>70years) patients with cancer. Phases 1-3 were conducted in seven countries following modified EORTC Quality of Life Group guidelines for module development. Phase 1: potentially relevant issues were identified by a systematic literature review, a questionnaire survey of 17 multi-disciplinary health professionals and two rounds of qualitative interviews. The first round included 9 patients aged >70. The second round was a comparative series of interviews with 49 patients >70years with a range of cancer diagnoses and 40 patients aged 50-69years matched for gender and disease site. In Phase 2 the issues were formulated into a long provisional item list. This was administered in Phase 3 together with the QLQ-C30 to two further groups of cancer patients aged >70 (n=97) or 50-69years (n=85) to determine the importance, relevance and acceptability of each item. Redundant and duplicate items were removed; issues specific to the older group were selected for the final questionnaire. In Phase 1, 75 issues were identified. These were reduced in Phase 2 to create a 45 item provisional list. Phase 3 testing of the provisional list led to the selection of 15 items with good range of response, high scores of importance and relevance in the older patients. This resulted in the EORTC QLQ-ELD15, containing five conceptually coherent scales (functional independence, relationships with family and friends, worries about the future, autonomy and burden of illness). The EORTC QLQ-ELD15 in combination with the EORTC QLQ-C30 is ready for large-scale validation studies, and will assess HRQOL issues of most relevance and concern for older people with cancer across a wide range of cancer sites and treatment stages. Copyright 2010 Elsevier Ltd. All rights reserved.

Monitoring ethical, legal, and social issues in developing population genetic databases.

PubMed

Austin, Melissa A; Harding, Sarah E; McElroy, Courtney E

2003-01-01

To characterize ethical, legal, and social issues unique to population genetic database research and to determine the relevance of international recommendations and guidelines for addressing these issues in the development of "genebank" projects globally. Building on our previous description of eight international genebanks, we conducted a comprehensive electronic search and literature review of relevant publications and consulted national and international documents applicable to genebank research. We identified and characterized five categories of ethical, legal, and social issues unique to genebank development: sponsorship and benefit-sharing, neutrality and regulatory power of ethics committees, public engagement, consent, and data protection. We illustrate these issues with examples from specific genebanks. Not all of the issues are addressed in current international guidelines, many of which are nonspecific and unenforceable. The trend of genebank development promises to provide new discoveries to the field of medical science and to greatly improve public health. However, there is a growing need for more explicit, enforceable, and coordinated international guidelines relevant to the development and implementation of genebanks. By comparing ethical, legal and social issues as they arise in genebanks, researchers can better evaluate how to best use these projects to improve public health while protecting participating populations.

Examining the Role of Mental Health and Clinical Issues within Talent Development

PubMed Central

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2016-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches identified as well placed to detect general “warning signs” such as behavioral change. Short of integrating trained clinicians into talent development environments, as part of a triangulation process, ecologically validated assessment tools—coupled with appropriate training and signposting—could offer a practical way of flagging potential issues in developing athletes. The need for the development of such an instrument is therefore apparent. Finally, education around the influential role of family is also recommended in order to promote the protective elements and mitigate risk factors. PMID:26793153

Examining the Role of Mental Health and Clinical Issues within Talent Development.

PubMed

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2015-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches identified as well placed to detect general "warning signs" such as behavioral change. Short of integrating trained clinicians into talent development environments, as part of a triangulation process, ecologically validated assessment tools-coupled with appropriate training and signposting-could offer a practical way of flagging potential issues in developing athletes. The need for the development of such an instrument is therefore apparent. Finally, education around the influential role of family is also recommended in order to promote the protective elements and mitigate risk factors.

Sex- and gender-specific research priorities in cardiovascular resuscitation: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Resuscitation Research Workgroup.

PubMed

Wigginton, Jane G; Perman, Sarah M; Barr, Gavin C; McGregor, Alyson J; Miller, Andrew C; Napoli, Anthony M; Napoli, Anthony F; Safdar, Basmah; Weaver, Kevin R; Deutsch, Steven; Kayea, Tami; Becker, Lance

2014-12-01

Significant sex and gender differences in both physiology and psychology are readily acknowledged between men and women; however, data are lacking regarding differences in their responses to injury and treatment and in their ultimate recovery and survival. These variations remain particularly poorly defined within the field of cardiovascular resuscitation. A better understanding of the interaction between these important factors may soon allow us to dramatically improve outcomes in disease processes that currently carry a dismal prognosis, such as sudden cardiac arrest. As part of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," our group sought to identify key research questions and knowledge gaps pertaining to both sex and gender in cardiac resuscitation that could be answered in the near future to inform our understanding of these important issues. We combined a monthly teleconference meeting of interdisciplinary stakeholders from largely academic institutions with a focused interest in cardiovascular outcomes research, an extensive review of the existing literature, and an open breakout session discussion on the recommendations at the consensus conference to establish a prioritization of the knowledge gaps and relevant research questions in this area. We identified six priority research areas: 1) out-of-hospital cardiac arrest epidemiology and outcome, 2) customized resuscitation drugs, 3) treatment role for sex steroids, 4) targeted temperature management and hypothermia, 5) withdrawal of care after cardiac arrest, and 6) cardiopulmonary resuscitation training and implementation. We believe that exploring these key topics and identifying relevant questions may directly lead to improved understanding of sex- and gender-specific issues seen in cardiac resuscitation and ultimately improved patient outcomes. © 2014 by the Society for Academic Emergency Medicine.

The Role of the School Climate in High School Students' Mental Health and Identity Formation: A South Australian Study

ERIC Educational Resources Information Center

Riekie, Helen; Aldridge, Jill M.; Afari, Ernest

2017-01-01

The well-documented increase in student mental health issues in Australia and growing recognition of the need for education to play a part in students' identity formation prompted this study. The research reported in this article sought to identify specific elements of the school climate that were likely to influence the interplay of adolescent…

Active member control of a precision structure with an H(infinity) performance objective

NASA Technical Reports Server (NTRS)

Fanson, J. L.; Chu, C.-C.; Smith, R. S.; Anderson, E. H.

1990-01-01

This paper addresses the noncollocated control of active structures using active structural elements. A top level architecture for active structures is presented, and issues pertaining to robust control of structures are discussed. Controllers optimized for an H sub inf performance specification are implemented on a test structure and the results are compared with analytical predictions. Directions for further research are identified.

Creating a Front Porch in Systems of Care: Improving Access to Behavioral Health Services for Diverse Children and Families

ERIC Educational Resources Information Center

Callejas, Linda M.; Hernandez, Mario; Nesman, Teresa; Mowery, Debra

2010-01-01

Despite recognition of the central role that service accessibility (and availability) should assume within a system of care, the definition proposed in the feature article of this special issue does not identify specific factors that systems of care must take into account in order to serve diverse children with serious emotional disturbance and…

National Symposium on Children and Youth Who Are Deaf-Blind. Proceedings (McLean, Virginia, December 5-7, 1992).

ERIC Educational Resources Information Center

Reiman, John W., Ed.; Johnson, Pattie A., Ed.

This national symposium was held to identify critical issues and "best practices" in providing services for individuals with deaf-blindness and to develop strategies for future actions. The symposium focused on several specific topical areas in an effort to find ways in which resources might be marshalled at the federal, state, local, family, and…

Identity Politics, State Standards, and on the Ground Realities: A Critical Policy Analysis of Teaching/Learning Gender/Sexuality in a Virginia Elementary School

ERIC Educational Resources Information Center

Hudson, Stefanie R.

2017-01-01

Even though America has seen an increase in the level of acceptance for people who identify as LGBTQ and/or gender non-conforming, certain aspects within society continue to hinder their rights, especially within public education. Specifically, there are insufficiencies regarding content of and attitudes toward including LGBTQ issues in teaching…

Ethical issues in laryngology: tracheal stenting as palliative care.

PubMed

Kazi, Aasif A; Flowers, W Jeffrey; Barrett, Jeanna M; O'Rourke, Ashli K; Postma, Gregory N; Weinberger, Paul M

2014-07-01

To improve understanding of aspects of end-of-life care that may not be intuitive to the otolaryngology community. A comprehensive review of the literature was performed by searching Medline, Embase, and Google Scholar databases. Primary manuscripts' bibliographies were reviewed to identify any nonindexed references. Prospective consultation by means of one-on-one interviews was sought from nonotolaryngology key stakeholders in the areas of hospice nursing care and patient advocacy in order to identify pertinent issues. We identified over 1,000 articles published from 1965 to 2013 on the topic of tracheal stents, as well as over 40,000 on hospice/end-of-life care. Three articles focusing specifically on palliative care and airway stenting were identified, of which three were case reports and none were definitive reviews. There are a number of significant issues and concepts unique to hospice care. These are likely unfamiliar to all except for head and neck oncology-specialized otolaryngologists. An example is that hospice care focuses on quality of life rather than prolongation of life (such as curative surgery). Patients with nonoperable tracheal obstruction from malignancy face an unpleasant demise from suffocation. For those patients, stenting can relieve suffering by restoring airway patency. Airway stenting can be a valid palliative care option, even for terminal patients receiving hospice care, when performed to relieve airway obstruction and improve quality of life. End-of-life ethics is an underdeveloped area of otolaryngology that should be explored. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Who helps the leaders? Difficulties experienced by cancer support group leaders.

PubMed

Kirsten, Laura; Butow, Phyllis; Price, Melanie; Hobbs, Kim; Sunquist, Kendra

2006-07-01

Cancer support groups are an important source of support for cancer patients, yet little is known about the challenges and training needs of both professionally trained and untrained leaders. The aim of this study was to discover the difficulties experienced and training desired by cancer support group leaders. Twenty-seven leaders of 34 cancer support groups participated in focus groups or individual interviews. Groups were purposively selected as representative of 173 support groups identified in New South Wales which were for adults with cancer and/or their adult carers and were not therapeutic or education-only groups. Difficulties identified included dealing with people's different communication styles and needs; dealing with recurrence, metastases and death; practical issues, including resources, setting the programme and funding security; maintaining personal balance and preventing burn out; establishing group credibility; dealing with group cycles; and leading groups in rural areas. Leaders also identified benefits and rewards from group leadership such as contributing to others' well-being, self-development and insight into others' lives. Non-professionally trained leaders experienced more difficulties, particularly in dealing with group process and practical issues. Difficulties identified were related both to working with a cancer population specifically and to working with groups in general. While some issues were common to both health professionals and non-health professionals, non-health professionals reported greater supportive needs. Clear guidelines, targeted training and development of better methods of support to reduce the stress and burn out experienced by group leaders are needed.

Data-driven risk identification in phase III clinical trials using central statistical monitoring.

PubMed

Timmermans, Catherine; Venet, David; Burzykowski, Tomasz

2016-02-01

Our interest lies in quality control for clinical trials, in the context of risk-based monitoring (RBM). We specifically study the use of central statistical monitoring (CSM) to support RBM. Under an RBM paradigm, we claim that CSM has a key role to play in identifying the "risks to the most critical data elements and processes" that will drive targeted oversight. In order to support this claim, we first see how to characterize the risks that may affect clinical trials. We then discuss how CSM can be understood as a tool for providing a set of data-driven key risk indicators (KRIs), which help to organize adaptive targeted monitoring. Several case studies are provided where issues in a clinical trial have been identified thanks to targeted investigation after the identification of a risk using CSM. Using CSM to build data-driven KRIs helps to identify different kinds of issues in clinical trials. This ability is directly linked with the exhaustiveness of the CSM approach and its flexibility in the definition of the risks that are searched for when identifying the KRIs. In practice, a CSM assessment of the clinical database seems essential to ensure data quality. The atypical data patterns found in some centers and variables are seen as KRIs under a RBM approach. Targeted monitoring or data management queries can be used to confirm whether the KRIs point to an actual issue or not.

DOIs for Data: Progress in Data Citation and Publication in the Geosciences

NASA Astrophysics Data System (ADS)

Callaghan, S.; Murphy, F.; Tedds, J.; Allan, R.

2012-12-01

Identifiers for data are the bedrock on which data citation and publication rests. These, in their turn, are widely proposed as methods for encouraging researchers to share their datasets, and at the same time receive academic credit for their efforts in producing them. However, neither data citation nor publication can be properly achieved without a method of identifying clearly what is, and what isn't, part of the dataset. Once a dataset becomes part of the scientific record (either through formal data publication or through being cited) then issues such as dataset stability and permanence become vital to address. In the geosciences, several projects in the UK are concentrating on issues of dataset identification, citation and publication. The UK's Natural Environment Research Council's (NERC) Science Information Strategy data citation and publication project is addressing the issue of identifiers for data, stability, transparency, and credit for data producers through data citation. At a data publication level, 2012 has seen the launch of the new Wiley title Geoscience Data Journal and the PREPARDE (Peer Review for Publication & Accreditation of Research Data in the Earth sciences) project, both aiming to encourage data publication by addressing issues such as data paper submission workflows and the scientific peer-review of data. All of these initiatives work with a range of partners including academic institutions, learned societies, data centers and commercial publishers, both nationally and internationally, with a cross-project aim of developing the mechanisms so data can be identified, cited and published with confidence. This involves investigating barriers and drivers to data publishing and sharing, peer review, and re-use of geoscientific datasets, and specifically such topics as dataset requirements for citation, workflows for dataset ingestion into data centers and publishers, procedures and policies for editors, reviewers and authors of data publication, and assessing the trustworthiness of data archives. A key goal is to ensure that these projects reach out to, and are informed by, other related initiatives on a global basis, in particular anyone interested in developing long-term sustainable policies, processes, incentives and business models for managing and publishing research data. This presentation will give an overview of progress in the projects mentioned above, specifically focussing on the use of DOIs for datasets hosted in the NERC environmental data centers, and how DOIs are enabling formal data citation and publication in the geosciences.

Hanford Site Beryllium Program: Past, Present, and Future - 12428

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

Fisher, Mark; Garcia, Pete; Goeckner, Julie

2012-07-01

The U.S. Department of Energy (DOE) has a long history of beryllium use because of the element's broad application to many nuclear operations and processes. At the Hanford Site beryllium alloy was used to fabricate parts for reactors, including fuel rods for the N-Reactor during plutonium production. Because of continued confirmed cases of chronic beryllium disease (CBD), and data suggesting CBD occurs at exposures to low-level concentrations, the DOE decided to issue a rule to further protect federal and contractor workers from hazards associated with exposure to beryllium. When the beryllium rule was issued in 1999, each of the Hanfordmore » Site contractors developed a Chronic Beryllium Disease Prevention Program (CBDPP) and initial site wide beryllium inventories. A new site-wide CBDPP, applicable to all Hanford contractors, was issued in May, 2009. In the spring of 2010 the DOE Headquarters Office of Health, Safety, and Security (HSS) conducted an independent inspection to evaluate the status of implementation of the Hanford Site Chronic Beryllium Disease Prevention Program (CBDPP). The report identified four Findings and 12 cross-cutting Opportunities for Improvement (OFIs). A corrective action plan (CAP) was developed to address the Findings and crosscutting OFIs. The DOE directed affected site contractors to identify dedicated resources to participate in development of the CAP, along with involving stakeholders. The CAP included general and contractor-specific recommendations. Following initiation of actions to implement the approved CAP, it became apparent that additional definition of product deliverables was necessary to assure that expectations were adequately addressed and CAP actions could be closed. Consequently, a supplement to the original CAP was prepared and transmitted to DOE-HQ for approval. Development of the supplemental CAP was an eight month effort. From the onset a core group of CAP development members were identified to develop a mechanism for assuring that consensus was achieved on products developed as part of the CAP and the closure process. The original CAP was developed based on a large number of actions developed from the HSS report. This was essentially a 'bottoms up' approach. The revised CAP development team concluded that a more holistic, process-based approach was appropriate to assure that the resulting deliverable resulted in a best-in-class product. Consequently, issues and recommendations contained in the HSS report were grouped into 11 program areas, specific product deliverables were identified within each of the program areas, and a work breakdown structure (WBS) was logically applied to number the groupings. While the revised approach to product development utilizes a more holistic, 'top down' approach, the intent was still to incorporate specific recommendations and address specific issues contained in the HSS report. Through implementation of this new approach, a collaborative team has been established that works together using a consensus process for ensuring product completion. Benefits of the new approach include building a level of trust amongst all parties, quality of the products have improved, and acceptance by all parties of what action will truly meet the intent of the deficiency and make the beryllium program stronger. Open dialogue occurs amongst the core Be CAP team members, Hanford contractors, and DOE. It has been a learning process and will continue to be one, but everyone shares the common goal of reducing worker exposure to beryllium. (authors)« less

Leading trends in environmental regulation that affect energy development. Final report

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

Steele, R V; Attaway, L D; Christerson, J A

1980-01-01

Major environmental issues that are likely to affect the implementation of energy technologies between now and the year 2000 are identified and assessed. The energy technologies specifically addressed are: oil recovery and processing; gas recovery and processing; coal liquefaction; coal gasification (surface); in situ coal gasification; direct coal combustion; advanced power systems; magnetohydrodynamics; surface oil shale retorting; true and modified in situ oil shale retorting; geothermal energy; biomass energy conversion; and nuclear power (fission). Environmental analyses of these technologies included, in addition to the main processing steps, the complete fuel cycle from resource extraction to end use. A comprehensive surveymore » of the environmental community (including environmental groups, researchers, and regulatory agencies) was carried out in parallel with an analysis of the technologies to identify important future environmental issues. Each of the final 20 issues selected by the project staff has the following common attributes: consensus of the environmental community that the issue is important; it is a likely candidate for future regulatory action; it deals with a major environmental aspect of energy development. The analyses of the 20 major issues address their environmental problem areas, current regulatory status, and the impact of future regulations. These analyses are followed by a quantitative assessment of the impact on energy costs and nationwide pollutant emissions of possible future regulations. This is accomplished by employing the Strategic Environmental Assessment System (SEAS) for a subset of the 20 major issues. The report concludes with a more general discussion of the impact of environmental regulatory action on energy development.« less

Pharmacy Faculty Workplace Issues: Findings From the 2009-2010 COD-COF Joint Task Force on Faculty Workforce

PubMed Central

Peirce, Gretchen L.; Crabtree, Brian L.; Acosta, Daniel; Early, Johnnie L.; Kishi, Donald T.; Nobles-Knight, Dolores; Webster, Andrew A.

2011-01-01

Many factors contribute to the vitality of an individual faculty member, a department, and an entire academic organization. Some of the relationships among these factors are well understood, but many questions remain unanswered. The Joint Task Force on Faculty Workforce examined the literature on faculty workforce issues, including the work of previous task forces charged by the American Association of Colleges of Pharmacy (AACP). We identified and focused on 4 unique but interrelated concepts: organizational culture/climate, role of the department chair, faculty recruitment and retention, and mentoring. Among all 4 resides the need to consider issues of intergenerational, intercultural, and gender dynamics. This paper reports the findings of the task force and proffers specific recommendations to AACP and to colleges and schools of pharmacy. PMID:21769139

Use of simulation to assess electronic health record safety in the intensive care unit: a pilot study

PubMed Central

March, Christopher A; Steiger, David; Scholl, Gretchen; Mohan, Vishnu; Hersh, William R; Gold, Jeffrey A

2013-01-01

Objective To establish the role of high-fidelity simulation training to test the efficacy and safety of the electronic health record (EHR)–user interface within the intensive care unit (ICU) environment. Design Prospective pilot study. Setting Medical ICU in an academic medical centre. Participants Postgraduate medical trainees. Interventions A 5-day-simulated ICU patient was developed in the EHR including labs, hourly vitals, medication administration, ventilator settings, nursing and notes. Fourteen medical issues requiring recognition and subsequent changes in management were included. Issues were chosen based on their frequency of occurrence within the ICU and their ability to test different aspects of the EHR–user interface. ICU residents, blinded to the presence of medical errors within the case, were provided a sign-out and given 10 min to review the case in the EHR. They then presented the case with their management suggestions to an attending physician. Participants were graded on the number of issues identified. All participants were provided with immediate feedback upon completion of the simulation. Primary and secondary outcomes To determine the frequency of error recognition in an EHR simulation. To determine factors associated with improved performance in the simulation. Results 38 participants including 9 interns, 10 residents and 19 fellows were tested. The average error recognition rate was 41% (range 6–73%), which increased slightly with the level of training (35%, 41% and 50% for interns, residents, and fellows, respectively). Over-sedation was the least-recognised error (16%); poor glycemic control was most often recognised (68%). Only 32% of the participants recognised inappropriate antibiotic dosing. Performance correlated with the total number of screens used (p=0.03). Conclusions Despite development of comprehensive EHRs, there remain significant gaps in identifying dangerous medical management issues. This gap remains despite high levels of medical training, suggesting that EHR-specific training may be beneficial. Simulation provides a novel tool in order to both identify these gaps as well as foster EHR-specific training. PMID:23578685

Nursing implications: symptom presentation and quality of life in rectal cancer patients.

PubMed

O'Gorman, Claire; Barry, Amanda; Denieffe, Suzanne; Sasiadek, Wojciech; Gooney, Martina

2016-05-01

To determine the changes in symptoms experienced by rectal cancer patients during preoperative chemoradiotherapy, with a specific focus on fatigue and to explore how symptoms impact the quality of life. Rectal cancer continues to be a healthcare issue internationally, despite advances in management strategies, which includes the administration of preoperative chemoradiotherapy to improve locoregional control. It is known that this treatment may cause adverse effects; however, there is a paucity of literature that specifically examines fatigue, symptoms and quality of life in this patient cohort. A prospective, quantitative correlational design using purposive sampling was adopted. Symptoms and quality of life were measured with validated questionnaires in 35 patients at four time points. Symptoms that changed significantly over time as examined using rm-anova include fatigue, bowel function issues, nutritional issues, pain, dermatological issues and urinary function issues. Findings indicate that fatigue leads to poorer quality of life, with constipation, bloating, stool frequency, appetite loss, weight worry, nausea and vomiting, dry mouth and pain also identified as influencing factors on quality of life. Findings have highlighted the importance of thorough symptom assessment and management of patients receiving preoperative chemoradiotherapy, particularly midway through treatment, in order to optimise quality of life and minimise interruptions to treatment. Close monitoring of symptoms during preoperative chemoradiotherapy, particularly at week 4, will enable the implementation of timely interventions so that interruptions to treatment are prevented and the quality of life is optimised, which may hasten postoperative recovery times. © 2016 John Wiley & Sons Ltd.

Data Mining SIAM Presentation

NASA Technical Reports Server (NTRS)

Srivastava, Ashok; McIntosh, Dawn; Castle, Pat; Pontikakis, Manos; Diev, Vesselin; Zane-Ulman, Brett; Turkov, Eugene; Akella, Ram; Xu, Zuobing; Kumaresan, Sakthi Preethi

2006-01-01

This viewgraph document describes the data mining system developed at NASA Ames. Many NASA programs have large numbers (and types) of problem reports.These free text reports are written by a number of different people, thus the emphasis and wording vary considerably With so much data to sift through, analysts (subject experts) need help identifying any possible safety issues or concerns and help them confirm that they haven't missed important problems. Unsupervised clustering is the initial step to accomplish this; We think we can go much farther, specifically, identify possible recurring anomalies. Recurring anomalies may be indicators of larger systemic problems. The requirement to identify these anomalies has led to the development of Recurring Anomaly Discovery System (ReADS).

Internationalizing professional codes in engineering.

PubMed

Harris, Charles E

2004-07-01

Professional engineering societies which are based in the United States, such as the American Society of Mechanical Engineers (ASME, now ASME International) are recognizing that their codes of ethics must apply to engineers working throughout the world. An examination of the ethical code of the ASME International shows that its provisions pose many problems of application, especially in societies outside the United States. In applying the codes effectively in the international environment, two principal issues must be addressed. First, some Culture Transcending Guidelines must be identified and justified. Nine such guidelines are identified Second, some methods for applying the codes to particular situations must be identified Three such methods are specification, balancing, and finding a creative middle way.

Technology transfer in the NASA Ames Advanced Life Support Division

NASA Technical Reports Server (NTRS)

Connell, Kathleen; Schlater, Nelson; Bilardo, Vincent; Masson, Paul

1992-01-01

This paper summarizes a representative set of technology transfer activities which are currently underway in the Advanced Life Support Division of the Ames Research Center. Five specific NASA-funded research or technology development projects are synopsized that are resulting in transfer of technology in one or more of four main 'arenas:' (1) intra-NASA, (2) intra-Federal, (3) NASA - aerospace industry, and (4) aerospace industry - broader economy. Each project is summarized as a case history, specific issues are identified, and recommendations are formulated based on the lessons learned as a result of each project.

Predicting Drug Recalls From Internet Search Engine Queries.

PubMed

Yom-Tov, Elad

2017-01-01

Batches of pharmaceuticals are sometimes recalled from the market when a safety issue or a defect is detected in specific production runs of a drug. Such problems are usually detected when patients or healthcare providers report abnormalities to medical authorities. Here, we test the hypothesis that defective production lots can be detected earlier by monitoring queries to Internet search engines. We extracted queries from the USA to the Bing search engine, which mentioned one of the 5195 pharmaceutical drugs during 2015 and all recall notifications issued by the Food and Drug Administration (FDA) during that year. By using attributes that quantify the change in query volume at the state level, we attempted to predict if a recall of a specific drug will be ordered by FDA in a time horizon ranging from 1 to 40 days in future. Our results show that future drug recalls can indeed be identified with an AUC of 0.791 and a lift at 5% of approximately 6 when predicting a recall occurring one day ahead. This performance degrades as prediction is made for longer periods ahead. The most indicative attributes for prediction are sudden spikes in query volume about a specific medicine in each state. Recalls of prescription drugs and those estimated to be of medium-risk are more likely to be identified using search query data. These findings suggest that aggregated Internet search engine data can be used to facilitate in early warning of faulty batches of medicines.

Machine Learning in Radiation Oncology: Opportunities, Requirements, and Needs

PubMed Central

Feng, Mary; Valdes, Gilmer; Dixit, Nayha; Solberg, Timothy D.

2018-01-01

Machine learning (ML) has the potential to revolutionize the field of radiation oncology, but there is much work to be done. In this article, we approach the radiotherapy process from a workflow perspective, identifying specific areas where a data-centric approach using ML could improve the quality and efficiency of patient care. We highlight areas where ML has already been used, and identify areas where we should invest additional resources. We believe that this article can serve as a guide for both clinicians and researchers to start discussing issues that must be addressed in a timely manner. PMID:29719815

Bibliography of Lewis Research Center technical contributions announced in 1976

NASA Technical Reports Server (NTRS)

1977-01-01

Abstracts of Lewis authored publications and publications resulting from Lewis managed contracts which were announced in the 1976 issues of STAR (Scientific and Technical Aerospace Reports) and IAA (International Aerospace Abstracts) are presented. Research reports, journal articles, conference presentations, patents and patent applications, and these are included. The arrangement is by NASA subject category. Citations indicate report literature (identified by their N-numbers) and the journal and conference presentations (identified by their A-numbers). A grouping of indexes helps locate specific publications by author (including contractor authors), contractor organization, contract number, and report number.

Measuring patient anxiety in coronary care. Part 1.

PubMed

Elliott, D

1992-06-01

Patient anxiety is a common problem identified by nurses. However, the difficulty of assessing the level and significance of the anxiety is problematic. This paper discusses the issue of measuring patient anxiety, specifically in Coronary Care. As well as discussing physiological measures, three appropriate psychometric instruments are identified (the State-Trait Anxiety Inventory--STAI; the Hospital Anxiety and Depression Scale--HAD; a Linear Analogue Anxiety Scale--LAAS), along with a review of the relevant literature. Systematic anxiety measurement, and management of maladaptive anxiety would appear to be appropriate and meaningful nursing functions within the provision of holistic patient care in Coronary Care.

State of emergency preparedness for US health insurance plans.

PubMed

Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

2015-01-01

Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

[Sexual health and intellectual disability: a narrative literature review and its implications for nursing practice.

PubMed

Pariseau-Legault, Pierre; Holmes, Dave

2017-09-01

Issues associated with affectivity and sexuality in the context of intellectual disability have recently been the subject of various interdisciplinary discussions in academia. In nursing, interventions in sexual health are supported with hesitation and those issues constitute a marginal field of nursing research. A narrative literature review was realized in order to establish a portrait of the knowledge produced on this topic in the last decade. This paper illustrates three specific research areas recently developed, namely issues related to sexual autonomy, contextual factors positively or negatively contributing to emotional and sexual life, and the experiences of people identified as having an intellectual disability in this regard. On the basis of these results, different issues related to sexuality and intellectual disability are discussed, including those associated with the negotiation process of affective and sexual life, parenthood as a mediator of emotional and sexual expression, and the inclusiveness issues of sexual diversity in health interventions. Implications for nursing are finally discussed in light of the recent development of its role in sexual health.

Website design: technical, social and medical issues for self-reporting by elderly patients.

PubMed

Taylor, Mark J; Stables, Rod; Matata, Bashir; Lisboa, Paulo J G; Laws, Andy; Almond, Peter

2014-06-01

There is growing interest in the use of the Internet for interacting with patients, both in terms of healthcare information provision and information gathering. In this article, we examine the issues in designing healthcare websites for elderly users. In particular, this article uses a year-long case study of the development of a web-based system for self-reporting of symptoms and quality of life with a view to examine the issues relating to website design for elderly users. The issues identified included the technical, social and medical aspects of website design for elderly users. The web-based system developed was based on the European Quality of Life 5-Dimensions health-status questionnaire, a commonly used tool for patient self-reporting of quality of life, and the more specific coronary revascularisation outcome questionnaire. Currently, self-reporting is generally administered in the form of paper-based questionnaires to be completed in the outpatient clinic or at home. There are a variety of issues relating to elderly users, which imply that websites for elderly patients may involve different design considerations to other types of websites.

Implementing the community health worker model within diabetes management: challenges and lessons learned from programs across the United States.

PubMed

Cherrington, Andrea; Ayala, Guadalupe X; Amick, Halle; Allison, Jeroan; Corbie-Smith, Giselle; Scarinci, Isabel

2008-01-01

The purpose of this qualitative study was to examine methods of implementation of the community health worker (CHW) model within diabetes programs, as well as related challenges and lessons learned. Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC's 1998 directory of CHW programs, and Google Search Engine were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Sixteen programs were assessed, all but 3 focused on minority populations. Most CHWs were recruited informally; 6 programs required CHWs to have diabetes. CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate nondiabetes related issues. Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes.

TeamSTEPPS Improves Operating Room Efficiency and Patient Safety.

PubMed

Weld, Lancaster R; Stringer, Matthew T; Ebertowski, James S; Baumgartner, Timothy S; Kasprenski, Matthew C; Kelley, Jeremy C; Cho, Doug S; Tieva, Erwin A; Novak, Thomas E

2016-09-01

The objective was to evaluate the effect of TeamSTEPPS on operating room efficiency and patient safety. TeamSTEPPS consisted of briefings attended by all health care personnel assigned to the specific operating room to discuss issues unique to each case scheduled for that day. The operative times, on-time start rates, and turnover times of all cases performed by the urology service during the initial year with TeamSTEPPS were compared to the prior year. Patient safety issues identified during postoperative briefings were analyzed. The mean case time was 12.7 minutes less with TeamSTEPPS (P < .001). The on-time first-start rate improved by 21% with TeamSTEPPS (P < .001). The mean room turnover time did not change. Patient safety issues declined from an initial rate of 16% to 6% at midyear and remained stable (P < 0.001). TeamSTEPPS was associated with improved operating room efficiency and diminished patient safety issues in the operating room. © The Author(s) 2015.

Better bioinformatics through usability analysis.

PubMed

Bolchini, Davide; Finkelstein, Anthony; Perrone, Vito; Nagl, Sylvia

2009-02-01

Improving the usability of bioinformatics resources enables researchers to find, interact with, share, compare and manipulate important information more effectively and efficiently. It thus enables researchers to gain improved insights into biological processes with the potential, ultimately, of yielding new scientific results. Usability 'barriers' can pose significant obstacles to a satisfactory user experience and force researchers to spend unnecessary time and effort to complete their tasks. The number of online biological databases available is growing and there is an expanding community of diverse users. In this context there is an increasing need to ensure the highest standards of usability. Using 'state-of-the-art' usability evaluation methods, we have identified and characterized a sample of usability issues potentially relevant to web bioinformatics resources, in general. These specifically concern the design of the navigation and search mechanisms available to the user. The usability issues we have discovered in our substantial case studies are undermining the ability of users to find the information they need in their daily research activities. In addition to characterizing these issues, specific recommendations for improvements are proposed leveraging proven practices from web and usability engineering. The methods and approach we exemplify can be readily adopted by the developers of bioinformatics resources.

Is EIA part of the wind power planning problem?

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

Smart, Duncan Ewan; Stojanovic, Timothy A., E-mail: tas21@st-andrews.ac.uk; Warren, Charles R.

2014-11-15

This research evaluates the importance and effectiveness of Environmental Impact Assessment (EIA) within wind farm planning debates, drawing on insights from case studies in Scotland. Despite general public support for renewable energy on the grounds that it is needed to tackle climate change and implement sustainable development, many proposed wind farms encounter significant resistance. The importance of planning issues and (EIA) processes has arguably been overlooked within recent wind farm social acceptability discourse. Through semi-structured interviews with key stakeholders and textual analysis of EIA documents, the characteristics of EIA are assessed in terms of its perceived purpose and performance. Themore » data show that whilst respondents perceive EIA to be important, they express concerns about bias and about the inability of EIA to address climate change and wind farm decommissioning issues adequately. Furthermore, the research identifies key issues which impede the effectiveness of EIA, and reveals differences between theoretical and practical framings of EIA. The paper questions the assumption that EIA is a universally applicable tool, and argues that its effectiveness should be analysed in the context of specific development sectors. The article concludes by reviewing whether the recently amended EIA Directive (2014/52/EU) could resolve identified problems within national EIA practice. - Highlights: • Evaluation of EIA for onshore wind farm planning in Scotland. • EIA is important for multiple aspects of onshore wind farm planning. • Multiple substantive deficiencies of relevance to wind farm planning exist in EIA. • Further research into EIA effectiveness for specific development types is required. • Directive 2014/52/EU may improve EIA effectiveness within wind farm planning.« less

Identifying Health Promotion Needs Among Dominican-American Adolescents.

PubMed

Champion, Jane Dimmitt; Roye, Carol F

Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although adolescent pregnancy and obesity are common concerns among Hispanics, little is known specifically about Dominican adolescent health. This study was undertaken to assess Dominican-American adolescents' health concerns and their perceptions about their health promotion needs. Dominican-American adolescents (N=25) were recruited in a pediatric clinic in New York City which primarily serves a Dominican population. Eligibility criteria included age 13-21years, self-identifying as Dominican ethnicity, and able to speak and read English. They completed a questionnaire, with demographic questions and questions about their risk behaviors including sexual and substance use. After completing the questionnaire, they participated in a semi-structured interview addressing their health education experiences and suggestions for such programs. Quantitative data were analyzed using frequencies to provide a demographic and behavioral profile. Qualitative data were analyzed using thematic analysis. Twenty-five adolescents, ages 13-21years, (female N=19, male N=6) participated in the study. Most were in school (92%) and were sexually experienced (68%). Programmatic preferences included in-person programs rather than online. They spontaneously addressed the importance of cultural issues, and the need to address several issues in addition to sexuality, including obesity and substance use. Programming for this population should address a broad conceptualization of health, and incorporate Dominican cultural issues. Nurses working with adolescents of Dominican origin, should provide health education that incorporates the specific needs of this population, including culturally congruent face-to-face interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Multi-Objective Optimization of System Capability Satisficing in Defense Acquisition

DTIC Science & Technology

2012-04-30

sponsored by the USD(AT&L). Second, we issue an annual internal call for proposals to seek NPS faculty research supporting the interests of our...program sponsors. Finally, we serve as a “broker” to market specific research topics identified by our sponsors to NPS graduate students. This three...expanding the technology readiness level within defense acquisition. International Journal of Defense Acquisition Management, 1, 39–58. Tan, W

Movement Issues Identified in Movement ABC2 Checklist Parent Ratings for Students with Persisting Dysgraphia, Dyslexia, and OWL LD and Typical Literacy Learners

ERIC Educational Resources Information Center

Nielsen, Kathleen; Henderson, Sheila; Barnett, Anna L.; Abbott, Robert D.; Berninger, Virginia

2018-01-01

Movement, which draws on motor skills and executive functions for managing them, plays an important role in literacy learning (e.g., movement of mouth during oral reading and movement of hand and fingers during writing); but relatively little research has focused on movement skills in students with specific learning disabilities as the current…

Growing the Leadership Talent Pool: Perceptions of Heads, Middle Leaders and Classroom Teachers about Professional Development and Leadership Succession Planning within Their Own Schools

ERIC Educational Resources Information Center

Rhodes, Christopher; Brundrett, Mark

2009-01-01

This article reports on outcomes from a study funded by the National College for School Leadership designed to explore the factors that assist in the leadership development of teachers at a number of stages of their career development. More specifically, the study sought to identify issues associated with leadership talent identification,…

Girls to Women: Setting the Agenda for the 21st Century. A Report by the Steering Committee of the Girls to Women Initiative.

ERIC Educational Resources Information Center

Maryland State Commission for Women, Baltimore.

The Girls to Women Initiative was undertaken by a group of Maryland professionals and volunteers to identify and help meet the needs of Maryland's girls and young women in the 21st century. The professionals and volunteers researched and held conferences examining gender-specific issues concerning health and lifestyle, family life, education, and…

Test Protocol for Room-to-Room Distribution of Outside Air by Residential Ventilation Systems

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

Barley, C. D.; Anderson, R.; Hendron, B.

2007-12-01

This test and analysis protocol has been developed as a practical approach for measuring outside air distribution in homes. It has been used successfully in field tests and has led to significant insights on ventilation design issues. Performance advantages of more sophisticated ventilation systems over simpler, less-costly designs have been verified, and specific problems, such as airflow short-circuiting, have been identified.

Clinical governance in Scotland: an educational model.

PubMed Central

Lough, Murray; Kelly, Diane; Taylor, Mike; Snadden, David; Patterson, Bill; McNamara, Iain; Murray, Stuart

2002-01-01

The concepts underpinning clinical governance are similar throughout the United Kingdom but models for its implementation will differ widely. This model aims to enable practices to identify areas for further learning and development against specific outcomes. Criteria sets and standards are suggested and a governance plan is used to allow practices to prioritise their objectives. Resourcing will always be a major issue and such a model should be fully evaluated. PMID:11942453

Clinical governance in Scotland: an educational model.

PubMed

Lough, Murray; Kelly, Diane; Taylor, Mike; Snadden, David; Patterson, Bill; McNamara, Iain; Murray, Stuart

2002-04-01

The concepts underpinning clinical governance are similar throughout the United Kingdom but models for its implementation will differ widely. This model aims to enable practices to identify areas for further learning and development against specific outcomes. Criteria sets and standards are suggested and a governance plan is used to allow practices to prioritise their objectives. Resourcing will always be a major issue and such a model should be fully evaluated.

Contextualizing Competence: Language and LGBT-Based Competency in Health Care.

PubMed

Rossi, Alexis L; Lopez, Eliot J

2017-01-01

Changes in the language and terminology used to refer to individuals identifying as lesbian, gay, bisexual, and transgender (LGBT), as well as how best to discuss issues of sexual and gender identity, can prove challenging for health care providers due to (1) lack of training; (2) interdisciplinary issues; and (3) prejudices on personal and institutional levels. Given the importance of language in the relationship between health care provider and patient as well as the myriad ways in which language can reflect knowledge, skills, and attitudes, we contend that language is both a facilitator and inhibitor of competence. In this article, we discuss language as a means of exhibiting cultural competence as well as the barriers to facilitating this degree of competence. Communicative competence, a concept traditionally used in linguistics, is discussed as a framework for contextualizing LGBT-specific cultural competence in health care. Ideally, a professional will be considered competent once they (1) acquire a foundation in issues associated with LGBT individuals, as well as a basic understanding of appropriate vocabulary' (2) reconcile personal beliefs with their professional role; (3) create an inclusive healthcare environment such that the influence of personal biases does not negatively impact care; and (4) use identifiers suggested by the patient.

The Environmental Protection Agency's Community-Focused Exposure and Risk Screening Tool (C-FERST) and its potential use for environmental justice efforts.

PubMed

Zartarian, Valerie G; Schultz, Bradley D; Barzyk, Timothy M; Smuts, Marybeth; Hammond, Davyda M; Medina-Vera, Myriam; Geller, Andrew M

2011-12-01

Our primary objective was to provide higher quality, more accessible science to address challenges of characterizing local-scale exposures and risks for enhanced community-based assessments and environmental decision-making. After identifying community needs, priority environmental issues, and current tools, we designed and populated the Community-Focused Exposure and Risk Screening Tool (C-FERST) in collaboration with stakeholders, following a set of defined principles, and considered it in the context of environmental justice. C-FERST is a geographic information system and resource access Web tool under development for supporting multimedia community assessments. Community-level exposure and risk research is being conducted to address specific local issues through case studies. C-FERST can be applied to support environmental justice efforts. It incorporates research to develop community-level data and modeled estimates for priority environmental issues, and other relevant information identified by communities. Initial case studies are under way to refine and test the tool to expand its applicability and transferability. Opportunities exist for scientists to address the many research needs in characterizing local cumulative exposures and risks and for community partners to apply and refine C-FERST.

Gaps in the Substance Use Disorder Treatment Referral Process: Provider Perceptions.

PubMed

Blevins, Claire E; Rawat, Nishi; Stein, Michael D

2018-05-07

The demand for substance use disorder treatment is increasing, fueled by the opioid epidemic and the Affordable Care Act mandate to treat substance use disorders. The increased demand for treatment, however, is not being met by a corresponding increase in access to or availability of treatment. This report focuses specifically on the treatment referral process, which we have identified as 1 of the key barriers to timely and effective treatment. Difficulties in referral to substance use disorder treatment are examined through the lens of providers who make referrals (ie, referral source) and individuals who work in substance use disorder facilities (ie, referral recipient). Administrative officials, emergency department physicians, addiction physicians, government officials, providers, insurance officials, and mental health advocates (n = 59) were interviewed on the referral process protocol, challenges for providers and others making referrals, and issues with substance use treatment facility intake procedures. Several main themes were identified as barriers in the process: difficulties in determining patient eligibility, lack of transparency regarding treatment capacity, referral source knowledge/understanding of options, and issues with communication between referral source and recipient. We then proposed several solutions to address specific barriers. Current gaps in the referral process cause delays to care. Improving systems would involve addressing these themes and expanding the use of appropriate treatments for the many patients in need.

Zoonoses and marginalised infectious diseases of poverty: where do we stand?

PubMed

Molyneux, David; Hallaj, Zuhair; Keusch, Gerald T; McManus, Donald P; Ngowi, Helena; Cleaveland, Sarah; Ramos-Jimenez, Pilar; Gotuzzo, Eduardo; Kar, Kamal; Sanchez, Ana; Garba, Amadou; Carabin, Helene; Bassili, Amal; Chaignat, Claire L; Meslin, Francois-Xavier; Abushama, Hind M; Willingham, Arve L; Kioy, Deborah

2011-06-14

Despite growing awareness of the importance of controlling neglected tropical diseases as a contribution to poverty alleviation and achieving the Millennium Development Goals, there is a need to up-scale programmes to achieve wider public health benefits. This implementation deficit is attributable to several factors but one often overlooked is the specific difficulty in tackling diseases that involve both people and animals - the zoonoses. A Disease Reference Group on Zoonoses and Marginalised Infectious Diseases (DRG6) was convened by the Special Programme for Research and Training in Tropical Diseases (TDR), a programme executed by the World Health Organization and co-sponsored by UNICEF, UNDP, the World Bank and WHO. The key considerations included: (a) the general lack of reliable quantitative data on their public health burden; (b) the need to evaluate livestock production losses and their additional impacts on health and poverty; (c) the relevance of cross-sectoral issues essential to designing and implementing public health interventions for zoonotic diseases; and (d) identifying priority areas for research and interventions to harness resources most effectively. Beyond disease specific research issues, a set of common macro-priorities and interventions were identified which, if implemented through a more integrated approach by countries, would have a significant impact on human health of the most marginalised populations characteristically dependent on livestock.

Zoonoses and marginalised infectious diseases of poverty: Where do we stand?

PubMed Central

2011-01-01

Despite growing awareness of the importance of controlling neglected tropical diseases as a contribution to poverty alleviation and achieving the Millennium Development Goals, there is a need to up-scale programmes to achieve wider public health benefits. This implementation deficit is attributable to several factors but one often overlooked is the specific difficulty in tackling diseases that involve both people and animals - the zoonoses. A Disease Reference Group on Zoonoses and Marginalised Infectious Diseases (DRG6) was convened by the Special Programme for Research and Training in Tropical Diseases (TDR), a programme executed by the World Health Organization and co-sponsored by UNICEF, UNDP, the World Bank and WHO. The key considerations included: (a) the general lack of reliable quantitative data on their public health burden; (b) the need to evaluate livestock production losses and their additional impacts on health and poverty; (c) the relevance of cross-sectoral issues essential to designing and implementing public health interventions for zoonotic diseases; and (d) identifying priority areas for research and interventions to harness resources most effectively. Beyond disease specific research issues, a set of common macro-priorities and interventions were identified which, if implemented through a more integrated approach by countries, would have a significant impact on human health of the most marginalised populations characteristically dependent on livestock. PMID:21672216

Evaluating barriers to adopting telemedicine worldwide: A systematic review.

PubMed

Scott Kruse, Clemens; Karem, Priyanka; Shifflett, Kelli; Vegi, Lokesh; Ravi, Karuna; Brooks, Matthew

2018-01-01

Introduction and objective Studies on telemedicine have shown success in reducing the geographical and time obstacles incurred in the receipt of care in traditional modalities with the same or greater effectiveness; however, there are several barriers that need to be addressed in order for telemedicine technology to spread. The aim of this review is to evaluate barriers to adopting telemedicine worldwide through the analysis of published work. Methods The authors conducted a systematic literature review by extracting the data from the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PubMed (MEDLINE) research databases. The reviewers in this study analysed 30 articles (nine from CINAHL and 21 from Medline) and identified barriers found in the literature. This review followed the checklist from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009. The reviewers organized the results into one table and five figures that depict the data in different ways, organized by: barrier, country-specific barriers, organization-specific barriers, patient-specific barriers, and medical-staff and programmer-specific barriers. Results The reviewers identified 33 barriers with a frequency of 100 occurrences through the 30 articles. The study identified the issues with technically challenged staff (11%), followed by resistance to change (8%), cost (8%), reimbursement (5%), age of patient (5%), and level of education of patient (5%). All other barriers occurred at or less than 4% of the time. Discussion and conclusions Telemedicine is not yet ubiquitous, and barriers vary widely. The top barriers are technology-specific and could be overcome through training, change-management techniques, and alternating delivery by telemedicine and personal patient-to-provider interaction. The results of this study identify several barriers that could be eliminated by focused policy. Future work should evaluate policy to identify which one to lever to maximize the results.

ONC201: Stressing tumors to death.

PubMed

Endo Greer, Yoshimi; Lipkowitz, Stanley

2016-02-16

The small molecule ONC201 was identified in a screen for compounds that would induce expression of the gene encoding tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in tumors and thus cause an autocrine- or paracrine-induced death in tumor cells. Two Research Articles in this issue of Science Signaling by Ishizawa et al. and Kline et al. describe how ONC201 can also trigger cytotoxicity by inducing a stress response. The mechanisms of the stress response induced differ between hematological malignancies and solid tumors, highlighting the complexity of ONC201-induced toxicity and raising intriguing issues of tissue-specific pathways activated by the drug. Copyright © 2016, American Association for the Advancement of Science.

Liability and Litigation Risks for Colleges and Schools of Pharmacy

PubMed Central

Van Dusen, Virgil

2011-01-01

The potential for legal liability involving faculty members and students in higher education settings is a topic that warrants serious attention by administrators. Specific areas identified as high risk include dismissal of a faculty member, denial of tenure, misappropriation of grant-funding, intellectual property conflicts, Family and Medical Leave Act (FMLA) issues, sexual harassment, student suspension, disabilities, and student privacy issues. Examples of litigation in the higher-education setting are presented, along with a list of online resources for additional information. It is important for higher education administrators, faculty members, staff members, and students to recognize the currently accepted legal rights and responsibilities associated with these high-risk areas. PMID:21655406

How do we Remain Us in a Time of Change: Culture and Knowledge Management at NASA

NASA Technical Reports Server (NTRS)

Linde, Charlotte

2003-01-01

This viewgraph representation presents an overview of findings of a NASA agency-wide Knowledge Management Team considering culture and knowledge management issues at the agency. Specific issues identified by the team include: (1) NASA must move from being a knowledge hoarding culture to a knowledge sharing culture; (2) NASA must move from being center focused to being Agency focused; (3) NASA must capture the knowledge of a departing workforce. Topics considered include: what must NASA know to remain NASA, what were previous forms of knowledge reproduction and how has technological innovations changed these systems, and what changes in funding and relationships between contractors and NASA affected knowledge reproduction.

Improving Olympic health services: what are the common health care planning issues?

PubMed

Kononovas, Kostas; Black, Georgia; Taylor, Jayne; Raine, Rosalind

2014-12-01

Due to their scale, the Olympic and Paralympic Games have the potential to place significant strain on local health services. The Sydney 2000, Athens 2004, Beijing 2008, Vancouver 2010, and London 2012 Olympic host cities shared their experiences by publishing reports describing health care arrangements. Olympic planning reports were compared to highlight best practices, to understand whether and which lessons are transferable, and to identify recurring health care planning issues for future hosts. A structured, critical, qualitative analysis of all available Olympic health care reports was conducted. Recommendations and issues with implications for future Olympic host cities were extracted from each report. The six identified themes were: (1) the importance of early planning and relationship building: clarifying roles early to agree on responsibility and expectations, and engaging external and internal groups in the planning process from the start; (2) the development of appropriate medical provision: most health care needs are addressed inside Olympic venues rather than by hospitals which do not experience significant increases in attendance during the Games; (3) preparing for risks: gastrointestinal and food-borne illnesses are the most common communicable diseases experienced during the Games, but the incidence is still very low; (4) addressing the security risk: security arrangements are one of the most resource-demanding tasks; (5) managing administration and logistical issues: arranging staff permission to work at Games venues ("accreditation") is the most complex administrative task that is likely to encounter delays and errors; and (6) planning and assessing health legacy programs: no previous Games were able to demonstrate that their health legacy initiatives were effective. Although each report identified similar health care planning issues, subsequent Olympic host cities did not appear to have drawn on the transferable experiences of previous host cities. Repeated recommendations and lessons from host cities show that similar health care planning issues occur despite different health systems. To improve health care planning and delivery, host cities should pay heed to the specific planning issues that have been highlighted. It is also advisable to establish good communication with organizers from previous Games to learn first-hand about planning from previous hosts.

DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale

PubMed Central

Hasin, Deborah S.; O’Brien, Charles P.; Auriacombe, Marc; Borges, Guilherme; Bucholz, Kathleen; Budney, Alan; Compton, Wilson M.; Crowley, Thomas; Ling, Walter; Petry, Nancy M.; Schuckit, Marc; Grant, Bridget F.

2013-01-01

Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions. This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available. PMID:23903334

DSM-5 criteria for substance use disorders: recommendations and rationale.

PubMed

Hasin, Deborah S; O'Brien, Charles P; Auriacombe, Marc; Borges, Guilherme; Bucholz, Kathleen; Budney, Alan; Compton, Wilson M; Crowley, Thomas; Ling, Walter; Petry, Nancy M; Schuckit, Marc; Grant, Bridget F

2013-08-01

Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions.This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available.

Managing flood risks in the Mekong Delta: How to address emerging challenges under climate change and socioeconomic developments.

PubMed

Hoang, Long Phi; Biesbroek, Robbert; Tri, Van Pham Dang; Kummu, Matti; van Vliet, Michelle T H; Leemans, Rik; Kabat, Pavel; Ludwig, Fulco

2018-02-24

Climate change and accelerating socioeconomic developments increasingly challenge flood-risk management in the Vietnamese Mekong River Delta-a typical large, economically dynamic and highly vulnerable delta. This study identifies and addresses the emerging challenges for flood-risk management. Furthermore, we identify and analyse response solutions, focusing on meaningful configurations of the individual solutions and how they can be tailored to specific challenges using expert surveys, content analysis techniques and statistical inferences. Our findings show that the challenges for flood-risk management are diverse, but critical challenges predominantly arise from the current governance and institutional settings. The top-three challenges include weak collaboration, conflicting management objectives and low responsiveness to new issues. We identified 114 reported solutions and developed six flood management strategies that are tailored to specific challenges. We conclude that the current technology-centric flood management approach is insufficient given the rapid socioecological changes. This approach therefore should be adapted towards a more balanced management configuration where technical and infrastructural measures are combined with institutional and governance resolutions. Insights from this study contribute to the emerging repertoire of contemporary flood management solutions, especially through their configurations and tailoring to specific challenges.

Forensic intelligence framework--Part I: Induction of a transversal model by comparing illicit drugs and false identity documents monitoring.

PubMed

Morelato, Marie; Baechler, Simon; Ribaux, Olivier; Beavis, Alison; Tahtouh, Mark; Kirkbride, Paul; Roux, Claude; Margot, Pierre

2014-03-01

Forensic intelligence is a distinct dimension of forensic science. Forensic intelligence processes have mostly been developed to address either a specific type of trace or a specific problem. Even though these empirical developments have led to successes, they are trace-specific in nature and contribute to the generation of silos which hamper the establishment of a more general and transversal model. Forensic intelligence has shown some important perspectives but more general developments are required to address persistent challenges. This will ensure the progress of the discipline as well as its widespread implementation in the future. This paper demonstrates that the description of forensic intelligence processes, their architectures, and the methods for building them can, at a certain level, be abstracted from the type of traces considered. A comparative analysis is made between two forensic intelligence approaches developed independently in Australia and in Europe regarding the monitoring of apparently very different kind of problems: illicit drugs and false identity documents. An inductive effort is pursued to identify similarities and to outline a general model. Besides breaking barriers between apparently separate fields of study in forensic science and intelligence, this transversal model would assist in defining forensic intelligence, its role and place in policing, and in identifying its contributions and limitations. The model will facilitate the paradigm shift from the current case-by-case reactive attitude towards a proactive approach by serving as a guideline for the use of forensic case data in an intelligence-led perspective. A follow-up article will specifically address issues related to comparison processes, decision points and organisational issues regarding forensic intelligence (part II). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Supporting women with postpartum anxiety: exploring views and experiences of specialist community public health nurses in the UK.

PubMed

Ashford, Miriam T; Ayers, Susan; Olander, Ellinor K

2017-05-01

Anxiety is common among postpartum women and can have adverse effects on mother's and child's somatic and psychological health if left untreated. In the UK, nurses or midwifes with a specialisation in community public health nursing, also called health visitors (HVs), work with families who have children younger than 5 years of age and are therefore in a key position to identify and support women with postpartum mental health issues. Until recently, postpartum mental health support provided by HVs mainly focused on identifying and managing depression, but the updated clinical guidance by the National Institute for Health and Care Excellence also includes guidance regarding screening and psychological interventions for perinatal anxiety. This study therefore aimed to explore HVs' experiences of supporting women with postpartum anxiety and their views on currently available care. Using a qualitative approach, in-depth semi-structured interviews were conducted with 13 HVs from the UK between May and October 2015. Participants were interviewed in person at their workplace or on the phone/Skype. Using thematic analysis, four main themes emerged: identification and screening issues; importance of training; service usage; and status of current service provision. Women with postpartum anxiety were commonly encountered by HVs in their clinical practice and described as often heavily using their or other related healthcare services, which puts additional strain on HVs' already heavy workload. Issues with identifying and screening for postpartum anxiety were raised and the current lack of perinatal mental health training for HVs was highlighted. In addition, HVs described a current lack of good perinatal mental health services in general and specifically for anxiety. The study highlights the need for HV perinatal mental health training in general and postpartum anxiety specifically, as well as better coverage of specialist mental health services and the need for development of interventions targeted at postpartum anxiety. © 2017 John Wiley & Sons Ltd.

The role of ethics in information technology decisions: a case-based approach to biomedical informatics education.

PubMed

Anderson, James G

2004-03-18

The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.

Understanding the quality of life (QOL) issues in survivors of cancer: towards the development of an EORTC QOL cancer survivorship questionnaire.

PubMed

van Leeuwen, Marieke; Husson, Olga; Alberti, Paola; Arraras, Juan Ignacio; Chinot, Olivier L; Costantini, Anna; Darlington, Anne-Sophie; Dirven, Linda; Eichler, Martin; Hammerlid, Eva B; Holzner, Bernhard; Johnson, Colin D; Kontogianni, Meropi; Kjær, Trille Kristina; Morag, Ofir; Nolte, Sandra; Nordin, Andrew; Pace, Andrea; Pinto, Monica; Polz, Katja; Ramage, John; Reijneveld, Jaap C; Serpentini, Samantha; Tomaszewski, Krzysztof A; Vassiliou, Vassilios; Verdonck-de Leeuw, Irma M; Vistad, Ingvild; Young, Teresa E; Aaronson, Neil K; van de Poll-Franse, Lonneke V

2018-06-04

The number of cancer survivors is growing steadily and increasingly, clinical trials are being designed to include long-term follow-up to assess not only survival, but also late effects and health-related quality of life (HRQOL). Therefore it is is essential to develop patient-reported outcome measures (PROMs) that capture the full range of issues relevant to disease-free cancer survivors. The objectives of this project are: 1) to develop a European Organisation for Research and Treatment of Cancer (EORTC) questionnaire that captures the full range of physical, mental and social HRQOL issues relevant to disease-free cancer survivors; and 2) to determine at which minimal time since completion of treatment the questionnaire should be used. We reviewed 134 publications on cancer survivorship and interviewed 117 disease-free cancer survivors with 11 different types of cancer across 14 countries in Europe to generate an exhaustive, provisional list of HRQOL issues relevant to cancer survivors. The resulting issue list, the EORTC core questionnaire (QLQ-C30), and site-specific questionnaire modules were completed by a second group of 458 survivors. We identified 116 generic survivorship issues. These issues covered body image, cognitive functioning, health behaviors, negative and positive outlook, health distress, mental health, fatigue, sleep problems, physical functioning, pain, several physical symptoms, social functioning, and sexual problems. Patients rated most of the acute symptoms of cancer and its treatment (e.g. nausea) as no longer relevant approximately one year after completion of treatment. Compared to existing cancer survivorship questionnaires, our findings underscore the relevance of assessing issues related to chronic physical side effects of treatment such as neuropathy and joint pain. We will further develop a core survivorship questionnaire and three site-specific modules for disease-free adult cancer survivors who are at least one year post-treatment.

Towards pervasive computing in health care - a literature review.

PubMed

Orwat, Carsten; Graefe, Andreas; Faulwasser, Timm

2008-06-19

The evolving concepts of pervasive computing, ubiquitous computing and ambient intelligence are increasingly influencing health care and medicine. Summarizing published research, this literature review provides an overview of recent developments and implementations of pervasive computing systems in health care. It also highlights some of the experiences reported in deployment processes. There is no clear definition of pervasive computing in the current literature. Thus specific inclusion criteria for selecting articles about relevant systems were developed. Searches were conducted in four scientific databases alongside manual journal searches for the period of 2002 to 2006. Articles included present prototypes, case studies and pilot studies, clinical trials and systems that are already in routine use. The searches identified 69 articles describing 67 different systems. In a quantitative analysis, these systems were categorized into project status, health care settings, user groups, improvement aims, and systems features (i.e., component types, data gathering, data transmission, systems functions). The focus is on the types of systems implemented, their frequency of occurrence and their characteristics. Qualitative analyses were performed of deployment issues, such as organizational and personnel issues, privacy and security issues, and financial issues. This paper provides a comprehensive access to the literature of the emerging field by addressing specific topics of application settings, systems features, and deployment experiences. Both an overview and an analysis of the literature on a broad and heterogeneous range of systems are provided. Most systems are described in their prototype stages. Deployment issues, such as implications on organization or personnel, privacy concerns, or financial issues are mentioned rarely, though their solution is regarded as decisive in transferring promising systems to a stage of regular operation. There is a need for further research on the deployment of pervasive computing systems, including clinical studies, economic and social analyses, user studies, etc.

Lunar base mission technology issues and orbital demonstration requirements on space station

NASA Technical Reports Server (NTRS)

Llewellyn, Charles P.; Weidman, Deene J.

1992-01-01

The International Space Station has been the object of considerable design, redesign, and alteration since it was originally proposed in early 1984. In the intervening years the station has slowly evolved to a specific design that was thoroughly reviewed by a large agency-wide Critical Evaluation Task Force (CETF). As space station designs continue to evolve, studies must be conducted to determine the suitability of the current design for some of the primary purposes for which the station will be used. This paper concentrates on the technology requirements and issues, the on-orbit demonstration and verification program, and the space station focused support required prior to the establishment of a permanently manned lunar base as identified in the National Commission on Space report. Technology issues associated with the on-orbit assembly and processing of the lunar vehicle flight elements are also discussed.

Older Driver Safety: A Survey of Psychologists' Attitudes, Knowledge, and Practices.

PubMed

Love, Janet; Tuokko, Holly

2016-09-01

Using an online survey, we examined the knowledge, attitudes, and practices with respect to older driver safety concerns of clinical psychologists from across Canada who self-identified as working with at least some drivers over 60 years of age. Eighty-four psychologists completed the survey, and many were aware of the issues relevant to older driver safety, although only about half reported that assessing fitness to drive was an important issue in their practice. The majority (75%) reported that they would benefit from education concerning evaluation of fitness to drive. The primary recommendation emerging from this investigation is to increase efforts to inform and educate psychologists about driving-related assessment and regulatory issues in general, and specifically with respect to older adults. As the population ages, it is of growing importance for all health care providers to understand the influence of mental health conditions-including cognitive impairment and dementia-on driving skills.

Evolutions in Metadata Quality

NASA Astrophysics Data System (ADS)

Gilman, J.

2016-12-01

Metadata Quality is one of the chief drivers of discovery and use of NASA EOSDIS (Earth Observing System Data and Information System) data. Issues with metadata such as lack of completeness, inconsistency, and use of legacy terms directly hinder data use. As the central metadata repository for NASA Earth Science data, the Common Metadata Repository (CMR) has a responsibility to its users to ensure the quality of CMR search results. This talk will cover how we encourage metadata authors to improve the metadata through the use of integrated rubrics of metadata quality and outreach efforts. In addition we'll demonstrate Humanizers, a technique for dealing with the symptoms of metadata issues. Humanizers allow CMR administrators to identify specific metadata issues that are fixed at runtime when the data is indexed. An example Humanizer is the aliasing of processing level "Level 1" to "1" to improve consistency across collections. The CMR currently indexes 35K collections and 300M granules.

Salt-gradient Solar Ponds: Summary of US Department of Energy Sponsored Research

NASA Technical Reports Server (NTRS)

French, R. L.; Johnson, D. H.; Jones, G. F.; Zangrando, F.

1984-01-01

The solar pond research program conducted by the United States Department of Energy was discontinued after 1983. This document summarizes the results of the program, reviews the state of the art, and identifies the remaining outstanding issues. Solar ponds is a generic term but, in the context of this report, the term solar pond refers specifically to saltgradient solar pond. Several small research solar ponds have been built and successfully tested. Procedures for filling the pond, maintaining the gradient, adjusting the zone boundaries, and extracting heat were developed. Theories and models were developed and verified. The major remaining unknowns or issues involve the physical behavior of large ponds; i.e., wind mixing of the surface, lateral range or reach of horizontally injected fluids, ground thermal losses, and gradient zone boundary erosion caused by pumping fluid for heat extraction. These issues cannot be scaled and must be studied in a large outdoor solar pond.

Summary of SMIRT20 Preconference Topical Workshop – Identifying Structural Issues in Advanced Reactors

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

William Richins; Stephen Novascone; Cheryl O'Brien

Summary of SMIRT20 Preconference Topical Workshop – Identifying Structural Issues in Advanced Reactors William Richins1, Stephen Novascone1, and Cheryl O’Brien1 1Idaho National Laboratory, US Dept. of Energy, Idaho Falls, Idaho, USA, e-mail: William.Richins@inl.gov The Idaho National Laboratory (INL, USA) and IASMiRT sponsored an international forum Nov 5-6, 2008 in Porvoo, Finland for nuclear industry, academic, and regulatory representatives to identify structural issues in current and future advanced reactor design, especially for extreme conditions and external threats. The purpose of this Topical Workshop was to articulate research, engineering, and regulatory Code development needs. The topics addressed by the Workshop were selectedmore » to address critical industry needs specific to advanced reactor structures that have long lead times and can be the subject of future SMiRT technical sessions. The topics were; 1) structural/materials needs for extreme conditions and external threats in contemporary (Gen. III) and future (Gen. IV and NGNP) advanced reactors and 2) calibrating simulation software and methods that address topic 1 The workshop discussions and research needs identified are presented. The Workshop successfully produced interactive discussion on the two topics resulting in a list of research and technology needs. It is recommended that IASMiRT communicate the results of the discussion to industry and researchers to encourage new ideas and projects. In addition, opportunities exist to retrieve research reports and information that currently exists, and encourage more international cooperation and collaboration. It is recommended that IASMiRT continue with an off-year workshop series on select topics.« less

Human Health and Environmental Risks Posed by Synthetic Biology R&D for Energy Applications: A Literature Analysis

DOE PAGES

Hewett, Joel P.; Wolfe, Amy K.; Bergmann, Rachael A.; ...

2016-10-07

What are the human health and environmental risks posed by synthetic biology research and development (R&D) for energy applications? In this study, we found it surprisingly difficult to answer this seemingly straightforward question in our review of the risk-related synthetic biology literature. To our knowledge, no entity to date has published a comprehensive review of this literature. Thus, this analysis aims to fill that void and, at a high level, answer the question that we pose. Risk-related synthetic biology literature addresses risk from different perspectives. Much of the literature that we reviewed treats the concept of risk in synthetic biologymore » R&D broadly, enumerating few specific risks. Nevertheless, after reviewing >200 documents, we identified 44 discrete risk issues; 18 of those related to human health and 26 to the environment. We clustered these risk issues into categories that reflect and summarize their content. We categorized human health risk issues as follows: allergies, antibiotic resistance, carcinogens, and pathogenicity or toxicity. Environmental risk issues were categorized as follows: change or depletion of the environment, competition with native species, horizontal gene transfer, and pathogenicity or toxicity. Our efforts to understand what the synthetic biology R&D-related risk issues are stemmed from a larger research project in which we used risk issues identified in the literature as a point of departure in interviews with biosafety professionals and scientists engaged in synthetic biology R&D. Finally, we wrote this article after multiple biosafety professionals told us that accessing our risk-related literature analysis would aid them in their work.« less

Human Health and Environmental Risks Posed by Synthetic Biology R&D for Energy Applications: A Literature Analysis

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

Hewett, Joel P.; Wolfe, Amy K.; Bergmann, Rachael A.

What are the human health and environmental risks posed by synthetic biology research and development (R&D) for energy applications? In this study, we found it surprisingly difficult to answer this seemingly straightforward question in our review of the risk-related synthetic biology literature. To our knowledge, no entity to date has published a comprehensive review of this literature. Thus, this analysis aims to fill that void and, at a high level, answer the question that we pose. Risk-related synthetic biology literature addresses risk from different perspectives. Much of the literature that we reviewed treats the concept of risk in synthetic biologymore » R&D broadly, enumerating few specific risks. Nevertheless, after reviewing >200 documents, we identified 44 discrete risk issues; 18 of those related to human health and 26 to the environment. We clustered these risk issues into categories that reflect and summarize their content. We categorized human health risk issues as follows: allergies, antibiotic resistance, carcinogens, and pathogenicity or toxicity. Environmental risk issues were categorized as follows: change or depletion of the environment, competition with native species, horizontal gene transfer, and pathogenicity or toxicity. Our efforts to understand what the synthetic biology R&D-related risk issues are stemmed from a larger research project in which we used risk issues identified in the literature as a point of departure in interviews with biosafety professionals and scientists engaged in synthetic biology R&D. Finally, we wrote this article after multiple biosafety professionals told us that accessing our risk-related literature analysis would aid them in their work.« less

The experiences and support needs of people with intellectual disabilities who identify as LGBT: A review of the literature.

PubMed

McCann, Edward; Lee, Regina; Brown, Michael

2016-10-01

People who identify as lesbian, gay, bisexual and transgender (LGBT) can face many challenges in society including accessing education, care and support appropriate to individual needs. However, there is a growing and evolving evidence base about the specific needs of people with intellectual disabilities (ID) in this regard. The aim of this review was to explore the experiences of people with ID who identified as LGBT through an examination of studies that addressed their views and highlighted specific issues, concerns and service responses. A comprehensive search of relevant databases from February 1995 to February 2015 was conducted. Studies were identified that met specific criteria that included: empirical peer reviewed studies, the use of recognised research methods and focused on people with ID whom identified as LGBT. The search yielded 161 papers in total. The search was narrowed and 37 papers were screened using rigorous inclusion and exclusion criteria. Finally, 14 papers were considered suitable for the review. The data were analysed and key themes identified that included accessing health services, gender and sexual identity, attitudes of people with ID regarding their LGBT status, and education, supports and therapeutic interventions. There is a need for service providers and carers to be more responsive to the concerns of people with ID who identify as LGBT to improve their health and well-being by reducing stigma and discrimination and by increasing awareness of their care and support needs. The implications are discussed in terms of policy, education, research and practice developments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Increased Length of Awareness of Assisted Reproductive Technologies Fosters Positive Attitudes and Acceptance among Women

PubMed Central

Fortin, Chelsea; Abele, Susanne

2016-01-01

Background The field of infertility medicine has witnessed a surge of scientific developments in recent years, but research on public attitudes towards infertility treatments has remained minimal. This study examined the social and demographic factors that affect women’s attitudes towards assisted reproductive technology (ART) in general, as well as their opinions of specific issues related to ART. Materials and Methods This cross-sectional study was conducted from March 2011 to April 2011 by means of an online survey administered to a sample of 287 women. Results Women with a longer length of awareness of ART had significantly greater attitudinal favorability towards ART. Political affiliation was also significantly related to general attitudes, as well as several specific aspects of ART issues. Conclusion The results of this study suggest that several factors influence attitudes that women hold in regards to ART. Identifying some of these factors serves as a crucial starting point for devising strategies to increase public acceptance of ART. PMID:27110326

Review of work-related stress in mainland Chinese nurses.

PubMed

Zeng, Yingchun

2009-03-01

The aim of this review was to identify the specific work-related stressors of mainland Chinese nurses and to present the current state of stress research in order to discuss directions for further research. A literature search from January 2000 to June 2007 was conducted among three electronic databases. The specific stressors among Chinese nurses were effort-reward imbalance, the poor image of nursing in the community, and managerial issues. The studies were limited to either descriptive or correlation designs, a variety of stress scales were used to investigate the nurses' work-related stressors, and there were no published studies reporting stress management interventions for Chinese nurses. This review highlights that further stress research targeted to Chinese nurses needs more prospective and longitudinal studies and has to develop a consistent instrument to measure stressors. The priority issue is the initiation of stress management interventions to improve nurses' coping skills, while the long-term goal is to reduce the level of stress or eliminate the stressors through individual, organizational, and societal interventions.

Global and local networking for HIV/AIDS prevention: the case of the Saathii E-forum.

PubMed

Desouza, Rebecca; Jyoti Dutta, Mohan

2008-06-01

The global spread of HIV/AIDS has sparked the proliferation of civil society groups working on various aspects of the disease such as prevention, treatment, support, and policy. In this article, we explore the role of the Internet in networking civil society organizations working on HIV/AIDS-related issues across local and global spaces. Specifically, we conducted a thematic analysis of an e-forum established by the nongovernmental organization (NGO) Saathii, working on HIV/AIDS issues in India to (a) identify the specific functions served by the e-forum and (b) explore how global and local actors use the e-forum to network with one another. The thematic analysis documented four key functions of the online forum: (a) to provide HIV/AIDS-related news, (b) to serve as an informational resource, (c) to promote political activism, and (d) to express emotions. The discussion elaborates on the how global and local actors network with one another and build solidarity.

Application of Surface Analysis Methods to Nanomaterials: Summaryof ISO/TC 201 Technical Report: ISO 14187:2011 -Surface Chemical Analysis- Characterization of Nanomaterials

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

Baer, Donald R.

ISO Technical Report (TR) 14187 provides an introduction to (and examples of) the information that can be obtained about nanostructured materials using surface-analysis tools. In addition, both general issues and challenges associated with characterising nanostructured materials and the specific opportunities and challenges associated with individual analytical methods are identified. As the size of objects or components of materials approaches a few nanometres, the distinctions among 'bulk', 'surface' and 'particle' analysis blur. This Technical Report focuses on issues specifically relevant to surface chemical analysis of nanostructured materials. The report considers a variety of analysis methods but focuses on techniques that aremore » in the domain of ISO/TC 201 including Auger electron spectroscopy, X-ray photoelectron spectroscopy, secondary ion mass spectrometry, and scanning probe microscopy. Measurements of nanoparticle surface properties such as surface potential that are often made in a solution are not discussed.« less

Evaluation of multiplex assay platforms for detection of influenza hemagglutinin subtype specific antibody responses.

PubMed

Li, Zhu-Nan; Weber, Kimberly M; Limmer, Rebecca A; Horne, Bobbi J; Stevens, James; Schwerzmann, Joy; Wrammert, Jens; McCausland, Megan; Phipps, Andrew J; Hancock, Kathy; Jernigan, Daniel B; Levine, Min; Katz, Jacqueline M; Miller, Joseph D

2017-05-01

Influenza hemagglutination inhibition (HI) and virus microneutralization assays (MN) are widely used for seroprevalence studies. However, these assays have limited field portability and are difficult to fully automate for high throughput laboratory testing. To address these issues, three multiplex influenza subtype-specific antibody detection assays were developed using recombinant hemagglutinin antigens in combination with Chembio, Luminex ® , and ForteBio ® platforms. Assay sensitivity, specificity, and subtype cross-reactivity were evaluated using a panel of well characterized human sera. Compared to the traditional HI, assay sensitivity ranged from 87% to 92% and assay specificity in sera collected from unexposed persons ranged from 65% to 100% across the platforms. High assay specificity (86-100%) for A(H5N1) rHA was achieved for sera from exposed or unexposed to hetorosubtype influenza HAs. In contrast, assay specificity for A(H1N1)pdm09 rHA using sera collected from A/Vietnam/1204/2004 (H5N1) vaccinees in 2008 was low (22-30%) in all platforms. Although cross-reactivity against rHA subtype proteins was observed in each assay platform, the correct subtype specific responses were identified 78%-94% of the time when paired samples were available for analysis. These results show that high throughput and portable multiplex assays that incorporate rHA can be used to identify influenza subtype specific infections. Published by Elsevier B.V.

Employee problems and their consequences in the technology industry: evidence from surveys and counseling records.

PubMed

Wang, Ching-Wen; Lin, Po-Chang; Sha, Chyuan

2014-06-01

To support employees' work and health, organizations should help employees cope with common problems. Previous studies have focused primarily on work-related problems across multiple industries rather than on evaluating industry-specific issues. Here, two approaches identified common work and non-work employee problems in the technology industry with the strongest correlations with psychosomatic health and life satisfaction. Study 1 used questionnaires to identify the problems that were perceived as the most frequent by lower-level employees (N = 355) working in the technology industry. Study 2 evaluated employees' coping behaviors by analyzing (with permission) counseling records collected from an employee assistance service company (N = 276). Employees reported a variety of problems; work problems were the only problems (of the top 5 problems) reported in both studies. Several problems emerged in the counseling records (e.g., legal issues, career development, family and marriage problems, and emotional problems) but not in the surveys. Future research should apply these observations to develop scales for measuring employee stressors.

Methodological issues in the design and analyses of neonatal research studies: Experience of the NICHD Neonatal Research Network.

PubMed

Das, Abhik; Tyson, Jon; Pedroza, Claudia; Schmidt, Barbara; Gantz, Marie; Wallace, Dennis; Truog, William E; Higgins, Rosemary D

2016-10-01

Impressive advances in neonatology have occurred over the 30 years of life of The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN). However, substantial room for improvement remains in investigating and further developing the evidence base for improving outcomes among the extremely premature. We discuss some of the specific methodological challenges in the statistical design and analysis of randomized trials and observational studies in this population. Challenges faced by the NRN include designing trials for unusual or rare outcomes, accounting for and explaining center variations, identifying other subgroup differences, and balancing safety and efficacy concerns between short-term hospital outcomes and longer-term neurodevelopmental outcomes. In conclusion, the constellation of unique patient characteristics in neonates calls for broad understanding and careful consideration of the issues identified in this article for conducting rigorous studies in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

Child Maltreatment: Optimizing Recognition and Reporting by School Nurses.

PubMed

Jordan, Kathleen S; MacKay, Peggy; Woods, Stephanie J

2017-05-01

School nurses perform a crucial role in the prevention, identification, intervention, and reporting of child maltreatment. The purpose of this article is to share the highlights of a research project conducted to (a) examine the effectiveness of an educational intervention program in increasing the knowledge, confidence, and self-efficacy in school nurses regarding children at risk of maltreatment; and (b) discover issues surrounding the comfort level engaging with children, communicating with teachers and other personnel, and ethical issues. The study consisted of two phases. Phase 1 was a face-to-face evidenced-based educational intervention. Focus groups implemented in Phase 2 discovered specific concerns of school nurses. Results indicate a significant increase in school nurse knowledge, confidence, and self-efficacy related to children at risk. Five themes were identified from the focus groups: the importance of interprofessional collaboration, identifiers of children at risk of maltreatment, the role of the school nurse as a mentor and leader, the importance of advancing one's knowledge and skill set, and constraints faced by school nurses.

“I Need my Own Place to get Better”: Patient Perspectives on the Role of Housing in Potentially Preventable Hospitalizations

PubMed Central

Quensell, Michelle L.; Taira, Deborah A.; Seto, Todd B.; Braun, Kathryn L.; Sentell, Tetine L.

2017-01-01

Objective To analyze patient perspectives on the role of housing in their potentially preventable hospitalization. Methods Individuals admitted with cardiovascular-or diabetes-related diagnoses (n = 90) in a major medical center in Hawai‘i completed an in-person interview eliciting patient perspectives on key factors leading to hospitalization. Using the framework approach, two independent coders identified themes. This study focused on housing-related findings. Results Overall, 23% of participants reported housing as a precipitating factor to their hospitalization, including 12 with no regular place to stay. Four housing-related themes emerged: challenges meeting basic needs, complex chronic care management difficulties, stigma and relationship with provider, and stress and other mental health issues. Discussion Almost 25% of patients identified housing as a key factor to their hospital stay. Patient-reported themes highlight specific mechanisms by which housing challenges may lead to hospitalization. Addressing housing issues could help reduce the number and associated cost burden of preventable hospitalizations. PMID:28529224

Culture and end of life care: a scoping exercise in seven European countries.

PubMed

Gysels, Marjolein; Evans, Natalie; Meñaca, Arantza; Andrew, Erin; Toscani, Franco; Finetti, Sylvia; Pasman, H Roeline; Higginson, Irene; Harding, Richard; Pool, Robert

2012-01-01

Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. We scoped the literature for Germany, Norway, Belgium, The Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

Investigation of Mechanical Breakdowns Leading to Lock Closures

DTIC Science & Technology

2017-06-01

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

R & D in the US today: A difficult moment and new needs

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

Bugliarello, G.

1995-12-31

This paper discusses the impact of federal policy and industrial changes on research and development activities in the U.S. The role of government and industry in research and development activities are discussed, and current trends are identified and analyzed. The impact of federal research and development on competition and university programs is outlined. Specific energy issues that are impacted by decreased research activities are also noted. 4 figs.

The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey.

PubMed

Erdal, Erik P; Mitra, Debanjali; Khangulov, Victor S; Church, Stephen; Plokhoy, Elizabeth

2017-03-01

Background Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored. Methods A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues. Results Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247. Conclusions Measures to improve blood sample quality present an important step towards improved laboratory operations.

Why Research Design and Methods Is So Crucial to Understanding Drug Use/Abuse: Introduction to the Special Issue.

PubMed

Scheier, Lawrence M

2018-06-01

The collection of articles in this special issue both raise the bar and inspire new thinking with regard to both design and methodology concerns that influence drug use/abuse research. Thematically speaking, the articles focus on issues related to missing data, response formats, strategies for data harmonization, propensity scoring methods as an alternative to randomized control trials, integrative data analysis, statistical corrections to reduce bias from attrition, challenges faced from conducting large-scale evaluations, and employing abductive theory of method as an alternative to the more traditional hypothetico-deductive reasoning. Collectively, these issues are of paramount importance as they provide specific means to improve our investigative tools and refine the logical framework we employ to examine the problem of drug use/abuse. Each of the authors addresses a specific challenge outlining how it affects our current research efforts and then outlines remedies that can advance the field. To their credit, they have included issues that affect both etiology and prevention, thus broadening our horizons as we learn more about developmental processes causally related to drug use/abuse and intervention strategies that can mitigate developmental vulnerability. This is the essential dialogue required to advance our intellectual tool kit and improve the research skills we bring to bear on the important questions facing the field of drug use/abuse. Ultimately, the goal is to increase our ability to identify the causes and consequences of drug use/abuse and find ways to ameliorate these problems as we engage the public health agenda.

Biomedical technology prosperity game{trademark}

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

Berman, M.; Boyack, K.W.; Wesenberg, D.L.

1996-07-01

Prosperity Games{trademark} are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games{trademark} are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games{trademark} are unique in that both the game format and the player contributions vary from game to game. This report documents the Biomedical Technology Prosperity Game{trademark} conducted under the sponsorship of Sandia National Laboratories, the Defensemore » Advanced Research Projects Agency, and the Koop Foundation, Inc. Players were drawn from all stakeholders involved in biomedical technologies including patients, hospitals, doctors, insurance companies, legislators, suppliers/manufacturers, regulators, funding organizations, universities/laboratories, and the legal profession. The primary objectives of this game were to: (1) Identify advanced/critical technology issues that affect the cost and quality of health care. (2) Explore the development, patenting, manufacturing and licensing of needed technologies that would decrease costs while maintaining or improving quality. (3) Identify policy and regulatory changes that would reduce costs and improve quality and timeliness of health care delivery. (4) Identify and apply existing resources and facilities to develop and implement improved technologies and policies. (5) Begin to develop Biomedical Technology Roadmaps for industry and government cooperation. The deliberations and recommendations of these players provided valuable insights as to the views of this diverse group of decision makers concerning biomedical issues. Significant progress was made in the roadmapping of key areas in the biomedical technology field.« less

Risk factors for 30-day postoperative complications and mortality after below-knee amputation: a study of 2,911 patients from the national surgical quality improvement program.

PubMed

Belmont, Philip J; Davey, Shaunette; Orr, Justin D; Ochoa, Leah M; Bader, Julia O; Schoenfeld, Andrew J

2011-09-01

This investigation sought to evaluate risk factors for morbidity and mortality from a large series of below-knee amputees prospectively entered in a national database. All patients undergoing below-knee amputations in the years 2005-2008 were identified in the database of the National Surgical Quality Improvement Program (NSQIP). Demographic data, medical comorbidities, and medical history were obtained. Mortality and postoperative complications within 30 days of the below-knee amputation were also documented. Chi-square test, univariate, and multivariate logistic regression analyses were used to assess the effect of specific risk factors on mortality, as well as the likelihood of developing major, minor, or any complications developing. Below-knee amputations were performed in 2,911 patients registered in the NSQIP database between 2005 and 2008. The average age of patients was 65.8 years old and 64.3% were male. There was a 7.0% 30-day mortality rate and 1,627 complications occurred in 1,013 patients (34.4%). Multivariate logistic regression analysis identified renal insufficiency, cardiac issues, history of sepsis, steroid use, COPD, and increased patient age as independent predictors of mortality. The most common major complications were return to the operating room (15.6%), wound infection (9.3%), and postoperative sepsis (9.3%). History of sepsis, alcohol use, steroid use, cardiac issues, renal insufficiency, and contaminated/infected wounds were independent predictors of one or more complications developing. Renal disease, cardiac issues, history of sepsis, steroid use, COPD, and increased patient age were identified as predictors of mortality after below-knee amputation. Renal disease, cardiac issues, history of sepsis, steroid use, contaminated/infected wounds, and alcohol use were also found to be predictors of postoperative complications. Published by Elsevier Inc.

A systematic review of explanatory factors of barriers and facilitators to improving asthma management in South Asian children

PubMed Central

2014-01-01

Background South Asian children with asthma are less likely to receive prescriptions and more likely to suffer uncontrolled symptoms and acute asthma admissions compared with White British children. Understanding barriers are therefore vital in addressing health inequalities. We undertook a systematic review identifying explanatory factors for barriers and facilitators to asthma management in South Asian children. South Asians were defined as individuals of Indian, Pakistani or Bangladeshi descent. Methods Data Sources - Medline, HMIC, EMBASE, ASSIA, Web of Science, BNI, CINAHL, PsycINFO, OpenSIGLE, CRD, Scopus, NHS Evidence, Cochrane Library, Campbell Collaboration, RCPCH, ATS, ERS, Asthma UK, Google Scholar & Asthma Guidelines (BTS, GINA, ATS, Monash, NAEPP, Singapore & New Zealand) to August 2013. Inclusion Criteria – Qualitative, quantitative or mixed methods research with primary focus on identifying explanations for barriers and/or facilitators to asthma management in South Asian children aged 0–18 years with diagnosed/suspected asthma and/or carers and/or healthcare professionals. Data Extraction – Three authors independently reviewed, selected & extracted eligible articles with disagreements resolved by research team discussion. Results 15 studies encompassing 25,755 children, 18,483 parents/carers and 239 healthcare professionals were included. Barriers and explanatory factors identified were: 1. Lack of asthma knowledge in families and healthcare professionals. 2. Under-use of preventer medications. 3. Non-acceptance/denial of asthma. 4. Over-reliance on Emergency Department management. 5. Communication problems. 6. Non-adherence to medication. 7. Use of complementary therapies. Little facilitators regarding asthma management were identified. Conclusions Several key issues were identified as likely to be ethnic-specific to South Asian families, rather than a reflection of minority status: impact of parental and professional knowledge and beliefs, health service utilisation pattern explanations and the impact of prejudice and stigmatisation. Other explanations such as language barriers are not strictly ethnic specific but instead reflect a minority position. Further research is required to identify why barriers exist, the mechanisms by which they impact on asthma management and how they can be overcome. Furthermore, understanding the difference between barriers and explanations that are ethnic-specific and those that are related to being a minority will enable the application of generic system-wide interventions where ethnicity is not the issue and ethnically-tailored interventions where needed. PMID:24767303

Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH) program

NASA Astrophysics Data System (ADS)

Fayette, Daniel F.; Speicher, Patricia; Stoklosa, Mark J.; Evans, Jillian V.; Evans, John W.; Gentile, Mike; Pagel, Chuck A.; Hakim, Edward

1993-08-01

A joint military-commercial effort to evaluate multichip module (MCM) structures is discussed. The program, Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH), has been designed to identify the failure mechanisms that are possible in MCM structures. The RELTECH test vehicles, technical assessment task, product evaluation plan, reliability modeling task, accelerated and environmental testing, and post-test physical analysis and failure analysis are described. The information obtained through RELTECH can be used to address standardization issues, through development of cost effective qualification and appropriate screening criteria, for inclusion into a commercial specification and the MIL-H-38534 general specification for hybrid microcircuits.

Genetic influence on contrast sensitivity in middle-aged male twins.

PubMed

Cronin-Golomb, Alice; Panizzon, Matthew S; Lyons, Michael J; Franz, Carol E; Grant, Michael D; Jacobson, Kristen C; Eisen, Seth A; Laudate, Thomas M; Kremen, William S

2007-07-01

Contrast sensitivity is strongly associated with daily functioning among older adults, but the genetic and environmental contributions to this ability are unknown. Using the classical twin method, we addressed this issue by examining contrast sensitivity at five spatial frequencies (1.5-18 cycles per degree) in 718 middle-aged male twins from the Vietnam Era Twin Study of Aging (VETSA). Heritability estimates were modest (14-38%), whereas individual-specific environmental influences accounted for 62-86% of the variance. Identifying the types of individual-specific events that impact contrast sensitivity may suggest interventions to modulate this ability and thereby improve overall quality of life as adults age.

Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH) program

NASA Technical Reports Server (NTRS)

Fayette, Daniel F.; Speicher, Patricia; Stoklosa, Mark J.; Evans, Jillian V.; Evans, John W.; Gentile, Mike; Pagel, Chuck A.; Hakim, Edward

1993-01-01

A joint military-commercial effort to evaluate multichip module (MCM) structures is discussed. The program, Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH), has been designed to identify the failure mechanisms that are possible in MCM structures. The RELTECH test vehicles, technical assessment task, product evaluation plan, reliability modeling task, accelerated and environmental testing, and post-test physical analysis and failure analysis are described. The information obtained through RELTECH can be used to address standardization issues, through development of cost effective qualification and appropriate screening criteria, for inclusion into a commercial specification and the MIL-H-38534 general specification for hybrid microcircuits.

Multi-Unit Considerations for Human Reliability Analysis

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

St. Germain, S.; Boring, R.; Banaseanu, G.

This paper uses the insights from the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) methodology to help identify human actions currently modeled in the single unit PSA that may need to be modified to account for additional challenges imposed by a multi-unit accident as well as identify possible new human actions that might be modeled to more accurately characterize multi-unit risk. In identifying these potential human action impacts, the use of the SPAR-H strategy to include both errors in diagnosis and errors in action is considered as well as identifying characteristics of a multi-unit accident scenario that may impact themore » selection of the performance shaping factors (PSFs) used in SPAR-H. The lessons learned from the Fukushima Daiichi reactor accident will be addressed to further help identify areas where improved modeling may be required. While these multi-unit impacts may require modifications to a Level 1 PSA model, it is expected to have much more importance for Level 2 modeling. There is little currently written specifically about multi-unit HRA issues. A review of related published research will be presented. While this paper cannot answer all issues related to multi-unit HRA, it will hopefully serve as a starting point to generate discussion and spark additional ideas towards the proper treatment of HRA in a multi-unit PSA.« less

Conference on Gender-specific Research in Emergency Care: An Executive Summary

PubMed Central

Safdar, Basmah; Greenberg, Marna Rayl

2015-01-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, “Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes,” convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex-and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the results of the 2014 consensus conference as well as related original research with the goal of bringing high-quality equitable care to male and female emergency patients. PMID:25420469

The effects of workplace physical activity interventions in men: a systematic review.

PubMed

Wong, Jason Y L; Gilson, Nicholas D; van Uffelen, Jannique G Z; Brown, Wendy J

2012-07-01

The workplace is cited as a promising setting for physical activity (PA) promotion, but workplace PA interventions tend not to specifically target men. The aim of this article was to review the literature on workplace PA interventions for men and to identify key issues for future intervention development. Articles targeting PA at the workplace were located through a structured database search. Information on intervention strategies and PA outcomes were extracted. Only 13 studies (10.5%) reviewed focused on men, of which 5 showed significant increases in PA. These studies used generic, multicomponent, health promotion strategies with a variety of timeframes, self-report PA measures, and PA outcomes. The systematic review identified that evidence on the effectiveness of workplace PA interventions for men is equivocal and highlighted methodological concerns. Future research should use reliable and valid measures of PA and interventions that focus specifically on men's needs and PA preferences.

Relationship between total quality management, critical paths, and outcomes management.

PubMed

Lynn, P A

1996-09-01

Total quality management (TQM), clinical paths, and outcomes management are high-profile strategies in today's health care environment. Each strategy is distinct, yet there are interrelationships among them. TQM supports a customer-focused organizational culture, providing tools and techniques to identify and solve problems. Clinical paths are tools for enhancing patient care coordination and for identifying system-wide and patient population specific issues. Outcomes management is an integrated system for measuring the results in patient populations over time. There is a recent shift in outcomes measurement towards expanding both the nature of the outcomes examined and the timeframes in which they are studied.

Emerging Methodologies in Pediatric Palliative Care Research: Six Case Studies

PubMed Central

Nelson, Katherine E.; Gerhardt, Cynthia A.; Rosenberg, Abby R.; Widger, Kimberley; Faerber, Jennifer A.; Feudtner, Chris

2018-01-01

Given the broad focus of pediatric palliative care (PPC) on the physical, emotional, and spiritual needs of children with potentially life-limiting illnesses and their families, PPC research requires creative methodological approaches. This manuscript, written by experienced PPC researchers, describes issues encountered in our own areas of research and the novel methods we have identified to target them. Specifically, we discuss potential approaches to: assessing symptoms among nonverbal children, evaluating medical interventions, identifying and treating problems related to polypharmacy, addressing missing data in longitudinal studies, evaluating longer-term efficacy of PPC interventions, and monitoring for inequities in PPC service delivery. PMID:29495384

Emergency management in health: key issues and challenges in the UK.

PubMed

Lee, Andrew C K; Phillips, Wendy; Challen, Kirsty; Goodacre, Steve

2012-10-19

Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Four thematic categories for future research emerged:(i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained.(ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required.(iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus specific planning, and reactive versus proactive approaches to emergencies.(iv) Emergency management system: More study is required of system-wide issues relating to system configuration and operation, public engagement, and how emergency planning is assessed.

Hospital ergonomics: a qualitative study to explore the organizational and cultural factors.

PubMed

Hignett, Sue

2003-07-15

The primary objective was to identify the characteristics of the health care industry with respect to organizational and cultural factors and consider how these might impact on the practice of ergonomics. Qualitative methodology was chosen as a suitable approach. This was supported by a middle ground philosophical position. Twenty-one interviews were carried out with academics and practitioners using a questionnaire proforma which developed iteratively over the 18 months of the project. A progressive four stage sampling strategy was used starting with purposive sampling to spread the net. Suggested contacts were then followed up (snowball sampling), before the third stage of intensity sampling to focus on participants with specific experience in hospital ergonomics. A final strategy of analysis sampling sought extreme and deviant cases to achieve theoretical saturation. The analysis resulted in three categories: organizational, staff and patient issues. The organizational issues included both the size and complexity of the National Health Service. For example, three hierarchical lines were identified in the management structure: an administrative line, a professional line and a patient-focused clinical management line. One of the surprising findings for the staff issues was the perceived lack of ergonomic information about female workers as a population group and traditional female employment sectors. The patient issues incorporated three dimensions associated with the caring role: the type of work; expectations; and possible outcomes. The work tends to be dirty and emotional, with a professional subculture to allow the handling of other peoples' bodies. This subculture was linked to a 'coping' attitude where staff put the patients' needs and well-being before their own. The change in patient expectations (from being apologetic through to demanding their rights) is mirrored in a changing model of care from paternalism to partnership. A lack of ergonomic research was identified for female workers in the health care industry relating to both the type of work and gender issues.

What does it mean to "employ" the RE-AIM model?

PubMed

Kessler, Rodger S; Purcell, E Peyton; Glasgow, Russell E; Klesges, Lisa M; Benkeser, Rachel M; Peek, C J

2013-03-01

Many grant proposals identify the use of a given evaluation model or framework but offer little about how such models are implemented. The authors discuss what it means to employ a specific model, RE-AIM, and key dimensions from this model for program planning, implementation, evaluation, and reporting. The authors report both conceptual and content specifications for the use of the RE-AIM model and a content review of 42 recent dissemination and implementation grant applications to National Institutes of Health that proposed the use of this model. Outcomes include the extent to which proposals addressed the overall RE-AIM model and specific items within the five dimensions in their methods or evaluation plans. The majority of grants used only some elements of the model (less than 10% contained thorough measures across all RE-AIM dimensions). Few met criteria for "fully developed use" of RE-AIM and the percentage of key issues addressed varied from, on average, 45% to 78% across the RE-AIM dimensions. The results and discussion of key criteria should help investigators in their use of RE-AIM and illuminate the broader issue of comprehensive use of evaluation models.

HTA and its legal issues: a framework for identifying legal issues in health technology assessment.

PubMed

Widrig, Daniel; Tag, Brigitte

2014-12-01

Legal analysis can highlight important issues that are relevant when deciding whether a medical technology should be implemented or reimbursed. Literature and studies show that even though the law is an acknowledged part of health technology assessment (HTA), legal issues are rarely considered in practice. One reason for this may be the lack of knowledge about the diversity of legal issues that are relevant for HTA. Therefore, this contribution aims primarily to identify and then explain the relevant legal issues in HTA. This study offers a framework for identifying the legal issues in HTAs in different jurisdictions and provides a basis for further research. After extensive literature search, the authors review Swiss health law to identify legal issues that are relevant to HTA. The authors then categorize these legal issues using a framework with an inside and outside perspective. Finally, they explain a selection of these legal issues with several examples. This study reveals numerous legal issues that are relevant for HTA and underlines the necessity of incorporating legal analysis in HTAs. The suggested perspectival framework in this study provides a basis to structure the legal analysis. The identified legal issues are relevant in other countries and the perspectival framework is transferable to other jurisdictions. The article underlines the importance of in-depth discussion about the role of law in HTA. It provides a structured overview of the legal issues in HTA and suggests a development of more concrete instruments toward a standardized legal technology assessment.

Workshop on Two-Phase Fluid Behavior in a Space Environment

NASA Technical Reports Server (NTRS)

Swanson, Theodore D. (Editor); Juhasz, AL (Editor); Long, W. Russ (Editor); Ottenstein, Laura (Editor)

1989-01-01

The Workshop was successful in achieving its main objective of identifying a large number of technical issues relating to the design of two-phase systems for space applications. The principal concern expressed was the need for verified analytical tools that will allow an engineer to confidently design a system to a known degree of accuracy. New and improved materials, for such applications as thermal storage and as heat transfer fluids, were also identified as major needs. In addition to these research efforts, a number of specific hardware needs were identified which will require development. These include heat pumps, low weight radiators, advanced heat pipes, stability enhancement devices, high heat flux evaporators, and liquid/vapor separators. Also identified was the need for a centralized source of reliable, up-to-date information on two-phase flow in a space environment.

Using resources for scientific-driven pharmacovigilance: from many product safety documents to one product safety master file.

PubMed

Furlan, Giovanni

2012-08-01

Current regulations require a description of the overall safety profile or the specific risks of a drug in multiple documents such as the Periodic and Development Safety Update Reports, Risk Management Plans (RMPs) and Signal Detection Reports. In a resource-constrained world, the need for preparing multiple documents reporting the same information results in shifting the focus from a thorough scientific and medical evaluation of the available data to maintaining compliance with regulatory timelines. Since the aim of drug safety is to understand and characterize product issues to take adequate risk minimization measures rather than to comply with bureaucratic requirements, there is the need to avoid redundancy. In order to identify core drug safety activities that need to be undertaken to protect patient safety and reduce the number of documents reporting the results of these activities, the author has reviewed the main topics included in the drug safety guidelines and templates. The topics and sources that need to be taken into account in the main regulatory documents have been found to greatly overlap and, in the future, as a result of the new Periodic Safety Update Report structure and requirements, in the author's opinion this overlap is likely to further increase. Many of the identified inter-document differences seemed to be substantially formal. The Development Safety Update Report, for example, requires separate presentation of the safety issues emerging from different sources followed by an overall evaluation of each safety issue. The RMP, instead, requires a detailed description of the safety issues without separate presentation of the evidence derived from each source. To some extent, however, the individual documents require an in-depth analysis of different aspects; the RMP, for example, requires an epidemiological description of the indication for which the drug is used and its risks. At the time of writing this article, this is not specifically required by other documents. The author has identified signal detection (intended not only as adverse event disproportionate reporting, but including non-clinical, laboratory, clinical analysis data and literature screening) and characterization as the basis for the preparation of all drug safety documents, which can be viewed as different ways of presenting the results of this activity. Therefore, the author proposes to merge all the aggregate reports required by current regulations into a single document - the Drug Safety Master File. This report should contain all the available information, from any source, regarding the potential and identified risks of a drug. It should be a living document updated and submitted to regulatory authorities on an ongoing basis.

How Methodologic Differences Affect Results of Economic Analyses: A Systematic Review of Interferon Gamma Release Assays for the Diagnosis of LTBI

PubMed Central

Oxlade, Olivia; Pinto, Marcia; Trajman, Anete; Menzies, Dick

2013-01-01

Introduction Cost effectiveness analyses (CEA) can provide useful information on how to invest limited funds, however they are less useful if different analysis of the same intervention provide unclear or contradictory results. The objective of our study was to conduct a systematic review of methodologic aspects of CEA that evaluate Interferon Gamma Release Assays (IGRA) for the detection of Latent Tuberculosis Infection (LTBI), in order to understand how differences affect study results. Methods A systematic review of studies was conducted with particular focus on study quality and the variability in inputs used in models used to assess cost-effectiveness. A common decision analysis model of the IGRA versus Tuberculin Skin Test (TST) screening strategy was developed and used to quantify the impact on predicted results of observed differences of model inputs taken from the studies identified. Results Thirteen studies were ultimately included in the review. Several specific methodologic issues were identified across studies, including how study inputs were selected, inconsistencies in the costing approach, the utility of the QALY (Quality Adjusted Life Year) as the effectiveness outcome, and how authors choose to present and interpret study results. When the IGRA versus TST test strategies were compared using our common decision analysis model predicted effectiveness largely overlapped. Implications Many methodologic issues that contribute to inconsistent results and reduced study quality were identified in studies that assessed the cost-effectiveness of the IGRA test. More specific and relevant guidelines are needed in order to help authors standardize modelling approaches, inputs, assumptions and how results are presented and interpreted. PMID:23505412

Factors influencing nurses' attitudes toward simulation-based education.

PubMed

Decarlo, Deborah; Collingridge, Dave S; Grant, Carrie; Ventre, Kathleen M

2008-01-01

To identify barriers to nurses' participation in simulation, and to determine whether prior simulation exposure, professional experience, and practice location influence their tendency to perceive specific issues as barriers. We also sought to identify nurses' educational priorities, and to determine whether these were influenced by years of experience or practice location. We surveyed full-time and part-time nurses in a university-affiliated children's hospital to gather data on professional demographics, simulation exposure, perceived barriers to participation in simulation, and training priorities. A total of 523 of 936 (56%) eligible nurses completed the survey. Binary logistic regression analysis revealed that "simulation is 'not the real thing'" was selected as a barrier more often by nurses with prior simulation experience (P = 0.02), fewer years in practice (P = 0.02), and employment in non-acute care areas of the hospital (P = 0.03). "Unfamiliarity with equipment" was reported more often by nurses with less experience (P = 0.01). "Stressful or intimidating environment" was selected more often by those who work in non-acute care areas (P < 0.01). "Providing opportunities to manage rare events" was suggested as a training priority by nurses with less experience (P = 0.08) and by those practicing in acute care areas (P = 0.03). We identified several barriers to nurses' participation in simulation training. Nurses' tendency to name specific issues as barriers is related to prior simulation exposure, years of experience, and area of hospital practice. Rehearsing rare event management is a priority for less-experienced nurses and those in acute care areas.

Making good use of online case study materials.

PubMed

Keefer, Matthew Wilks

2005-07-01

Web-based access to engaging instructional materials for SEE instruction represents an increasingly viable and attractive opportunity for educators. This paper will review research findings that demonstrate important differences in more experienced and novice ethical responses to engaging online materials, including authentic cases, codes, and commentaries. Results demonstrate that experienced ethical thinkers are more likely than novices to appeal to middle level principles that identify professional role-specific obligations (RSO); to make greater use of professional knowledge in order to recognize moral issues and relevant facts; and to employ more 'contextually sensitive' reasoning strategies when crafting resolutions to moral problems--e.g., identify alternative moral issues, assess the moral implications of actions, and provide alternative practical resolutions to conflicts. These findings suggest that when effectively integrated into SEE courses, authentic instructional materials have the potential to effectively challenge students and enhance student learning. However, there is evidence that the uses and benefits of these materials are not well understood. In the second part of this paper, five research-based instructional principles will be identified and discussed that can help SEE instructors better understand how to effectively integrate these materials into their courses.

An end-users oriented methodology for enhancing the integration of knowledge on soil-water-sediment systems in River Basin Management: an illustration from the AquaTerra project.

PubMed

Merly, Corinne; Chapman, Antony; Mouvet, Christophe

2012-01-01

Research results in environmental and socio-economic sciences are often under-used by stakeholders involved in the management of natural resources. To minimise this gap, the FP6 EU interdisciplinary project AquaTerra (AT) developed an end-users' integration methodology in order to ensure that the data, knowledge and tools related to the soil-water-sediment system that were generated by the project were delivered in a meaningful way for end-users, thus improving their uptake. The methodology and examples of its application are presented in this paper. From the 408 project deliverables, 96 key findings were identified, 53 related to data and knowledge, and 43 describing advanced tools. River Basin Management (RBM) stakeholders workshops identified 8 main RBM issues and 25 specific stakeholders' questions related to RBM which were classified into seven groups of cross-cutting issues, namely scale, climate change, non-climatic change, the need for systemic approaches, communication and participation, international and inter-basin coordination and collaboration, and the implementation of the Water Framework Directive. The integration methodology enabled an assessment of how AT key findings meet stakeholders' demands, and for each main RBM issue and for each specific question, described the added-value of the AT project in terms of knowledge and tools generated, key parameters to consider, and recommendations that can be made to stakeholders and the wider scientific community. Added value and limitations of the integration methodology and its outcomes are discussed and recommendations are provided to further improve integration methodology and bridge the gaps between scientific research data and their potential uptake by end-users.

Focusing biodiversity research on the needs of decision makers

NASA Astrophysics Data System (ADS)

Smythe, Katie D.; Bernabo, J. Christopher; Carter, Thomas B.; Jutro, Peter R.

1996-11-01

The project on Biodiversity Uncertainties and Research Needs (BURN) ensures the advancement of usable knowledge on biodiversity by obtaining input from decision makers on their priority information needs about biodiversity and then using this input to engage leading scientists in designing policy-relevant research. Decision makers articulated concerns related to four issues: significance of biodiversity; status and trends of biodiversity; management for biodiversity; and the linkage of social, cultural, economic, legal, and biological objectives. Leading natural and social scientists then identified the research required to address the decision makers' needs and determined the probability of success. The diverse group of experts reached consensus on several fundamental issues, helping to clarify the role of biodiversity in land and resource management. The BURN participants identified several features that should be incorporated into policy-relevant research plans and management strategies for biodiversity. Research and assessment efforts should be: multidisciplinary and integrative, participatory with stakeholder involvement, hierarchical (multiple scales), and problem- and region-specific. The activities should be focused regionally within a global perspective. Meta-analysis of existing data is needed on all fronts to assess the state of the science. More specifically, the scientists recommended six priority research areas that should be pursued to address the information needs articulated by decision makers: (1) characterization of biodiversity, (2) environmental valuation, (3) management for sustainability—for humans and the environment (adaptive management), (4) information management strategies, (5) governance and stewardship issues, and (6) communication and outreach. Broad recommendations were developed for each research area to provide direction for research planning and resource management strategies. The results will directly benefit those groups that require biodiversity research to address their needs—whether to develop policy, manage natural resources, or make other decisions affecting biodiversity.

Coal to methanol feasiblity study: Beluga methanol project. Volume 4: Environmental

NASA Astrophysics Data System (ADS)

1981-09-01

The major environmental issues relevant to development of a coal gasification and methanol fuels production facility and related coal mining activities and transportation systems in the west Cook Inlet area, Alaska were assessed. An extensive review into existing information on the Beluga region of west Cook Inlet was conducted and updated with the findings of land resource projects. Specific field activities then were initiated to expand the environmental data base in areas relevant to this project where there was a paucity of information. Based on these findings the project was reviewed in detail to identify significant environmental issues and to outline the state and federal permit requirements to ensure that these element are an integral component of all subsequent project planning and management decisions.

Martian Chronology: Goals for Investigations from a Recent Multidisciplinary Workshop

NASA Technical Reports Server (NTRS)

Nyquist, L.; Doran, P. T.; Cerling, T. E.; Clifford, S. M.; Forman, S. L.; Papanastassiou, D. A.; Stewart, B. W.; Sturchio, N. C.; Swindle, T. D.

2000-01-01

The absolute chronology of Martian rocks and events is based mainly on crater statistics and remains highly uncertain. Martian chronology will be critical to building a time scale comparable to Earth's to address questions about the early evolution of the planets and their ecosystems. In order to address issues and strategies specific to Martian chronology, a workshop was held, 4-7 June 2000, with invited participants from the planetary, geochronology, geochemistry, and astrobiology communities. The workshop focused on identifying: a) key scientific questions of Martian chronology; b) chronological techniques applicable to Mars; c) unique processes on Mars that could be exploited to obtain rates, fluxes, ages; and d) sampling issues for these techniques. This is an overview of the workshop findings and recommendations.

Gender differences affecting vocal health of women in vocally demanding careers

PubMed Central

Hunter, Eric J.; Smith, Marshall E.; Tanner, Kristine

2012-01-01

Studies suggest that occupational voice users have a greater incidence of vocal issues than the general population. Women have been found to experience vocal health problems more frequently than men, regardless of their occupation. Traditionally, it has been assumed that differences in the laryngeal system are the cause of this disproportion. Nevertheless, it is valuable to identify other potential gender distinctions which may make women more vulnerable to voice disorders. A search of the literature was conducted for gender-specific characteristics which might impact the vocal health of women. This search can be used by healthcare practitioners to help female patients avoid serious vocal health injuries, as well as to better treat women who already suffer from such vocal health issues. PMID:21722077

Footwear Experiences of People With Chronic Musculoskeletal Diseases.

PubMed

Hendry, Gordon J; Brenton-Rule, Angela; Barr, Georgina; Rome, Keith

2015-08-01

Foot pain and deformities are frequently reported by people with chronic musculoskeletal diseases, but only limited research has been conducted to explore the key issues concerning footwear difficulties in this population. The aim of this study is to explore, identify, and describe the main issues surrounding the footwear experiences of people with chronic musculoskeletal diseases. A qualitative manifest content analysis of open-ended survey responses concerning footwear experiences was conducted from a national footwear survey of people with chronic musculoskeletal diseases in New Zealand. Eighty-five respondents submitted usable responses. Specific statements in the text were identified as units of analysis prior to coding and organizing these units into emerging mutually exclusive categories. Content analysis was independently undertaken by 3 researchers, and the final categories and coding were achieved through consensus. Frequencies of assigned units of analysis were calculated in order to obtain a quantitative description for each category. Four categories encompassing a total of 9 subcategories related to the footwear experiences of respondents emerged from the qualitative data content analysis: difficulty finding appropriate footwear; dissatisfaction with therapeutic footwear provision and foot care access; high costs of footwear, foot care, and self-care; and satisfaction with therapeutic footwear and foot care. Key categories describing the important issues surrounding the footwear experiences of respondents with chronic musculoskeletal diseases were identified, which may provide important targets for improving footwear and foot care services and self-management strategies. © 2015, American College of Rheumatology.

Gender differences in quality of life among long-term colorectal cancer survivors with ostomies.

PubMed

Grant, Marcia; McMullen, Carmit K; Altschuler, Andrea; Mohler, M Jane; Hornbrook, Mark C; Herrinton, Lisa J; Wendel, Christopher S; Baldwin, Carol M; Krouse, Robert S

2011-09-01

To describe how gender shapes the concerns and adaptations of long-term (i.e., more than five years) colorectal cancer survivors with ostomies. Qualitative study using content analysis of focus group content. Oregon, southwestern Washington, and northern California. Four female and four male focus groups (N = 33) selected from 282 quantitative survey participants with health-related quality-of-life (HRQOL) scores in the highest or lowest quartile. Eight focus groups discussed the challenges of living with an ostomy. Content was recorded, transcribed, and analyzed using directive and summative content analysis. HRQOL domains of physical, psychological, social, and spiritual well-being. All groups reported avoiding foods that cause gas or rapid transit and discussed how limiting the amount of food eaten controlled the output. All groups discussed physical activities, getting support from friends and family, and the importance of being resilient. Both genders identified challenges with sexuality and intimacy. Coping and adjustment difficulties mostly were discussed by women, with men only discussing these issues to a small extent. Difficulties with sleep primarily were identified by women with low HRQOL. Problems with body image and depression were discussed only by women with low HRQOL. Common issues included diet management, physical activity, social support, and sexuality. Although both genders identified challenges, women described more specific psychological and social issues than men. Application of these gender-based differences can inform educational interventions for colorectal cancer survivors with ostomies.

Behavioral health services utilization among older adults identified within a state abuse hotline database.

PubMed

Schonfeld, Lawrence; Larsen, Rebecca G; Stiles, Paul G

2006-04-01

This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost 6 times greater at approximately twice the cost compared to other service users. The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect.

Issues and Concerns Faced by Undergraduate Language Student Teachers during Teaching Practicum Experiences

ERIC Educational Resources Information Center

Ali, Mohd Sofi; Othman, Abdul Jalil; Karim, Abdul Faruk Abdul

2014-01-01

This study examined specific issues and concerns faced by Bachelor of Education student teachers majoring in Language and Literature during their 12-week teaching practicum experience. Specifically, three main areas of concerns were examined. They were: (1) specific issues and concerns related to the implementation of teaching practicum faced by…

Security Vulnerability Profiles of Mission Critical Software: Empirical Analysis of Security Related Bug Reports

NASA Technical Reports Server (NTRS)

Goseva-Popstojanova, Katerina; Tyo, Jacob

2017-01-01

While some prior research work exists on characteristics of software faults (i.e., bugs) and failures, very little work has been published on analysis of software applications vulnerabilities. This paper aims to contribute towards filling that gap by presenting an empirical investigation of application vulnerabilities. The results are based on data extracted from issue tracking systems of two NASA missions. These data were organized in three datasets: Ground mission IVV issues, Flight mission IVV issues, and Flight mission Developers issues. In each dataset, we identified security related software bugs and classified them in specific vulnerability classes. Then, we created the security vulnerability profiles, i.e., determined where and when the security vulnerabilities were introduced and what were the dominating vulnerabilities classes. Our main findings include: (1) In IVV issues datasets the majority of vulnerabilities were code related and were introduced in the Implementation phase. (2) For all datasets, around 90 of the vulnerabilities were located in two to four subsystems. (3) Out of 21 primary classes, five dominated: Exception Management, Memory Access, Other, Risky Values, and Unused Entities. Together, they contributed from 80 to 90 of vulnerabilities in each dataset.

Effect of safety issues with HIV drugs on the approval process of other drugs in the same class: an analysis of European Public Assessment Reports.

PubMed

Arnardottir, Arna H; Haaijer-Ruskamp, Flora M; Straus, Sabine M J; de Graeff, Pieter A; Mol, Peter G M

2011-11-01

Knowledge on the safety of new medicines is limited at the time of market entry. Nearly half of all drugs used to treat HIV registered in the EU required ≥1 Direct Healthcare Professional Communication (DHPC) in the past 10 years for safety issues identified post-approval. The aim was to evaluate the extent to which regulators and industry have addressed the risk of safety issues for HIV drugs based on prior experience with other drugs in the same class and whether doing so impacts development time of these drugs. HIV drugs receiving ≥1 DHPC in the Netherlands between January 1999 and December 2008 were identified. Each drug with a DHPC ('index' drug) was paired with subsequently approved HIV drug(s) in the same class (Anatomical Therapeutic Chemical [ATC] 4th level) ['follow-on' drugs]. Characteristics of safety issues were extracted from the DHPCs of the 'index' drugs. European Public Assessment Reports (EPARs) were reviewed regarding whether the safety issues had been considered during development and approval. Consideration of previously identified safety issues in 'follow-on' drug applications was assessed regarding attention paid to adverse drug reaction (ADR) symptoms in pre-marketing studies, Summary of Product Characteristics (SmPC) and postmarketing commitments, and whether size of the safety population was in accordance with Regulatory guidelines. 'Index' drugs were also paired with drugs in the same class already on the market ('older' drugs). For 'older' drugs, we identified whether the safety issue led to appropriate changes in the current SmPC (January 2011) compared with the SmPC at the time of marketing authorization. Clinical development time was assessed using time from first patent application to market authorization as proxy, and comparison was made between 'index' and 'follow-on' drugs. For 9 (43%) of the 21 centrally authorized HIV drugs, 11 serious safety issues that required a DHPC were identified. Two drugs were excluded from our analysis (DHPCs related to contamination/medication error). Six 'index' drugs were paired, each with one to six 'follow-on' drugs. Three concerned drug-drug interactions (DDIs); the other three were intracranial haemorrhage, neuromuscular weakness and severe skin/hepatic reactions. All but one 'follow-on' drug had information in the EPAR on that specific ADR (i.e. attention was paid to the ADR). The DDIs were addressed in pre-marketing studies and/or the SmPC. Two of the other ADRs were addressed by postmarketing surveillance commitments; intracranial haemorrhage was not addressed. Three safety issues for two 'index' drugs could not be paired with a 'follow-on' drug as no drug in the same class was approved after the corresponding DHPCs were issued. Five of the nine safety issues were added to at least one of the current SmPCs for the 'older' drugs already on the market at the time of DHPC issue. Two safety issues were already in the SmPC of the 'older' drugs at time of market approval and two were not introduced into the SmPC of 'older' drugs. Population size to assess short-term safety complied with the guidelines for four 'index', seven 'follow-on' and three 'older' drugs; population size to assess long-term safety complied for one, three and two drugs, respectively. For five drugs, EPARs did not provide adequate information on population size. No statistically significant difference in development time between 'index' and 'follow-on' drugs was found. Generally, safety issues were taken into account in the approval process of other drugs in the class. The approaches were different and determined by the nature of the ADR. Taking safety issues into account in the approval process did not seem to impact on the time taken to perform the pre-approval clinical programme.

New and incremental FDA black box warnings from 2008 to 2015.

PubMed

Solotke, Michael T; Dhruva, Sanket S; Downing, Nicholas S; Shah, Nilay D; Ross, Joseph S

2018-02-01

The boxed warning (also known as 'black box warning [BBW]') is one of the strongest drug safety actions that the U.S. Food & Drug Administration (FDA) can implement, and often warns of serious risks. The objective of this study was to comprehensively characterize BBWs issued for drugs after FDA approval. We identified all post-marketing BBWs from January 2008 through June 2015 listed on FDA's MedWatch and Drug Safety Communications websites. We used each drug's prescribing information to classify its BBW as new, major update to a preexisting BBW, or minor update. We then characterized these BBWs with respect to pre-specified BBW-specific and drug-specific features. There were 111 BBWs issued to drugs on the US market, of which 29% (n = 32) were new BBWs, 32% (n = 35) were major updates, and 40% (n = 44) were minor updates. New BBWs and major updates were most commonly issued for death (51%) and cardiovascular risk (27%). The new BBWs and major updates impacted 200 drug formulations over the study period, of which 64% were expected to be used chronically and 58% had available alternatives without a BBW. New BBWs and incremental updates to existing BBWs are frequently added to drug labels after regulatory approval.

Mental Health Care for LGBT Older Adults in Long-Term Care Settings: Competency, Training, and Barriers for Mental Health Providers.

PubMed

Smith, Ronald W; Altman, Jennifer K; Meeks, Suzanne; Hinrichs, Kate Lm

2018-06-07

To assess mental health providers' experience with LGBT older adults in long-term care (LTC) settings and perceived barriers to quality care. Providers (N = 57) completed an online survey on demographics and practice characteristics. They were also asked about: number of LGBT residents they've worked with, relevance of LGBT issues to their practice, preparedness, willingness to learn, hours of formal/informal training, and barriers to providing care to LGBT patients. Respondents were 63% psychologists, 16% social workers, 14% psychiatrists, and 5% nurses, most of whom practiced in LTC consulting roles. Most providers felt working with LGBT issues was relevant to their practice and felt well-prepared and willing to learn, though they were unaware of evidence based practices (EBTs), especially for LTC settings. They had little coursework on LGBT issues, and identified lack of training, stigma, and residents concealing their identity as the greatest barriers to quality care. Mental health providers in LTC facilities would benefit from more training in LGBT-specific mental health problems and evidence-based treatments, and efforts to destigmatize LGBT identities in these settings might improve access to mental health care. LGBT-specific training and EBTs are needed. Facilities need to address stigma with residents and providers.

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

PubMed

Jenkins, Constance L; Elliott, Aaron R; Harris, Janet R

2006-08-01

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

Principles of Development of Model Health Care Programmes. Report on a WHO Meeting. (Turku, Finland, May 3-6, 1982). EURO Reports and Studies 96.

ERIC Educational Resources Information Center

World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

A report is given of the work of a group convened by the World Health Organization (WHO) to address the issues related to the development of Model Health Care Programs (MHCPs), and to apply the principles thus identified to the case of a specific health problem--low back pain. A discussion of the principles of the development of MHCPs includes…

Modeling Open Architecture and Evolutionary Acquisition: Implementation Lessons from the ARCI Program for the Rapid Capability Insertion Process

DTIC Science & Technology

2009-04-22

Implementation Issues Another RCIP implementation risk is program management burnout . The ACRI program manager specifically identified the potential...of burnout in his program management team due to the repeated, intense Integration phases. To investigate the possibility and severity of this risk to...the ACRI simulation. This suggests that the burnout risk will be larger for RCIP than it was for ACRI. Successfully implementing a sustainable RCIP

A conceptual design study for the secondary mirror drive of the shuttle infrared telescope facility (SIRTF)

NASA Technical Reports Server (NTRS)

Sager, R. E.; Cox, D. W.

1983-01-01

Various conceptual designs for the secondary mirror actuator system to be used in the Shuttle Infrared Telescope Facility (SIRTF) were evaluated. In addition, a set of design concepts was developed to assist in the solution of problems crucial for optimum performance of the secondary mirror actuator system. A specific conceptual approach was presented along with a plan for developing that approach and identifying issues of critical importance in the developmental effort.

Uranus and Neptune

NASA Technical Reports Server (NTRS)

Bergstralh, J. T. (Editor)

1984-01-01

A scientific framework within which to plan the Voyager encounters with Uranus and Neptune was sought. Specific objectives were: (1) to assess the current state of knowledge of Uranus and Neptune, their magnetospheres, and their respective systems of satellites and rings (if any), (2) to identify important scientific issues that can be addressed effectively by Voyager, and (3) to provide an opportunity for Voyager investigators to interact with other scientists knowledgeable in the field of physical studies of the Uranian and Neptunian systems.

Experimental investigation of orbitally shaken bioreactor hydrodynamics

NASA Astrophysics Data System (ADS)

Reclari, Martino; Dreyer, Matthieu; Farhat, Mohamed

2010-11-01

The growing interest in the use of orbitally shaken bioreactors for mammalian cells cultivation raises challenging hydrodynamic issues. Optimizations of mixing and oxygenation, as well as similarity relations between different culture scales are still lacking. In the present study, we investigated the relation between the shape of the free surface, the mixing process and the velocity fields, using specific image processing of high speed visualization and Laser Doppler velocimetry. Moreover, similarity parameters were identified for scale-up purposes.

Identifying Topics in Microblogs Using Wikipedia.

PubMed

Yıldırım, Ahmet; Üsküdarlı, Suzan; Özgür, Arzucan

2016-01-01

Twitter is an extremely high volume platform for user generated contributions regarding any topic. The wealth of content created at real-time in massive quantities calls for automated approaches to identify the topics of the contributions. Such topics can be utilized in numerous ways, such as public opinion mining, marketing, entertainment, and disaster management. Towards this end, approaches to relate single or partial posts to knowledge base items have been proposed. However, in microblogging systems like Twitter, topics emerge from the culmination of a large number of contributions. Therefore, identifying topics based on collections of posts, where individual posts contribute to some aspect of the greater topic is necessary. Models, such as Latent Dirichlet Allocation (LDA), propose algorithms for relating collections of posts to sets of keywords that represent underlying topics. In these approaches, figuring out what the specific topic(s) the keyword sets represent remains as a separate task. Another issue in topic detection is the scope, which is often limited to specific domain, such as health. This work proposes an approach for identifying domain-independent specific topics related to sets of posts. In this approach, individual posts are processed and then aggregated to identify key tokens, which are then mapped to specific topics. Wikipedia article titles are selected to represent topics, since they are up to date, user-generated, sophisticated articles that span topics of human interest. This paper describes the proposed approach, a prototype implementation, and a case study based on data gathered during the heavily contributed periods corresponding to the four US election debates in 2012. The manually evaluated results (0.96 precision) and other observations from the study are discussed in detail.

Identifying Topics in Microblogs Using Wikipedia

PubMed Central

Yıldırım, Ahmet; Üsküdarlı, Suzan; Özgür, Arzucan

2016-01-01

Twitter is an extremely high volume platform for user generated contributions regarding any topic. The wealth of content created at real-time in massive quantities calls for automated approaches to identify the topics of the contributions. Such topics can be utilized in numerous ways, such as public opinion mining, marketing, entertainment, and disaster management. Towards this end, approaches to relate single or partial posts to knowledge base items have been proposed. However, in microblogging systems like Twitter, topics emerge from the culmination of a large number of contributions. Therefore, identifying topics based on collections of posts, where individual posts contribute to some aspect of the greater topic is necessary. Models, such as Latent Dirichlet Allocation (LDA), propose algorithms for relating collections of posts to sets of keywords that represent underlying topics. In these approaches, figuring out what the specific topic(s) the keyword sets represent remains as a separate task. Another issue in topic detection is the scope, which is often limited to specific domain, such as health. This work proposes an approach for identifying domain-independent specific topics related to sets of posts. In this approach, individual posts are processed and then aggregated to identify key tokens, which are then mapped to specific topics. Wikipedia article titles are selected to represent topics, since they are up to date, user-generated, sophisticated articles that span topics of human interest. This paper describes the proposed approach, a prototype implementation, and a case study based on data gathered during the heavily contributed periods corresponding to the four US election debates in 2012. The manually evaluated results (0.96 precision) and other observations from the study are discussed in detail. PMID:26991442

NASA Composite Materials Development: Lessons Learned and Future Challenges

NASA Technical Reports Server (NTRS)

Tenney, Darrel R.; Davis, John G., Jr.; Pipes, R. Byron; Johnston, Norman

2009-01-01

Composite materials have emerged as the materials of choice for increasing the performance and reducing the weight and cost of military, general aviation, and transport aircraft and space launch vehicles. Major advancements have been made in the ability to design, fabricate, and analyze large complex aerospace structures. The recent efforts by Boeing and Airbus to incorporate composite into primary load carrying structures of large commercial transports and to certify the airworthiness of these structures is evidence of the significant advancements made in understanding and use of these materials in real world aircraft. NASA has been engaged in research on composites since the late 1960 s and has worked to address many development issues with these materials in an effort to ensure safety, improve performance, and improve affordability of air travel for the public good. This research has ranged from synthesis of advanced resin chemistries to development of mathematical analyses tools to reliably predict the response of built-up structures under combined load conditions. The lessons learned from this research are highlighted with specific examples to illustrate the problems encountered and solutions to these problems. Examples include specific technologies related to environmental effects, processing science, fabrication technologies, nondestructive inspection, damage tolerance, micromechanics, structural mechanics, and residual life prediction. The current state of the technology is reviewed and key issues requiring additional research identified. Also, grand challenges to be solved for expanded use of composites in aero structures are identified.

The information needs of patients receiving procedural sedation in a hospital emergency department.

PubMed

Revell, Sue; Searle, Judy; Thompson, Shona

2017-07-01

This research investigated the information needs of patients receiving ED procedural sedation to determine the best format to consistently deliver key information in a way acceptable to all involved. Of particular interest was the question concerning patients' need for receiving written information. A descriptive exploratory study gathered qualitative data through face-to-face interviews and focus groups involving patients, nurses and medical staff. Individual interviews were conducted with eight adult patients following procedural sedation. They identified very few gaps in terms of specific information they needed pertaining to procedural sedation and rejected the need for receiving information in a written format. Their information needs related to a central concern for safety and trust. Focus groups, reflecting on the findings from patients, were conducted with five ED nurses and four emergency medicine consultants/registrars who regularly provided procedural sedation. Themes that emerged from the analysis of data from all three groups identified the issues concerning patient information needs as being: competence and efficiency of staff; explanations of procedures and progress; support person presence; and medico-legal issues. The research confirms that the quality of the patient's ED experience, specifically related to procedural sedation, is enhanced by ED staff, especially nurses, providing them with ongoing and repeated verbal information relevant to their circumstances. Copyright © 2017 Elsevier Ltd. All rights reserved.

Factors driving physician-hospital alignment in orthopaedic surgery.

PubMed

Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

2013-06-01

The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

Working with culture: culturally appropriate mental health care for Asian Americans.

PubMed

Park, Mijung; Chesla, Catherine A; Rehm, Roberta S; Chun, Kevin M

2011-11-01

The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans. As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines. Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007. Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided. Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice. © 2011 Blackwell Publishing Ltd.

Reflections on Ethics and Humanity in Pediatric Neurology: the Value of Recognizing Ethical Issues in Common Clinical Practice.

PubMed

Ronen, Gabriel M; Rosenbaum, Peter L

2017-05-01

Our goals in this reflection are to (i) identify the ethical dimensions inherent in any clinical encounter and (ii) bring to the forefront of our pediatric neurology practice the myriad of opportunities to explore and learn from these ethical questions. We highlight specifically Beauchamp and Childress's principles of biomedical ethics. We use the terms ethics in common clinical practice and an ethical lens to remind people of the ubiquity of ethical situations and the usefulness of using existing ethical principles to analyze and resolve difficult situations in clinical practice. We start with a few common situations with which many of us tend to struggle. We describe what we understand as ethics and how and why developments in technology, novel potential interventions, policies, and societal perspectives challenge us to think about and debate ethical issues. Individual patients are not a singular population; each patient has their own unique life situations, culture, goals, and expectations that need to be considered with a good dose of humanity and humility. We believe that using an ethical lens-by which we mean making an explicit effort to identify and consider these issues openly-will help us to achieve this goal in practice, education, and research.

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

Berman, M.; Boyack, K.; VanDevender, J.P.

Prosperity Games are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games are unique in that both the game format and the player contributions vary from game to game. This report documents the Environmental Prosperity Game conducted under the sponsorship of the Silicon Valley Environmental Partnership. Playersmore » were drawn from all stakeholders involved in environmental technologies including small and large companies, government, national laboratories, universities, environmentalists, the legal profession, finance, and the media. The primary objectives of this game were to: investigate strategies for developing a multi-agency (national/state/regional), one-step regulatory approval process for certifying and implementing environmental technologies and evaluating the simulated results; identify the regulatory hurdles and requirements, and the best approaches for surmounting them; identify technical problems and potential resources (environmental consultants, labs, universities) for solving them. The deliberations and recommendations of these players provided valuable insights as to the views of this diverse group of decision makers concerning environmental issues, including the development, licensing, and commercialization of new technologies.« less

ShopTalk: a pilot study of the feasibility and utility of a therapeutic board game for youth living with cancer

PubMed Central

Wiener, Lori; Battles, Haven; Mamalian, Cynthia; Zadeh, Sima

2016-01-01

Purpose ShopTalk is a therapeutic game, created to help youth living with cancer talk about their illness in a non-threatening way. The aim of this study is to learn how the game is being used in clinical settings and to gather information regarding the usefulness of ShopTalk in establishing a therapeutic relationship and in assessing key psychosocial issues in the child’s life. Methods ShopTalk was distributed at a social work pediatric oncology conference and to 70 sites. Game holders were asked to complete a survey regarding their clinical experience using ShopTalk. Results Responses came from 110 professionals. ShopTalk has been found to be as an effective tool in identifying coping skills and psychological adjustment, as well as issues related to family relationships, depression/sadness, stress, prognosis, peer relationships, and self-esteem. Respondents found ShopTalk useful from diagnosis to end of life. Qualitative feedback suggested therapeutic value along with discomfort with specific questions. Conclusion ShopTalk appears to be a beneficial therapeutic tool in building rapport and identifying and discussing difficult issues with medically ill children. Areas for future versions of the game and research exploring patient/therapist outcomes are discussed PMID:21451945

Editorial Perspective: Pathological social withdrawal during in adolescence: a culture-specific or a global phenomenon?

PubMed

Li, Tim M H; Wong, Paul W C

2015-10-01

Impairing patterns of long-term adolescent social withdrawal and self-exclusion, including nonattendance at school or work, and minimal social contact, have been identified as a significant clinical and social problem in Japan since the late 1990s, where it is termed hikikomori. As well clinical impairment for the withdrawn youths and burden for the families, hikikomori has brought societal and health service costs in Japan. Since its first identification, similar cases have been reported in other countries. Socially withdrawn youths, unfortunately, are difficult to identify and their risks can be 'invisible' because of their withdrawn nature and the traditional perspective of what is perceived as at-risk youth. Understanding of the issue including its causes, risks, and outcomes is very limited. In this editorial perspective, we highlight how youth social withdrawal is becoming a clinical and social concern in some parts of the world and respond to the lack of research on this issue by synthesizing some of the basic research findings, and suggesting future directions for research and practice relating to this emerging youth phenomenon in middle-and-high-income countries in the hope of bringing more attention to this issue. © 2015 Association for Child and Adolescent Mental Health.

Teachable Moments Matter for: An analysis of the use of Pharmacy Curriculum Outcomes Assessment (PCOA) scores within one professional program.

PubMed

Peeters, Michael J; Garavalia, Linda S

Editors Note: The Teachable Moments Matter category of articles is designed to offer readers insight into a methodological issue identified within a companion article. Written in collaboration with one of these authors, these articles provide an opportunity to focus on a challenge experienced by the authors and, in the process, provide one or more perspectives as to how to successfully navigate this issue. Notably, this "issue" is not necessarily a problem (as this first paper in this series demonstrates). The Journal hopes this case-based approach will help highlight an issue nuance in context, something that might get "lost" in the entirety of a full-length article. This article discusses the importance of communicating a conceptual framework (i.e., theory) as a basis for scholarly articles. A specific example in the companion article is use of validity theory. In our community of researchers, we need to better communicate a conceptual framework as a basis to allow others to build on and grow our knowledge in pharmacy education. Copyright © 2017 Elsevier Inc. All rights reserved.

Report of the APS Ad-Hoc Committee on LGBT Issues - Presentation of Findings and Recommendations

NASA Astrophysics Data System (ADS)

Falk, Michael

In 2014 the Executive Officer of the American Physical Society (APS), Kate Kirby, created an Ad-Hoc Committee on LGBT Issues (C-LGBT) charged with reporting on the obstacles to inclusion of LGBT physicists, a term which for the purpose of this report refers to persons who self-identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, or asexual, as well as other sexual and gender minorities. The full charge was as follows: ``The committee will advise the APS on the current status of LGBT issues in physics, provide recommendations for greater inclusion, and engage physicists in laying the foundation for a more inclusive physics community. ?More specifically, the committee will investigate LGBT representation in physics, assess the educational and professional climate in physics, recommend changes in policies and practices that impact LGBT physicists, and address other issues that affect inclusion.'' We will present the findings and recommendations of the C-LGBT final report, and a panel discussion will be held following the presentation to discuss the future of APS efforts toward LGBT inclusion in physics.

Report of the APS Ad-Hoc Committee on LGBT Issues - Presentation of Findings and Recommendations

NASA Astrophysics Data System (ADS)

Long, Elena

2016-03-01

In 2014 the Executive Officer of the American Physical Society (APS), Kate Kirby, created an Ad-Hoc Committee on LGBT Issues (C-LGBT) charged with reporting on the obstacles to inclusion of LGBT physicists, a term which for the purpose of this report refers to persons who self-identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, or asexual, as well as other sexual and gender minorities. The full charge was as follows: ``The committee will advise the APS on the current status of LGBT issues in physics, provide recommendations for greater inclusion, and engage physicists in laying the foundation for a more inclusive physics community? More specifically, the committee will investigate LGBT representation in physics, assess the educational and professional climate in physics, recommend changes in policies and practices that impact LGBT physicists, and address other issues that affect inclusion.'' We will present the findings and recommendations of the C-LGBT final report, and a panel discussion will be held following the presentation to discuss the future of APS efforts toward LGBT inclusion in physics.

Dryland ecohydrology and climate change: critical issues and technical advances

NASA Astrophysics Data System (ADS)

Wang, L.; D'Odorico, P.; Evans, J. P.; Eldridge, D.; McCabe, M. F.; Caylor, K. K.; King, E. G.

2012-04-01

Drylands cover about 40% of the terrestrial land surface and account for approximately 40% of global net primary productivity. Water is fundamental to the biophysical processes that sustain ecosystem function and food production, particularly in drylands, where a tight coupling exists between water resource availability and ecosystem productivity, surface energy balance, and biogeochemical cycles. Currently, drylands support at least 2 billion people and comprise both natural and managed ecosystems. In this synthesis, we identify some current critical issues in the understanding of dryland systems and discuss how arid and semiarid environments are responding to the changes in climate and land use. Specifically, we focus on dryland agriculture and food security, dryland population growth, desertification, shrub encroachment and dryland development issues as factors of change requiring increased understanding and management. We also review recent technical advances in the quantitative assessment of human versus climate change related drivers of desertification, evapotranspiration partitioning using field deployable stable water isotope systems and the remote sensing of key ecohydrological processes. These technological advances provide new tools that assist in addressing major critical issues in dryland ecohydrology under climate change

Human-animal chimera: a neuro driven discussion? Comparison of three leading European research countries.

PubMed

Cabrera Trujillo, Laura Yenisa; Engel-Glatter, Sabrina

2015-06-01

Research with human-animal chimera raises a number of ethical concerns, especially when neural stem cells are transplanted into the brains of non-human primates (NHPs). Besides animal welfare concerns and ethical issues associated with the use of embryonic stem cells, the research is also regarded as controversial from the standpoint of NHPs developing cognitive or behavioural capabilities that are regarded as "unique" to humans. However, scientists are urging to test new therapeutic approaches for neurological diseases in primate models as they better mimic human physiology than all current animal models. As a response, various countries have issued reports on the topic. Our paper summarizes the ethical issues raised by research with human-animal brain chimeras and compares the relevant regulatory instruments and different recommendations issued in national reports from three important European research nations: Germany, Switzerland and the United Kingdom. We assess and discuss the focus and priorities set by the different reports, review various reasons for and perspectives on the importance of the brain in chimera research, and identify critical points in the reports that warrant further specification and debate.

76 FR 35619 - Labeling and Effectiveness Testing; Sunscreen Drug Products for Over-the-Counter Human Use

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

...The Food and Drug Administration (FDA) is issuing this document to address labeling and effectiveness testing for certain over-the counter (OTC) sunscreen products containing specified active ingredients and marketed without approved applications. This document addresses labeling and effectiveness testing issues raised by the nearly 2,900 submissions that we received in response to the sunscreen proposed rule of August 27, 2007 (2007 proposed rule). The document also identifies specific claims that render a product that is subject to this rule misbranded or would not be allowed on any OTC sunscreen product marketed without an approved application. The document does not address issues related to sunscreen active ingredients or certain other issues regarding the GRASE determination for sunscreen products. The document requires OTC sunscreen products to comply with the content and format requirements for OTC drug labeling contained in the 1999 Drug Facts final rule (published in the Federal Register of March 17, 1999, by lifting the delay of implementation date for that rule that we published on September 3, 2004).

[Psychosocial and developmental outcomes of TYAs with cancer: Are there any specific characteristics for the young adults?

PubMed

Leprince, Tanguy; Sauveplane, Dominique; Ricadat, Elise; Seigneur, Étienne; Marioni, Gabrielle

2016-12-01

During the last few years, specific support devices and even dedicated units for teenagers and young adults (TYAs - patients grouped in the 15-25 years age group) appeared in oncology. If the existing literature review allows identifying many written work related to the experience of cancer during adolescence, resources about "young adults" are not only far less abundant, but rarely give the definition of what is a "young adult". Based on this observation, it appears necessary, at this stage of our practice, to question the definition and psychosocial outcomes of those psychiatrists and psychologists also call "young adults". Are they so different compared to teenagers? Do they have their own specificities? Based on the analysis of the general literature, we will seek to define the highlights of this moment of life and to identify their specific psychosocial and developmental outcomes. Thus, we will be able to study more accurately the experience of young adults facing cancer and the associated psychological side effects. Based on this analysis, we will present the issues which seemed to be specific in the psychological support of young adults and their relatives. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

A Ten Year Retrospective on Environmental Justice: What Have We Learned?

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

Scott, Michael J.; Jaksch, John A.; Cort, Katherine A.

2005-03-01

Beginning in 1994, Executive Order 12898 has directed federal executive agencies to identify and address, as appropriate, disproportionately high and adverse health or environmental effects of their programs, policies, and activities on minority and low income populations. The policy behind the Executive Order was to prevent minority and low income groups from bearing disproportionate adverse environmental consequences of federal actions. During the last ten years, federal agencies have implemented Executive Order 12898, and some also have developed explicit procedures or guidance for the steps that need to be taken during the preparation of environmental impact statements. Based on the authors’more » experience, the paper examines how environmental justice practice has evolved in the ten years since the original Executive Order was issued. This evolution has been both procedural and substantive. The paper examines how the actual practice of environmental justice analysis has progressed in federal agencies that deal with waste management issues. Reference is made to changes in case law and agency practice. The 2000 Census of Population and the ongoing development of geographic information systems in particular have made it easier to identify minority and low-income populations at risk. At the same time, a number of stakeholder groups have taken positions over specific federal actions that have given rise to novel issues and challenges for analysts. The paper discusses how NEPA practice is evolving to deal with these issues and challenges.« less

How can we not 'lose it' if we still don't understand how to 'use it'? Unanswered questions about the influence of activity participation on cognitive performance in older age--a mini-review.

PubMed

Bielak, Allison A M

2010-01-01

The 'use it or lose it' hypothesis of cognitive aging predicts that engagement in intellectual, social, and physical activities offers protective benefits from age-related cognitive decline and lowers dementia risk. Although this hypothesis has not yet been supported conclusively, there is some empirical evidence in favor of the proposal. However, a number of questions surrounding the relationship between activity participation and cognitive ability in older adulthood are not yet well answered. This mini-review identifies seven key methodological and theoretical issues that are critical to our understanding and eventual possible promotion of activity participation as a way to maintain cognitive well-being. These include the mechanisms involved, the optimal ways of assessing activity engagement, which cognitive domains receive the most benefit from activity engagement, the temporal nature and the directionality of the relationship, the influence of demographic variables such as age, gender, or education, and whether one activity domain offers the most benefit to cognition. The current knowledge on each of these issues is critically evaluated, including describing what we already know about the issue, and identifying potential difficulties and opportunities that may exist in finding an answer. More studies need to take on the challenge of specifically targeting these issues, as each is essential to moving the field forward. Copyright (c) 2009 S. Karger AG, Basel.

78 FR 2397 - Agency Information Collection Activities: Announcement of Board Approval Under Delegated...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

...--Division of Research and Statistics, Board of Governors of the Federal Reserve System, Washington, DC 20551... Report of Specific Issues (FR 2004SI), Daily Report of Specific Issues (FR 2004SD), Supplement to the Daily Report of Specific Issues (FR 2004SD ad hoc), and Daily Report of Dealer Activity in Treasury...

Ethical issues experienced by healthcare workers in nursing homes: Literature review.

PubMed

Preshaw, Deborah Hl; Brazil, Kevin; McLaughlin, Dorry; Frolic, Andrea

2016-08-01

Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress. The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs' experiences of ethical issues. Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home. The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work. The review highlighted a need for improved ethics education for care-providers. © The Author(s) 2015.

Central station market development strategies for photovoltaics

NASA Technical Reports Server (NTRS)

1980-01-01

Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

Central station market development strategies for photovoltaics

NASA Astrophysics Data System (ADS)

1980-11-01

Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

The acceptability of conducting data linkage research without obtaining consent: lay people's views and justifications.

PubMed

Xafis, Vicki

2015-11-17

A key ethical issue arising in data linkage research relates to consent requirements. Patients' consent preferences in the context of health research have been explored but their consent preferences regarding data linkage specifically have been under-explored. In addition, the views on data linkage are often those of patient groups. As a result, little is known about lay people's views and their preferences about consent requirements in the context of data linkage. This study explores lay people's views and justifications regarding the acceptability of conducting data linkage research without obtaining consent. A qualitative study explored lay people's views regarding consent requirements in data linkage via four hypothetical data linkage scenarios of increasing complexity. Prior to considering the scenarios, participants were provided with information regarding best practice data linkage processes via discussion and a diagrammatic representation of the process. Lay people were able to understand the intricate processes involved in data linkage and the key protections afforded within a short amount of time. They were supportive of data linkage research and, on the whole, believed it should be conducted without consent provided a data linkage organization de-identifies the data used so that researchers do not handle identifiable data. Many thought that de-identified data holds a different status to identifiable data and should be used without specific consent in research that aims to benefit society. In weighing up conflicting values and interests, participants shifted consent preferences before arriving at their final consent preference for each scenario and provided justifications for their choices. They considered the protection of people's information, societal benefits, and the nature and constraints of research and recognized that these need to be balanced. With some exposure to the features of data linkage, lay people have the capacity to understand the processes sufficiently in order to consider ethical issues associated with consent preferences. Shifts in views reveal the complexity of such decisions. While privacy protection remained an important consideration for most participants, adequate protection measures adopted in best practice data linkage were viewed by most as protection enough for data linkage to proceed without specific individual consent.

Effective Connectivity Modeling for fMRI: Six Issues and Possible Solutions Using Linear Dynamic Systems

PubMed Central

Smith, Jason F.; Pillai, Ajay; Chen, Kewei; Horwitz, Barry

2012-01-01

Analysis of directionally specific or causal interactions between regions in functional magnetic resonance imaging (fMRI) data has proliferated. Here we identify six issues with existing effective connectivity methods that need to be addressed. The issues are discussed within the framework of linear dynamic systems for fMRI (LDSf). The first concerns the use of deterministic models to identify inter-regional effective connectivity. We show that deterministic dynamics are incapable of identifying the trial-to-trial variability typically investigated as the marker of connectivity while stochastic models can capture this variability. The second concerns the simplistic (constant) connectivity modeled by most methods. Connectivity parameters of the LDSf model can vary at the same timescale as the input data. Further, extending LDSf to mixtures of multiple models provides more robust connectivity variation. The third concerns the correct identification of the network itself including the number and anatomical origin of the network nodes. Augmentation of the LDSf state space can identify additional nodes of a network. The fourth concerns the locus of the signal used as a “node” in a network. A novel extension LDSf incorporating sparse canonical correlations can select most relevant voxels from an anatomically defined region based on connectivity. The fifth concerns connection interpretation. Individual parameter differences have received most attention. We present alternative network descriptors of connectivity changes which consider the whole network. The sixth concerns the temporal resolution of fMRI data relative to the timescale of the inter-regional interactions in the brain. LDSf includes an “instantaneous” connection term to capture connectivity occurring at timescales faster than the data resolution. The LDS framework can also be extended to statistically combine fMRI and EEG data. The LDSf framework is a promising foundation for effective connectivity analysis. PMID:22279430

Common Filing Deficiencies in Abbreviated New Drug Applications Containing Clinical Endpoint Studies.

PubMed

Fermaglich, Lewis J; Chen, Ru; Kim, Carol Y; Chuh, Eunjung Esther; Thomas, Teena; Shetty, Daiva; Lee, Julia; Young, Johnny; Fan, Ying

2018-01-01

The objective of this report is to summarize common deficiencies identified in the filing reviews of abbreviated new drug applications (ANDAs) with clinical endpoint bioequivalence studies and skin irritation, sensitization, and adhesion (I/S/A) studies received by the US Food and Drug Administration (FDA) between 2007 and 2017, to help applicants avoid common deficiencies, minimize "refuse-to-receive" (RTR) actions, "information requests," and ANDA approval delays. Multiple internal FDA databases were searched to evaluate and summarize common deficiencies identified in ANDA submissions containing clinical endpoint studies and skin I/S/A studies that required review by the Division of Clinical Review. A total of 275 ANDA submissions with filing reviews from January 2007 to June 2017 were analyzed in this report. Two hundred eighteen (79.3%) filing reviews contained one or more deficiencies. Seventy-nine (28.7%) ANDAs were issued RTR letters because of major clinical deficiencies, specifically bioequivalence and clinical deficiencies, accounting for 9% of overall identified deficiencies. Twenty-two other categories of deficiencies are summarized into 4 main categories: missing information related to the clinical studies other than data sets (38%), missing data sets (35%), formulation issues (12%), and organization/format issues (6%). The most common deficiency in the "missing information related to the clinical studies other than data sets" category was "missing clarification of information" (22%). We also noted that the Division of Filing Review has identified these same types of deficiencies since assuming responsibility of the filing assessment for ANDAs with clinical endpoint BE studies and skin I/S/A studies. In conclusion, to minimize "refuse-to-receive" actions, "information requests," and approval of ANDA delays for generic drug products, applicants should submit full clinical study reports, including all data sets for drug products recommending clinical studies.

Space Station Freedom biomedical monitoring and countermeasures: Biomedical facility hardware catalog

NASA Technical Reports Server (NTRS)

1990-01-01

This hardware catalog covers that hardware proposed under the Biomedical Monitoring and Countermeasures Development Program supported by the Johnson Space Center. The hardware items are listed separately by item, and are in alphabetical order. Each hardware item specification consists of four pages. The first page describes background information with an illustration, definition and a history/design status. The second page identifies the general specifications, performance, rack interface requirements, problems, issues, concerns, physical description, and functional description. The level of hardware design reliability is also identified under the maintainability and reliability category. The third page specifies the mechanical design guidelines and assumptions. Described are the material types and weights, modules, and construction methods. Also described is an estimation of percentage of construction which utilizes a particular method, and the percentage of required new mechanical design is documented. The fourth page analyzes the electronics, the scope of design effort, and the software requirements. Electronics are described by percentages of component types and new design. The design effort, as well as, the software requirements are identified and categorized.

Domestic violence and employment: a qualitative study.

PubMed

Swanberg, Jennifer E; Logan, T K

2005-01-01

This exploratory study sought to gather detailed information about how domestic violence affects women's employment, specifically to identify the types of job interference tactics used by abusers and their consequences on women's job performance; identify and understand the context associated with disclosure about victimization to employers and coworkers; and identify the supports offered to employees after disclosure. Qualitative analyses, guided by grounded theory, revealed that perpetrators exhibited job interference behaviors before, during, and after work. Abuser tactics reduced women's job performance as measured by absenteeism, tardiness, job leavings, and terminations. Among women who disclosed victimization to employers, informal and formal job supports were offered. Workplace supports led to short-term job retention, but fear and safety issues mitigated employers' attempts to retain workers. ((c) 2005 APA, all rights reserved).

IN-SITU CHEMICAL OXIDATION--ENGINEERING ISSUE

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Engineering Issue Papers are a series of technology transfer documents that summarize the latest available information on specific technical issues, including fate and transport, specific contaminants, selected treatment and site rem...

Behavioural Difficulties That Co‐occur With Specific Word Reading Difficulties: A UK Population‐ Based Cohort Study

PubMed Central

Ryder, Denise; Norwich, Brahm; Ford, Tamsin

2015-01-01

This study aimed to examine the association between specific word reading difficulties (SWRD) identified at age 7 years using a discrepancy approach and subsequent dimensional measures of behavioural difficulties reported by teachers and parents at age 11 years. Behavioural problems were assessed using the Strengths and Difficulties Questionnaire. Secondary analysis of a UK representative population‐based sample of children (n = 12 631) was conducted using linear regression models. There were 284 children (2.2%) identified with SWRD at age 7 years. Children with SWRD had significantly higher scores on all measures of behavioural difficulties in unadjusted analysis. SWRD was associated with elevated behavioural difficulties at age 11 years according to parent report, and with greater emotional problems, hyperactivity and conduct issues according to teachers, even after having controlled for baseline difficulties. These results were replicated for children with low reading attainment, but no cognitive ability discrepancy. Categories of special educational need into which children with SWRD were classed at school were varied. Given high rates of co‐occurring behavioural difficulties, assessment that identifies each individual child's specific functional, rather than categorical, difficulties is likely to be the most effective way of providing classroom support. © 2015 The Authors. Dyslexia published by John Wiley & Sons Ltd. PMID:25693052

Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up.

PubMed

Dutton, Tegan; Stevens, Wendy; Newman, Jamie

2016-01-01

This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

42 CFR 405.1889 - Effect of a revision; issue-specific nature of appeals of revised determinations and decisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Effect of a revision; issue-specific nature of appeals of revised determinations and decisions. 405.1889 Section 405.1889 Public Health CENTERS FOR... revision; issue-specific nature of appeals of revised determinations and decisions. (a) If a revision is...

42 CFR 405.1889 - Effect of a revision; issue-specific nature of appeals of revised determinations and decisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Effect of a revision; issue-specific nature of appeals of revised determinations and decisions. 405.1889 Section 405.1889 Public Health CENTERS FOR... revision; issue-specific nature of appeals of revised determinations and decisions. (a) If a revision is...

42 CFR 405.1889 - Effect of a revision; issue-specific nature of appeals of revised determinations and decisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Effect of a revision; issue-specific nature of appeals of revised determinations and decisions. 405.1889 Section 405.1889 Public Health CENTERS FOR... revision; issue-specific nature of appeals of revised determinations and decisions. (a) If a revision is...

42 CFR 405.1889 - Effect of a revision; issue-specific nature of appeals of revised determinations and decisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Effect of a revision; issue-specific nature of appeals of revised determinations and decisions. 405.1889 Section 405.1889 Public Health CENTERS FOR... revision; issue-specific nature of appeals of revised determinations and decisions. (a) If a revision is...

42 CFR 405.1889 - Effect of a revision; issue-specific nature of appeals of revised determinations and decisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Effect of a revision; issue-specific nature of appeals of revised determinations and decisions. 405.1889 Section 405.1889 Public Health CENTERS FOR... revision; issue-specific nature of appeals of revised determinations and decisions. (a) If a revision is...

Safety Communication Tools and Healthcare Professionals' Awareness of Specific Drug Safety Issues in Europe: A Survey Study.

PubMed

de Vries, Sieta T; van der Sar, Maartje J M; Coleman, Anna Marie; Escudero, Yvette; Rodríguez Pascual, Alfonso; Maciá Martínez, Miguel-Ángel; Cupelli, Amelia; Baldelli, Ilaria; Šipić, Ivana; Andrić, Adriana; Michan, Line; Denig, Petra; Mol, Peter G M

2018-07-01

National competent authorities (NCAs) use Direct Healthcare Professional Communications (DHPCs) to communicate new drug safety issues to healthcare professionals (HCPs). More knowledge is needed about the effectiveness of DHPCs and the extent to which they raise awareness of new safety issues among HCPs. The objective was to assess and compare general practitioners' (GPs'), cardiologists', and pharmacists' familiarity with DHPCs as communication tools, their awareness of specific drug safety issues, and the sources through which they had become aware of the specific issues. GPs, cardiologists, and pharmacists from nine European countries (Croatia, Denmark, Ireland, Italy, the Netherlands, Norway, Spain, Sweden, and the UK) completed a web-based survey. The survey was conducted in the context of the Strengthening Collaboration for Operating Pharmacovigilance in Europe (SCOPE) Joint Action. Respondents were asked about their familiarity with DHPCs in general and their awareness of safety issues that had recently been communicated and involved the following drugs: combined hormonal contraceptives, diclofenac, valproate, and ivabradine. Those HCPs who were aware of the specific safety issues were subsequently asked to indicate the source through which they had become aware of them. Differences between professions in familiarity with DHPCs and awareness were tested using a Pearson χ 2  test per country and post hoc Pearson χ 2  tests in the case of statistically significant differences. Of the 3288 included respondents, 54% were GPs, 40% were pharmacists, and 7% were cardiologists. The number of respondents ranged from 67 in Denmark to 916 in Spain. Most respondents (92%) were familiar with DHPCs, with one significant difference between the professions: pharmacists were more familiar than GPs in Italy (99 vs 90%, P = 0.004). GPs' awareness ranged from 96% for the diclofenac issue to 70% for the ivabradine issue. A similar pattern was shown for pharmacists (91% aware of the diclofenac issue to 66% of the ivabradine issue). Cardiologists' awareness ranged from 91% for the ivabradine issue to 34% for the valproate issue. Overall, DHPCs were a common source through which GPs (range: 45% of those aware of the contraceptives issue to 60% of those aware of the valproate issue), cardiologists (range: 33% for the contraceptives issue to 61% for the valproate issue), and pharmacists (range: 41% for the contraceptives issue to 51% for the ivabradine issue) had become aware of the specific safety issues, followed by information on websites or in newsletters. GPs, cardiologists, and pharmacists were to a similar extent (highly) familiar with DHPCs, but they differed in awareness levels of specific safety issues. Cardiologists were less aware of safety issues associated with non-cardiology drugs even if these had cardiovascular safety concerns. This implies that additional strategies may be needed to reach specialists when communicating safety issues regarding drugs outside their therapeutic area but with risks related to their field of specialisation. DHPCs were an important source for the different professions to become aware of specific safety issues, but other sources were also often used. NCAs should consider the use of a range of sources when communicating important safety issues to HCPs.

Meta-Analyses and Orthodontic Evidence-Based Clinical Practice in the 21st Century

PubMed Central

Papadopoulos, Moschos A.

2010-01-01

Introduction: Aim of this systematic review was to assess the orthodontic related issues which currently provide the best evidence as documented by meta-analyses, by critically evaluating and discussing the methodology used in these studies. Material and Methods: Several electronic databases were searched and handsearching was also performed in order to identify the corresponding meta-analyses investigating orthodontic related subjects. In total, 197 studies were retrieved initially. After applying specific inclusion and exclusion criteria, 27 articles were identified as meta-analyses treating orthodontic-related subjects. Results: Many of these 27 papers presented sufficient quality and followed appropriate meta-analytic approaches to quantitatively synthesize data and presented adequately supported evidence. However, the methodology used in some of them presented weaknesses, limitations or deficiencies. Consequently, the topics in orthodontics which currently provide the best evidence, include some issues related to Class II or Class III treatment, treatment of transverse problems, external apical root resorption, dental anomalies, such as congenital missing teeth and tooth transposition, frequency of severe occlusal problems, nickel hypersensitivity, obstructive sleep apnea syndrome, and computer-assisted learning in orthodontic education. Conclusions: Only a few orthodontic related issues have been so far investigated by means of MAs. In addition, for some of these issues investigated in the corresponding MAs no definite conclusions could be drawn, due to significant methodological deficiencies of these studies. According to this investigation, it can be concluded that at the begin of the 21st century there is evidence for only a few orthodontic related issues as documented by meta-analyses, and more well-conducted high quality research studies are needed to produce strong evidence in order to support evidence-based clinical practice in orthodontics. PMID:21673839

Did I Tell You That? Ethical Issues Related to Using Computational Methods to Discover Non-Disclosed Patient Characteristics

PubMed Central

Cato, Kenrick D; Bockting, Walter; Larson, Elaine

2016-01-01

Background Widespread availability of large data sets through warehousing of electronic health records coupled with increasingly sophisticated information technology and related statistical methods offer great potential for a variety of applications for health and disease surveillance, developing predictive models and advancing decision support for clinicians. However, use of such ‘big data’ mining and discovery techniques has also raised ethical issues such as how to balance privacy and autonomy with the wider public benefits of data sharing. More specifically, electronic data are being increasingly used to identify individual characteristics which can be useful for clinical prediction and management, but that were not previously disclosed to a clinician. This process in computer parlance is called electronic phenotyping, and has a number of ethical implications. Approach Using the Belmont Report’s principles of respect for persons, beneficence, and justice as a framework, we examined the ethical issues posed by electronic phenotyping. Findings Ethical issues identified include the ability of the patient to consent for the use of their information, the ability to suppress pediatric information, ensuring that the potential benefits justify the risks of harm to patients, and acknowledging that the clinician’s biases or stereotypes, conscious or unintended, may also become a factor in the therapeutic interaction. We illustrate these issues with two vignettes, using the person characteristic of gender minority status (i.e., transgender identity) and the health history characteristic of substance abuse. Conclusion Big data mining has the potential to uncover patient characteristics previously obscured which can provide clinicians with beneficial clinical information. Hence, ethical guidelines must be updated to ensure that electronic phenotyping supports the principles of respect for persons, beneficence, and justice. PMID:27534587

Aptamers against pathogenic microorganisms

PubMed Central

Davydova, Anna; Vorobjeva, Maria; Pyshnyi, Dmitrii; Altman, Sidney; Vlassov, Valentin; Venyaminova, Alya

2016-01-01

Abstract An important current issue of modern molecular medicine and biotechnology is the search for new approaches to early diagnostic assays and adequate therapy of infectious diseases. One of the promising solutions to this problem might be a development of nucleic acid aptamers capable of interacting specifically with bacteria, protozoa, and viruses. Such aptamers can be used for the specific recognition of infectious agents as well as for blocking of their functions. The present review summarizes various modern SELEX techniques used in this field, and of several currently identified aptamers against viral particles and unicellular organisms, and their applications. The prospects of applying nucleic acid aptamers for the development of novel detection systems and antibacterial and antiviral drugs are discussed. PMID:26258445

Genetic Influence on Contrast Sensitivity in Middle-Aged Male Twins

PubMed Central

Cronin-Golomb, Alice; Panizzon, Matthew S.; Lyons, Michael J.; Franz, Carol E.; Grant, Michael D.; Jacobson, Kristen C.; Eisen, Seth A.; Laudate, Thomas M.; Kremen, William S.

2007-01-01

Contrast sensitivity is strongly associated with daily functioning among older adults, but the genetic and environmental contributions to this ability are unknown. Using the classical twin method, we addressed this issue by examining contrast sensitivity at five spatial frequencies (1.5–18 cycles per degree) in 718 middle-aged male twins from the Vietnam Era Twin Study of Aging (VETSA). Heritability estimates were modest (14%–38%), whereas individual-specific environmental influences accounted for 62%–86% of the variance. Identifying the types of individual-specific events that impact contrast sensitivity may suggest interventions to modulate this ability and thereby improve overall quality of life as adults age. PMID:17604073

Safeguards Knowledge Management & Retention at U.S. National Laboratories.

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

Haddal, Risa; Jones, Rebecca; Bersell, Bridget

In 2017, four U.S. National Laboratories collaborated on behalf of DOE/NNSA to explore the safeguards knowledge retention problem, identify possible approaches, and develop a strategy to address it. The one-year effort consisted of four primary tasks. First, the project sought to identify critical safeguards information at risk of loss. Second, a survey and workshop were conducted to assess nine U.S. National Laboratories' efforts to determine current safeguards knowledge retention practices and challenges, and identify best practices. Third, specific tools were developed to identify and predict critical safeguards knowledge gaps and how best to recruit in order to fill those gaps.more » Finally, based on findings from the first three tasks and research on other organizational approaches to address similar issues, a strategy was developed on potential knowledge retention methods, customized HR policies, and best practices that could be implemented across the National Laboratory Complex.« less

Problems associated with the utilization of algae in bioregenerative life support systems

NASA Technical Reports Server (NTRS)

Averner, M. M.; Karel, M.; Radmer, R.

1984-01-01

A workshop was conducted to identify the potential problems associated with the use of microalgae in biorregenerative life support systems, and to identify algae rlated research issues that must be addressed through space flight experimentation. Major questions to be resolved relate to the choice of algal species for inclusion in a bioregenerative life support system, their long term behavior in the space environment, and the nature of the techniques required for the continuous growth of algae on the scale required. Consideration was given to the problems associated with the conversion of algal biomass into edible components. Specific concerns were addressed and alternative transformation processes identified and compared. The workshop identified the following major areas to be addressed by space flight experimentation: (1) long term culture stability, (2) optimal design of algal growth reactors, and (3) post growth harvesting and processing in the space environment.

A Treatment Stage Specific Approach to Improving Quality of Life for Women with Ovarian Cancer

DTIC Science & Technology

2005-10-01

This study focuses on quality of life among women with ovarian cancer. The primary objective of the study is to identify the issues that are of...repeated measures design will be used to assess changes in problem areas and quality of life from diagnosis to recurrence among women newly diagnosed with...objectives are of the study are as follows: (1) to assess changes in quality of life (as quantified by the FACT-O questionnaire) across the different

Information Processing Theory of Human Performance and Related Research.

DTIC Science & Technology

1979-05-01

features are analyzed or compared at one or more times. Excellent reviews are available ( LaBerge , 1976; Sutherland, 1973). Without belaboring the issue, the...We propose then that it is not absolute values which are "features," but rela- tive values, and more specifically based on the work of Stevens ... Stevens , 1975a, 1975b; Stevens & Galanter, 1957) and his colleagues, that a feature is a ratio of actual stimulation to an identifia~ble absolute value on a

Board on Earth Sciences and Resources and its Activities

NASA Technical Reports Server (NTRS)

Schiffries, Craig M.

1997-01-01

The Board will provide oversight of the earth science and resource activities within the National Research Council, provide a review of research and public activities in the solid-earth sciences, and provide analyses and recommendations relevant to the supply, delivery, and associated impacts of and issues related to hydrocarbon, metallic, and non-metallic mineral resources. The Board will monitor the status of the earth sciences, assess the health of the disciplines, and identify research opportunities, and will respond to specific agency requests.

Make or Buy: A Systematic Approach to Department of Defense Sourcing Decisions for Services (An Interim Report)

DTIC Science & Technology

2013-04-01

serve as a “broker” to market specific research topics identified by our sponsors to NPS graduate students. This three-pronged approach provides for...issues and their impact on the transatlantic defense market . Before joining CSIS, Hofbauer worked as a defense analyst in Germany and the United Kingdom...economies of scale.  The work requires highly specialized human or capital assets.  The market is not large enough to support competition among

Implant ethics

PubMed Central

Hansson, S

2005-01-01

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and personal identity, and cultural effects. PMID:16131553

[International legal aspects of responsibility of states and international organizations for the spread of epidemics, pandemics and mass disease].

PubMed

Kholikov, I V; Sazonova, K L

2015-08-01

The present article deals with international legal issues that arise in case when various mass diseases go beyond any national jurisdiction. The emphasis is made on the problem of international responsibility, which different actors have to bear in such cases. The authors also examine the implementation of responsibility mechanism, including the indentication of the relevant international court, authorized to establish such liability and identify the specific forms of its realization.

Texas Solar Collaboration Action Plan

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

Winland, Chris

2013-02-14

Texas Solar Collaboration Permitting and Interconenction Process Improvement Action Plan. San Antonio-specific; Investigate feasibility of using electronic signatures; Investigate feasibility of enabling other online permitting processes (e.g., commercial); Assess need for future document management and workflow/notification IT improvements; Update Information Bulletin 153 regarding City requirements and processes for PV; Educate contractors and public on CPS Energy’s new 2013 solar program processes; Continue to discuss “downtown grid” interconnection issues and identify potential solutions; Consider renaming Distributed Energy Resources (DER); and Continue to participate in collaborative actions.

Barriers to treatment for older adults seeking psychological therapy.

PubMed

Wuthrich, Viviana M; Frei, Jacqueline

2015-07-01

Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.

Building an Ontology for Identity Resolution in Healthcare and Public Health.

PubMed

Duncan, Jeffrey; Eilbeck, Karen; Narus, Scott P; Clyde, Stephen; Thornton, Sidney; Staes, Catherine

2015-01-01

Integration of disparate information from electronic health records, clinical data warehouses, birth certificate registries and other public health information systems offers great potential for clinical care, public health practice, and research. Such integration, however, depends on correctly matching patient-specific records using demographic identifiers. Without standards for these identifiers, record linkage is complicated by issues of structural and semantic heterogeneity. Our objectives were to develop and validate an ontology to: 1) identify components of identity and events subsequent to birth that result in creation, change, or sharing of identity information; 2) develop an ontology to facilitate data integration from multiple healthcare and public health sources; and 3) validate the ontology's ability to model identity-changing events over time. We interviewed domain experts in area hospitals and public health programs and developed process models describing the creation and transmission of identity information among various organizations for activities subsequent to a birth event. We searched for existing relevant ontologies. We validated the content of our ontology with simulated identity information conforming to scenarios identified in our process models. We chose the Simple Event Model (SEM) to describe events in early childhood and integrated the Clinical Element Model (CEM) for demographic information. We demonstrated the ability of the combined SEM-CEM ontology to model identity events over time. The use of an ontology can overcome issues of semantic and syntactic heterogeneity to facilitate record linkage.

Strategic plan for science-U.S. Geological Survey, Ohio Water Science Center, 2010-15

USGS Publications Warehouse

,

2010-01-01

This Science Plan identifies specific scientific and technical programmatic issues of current importance to Ohio and the Nation. An examination of those issues yielded a set of five major focus areas with associated science goals and strategies that the Ohio Water Science Center will emphasize in its program during 2010-15. A primary goal of the Science Plan is to establish a relevant multidisciplinary scientific and technical program that generates high-quality products that meet or exceed the expectations of our partners while supporting the goals and initiatives of the U.S. Geological Survey. The Science Plan will be used to set the direction of new and existing programs and will influence future training and hiring decisions by the Ohio Water Science Center.

Text Mining of UU-ITE Implementation in Indonesia

NASA Astrophysics Data System (ADS)

Hakim, Lukmanul; Kusumasari, Tien F.; Lubis, Muharman

2018-04-01

At present, social media and networks act as one of the main platforms for sharing information, idea, thought and opinions. Many people share their knowledge and express their views on the specific topics or current hot issues that interest them. The social media texts have rich information about the complaints, comments, recommendation and suggestion as the automatic reaction or respond to government initiative or policy in order to overcome certain issues.This study examines the sentiment from netizensas part of citizen who has vocal sound about the implementation of UU ITE as the first cyberlaw in Indonesia as a means to identify the current tendency of citizen perception. To perform text mining techniques, this study used Twitter Rest API while R programming was utilized for the purpose of classification analysis based on hierarchical cluster.

Making Temporal Logic Calculational: A Tool for Unification and Discovery

NASA Astrophysics Data System (ADS)

Boute, Raymond

In temporal logic, calculational proofs beyond simple cases are often seen as challenging. The situation is reversed by making temporal logic calculational, yielding shorter and clearer proofs than traditional ones, and serving as a (mental) tool for unification and discovery. A side-effect of unifying theories is easier access by practicians. The starting point is a simple generic (software tool independent) Functional Temporal Calculus (FTC). Specific temporal logics are then captured via endosemantic functions. This concept reflects tacit conventions throughout mathematics and, once identified, is general and useful. FTC also yields a reasoning style that helps discovering theorems by calculation rather than just proving given facts. This is illustrated by deriving various theorems, most related to liveness issues in TLA+, and finding strengthenings of known results. Educational issues are addressed in passing.

Man-machine interface analysis of the flight design system

NASA Technical Reports Server (NTRS)

Ramsey, H. R.; Atwood, M. E.; Willoughby, J. K.

1978-01-01

The objective of the current effort was to perform a broad analysis of the human factors issues involved in the design of the Flight Design System (FDS). The analysis was intended to include characteristics of the system itself, such as: (1) basic structure and functional capabilities of FDS; (2) user backgrounds, capabilities, and possible modes of use; (3) FDS interactive dialogue, problem solving aids; (4) system data management capabilities; and to include, as well, such system related matters as: (1) flight design team structure; (2) roles of technicians; (3) user training; and (4) methods of evaluating system performance. Wherever possible, specific recommendations are made. In other cases, the issues which seem most important are identified. In some cases, additional analyses or experiments which might provide resolution are suggested.

Space station systems technology study (add-on task). Volume 2: Trade study and technology selection

NASA Technical Reports Server (NTRS)

1985-01-01

The current Space Station Systems Technology Study add on task was an outgrowth of the Advanced Platform Systems Technology Study (APSTS) that was completed in April 1983 and the subsequent Space Station System Technology Study completed in April 1984. The first APSTS proceeded from the identification of 106 technology topics to the selection of five for detailed trade studies. During the advanced platform study, the technical issues and options were evaluated through detailed trade processes, individual consideration was given to costs and benefits for the technologies identified for advancement, and advancement plans were developed. An approach similar to that was used in the subsequent study, with emphasis on system definition in four specific technology areas to facilitate a more in depth analysis of technology issues.

Bench-Scale Filtration Testing in Support of the Pretreatment Engineering Platform (PEP)

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

Billing, Justin M.; Daniel, Richard C.; Kurath, Dean E.

Pacific Northwest National Laboratory (PNNL) has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to perform research and development activities to resolve technical issues identified for the Pretreatment Facility (PTF). The Pretreatment Engineering Platform (PEP) was designed, constructed and operated as part of a plan to respond to issue M12, “Undemonstrated Leaching Processes.” The PEP is a 1/4.5-scale test platform designed to simulate the WTP pretreatment caustic leaching, oxidative leaching, ultrafiltration solids concentration, and slurry washing processes. The PEP testing program specifies that bench-scale testing is to bemore » performed in support of specific operations, including filtration, caustic leaching, and oxidative leaching.« less

Occupational health issues affecting the pharmaceutical sales force.

PubMed

Harris, G; Mayho, G; Page, L

2003-09-01

The sales force forms a significant sub-population in the pharmaceutical industry workforce. Role and organizational characteristics, such as isolation, peripatetic working and car travel and the psychosocial and ergonomic hazards related to work tasks, present particular occupational health risks. To review the occupational risks associated with peripatetic sales force work and evidence for the effectiveness of preventive interventions. We carried out a review of the available literature between 1990 and 2003. The following hazards were identified as significant and worthy of further investigation for this occupational group: driving on company business; violence in the workplace; stress; ergonomic issues; and mobile phone use. To ensure effective prevention and management of employee health problems, specific health management strategies and interventions must be developed to meet the occupational health needs of this group.

Frontal alpha asymmetry as a pathway to behavioural withdrawal in depression: Research findings and issues.

PubMed

Jesulola, Emmanuel; Sharpley, Christopher F; Bitsika, Vicki; Agnew, Linda L; Wilson, Peter

2015-10-01

Depression has been described as a process of behavioural withdrawal from overwhelming aversive stressors, and which manifests itself in the diagnostic symptomatology for Major Depressive Disorder (MDD). The underlying neurobiological pathways to that behavioural withdrawal are suggested to include greater activation in the right vs the left frontal lobes, described as frontal EEG asymmetry. However, despite a previous meta-analysis that provided overall support for this EEG asymmetry hypothesis, inconsistencies and several methodological confounds exist. The current review examines the literature on this issue, identifies inconsistencies in findings and discusses several key research issues that require addressing for this field to move towards a defensible theoretical model of depression and EEG asymmetry. In particular, the position of EEG asymmetry in the brain, measurement of severity and symptoms profiles of depression, and the effects of gender are considered as potential avenues to more accurately define the specific nature of the depression-EEG asymmetry association. Copyright © 2015 Elsevier B.V. All rights reserved.

Quality-of-Life Priorities in Patients with Thyroid Cancer: A Multinational European Organisation for Research and Treatment of Cancer Phase I Study.

PubMed

Singer, Susanne; Husson, Olga; Tomaszewska, Iwona M; Locati, Laura D; Kiyota, Naomi; Scheidemann-Wesp, Ulrike; Hofmeister, Dirk; Winterbotham, Melanie; Brannan, Christine; Araújo, Cláudia; Gamper, Eva M; Kulis, Dagmara; Rimmele, Harald; Andry, Guy; Licitra, Lisa

2016-11-01

The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally, and to identify those with highest relevance to them in addition to the more general issues covered by the core European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30, which is widely used in research and in care and addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues that they would include in a thyroid cancer-specific QoL module. The literature search and expert discussion provided a list of 71 QoL issues that was rated by thyroid cancer patients (n = 110) from seven countries. All issues were of high priority to at least some of the patients. The most frequently selected issues were sudden attacks of tiredness, exhaustion, quality of sleep, employment, social support, fear of cancer progression, fear of second operation, difficulties swallowing, and globus sensation. Thyroid cancer patients cross-culturally rate fatigue-related issues as highly important for their QoL, calling for increased efforts to find successful treatments for this problem. Vocational rehabilitation is also highly relevant for them and should therefore be an important aim of multidisciplinary care. The third important area of concern is psychological issues, especially fear of progression and of additional treatments.

Smart-Glasses: Exposing and Elucidating the Ethical Issues.

PubMed

Hofmann, Bjørn; Haustein, Dušan; Landeweerd, Laurens

2017-06-01

The objective of this study is to provide an overview over the ethical issues relevant to the assessment, implementation, and use of smart-glasses. The purpose of the overview is to facilitate deliberation, decision making, and the formation of knowledge and norms for this emerging technology. An axiological question-based method for human cognitive enhancement including an extensive literature search on smart-glasses is used to identify relevant ethical issues. The search is supplemented with relevant ethical issues identified in the literature on human cognitive enhancement (in general) and in the study of the technical aspects of smart-glasses. Identified papers were subject to traditional content analysis: 739 references were identified of which 247 were regarded as relevant for full text examinations, and 155 were included in the study. A wide variety of ethical issues with smart-glasses have been identified, such as issues related to privacy, safety, justice, change in human agency, accountability, responsibility, social interaction, power and ideology. Smart-glasses are envisioned to change individual human identity and behavior as well as social interaction. Taking these issues into account appears to be relevant when developing, deliberating, deciding on, implementing, and using smart-glasses.

I know why you voted for Trump: (Over)inferring motives based on choice.

PubMed

Barasz, Kate; Kim, Tami; Evangelidis, Ioannis

2018-05-10

People often speculate about why others make the choices they do. This paper investigates how such inferences are formed as a function of what is chosen. Specifically, when observers encounter someone else's choice (e.g., of political candidate), they use the chosen option's attribute values (e.g., a candidate's specific stance on a policy issue) to infer the importance of that attribute (e.g., the policy issue) to the decision-maker. Consequently, when a chosen option has an attribute whose value is extreme (e.g., an extreme policy stance), observers infer-sometimes incorrectly-that this attribute disproportionately motivated the decision-maker's choice. Seven studies demonstrate how observers use an attribute's value to infer its weight-the value-weight heuristic-and identify the role of perceived diagnosticity: more extreme attribute values give observers the subjective sense that they know more about a decision-maker's preferences, and in turn, increase the attribute's perceived importance. The paper explores how this heuristic can produce erroneous inferences and influence broader beliefs about decision-makers. Copyright © 2018 Elsevier B.V. All rights reserved.

Integrated Network Analyses for Functional Genomic Studies in Cancer

PubMed Central

Wilson, Jennifer L.; Hemann, Michael T.; Fraenkel, Ernest; Lauffenburger, Douglas A.

2013-01-01

RNA-interference (RNAi) studies hold great promise for functional investigation of the significance of genetic variations and mutations, as well as potential synthetic lethalities, for understanding and treatment of cancer, yet technical and conceptual issues currently diminish the potential power of this approach. While numerous research groups are usefully employing this kind of functional genomic methodology to identify molecular mediators of disease severity, response, and resistance to treatment, findings are generally confounded by “off-target” effects. These effects arise from a variety of issues beyond non-specific reagent behavior, such as biological cross-talk and feedback processes so thus can occur even with specific perturbation. Interpreting RNAi results in a network framework instead of merely as individual “hits” or “targets” leverages contributions from all hit/target contributions to pathways via their relationships with other network nodes. This interpretation can ameliorate dependence on individual reagent performance and increase confidence in biological validation. Here we provide background on RNAi studies in cancer applications, review key challenges with functional genomics, and motivate the use of network models grounded in pathway analyses. PMID:23811269

Estimating abundance in the presence of species uncertainty

USGS Publications Warehouse

Chambert, Thierry A.; Hossack, Blake R.; Fishback, LeeAnn; Davenport, Jon M.

2016-01-01

1.N-mixture models have become a popular method for estimating abundance of free-ranging animals that are not marked or identified individually. These models have been used on count data for single species that can be identified with certainty. However, co-occurring species often look similar during one or more life stages, making it difficult to assign species for all recorded captures. This uncertainty creates problems for estimating species-specific abundance and it can often limit life stages to which we can make inference. 2.We present a new extension of N-mixture models that accounts for species uncertainty. In addition to estimating site-specific abundances and detection probabilities, this model allows estimating probability of correct assignment of species identity. We implement this hierarchical model in a Bayesian framework and provide all code for running the model in BUGS-language programs. 3.We present an application of the model on count data from two sympatric freshwater fishes, the brook stickleback (Culaea inconstans) and the ninespine stickleback (Pungitius pungitius), ad illustrate implementation of covariate effects (habitat characteristics). In addition, we used a simulation study to validate the model and illustrate potential sample size issues. We also compared, for both real and simulated data, estimates provided by our model to those obtained by a simple N-mixture model when captures of unknown species identification were discarded. In the latter case, abundance estimates appeared highly biased and very imprecise, while our new model provided unbiased estimates with higher precision. 4.This extension of the N-mixture model should be useful for a wide variety of studies and taxa, as species uncertainty is a common issue. It should notably help improve investigation of abundance and vital rate characteristics of organisms’ early life stages, which are sometimes more difficult to identify than adults.

Development and application of a database of food ingredient fraud and economically motivated adulteration from 1980 to 2010.

PubMed

Moore, Jeffrey C; Spink, John; Lipp, Markus

2012-04-01

Food ingredient fraud and economically motivated adulteration are emerging risks, but a comprehensive compilation of information about known problematic ingredients and detection methods does not currently exist. The objectives of this research were to collect such information from publicly available articles in scholarly journals and general media, organize into a database, and review and analyze the data to identify trends. The results summarized are a database that will be published in the US Pharmacopeial Convention's Food Chemicals Codex, 8th edition, and includes 1305 records, including 1000 records with analytical methods collected from 677 references. Olive oil, milk, honey, and saffron were the most common targets for adulteration reported in scholarly journals, and potentially harmful issues identified include spices diluted with lead chromate and lead tetraoxide, substitution of Chinese star anise with toxic Japanese star anise, and melamine adulteration of high protein content foods. High-performance liquid chromatography and infrared spectroscopy were the most common analytical detection procedures, and chemometrics data analysis was used in a large number of reports. Future expansion of this database will include additional publically available articles published before 1980 and in other languages, as well as data outside the public domain. The authors recommend in-depth analyses of individual incidents. This report describes the development and application of a database of food ingredient fraud issues from publicly available references. The database provides baseline information and data useful to governments, agencies, and individual companies assessing the risks of specific products produced in specific regions as well as products distributed and sold in other regions. In addition, the report describes current analytical technologies for detecting food fraud and identifies trends and developments. © 2012 US Pharmacupia Journal of Food Science © 2012 Institute of Food Technologistsreg;

Worldwide wind/diesel hybrid power system study: Potential applications and technical issues

NASA Astrophysics Data System (ADS)

King, W. R.; Johnson, B. L., III

1991-04-01

The world market potential for wind/diesel hybrid technology is a function of the need for electric power, the availability of sufficient wind resource to support wind/diesel power, and the existence of buyers with the financial means to invest in the technology. This study includes data related to each of these three factors. This study does not address market penetration, which would require analysis of application specific wind/diesel economics. Buyer purchase criteria, which are vital to assessing market penetration, are discussed only generally. Countries were screened for a country-specific market analysis based on indicators of need and wind resource. Both developed countries and less developed countries (LDCs) were screened for wind/diesel market potential. Based on the results of the screening, ten countries showing high market potential were selected for more extensive market analyses. These analyses provide country-specific market data to guide wind/diesel technology developers in making design decisions that will lead to a competitive product. Section 4 presents the country-specific data developed for these analyses, including more extensive wind resource characterization, application-specific market opportunities, business conditions, and energy market characterizations. An attempt was made to identify the potential buyers with ability to pay for wind/diesel technology required to meet the application-specific market opportunities identified for each country. Additionally, the country-specific data are extended to corollary opportunities in countries not covered by the study. Section 2 gives recommendations for wind/diesel research based on the findings of the study.

Seeing the Invisible: Embedding Tests in Code That Cannot be Modified

NASA Technical Reports Server (NTRS)

O'Malley, Owen; Mansouri-Samani, Masoud; Mehlitz, Peter; Penix, John

2005-01-01

The difficulty of characterizing and observing valid software behavior during testing can be very difficult in flight systems. To address this issue, we evaluated several approaches to increasing test observability on the Shuttle Abort Flight Management (SAFM) system. To increase test observability, we added probes into the running system to evaluate the internal state and analyze test data. To minimize the impact of the instrumentation and reduce manual effort, we used Aspect-Oriented Programming (AOP) tools to instrument the source code. We developed and elicited a spectrum of properties, from generic to application specific properties, to be monitored via the instrumentation. To evaluate additional approaches, SAFM was ported to Linux, enabling the use of gcov for measuring test coverage, Valgrind for looking for memory usage errors, and libraries for finding non-normal floating point values. An in-house C++ source code scanning tool was also used to identify violations of SAFM coding standards, and other potentially problematic C++ constructs. Using these approaches with the existing test data sets, we were able to verify several important properties, confirm several problems and identify some previously unidentified issues.

Advanced transportation system studies, technical area 3. Alternate propulsion subsystem concepts: J-2S restart study

NASA Astrophysics Data System (ADS)

Vilja, John; Levack, Daniel

1993-04-01

The objectives were to assess what design changes would be required to remit late production of the J-2S engine for use as a large high energy upper stage engine. The study assessed design changes required to perform per the J-2S model specification, manufacturing changes required due to obsolescence or improvements in state-of-the-practice, availability issues for supplier provided items, and provided cost and schedule estimates for this configuration. The confidence that J-2S production could be reinitiated within reasonable costs and schedules was provided. No significant technical issues were identified in either the producibility study or in the review of previous technical data. Areas of potential cost reduction were identified which could be quantified to a greater extent with further manufacturing planning. The proposed schedule can be met with no foreseeable impacts. The results of the study provided the necessary foundation for the detailed manufacturing and test plans and non-recurring and recurring cost estimates that are needed to complete the effort to reinitiate production of the J-2S engine system.

Identification of Quarries Rehabilitation Scenarios: A Case Study Within the Metropolitan Area of Bari (Italy)

NASA Astrophysics Data System (ADS)

Dal Sasso, Pasquale; Ottolino, Maria Antonella; Caliandro, Lucia Patrizia

2012-06-01

This paper addresses quarries rehabilitation issue within a Metropolitan Area. Areas where mining activity is carried out have been subjected to physical and environmental degradation linked both to pursue the building materials extraction and to the city expansion continuously asking for new areas to be developed with residential and service functions. These changes also occurred where environmental and landscape values are present. It has been therefore pointed out the issue of such areas redevelopment that, to be functionally reintegrated, must be consistently linked to the activities and the territorial local contexts characteristics. In this paper the quarries reuse issue is carried out through parameters identification able to define the quarries relationship with the neighboring towns and with their surroundings besides to identify their physical, environmental and landscaping characteristics. Quarry reuse alternatives have been identified among those consistent with the rehabilitation goals, as defined by the planning sector and internationally approved, while their selection is derived from the application of a two-step methodology: a multi-criteria analysis related to punctual parameters at a "site-specific" level, followed by a further territorial indicators checking over the wide area. This application has led to socially accepted results identifying the examined quarries for reuses ranging from agricultural-forestry and urban to functional or naturalistic. The proposed method has also proved to be suitable to address the abandoned quarries reuse problem with a systemic and consultative approach, as it is able to correlate the many variables present in the social and spatial complexity of the Metropolitan Areas.

Implementing the Community Health Worker Model within Diabetes Management: Challenges and Lessons Learned from Programs across the U.S.

PubMed Central

Cherrington, Andrea; Ayala, Guadalupe X.; Amick, Halle; Allison, Jeroan; Corbie-Smith, Giselle; Scarinci, Isabel

2018-01-01

Introduction/objectives The Community Health Worker (CHW) model has gained popularity as a method for reaching vulnerable populations with diabetes mellitus (DM), yet little is known about its actual role in program delivery. The purpose of this qualitative study was to examine methods of implementation as well as related challenges and lessons learned. Methods Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC’s 1998 directory of CHW programs and Google Search Engine and were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Results Sixteen programs were assessed, all but three focused on minority populations. Most CHWs were recruited informally; six programs required CHWs to have diabetes. CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate non-diabetes related issues. Conclusions Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes. PMID:18832287

Appropriate evidence sources for populating decision analytic models within health technology assessment (HTA): a systematic review of HTA manuals and health economic guidelines.

PubMed

Zechmeister-Koss, Ingrid; Schnell-Inderst, Petra; Zauner, Günther

2014-04-01

An increasing number of evidence sources are relevant for populating decision analytic models. What is needed is detailed methodological advice on which type of data is to be used for what type of model parameter. We aim to identify standards in health technology assessment manuals and economic (modeling) guidelines on appropriate evidence sources and on the role different types of data play within a model. Documents were identified via a call among members of the International Network of Agencies for Health Technology Assessment and by hand search. We included documents from Europe, the United States, Canada, Australia, and New Zealand as well as transnational guidelines written in English or German. We systematically summarized in a narrative manner information on appropriate evidence sources for model parameters, their advantages and limitations, data identification methods, and data quality issues. A large variety of evidence sources for populating models are mentioned in the 28 documents included. They comprise research- and non-research-based sources. Valid and less appropriate sources are identified for informing different types of model parameters, such as clinical effect size, natural history of disease, resource use, unit costs, and health state utility values. Guidelines do not provide structured and detailed advice on this issue. The article does not include information from guidelines in languages other than English or German, and the information is not tailored to specific modeling techniques. The usability of guidelines and manuals for modeling could be improved by addressing the issue of evidence sources in a more structured and comprehensive format.

The Development and Assessment of an NIH-Funded Research Ethics Training Program

PubMed Central

DuBois, James M.; Dueker, Jeffrey M.; Anderson, Emily E.; Campbell, Jean

2015-01-01

In an effort to increase the number of researchers with skills “in identifying and addressing the ethical, legal, and social implications of their research,” the National Institutes of Health (NIH) solicited training grant proposals from 1999 to 2004 and subsequently funded approved programs. The authors describe the content, format, and outcomes of one such training program that ran from 2002–2006 and shares key lessons learned about program formats and assessment methods. Jointly developed by the Saint Louis University Center for Health Care Ethics and the Missouri Institute of Mental Health Continuing Education department, the training program focused on mental health research and adopted a train-the-trainer model. It was offered in onsite and distance-learning formats. Key outcomes of the program included educational products (such as 70 case studies posted on the course website, a textbook, and an instructional DVD) and program completion by 40 trainees. Assessment involved pre- and post-testing focused on knowledge of research ethics, ethical problem-solving skills, and levels of confidence in addressing ethical issues in mental health research. The program succeeded in increasing participants’ knowledge of ethical issues and their beliefs that they could identify issues, identify problem-solving resources, and solve ethical problems. However, scores on the case-based problem-solving assessment dropped in post-testing, apparently due to diminished confidence about the right course of action in the specific dilemma presented; the implications of this finding for ethics assessment are discussed. Overall satisfaction was high and dropout rates were low, but 3 times higher for distance-learners than onsite participants. PMID:18520469

Caring for women living with HIV: gaps in the evidence

PubMed Central

Loutfy, Mona R; Sherr, Lorraine; Sonnenberg-Schwan, Ulrike; Walmsley, Sharon L; Johnson, Margaret; d'Arminio Monforte, Antonella

2013-01-01

Introduction In the management of HIV, women and men generally undergo the same treatment pathway, with gender differences being given limited consideration. This is in spite of accumulating evidence that there are a number of potential differences between women and men which may affect response to treatment, pharmacokinetics, toxicities and coping. There are also notable psychological, behavioural, social and structural factors that may have a unique impact on women living with HIV (WLWH). Despite our increasing knowledge of HIV and advances in treatment, there are significant gaps in the data relating specifically to women. One of the factors contributing to this situation is the under-representation of women in all aspects of HIV clinical research. Furthermore, there are clinical issues unique to women, including gynaecologic and breast diseases, menopause-related factors, contraception and other topics related to women's and sexual health. Methods Using scoping review methodology, articles from the literature from 1980 to 2012 were identified using appropriate MeSH headings reflecting the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. Titles and abstracts were scanned to determine whether they were relevant to non-reproductive health in WLWH, and papers meeting inclusion criteria were reviewed. Results This review summarizes our current knowledge of the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. It suggests that there are a number of gender differences in disease and treatment outcomes, and distinct women-specific issues, such as menopause and co-morbidities, that pose significant challenges to the care of WLWH. Conclusions Based on a review of this evidence, outstanding questions and areas where further studies are required to determine gender differences in the efficacy and safety of treatment and other clinical and psychological issues specifically affecting WLWH have been identified. Well-controlled and adequately powered clinical studies are essential to help provide answers to these questions and to contribute to activities aimed at improving the health and wellbeing of WLWH. PMID:24088395

Non Linear Programming (NLP) Formulation for Quantitative Modeling of Protein Signal Transduction Pathways

PubMed Central

Morris, Melody K.; Saez-Rodriguez, Julio; Lauffenburger, Douglas A.; Alexopoulos, Leonidas G.

2012-01-01

Modeling of signal transduction pathways plays a major role in understanding cells' function and predicting cellular response. Mathematical formalisms based on a logic formalism are relatively simple but can describe how signals propagate from one protein to the next and have led to the construction of models that simulate the cells response to environmental or other perturbations. Constrained fuzzy logic was recently introduced to train models to cell specific data to result in quantitative pathway models of the specific cellular behavior. There are two major issues in this pathway optimization: i) excessive CPU time requirements and ii) loosely constrained optimization problem due to lack of data with respect to large signaling pathways. Herein, we address both issues: the former by reformulating the pathway optimization as a regular nonlinear optimization problem; and the latter by enhanced algorithms to pre/post-process the signaling network to remove parts that cannot be identified given the experimental conditions. As a case study, we tackle the construction of cell type specific pathways in normal and transformed hepatocytes using medium and large-scale functional phosphoproteomic datasets. The proposed Non Linear Programming (NLP) formulation allows for fast optimization of signaling topologies by combining the versatile nature of logic modeling with state of the art optimization algorithms. PMID:23226239

The art of co-production of knowledge in environmental sciences and management: lessons from international practice

NASA Astrophysics Data System (ADS)

Djenontin, Ida Nadia S.; Meadow, Alison M.

2018-06-01

This review paper addresses the challenging question of "how to" design and implement co-production of knowledge in climate science and other environmental and agricultural sciences. Based on a grounded theory review of nine (9) published case studies of transdisciplinary and collaborative research projects, the paper offers a set of common themes regarding specific components and processes for the design, implementation, and achievement of co-production of knowledge work, which represent the "Modus Operandi" of knowledge co-production. The analysis focuses on practical methodological guidance based on lessons from how different research teams have approached the challenges of complex collaborative research. We begin by identifying broad factors or actions that inhibit or facilitate the process, then highlight specific practices associated with co-production of knowledge and necessary competencies for undertaking co-production. We provide insights on issues such as the integration of social and professional cultures, gender and social equity, and power dynamics, and illustrate the different ways in which researchers have addressed these issues. By exploring the specific practices involved in knowledge co-production, this paper provides guidance to researchers on how to navigate different possibilities of the process of conducting transdisciplinary and co-production of knowledge research projects that best fit their research context, stakeholder needs, and research team capacities.

Effectively engaging stakeholders and the public in developing violence prevention messages.

PubMed

Boyko, Jennifer A; Wathen, C Nadine; Kothari, Anita

2017-05-11

Preventing family violence requires that stakeholders and the broader public be involved in developing evidence-based violence prevention strategies. However, gaps exist in between what we know (knowledge), what we do (action), and the structures supporting practice (policy). We discuss the broad challenge of mobilizing knowledge-for-action in family violence, with a primary focus on the issue of how stakeholders and the public can be effectively engaged when developing and communicating evidence-based violence prevention messages. We suggest that a comprehensive approach to stakeholder and public engagement in developing violence prevention messages includes: 1) clear and consistent messaging; 2) identifying and using, as appropriate, lessons from campaigns that show evidence of reducing specific types of violence; and 3) evidence-informed approaches for communicating to specific groups. Components of a comprehensive approach must take into account the available research evidence, implementation feasibility, and the context-specific nature of family violence. While strategies exist for engaging stakeholders and the public in messaging about family violence prevention, knowledge mobilization must be informed by evidence, dialogue with stakeholders, and proactive media strategies. This paper will be of interest to public health practitioners or others involved in planning and implementing violence prevention programs because it highlights what is known about the issue, potential solutions, and implementation considerations.

Research on U.S. Military Women: Recruitment and Retention Challenges and Strategies.

PubMed

Braun, Lisa A; Kennedy, Holly P; Sadler, Lois S; Dixon, Jane

2015-12-01

To examine literature on recruitment and retention of military women in research studies as an underrepresented, and potentially marginalized, population. A literature search was conducted to examine challenges, identify potential barriers and facilitators, and to inform strategies for recruitment and retention of military women in research studies. This search was supplemented by findings in military-specific databases and discussions with Military Women's Health Research Interest Group subject matter experts. Ten articles addressed research recruitment and retention challenges and strategies in marginalized/underrepresented populations, providing an effective context to inform research recruitment and retention in military settings. Research with military women is often challenged by logistical, cultural, social, ethical, and methodological issues, which may hinder exploration of potentially sensitive issues. Researchers must consider military-specific challenges to conducting research that include lengthy deployments, unpredictable military exercises, and foreign assignments, in accessing research participants. A case example shows strategies used in a military cervical cancer screening study. There are few published articles specific to research recruitment and retention in female military populations. Available resources broadly address recruitment challenges for Veterans, marginalized, hard-to-access, and transient research participants, which may provide guidance and strategies for success when applied to military populations. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

The art of co-production of knowledge in environmental sciences and management: lessons from international practice.

PubMed

Djenontin, Ida Nadia S; Meadow, Alison M

2018-06-01

This review paper addresses the challenging question of "how to" design and implement co-production of knowledge in climate science and other environmental and agricultural sciences. Based on a grounded theory review of nine (9) published case studies of transdisciplinary and collaborative research projects, the paper offers a set of common themes regarding specific components and processes for the design, implementation, and achievement of co-production of knowledge work, which represent the "Modus Operandi" of knowledge co-production. The analysis focuses on practical methodological guidance based on lessons from how different research teams have approached the challenges of complex collaborative research. We begin by identifying broad factors or actions that inhibit or facilitate the process, then highlight specific practices associated with co-production of knowledge and necessary competencies for undertaking co-production. We provide insights on issues such as the integration of social and professional cultures, gender and social equity, and power dynamics, and illustrate the different ways in which researchers have addressed these issues. By exploring the specific practices involved in knowledge co-production, this paper provides guidance to researchers on how to navigate different possibilities of the process of conducting transdisciplinary and co-production of knowledge research projects that best fit their research context, stakeholder needs, and research team capacities.