WorldWideScience

Sample records for challenges facing families

  1. Challenges facing production grids

    Energy Technology Data Exchange (ETDEWEB)

    Pordes, Ruth; /Fermilab

    2007-06-01

    Today's global communities of users expect quality of service from distributed Grid systems equivalent to that their local data centers. This must be coupled to ubiquitous access to the ensemble of processing and storage resources across multiple Grid infrastructures. We are still facing significant challenges in meeting these expectations, especially in the underlying security, a sustainable and successful economic model, and smoothing the boundaries between administrative and technical domains. Using the Open Science Grid as an example, I examine the status and challenges of Grids operating in production today.

  2. Challenges facing community health workers in Brazil's Family Health Strategy: A qualitative study.

    Science.gov (United States)

    Grossman-Kahn, Rebecca; Schoen, Julia; Mallett, John William; Brentani, Alexandra; Kaselitz, Elizabeth; Heisler, Michele

    2017-09-21

    Community health worker (CHW) programs are implemented in many low- and middle-income countries such as Brazil to increase access to and quality of care for underserved populations; CHW programs have been found to improve certain indicators of health, but few studies have investigated the daily work of CHWs, their perspectives on what both helps and hinders them from fulfilling their roles, and ways that their effectiveness and job satisfaction could be increased. To examine these questions, we observed clinic visits, CHW home visits, and conducted semistructured interviews with CHWs in 7 primary care centers in Brazil-2 in Salvador, Bahia, and 5 in São Paulo, SP-in which CHWs are incorporated into the work of all primary care health teams. In addition to enhancing communication between the medical system and the community, CHWs consider their key roles to be helping persuade community members to seek medical care and increasing health professionals' awareness of the social conditions affecting their patients' health. Key obstacles that CHWs face include failure to be fully integrated into the primary care team, inability to follow-up on identified health needs due to limited resources, as well as community members' lack of understanding of their work and undervaluing of preventative medicine. Increased training, better incorporation of CHWs into clinic flow and decision making, and establishing a clear community awareness of the roles and value of CHWs will help increase the motivation and effectiveness of CHWs in Brazil. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Facing the Challenges

    DEFF Research Database (Denmark)

    He, Kai

    2014-01-01

    China's rise signifies a gradual transformation of the international system from unipolarity to a non-unipolar world. ,4s an organization of small and middle powers, ASEAN faces strategic uncertainties brought about by the power transition in the system. Deepening economic interdependence between...... Summit (EAS), the Regional Comprehensive Economic Partnership (RCEP), and the ASEAN Community, to constrain and shape China's behaviour in the region in the post-Cold War era. It argues that due to globalization and economic interdependence, the power transition in the 21st century is different from...... the previous ones. ASEAN can potentially make a great contribution to a peaceful transformation of the international system. How to resolve the South China Sea disputes peacefully will be a critical task for both the ASEAN and Chinese leaders in the next decade or two....

  4. Families Facing the Nuclear Taboo.

    Science.gov (United States)

    Jacobs, Judith Bula

    1988-01-01

    Discusses attitudes of 12 families participating in group which was formed to focus on issues related to the possibility of a nuclear disaster. Why and how these families are facing the nuclear taboo plus various outcomes of doing so are discussed as well as the role of the professional in encouraging such openness about these difficult issues.…

  5. Grand Challenges facing Storage Systems

    CERN Multimedia

    CERN. Geneva

    2004-01-01

    In this talk, we will discuss the future of storage systems. In particular, we will focus on several big challenges which we are facing in storage, such as being able to build, manage and backup really massive storage systems, being able to find information of interest, being able to do long-term archival of data, and so on. We also present ideas and research being done to address these challenges, and provide a perspective on how we expect these challenges to be resolved as we go forward.

  6. Female entrepreneurship and challenges faced by women entrepreneurs to reconcile conflicts between work and family: multiple case study in travel agencies

    Directory of Open Access Journals (Sweden)

    Rivanda Meira Teixeira

    2016-03-01

    Full Text Available Women have gained more and more space in various professional areas and this development also occurs in the field of entrepreneurship. In Brazil GEM 2013 identified for the first time, that the number of new woman entrepreneurs was higher than male entrepreneurs. However, it is recognized that women entrepreneurs face many difficulties when trying to reconcile their companies with the family. The main objective of this research is to analyse the challenges faced by women entrepreneurs of travel agencies to reconcile the conflict between work and family. This study adopted the multiple cases research strategy and were selected seven women creators and managers of travel agencies in the cities of Aracaju and the Barra dos Coqueiros, in the state of Sergipe (east coast of Brazil. In an attempt to reconcile well the multiple roles these women often face the frustration and guilt. At this moment, it shows the importance of emotional contribution of husband and children. It is noticed that the search for balance between the conflicting demands generate emotional distress and / or physical.

  7. Facing Tomorrow's Challenges - An Overview

    Science.gov (United States)

    ,

    2008-01-01

    In 2007, the U.S. Geological Survey (USGS) developed a science strategy outlining the major natural-science issues facing the Nation in the next decade. The science strategy consists of six science directions of critical importance, focusing on areas where natural science can make a substantial contribution to the well-being of the Nation and the world. This fact sheet is an overview of the science strategy and describes how USGS research can strengthen the Nation with information needed to meet the challenges of the 21st century.

  8. "I don't like talking about it because that's not who I am": Challenges children face during epilepsy-related family communication.

    Science.gov (United States)

    O'Toole, S; Lambert, V; Gallagher, P; Shahwan, A; Austin, J K

    2016-09-01

    Childhood epilepsy not only significantly impacts a child's social relationships and psychosocial wellbeing, but it can also cause disruptions in family relations. Children living with epilepsy often rely on parental figures for guidance in relation to their condition. A paucity of research has examined the challenges for children when communicating about epilepsy with parental figures. This qualitative study explored the challenges faced by children when talking about epilepsy with their parent(s). Semi-structured interviews were conducted with 29 children (aged 6-16 years) living with epilepsy. Participants were recruited from a neurology department of a major pediatric hospital and from a national epilepsy association. Interviews were transcribed verbatim and thematically analyzed. Findings revealed four themes: communication impeding normalcy, parental overprotection, parental reactions to epilepsy-related communication, and restriction of activities as a consequence of epilepsy-related communication. The study highlights the need for a greater understanding of parent-child dialogue surrounding epilepsy and where challenges lie for children in conversing about their condition. Parents and health care professionals play a pivotal role in facilitating an environment where children feel comfortable talking about epilepsy. This information will be instrumental in the development of a communication-based intervention for families living with epilepsy. © The Author(s) 2016.

  9. Educational Challenges and Diminishing Family Safety Net Faced by High-School Girls in a Slum Residence, Nairobi, Kenya

    Science.gov (United States)

    Abuya, Benta A.; Onsomu, Elijah O.; Moore, Dakysha

    2012-01-01

    In 2010, there was a slight decrease in the number of out-of school adolescents from 75 million in 2009 (UNESCO, 2009) to 71 million in 2010, of which 55% are girls (UNESCO, 2010). In Kenya, only 17% of girls have secondary education (CBS, 2004). This paper analyzes the role of families in girls' secondary education in two schools within Nairobi…

  10. Sponge systematics facing new challenges.

    Science.gov (United States)

    Cárdenas, P; Pérez, T; Boury-Esnault, N

    2012-01-01

    Systematics is nowadays facing new challenges with the introduction of new concepts and new techniques. Compared to most other phyla, phylogenetic relationships among sponges are still largely unresolved. In the past 10 years, the classical taxonomy has been completely overturned and a review of the state of the art appears necessary. The field of taxonomy remains a prominent discipline of sponge research and studies related to sponge systematics were in greater number in the Eighth World Sponge Conference (Girona, Spain, September 2010) than in any previous world sponge conferences. To understand the state of this rapidly growing field, this chapter proposes to review studies, mainly from the past decade, in sponge taxonomy, nomenclature and phylogeny. In a first part, we analyse the reasons of the current success of this field. In a second part, we establish the current sponge systematics theoretical framework, with the use of (1) cladistics, (2) different codes of nomenclature (PhyloCode vs. Linnaean system) and (3) integrative taxonomy. Sponges are infamous for their lack of characters. However, by listing and discussing in a third part all characters available to taxonomists, we show how diverse characters are and that new ones are being used and tested, while old ones should be revisited. We then review the systematics of the four main classes of sponges (Hexactinellida, Calcispongiae, Homoscleromorpha and Demospongiae), each time focusing on current issues and case studies. We present a review of the taxonomic changes since the publication of the Systema Porifera (2002), and point to problems a sponge taxonomist is still faced with nowadays. To conclude, we make a series of proposals for the future of sponge systematics. In the light of recent studies, we establish a series of taxonomic changes that the sponge community may be ready to accept. We also propose a series of sponge new names and definitions following the PhyloCode. The issue of phantom species

  11. Challenges Facing Group Work Online

    Science.gov (United States)

    Chang, Bo; Kang, Haijun

    2016-01-01

    Online group work can be complicated because of its asynchronous characteristics and lack of physical presence, and its requirements for skills in handling technology, human relationships, and content-related tasks. This study focuses on the administrative, logistical and relationship-related challenges in online group work. Challenges in areas…

  12. Homeland Security. Management Challenges Facing Federal Leadership

    Science.gov (United States)

    2002-12-01

    Security Management Challenges Facing Federal Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...including attention to management practices and key success factors. HOMELAND SECURITY Management Challenges Facing Federal Leadership www.gao.gov/cgi...significant management and coordination challenges if it is to provide this leadership and be successful in preventing and responding to any future

  13. Interpretative challenges in face analysis

    DEFF Research Database (Denmark)

    de Oliveira, Sandi Michele; Hernández-Flores, Nieves

    2015-01-01

    In current research on face analysis questions of who and what should be interpreted, as well as how, are of central interest. In English language research, this question has led to a debate on the concepts of P1 (laypersons, representing the “emic” perspective) and P2 (researchers, representing...... in Spanish and address forms in European Portuguese, we view P1 and P2 as being far more complex than the literature suggests, with subgroups (different types of laypersons and researchers, respectively). At the micro-level we will describe the roles each subgroup plays in the interpretative process...

  14. Gender-Specific Health Challenges Facing Women

    Science.gov (United States)

    ... with facebook share with twitter share with linkedin Gender-Specific Health Challenges Facing Women Global Research Global ... adverse reactions to the drugs. Women also suffer gender-specific consequences of HIV, including recurrent vaginal yeast ...

  15. Exploring the challenges faced by polytechnic students

    Science.gov (United States)

    Matore, Mohd Effendi @ Ewan Mohd; Khairani, Ahmad Zamri

    2015-02-01

    This study aims to identify other challenges besides those already faced by students, in seven polytechnics in Malaysia as a continuation to the previous research that had identified 52 main challenges faced by students using the Rasch Model. The explorative study focuses on the challenges that are not included in the Mooney Problem Checklist (MPCL). A total of 121 polytechnic students submitted 183 written responses through the open questions provided. Two hundred fifty two students had responded from a students' perspective on the dichotomous questions regarding their view on the challenges faced. The data was analysed qualitatively using the NVivo 8.0. The findings showed that students from Politeknik Seberang Perai (PSP) gave the highest response, which was 56 (30.6%) and Politeknik Metro Kuala Lumpur (PMKL) had the lowest response of 2 (1.09%). Five dominant challenges were identified, which were the English language (32, 17.5%), learning (14, 7.7%), vehicles (13, 7.1%), information technology and communication (ICT) (13, 7.1%), and peers (11, 6.0%). This article, however, focus on three apparent challenges, namely, English language, vehicles, as well as computer and ICT, as the challenges of learning and peers had been analysed in the previous MPCL. The challenge of English language that had been raised was regarding the weakness in commanding the aspects of speech and fluency. The computer and ICT challenge covered the weakness in mastering ICT and computers, as well as computer breakdowns and low-performance computers. The challenge of vehicles emphasized the unavailability of vehicles to attend lectures and go elsewhere, lack of transportation service in the polytechnic and not having a valid driving license. These challenges are very relevant and need to be discussed in an effort to prepare polytechnics in facing the transformational process of polytechnics.

  16. Medical physics and challenges faced in Africa

    International Nuclear Information System (INIS)

    Nakatudde, R.

    2010-01-01

    improve the training of medical physicists. To promote research and development in the field of medical physics. To promote appropriate use of technology to the benefit of rural populations. To organize and / or sponsor international conferences, regional and other meetings or courses. To collaborate or affiliate with other scientific organizations according to article 8 of the constitution. Conclusion a. The challenges identified in the study can be solved by effective execution of FAMPO.s objectives. b. Governments of African countries should support, train, employ and recognize more medical physicists to handle all radiation dose safety issues pertaining to all departments using ionizing radiation in medicine. There is need for training more qualified medical physicists in Africa and their role should not be ignored. d. Effective communication among the family of medical physicists in Africa should improve to solve the challenges faced in our countries. With the establishment of FAMPO, which is a virile regional chapter, the pride of all medical physicists in Africa, support and hard work of all FAMPO members will make medical physics in Africa shine and many lives of Africans saved

  17. Fiber quality challenges facing the cotton industry

    Science.gov (United States)

    The cotton industry is in the midst of an exciting time with increased domestic consumption, but also facing pressure from other crops and the global marketplace. In order to ensure the US cotton crop remains the fiber of choice for the world it is important to keep an eye on the challenges to fibe...

  18. The Challenges Facing Distance Students in Undertaking ...

    African Journals Online (AJOL)

    This paper discusses the challenges facing distance students in Geography field Practical projects (GFPs) at The Open University of Tanzania (OUT). A random sample size of 19 students who participated in GFP1 in 2009 and 2010 were selected from randomly sampled regional centres of Singida, Dodoma, Njombe, and ...

  19. Facing the challenges of a competitive market

    International Nuclear Information System (INIS)

    Hollins, P.

    2001-01-01

    British Energy is one of the world's largest nuclear generating companies. This paper describes the business environment in which the company competes, its strategic responses to the challenges it faces, and gives some conclusions regarding the priorities for the nuclear generation industry if it is to thrive as a mainstream source of energy. (author)

  20. Challenges facing water management in China

    International Nuclear Information System (INIS)

    Varis, O.; Vakkilainen, P.

    2000-01-01

    The amount of water per person in northern China is less than half of that in Egypt, a country with very scarce water resources. Clearly, then, China is one of the regions on our planet that is going to have to face severe problems of water supply in the future. Rapid urbanisation and industrialisation growing agricultural output, environmental degradation, climatic instability, a large population density and worsening regional disparities are all factors that will challenge the management and utilisation of China's water resources in the years to come. (orig.)

  1. The Face Management Challenges of Sport Celebrity

    Directory of Open Access Journals (Sweden)

    Diana-Luiza DUMITRIU

    2015-03-01

    Full Text Available While gaining centrality within the sport field, media accelerated its commodification process and facilitated sport actors becoming competitive on the celebrity market. The aim of this paper is to discuss the reconfiguration that the celebrity logic brought in terms of the mere condition of the sport actor and the face management challenges and remedial strategies that he has to cope with. I will thus focus on two main dimensions that I find to be constitutive for the celebrity status: one related to the augmented media exposure that sport stars are subject to and to the corollary symbolic reconfiguration of the boundaries between his public and his private life, and the second one related to the vulnerability that comes along with the new visibility of the complex repertoire of identities and social roles performed by the sport actors. Within this last dimension of the sport-related celebrity cycle of promotion, I will lay stress not only on the face threatening aspects for the sport stars, but also on the vulnerability transfer within the affinal branding network and the challenges it could bring for the brands that chose to associate their image with a sport celebrity. Thus, I argue that the kaleidoscopic public figures of sport celebrities requires high impression management involvement on their part, as well as more caution on the marketeers part.

  2. Four Challenges That Global Health Networks Face

    Directory of Open Access Journals (Sweden)

    Jeremy Shiffman

    2017-04-01

    Full Text Available Global health networks, webs of individuals and organizations with a shared concern for a particular condition, have proliferated over the past quarter century. They differ in their effectiveness, a factor that may help explain why resource allocations vary across health conditions and do not correspond closely with disease burden. Drawing on findings from recently concluded studies of eight global health networks—addressing alcohol harm, early childhood development (ECD, maternal mortality, neonatal mortality, pneumonia, surgically-treatable conditions, tobacco use, and tuberculosis—I identify four challenges that networks face in generating attention and resources for the conditions that concern them. The first is problem definition: generating consensus on what the problem is and how it should be addressed. The second is positioning: portraying the issue in ways that inspire external audiences to act. The third is coalition-building: forging alliances with these external actors, particularly ones outside the health sector. The fourth is governance: establishing institutions to facilitate collective action. Research indicates that global health networks that effectively tackle these challenges are more likely to garner support to address the conditions that concern them. In addition to the effectiveness of networks, I also consider their legitimacy, identifying reasons both to affirm and to question their right to exert power.

  3. "Maybe They Don't Even Know That I Exist": Challenges Faced by Family Members and Friends of Patients with Advanced Kidney Disease.

    Science.gov (United States)

    O'Hare, Ann M; Szarka, Jackie; McFarland, Lynne V; Vig, Elizabeth K; Sudore, Rebecca L; Crowley, Susan; Reinke, Lynn F; Trivedi, Ranak; Taylor, Janelle S

    2017-06-07

    Family members and friends of patients with advanced chronic illness are increasingly called on to assist with ever more complex medical care and treatment decisions arising late in the course of illness. Our goal was to learn about the experiences of family members and friends of patients with advanced kidney disease. As part of a study intended to identify opportunities to enhance advance care planning, we conducted semistructured interviews at the Veterans Affairs Puget Sound Health Care System with 17 family members and friends of patients with advanced kidney disease. Interviews were conducted between April of 2014 and May of 2016 and were audiotaped, transcribed, and analyzed inductively using grounded theory to identify emergent themes. The following three themes emerged from interviews with patients' family members and friends: ( 1 ) their roles in care and planning were fluid over the course of the patient's illness, shaped by the patients' changing needs and their readiness to involve those close to them; ( 2 ) their involvement in patients' care was strongly shaped by health care system needs. Family and friends described filling gaps left by the health care system and how their involvement in care and decision-making was at times constrained and at other times expected by providers, depending on system needs; and ( 3 ) they described multiple sources of tension and conflict in their interactions with patients and the health care system, including instances of being pitted against the patient. Interviews with family members and friends of patients with advanced kidney disease provide a window on the complex dynamics shaping their engagement in patients' care, and highlight the potential value of offering opportunities for engagement throughout the course of illness. Copyright © 2017 by the American Society of Nephrology.

  4. Compulsive exercise: links, risks and challenges faced

    Directory of Open Access Journals (Sweden)

    Lichtenstein MB

    2017-03-01

    Full Text Available Mia Beck Lichtenstein,1 Cecilie Juul Hinze,2 Bolette Emborg,3 Freja Thomsen,2 Simone Daugaard Hemmingsen4 1Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, 2Research Unit for Telepsychiatry and E-mental Health, Mental Health Services in the Region of Southern Denmark, Odense, 3Department of Public Health, Aarhus University, Aarhus, 4Research Unit, Child and Adolescent Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark Abstract: Compulsive exercise is a condition described since 1970s. It is characterized by a craving for physical training, resulting in uncontrollable excessive exercise behavior with harmful consequences, such as injuries and impaired social relations. It has not been accepted as a mental disorder in either International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders. The aim of this literature review was to critically examine the research on links (comorbidity, risks (negative consequences, and challenges faced (problems in a treatment context. This review found that compulsive exercise is associated with eating disorder pathology, perfectionism, neuroticism, narcissism, and obsessive compulsive traits. The most prominent negative consequences were injuries, social impairment, and depression, but more research is needed to uncover the potential dysfunction resulting from compulsive exercise. As the condition is not recognized as a psychiatric disorder, studies on treatment interventions are sparse. Problems with compliance have been reported; therefore, motivational interviewing has been proposed as a treatment approach, in combination with cognitive behavioral therapy. This review summarizes and discusses findings on links/comorbidity, risks/negative consequences, and treatment challenges. We suggest that future studies should pay attention to both prevention and counseling in sports settings, where compulsive exercise

  5. Oil producers facing a common challenge

    International Nuclear Information System (INIS)

    Galal, E.E.

    1992-01-01

    Among the numerous challenges facing our modern world, perhaps the most urgent and dominant are energy related. From the perspective of developing countries they are, in order of priorities, development, energy security and environment. Oil covers above 38% of the global commercial energy needs and gas about 20%. In some commanding sectors of the economy, like transport, oil is for now virtually the irreplaceable source of energy. In addition, oil and gas are two valuable primary materials of the chemical industry. It also happens that oil consumption is one of the sources of environmental pollution through the emission of CO 2 . Utilisation of the world's finite fossil energy resources (88% of total commercial energy) in the service of development reflects all the negative attributes of the mismanagement of the global economy, exemplified by waste, inefficiency, unfair terms of trade, market instability and short-sighted policies. These serious inequities have been further compounded by the growing menace of environmental and climatic degradation. In dealing with the interactions between these three complex systems, i.e., energy, environment and development, it is important for oil producers to delineate their priorities clearly, if they are to disentangle credible common goals for an international convention. (author)

  6. The challenges that parents of children with epilepsy face

    DEFF Research Database (Denmark)

    Kampra, Matina; Tzerakis, Nikolas; Thomsen, Louise Lund Holm

    2017-01-01

    , parents/caregivers found that they needed more education about the existing sources of psychosocial and emotional support to cope with their child's epilepsy personally and as a family. Finally, the parents/caregivers who let their child know about the epilepsy and discussed the implications......Objective This qualitative study explored the challenges that Greek parents/caregivers of children with controlled epilepsy (CwE) face regarding the disorder. Methods Interviews were conducted based on open-ended questions guided by a review of the literature. A total of 91 parents/caregivers were...... recruited by neurologists at the neurology clinics of two Athens public hospitals. A hermeneutic phenomenological approach was used to explore parent/caregiver experiences. The data were grouped and analyzed through a textual interpretation. Results Two key challenges were identified for parents of Cw...

  7. What are the challenges facing our industry

    International Nuclear Information System (INIS)

    1998-01-01

    This presentation relates to the changing business climate of the petroleum industry worldwide. The author gives a touch on the changes of what the industry is facing and the response together with the keys to long-term shareholder value

  8. What are the challenges facing our industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    This presentation relates to the changing business climate of the petroleum industry worldwide. The author gives a touch on the changes of what the industry is facing and the response together with the keys to long-term shareholder value

  9. Psychosocial challenges facing physicians of today.

    Science.gov (United States)

    Arnetz, B B

    2001-01-01

    Fundamental changes in the organization, financing, and delivery of health care have added new stressors or opportunities to the medical profession. These new potential stressors are in addition to previously recognized external and internal ones. The work environment of physicians poses both psychosocial, ergonomic, and physico-chemical threats. The psychosocial work environment has, if anything, worsened. Demands at work increase at the same time as influence over one's work and intellectual stimulation from work decrease. In addition, violence and the threat of violence is another major occupational health problem physicians increasingly face. Financial constraint, managed care and consumerism in health care are other factors that fundamentally change the role of physicians. The rapid deployment of new information technologies will also change the role of the physician towards being more of an advisor and information provider. Many of the minor health problems will increasingly be managed by patients themselves and by non-physician professionals and practitioners of complementary medicine. Finally, the economic and social status of physicians are challenged which is reflected in a slower salary increase compared to many other professional groups. The picture painted above may be seen as uniformly gloomy. In reality, that is not the case. There is growing interest in and awareness of the importance of the psychosocial work environment for the delivery of high quality care. Physicians under stress are more likely to treat patients poorly, both medically and psychologically. They are also more prone to make errors of judgment. Studies where physicians' work environment in entire hospitals has been assessed, results fed-back, and physicians and management have worked with focused improvement processes, have demonstrated measurable improvements in the ratings of the psychosocial work environment. However, it becomes clear from such studies that quality of the

  10. The Challenges Facing Accounting Education: The Nigerian ...

    African Journals Online (AJOL)

    The need of the accounting profession to effectively and continuously meet new challenges confronting it and adapt its services to changing conditions and circumstances has become a necessity to the survival of the profession and the society. The challenges confronting the accountant on his role to the society at large in a ...

  11. Extending Face-to-Face Interactions: Understanding and Developing an Online Teacher and Family Community

    Science.gov (United States)

    Zhang, Chun; Du, Jianxia; Sun, Li; Ding, Yi

    2018-01-01

    Technology has been quickly changing human interactions, traditional practices, and almost every aspect of our lives. It is important to maintain effective face-to-face communication and interactions between teachers and families. Nonetheless, technology and its tools can also extend and enhance family-teacher relationships and partnerships. This…

  12. The challenges facing sustainable and adaptive groundwater ...

    African Journals Online (AJOL)

    These are: the undervaluation of groundwater importance and significance; the need for expertise and information at all scales; the centralisation of power; and the disregard of ecosystems and the associated goods and services. As a means to tackle these challenges, it has been assumed that the concept of adaptive water ...

  13. Original Research Challenges facing young African scientists in ...

    African Journals Online (AJOL)

    This study aimed at identifying the challenges that young African scientists face in their career development. Methods ... The research profile of Africans is relatively new, and the .... outside the country because it will support my original ideas.”.

  14. Challenges facing primary school educators of English Second (or ...

    African Journals Online (AJOL)

    ESOL) learners identified by educators as having language disorders and being referred for Speech-Language Therapy. We describe challenges faced by Grade 1, 2 and 3 educators at government schools in the Cape Metropolitan area who ...

  15. What are gender-based challenges facing Free Primary Education ...

    African Journals Online (AJOL)

    Rural teachers' views: What are gender-based challenges facing. Free Primary Education in Lesotho .... resulted in high levels of poverty amongst women, particularly in rural areas. Women ...... Lesotho demographics profile 2010. Available at ...

  16. Children at Risk: Global Views on Challenges Facing Children

    Science.gov (United States)

    Neugebauer, Roger

    2011-01-01

    Members of the World Forum community were invited to respond to the question: "What is the most urgent challenge facing young children in your country?" Here are some of their responses. Jamils Richard Achunji Anguaseh mentions that in Cameroon, young children face lots of insecurity, both from health hazards and poor parenting practices. There…

  17. Innovation in the face of future challenges

    International Nuclear Information System (INIS)

    Albistur, F. X.

    2006-01-01

    The Chairman of the Senate Commission for Industry. Tourism and Commerce emphasises the legitimate ambition felt by the citizens of all democratic States with respect to safety and underlines his trust in the regulatory body. He analyses the interesting example of the Spanish Nuclear Safety Council, true reflection of the democracy achieved in the country, from the standpoint of its history, the functions that have been added to its realm of competence in recent years environmental radiological surveillance, intervention in emergencies and activities at non-regulated facilities- and the need for it to adapt, within a framework of overall consensus, to improve its response to future challenges and to the goal of promoting credibility and forging a closer relationship with the public. (Author)

  18. Facing Global Challenges with Materials Innovation

    Science.gov (United States)

    Rizzo, Fernando

    2017-10-01

    The path of society evolution has long been associated with a growing demand for natural resources and continuous environmental degradation. During the last decades, this pace has accelerated considerably, despite the general concern with the legacy being left for the next generations. Looking ahead, the predicted growth of the world population, and the improvement of life conditions in most regions, point to an increasing demand for energy generation, resulting in additional pressure on the Earth's sustainability. Materials have had a key role in decreasing the use of natural resources, by either improving efficiency of existing technologies or enabling the development of radical new ones. The greenhouse effect (CO2 emissions) and the energy crisis are global challenges that can benefit from the development of new materials for the successful implementation of promising technologies and for the imperative replacement of fossil fuels by renewable sources.

  19. Changing Face of Family Planning Funding in Kenya: A Cross ...

    African Journals Online (AJOL)

    USER

    Changing Face of Family Planning Funding in Kenya: A Cross-. Sectional Survey of ... Keywords: Contraception, Expenditure, Budget, Decision-making. Résumé. A mesure ... increasingly receiving attention, including in. Kenya17. In Kenya ...

  20. THE CHALLENGES OF FAMILY BUSINESS

    Directory of Open Access Journals (Sweden)

    Stoilkovska Aleksandra

    2011-12-01

    Full Text Available Small businesses give a lot of possibilities for realization of your own creativity and inventivity. Employment of new family members creates work atmosphere that cannot be felt in other companies. Organizational culture results from the employee cohesion and from their devotion to the organization and to the work, and therefore cannot be achieved in other organizations and with any other motivational techniques. These excellent working conditions are a great base for fulfilling the organizational aims, as well as for united and satisfied family. The work in the family organizations is specific from two aspects: from the advantages that it offers and from the problems that arise from this kind of business. Knowing the conditions in the family business, i.e. knowing the factors that influence the effectiveness and efficiency of family business enables more efficient work. Family business development with change of generation or with the increase in the number of family members brings new moments. In addition, one good story can be transformed in an unpleasant conflict and can get to disunion in the family as well in the business. Knowing the possibilities and threats in connection to the factors that influence the family business enables preventive actions in order to avoid undesirable situations.

  1. Challenges facing the marketing of scientific and research institutes

    OpenAIRE

    Bogdan Sojkin

    2015-01-01

    This article presents the challenges that scientific research institutions face in terms of their marketing, which have been divided into two groups of those associated with internal marketing and those linked to external marketing. The most significant and important determinants that constitute challenges to both internal and external marketing were described. The key aspects of each of the identified challenges were indicated, as was their impact on the implementation of the marketing polic...

  2. Challenges facing the marketing of scientific and research institutes

    Directory of Open Access Journals (Sweden)

    Bogdan Sojkin

    2015-12-01

    Full Text Available This article presents the challenges that scientific research institutions face in terms of their marketing, which have been divided into two groups of those associated with internal marketing and those linked to external marketing. The most significant and important determinants that constitute challenges to both internal and external marketing were described. The key aspects of each of the identified challenges were indicated, as was their impact on the implementation of the marketing policy at institutions.

  3. NC Families and Communities Equals Success (FACES): Six Months Later.

    Science.gov (United States)

    Fernandez, Maria E.; Campbell, Kimm; Honess, Karen; Gallagher, Natalie Gibbs; Thurber, Lori; Smitley, Andy

    This paper reports on clinical and school outcomes after 6 months of implementing the North Carolina FACES (Families and Communities Equals Success) mental health program. Of the 210 children and youth participating in the program evaluation, 42 percent were African American, more than three quarters were male, 55 percent of families had annual…

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

    Science.gov (United States)

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

    2012-05-01

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

  5. NEW CHALLENGES FACED BY EUROPEAN COMPANIES AND THEIR STAKEHOLDERS

    Directory of Open Access Journals (Sweden)

    BOBE Claudia-Maria

    2010-07-01

    Full Text Available The European Union is currently affected by the financial crisis that spread internationally. The member states face difficulties such as price volatility, uncertainties, liquidity issues, cases of bankruptcy, increased unemployment rate, and decreasing GDP. The present paper analyses the challenges faced under these new circumstances by the European companies and their stakeholders. By taking into consideration the threats and weaknesses faced by firms and other interested parties, we emphasize the importance that transparency and communication among companies and their stakeholder have in overcoming financial difficulties.

  6. Promoting Family Literacy through the Five Pillars of Family and Community Engagement (FACE)

    Science.gov (United States)

    Kuo, Nai-Cheng

    2016-01-01

    Family literacy involves factors beyond what is done at home between parents and children. To help preservice teachers develop their understanding of the multiple dimensions of family literacy, this study uses the five pillars of family and community engagement (FACE)--early literacy, family involvement, access to books, expanded learning, and…

  7. Beyond survival: Challenges facing South African automotive component exporters

    Directory of Open Access Journals (Sweden)

    M. J. Naude

    2006-12-01

    Full Text Available Purpose and Objective: The South African automotive component industry faces huge challenges in a very competitive global market. The primary focus of this research article is to determine the challenges facing exporters within this industry with special reference to selected sub-sectors. The challenges are approached from a supply chain perspective only. Problem Investigated: The research problem of this study was to identify these unique challenges and ascertain whether the implementation of a 'philosophy of continuous improvement' could be used as a strategic tool to address the challenges they face in the market. Methodology: This study included a combination of literature review, interviews with managers in the selected sub-groups and questionnaires sent out to determine the challenges facing automotive component exporters. In order to test the content validity and the reliability of the questionnaire, a pilot study was conducted at two organisations that are the main suppliers of automotive filters for passenger vehicles. The non-probability convenience sample technique was used to select the sample and consisted of selected sub-sectors that contribute 64,1% of the total value of automotive component exports in South Africa. Out of twenty-seven questionnaires sent out, twenty (74% response rate were duly completed by the respondents and returned to the researcher. Findings: South Africa faces unique challenges and these are listed and ranked according to priority from most to least important as follows: 1. The reduction of production costs; 2. R/US$ exchange rate effect on the respondent's export sales and profit margin; 3. Exchange rate fluctuations; 4. Threats to the local automotive component market; and 5. Increased competition by way of manufactured imports being sold in the South African market. Value of Research: The study provides recommendations that can be used within the automotive component industry.

  8. Challenges and Opportunities Facing Technology Education in Taiwan

    Science.gov (United States)

    Lee, Lung-Sheng Steven

    2009-01-01

    The technology education in Taiwan is prescribed in the national curriculum and provided to all students in grades 1-12. However, it faces the following challenges: (1) Lack of worthy image, (2) Inadequate teachers in elementary schools, (3) Deficient teaching vitality in secondary schools, and (4) Diluted technology teacher education programs. In…

  9. Strategies being followed in India to face challenge of drug ...

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Strategies being followed in India to face challenge of drug resistance in tuberculosis. Increasing the coverage with DOTS. Operational research to monitor the trends in drug resistance. Research in methods for rapid detection of drug resistance. Improving methods/ ...

  10. Challenges Facing Supervisors and Students in the Process of ...

    African Journals Online (AJOL)

    The paper established that communication, supervisorstudent relationship, access to literature, plagiarism, and poor writing skills among some students are some of the key challenges facing students and supervisors in writing dissertations/theses at OUT. The paper recommends that communication between students and ...

  11. Challenges facing young African scientists in their research careers ...

    African Journals Online (AJOL)

    Background: Africa accounts for 14% of world's population, and the economies of most African countries are considered to be growing, but this is not reflected in the amount of research published by Africans. This study aimed at identifying the challenges that young African scientists face in their career development.

  12. The challenges facing commercial motorcycle occupation in Etsako ...

    African Journals Online (AJOL)

    This study examined the challenges facing commercial motorcycle occupation in Edo State, Nigeria. A descriptive survey design was adopted. Data were collected through questionnaires and in-depth interviews (IDIs) among selected motorcyclists, police officers and road safety officials in Etsako West Local Government ...

  13. The Challenges Facing Catholic Education in France Today

    Science.gov (United States)

    Moog, François

    2016-01-01

    The effects of secularisation on society demand a rethinking of the identity and mission of Catholic schools in France. In 2013, the French bishops published a new directory which offers new approaches, described here, based on the three challenges facing Catholic education in France: linking social responsibility and evangelisation, setting up…

  14. Rural teachers' views: What are gender-based challenges facing ...

    African Journals Online (AJOL)

    This paper gives prominence to rural teachers' accounts of gender-based challenges facing Free Primary Education in Lesotho. It draws on feminist interpretations of social constructionism to discuss factors within the Basotho communities that affect gender equality in the schools. The inductive analysis offered makes use ...

  15. Challenges new entrant countries face in establishing a nuclear program

    International Nuclear Information System (INIS)

    Brister, J.

    2012-01-01

    Challenges new entrant countries face in establishing a nuclear programme are distilled into four major categories: human resource development, financing, infrastructure and process. In implementing a successful nuclear programme role of the government is key to success. It requires clear and sustained policy support, international and bilateral agreements, developing the depth required of technical skills and infrastructure, proven delivery programme, management of radioactive waste and spent fuel, decommissioning and electricity market regulation.

  16. E-learning challenges faced by academics in higher education

    OpenAIRE

    Islam, Nurul; Beer, Martin; Slack, Frances

    2015-01-01

    E-learning has become a necessity in higher education institutions and is being deployed in educational establishments throughout the world. Researchers have made much emphasis on its benefits but not much is discussed on the disadvantages of e-learning technology. This paper references some of the research work on the limitations of e-learning technology, categorises it in five challenges that teachers are faced with and suggestions for a successful e-learning outcome. This paper also discus...

  17. Families of returned defence force personnel: a changing landscape of challenges.

    Science.gov (United States)

    Berle, David; Steel, Zachary

    2015-08-01

    This paper aims to identify the key challenges experienced by the families of defence force personnel following deployment. We undertook a selective review of four post-deployment challenges to the families of defence force personnel: (1) changes to relationships; (2) changes to family member roles and responsibilities; (3) adjustment of children and parenting challenges; and (4) anger, family conflict and violence. Emerging issues in the area of post-deployment adjustment are also discussed. Empirical studies of post-deployment family adjustment are lacking. Each of the reviewed challenges can contribute to psychological difficulties and precipitate contact with mental health services. The challenges faced by defence force personnel when returning from deployment arise within a family context. Clinicians should thoroughly assess these factors in families following deployment, but also recognise family strengths and resilience to these challenges. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  18. Challenges Facing Healthwatch, a New Consumer Champion in England.

    Science.gov (United States)

    Carter, Pam; Martin, Graham

    2016-01-21

    This article engages with debates about the conceptualisation and practical challenges of patient and public involvement (PPI) in health and social care services. Policy in this area in England has shifted numerous times but increasingly a consumerist discourse seems to override more democratic ideas concerning the relationship between citizens and public services. Recent policy change in England has seen the creation of new consumer champion bodies in the form of local Healthwatch. The article describes these new organisational structures for PPI and shows how those who seek to influence planning and delivery of services or comment or complain about aspects of their care face considerable complexity. This is due, in part, to the ambiguous remit set out for newly instigated Healthwatch organisations by government. Drawing on governance theory, we show that it can also be understood as a function of an increasingly polycentric governance arena. Challenges that flow from this include problems of specifying jurisdictional responsibility, accountability, and legitimacy. We review Healthwatch progress to date, then we set out four challenges facing local Healthwatch organisations before discussing the implications of these for patients and the public. The first challenge relates to non-coterminous boundaries and jurisdictional integrity. Secondly, establishing the unique features of Healthwatch is problematic in the crowded PPI arena. The third challenge arises from limited resources as well as the fact that resources flow to Healthwatch from the local authorities that Healthwatch are expected to hold to account. The fourth challenge we identify is how local Healthwatch organisations negotiate the complexity of being a partner to statutory and other organisations, while at the same time being expected to champion local people's views. © 2016 by Kerman University of Medical Sciences.

  19. Higher education in the face of social challenges

    Directory of Open Access Journals (Sweden)

    Adrián Cuevas Jiménez

    2016-08-01

    Full Text Available Higher education refers to the subsequent training to high school education; that is undergraduate and graduate; whose mission is to preserve; develop and disseminate culture. Throughout the history of higher education it has undergone a process of transformation; mainly due to the development of knowledge and the transformation of society. In the process they highlighted two great moments; in the first; which culminated in the mid-twentieth century; it conceived the higher education institution encompassing all knowledge of society; and who graduated was ready to perform professionally throughout life; the second time; after those dates; it is conceivable that knowledge is no longer exclusive to the institution of higher education; and there can be no efficient performance without continuous training and continuous updating of knowledge. The objective of this work is to point out the general goals and some strategies of the students’ formation of superior education; to confront the big challenges that it faces today the society. To define this goals and strategies four challenge levels are considered: a physical; structural and politicalideological challenges; b challenges around the scientifictechnician and of the knowledge advances; c challenges of the internal structure of the formative process and the access to the superior education; and d challenges in the formation of values in the students. 

  20. Family Photography and Persecuted Communities: Methodological Challenges.

    Science.gov (United States)

    McAllister, Kirsten Emiko

    2018-05-01

    This paper examines methodological challenges involved in conducting research on family photographs from persecuted communities, using Japanese Canadian photos as a case study. Approaching family photography as a social practice that instills dominant familial ideologies, the paper examines their "performative scripts" that arrange family members according to normative identities and roles. The paper argues that researchers are not immune to scripts that shape how and what we have been socialized to see (and not see) in family photos. The paper thus presents techniques to distance oneself from these performative scripts and one's involvement in their social and emotional dynamics. Once able to disentangle oneself from the genre's normative practices, the paper argues it is necessary to situate the photos in their social and political context of persecution and survival. Given the insular, inward looking character of family photographs, the paper concludes by calling for intersectional analyses, reflecting on how one might bring one's own family photos into engagement with the photos of Indigenous families and turns to those of the Skwxwú7mesh (Squamish) Nation. © 2018 Canadian Sociological Association/La Société canadienne de sociologie.

  1. A Variety of Diversity: Facing Higher Education's Educational Challenges

    Science.gov (United States)

    Dey, Eric L.

    2008-10-01

    First among the many important challenges facing American higher education is the need to improve the effectiveness of our educational programs. Public concern has heightened the sense of urgency for colleges and universities to make progress on improving and measuring educational outcomes, which is made more challenging by the varieties of diversity facing us. Diversity is not just an issue related to student recruitment or experience, but rather it is one that also relates to institutions and their faculties. New educational methods must address such diversity to be effective, and one possible example can be found in ongoing research at the University of Michigan that explores the educational implications of implementing a web-based lecture capture system in large lecture courses. Student use of and reactions to such systems is important, as is the potential to influence course performance for students in general, but also for underrepresented and at-risk student subpopulations. In addition to helping bring our current landscape into focus, this paper will identify effective practices as well as continuing challenges to improving educational practice for undergraduate students.

  2. Educational challenges faced by international medical graduates in the UK

    Directory of Open Access Journals (Sweden)

    Hashim A

    2017-06-01

    Full Text Available Ahmed Hashim Gastroenterology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK Introduction: International medical graduates (IMGs in the UK constitute approximately one-quarter of the total number of doctors registered in the General Medical Council (GMC. The transition of IMGs into the health care system in the UK is accompanied by significant sociocultural and educational challenges. This study aims to explore the views of IMGs in medical training on the educational challenges they face.Methods: This study was conducted in the Kent, Surrey and Sussex region in 2015. All IMGs who work in medical (physicianly training programs were included. Data were collected through a questionnaire and semi-structured interviews. Thematic approach was used to analyze the qualitative data.Results: Of the total 61 IMGs included, 17 responded to the survey and 3 were interviewed. The common educational barriers faced by IMGs were related to lack of appreciation of the values and structure of the National Health Service (NHS, ethical and medicolegal issues, receiving feedback from colleagues and the different learning strategies in the UK. IMGs suggested introduction of a mandatory dedicated induction program in the form of formal teaching sessions. They also believed that a supervised shadowing period prior in the first job in the UK would be beneficial. Further assessment areas should be incorporated into the prequalifying examinations to address specific educational needs such as NHS structure and hospital policies. Other measures such as buddying schemes with senior IMGs and educating NHS staff on different needs of IMGs should also be considered.Conclusion: This study highlighted important educational challenges faced by IMGs and generated relevant solutions. However, the opinions of the supervisors and other health care professionals need to be explored. Keywords: international medical graduates, IMG, educational barriers

  3. Regulatory challenges faced first Indonesia NPPs by independent TSOs

    International Nuclear Information System (INIS)

    Sri Budi Utami

    2010-01-01

    Technical and scientific support organizations (TSOs) dedicated to supporting national regulatory authorities. At present BAPETEN has internal TSOs. Pertaining to the regulatory control of nuclear safety, security, and safeguards for nuclear power plants (NPPs), independent TSOs providing support to the safety regulatory bodies are facing a number of technical challenges to ensuring the safety of NPPs. It is essential that BAPETEN need independent TSOs in order to warrant a sufficient level of safety, security and non proliferation in building and operating of first NPP. It is essential that BAPETEN need independent TSOs in order to warrant a sufficient level of safety, security and non proliferation in building and operating of first NPPs. (author)

  4. Challenges Facing 3-D Audio Display Design for Multimedia

    Science.gov (United States)

    Begault, Durand R.; Null, Cynthia H. (Technical Monitor)

    1998-01-01

    The challenges facing successful multimedia presentation depend largely on the expectations of the designer and end user for a given application. Perceptual limitations in distance, elevation and azimuth sound source simulation differ significantly between headphone and cross-talk cancellation loudspeaker listening and therefore must be considered. Simulation of an environmental context is desirable but the quality depends on processing resources and lack of interaction with the host acoustical environment. While techniques such as data reduction of head-related transfer functions have been used widely to improve simulation fidelity, another approach involves determining thresholds for environmental acoustic events. Psychoacoustic studies relevant to this approach are reviewed in consideration of multimedia applications

  5. The Challenges Faced by New Science Teachers in Saudi Arabia

    Science.gov (United States)

    Alsharari, Salman

    Growing demand for science teachers in the Kingdom of Saudi Arabia, fed by increasing numbers of public school students, is forcing the Saudi government to attract, recruit and retain well-qualified science teachers. Beginning science teachers enter the educational profession with a massive fullfilment and satisfaction in their roles and positions as teachers to educating children in a science classroom. Nevertheless, teachers, over their early years of practice, encounter numerous challenges to provide the most effective science instruction. Therefore, the current study was aimed to identify academic and behavioral classroom challenges faced by science teachers in their first three years of teaching in the Kingdom of Saudi Arabia. In addition, new science teacher gender, school level and years of teaching experience differences in perceptions of the challenges that they encountered at work were analyzed. The present study also investigated various types of support that new science teachers may need to overcome academic and behavioral classroom challenges. In order to gain insights about ways to adequately support novice science teachers, it was important to examine new science teachers' beliefs, ideas and perceptions about effective science teaching. Three survey questionnaires were developed and distributed to teachers of both sexes who have been teaching science subjects, for less than three years, to elementary, middle and high school students in Al Jouf public schools. A total of 49 novice science teachers responded to the survey and 9 of them agreed to participate voluntarily in a face-to-face interview. Different statistical procedures and multiple qualitative methodologies were used to analyze the collected data. Findings suggested that the top three academic challenges faced by new science teachers were: poor quality of teacher preparation programs, absence of appropriate school equipment and facilities and lack of classroom materials and instructional

  6. Faces

    DEFF Research Database (Denmark)

    Mortensen, Kristine Køhler; Brotherton, Chloe

    2018-01-01

    for the face the be put into action. Based on an ethnographic study of Danish teenagers’ use of SnapChat we demonstrate how the face is used as a central medium for interaction with peers. Through the analysis of visual SnapChat messages we investigate how SnapChat requires the sender to put an ‘ugly’ face...... already secured their popular status on the heterosexual marketplace in the broad context of the school. Thus SnapChat functions both as a challenge to beauty norms of ‘flawless faces’ and as a reinscription of these same norms by further manifesting the exclusive status of the popular girl...

  7. Generation Y facing the challenge of employability: facts against stereotypes

    Directory of Open Access Journals (Sweden)

    Alberto Vallejo Peña

    2017-07-01

    Full Text Available Young people Spain classed as belonging Generation Y are facing the transition to employment under even more adverse conditions than the previous generation (X, as a result of the economic crisis (2008-2015 prevailing as they reach working age. This paper aims to address the generational traits that are attributed to these young people in Spain, and contrast them with the data offered (Labour Force Survey, LFS, and Organization for Economic Co-operation and Development, OECD, mainly. This aims to achieve a better understanding of the phenomenon to distinguish their true features and generational experiences from the testimony of somewhat unreliable sources. To this end, we analyse the main social types attributed to this generation (Not in Education, Employment, or Training, NEETs, mileuristas and boomerangs, technological changes that determine their profile (digital society, new migration trends, the influence of social stratification and the contribution of the family. The conclusions look in particular at the influence of certain factors (education, social class to improve their employability, and the prevalence of the family as a key institution in supporting these young people, given the lack of other social actors.

  8. Who governs energy? The challenges facing global energy governance

    International Nuclear Information System (INIS)

    Florini, Ann; Sovacool, Benjamin K.

    2009-01-01

    This article conceptualizes the energy problems facing society from a global governance perspective. It argues that a notion of 'global energy governance,' taken to mean international collective action efforts undertaken to manage and distribute energy resources and provide energy services, offers a meaningful and useful framework for assessing energy-related challenges. The article begins by exploring the concepts of governance, global governance, and global energy governance. It then examines some of the existing institutions in place to establish and carry out rules and norms governing global energy problems and describes the range of institutional design options available to policymakers. It briefly traces the role of a selection of these institutions, from inter-governmental organizations to summit processes to multilateral development banks to global action networks, in responding to energy issues, and points out their strengths and weaknesses. The article concludes by analyzing how the various approaches to global governance differ in their applicability to addressing the conundrums of global energy problems.

  9. Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

    Science.gov (United States)

    Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

    2017-07-01

    To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

  10. Families overcoming under stress: implementing family-centered prevention for military families facing wartime deployments and combat operational stress.

    Science.gov (United States)

    Lester, Patricia; Mogil, Catherine; Saltzman, William; Woodward, Kirsten; Nash, William; Leskin, Gregory; Bursch, Brenda; Green, Sara; Pynoos, Robert; Beardslee, William

    2011-01-01

    The toll of multiple and prolonged deployments on families has become clearer in recent years as military families have seen an increase in childhood anxiety, parental psychological distress, and marital discord. Families overcoming under stress (FOCUS), a family-centered evidence-informed resiliency training program developed at University of California, Los Angeles and Harvard Medical School, is being implemented at military installations through an initiative from Navy Bureau of Medicine and Surgery. The research foundation for FOCUS includes evidence-based preventive interventions that were adapted to meet the specific needs of military families facing combat operational stress associated with wartime deployments. Using a family narrative approach, FOCUS includes a customized approach utilizing core intervention components, including psychoeducation, emotional regulation skills, goal setting and problem solving skills, traumatic stress reminder management techniques, and family communication skills. The purpose of this study is to describe the development and implementation of FOCUS for military families. A case example is also presented.

  11. Facing the challenges of nuclear power at Ontario Power Generation

    International Nuclear Information System (INIS)

    Howes, H.

    1999-01-01

    Nuclear power represents a major portion of Ontario Power Generation's generation mix and it will be the bedrock upon which we build a successful, competitive company. Our nuclear units offer many environmental and economic benefits, the one most relevant to this meeting is their significant contribution to the relatively low carbon intensity of Ontario's and Canada's electricity supply. In recent weeks, we have listened with great interest to the endorsement by our federal Minister of the Environment of nuclear technology as a means of reducing global warming. But endorsements of this type alone are not sufficient to ensure that nuclear remains an acceptable option for managing greenhouse gas emissions. Without public acceptance and support, the entire nuclear investment is endangered. At OPG we face three challenges to building this public support: we must continue to improve our safety margins and operating performance; we must continue to improve the environmental performance at our stations; and we must increase our community outreach. Today I would like to focus on the last two challenges and the actions that we are taking to maintain our social and environmental 'licence to operate.' But before I describe these initiatives, I will tell you about: the new company - Ontario Power Generation; the changes in store for Ontario's electricity sector; and our greenhouse gas emissions - the legacy from Ontario Hydro. (author)

  12. Western United States Dams Challenges Faced, Options, and Opportunities

    Science.gov (United States)

    Raff, D.

    2017-12-01

    Water management in the Western United States relies significantly upon a fleet of small to very large engineered dams to store water during times of runoff and distribute that water during times of need. Much of this infrastructure is Federally owned and/or operated, and was designed and funded during the first half of the twentieth century through a complex set of repayment contracts for Federally authorized purposes addressing water supply, recreation, and hydropower, and other water management objectives. With environmental laws, namely the Endangered Species Act, and other environmental concerns taking a more active role in water resources in the mid to latter half of the twentieth century, this infrastructure is being stressed even greater than anticipated to provide authorized purposes. Additionally, weather and climate norms being experienced are certainly near the edges, if not outside, of anticipated variability in the climate and hydrology scenarios for which the infrastructure was designed. And, finally, these dams, economically designed for a lifespan of 50 - 100 years, are experiencing maintenance challenges from routine to significant. This presentation will focus on identifying some of the history and challenges facing the water infrastructure in the Western United States. Additionally, some perspectives on future paths to meet the needs of western irrigation and hydropower production will be provided.

  13. Electronic health systems: challenges faced by hospital-based providers.

    Science.gov (United States)

    Agno, Christina Farala; Guo, Kristina L

    2013-01-01

    The purpose of this article is to discuss specific challenges faced by hospitals adopting the use of electronic medical records and implementing electronic health record (EHR) systems. Challenges include user and information technology support; ease of technical use and software interface capabilities; compliance; and financial, legal, workforce training, and development issues. Electronic health records are essential to preventing medical errors, increasing consumer trust and use of the health system, and improving quality and overall efficiency. Government efforts are focused on ways to accelerate the adoption and use of EHRs as a means of facilitating data sharing, protecting health information privacy and security, quickly identifying emerging public health threats, and reducing medical errors and health care costs and increasing quality of care. This article will discuss physician and nonphysician staff training before, during, and after implementation; the effective use of EHR systems' technical features; the selection of a capable and secure EHR system; and the development of collaborative system implementation. Strategies that are necessary to help health care providers achieve successful implementation of EHR systems will be addressed.

  14. Family Policy: The Conservative Challenge and the Progressive Response.

    Science.gov (United States)

    Cherlin, Andrew

    1983-01-01

    Examines the question of how family professionals should respond to the conservative pro-family movement. Argues that the response of liberal family professionals to date--consisting largely of a defense of pluralism--has been inadequate and should concentrate on the most important issues facing families currently. (JAC)

  15. Autism in Brazil: a systematic review of family challenges and coping strategies

    Directory of Open Access Journals (Sweden)

    Paulyane T.M. Gomes

    2015-04-01

    Full Text Available OBJECTIVE: To describe the challenges faced by families caring for children with autism spectrum disorder (ASD in Brazil and the coping strategies employed. SOURCES: Systematic review of articles published until September of 2013, without language restrictions, using quality appraisal (AMSTAR and CASP/Oxford instruments. SUMMARY OF THE FINDINGS: The literature shows parental emotional overload as one of the main challenges faced by families, especially mothers. The main stressors were diagnostic postponement, difficulty dealing with the diagnosis and associated symptoms, and poor access to health services and social support. The predominant coping strategies found included information exchange between affected families and integrated healthcare network for patient and family support. CONCLUSION: ASD exerts strong influence on family dynamics, resulting in caregiver overload, especially in mothers. The Brazilian Unified Health System needs to provide comprehensive, continuous, and coordinated care to strengthen the patient-family dyad and promote the full development and societal inclusion of children with ASD.

  16. Addressing professional resource challenges facing modern utilities with technological solutions

    Energy Technology Data Exchange (ETDEWEB)

    Goldie, T. [Hydro One Networks Inc., Toronto, ON (Canada); Hodder, S. [GE Digital Energy, Toronto, ON (Canada)

    2008-07-01

    The challenges facing electric utilities regarding a shortage of highly qualified labour to maintain, refurbish and expand electrical infrastructure can be attributed to a wave of retirements in skilled employees, a shortage of entry-level workers and a rapidly increasing workload caused by investment in electricity infrastructure. Two solutions were presented for finding and sustaining an adequate personnel base. The first involved developing local talent, both entry-level and mid-career staff to ensure that work continuity and workplace safety are maintained. The second involved the implementation of technological solutions to help optimize the use of existing and future labour resources. This paper presented the human resource programs developed by Hydro One, the largest electrical transmission and distribution utility in the province of Ontario. Their initiatives include raising the profile of the utility work environment through strategic partnerships with educational institutions and developing in house offerings to supplement existing academic programs. This paper also presented a technical solution to address the resources challenges specifically associated with power system protection and control. The solution targets professional and skilled trades involved in the design, installation and maintenance of automated substations and protection and control systems. It is based on the premise that resource optimization can be achieved by reducing inconsistent design and construction practices and replacing these designs with highly standardized materials with digital communications using IEC 61850. This new technology should attract young professionals to the power engineering field while still maintaining a high comfort level with the established professional workforce. 5 refs., 4 figs.

  17. Challenges Facing Crop Production And (Some) Potential Solutions

    Science.gov (United States)

    Schnable, P. S.

    2017-12-01

    To overcome some of the myriad challenges facing sustainable crop production we are seeking to develop statistical models that will predict crop performance in diverse agronomic environments. Crop phenotypes such as yield and drought tolerance are controlled by genotype, environment (considered broadly) and their interaction (GxE). As a consequence of the next generation sequencing revolution genotyping data are now available for a wide diversity of accessions in each of the major crops. The necessary volumes of phenotypic data, however, remain limiting and our understanding of molecular basis of GxE is minimal. To address this limitation, we are collaborating with engineers to construct new sensors and robots to automatically collect large volumes of phenotypic data. Two types of high-throughput, high-resolution, field-based phenotyping systems and new sensors will be described. Some of these technologies will be introduced within the context of the Genomes to Fields Initiative. Progress towards developing predictive models will be briefly summarized. An administrative structure that fosters transdisciplinary collaborations will be briefly described.

  18. Technological challenges at ITER plasma facing components production in Russia

    Energy Technology Data Exchange (ETDEWEB)

    Mazul, I.V., E-mail: mazuliv@niiefa.spb.su [Efremov Institute, 196641 St. Petersburg (Russian Federation); Belyakov, V.A.; Gervash, A.A.; Giniyatulin, R.N.; Guryeva, T.M.; Kuznetsov, V.E.; Makhankov, A.N.; Okunev, A.A. [Efremov Institute, 196641 St. Petersburg (Russian Federation); Sevryukov, O.N. [MEPhI, 115409 Moscow (Russian Federation)

    2016-11-01

    Highlights: • Technological aspects of ITER PFC manufacturing in Russia are presented. • Range of technologies to be used during manufacturing of ITER PFC at Efremov Institute has been, in general, defined and their complexity, originality and difficulty are described. • Some features and challenges of welding, brazing and various tests are discussed. - Abstract: Major part of ITER plasma facing components will be manufactured in the Russian Federation (RF). Operational conditions and other requirements to these components, as well as the scale of production, are quite unique. These unique features and related technological solutions found in the frame of the project are discussed. Procedure breakdown and results of qualification for the proposed technologies and potential producers are presented, based on mockups production and testing. Design of qualification mockups and prototypes, testing programs and results are described. Basic quantitative and qualitative parameters of manufactured components and methods of quality control are presented. Critical manufacturing issues and prospects for unique production for future fusion needs are discussed.

  19. The challenges facing today's operators

    Energy Technology Data Exchange (ETDEWEB)

    Walach, T. [Canadian District Energy Association, Vaughan, ON (Canada)

    2004-07-01

    A summary of how the Northwind Windsor plant operates was presented along with reasons why it is advantageous to get connected to a district heating system. The plant is a joint venture between Exelon Thermal Technologies and Ontario Power Generation. The plant produces and sells hot water, chilled water, steam and electricity to the Windsor Utilities Commission. Energy is then piped out to buildings in the area, including the Art Gallery of Windsor, the Royal Bank Business Centre, the Windsor Justice Facility, the Windsor Casino, and Northwind Windsor. The energy, which is transferred through heat exchangers, is used for space heating, domestic hot water heating, and air conditioning. The plant offers less management costs, lower energy costs, a lower level of risk management, stable energy rates, better use of building space, reliable service, and a cleaner environment. However, operators face significant challenges in terms of plant operation. They must be knowledgeable in the operation and maintenance of innovative equipment, and must have detailed information regarding operating efficiencies. District Energy requires more complex plants that use various energy saving technologies that deliver a broad range of energy types.

  20. Challenges facing air management for fuel cell systems

    Energy Technology Data Exchange (ETDEWEB)

    Davis, P.B. [Department of Energy (United States); Sutton, R. [Argonne National Lab. (United States); Wagner, F.W. [Energetics Incorporated (United States)

    2000-07-01

    The U.S. Department of Energy (DOE) and the U.S. automotive industry are working cooperatively under the auspices of the Partnership for a New Generation of Vehicles (PNGV) to develop a six-passenger automobile that can achieve up to 80 mpg. while meeting customer needs and all safety and emission requirements. These partners are continuing to invest heavily in the research and development of polymer electrolyte membrane (PEM) fuel cells as a clean and efficient energy conversion system for the PNGV. A critical challenge facing fuel cell systems for the PNGV is the development of efficient, compact, cost-effective air management systems. The U.S. Department of Energy has been exploring several compressor/expander options for pressurized fuel cell systems, including scroll, toroidal intersecting vane, turbine, twin screw, and piston technologies. Each of these technologies has strengths and weaknesses regarding efficiency, pressure ratio over turndown, size and weight, and cost. This paper will present data from the U.S. Department of Energy's research and development efforts on air management systems and will discusses recent program developments resulting from an independent peer review evaluation. (author)

  1. Who governs energy? The challenges facing global energy governance

    Energy Technology Data Exchange (ETDEWEB)

    Florini, Ann; Sovacool, Benjamin K. [Centre on Asia and Globalisation, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore 259772 (Singapore)

    2009-12-15

    This article conceptualizes the energy problems facing society from a global governance perspective. It argues that a notion of 'global energy governance,' taken to mean international collective action efforts undertaken to manage and distribute energy resources and provide energy services, offers a meaningful and useful framework for assessing energy-related challenges. The article begins by exploring the concepts of governance, global governance, and global energy governance. It then examines some of the existing institutions in place to establish and carry out rules and norms governing global energy problems and describes the range of institutional design options available to policymakers. It briefly traces the role of a selection of these institutions, from inter-governmental organizations to summit processes to multilateral development banks to global action networks, in responding to energy issues, and points out their strengths and weaknesses. The article concludes by analyzing how the various approaches to global governance differ in their applicability to addressing the conundrums of global energy problems. (author)

  2. Material Challenges For Plasma Facing Components in Future Fusion Reactors

    International Nuclear Information System (INIS)

    Linke, J; Pintsuk, G.; Rödig, M.

    2013-01-01

    Increasing attention is directed towards thermonuclear fusion as a possible future energy source. Major advantages of this energy conversion technology are the almost inexhaustible resources and the option to produce energy without CO2-emissions. However, in the most advanced field of magnetic plasma confinement a number of technological challenges have to be met. In particular high-temperature resistant and plasma compatible materials have to be developed and qualified which are able to withstand the extreme environments in a commercial thermonuclear power reactor. The plasma facing materials (PFMs) and components (PFCs) in such fusion devices, i.e. the first wall (FW), the limiters and the divertor, are strongly affected by the plasma wall interaction processes and the applied intense thermal loads during plasma operation. On the one hand, these mechanisms have a strong influence on the plasma performance; on the other hand, they have major impact on the lifetime of the plasma facing armour. In present-day and next step devices the resulting thermal steady state heat loads to the first wall remain below 1 MWm-2; the limiters and the divertor are expected to be exposed to power densities being at least one order of magnitude above the FW-level, i.e. up to 20 MWm-2 for next step tokamaks such as ITER or DEMO. These requirements are responsible for high demands on the selection of qualified PFMs and heat sink materials as well as reliable fabrication processes for actively cooled plasma facing components. The technical solutions which are considered today are mainly based on the PFMs beryllium, carbon or tungsten joined to copper alloys or stainless steel heat sinks. In addition to the above mentioned quasi-stationary heat loads, short transient thermal pulses with deposited energy densities up to several tens of MJm-2 are a serious concern for next step tokamak devices. The most frequent events are so-called Edge Localized Modes (type I ELMs) and plasma disruptions

  3. Face-to-face communication between patients and family physicians in Canada: A scoping review.

    Science.gov (United States)

    Armas, Alana; Meyer, Samantha B; Corbett, Kitty K; Pearce, Alex R

    2018-05-01

    Patient-provider communication is critical in primary care. Canada's unique health system, population distribution, and cultural context suggest there is value in addressing the topic in the Canadian context. We conducted a scoping review to synthesize recent Canadian literature to inform practice in primary care settings and identify research agendas for patient-provider communication in Canada. Using Arksey and O'Malley's framework we searched four literature databases: Medline, Web of Science, CINAHL and EMBASE. We extracted 21,932 articles published between 2010 and 2017. A total of 108 articles met the inclusion criteria. The articles were analyzed qualitatively using thematic analysis to identify major themes. Four major themes were identified: information sharing, relationships, health system challenges, and development and use of communication tools. Our review identified a need for Canadian research regarding: communication in primary care with Aboriginal, immigrant, and rural populations; the impact of medical tourism on primary care; and how to improve communication to facilitate continuity of care. Challenges providers face in primary care in Canada include: communicating with linguistically and culturally diverse populations; addressing issues that emerge with the rise of medical tourism; a need for decision aids to improve communication with patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Reentry challenges facing women with mental health problems.

    Science.gov (United States)

    Visher, Christy A; Bakken, Nicholas W

    2014-01-01

    Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this article, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston, Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The article concludes with a discussion of recommendations for improved policy and practice.

  5. Towards Lead-Free Piezoceramics: Facing a Synthesis Challenge

    Directory of Open Access Journals (Sweden)

    María Elena Villafuerte-Castrejón

    2016-01-01

    Full Text Available The search for electroceramic materials with enhanced ferro-pyro-piezoelectric properties and revealing the perovskite type structure has been the objective of a significant number of manuscripts reported in the literature. This has been usually carried out by proposing the synthesis and processing of new compounds and solid solution series. In this work, several methods to obtain ferro-pyro-piezoelectric families of materials featuring the well-known ABO3 perovskite structure (or related such as BaTiO3, Ba1–xCaxTi1–yZryO3, (Bi0.5Na0.5TiO3, (K0.5Na0.5NbO3 and their solid solutions with different cations either in the A or B positions, are presented. For this kind of materials, the challenge for obtaining a single phase compound with a specific grain size and morphology and, most importantly, with the adequate stoichiometry, will also be discussed. The results reviewed herein will be discussed in terms of the tendency of working with softer conditions, i.e., lower temperature and shorter reaction times, also referred to as soft-chemistry.

  6. The Roles of Women in Family Businesses: Challenges and Opportunities : A research study on Bangladesh and Pakistan

    OpenAIRE

    Rahman, Md.Sayedur; Ullah, Kaleem

    2012-01-01

    Introduction: The Roles of women in family businesses and the challenges and opportuni- ties they face in relations to these roles in the family businesses will be explored in this re- search. Although women are accepted very important players, yet the roles of women are not frequently well-defined. The thesis will explore roles of women who play an important role in family firms and challenges and opportunities they have within the Family Business- es in Pakistan and Bangladesh. Purpose: The...

  7. Challenges faced by nuclear research centres in Indonesia

    International Nuclear Information System (INIS)

    Subki, I.R.; Soentono, S.

    2001-01-01

    Nuclear research centres in Indonesia are mainly owned and operated by the National Nuclear Energy Agency, covering basically various research and development facilities for non-energy and energy related activities. The research and development activities cover a broad spectrum of basic, applied, and developmental research involving nuclear science and technology in supporting various fields ranging from basic human needs, e.g. food and health; natural resources and nuclear and environmental safety; as well as industry. Recent economic crisis, triggered by monetary turmoil, has dictated the IAEA to face new challenges and to give more efforts on the application of the so called 'instant technology' i.e. the technology which has been developed and is ready for implementation, especially on food and health, to be better utilized to overcome various problems in the society. Various short and medium term programmes on the application of isotopes, radiation, and nuclear techniques for non-energy related activities have emerged in accord with these efforts. In this regard, besides the intensification of the instant technology implementation on food and health, the nuclear research and development on food plant mutation, fertilizers, radio-vaccines, production of meat and milk, production processes of various radiopharmaceuticals, and radioisotopes as well as radiation processing related to agro-industry have to be intensified using the available laboratories processing facilities. The possibility of the construction of irradiators for post harvesting processes in some provinces is being studied, while the designing and manufacturing of various prototypes of devices, equipment, and instruments for nuclear techniques in health and industry are continued. Considering the wide applications of accelerators for non-energy and energy related research and development, construction of accelerator-based laboratories is being studied. In energy related research the feasibility of

  8. A personal perspective on challenges that face women scientists

    Science.gov (United States)

    Cashman, Katharine

    2016-04-01

    Gender equality has been a topic of discussion throughout my long (now three decade) career. This alone illustrates the complex nature of the issue, and the lack of a simple solution, particularly as many of the daily challenges that women face are institution or discipline-specific. For this reason, I will summarize some of the issues that appear to me to be more general, and therefore ones that may have general solutions. The first and foremost relates to demands on women's time. One way that academic institutions have sought to overcome gender bias has been to require that every university committee have a female member; in departments, schools and faculties where women represent a minority, this necessarily means that women shoulder an inequitable share of the service duties. I have experienced this myself, seen it in promotion files at all levels, and observed it with regard to my female colleagues. Clearly time spent doing service is time not spent doing science. There is also an easy solution to this problem, which is to re-think the underlying assumption that men are necessarily gender-biased if they don't have a woman sitting in the room! Additional time demands can come from informal mentoring of both students and younger colleagues, particularly in cases where senior male colleagues are viewed as too important, or too intimidating, to be consulted on personal issues. Although I suspect that this problem may also be widespread, it is more difficult to quantify, and is therefore more difficult to factor into time allotments of departmental duties. A final thought relates to hiring practices. I have now worked in both the US and UK educational systems, which have very different interview and hiring protocols. I will review both, highlighting components that I think are most likely to promote equitable hiring practices.

  9. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients.

    Science.gov (United States)

    Kierans, Ciara; Padilla-Altamira, Cesar; Garcia-Garcia, Guillermo; Ibarra-Hernandez, Margarita; Mercado, Francisco J

    2013-01-01

    Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs). Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT) and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so constitute an important source of evidence in that effort.

  10. Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans.

    Science.gov (United States)

    Chesla, Catherine A; Chun, Kevin M; Kwan, Christine M L

    2009-10-01

    Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted.

  11. Overcoming Family Planning Challenges in Africa: Toward Meeting ...

    African Journals Online (AJOL)

    USER

    Overcoming Family Planning Challenges in Africa: Toward Meeting. Unmet Need ... The challenges posed are greater in ... Gaps in meeting women's needs persist especially ..... WHO. Everybody's business: Strengthening health systems to.

  12. Recurrent subcutaneous emphysema of the face: a challenging clinical problem.

    Science.gov (United States)

    Hojjati, Hossein; Davani, Sam Zeraatian Nejad; Johari, Hamed Ghoddusi

    2007-01-01

    In the neck or face, there are different causes for subcutaneous emphysema such as injury to the sinuses, the hypopharynx, the laryngotracheal complex, the pulmonary parenchyma, the esophagus or the presence of gas-forming organisms. However, factitious subcutaneous emphysema, a rare cause, must be considered in the differential diagnosis. In this clinical report, we discuss a 20-year-old girl who was under follow-up because of recurrent subcutaneous emphysema of the face and periorbital area. After 2 years of work-ups, including a period of close observation in the intensive care unit, self air injection by syringe was found as the cause of recurrent subcutaneous emphysema of the face, and the patient was labeled as having factitious recurrent subcutaneous emphysema. Therefore, when a patient presents with unexplained recurrent subcutaneous emphysema, one should suspect self-infliction and examine for puncture marks.

  13. Tolerance for distorted faces: challenges to a configural processing account of familiar face recognition.

    Science.gov (United States)

    Sandford, Adam; Burton, A Mike

    2014-09-01

    Face recognition is widely held to rely on 'configural processing', an analysis of spatial relations between facial features. We present three experiments in which viewers were shown distorted faces, and asked to resize these to their correct shape. Based on configural theories appealing to metric distances between features, we reason that this should be an easier task for familiar than unfamiliar faces (whose subtle arrangements of features are unknown). In fact, participants were inaccurate at this task, making between 8% and 13% errors across experiments. Importantly, we observed no advantage for familiar faces: in one experiment participants were more accurate with unfamiliars, and in two experiments there was no difference. These findings were not due to general task difficulty - participants were able to resize blocks of colour to target shapes (squares) more accurately. We also found an advantage of familiarity for resizing other stimuli (brand logos). If configural processing does underlie face recognition, these results place constraints on the definition of 'configural'. Alternatively, familiar face recognition might rely on more complex criteria - based on tolerance to within-person variation rather than highly specific measurement. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. The role of family therapy in the management of schizophrenia: challenges and solutions

    Science.gov (United States)

    Caqueo-Urízar, Alejandra; Rus-Calafell, Mar; Urzúa, Alfonso; Escudero, Jorge; Gutiérrez-Maldonado, José

    2015-01-01

    Family interventions for schizophrenia have been amply demonstrated to be effective and are recommended by most of the international clinical guidelines. However, their implementation in the clinical setting as well as in treatment protocols of patients with psychosis has not been fully achieved yet. With the increasing deinstitutionalization of patients, family has begun to assume the role of care performed by psychiatric hospitals, with a high emotional cost for caregivers as well as the recognition of burden experiences. Families have been the substitute in the face of the scarcity of therapeutic, occupational, and residential resources. For this reason, the viability of patients’ care by their families has become a challenge. This article aims to discuss the most important aspects of family interventions, their impact on families, and the most important challenges that need to be overcome in order to achieve well-being and recovery in both patients and caregivers. PMID:25609970

  15. Assessment of dietary challenges faced by Sub-Saharan immigrants ...

    African Journals Online (AJOL)

    Data relating to socio-demographic characteristics, such as continuity with ethnic food culture and the problems faced by Sub-Saharan immigrants with regard to them retaining their traditional food culture was collected. All the respondents indicated that they treasured and maintained their traditional food culture, albeit to ...

  16. The mighty oak faces challenges in the Pacific West

    Science.gov (United States)

    Gail Wells

    2010-01-01

    In popular imagination, the oak tree stands for strength, endurance, and longevity. But in the coastal lowlands and central valleys of British Columbia, Washington, Oregon, and California, oaks face a battery of natural and human-induced threats. Sudden oak death, caused by a virulent pathogen identified in 2000, has killed millions of tanoaks, California black oaks,...

  17. Challenges Faced by Adult Learners Enrolled in Blended Distance ...

    African Journals Online (AJOL)

    This research attempted to provide an insight into major barriers facing adult learners pursuing a diploma in adult and continuing education programme through Blended Distance Learning. Participants included the adult learners, staff from the Department of Open and Distance Learning who are also the facilitators of the ...

  18. Perceptions of family caregivers of cancer patients about the challenges of caregiving: a qualitative study.

    Science.gov (United States)

    Nemati, Shahnaz; Rassouli, Maryam; Ilkhani, Mahnaz; Baghestani, Ahmad Reza

    2018-03-01

    The experience of caring for a family member with cancer is associated with several care-related problems and challenges for the caregiver. The comprehensive and in-depth understanding of the trials and tribulations of caregiving can be a step towards resolving the problems faced by family caregivers of these patients. The present study aimed to explore challenges faced by Iranian family caregivers of cancer patients. The present qualitative study was conducted through in-depth semi-structured interviews held with 21 family caregivers of cancer patients selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analysed through conventional content analysis. The codes extracted from interviews produced four main themes, including 'confusion', 'uncertainty', 'disintegration' and 'setback', which collectively caused suffering for family caregivers. Care provided in an atmosphere of suffering and discontent diminishes caregiver's quality of life and quality of patient care. Health planners should therefore consider the challenges and sufferings faced by family caregivers and should seek to obviate them through appropriate plans. © 2017 Nordic College of Caring Science.

  19. Challenges when electricity markets face the investment phase

    International Nuclear Information System (INIS)

    Finon, Dominique; Johnsen, Tor Arnt; Midttun, Atle

    2004-01-01

    Deregulation of electricity industry in Europe has tended to start with a grace period of energy surplus inherited from the previously expansive coordinated economies and further amplified by better resource utilisation from extended international trade. The regulatory challenge has therefore primarily been to allocate existing generation to consumers in an efficient way. However, as energy demand increases, due to economic growth, the challenge of providing new capacity surfaces. The Nordic region, which has been a pioneer in internationalising and deregulating electricity, is now approaching this stage, ahead of most of the rest of Europe. While the Nordic case is characterised by specificities related to hydropower it also raises the more general challenge of capacity expansion under a deregulated market economy. The article therefore discusses how the Nordic investment challenges of today shed light on more generic challenges that may become more general European challenges of tomorrow. In a final section, the article discusses policy options available to address the investment/price-hike challenge. The argument is put forward that recursion to some degree of coordinated governance might seem necessary if solutions are confined within large-scale technical systems. However, within the context of a small-scale decentralised technological development, one may be more confident of competitive solutions. (Author)

  20. East Indian Families Raising ABCD Adolescents: Cultural and Generational Challenges

    Science.gov (United States)

    Poulsen, Shruti S.

    2009-01-01

    Immigration is a process fraught with both challenges and opportunities for families. In particular, East Indian families with U.S.-born adolescents experience the challenges of bridging cultures across generational divides; they are perceived by others as confused, identity less, and conflicted or as American-Born, Confused Desis (ABCDs). This…

  1. Issues facing families of infants discharged after cardiac surgery: the perceptions of charity helpline staff.

    Science.gov (United States)

    Wray, Jo; Tregay, Jenifer; Bull, Catherine; Knowles, Rachel L; Crowe, Sonya; Brown, Katherine

    2018-03-05

    To elicit the perceptions of helpline staff who talk to parents of children discharged after cardiac surgery in infancy about parents' key concerns. A qualitative study involving semistructured interviews with 10 staff at four heart charities. Interviews were recorded, transcribed and analysed using Framework analysis. Staff identified the knowledge, communication and support needs of parents which they described in terms of the impact of patient and family factors, sources of support and systems. Staff perceptions of helplines, in terms of the function of a helpline and the roles of its staff, together with staff's personal views based on their experience of multiple encounters with many families, influenced how they viewed families' needs and responded to their requests. Helpline staff provided important, previously uncaptured evidence about the challenges faced by parents of children discharged after cardiac surgery in infancy. Staff have an important role in supporting communication, in terms of speaking to families about how to talk to professionals and talking to professionals directly to get or give information when parents are unable to do so. Capturing the perspective of helpline staff about communication issues has highlighted the need for interventions with professionals as well as parents. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  2. Top Ten Challenges Facing the Next Secretary of Homeland Security

    National Research Council Canada - National Science Library

    2008-01-01

    In an effort to assist with the first Presidential administration transition of the Department of Homeland Security, the Homeland Security Advisory Council has identified ten key challenges that will...

  3. A Challenging Giant Dermatofibrosarcoma Protuberans on the Face

    Directory of Open Access Journals (Sweden)

    Gimena Castro Pérez

    2016-01-01

    Full Text Available Dermatofibrosarcoma protuberans (DFSP is a malignant fibrohistiocytic tumor that appears exclusively on the skin. It is a low-grade malignant soft tissue tumor of subcutaneous tissues that has a propensity for local recurrence but seldom metastasizes. It may rarely occur on the head and neck accounting for less than one percent of total head and neck malignancies. We present a man with a giant DFSP on the face. Oncological, functional, and aesthetic aspects are set forth.

  4. Family therapy for schizophrenia: cultural challenges and ...

    African Journals Online (AJOL)

    Family therapy is an effective, evidence based intervention for schizophrenia. This literature review explores the impact of culture on family therapy as a treatment model for schizophrenia and examines how cultural beliefs impact on access to care. Although there is a good deal of evidence to suggest that certain principles ...

  5. Challenges facing the development of the Arabic chatbot

    Science.gov (United States)

    AlHagbani, Eman Saad; Khan, Muhammad Badruddin

    2016-07-01

    The future information systems are expected to be more intelligent and will take human queries in natural language as input and answer them promptly. To develop a chatbot or a computer program that can chat with humans in realistic manner to extent that human get impressions that he/she is talking with other human is a challenging task. To make such chatbots, different technologies will work together ranging from artificial intelligence to development of semantic resources. Sophisticated chatbots are developed to perform conversation in number of languages. Arabic chatbots can be helpful in automating many operations and serve people who only know Arabic language. However, the technology for Arabic language is still in its infancy stage due to some challenges surrounding the Arabic language. This paper offers an overview of the chatbot application and the several obstacles and challenges that need to be resolved to develop an effective Arabic chatbot.

  6. Wise reasoning in the face of everyday life challenges

    NARCIS (Netherlands)

    Grossmann, Igor; Gerlach, Tanja M.; Denissen, J.J.A.

    2016-01-01

    How stable vs. dynamic is wisdom in daily life? We conducted a daily diary study of wise reasoning (WR) by recording people's reflections on daily challenges in terms of three facets: intellectual humility, self-transcendence, and consideration of others' perspectives/compromise. We observed

  7. Confronting the Challenges Facing the Nigerian Nation State: Using ...

    African Journals Online (AJOL)

    This paper explains the concept of nation-state and sports. It critically examines some of the challenges characterizing Nigerian nation state such as ethnicity, corruption, politics of godfatherisms, tribalism, language differences, and religious crises among others. It emphasizes the use of sports for creating of friendship ...

  8. Issues and Challenges Facing the Minority Woman Dentist.

    Science.gov (United States)

    Sinkford, Jeanne C.

    1992-01-01

    The status of minority women dentists is reviewed, and initiatives to improve it are noted. Issues and challenges for African-American female dentists are outlined, including negative racial/gender stereotypes, lack of advancement opportunities, difficulties in starting practices and securing professional and social support systems, lack of…

  9. Facing the Issues: Challenges, Censorship, and Reflection through Dialogue

    Science.gov (United States)

    Lent, ReLeah Cossett

    2008-01-01

    ReLeah Cossett Lent provides practical advice for ensuring that books are kept on shelves and in classrooms for students to read. She outlines steps for creating professional learning communities that engage with censorship issues and prepare schools to deal with book challenges in thoughtful, supportive ways. (Contains 4 figures.)

  10. Family therapy for schizophrenia: cultural challenges and ...

    African Journals Online (AJOL)

    developing countries. An effective, evidence based .... treatment varies within and between developing countries .... supervision, staff support, and management input in order to become ... perspective, understanding the patient's and family's.

  11. THE CHALLENGES POLITICAL LEADERSHIP FACES IN THE MODERN WORLD

    Directory of Open Access Journals (Sweden)

    T. N. Samsonova

    2016-01-01

    Full Text Available Political leadership is a concept central to understanding political processes and outcomes, yet its definition is elusive. The study of political leadership has a long history. Many disciplines have contributed to this study, including history, philosophy, political theory, psychology etc. Leadership is a process in which leaders and followers interact dynamically in a particular situation or context. Leaders must be able to connect with followers to understand their mood and their initiative. There are essential and operational differences between a leader and a manager. Managerial effectiveness is related to an emphasis on rationality and organizational structure. Leadership effectiveness is linked to symbols and culture. The interactive nature of leader-followers-situation can help us better understand the changing nature of the leaderfollower relationship and the increasingly greater complexity of situations leaders and followers face in contemporary world. Good leadership makes a difference, and it can be enhanced through greater awareness of the important factors influencing the leadership process. The changes we are facing in today’s world demand a new breed of political leaders, new forms and mechanisms of leader-follower interaction that provide effective leadership. 

  12. The experience of rural families in the face of cancer.

    Science.gov (United States)

    Girardon-Perlini, Nara Marilene Oliveira; Ângelo, Margareth

    2017-01-01

    To understand the meanings of cancer within the experience of rural families and how such meanings influence family dynamics. Qualitative study guided by Symbolic Interactionism as a theoretical framework and Grounded Theory as a methodological framework. Six rural families (18 participants) undergoing the experience of having a relative with cancer participated in the interview. Constant comparative analysis of data allowed the elaboration of an explanatory substantive theory, defined by the main category Caregiving to support the family world, which represents the family's symbolic actions and strategies to reconcile care for the patient and care for family life. Throughout the experience, rural families seek to preserve the interconnected symbolic elements that provide support for the family world: family unit, land, work and care. Compreender os significados do câncer presentes na experiência de famílias rurais e como esses significados influenciam a dinâmica familiar. Estudo qualitativo orientado pelo Interacionismo Simbólico como referencial teórico e pela Teoria Fundamentada nos Dados como referencial metodológico. Participaram, por meio de entrevista, seis famílias rurais (18 participantes) que estavam vivendo a experiência de ter um familiar com câncer. A análise comparativa constante dos dados permitiu a elaboração de uma teoria substantiva explicativa da experiência, definida pela categoria central Cuidando para manter o mundo da família amparado, que representa as ações e estratégias simbólicas da família visando a conciliar o cuidado do familiar doente e o cuidado da vida familiar. Ao longo da experiência, a família rural procura preservar os elementos simbólicos que, conectados, constituem o amparo do mundo da família: a unidade familiar, a terra, o trabalho e o cuidado.

  13. IT Project Portfolio Management; Challenges faced by Danish municipalities

    DEFF Research Database (Denmark)

    Hansen, Lars Kristian

    2010-01-01

    Abstract. Increasing the organizational benefits from IT projects is a key concern in most organizations. The use of Project Portfolio Management (PPM) is generally recommended by consultants (e.g. Kaplan 2005) and researchers (e.g. De Reyck et al 2005) as one way of increasing the organizational...... benefits from IT investments. This article reports from an action research project aiming at understanding and improving IT PPM practices in Danish municipalities, thereby contributing to the general body of knowledge concerning PPM of IT projects. Our findings suggest that the participating organizations...... might benefit from a structured approach as suggested by the literature (e.g. Kaplan 2005), but also that the prescriptive PPM literature in some areas is too simplistic when compared to the reality faced by the participating practitioners. Especially, our research suggests that different PPM elements...

  14. Should continued family firms face lower taxes than other estates?

    OpenAIRE

    Grossmann, Volker; Strulik, Holger

    2008-01-01

    Inheritance taxes may induce heirs to discontinue family firms. Because firm dissolution incurs transaction costs, a preferential tax treatment of transferred family businesses seems to be desirable from a macroeconomic viewpoint. The support of dynastic succession, however, entails also a cost on the economy if firm continuation by less able heirs prevents entry into entrepreneurship. Here, we investigate analytically and quantitatively the trade-off between transaction costs saved and creat...

  15. Power distribution faced with the challenges posed by competition

    International Nuclear Information System (INIS)

    Angelier, J.P.; Hadjsaid, N.; Sabonnadiere, J.C.

    2009-01-01

    The introduction of liberalization, the increasing share of decentralized electricity generation, the aging of electrical infrastructures, ambitious generation objectives and technological evolution are the key drivers that require substantial investments in the distribution grid. The most urgent challenges are to adapt the network architecture and operation, modernize and improve metering equipment, renovate existing facilities. The Energy Regulatory Commission sets the price to be paid by users of the distribution grid; this price is set rather low, in order to encourage the system operator to make productivity gains. But resultant low income may deprive the operator of the financial resources needed to adapt the system to the new conditions. (authors)

  16. Challenges faced by young persons living with HIV: The case of ...

    African Journals Online (AJOL)

    Challenges faced by young persons living with HIV: The case of children on the ... Journal of Social Development in Africa ... to 34 randomly selected children who were beneficiaries of an initiative called the Community Outreach Programme.

  17. Co-Creating Desired Outcomes and Strengthening the Resilience of Multi-Challenged Families

    Directory of Open Access Journals (Sweden)

    Nina Mešl

    2016-12-01

    Full Text Available Families facing poverty suffer from many other stresses, with children’s school performance being one of the common topics. A life of poverty and the related unfavourable circumstances should not define children’s life stories. Ensuring this is not the case is partly the responsibility of professionals working with families. It is important to overcome the problem of the frequently dispersed help given to multi-challenged families. We proceed from the premise that the vicious circle of failures can be broken by providing support and help to the family and by establishing a co-creative working relationship involving all of the participants in a joint working project. The results of the plural case study confirmed the importance of working with multi-challenged families, which includes dealing with the children’s poor school performance, in their homes. They also showed the inadequacy of the often dominant discourse claiming that families do not want to receive help. The results prioritise the role of social workers and the relationship established at the beginning of the collaboration with the family. The presence of a social worker who persists with a joint project even in the case of failure represents an important new experience for families. Although multi-challenged families are resilient, they sometimes need an interlocutor to help them recognise and strengthen that resilience.

  18. The impact of war on Puerto Rican families: challenges and strengthened family relationships.

    Science.gov (United States)

    Magaly Freytes, I; Hannold, Elizabeth M; Resende, Rosana; Wing, Kristen; Uphold, Constance R

    2013-08-01

    We describe the impact of war on Puerto Rican Veterans and family members. We used qualitative research methods to collect and analyze data. We interviewed 8 Veterans and 8 family members. We used the constant comparison method to review data to identify prominent themes. Two categories emerged: (1) Challenges associated with post-deployment family reintegration, and (2) A positive aftermath of war on the family. Overall, findings indicate that OEF/OIF Veterans and family members were not prepared for the changes they encounter post-deployment. Despite these challenges, some Veterans and family members strengthened their relationships and renewed their appreciation for one another.

  19. Issue and challenges facing rechargeable thin film lithium batteries

    International Nuclear Information System (INIS)

    Patil, Arun; Patil, Vaishali; Shin, Dong Wook; Choi, Ji-Won; Paik, Dong-Soo; Yoon, Seok-Jin

    2008-01-01

    New materials hold the key to fundamental advances in energy conversion and storage, both of which are vital in order to meet the challenge of global warming and the finite nature of fossil fuels. Nanomaterials in particular offer unique properties or combinations of properties as electrodes and electrolytes in a range of energy devices. Technological improvements in rechargeable solid-state batteries are being driven by an ever-increasing demand for portable electronic devices. Lithium batteries are the systems of choice, offering high energy density, flexible, lightweight design and longer lifespan than comparable battery technologies. We present a brief historical review of the development of lithium-based thin film rechargeable batteries highlight ongoing research strategies and discuss the challenges that remain regarding the discovery of nanomaterials as electrolytes and electrodes for lithium batteries also this article describes the possible evolution of lithium technology and evaluates the expected improvements, arising from new materials to cell technology. New active materials under investigation and electrode process improvements may allow an ultimate final energy density of more than 500 Wh/L and 200 Wh/kg, in the next 5-6 years, while maintaining sufficient power densities. A new rechargeable battery technology cannot be foreseen today that surpasses this. This report will provide key performance results for thin film batteries and highlight recent advances in their development

  20. Challenges faced by public health nursing leaders in hyperturbulent times.

    Science.gov (United States)

    Reyes, David J; Bekemeier, Betty; Issel, L Michele

    2014-01-01

    This study discusses the challenges and characteristics of effective public health nursing leaders in local health departments and barriers to effective leadership during the hyperturbulent conditions of 2008-2010. Participants were drawn from a purposive sample of seven directors of nursing (DON) in six county LHDs in two states for this qualitative study using inductive methods. Semistructured telephone interviews were conducted, using open-ended questions. Data analysis consisted of coding, pattern identification, and theme development, assisted by the use of ATLAS.ti™. Credibility was achieved through intercoder agreement and resonance of the findings with participants. Two underlying challenges emerged: leadership dissonance and leading through ambiguity. Three key effective leadership attributes identified were as follows: collaborative change management, life-long learning, and being visionary. DONs identified extrinsic and intrinsic barriers to leadership effectiveness and leading change in public health systems and PHN practice. Results suggest ways to support PHN leaders in order to overcome barriers to effective leadership such as defined leadership competencies, continuing education, and mentorship opportunities. © 2013 Wiley Periodicals, Inc.

  1. Myth 15: High-Ability Students Don't Face Problems and Challenges

    Science.gov (United States)

    Moon, Sidney M.

    2009-01-01

    One rationale for failure to address the needs of high-ability students in schools is that high-ability students do not need special services because they do not face any special problems or challenges. A more extreme corollary of this attitude is the notion that high ability is so protective that students with high ability do not face problems or…

  2. Challenges Faced by Undergraduate Military Students at American Public University System

    Science.gov (United States)

    Machuca, Ana; Torres, Karin; Morris, Pamela; Whitley, William

    2014-01-01

    This paper will summarize some of challenges faced by military students enrolled in an associate and bachelors online program at American Public University System (APUS). The survey results on which the study is based exposed the following problems faced by military personnel: 48.7% had difficulties working around military obligations, 33.3%…

  3. Recent Challenges Facing US Government Climate Science Access and Application

    Science.gov (United States)

    Goldman, G. T.; Carter, J. M.; Licker, R.

    2017-12-01

    Climate scientists have long faced politicization of their work, especially those working within the US federal government. However, political interference in federal government climate change science has escalated in the current political era with efforts by political actors to undermine and disrupt infrastructure supporting climate science. This has included funding changes, decreased access to climate science information on federal agency websites, restrictions on media access to scientific experts within the government, and rolling back of science-based policies designed to incorporate and respond to climate science findings. What are the impacts of such changes for both the climate science community and the broader public? What can be done to ensure that access to and application of climate change-related research to policy decisions continues? We will summarize and analyze the state of climate change research and application in the US government. The impacts of political interference in climate change science as well as opportunities the scientific community has to support climate science in the US government, will be discussed.

  4. Facing technological challenges of Solar Updraft Power Plants

    Science.gov (United States)

    Lupi, F.; Borri, C.; Harte, R.; Krätzig, W. B.; Niemann, H.-J.

    2015-01-01

    The Solar Updraft Power Plant technology addresses a very challenging idea of combining two kinds of renewable energy: wind and solar. The working principle is simple: a Solar Updraft Power Plant (SUPP) consists of a collector area to heat the air due to the wide-banded ultra-violet solar radiation, the high-rise solar tower to updraft the heated air to the atmosphere, and in between the power conversion unit, where a system of coupled turbines and generators transforms the stream of heated air into electric power. A good efficiency of the power plant can only be reached with extra-large dimensions of the tower and/or the collector area. The paper presents an up-to-date review of the SUPP technology, focusing on the multi-physics modeling of the power plant, on the structural behavior of the tower and, last but not least, on the modeling of the stochastic wind loading process.

  5. The environmental challenges facing a Chinese oil company in Chad

    International Nuclear Information System (INIS)

    Van Vliet, Geert; Magrin, Geraud; Dittgen, Romain; Tavares, Marie-Adeline; Doudjidingao, Antoine; Maoundonodji, Gilbert; Liang, Guohuang; Wang, Fan; Yang, Weiyong; Lin, Yiran

    2012-11-01

    This book analyses the factors that influence environmental management in the CNPC when operating outside of China, in the outer margins of the world oil system, specifically in Chad, a Least Developed Country. Within a sector marked by the regulations inherited from the Exxon project in Doba (implemented since 2000 with initial World Bank support), the 2007 CNPC Ronier project aims at refining part of the extracted oil and exporting the remainder, most probably through the pipeline built under the Exxon Doba project. The question of the compatibility between the systems of reference and practices in both firms thus arises. Through the prism of social and environmental responsibility, this text analyses the challenges in the interaction between Chinese oil firms, host countries and OCDE-based firms. (authors)

  6. [China faces a challenge of breast cancer prevention and control].

    Science.gov (United States)

    Zhang, B N; Chen, W Q; Zhang, X; Qiao, Y L

    2016-10-23

    The incidence and mortality of breast cancer is in an increasing trend. In contrast to the global breast cancer situation, the prevention and control is challenging in China. Some suggestions are presented to the project of breast cancer prevention and control in China. Combining the global screening experiences with the epidemiological features of Chinese female breast cancer, aims to improve the population screening and early detection rate. Standardizing clinical diagnosis and treatment practice, aims to increase the efficacy and decrease the mortality. Intervening lifestyle and dietary behaviors, and intends to reduce risk exposure and incidence. Building national breast cancer registry provides preventive strategies. Great efforts should be made to carry out large sample multicenter clinical trails and translational research on the prevention and cotrol of breast cancer coordiated by health care service and science and technology administrations. Breast cancer prevention and control has a long way to go in China.

  7. Challenges faced when identifying patients for combination immunotherapy.

    Science.gov (United States)

    Ernstoff, Marc S; Gandhi, Shipra; Pandey, Manu; Puzanov, Igor; Grivas, Petros; Montero, Alberto; Velcheti, Vamsidhar; Turk, Mary Jo; Diaz-Montero, Claudia Marcela; Lewis, Lionel D; Morrison, Carl

    2017-08-01

    In 1996, Jim Allison demonstrated that blocking the immune regulatory molecule CTLA-4 with anit-CTLA4 antibody led to enhance tumor responses in mice. It would take an additional 15 years for human studies to confirm the potency and clinical efficacy of anti-CTLA4, ultimately leading to US FDA approval of the first checkpoint inhibitor, ipilimumab. Now with a plethora of immune-modulating agents demonstrating single agent safety and benefit across many tumor types, investigation on the optimal combination of immune-based therapies has begun in earnest. While there are many challenges, a central one is how to select which combination for which patient is the best. Here we review the current approaches that a practitioner can use to achieve this therapeutic goal.

  8. Facing Domestic Violence Against Women in Brazil: Advances and Challenges

    Directory of Open Access Journals (Sweden)

    Thiago Pierobom de Avila

    2018-03-01

    Full Text Available This article aims to offer a critical overview of the Brazilian legal framework for confronting domestic violence against women. Intimate partner homicides are epidemic in Brazil: there are four deaths of women per day. In 2006, the Maria da Penha Law (MPL introduced integrated polices and transformed criminal procedures to deal with the complexities of gender violence. Reforms included the establishment of The House of Brazilian Women, women-only police stations, specialised courts, intervention orders, interdisciplinary experts, and perpetrator programs. In 2015, a new law created the crime of femicide, designed to prevent ‘honor killings’ defenses in cases of intimate partner homicide and to avoid impunity. Despite law reform, structuring and articulating the network of services remains a challenge. The MPL led to great social change in Brazil regarding awareness of the violence against women, facilitating a broader discussion about gender equality.

  9. Social Media: Challenges and Concerns for Families.

    Science.gov (United States)

    O'Keeffe, Gwenn Schurgin

    2016-10-01

    This article explores the impact of social media on child development and family health. Why do we allow our children to use social media sites before their privacy policies allow? Why do we let them lie about their ages to use these sites? What is it about technology that lets us bend these rules in a way we would never do in the unplugged world? Gaining insight into the answers to these questions and what is positive and negative about social media and the digital world allows us to talk to families about this world, allay their concerns, and keep children of all age safe when using social media. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. The challenges facing the European Union Centres of Excellence

    International Nuclear Information System (INIS)

    Dupre, Bruno; )

    2012-10-01

    On 19 April 2012, the United Nation Security Council congratulated the European Union for its initiative on centres of excellence in the nuclear, radiological, biological, and chemical fields. The time for glowing reports is over. Three years after its creation, the support of EU Member Sates, the Security Council, the G8, the IEAE, the WHO, the USA, Interpol, the ICRC, has been obtained. Other diplomatic, organisational, and communicative challenges have now arisen regarding implementation. The manifest challenges include: 1/Political exploitation of the centres. Following a recent round table in Algiers, the Algerian press ran headlines such as 'terrorism, the Malian crisis arrives in Algiers' CBRN centres of excellence' and 'Bouteflika, the centres of excellence slight'. 2/Communication errors. A unanimously approved expert in South East Asia became a persona non grata over the last six months despite not making any fundamental mistake, aside from his inability to evaluate the degree of a country's sensitivity and pride. The countries in the region went so far as to threaten to pull out of the Manila centre as a result of this ultimately minor error in communication. 3/The scope of the centres' role complicates the grasp of its objectives. To date, the focus has essentially been on non-proliferation and the fight against CBRN terrorism, under the well-established theme of Resolution 1540. The shift of CBRN focus, at the behest of certain regions, on to real natural risks (pandemics) or industrial risks (protection of crucial infrastructure following an earthquake, flooding, or a tsunami) fundamentally changes the teams' make-up and the mobilization of resources. The emergency services culture is different to that of nonproliferation. However, they both very much address CBRN risks and threats. 4/The limits of the 'bottom-up' approach. To date, the centres' success has been due to the lack of restrictive rules. The policy is to enlist willing third-party States

  11. The challenges that parents of children with epilepsy face: A qualitative study.

    Science.gov (United States)

    Kampra, Matina; Tzerakis, Nikolaos; Lund Holm Thomsen, Louise; Katsarou, Efstathia; Voudris, Konstantinos; D Mastroyianni, Sotiria; Mouskou, Stella; Drossou, Kyriaki S; Siatouni, Anna; Gatzonis, Stylianos

    2017-06-01

    This qualitative study explored the challenges that Greek parents/caregivers of children with controlled epilepsy (CwE) face regarding the disorder. Interviews were conducted based on open-ended questions guided by a review of the literature. A total of 91 parents/caregivers were recruited by neurologists at the neurology clinics of two Athens public hospitals. A hermeneutic phenomenological approach was used to explore parent/caregiver experiences. The data were grouped and analyzed through a textual interpretation. Two key challenges were identified for parents of CwE: the disclosure of epilepsy and the absence of adequate information about coping with epilepsy. Parents in Greece were hesitant to reveal their child's epilepsy to school staff and their wider social milieu. Also, although satisfied with the patient-centered approach they experienced with their hospital doctor, parents/caregivers found that they needed more education about the existing sources of psychosocial and emotional support to cope with their child's epilepsy personally and as a family. Finally, the parents/caregivers who let their child know about the epilepsy and discussed the implications with the child found that parent-child communication improved. This study provides valuable insight into the impact of epilepsy on parents of CwE, which might help hospital and school staff support families with greater understanding, sensitivity, and skill. The findings suggest that Greek authorities should staff hospitals and schools with experts and more systematically advertise sources of information about epilepsy and ways to cope with it. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Sustainable Digital Environments: What Major Challenges Is Humankind Facing?

    Directory of Open Access Journals (Sweden)

    Roland W. Scholz

    2016-07-01

    Full Text Available This paper identifies and discusses the benefits, threats, and vulnerabilities related to the digital revolution. It aims to motivate research and its funding regarding digital threats and vulnerabilities related, in particular, to anticipating unintended, undesirable rebound effects, tipping points, critically fast evolutionary change rates, trade-offs, etc. A brief analysis of the history of the mind and technology reveals slow technological development over tens of thousands of years (including the invention of a place-value digital number system. Then, a small series of groundbreaking ideas (e.g., binary logic, Shannon’s symbolic analysis of relay and switching circuits, architectures of computing enabled the industry-driven invention of programmable computing machines. Ultimately, the mastery of electron and semiconductor physics allowed for economical and seemingly unlimited storage capacity that made digital tools available to all domains of society. Based on the historical analysis, a coupled human-environment systems perspective (that includes a hierarchy assumption ranging from the human cell to the human species enables the identification of several potential challenges to society and science. First, digital nano-engineering promotes genetic modifications (i.e., directed evolution, and synthetic biology enables a new level of the appropriation of nature. The understanding of cell-based biocomputers may call for new forms of logic. These and other challenges require thorough sustainability research in order to anticipate major changes on all levels of human systems. Second, the human individual is exposed to new forms of vulnerability. In particular, the potential epigenetic effects resulting from the excessive use of digital information of historically unknown speed, density, and contents and the loss of (the Western common-law right to privacy resulting from big data (whose ownership is often unknown should become subjects of

  13. Indonesia's family planning story: success and challenge.

    Science.gov (United States)

    Hull, T H; Hull, V J; Singarimbun, M

    1977-11-01

    A historical overview and descriptions of family planning programs in Indonesia are presented. 85 million of the 135 million inhabitants of the Indonesian archipelago are concentrated on the island of Java, which comprises about 7% of the Indonesian land mass. The Dutch colonial government preferred a policy ("transmigration") which advocated the redistribution of population from Java to the other islands to relieve overpopulation. This policy was also advocated by President Sukarno after the Indonesian Revolution of 1940. The need for family planning was recognized by small groups, and official policy supported national family planning programs to replace transmigration programs only after Sukarno became president in 1966. The focus of the program was on Java and Bali, the 2 most populous islands. Local clinics became the locus for birth control efforts. Fieldworkers affiliated with the clinics were given the job of advocating birth control use door-to-door. Fieldworkers "incentive programs," area "target" (quota) programs, and "special drives" were organized to create new contraceptive "acceptors." A data reporting system and a research program increase the effectiveness of the family planning drive by ascertaining trends in contraceptive use which can determine where and how money and effort can best be applied. "Village Contraception Distribution Centers" bring the contraceptive means closer to the people than do the clinics. Figures from the years 1969-1977 show the great increase in acceptance of contraceptives by the inhabitants of the Java-Bali area. Steps are now being taken to alleviate the large monthly variations in the number of (often temporary) acceptors caused by the "target programs" and "special drives." The average acceptor is 27-years-old, has 2.6 children, has not finished primary school, and has a husband of low social status. Bali has shown the greatest success in family planning. It is a small island with a highly developed system of local

  14. The family in face of the elderly's reality of living alone.

    Science.gov (United States)

    Perseguino, Marcelo Geovane; Horta, Ana Lucia de Moraes; Ribeiro, Circéa Amalia

    2017-04-01

    to understand the family dynamics in face of the reality of the elderly living alone. study of qualitative approach with theoretical reference of symbolic interactionism that involved interviews with families. Data were analyzed by thematic analysis. six families participated in the study. The discourse analysis originated the following categories: The family respecting their decision making; The family organizing itself to the process of living alone after the age of 80 years; The family experiencing the freedom of living alone. in this study, it was possible to identify the facilitation of the possibility of living alone with preparation and agreements between the family during the family life cycle, leading to the feeling of freedom and quality of life of all members. Nursing, as a science responsible for elaborating care strategies, should work together with families to assist in the planning of care plans based on the individual social reality of the family.

  15. Representative Delay Measurements (RDM: Facing the Challenge of Modern Networks

    Directory of Open Access Journals (Sweden)

    Joachim Fabini

    2015-02-01

    Full Text Available Network access technologies have evolved significantly in the last years. They deploy novel mechanisms like reactive capacity allocation and time-slotted operation to optimize overall network capacity. From a single node's perspective, such optimizations decrease network determinism and measurement repeatability. Evolving application fields like machine to machine (M2M communications or real-time gaming often have strict real-time requirements to operate correctly. Highly accurate delay measurements are necessary to monitor network compliance with application demands or to detect deviations of normal network behavior, which may be caused by network failures, misconfigurations or attacks. This paper analyzes factors that challenge active delay measurements in modern networks. It introduces the Representative Delay Measurement tool (RDM that addresses these factors and proposes solutions that conform to requirements of the recently published RFC7312. Delay measurement results acquired using RDM in live networks confirm that advanced measurement methods can significantly improve the quality of measurement samples by isolating systematic network behavior. The resulting high-quality samples are one prerequisite for accurate statistics that support proper operation of subsequent algorithms and applications.

  16. Challenges Faced in Field Application of Phosphate-Solubilizing Bacteria

    KAUST Repository

    Eida, Abdul Aziz

    2017-08-01

    The general inaccessibility of soil phosphorous (P) to plants in combination with the depletion of global P reserves provides an incentive for researchers to find sustainable solutions to sustain food security for the ever-increasing world population. Bio-fertilizers based on bacteria and fungi able to solubilize endogenous P in soils have a high potential for increasing nutrient availability in agriculture. However, the inconsistency of bio-fertilizer performance in the field poses a major challenge for farmers. This discrepancy is thought to stem from the complexity of the interactions between crop plants, microbes, and their soil environments, as well as our lack of understanding of the processes involved. For farmers, a clear beneficial effect across different soil types, crop species, environmental conditions, and microbial communities will be required to make it worth to adopt bio-fertilizer technology based on phosphate-solubilizing microbes (PSMs). Here, we attempt to review the current knowledge of the complexity of the P-solubilization mechanisms used by PSMs and how they may be affected by interactions in the field. We also identify possible explanations for the inconsistent performance of P-solubilizing bacteria in the field and ways to solve these obstacles.

  17. U.S. drilling contractors could face stiff challenges

    International Nuclear Information System (INIS)

    Simmons, M.R.

    1993-01-01

    Although the outlook for most segments of the contract drilling business is now more optimistic than in the past decade, the increased activity has brought several problems: the availability of fully trained crews, the need for new capital, and the limited number of quality drillstrings. These problems will grow in importance if natural gas deliverability begins to decline visibly and once the scramble to correct this decline begins. As the drilling recovery unfolds, the most important lesson to remember, based on worldwide activity in the past year, is how rapidly conditions can change and how quickly excess capacity can turn into chronic shortages. The various segments of the world wide contract drilling industry's prospects have changed dramatically during the past 12 months, and oddly, some market sectors have improved while others have become worse. These quick changes highlight the unpredictable and volatile nature of the markets for contract drilling and other services needed to drill and complete oil and gas wells. The paper describes the business of well drilling onshore and offshore in the US, drilling activities in Canada, international markets, capacity, the supplies of natural gas, Gulf of Mexico activities, drill pipe shortages, manpower shortages, and challenges offshore

  18. Regulatory challenges facing the global nuclear energy partnership

    International Nuclear Information System (INIS)

    Lyman, Edwin S.

    2007-01-01

    In January 2006 the Department of Energy (DOE) announced the creation of the Global Nuclear Energy Partnership (GNEP), an ambitious plan to reshape the nuclear energy production sector both in the United States and worldwide. If fully realized in the United States, GNEP would entail the construction of a large number of sodium-cooled fast reactors utilizing actinide-based fuels, multiple commercial-scale reprocessing plants for both light-water and fast reactors, and fast reactor fuel fabrication plants. It appears likely that the first commercial-scale GNEP facilities, as well as a future full-scale GNEP complex, would fall under the licensing jurisdiction of the Nuclear Regulatory Commission (NRC). This will be a challenging endeavor for the NRC, primarily because the proposed GNEP facilities will in large part be based on novel and untested designs and processes that have not been developed on a commercial scale. In order to effectively regulate the GNEP complex, the NRC will have to quickly address the many technical and policy questions that will arise in any GNEP licensing scheme. This paper identifies some difficult issues that will be encountered in GNEP licensing by examining the potential implications of NRC's current policies and regulatory requirements, and analyzing the impacts of some emerging post-9/11 security issues. (author)

  19. Facing regulatory challenges of on-line hemodiafiltration.

    Science.gov (United States)

    Kümmerle, Wolfgang

    2011-01-01

    On-line hemodiafiltration (on-line HDF) is the result of a vision that triggered multifarious changes in very different areas. Driven by the idea to offer better medical treatment for renal patients, technological innovations were developed and established that also constituted new challenges in the field of regulatory affairs. The existing regulations predominantly addressed the quality and safety of those products needed to perform dialysis treatment which were supplied by industrial manufacturers. However, the complexity of treatment system required for the provision of on-line fluids demanded a holistic approach encompassing all components involved. Hence, focus was placed not only on single products, but much more on their interfacing, and the clinical infrastructure, in particular, had to undergo substantial changes. The overall understanding of the interaction between such factors, quite different in their nature, was crucial to overcome the arising regulatory obstacles. This essay describes the evolution of the on-line HDF procedure from the regulatory point of view. A simplified diagram demonstrates the path taken from the former regulatory understanding to the realization of necessary changes. That achievement was only possible through 'management of preview' and consequent promotion of technical and medical innovations as well as regulatory re-evaluations. Copyright © 2011 S. Karger AG, Basel.

  20. Challenges Faced in Field Application of Phosphate-Solubilizing Bacteria

    KAUST Repository

    Eida, Abdul Aziz; Hirt, Heribert; Saad, Maged

    2017-01-01

    The general inaccessibility of soil phosphorous (P) to plants in combination with the depletion of global P reserves provides an incentive for researchers to find sustainable solutions to sustain food security for the ever-increasing world population. Bio-fertilizers based on bacteria and fungi able to solubilize endogenous P in soils have a high potential for increasing nutrient availability in agriculture. However, the inconsistency of bio-fertilizer performance in the field poses a major challenge for farmers. This discrepancy is thought to stem from the complexity of the interactions between crop plants, microbes, and their soil environments, as well as our lack of understanding of the processes involved. For farmers, a clear beneficial effect across different soil types, crop species, environmental conditions, and microbial communities will be required to make it worth to adopt bio-fertilizer technology based on phosphate-solubilizing microbes (PSMs). Here, we attempt to review the current knowledge of the complexity of the P-solubilization mechanisms used by PSMs and how they may be affected by interactions in the field. We also identify possible explanations for the inconsistent performance of P-solubilizing bacteria in the field and ways to solve these obstacles.

  1. Talking about epilepsy: Challenges parents face when communicating with their child about epilepsy and epilepsy-related issues.

    Science.gov (United States)

    O'Toole, Stephanie; Lambert, Veronica; Gallagher, Pamela; Shahwan, Amre; Austin, Joan K

    2016-04-01

    The aim of this qualitative study was to explore the challenges that parents of children with epilepsy experienced when engaging in dialog with their child about epilepsy and epilepsy-related issues. Using a qualitative exploratory approach, interviews were conducted with 34 parents of children with epilepsy (aged 6-16 years), consisting of 27 mothers and 7 fathers. Data were transcribed verbatim and thematically analyzed. Findings revealed five main themes: normalizing epilepsy, the invisibility of epilepsy, information concealment, fear of misinforming the child, and difficulty in discussing particular epilepsy-related issues. Many of the communicative challenges experienced by parents impacted on their ability to engage openly in parent-child dialog about epilepsy in the home. Parents face specific challenges when choosing to communicate with their child about epilepsy, relating to creating a sense of normality, reducing fear of causing their child worry, and having a lack of epilepsy-related knowledge. Healthcare professionals who work closely with families living with epilepsy should remain mindful of the importance of discussing family communication surrounding epilepsy and the challenges parents of children with epilepsy face when talking about epilepsy within the home. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Unconventional combinations of prospective parents: ethical challenges faced by IVF providers.

    Science.gov (United States)

    Klitzman, Robert

    2017-02-28

    Professional guidelines have addressed ethical dilemmas posed by a few types of nontraditional procreative arrangements (e.g., gamete donations between family members), but many questions arise regarding how providers view and make decisions about these and other such arrangements. Thirty-seven ART providers and 10 patients were interviewed in-depth for approximately 1 h each. Interviews were systematically analyzed. Providers faced a range of challenges and ethical dilemmas concerning both the content and the process of decisions about requests for unconventional interfamilial and other reproductive combinations. Providers vary in how they respond - what they decide, who exactly decides (e.g., an ethics committee or not), and how - often undergoing complex decision-making processes. These combinations can involve creating or raising the child, and can shift over time - from initial ART treatment through to the child's birth. Patients' requests can vary from fully established to mere possibilities. Arrangements may also be unstable, fluid, or unexpected, posing challenges. Difficulties emerge concerning not only familial but social, combinations (e.g., between friends). These arrangements can involve blurry and confusing roles, questions about the welfare of the unborn child, and unanticipated and unfamiliar questions about how to weigh competing moral and scientific concerns - e.g., the autonomy of the individuals involved, and the potential risks and benefits. Clinicians may feel that these requests do not "smell right"; and at first respond with feelings of "yuck," and only later, carefully and explicitly consider the ethical principles involved. Proposed arrangements may, for instance, initially be felt to involve consanguineous individuals, but not in fact do so. Obtaining and verifying full and appropriate informed consent can be difficult, given implicit familial and/or cultural expectations and senses of duty. Social attitudes are changing, yet patients

  3. UK community health visiting: challenges faced during lean implementation

    Directory of Open Access Journals (Sweden)

    Carr SM

    2012-01-01

    Full Text Available Susan M Carr1,2, Pauline Pearson1, Lesley Young-Murphy3, Barbara Cleghorn41Centre for Community Health & Education Studies Research & Enterprise, Northumbria University, Newcastle upon Tyne, UK; 2School of Health, University of New England, Armidale, New South Wales, Australia; 3NHS North of Tyne, Newcastle upon Tyne, UK, 4Newcastle PCT, Newcastle upon Tyne, UKAbstract: This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole

  4. A Content Analysis Concerning the Studies on Challenges Faced by Novice Teachers

    Science.gov (United States)

    Kozikoglu, Ishak

    2017-01-01

    The purpose of this research is to analyze the studies concerning challenges faced by novice teachers in terms of various aspects and compare challenges according to location of the studies conducted in Turkey and abroad. A total of 30 research studies were included in detailed analysis. This is a descriptive study based on qualitative research…

  5. Romanian spatial planning research facing the challenges of globalizing sciences

    Directory of Open Access Journals (Sweden)

    Alexandru-Ionuţ Petrişor

    2018-03-01

    competitiveness, measured in terms of scientific yield and citations, primarily affects fields where articles and citations are not the traditional outputs, such as the humanities and social sciences in general and planning-related disciplines in particular. When discussing planning, it has to be stressed out that research has a merely societal value and is not aimed at developing products that can foster economic growth or delivering scientific articles that profoundly change the theoretical perspectives. Simply put, research in planning aims at increasing the safety and welfare of people. As a consequence, planning research topics have shifted from providing scientific grounds to regional development policies, to addressing research quality and social responsibility or producing research guidelines. This article looks at the particular case of Romanian planning research based on SCImago data, in an attempt to assess whether this field is able to meet these global challenges, especially after the consistent, albeit uneven, in terms of goal and pace, application of new research policies designed after joining the European Union, which were aimed at increasing its article output and its international visibility. The findings indicate that the numerical growth of articles and publications is spectacular in Romania for most fields, and even more so within the humanities, the social sciences and planning. However, the question remains whether this impressive growth is supported by an increase in quality. We have therefore left aside matters such as the globalization of authors, topics or citations. These aspects require a more in-depth research effort.

  6. Autism in Brazil: a systematic review of family challenges and coping strategies.

    Science.gov (United States)

    Gomes, Paulyane T M; Lima, Leonardo H L; Bueno, Mayza K G; Araújo, Liubiana A; Souza, Nathan M

    2015-01-01

    To describe the challenges faced by families caring for children with autism spectrum disorder (ASD) in Brazil and the coping strategies employed. Systematic review of articles published until September of 2013, without language restrictions, using quality appraisal (AMSTAR and CASP/Oxford instruments). The literature shows parental emotional overload as one of the main challenges faced by families, especially mothers. The main stressors were diagnostic postponement, difficulty dealing with the diagnosis and associated symptoms, and poor access to health services and social support. The predominant coping strategies found included information exchange between affected families and integrated healthcare network for patient and family support. ASD exerts strong influence on family dynamics, resulting in caregiver overload, especially in mothers. The Brazilian Unified Health System needs to provide comprehensive, continuous, and coordinated care to strengthen the patient-family dyad and promote the full development and societal inclusion of children with ASD. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  7. The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.

    Science.gov (United States)

    Bern-Klug, Mercedes

    2008-01-01

    Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. Secondary data analyses of qualitative ethnographic data. Two nursing homes in a large Midwestern city; 8 months of data collection in each. 44 family members of nursing home residents whose health was considered, "declining." Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis. Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated. Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.

  8. Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia.

    Science.gov (United States)

    Walubita, Mulima; Sikateyo, Bornwell; Zulu, Joseph M

    2018-05-02

    Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia, and their coping strategies. This was an exploratory health facility-based qualitative study that was conducted at a Paediatric oncology ward at referral hospital in Zambia. In-depth individual interviews conducted with fifteen (15) caregivers and seven (7) key informants were analysed using thematic analysis. Several challenges related to managing the childhood cancer diagnosis were recorded. Individual and family challenges were inadequate knowledge on childhood cancer, lack of finances to meet treatment and transport costs as well as long period of hospitalisation that affected women's ability to perform multiple responsibilities. Whereas challenges at community level were inadequate support to address emotional and physical distress and social stigmatisation experienced by caregivers. Health systems issues included inadequate specialised health workers, poor communication among health workers, limited space and beds as well as insufficient supplies such as blood. Cultural related factors were the belief that cancer is a product of witchcraft as well as religious beliefs regarding the role of faith healing in childhood cancer treatment. Coping strategies used by parents/ caregivers included praying to God, material support from organisations and church as well as delaying having another child. Addressing the challenges for health care providers, parents and patients who face a childhood cancer diagnosis may require adopting a systems or an ecological approach that allows developing strategies that simultaneously address challenges related to the individual, family, community, health system and cultural aspects.

  9. Quality of family history collection with use of a patient facing family history assessment tool.

    Science.gov (United States)

    Wu, R Ryanne; Himmel, Tiffany L; Buchanan, Adam H; Powell, Karen P; Hauser, Elizabeth R; Ginsburg, Geoffrey S; Henrich, Vincent C; Orlando, Lori A

    2014-02-13

    Studies have shown that the quality of family health history (FHH) collection in primary care is inadequate to assess disease risk. To use FHH for risk assessment, collected data must have adequate detail. To address this issue, we developed a patient facing FHH assessment tool, MeTree. In this paper we report the content and quality of the FHH collected using MeTree. A hybrid implementation-effectiveness study. Patients were recruited from 2009 to 2012. Two community primary care clinics in Greensboro, NC. All non-adopted adult English speaking patients with upcoming appointments were invited to participate. Education about and collection of FHH with entry into MeTree. We report the proportion of pedigrees that were high-quality. High-quality pedigrees are defined as having all the following criteria: (1) three generations of relatives, (2) relatives' lineage, (3) relatives' gender, (4) an up-to-date FHH, (5) pertinent negatives noted, (6) age of disease onset in affected relatives, and for deceased relatives, (7) the age and (8) cause of death (Prim Care31:479-495, 2004.). Enrollment: 1,184. Participant demographics: age range 18-92 (mean 58.8, SD 11.79), 56% male, and 75% white. The median pedigree size was 21 (range 8-71) and the FHH entered into MeTree resulted in a database of 27,406 individuals. FHHs collected by MeTree were found to be high quality in 99.8% (N = 1,182/1,184) as compared to quality of the FHH data that is collected and talking with relatives prior to the collection of FHH significantly improves the quantity and quality of the data provided. This allows more patients to be accurately risk stratified and offered appropriate preventive care guided by their risk level. NCT01372553.

  10. Children with chronic continence problems: the challenges for families.

    Science.gov (United States)

    Erickson, David V; Ray, Lynne D

    2004-01-01

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

  11. Family caregiver recruitment via social media: challenges, opportunities and lessons.

    Science.gov (United States)

    Hansen, Dana; Sheehan, Denice K; Stephenson, Pam

    2017-02-02

    Illness blogs are a way seriously ill people communicate publicly about their illness journey. As communication about serious illness increases on social media, it is important to evaluate how this affects the family caregiver. However, identifying and accessing family caregivers remains challenging, especially via social media. The aim of this article is to report the opportunities, challenges and lessons learned from using social media to recruit family caregivers. Recruitment methods included posting study invitations on illness blogs, advertising through Facebook and placing study fliers in the community. Using social media to recruit was inexpensive and provided a wide geographical reach. One important finding was discovering the importance of using language in the recruitment materials that family caregivers could identify with to help deem themselves as eligible to participate in the study.

  12. Exploring strategies to overcome extra-organisational challenges faced by community pharmacies in Sarawak, Malaysia.

    Science.gov (United States)

    Kho, Boon Phiaw; Hassali, Mohamed Azmi; Lim, Ching Jou; Saleem, Fahad

    2018-03-15

    The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations. Items were constructed based on the findings of a prior qualitative research supplemented with relevant literature about these issues. High levels of homogeneity in responses were recorded on various extra-organisational challenges faced, particularly those economy-oriented. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than services provision. Highly rated strategies included increasing discounts for customers (n = 54; 68%) and finding cheaper suppliers (n = 70; 88%). Legislative changes proposed that might increase their share of the pharmaceutical market were strongly supported by respondents, particularly about making it compulsory for general practitioners to provide patients the option to have their medicines dispensed in community pharmacies (n = 72; 90%). Current legislative conditions and Malaysian consumer mindset may have constrained the strategic choices of community pharmacies to deal with the strong extra-organisational challenges. A long-term multipronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change. © 2018 Royal Pharmaceutical Society.

  13. OPPORTUNITIES AND CHALLENGES FOR MICRO-SMALL AND MEDIUM BUSINESS IN INDONESIA FACING ASEAN ECONOMIC COMMUNITY

    OpenAIRE

    Raden Aswin Rahadi

    2016-01-01

    This research is a part of a continuous study to analyze the opportunities and challenges for micro-small and medium business in Indonesia when facing ASEAN Economic Community (AEC) in 2016. It has its own uniqueness, as it will combine the point of view between current business owners and current literature study synthesis on business perception towards AEC. Ten business owners have been interviewed. The results suggested AEC provides challenges for the business owners, particularly in terms...

  14. Developing Strategies for Islamic Banks to Face the Future Challenges of Financial Globalization

    OpenAIRE

    Al Ajlouni, Ahmed

    2004-01-01

    Developing Strategies for Islamic Banks to Face the Future Challenges of Financial Globalization Ahmed Al-Ajlouni Abstract This study aims at forming strategic response to assess the ability of Islamic banks in benefiting from the opportunities that may be provided by financial globalization and limits its threats, through assessing the capability of Islamic banks to meet the requirements and challenges of financial globalization, then suggests the suitable strategies that may be ...

  15. Women in orthodontics and work-family balance: challenges and strategies.

    Science.gov (United States)

    Davidson, Sarah; Major, Paul W; Flores-Mir, Carlos; Amin, Maryam; Keenan, Louanne

    2012-01-01

    The number of women entering the orthodontic profession over the past few decades has increased dramatically. A review of the literature revealed the lack of research on achieving a work-family balance among female dentists and dental specialists. Work-family balance has been researched more extensively in the field of medicine; however, despite some critical differences, parallels between these 2 professions exist. This study identified issues that Canadian female orthodontists face and strategies they use to achieve a work-family balance. A phenomenological qualitative study was used to analyze the results of semi-structured telephone interviews of a purposive sample of 13 Canadian female orthodontists. The results strongly support the role-conflict theory about the competing pressures of maternal and professional roles. Female orthodontists described their challenges and strategies to minimize role conflict in their attempt to achieve a work-family balance. The women defined balance as having success and satisfaction in both their family life and professional life. They identified specific challenges of achieving a work-family balance that are unique to orthodontic practice and strategies for adapting to their maternal and professional roles. Achieving a work-family balance is of paramount importance to female orthodontists, and the results of this study may be applied to other specialties in dentistry.

  16. A qualitative exploration of the major challenges facing pharmacovigilance in Saudi Arabia.

    Science.gov (United States)

    Aljadhey, Hisham; Mahmoud, Mansour A; Alshammari, Thamir M; Al-Dhaeefi, Mohammed; Le Louet, Herve; Perez-Gutthann, Susana; Pitts, Peter J

    2015-09-01

    To explore the challenges facing pharmacovigilance in Saudi Arabia and formulate recommendations to improve it from the perspective of healthcare professionals in Saudi Arabia. This was a qualitative study of 4 focus group discussions with pharmacists, physicians, and academicians held under the auspices of the King Saud University School of Pharmacy and the Center for Medicine in the Public Interest, Riyadh, Saudi Arabia. A total of 29 eligible healthcare professionals were invited to participate in the discussion. The predefined themes of the study were the current practice and major challenges facing pharmacovigilance in regulatory bodies, hospitals, the community, and academia, as well as recommendations to improve pharmacovigilance practice.  Of the 29 participants invited, 27 attended the discussion. Challenges facing regulatory bodies included complicated adverse drug reactions (ADR) reporting forms, lack of feedback on ADRs submitted to the Saudi Food and Drug Authority, lack of decisions from the local authority to withdraw medications, and lack of data on pharmacovigilance. The challenges to pharmacovigilance in hospitals included the lack of knowledge of the significance of ADR reporting, workload, blaming culture, and lack of collaboration between regulatory bodies and hospitals. However, challenges facing pharmaceutical industries included the lack of drug manufacturers in Saudi Arabia and lack of interest in pharmacovigilance. Recommendations to improve pharmacovigilance included the need for communication, stronger regulatory requirements, the need for research, the need for unified ADRs reporting, and continuous education and training.  The study has identified the challenges facing pharmacovigilance in Saudi Arabia and made certain recommendations to overcome them. These recommendations might be helpful for regulatory bodies to enhance spontaneous reporting and promote pharmacovigilance.

  17. Examining the Challenging Hindrances facing in the Construction Projects: South India’s Perspective

    Science.gov (United States)

    Subramanyam, K.; Haridharan, M. K.

    2017-07-01

    Developing countries like India require a huge infrastructure to facilitate needs of the people. Construction industry provides several opportunities to the individuals. Construction manager work is to supervise and organize the construction activities in construction projects. Now a day construction manager facing challenges. This paper aimed to study the challenges facing by the construction manager in the perception of construction professionals. 39 variables were taken from the literature review which found to be severe impact on construction managers’ performance. Construction manager, project manager and site engineers are the respondents for this survey. Using SPSS, regression analysis was done and recognized significant challenges. These challenges were classified into 5 domains. In management challenges, resource availability and allocation, risks and uncertainties existing in the project onsite, top management support and cost constraints are the most significant variables. In skills requirement of a construction manager challenges, technical skills required to learn and adapt new technology in the project, decision making and planning according to the situation in site are the most significant variables. In performance challenges, implementation of tasks according to the plan is the important variable whereas in onsite challenges, manage project risks, develop project policies and procedures are the most important.

  18. Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology

    Science.gov (United States)

    Magalhães-Sant'Ana, M.; More, S. J.; Morton, D. B.; Hanlon, A.

    2016-01-01

    Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. PMID:27613779

  19. Challenges Pre-Service Teachers Face When Implementing a 5E Inquiry Model of Instruction

    Science.gov (United States)

    Enugu, Ramya; Hokayem, Hayat

    2017-01-01

    This study examined the challenges that pre-service teachers faced when implementing inquiry and their perspective on how to overcome them. The data sample was 55 pre-service teachers (PSTs) enrolled into two sections of a science methods course in a private university in North Texas. The data sources consisted of inquiry-based lesson plans, PST…

  20. Rural Teachers' Views: What Are Gender-Based Challenges Facing Free Primary Education in Lesotho?

    Science.gov (United States)

    Morojele, Pholoho

    2013-01-01

    This paper gives prominence to rural teachers' accounts of gender-based challenges facing Free Primary Education in Lesotho. It draws on feminist interpretations of social constructionism to discuss factors within the Basotho communities that affect gender equality in the schools. The inductive analysis offered makes use of the data generated from…

  1. 'If it ain't broke, don't fix it': Challenges facing institutional ...

    African Journals Online (AJOL)

    recruitment and retention of blacks and women in senior posts is still the major challenge facing .... classed social space in order to gain trust and to succeed in their careers. ... In this paper, we examine how participants in one particular ADP experience the .... they didn't want a new way of doing things and they believed the.

  2. Transition Program: The Challenges Faced by Special Needs Students in Gaining Work Experience

    Science.gov (United States)

    Alias, Aliza

    2014-01-01

    Transition program for special needs students is known to open opportunities for students with learning disabilities to gain work experience in actual work environment. The program provides training activities and also an opportunity to go for internship to gain work experience. Therefore, this study is to identify the challenges faced by special…

  3. "Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia"

    Science.gov (United States)

    de Lange, Paul; Watty, Kim

    2011-01-01

    Of the various reports released in 2010, two purport to examine the state of accounting education in Australia. These are "Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia". Both were released as collaborations of the leading academic organisation, the Accounting and Finance…

  4. Becoming a nurse faculty leader: facing challenges through reflecting, persevering and relating in new ways.

    Science.gov (United States)

    Horton-Deutsch, Sara; Young, Patricia K; Nelson, Kristine A

    2010-05-01

    The aim of the present study was to explore the experience of becoming a nurse faculty leader. In a recent interpretation of 23 interviews conducted with nurse faculty leaders from across the United States about their experiences of becoming a leader three themes were identified: being thrust into leadership, taking risks and facing challenges. This interpretive phenomenological study further explicates three aspects of how nurse educators faced challenges in becoming and serving as a leader. Facing challenges meant reflecting, persevering through difficulties and learning to relate to others in new ways. Exemplars of participant experiences are provided for concreteness, to assist readers in determining how findings resonate with their own experience and how they can actualize this resonance in their own leadership practice. In the present study, reflecting, persevering through difficulties and learning to relate with others in a new way was how leaders faced challenges. Leadership development opportunities that facilitate self-exploration, caring and thoughtful interactions with others and values clarification serve as the foundation for becoming a nurse faculty leader who is, in turn, able to build leadership capacity in other individuals and organizations.

  5. Oral Academic Discourse Socialisation: Challenges Faced by International Undergraduate Students in a Malaysian Public University

    Science.gov (United States)

    Mahfoodh, Omer Hassan Ali

    2014-01-01

    This paper reports a qualitative study which examines the challenges faced by six international undergraduate students in their socialisation of oral academic discourse in a Malaysian public university. Data were collected employing interviews. Students' presentations were also collected. Semi-structured interviews were transcribed verbatim and…

  6. New Challenges Facing Universities in the Internet-Driven Global Environment

    Science.gov (United States)

    Rajasingham, Lalita

    2011-01-01

    This paper explores some new challenges facing universities in a global multimediated Internet-based environment, as they seek alternative paradigms and options to remain true to their core business. At a time of rapid technological change, and contested, complex concepts associated with globalisation, knowledge is becoming a primary factor of…

  7. Challenges Facing Women Academic Leadership in Secondary Schools of Irbid Educational Area

    Science.gov (United States)

    Al-Jaradat, Mahmoud Khaled Mohammad

    2014-01-01

    This study aimed at identifying the challenges facing women academic leadership in secondary schools of Irbid Educational Area. A random sample of 187 female leaders were chosen. They responded to a 49-item questionnaire prepared by the researcher. The items were distributed into four domains: organizational, personal, social and physical…

  8. A Short Twenty Years: Meeting the Challenges Facing Teachers Who Bring Rwanda into the Classroom

    Science.gov (United States)

    Gudgel, Mark

    2013-01-01

    As the twentieth anniversary of the 1994 genocide in Rwanda approaches, Mark Gudgel argues that we should face the challenges posed by teaching about Rwanda. Drawing on his experience as a history teacher in the US, his experience researching and supporting others' classrooms in the US and UK, his training in Holocaust education and his knowledge…

  9. Overcoming family planning challenges in Africa: toward meeting ...

    African Journals Online (AJOL)

    Overcoming family planning challenges in Africa: toward meeting unmet need and scaling up service delivery. Andrzej Kulczycki. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL.

  10. Challenges in diagnosis and counseling of a family with two ...

    African Journals Online (AJOL)

    ... of specific investigations, metabolic specialized labs and the deficiency of documentation. In this case report, we present the challenges that we met in diagnosis and counseling of a family with both Tay–Sachs and maple syrup urine disease depending mainly on history, clinical data and a few diagnostic investigations.

  11. Deriving consumer-facing disease concepts for family health histories using multi-source sampling.

    Science.gov (United States)

    Hulse, Nathan C; Wood, Grant M; Haug, Peter J; Williams, Marc S

    2010-10-01

    The family health history has long been recognized as an effective way of understanding individuals' susceptibility to familial disease; yet electronic tools to support the capture and use of these data have been characterized as inadequate. As part of an ongoing effort to build patient-facing tools for entering detailed family health histories, we have compiled a set of concepts specific to familial disease using multi-source sampling. These concepts were abstracted by analyzing family health history data patterns in our enterprise data warehouse, collection patterns of consumer personal health records, analyses from the local state health department, a healthcare data dictionary, and concepts derived from genetic-oriented consumer education materials. Collectively, these sources yielded a set of more than 500 unique disease concepts, represented by more than 2500 synonyms for supporting patients in entering coded family health histories. We expect that these concepts will be useful in providing meaningful data and education resources for patients and providers alike.

  12. [Brazilian Army nurses and transportation of the wounded: a challenge faced during World War II].

    Science.gov (United States)

    Bernardes, Margarida Maria Rocha; Lopes, Gertrudes Teixeira

    2007-01-01

    This historic-sociologic study aims to analyse the challenges faced by the Brazilian Expeditionary Force's Air Transportation Nurses of the Army with the Theatre of Operations on the course of World War II. The primary source was comprised of a photograph from this time period and oral testimonies of those who participated in the conflict. Ideas by sociologist Pierre Bourdieu support the discussion. Results suggest that Brazilian nurses were challenged to transport the wounded without medical advice. We conclude that the challenge to fulfill the task imposed, which led to independent decision-making, gave confidence and autonomy to the ones already responsible for the transportation of the wounded.

  13. THE SOCIAL AND OCCUPATIONAL HEALTH PROBLEMS OF CHILD LABOUR: A CHALLENGE THE WORLD IS FACING

    Directory of Open Access Journals (Sweden)

    Kapil Goel

    2012-03-01

    Full Text Available Eliminating child labour is one of the biggest challenges that the world is facing. Child labour not only causes damage to a child’s physical and mental health but also keeps him deprived of his basic rights to education, development, and freedom. Children of lower socio-economic class are known to be inducted as child labour. The main causes of child labour include poverty, unemployment, excess population and urbanization. The construction sector is one of the most hazardous working environments especially for children. Children are exposed to dangerous machinery causing fatal and non-fatal injuries, while operating or working near them. Children are exposed to strenuous labour, which can affect the musculo-skeletal development of the children. In industries, child workers are exposed to various physical, mental, social occupational hazards resulting in lower growth and poor health status. Working long hours, child labourers are often denied a basic school education, normal social interaction, personal development and emotional support from their family. The Child Labour Act was implemented in India in 1986 that outlaws child labour in certain areas and sets the minimum age of employment at fourteen. Eradicating poverty is only the first step on the road for eliminating child labour. There is an urgent need for intensive focus and research along with political and practical decisions to improve the conditions of working children for the betterment of their health and development. Proper education of the children and banning child labor will help in boosting the success of the country.

  14. ‘Everyone has a secret they keep close to their hearts’: challenges faced by adolescents living with HIV infection at the Kenyan coast

    Directory of Open Access Journals (Sweden)

    Amina Abubakar

    2016-02-01

    Full Text Available Abstract Background The upsurge in the uptake of antiretroviral therapy (ART has led to a significant increase in the survival of vertically acquired HIV infected children, many of whom are currently living into adolescence and early adulthood. However little if anything is known of the lived experiences and the challenges faced by HIV positive adolescents in the African context. We set out to investigate psychosocial challenges faced by HIV infected adolescents on the Kenyan coast. Methods A total of 44 participants (12 HIV-infected adolescents, 7 HIV uninfected adolescents, and 25 key informants took part in this qualitative study, using individually administered in-depth interviews. A framework approach was used to analyze the data using NVIVO software. Results We observed that the challenges faced by adolescents in rural Kenya could be placed into six major themes: poverty, poor mental and physical health, the lack of a school system that is responsive to their needs, challenges in how to disclose to peers and family members, high levels of stigma in its various forms, and challenges of medical adherence leading to the need for close monitoring. Conclusion In this African community, vertically acquired HIV-infected adolescents face a complex set of social, economic and medical challenges. Our study points to the urgent need to develop multisectorial intervention support programmes to fully address these challenges.

  15. Challenges and Specifications for Robust Face and Gait Recognition Systems for Surveillance Application

    Directory of Open Access Journals (Sweden)

    BUCIU Ioan

    2014-05-01

    Full Text Available Automated person recognition (APR based on biometric signals addresses the process of automatically recognize a person according to his physiological traits (face, voice, iris, fingerprint, ear shape, body odor, electroencephalogram – EEG, electrocardiogram, or hand geometry, or behavioural patterns (gait, signature, hand-grip, lip movement. The paper aims at briefly presenting the current challenges for two specific non-cooperative biometric approaches, namely face and gait biometrics as well as approaches that consider combination of the two in the attempt of a more robust system for accurate APR, in the context of surveillance application. Open problems from both sides are also pointed out.

  16. The organisational and human resource challenges facing primary care trusts: protocol of a multiple case study

    Directory of Open Access Journals (Sweden)

    Tim Scott J

    2001-11-01

    Full Text Available Abstract Background The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs. Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. Methods The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development.

  17. Different perspectives on the key challenges facing rural health: The challenges of power and knowledge.

    Science.gov (United States)

    Malatzky, Christina; Bourke, Lisa

    2018-05-25

    To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.

  18. [Family: a Challenge for the Future of our Earth].

    Science.gov (United States)

    Gamboa-Bernal, Gilberto A

    2016-01-01

    The Universal Declaration of Human Rights recognizes the family as the basic cell of society, highlighting its importance, the need to protect it, to promote it as a natural and fundamental group unit of society. To reflect on the effects that the actual culture is in the family is important from the situation as it is now presented, then move to raise the changes seen necessary to ensure their own future and that of their habitat that is Earth. To accomplish this first task some study results World Family Map 2015 is glossed. Later reflections on the binomial environmental ecology and human ecology, where the importance of adequate from anthropological concepts to succeed in each of these fields. The current decline of culture directly affects the family by undermining one of its main bases, human love, which is a real threat. They are proposed some challenges for the family and mentioned strategies to address them. As outlined that conclusion not to follow the activity of endangering the human species and destroy the planet, it is necessary to change the current social structure and culture, beginning with the family; must be helped to become aware of their problems and limitations, so that later you can give truly human solutions to these problems, almost always produced by the same man.

  19. Challenges faced by parents of children with learning disabilities in Opuwo, Namibia.

    Science.gov (United States)

    Taderera, Clever; Hall, Herna

    2017-01-01

    Parenting children with learning disabilities requires a high level of knowledge and access to resources, information and services. In developing countries, however, these resources and services are not always available. Parents in Namibia, a developing country, therefore face challenges addressing children's learning and other developmental disabilities, including challenges related to preventative and supportive interventions. This research focuses on challenges faced by parents as they parent children with learning disabilities in Opuwo, Namibia. In-depth interviews were conducted with eight parents regarding the challenges they face in parenting their children with learning disabilities. Thematic analysis enabled the researchers to identify, analyse and report on themes that emerged from the qualitative interview data. Analysis of the interviews indicated that some participants had only a vague understanding of learning disabilities, as they did not have access to essential knowledge about this phenomenon. They also lacked an awareness of the availability of programmes, services and policies meant to benefit their children with learning disabilities. Participants voiced that they, their children with learning disabilities and community members have stereotypes and prejudices regarding learning disabilities. In this study, most of the children with learning disabilities were raised by single, unemployed parents who seemed to have access to less support from external sources than married couples parenting children with learning disabilities. These single parents are usually not married and because of lack of financial support from the other parent, the majority of them indicated that they struggle to meet the financial and material needs of their children. The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main challenges emanate from financial instability, as

  20. A New World for Museum Marketing? Facing the Old Dilemmas while Challenging New Market Opportunities

    Directory of Open Access Journals (Sweden)

    Tanja Komarac

    2014-12-01

    Full Text Available Museums are part of a wider cultural and entertainment environment, which is ruled by highly demanding visitors who seek immersive experiences (edutainment and time-saving arrangement. This has encouraged and, in some opinions, forced museums to turn their focus from collections to visitors. In addition, museums have faced competition and new technologies in the form of virtual museums and virtual reality. This has emphasized the need to accept marketing as a survival tool and to make it into a link between museums and visitors. This article attempts to give current insights into museum marketing as part of the arts marketing field. Its aim is also to identify and explain some of the major challenges and opportunities facing everyday museum business, in order to provide insight into the complex world of museum marketing. Former findings about the development of museum marketing and its biggest changes and challenges are presented, summarized and analyzed.

  1. Women In Action: Challenges Facing Women Entrepreneurs In The Gauteng Province Of South Africa

    OpenAIRE

    Elizabeth Chinomona; Eugine Tafadzwa Maziriri

    2015-01-01

    In today’s post-modern era, the role of women entrepreneurs in economic development is inevitable and women are willing to take action in business and contribute to the nation’s growth. Women are stepping up to own and run businesses in numbers that would have been hard to imagine a mere few decades ago. However, women entrepreneurs face a wide variety of challenges both in starting and in growing their business ventures. The objective of this paper is to investigate the challenges women entr...

  2. The Challenges Facing Small-Scale Women Entrepreneurs: A Case of Kenya

    OpenAIRE

    Fridah Muriungi Mwobobia

    2012-01-01

    The study sought to identify the challenges facing small scale women entrepreneurs in Kenya and initiatives put in place to counter the challenges. The study employed desktop research. MSEs Baseline survey, recorded that 612,848 women in Micro and Small Enterprises (MSEs) in Kenya, accounting for 47.4 per cent of all those in MSEs. The study showed that women tended to operate enterprises associated with traditional women¡¯s roles, such as hairstyling. The small and micro enterprises (SMEs) p...

  3. Challenges and motivators to physical activity faced by retired men when ageing: a qualitative study.

    Science.gov (United States)

    Bredland, Ebba Langum; Söderström, Sylvia; Vik, Kjersti

    2018-05-15

    Active ageing reflects the message from World Health Organisation about addressing the challenge faced by the rapidly ageing population. Knowledge about barriers and facilitators to an active lifestyle must be given more attention. In addition, men seem to participate less in cultural activities and less in fall-prevention groups than women do. When mostly women work with the elderly in primary care, one might question whether the activities offered to older men meet their activity preferences. The aim of this study is to provide new knowledge about challenges and motivators encountered by retired men in maintaining physical activity when ageing. Nine retired men, aged between 66 and 83, wrote a Time Geographic Diary for 7 days each. Two focus group discussions with the men were held. A Systemic Text Condensation was used to analyse the data. The analyses identified three categories to describe challenges in being physical active: differences between men and women; meaningful physical activity; and environmental - especially socio-cultural - constraints. Motivating conditions were seen as: new activities to get younger friends, and more information about how to cope. To achieve the aim of active ageing, service providers as well as local authorities need to have a better understanding of the challenges retired men encounter when ageing. This study highlights vital aspects of the challenges faced by retired men in maintaining their physical activity level.

  4. Recommendations on Arresting Global Health Challenges Facing Adolescents and Young Adults.

    Science.gov (United States)

    Lassi, Zohra S; Salam, Rehana A; Bhutta, Zulfiqar A

    The health challenges faced by young people are more complex than adults and can compromise their full growth and development. Attention must be paid to the health of this age group, yet adolescents and youth remain largely invisible and often disappear from the major global datasets. The aim of this paper is to discuss the global health challenges faced by adolescents and youth, global legislations and guidelines pertaining to this particular age group, recommendations to arrest these challenges, and research priorities. Major direct and indirect global health risks faced by adolescents include early pregnancy and childbirth, femicide, honor killing, female genital mutilation, nutritional habits and choices, social media, and peer pressure. There are no standard legal age cut-offs for adulthood; rather, the age varies for different activities, such as age of consent or the minimum age that young people can legally work, leave school, drive, buy alcohol, marry, be held accountable for criminal action, and make medical decisions. This reflects the fact that the existing systems and structures are focused on either children or adults, with very few investments and interventions directed specifically to young people. Existing legislation and guidelines need transformation to bring about a specific focus on adolescents in the domains of substance use and sexual behaviors, and the capacity for adolescent learning should be exploited through graduated legal and policy frameworks. Sustainable development goals provide an opportunity to target this neglected and vulnerable age group. A multisectoral approach is needed to bring about healthy change and address the challenges faced by adolescents and youth, from modifications at a broader legislative and policy level to ground-level (community-level) implementations. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  5. Japan's shift to a proactive defense architecture: Challenges faced by industry, government, and society

    OpenAIRE

    Chung, Hoyoon

    2017-01-01

    Approved for public release; distribution is unlimited As a result of the changing security environment in the Asia-Pacific, Japan is shifting to a more proactive defense policy, as outlined in the National Defense Program Guidelines (NDPG). This thesis investigates the challenges faced by Japan's industry, government, and society in meeting the NDPG objectives. To do this, this thesis probes the following problem areas: difficulties with indigenous production of weapons systems, inability...

  6. Challenges facing the distribution of an artificial-intelligence-based system for nursing.

    Science.gov (United States)

    Evans, S

    1985-04-01

    The marketing and successful distribution of artificial-intelligence-based decision-support systems for nursing face special barriers and challenges. Issues that must be confronted arise particularly from the present culture of the nursing profession as well as the typical organizational structures in which nurses predominantly work. Generalizations in the literature based on the limited experience of physician-oriented artificial intelligence applications (predominantly in diagnosis and pharmacologic treatment) must be modified for applicability to other health professions.

  7. Nanotechnology: Nanomaterials are Widely Used in Commerce, but EPA Faces Challenges in Regulating Risk

    Science.gov (United States)

    2010-05-01

    549 Nanotechnology equivalent.17 In addition, nanotechnology -enabled water desalination and filtration systems may offer affordable...Senate NANOTECHNOLOGY Nanomaterials Are Widely Used in Commerce, but EPA Faces Challenges in Regulating Risk May 2010 GAO-10-549...2010 2. REPORT TYPE 3. DATES COVERED 00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Nanotechnology : Nanomaterials Are Widely Used in Commerce

  8. Post-industrial landscape - its identification and classification as contemporary challenges faced by geographic research

    Czech Academy of Sciences Publication Activity Database

    Kolejka, Jaromír

    2010-01-01

    Roč. 14, č. 2 (2010), s. 67-78 ISSN 1842-5135 Institutional research plan: CEZ:AV0Z30860518 Keywords : classification * geographical research * identification method * landscape structure Subject RIV: DE - Earth Magnetism, Geodesy, Geography http://studiacrescent.com/images/02_2010/09_jaromir_kolejka_post_industrial_landscape_its_identification_and_classification_as_contemporary_challenges_faced_by_geographic_.pdf

  9. "Don't lock me out": life-story interviews of family business owners facing succession.

    Science.gov (United States)

    Solomon, Alexandra; Breunlin, Douglas; Panattoni, Katherine; Gustafson, Mara; Ransburg, David; Ryan, Carol; Hammerman, Thomas; Terrien, Jean

    2011-06-01

    This qualitative study used a grounded theory methodology to analyze life-story interviews obtained from 10 family business owners regarding their experiences in their businesses with the goal of understanding the complexities of family business succession. The grounded theory that emerged from this study is best understood as a potential web of constraints that can bear on the succession process. Coding of these interviews revealed four key influences, which seem to have the potential to facilitate or constrain the family business owner's approach to succession. Influence 1, "The business within," captures intrapsychic dynamics of differentiation and control. Influence 2, "The marriage," addresses how traditional gender roles shape succession. Influence 3, "The adult children," examines the role of having a natural (accidental, organic, passively groomed) successor. Influence 4, "The vision of retirement," captures the impact of owners' notions of life post-succession. Family therapists frequently encounter family systems in which the family business is facing succession. Even if succession is not the presenting problem, and even if the business owner is in the indirect (rather than direct) system, this research reminds clinicians of the importance of the family's story about the family business. Therefore, clinical implications and recommendations are included. 2011 © FPI, Inc.

  10. Challenges faced by former child soldiers in the aftermath of war in Uganda.

    Science.gov (United States)

    Vindevogel, Sofie; De Schryver, Maarten; Broekaert, Eric; Derluyn, Ilse

    2013-06-01

    Warfare takes a profound toll of all layers of society, creating multiple and multilevel challenges that impinge on the psychosocial well-being of affected individuals. This study aims to assess the scope and salience of challenges confronting former child soldiers and at identifying additional challenges they face compared to non-recruited young people in war-affected northern Uganda. The study was carried out with a stratified random sample of northern Ugandan adolescents (n = 1,008), of whom a third had formerly been recruited (n = 330). The mixed-method comparison design consisted of a constrained free listing task to determine the challenges; a free sorting task to categorize them into clusters; and statistical analysis of their prevalence among formerly recruited youth and of how they compare with those of nonrecruited youth. Altogether, 237 challenges were identified and clustered into 15 categories, showing that formerly recruited participants mainly identified "emotional" and "training and skills"-related challenges. Compared with nonrecruited counterparts, they reported significantly more "emotional" and fewer "social and relational" challenges, with the exception of stigmatization. Overall, there was similarity between the challenges reported by both groups. The challenges confronting formerly recruited youths reach well beyond the effects of direct war exposure and emerge mainly from multiple influence spheres surrounding them. These challenges are largely shared in common with nonrecruited youths. This multidimensional and collective character of challenges calls for comprehensive psychosocial interventions through which healing the psychological wounds of war is complemented by mending the war-affected surroundings at all levels and in all life areas. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Polish families in the face of challenges and threats posed by the first half of the 20th century (in the light of „Szkoła” [Rodziny polskie wobec wyzwań i zagrożeń pierwszej połowy XX wieku (w świetle „Szkoły”

    Directory of Open Access Journals (Sweden)

    Agnieszka WAŁĘGA

    2016-06-01

    Full Text Available For Polish people and Polish families the first half of the 20th century was a difficult time. It was the final period of the Partitions, with intensified repression, especially Russification and Germanization, the time of World War I, and twenty years of the rebuilding of Polish statehood which ended in another worldwide armed conflict in 1939. The dynamic political changes which led to the outbreak of WWI and WWII and to the regaining of independence by Poland in 1918 were accompanied by significant transformations of social structure and new tendencies in the development of culture and education. The change of women’s social position and their political and educational emancipation forced new models of family relations to appear, and a uniform school system reconstructed after 123 years of bondage, together with the introduction of compulsory school attendance and the development of forms of pre-schooling education were significant challenges for many parents and their children. During the entire period the Polish family played a very important part in educational ideologies binding in Polish lands at that time – national and state education. Because of that it was the subject of interest of many pedagogic magazines. The aim of the paper is to indicate the main areas of tasks given to Polish families in the first half of the 20th century in the light of one of the oldest Polish periodicals of this type – „Szkoła”. Apart from the topics brought up in the pages of this magazine in the second half of the 19th century such as the cooperation of home and school, some new problems appeared then, including: the duties of a family in the difficult war and post-war period, concern for child’s health at home, or the significance of parents’ shaping of characteristics propagated by the supporters of national education.

  12. When family looks strange and strangers look normal : A case of impaired face perception and recognition after stroke

    NARCIS (Netherlands)

    Heutink, Joost; Brouwer, Wiebo H.; Kums, Evelien; Young, Andy; Bouma, Anke

    2012-01-01

    We describe a patient (JS) with impaired recognition and distorted visual perception of faces after an ischemic stroke. Strikingly, JS reports that the faces of family members look distorted, while faces of other people look normal. After neurological and neuropsychological examination, we assessed

  13. The Challenges Faced by Informal Traders in Greater Letaba Municipality in Limpopo Province, South Africa

    Directory of Open Access Journals (Sweden)

    Kole Legodi

    2015-12-01

    Full Text Available Informal trade has grown at an alarming rate in South Africa because of lack of employment opportunities in both the private and public sectors. This has resulted in many unemployed members of the population joining the informal business sector. The majority of people in this sector do not have skills that are needed in the formal employment sector, others are semi-literate and a small percentage has some level of qualification. Nevertheless, this sector is plagued by a number of challenges which this article presents.  The article reports on the study that was conducted at Greater Letaba Municipality in Limpopo Province. The aim of the study was to investigate the challenges that were faced by informal traders in Greater Letaba Municipality in Limpopo Province in South Africa. The area was chosen because of its accessibility to the researchers and its potential to provide relevant and accurate information for the research project. Thus, a qualitative research method was used to collect data through face to face interviews. The research discovered that some of the challenges experienced by the informal traders in the area ranged from lack of support from the local municipality to structural challenges like lack of ablution facilities and limited access to electricity. Furthermore, other challenges concerned safety and health issues that were also gender based. Most of the traders in the area were women; an element which attest to the fact that it is difficult to find employment in the country when one is less educated and is also a woman.

  14. Oncology nurses' communication challenges with patients and families: A qualitative study.

    Science.gov (United States)

    Banerjee, Smita C; Manna, Ruth; Coyle, Nessa; Shen, Megan Johnson; Pehrson, Cassandra; Zaider, Talia; Hammonds, Stacey; Krueger, Carol A; Parker, Patricia A; Bylund, Carma L

    2016-01-01

    The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Communication Challenges and Strategies of U.S. Health Professionals Caring for Seriously Ill South Asian Patients and Their Families.

    Science.gov (United States)

    Khosla, Nidhi; Washington, Karla T; Shaunfield, Sara; Aslakson, Rebecca

    2017-06-01

    While effective communication is important in the care of seriously ill patients, little is known about communication challenges faced by healthcare providers serving U.S. patients of South Asian origin, one of the fastest growing demographic groups in the United States. Researchers sought to examine communication challenges faced by healthcare providers serving seriously ill South Asian patients and their families and present strategies recommended by providers for effective communication. Researchers conducted a thematic analysis of qualitative data obtained through focus groups and individual interviews with 57 healthcare providers, including physicians, social workers, nurses, chaplains, and others drawn from different healthcare settings in one Midwestern city. While acknowledging the considerable diversity within the U.S. South Asian community, participants discussed three types of communication challenges they often encounter when serving this population: ensuring effective interpretation, identifying a spokesperson, and challenges posed by different cultural norms. Participants shared strategies to address these challenges such as proactively inquiring about patients' and families' preferences and encouraging early appointment of a spokesperson. While providers should avoid stereotyping patients, an awareness of common challenges and adoption of recommended strategies to address these challenges may enhance the provision of culturally responsive person-centered services for seriously ill South Asian patients and their families receiving care in the United States.

  16. Challenges faced by cocoyam farmers in adapting to climate change in Southeast Nigeria

    Directory of Open Access Journals (Sweden)

    C.C. Ifeanyi-Obi

    2017-01-01

    Full Text Available The study examined the challenges faced by cocoyam farmers in adapting to climate change in Southeast, Nigeria. Three hundred and eighty-four respondents selected through multi-stage sampling technique were used for the study. Data were collected using structured questionnaire and interview schedule and analysed using both descriptive and inferential statistical tools. Findings showed that majority were females (67%, married (92% and maintain average household size of 6 persons and a mean age of 51 years. They were mainly primary (32% and secondary (34% school certificate holders with farming (77% as their major occupation. The major cropping pattern practiced was mixed farming with cassava (63% and maize (58% as the major crops cultivated by the farmers. Majority of the farmers owned farms of one hectare and below accessed mainly through inheritance (76% and labour sourced mainly through hiring (50%. Most (81% of the farmers have spent more than ten years in farming. Climate change information was accessed mainly through their personal experience (64%, radio (42% and fellow villagers (39%. The study identified eight major challenges faced by cocoyam farmers in adapting to climate change namely Lack/high cost of farm inputs and low soil fertility (Factor 1, Land and labour constraints (Factor 2, Poor access to information and ineffectiveness of cooperatives (Factor 3, lack of/poor access to fund and credit facilities and poor government support (Factor 4, lack of improved varieties of cocoyam (factor 5, poor value attached to cocoyam (Factor 6, poor infrastructural capacity and technology know-how (Factor 7 and Transportation constraint (Factor 8. Analysis of variance identified significant variations in the challenges faced by cocoyam farmers in the study area. The study recommends enrollment in cooperatives and revitalizing existing cooperatives, re-orientation of farmers on the benefits of cocoyam and increased used of climate change

  17. The role of family therapy in the management of schizophrenia: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Caqueo-Urízar A

    2015-01-01

    Full Text Available Alejandra Caqueo-Urízar,1,* Mar Rus-Calafell,2,* Alfonso Urzúa,3 Jorge Escudero,1 José Gutiérrez-Maldonado4 1Departamento de Filosofía y Psicología, Universidad de Tarapacá, Arica, Chile; 2Department of Social Psychiatry, Institute of Psychiatry, King’s College London, London, UK; 3Alfonso Urzúa Morales, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile; 4Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universidad de Barcelona, Barcelona, Spain *These authors have contributed equally to this work Abstract: Family interventions for schizophrenia have been amply demonstrated to be effective and are recommended by most of the international clinical guidelines. However, their implementation in the clinical setting as well as in treatment protocols of patients with psychosis has not been fully achieved yet. With the increasing deinstitutionalization of patients, family has begun to assume the role of care performed by psychiatric hospitals, with a high emotional cost for caregivers as well as the recognition of burden experiences. Families have been the substitute in the face of the scarcity of therapeutic, occupational, and residential resources. For this reason, the viability of patients’ care by their families has become a challenge. This article aims to discuss the most important aspects of family interventions, their impact on families, and the most important challenges that need to be overcome in order to achieve well-being and recovery in both patients and caregivers. Keywords: family intervention, schizophrenia, caregivers, quality of life, therapy

  18. Difficulties faced by family physicians in primary health care centers in Jeddah, Saudi Arabia.

    Science.gov (United States)

    Mumenah, Sahar H; Al-Raddadi, Rajaa M

    2015-01-01

    The aim was to determine the difficulties faced by family physicians, and compare how satisfied those working with the Ministry of Health (MOH) are with their counterparts who work at some selected non-MOH hospitals. An analytical, cross-sectional study was conducted at King Abdulaziz University Hospital, King Faisal Specialist Hospital and Research Center (KFSH and RC), and 40 MOH primary health care centers across Jeddah. A structured multi-item questionnaire was used to collect demographic data and information on the difficulties family physicians face. The physicians' level of satisfaction and how it was affected by the difficulties was assessed. Women constituted 71.9% of the sample. Problems with transportation formed one of the main difficulties encountered by physicians. Compared to non-MOH physician, a significantly higher proportion of MOH physicians reported unavailability of radiology technicians (P = 0.011) and radiologists (P building maintenance (P < 0.001). Family physicians with the MOH were less satisfied with their jobs compared with non-MOH physicians (P = 0.032). MOH family physicians encountered difficulties relating to staff, services, and infrastructure, which consequently affected their level of satisfaction.

  19. Challenges faced by health workers in implementing the prevention of mother-to-child HIV transmission (PMTCT) programme in Uganda.

    Science.gov (United States)

    Nuwagaba-Biribonwoha, H; Mayon-White, R T; Okong, P; Carpenter, L M

    2007-09-01

    To report the experience of health workers who had played key roles in the early stages of implementing the prevention of mother-to-child HIV transmission services (PMTCT) in Uganda. Interviews were conducted with 15 key informants including counsellors, obstetricians and PMTCT coordinators at the five PMTCT test sites in Uganda to investigate the benefits, challenges and sustainability of the PMTCT programme. Audio-taped interviews were held with each informant between January and June 2003. These were transcribed verbatim and manually analysed using the framework approach. The perceived benefits reported by informants were improvement of general obstetric care, provision of antiretroviral prophylaxis for HIV-positive mothers, staff training and community awareness. The main challenges lay in the reluctance of women to be tested for HIV, incomplete follow-up of participants, non-disclosure of HIV status and difficulties with infant feeding for HIV-positive mothers. Key informants thought that the programme's sustainability depended on maintaining staff morale and numbers, on improving services and providing more resources, particularly antiretroviral therapy for the HIV-positive women and their families. Uganda's experience in piloting the PMTCT programme reflected the many challenges faced by health workers. Potentially resource-sparing strategies such as the 'opt-out' approach to HIV testing required further evaluation.

  20. Management challenges faced by managers of New Zealand long-term care facilities.

    Science.gov (United States)

    Madas, E; North, N

    2000-01-01

    This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

  1. Identity Issues and Challenges Faced by Russian Immigrants in New Zealand

    Directory of Open Access Journals (Sweden)

    Elena Maydell

    2009-08-01

    Full Text Available Among the processes cosmopolitan societies undergo at the present moment, is the unprecedented increase in mass migration across cultures. What challenges are faced by both immigrants, who have to settle in novel socio-cultural environments, and by the host populations accepting them? The current qualitative study investigates the nature of identity construction among Russian-speaking immigrants in New Zealand, applying thematic analysis for the interpretation of the data collected via 23 in-depth interviews. Among the most common themes articulated by the participants was the feeling of identity loss. A taken-for-granted sense of identity, brought by the participants from their culture of origin, was not validated by their new society of residence, mostly due to the lack of appropriate cultural resources. The participants were faced with a challenge of re-constructing their old identity, or constructing a new one, utilising the available resources in the community around them. At the same time, there was a sub-group for whom this challenge brought the realisation that the nature of their identity is cosmopolitan, rather than located within any particular culture or geographical space.

  2. Challenges and issues facing the future of nursing education: implications for ethnic minority faculty and students.

    Science.gov (United States)

    Davis, Sheila P; Davis, Danyetta D

    2010-01-01

    Current trends in higher education in the United States demand that nursing take stock of how it is prepared or being prepared to face challenges and issues impacting on its future. The intense effort made to attract students to pursue advanced training in science and engineering in the United States pales in comparison to the numbers of science and engineering majors produced yearly in international schools. As a result, more and more jobs are being outsourced to international markets. Could international outsourcing become a method of nursing education? Authors submit that to remain competitive, the nursing profession must attract a younger cohort of technologically savvy students and faculty reflective of the growing diverse population in the United States. Additionally, nursing programs in research universities face even more daunting challenges as it relates to mandates for funded research programs of educational units. This article offers suggestions and recommendations for nursing programs in higher education institutions on ways to attract and retain ethnic minorities and of how to harness the power of research to address burgeoning societal health challenges.

  3. Challenges facing procurement professionals in developing economies: Unlocking value through professional international purchasing

    Directory of Open Access Journals (Sweden)

    Marian Tukuta

    2015-04-01

    Objectives: The purpose of this article was to examine the critical role played by the procurement function in business and to reveal the challenges faced by procurement professionals in developing economies as well as to suggest solutions to these challenges. Method: A sequential literary analysis was used, complemented by cross-country qualitative data gathered from one hundred diverse procurement practitioners from Botswana, Namibia and Zimbabwe. These were primarily participants in a series of procurement workshops run by the researchers from January to June 2014. Results: Findings suggested that limited recognition, increasing unethical behaviour, poor supplier service delivery, poor regulatory environment, varying supplier standards and poor corporate governance are the main challenges faced by the procurement profession in these countries. Conclusion: The study’s findings imply that there is limited understanding regarding the role procurement plays in both government and non-government institutions in developing economies. The article suggests solutions which procurement professionals and organisations can implement in order to unlock the potential value in the procurement function.

  4. Challenges faced by international nurses when migrating: an integrative literature review.

    Science.gov (United States)

    Pung, L-X; Goh, Y-S

    2017-03-01

    Results from this literature review were used to identify the challenges faced by international nurses in their host countries following migration. The increasing strain of nursing shortages in the healthcare system has led to the recruitment of international nurses among many countries. However, following migration, international nurses are faced with challenges that may result in poor integration with their host countries. Using Cooper's five stages for integrative research reviews, a literature search was conducted across seven databases using a PRISMA search strategy. Additional manual searches were also conducted on the end-references of the retrieved articles. The authors then independently reviewed the selected articles using the Joanna Briggs Institute appraisal form to extract and generate the themes for the review. Twenty-four articles were selected for the review. The themes generated included: (i) difficulty orientating; (ii) a longing for what is missing; (iii) professional development and devaluing; (iv) communication barriers; (v) discrimination and marginalization; (vi) personal and professional differences; and (vii) a meaningful support system. By identifying the challenges faced by international nurses, interventions that ensure equal treatment (e.g. multifaceted transition programmes and culturally sensitive 'buddy' systems) can be implemented to help international nurses adapt to their new environments. Adequate communication can be achieved by encouraging international nurses to speak English and learn the colloquial language and non-verbal behaviours used by native nurses. With good integration international nurses may be able to reach their full career potential as professional nurses in their host countries. The adaptation process is a dynamic process that requires effort from both international and native nurses. Thus, any strategies that are developed and implemented must be multifaceted. © 2016 International Council of Nurses.

  5. Hospice Counsellor Facing the Grief of the Terminally Ill Child and Its Family

    Directory of Open Access Journals (Sweden)

    Grzegorz Godawa

    2012-09-01

    Full Text Available The child’s illness, suffering and death provoke many emotions in the family. The ill child and its family both experience grief which is an emotional reaction to the danger of losing health or life. Support offered by home hospices for children aims at overcoming the destructive influence of illness. A hospice counsellor’s task is to improve the ill child and its family’s quality of life. He is helping the family overcome grief and prepare for the child’s death. The hospice team supports the family members who experience anticipatory and later, actual mourning. Preventing pathological effects of grief is a basic challenge for people who offer help.

  6. Some environmental challenges which the uranium production industry faces in the 21st century

    International Nuclear Information System (INIS)

    Zhang Lisheng

    2004-01-01

    Some of the environmental challenges which the uranium production industry faces in the 21st century have been discussed in the paper. They are: the use of the linear non-threshold (LNT) model for radiation protection, the concept of 'controllable dose' as an alternative to the current International Commission on Radiological Protection (ICRP) system of dose limitation, the future of collective dose and the ALARA (As low As Reasonably Achievable) principle and the application of a risk-based framework for managing hazards. The author proposes that, the risk assessment/risk management framework could be used for managing the environmental, safety and decommissioning issues associated with the uranium fuel cycle. (author)

  7. [The Quebec Healthy Cities and Towns Network: a powerful movement faced with new challenges].

    Science.gov (United States)

    Simard, Paule

    2007-01-01

    After twenty years serving its members, the Quebec Healthy Cities and Towns Network (QHCTN) faces several challenges. There are currently many changes being made in the local organization and the administration of services. The Network, through its capacity to mobilize the different municipalities, is the best placed to advocate and support a coordinated approach to government initiatives and also to encourage partnerships with other institutions (education, health, socio-economic) and communities. There is, nonetheless, a need to rethink its direct support to members, especially in terms of communication and networking among them.

  8. Fathers see stronger family resemblances than non-fathers in unrelated children's faces.

    Science.gov (United States)

    Bressan, Paola; Dal Pos, Stefania

    2012-12-01

    Even after they have taken all reasonable measures to decrease the probability that their spouses cheat on them, men still face paternal uncertainty. Such uncertainty can lead to paternal disinvestment, which reduces the children's probability to survive and reproduce, and thus the reproductive success of the fathers themselves. A theoretical model shows that, other things being equal, men who feel confident that they have fathered their spouses' offspring tend to enjoy greater fitness (i.e., leave a larger number of surviving progeny) than men who do not. This implies that fathers should benefit from exaggerating paternal resemblance. We argue that the self-deceiving component of this bias could be concealed by generalizing this resemblance estimation boost to (1) family pairs other than father-child and (2) strangers. Here, we tested the prediction that fathers may see, in unrelated children's faces, stronger family resemblances than non-fathers. In Study 1, 70 men and 70 women estimated facial resemblances between children paired, at three different ages (as infants, children, and adolescents), either to themselves or to their parents. In Study 2, 70 men and 70 women guessed the true parents of the same children among a set of adults. Men who were fathers reported stronger similarities between faces than non-fathers, mothers, and non-mothers did, but were no better at identifying childrens' real parents. We suggest that, in fathers, processing of facial resemblances is biased in a manner that reflects their (adaptive) wishful thinking that fathers and children are related.

  9. Balancing act: the influence of adaptability and cohesion on satisfaction and communication in families facing TBI in Mexico.

    Science.gov (United States)

    Lehan, Tara J; Stevens, Lillian Flores; Arango-Lasprilla, Juan Carlos; Díaz Sosa, Dulce María; Espinosa Jove, Irma Guadalupe

    2012-01-01

    Much of what is known about family functioning in the face of traumatic brain injury (TBI) is based on research conducted in the United States. The purpose of this study was to (1) describe the levels of family adaptability, cohesion, communication, and satisfaction as reported by Mexican TBI survivors and their family caregivers, (2) test the hypothesis of the Circumplex Model that balanced families would exhibit better communication and greater satisfaction, and (3) explore how TBI survivors' and their family caregivers' perceptions of family adaptability and cohesion influenced their own and the other's perceptions of family communication and satisfaction. In the majority of dyads, both the TBI survivor and the family caregiver endorsed balanced family adaptability and cohesion. Both TBI survivors and their family caregivers reported a relatively high level of family communication and satisfaction. TBI survivors and family caregivers who reported greater levels of family adaptability and cohesion also endorsed better family communication and greater family satisfaction. In addition, individuals with TBI whose family caregiver endorsed balanced family adaptability and cohesion reported better family communication. Further, family caregivers of TBI survivors who reported balanced family adaptability and cohesion reported better family communication. Implications for research and practice are discussed.

  10. Facing new safety-challenges in a large particle accelerator experiment at CERN

    CERN Document Server

    Schmidt, Reiner

    1999-01-01

    An upgraded safety concept for CMS has been adapted to the size of the project and its organisational challenges under today's budgetary constraints, as well as to the increasing levels of risk. Strong magnetic fields and high radiation levels, including neutrons, pose additional hazards to materials, to operators, to maintenance and to ultimate deposit of activated materials. CMS also fits the insurer's risk-description for modern facilities, i.e. characterised by "higher energy density, more combustible materials and unattended operation". The regulatory environment, consisting essentially of CERN's autonomous regulations as well as of those of its host countries, also need to be satisfied with much attention. To face this challenge, seven distinct safety management tools have been identified, which are described in some detail, namely clear safety objectives, documented safety requirements, open items list, safety ( and design)reviews, safety risk analysis, enforcement of compliance and quality management....

  11. Nanomaterials for Polymer Electrolyte Membrane Fuel Cells; Materials Challenges Facing Electrical Energy Storate

    Energy Technology Data Exchange (ETDEWEB)

    Gopal Rao, MRS Web-Editor; Yury Gogotsi, Drexel University; Karen Swider-Lyons, Naval Research Laboratory

    2010-08-05

    Symposium T: Nanomaterials for Polymer Electrolyte Membrane Fuel Cells Polymer electrolyte membrane (PEM) fuel cells are under intense investigation worldwide for applications ranging from transportation to portable power. The purpose of this seminar is to focus on the nanomaterials and nanostructures inherent to polymer fuel cells. Symposium topics will range from high-activity cathode and anode catalysts, to theory and new analytical methods. Symposium U: Materials Challenges Facing Electrical Energy Storage Electricity, which can be generated in a variety of ways, offers a great potential for meeting future energy demands as a clean and efficient energy source. However, the use of electricity generated from renewable sources, such as wind or sunlight, requires efficient electrical energy storage. This symposium will cover the latest material developments for batteries, advanced capacitors, and related technologies, with a focus on new or emerging materials science challenges.

  12. OPPORTUNITIES AND CHALLENGES FOR MICRO-SMALL AND MEDIUM BUSINESS IN INDONESIA FACING ASEAN ECONOMIC COMMUNITY

    Directory of Open Access Journals (Sweden)

    Raden Aswin Rahadi

    2016-03-01

    Full Text Available This research is a part of a continuous study to analyze the opportunities and challenges for micro-small and medium business in Indonesia when facing ASEAN Economic Community (AEC in 2016. It has its own uniqueness, as it will combine the point of view between current business owners and current literature study synthesis on business perception towards AEC. Ten business owners have been interviewed. The results suggested AEC provides challenges for the business owners, particularly in terms of capital; competitiveness; sales system; innovation; finance, bureaucracy; and government preparedness. AEC also provides opportunities, in terms of market potential; creativity; export opportunities; business owners’ resistances and sustainability; and knowledge of local market. From all of the keywords mentioned by the respondents, there are four main attributes considered as important: human resources; creativities; market share; and capital. Finally, most of the respondents suggested that AEC will bring more positive influences for the development of micro-small and medium business in Indonesia.

  13. Challenges faced by nurses in managing pain in a critical care setting.

    Science.gov (United States)

    Subramanian, Pathmawathi; Allcock, Nick; James, Veronica; Lathlean, Judith

    2012-05-01

    To explore nurses' challenges in managing pain among ill patients in critical care. Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill. Qualitative prospective exploratory design. This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses. Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself. Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience. There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines. © 2011 Blackwell Publishing Ltd.

  14. Challenges facing primary school educators of English Second (or Other Language learners in the Western Cape

    Directory of Open Access Journals (Sweden)

    Julie O'Connor

    2009-05-01

    Full Text Available We were prompted by the prevalence of English Second or Other Language (ESOL learners identified by educators as having language disorders and being referred for Speech-Language Therapy. We describe challenges faced by Grade 1, 2 and 3 educators at government schools in the Cape Metropolitan area who were working with such learners. Applying a mixed-methods descriptive design, a self-administered questionnaire and three focus groups were used for data collection. Educator perceptions and experiences regarding ESOL learners were described. Some participant educators at schools that were not former Model C schools had large classes, including large proportions of ESOL learners. Fur­thermore, there was a shortage of educators who were able to speak isiXhosa, the most frequently occurring first (or home language of the region's ESOL learners. Challenges faced by educators when teaching ESOL learners included learners' academic and socio-emotional difficulties and a lack of parent in­volvement in their children's education. Participant educators indicated a need for departmental, professional and parental support, and additional training and resources. Implications and recommendations for speech-language thera­pist and educator collaborations and speech-language therapists' participation in educator training were identified.

  15. Indigenous mothers face more than three delays: The challenges of multiculturalism in health

    Directory of Open Access Journals (Sweden)

    Roosta-G., Manigeh

    2015-08-01

    Full Text Available Although the maternal mortality ratio has descended in Bolivia from 416 (1989 to 229 deaths (DHS 2003 per one hundred thousand live births, it is one of the highest in the region. As a national average, the ratio conceals the rural-urban, socio-economics differences and the reality of the indigenous population. Maternal mortality is one of the major challenges at national level. Reduction of maternal mortality, in addition of technical-medical measures offering health services, requires to focus on socio-cultural aspects that hamper the access to health services. This article examines challenges faced by indigenous mothers accessing the health services. In addition to the geographic, economic and administrative barriers that generate delays in access to the health services, there are others that are presented in the context of multiculturalism resulting from discriminatory attitudes exercised in health centers. The testimonies of indigenous mothers show delays faced in health centers because of prejudice and discrimination suffered, threatening the lives of mothers and their babies. The study also suggests the need to deepen the concept of multiculturalism as a successful strategy in health, in order to promote equity and social justice on the horizon of more inclusive societies.

  16. Finding a Trans-Affirmative Provider: Challenges Faced by Trans and Gender Diverse Psychologists and Psychology Trainees.

    Science.gov (United States)

    Dickey, Lore M; Singh, Anneliese A

    2017-08-01

    This article explores some of the challenges faced by trans and gender diverse (TGD) individuals who not only are attempting to access trans-affirmative care, but who are also members of the very profession from which they are seeking services. The authors explore challenges related to finding supervision, accessing care for assessment services, and finding a provider for personal counseling. With each example, the authors unpack the challenges and also address the implications for training for all involved. Based on these challenges that TGD psychologists and trainees face in attempting to access care, the authors provide recommendations related to trans-affirmative training for psychologists. © 2017 Wiley Periodicals, Inc.

  17. Evaluation of a Multimedia Intervention for Children and Families Facing Multiple Military Deployments.

    Science.gov (United States)

    Flittner O'Grady, Allison; Thomaseo Burton, E; Chawla, Neelu; Topp, David; MacDermid Wadsworth, Shelley

    2016-02-01

    Repeated military deployments have been a common experience for many military families in the past 15 years. While there has been an increase in research and intervention focused on the effects on families of military deployments, much of this work has not focused specifically on the particular needs of young children. Talk, Listen, Connect: Multiple Deployments (TLC-II MD), a multimedia kit designed for home use, is among the first interventions directed toward young children. Created by Sesame Workshop and using popular Sesame Street characters, TLC-II MD was designed to support and equip families with young children with skills to address challenges associated with multiple deployments. This study utilized a randomized experimental design to evaluate the impact of TLC-II MD relative to a control condition using a Sesame Workshop multimedia kit not tailored to military families. Parents in both groups reported that children enjoyed the video overall and watched it repeatedly. Also in both groups, caregivers' depressive symptoms and children's aggressive behaviors declined significantly over time. Caregivers in the test group reported significantly larger increases in comfort discussing the deployment with their child and stronger perceptions that the DVD helped children to cope. Thus, the resilience-oriented materials were helpful to both groups, but those tailored to military families were significantly more likely to be perceived as helpful. Findings offer evidence regarding the ability of multimedia self-administered interventions to assist military families.

  18. Difficulties faced by family physicians in primary health care centers in Jeddah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Sahar H Mumenah

    2015-01-01

    Full Text Available Aim: The aim was to determine the difficulties faced by family physicians, and compare how satisfied those working with the Ministry of Health (MOH are with their counterparts who work at some selected non-MOH hospitals. Methods: An analytical, cross-sectional study was conducted at King Abdulaziz University Hospital, King Faisal Specialist Hospital and Research Center (KFSH and RC, and 40 MOH primary health care centers across Jeddah. A structured multi-item questionnaire was used to collect demographic data and information on the difficulties family physicians face. The physicians′ level of satisfaction and how it was affected by the difficulties was assessed. Results: Women constituted 71.9% of the sample. Problems with transportation formed one of the main difficulties encountered by physicians. Compared to non-MOH physician, a significantly higher proportion of MOH physicians reported unavailability of radiology technicians (P = 0.011 and radiologists (P < 0.001, absence of the internet and computer access (P < 0.001, unavailability of laboratory services (P = 0.004, reagents (P = 0.001, X-ray equipment (P = 0.027, ultrasound equipment (P < 0.001, an electronic medical records system (P < 0.001, insufficient laboratory tests (P = 0.0001, and poor building maintenance (P < 0.001. Family physicians with the MOH were less satisfied with their jobs compared with non-MOH physicians (P = 0.032. Conclusion: MOH family physicians encountered difficulties relating to staff, services, and infrastructure, which consequently affected their level of satisfaction.

  19. The challenges of reintegration for service members and their families.

    Science.gov (United States)

    Danish, Steven J; Antonides, Bradley J

    2013-10-01

    The ongoing wars in Afghanistan and Iraq have posed a number of reintegration challenges to service members. Much of the research focuses on those service members experiencing psychological problems and being treated at the VA. In this article, we contend that much of the distress service members experience occurs following deployment and is a consequence of the difficulties encountered during their efforts to successfully reintegrate into their families and communities. We propose a new conceptual framework for intervening in this reintegration distress that is psycho-educational in nature as well as a new delivery model for providing such services. An example of this new intervention framework is presented. © 2013 American Orthopsychiatric Association.

  20. Operational HOF Practices in the AREVA Group to Face New Challenges

    International Nuclear Information System (INIS)

    Coye de Brunélis, T.; Bachellerie, E.; Sidaner, J.-F.

    2016-01-01

    Operating experience from TMI and and more general experience from three decades of nuclear facility operations, have shown the value of safety culture’s contribution to nuclear risk management. More than ever, this particular aspect of human and organizational factors (HOF) is central to the AREVA group’s concerns as it faces new challenges. The first generation of operators commissioned the facilities and optimized their operation. This first phase gave them a better understanding of operations and related limits, particularly through testing and start-up operations and the responses that were found for all of the technical issues that arose. All of these interactions offered opportunities to make the safety challenges of processes and facilities tangible and directly perceptible. The young operators of those bygone years are now the ones who are “in the know” in the organizations, the ones with unique technical know-how and a multi-layered perception of the risks involved. Those first generations of operators, with their unique operational knowledge, are gradually leaving the industrial world. Replacing those skills creates a new set of challenges. Concomitantly, the French nuclear safety authority benefited from these facility start-ups to increase its skills by sharing in the learning process concerning the facilities’ operational realities and in the construction of a safety configuration program, and by gaining a concrete perception of risk. This fostered the mutual trust that is vital and integral to facility safety.

  1. Psychosocial challenges facing women living with HIV during the perinatal period in rural Uganda.

    Directory of Open Access Journals (Sweden)

    Scholastic Ashaba

    Full Text Available The complexities of navigating pregnancy while living with HIV predispose women to additional stress. Finding ways to minimize psychosocial challenges during the perinatal period may maximize the well-being of mothers living with HIV and their children. The goal of this study was to explore psychosocial challenges experienced by women living with HIV (WLWH during pregnancy and the postpartum. We conducted individual in-depth interviews with 20 WLWH recruited from an HIV treatment cohort study in Mbarara, Uganda as part of a larger study exploring perinatal depression. We conducted content analyses to identify themes related to challenges of WLWH during pregnancy and the postpartum. Participants had a median age of 33 years [IQR: 28-35], a median of 3 living children [IQR: 2-5], and 95% had achieved HIV-RNA suppression. Challenges were organized around the following themes: HIV -related stigma from health professionals, HIV status disclosure dilemma, unintended pregnancy and intimate partner violence, HIV and environmental structural barriers and distress and fear related to maternal and child health. Stigma centered on discrimination by health care professionals and personal shame associated with being pregnant as a WLWH. This led to difficulty engaging in HIV care, particularly when coupled with structural barriers, such as lack of transportation to clinic. Participants experienced intimate partner violence and lacked support from their partners and family members. Distress and fear about the health and uncertainty about the future of the unborn baby due to maternal deteriorating physical health was common. The perinatal period is a time of stress for WLWH. Challenges experienced by WLWH may compromise successful engagement in HIV care and may reduce quality of life for women and their children. Strategies aimed at alleviating the challenges of WLWH should involve the larger structural environment including partners, family and community member

  2. Psychosocial challenges facing women living with HIV during the perinatal period in rural Uganda.

    Science.gov (United States)

    Ashaba, Scholastic; Kaida, Angela; Coleman, Jessica N; Burns, Bridget F; Dunkley, Emma; O'Neil, Kasey; Kastner, Jasmine; Sanyu, Naomi; Akatukwasa, Cecilia; Bangsberg, David R; Matthews, Lynn T; Psaros, Christina

    2017-01-01

    The complexities of navigating pregnancy while living with HIV predispose women to additional stress. Finding ways to minimize psychosocial challenges during the perinatal period may maximize the well-being of mothers living with HIV and their children. The goal of this study was to explore psychosocial challenges experienced by women living with HIV (WLWH) during pregnancy and the postpartum. We conducted individual in-depth interviews with 20 WLWH recruited from an HIV treatment cohort study in Mbarara, Uganda as part of a larger study exploring perinatal depression. We conducted content analyses to identify themes related to challenges of WLWH during pregnancy and the postpartum. Participants had a median age of 33 years [IQR: 28-35], a median of 3 living children [IQR: 2-5], and 95% had achieved HIV-RNA suppression. Challenges were organized around the following themes: HIV -related stigma from health professionals, HIV status disclosure dilemma, unintended pregnancy and intimate partner violence, HIV and environmental structural barriers and distress and fear related to maternal and child health. Stigma centered on discrimination by health care professionals and personal shame associated with being pregnant as a WLWH. This led to difficulty engaging in HIV care, particularly when coupled with structural barriers, such as lack of transportation to clinic. Participants experienced intimate partner violence and lacked support from their partners and family members. Distress and fear about the health and uncertainty about the future of the unborn baby due to maternal deteriorating physical health was common. The perinatal period is a time of stress for WLWH. Challenges experienced by WLWH may compromise successful engagement in HIV care and may reduce quality of life for women and their children. Strategies aimed at alleviating the challenges of WLWH should involve the larger structural environment including partners, family and community member as well as policy

  3. Technical progress faced with the challenges of the energy sector in the future

    International Nuclear Information System (INIS)

    Maillard, D.

    1999-01-01

    The colloquium organised by the Association of Energy Economists dealing with the theme 'Technical progress faced with the challenges of the energy sector in the future' takes place against a backdrop of ever-increasing initiatives in this field, for example at the World Energy Council or the International Energy Agency Faith in technical progress is widespread but should be supported by studies without any preconceived ideas. Research and development efforts must be fully supported, and in a climate of opening markets and liberalization the public authorities have a major role to pay. Historically, the markets have always been able to meet new needs thanks to technology, but the ambitious targets that the international community has set itself regarding the emission of greenhouse gases imply technical improvements and major investments. (authors)

  4. Organisational, technological and economic innovations: the nuclear industry reinvents itself to face 2030 challenges

    International Nuclear Information System (INIS)

    Faudon, Valerie; Jouette, Isabelle; Le Ngoc, Boris

    2016-06-01

    As the French nuclear industry is facing a major challenge (financial weakness, an electric power market in crisis, 15 years without building any reactor, delayed works), this report first outlines why innovation is necessary to guarantee a low carbon and competitive electricity, to comfort the leadership position of this sector in the world, and to respond to expectations of civil society. Then, it describes how the French nuclear industry is already implementing organisational, technological and social innovations, notably through the development of digital technologies. The third part identifies priorities of new public policies: to imagine a new business model for nuclear (a better visibility for investors, taking all induced costs in the power system into account in a diversified mix, reform of the carbon market, taking avoided atmospheric pollution into account), to rethink regulation in order to free innovation spirit, and to prepare the future by investing in research

  5. Revisiting hansen's disease: Recognizing the many neurodermatologic faces and its diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Bhaskara P Shelley

    2018-01-01

    Full Text Available Hansen's disease (HD looms still as a public health problem. Conventional wisdom and teaching largely view HD as a predominantly dermatologic disorder with much emphasis in the dermatology postgraduate curriculum. This review attempts to reorient this view and reemphasize that HD has primarily neurologic underpinnings since Mycobacterium leprae is an intracellular neurotropic bacterium. The main thrust of this article would, therefore, be a neurologist's perspective of HD. The cutaneous manifestations of HD are the sequelae of the neurobiology of M. leprae, its selective predilection to human Schwann cells, neurovascular bundle and its localization in the intracutaneous nerve plexus of the skin. We discuss the nuances of HD as a “great imitator,” the many faces of its neurodermatologic clinical presentation, the neurologic basis of HD clinical examination, and its diagnostic and therapeutic challenges.

  6. Animal models of binge drinking, current challenges to improve face validity.

    Science.gov (United States)

    Jeanblanc, Jérôme; Rolland, Benjamin; Gierski, Fabien; Martinetti, Margaret P; Naassila, Mickael

    2018-05-05

    Binge drinking (BD), i.e., consuming a large amount of alcohol in a short period of time, is an increasing public health issue. Though no clear definition has been adopted worldwide the speed of drinking seems to be a keystone of this behavior. Developing relevant animal models of BD is a priority for gaining a better characterization of the neurobiological and psychobiological mechanisms underlying this dangerous and harmful behavior. Until recently, preclinical research on BD has been conducted mostly using forced administration of alcohol, but more recent studies used scheduled access to alcohol, to model more voluntary excessive intakes, and to achieve signs of intoxications that mimic the human behavior. The main challenges for future research are discussed regarding the need of good face validity, construct validity and predictive validity of animal models of BD. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Anti-racist pedagogy: challenges faced by faculty of color in predominantly white schools of nursing.

    Science.gov (United States)

    Hassouneh, Dena

    2006-07-01

    Despite the significant effects of systems of oppression on health, nursing education tends not to include anti-racist pedagogy in its curricula, preferring instead to focus more narrowly on culture. This narrow focus allows nurses to depoliticize discussions of race and other social differences, largely ignoring the influence that systems of oppression, imperialism, and historical trauma have had on health in marginalized populations. In contrast, anti-racist pedagogy educates students in ways that make racialized power relations explicit, deconstruct the social construction of race, and analyze interlocking systems of oppression that serve to marginalize and exclude some groups while privileging others. This article describes anti-racist pedagogy from the perspective of a faculty member of color, drawing on personal experience and a review of the anti-racist pedagogical literature. Specifically, this article highlights some of the personal and professional challenges faced by faculty of color when engaged in anti-racist pedagogy in predominantly white schools of nursing.

  8. Challenges of microtome‐based serial block‐face scanning electron microscopy in neuroscience

    Science.gov (United States)

    WANNER, A. A.; KIRSCHMANN, M. A.

    2015-01-01

    Summary Serial block‐face scanning electron microscopy (SBEM) is becoming increasingly popular for a wide range of applications in many disciplines from biology to material sciences. This review focuses on applications for circuit reconstruction in neuroscience, which is one of the major driving forces advancing SBEM. Neuronal circuit reconstruction poses exceptional challenges to volume EM in terms of resolution, field of view, acquisition time and sample preparation. Mapping the connections between neurons in the brain is crucial for understanding information flow and information processing in the brain. However, information on the connectivity between hundreds or even thousands of neurons densely packed in neuronal microcircuits is still largely missing. Volume EM techniques such as serial section TEM, automated tape‐collecting ultramicrotome, focused ion‐beam scanning electron microscopy and SBEM (microtome serial block‐face scanning electron microscopy) are the techniques that provide sufficient resolution to resolve ultrastructural details such as synapses and provides sufficient field of view for dense reconstruction of neuronal circuits. While volume EM techniques are advancing, they are generating large data sets on the terabyte scale that require new image processing workflows and analysis tools. In this review, we present the recent advances in SBEM for circuit reconstruction in neuroscience and an overview of existing image processing and analysis pipelines. PMID:25907464

  9. Supply constraints : Australia and Canada coal industry face logistics and capacity challenges

    International Nuclear Information System (INIS)

    Borsato, J.

    2010-01-01

    Australia and Canada are benefiting from a global increase in coal consumption, but face challenges regarding coal and coal export capacity. Coal is Australia's biggest export commodity, accounting for over 50 percent of world coking coal exports, with almost 75 percent of those exports destined for Asian markets, primarily Japan. However, the number of ships delayed at Australian ports hit a record of 223 bulk carriers in early 2010. Compared to Canada, Australia faces greater logistical issues getting coal into port and onto ships at its 9 loading terminals. Two of Canada's 3 major shipping terminals, Westshore and Neptune, have some additional capacity. Its third terminal, Ridley Island, has considerable potential to carry more coal. With 98 percent of all coal moved by rail in Australia, rail issues also hinder growth. A national approach to planning freight transport on both roads and rail is being developed. While infrastructure issues remain the single greatest barrier to export growth for Australia's coal sector, Canada's most immediate issues pertain to mine permitting and mine-site expansion. In 2009, Canada exported 28 million tonnes of coal, 90 percent of it metallurgical. With approximately 70 million tonnes of annual production, mostly in British Columbia and Alberta, coal remains the number one commodity in Canada carried by rails and shipped from ports. 1 fig.

  10. Challenges faced in rural hospitals: the experiences of nurse managers in Uganda.

    Science.gov (United States)

    Kakyo, T A; Xiao, L D

    2018-04-19

    The aim of this study was to understand nurse ward managers perceived challenges in the rural healthcare setting in Uganda. The health workforce, essential medicines and equipment and political unrest are the main factors affecting the international community in addressing the hefty disease burden in World Health Organization African regions. Nurse ward managers have an important role to play to mitigate these factors in health facilities in these regions through leadership, supervision and support for staff. This study utilized interpretive phenomenology based on Gadamer's hermeneutical principles. Eleven nurse managers from two rural public hospitals in Uganda were interviewed. Those with more than a 2-year experience in their management role were invited to participate in the study. Nurse managers pointed out four major challenges with staffing, while they worked in the rural healthcare settings. These are summarized into themes: 'Numbers do matter'; 'I cannot access them when I need them at work'; 'Challenges in dealing with negative attitudes'; and 'Questioning own ability to manage health services'. Health facilities in rural areas face extremely low staff-to-patient ratio, a high level of workload, lack of essential medicines and equipment, low salaries and delayed payment for staff. Nurse managers demonstrated situation-based performance to minimize the impact of these challenges on the quality and safety of patient care, but they had less influence on policy and resource development. It is imperative to mobilize education for nurse ward managers to enable them to improve leadership, management skills and to have a greater impact on policy and resource development. © 2018 International Council of Nurses.

  11. Young Children in Immigrant Families Face Higher Risk of Food Insecurity. Research Brief. Publication #2009-07

    Science.gov (United States)

    Capps, Randy; Horowitz, Allison; Fortuny, Karina; Bronte-Tinkew, Jacinta; Zaslow, Martha

    2009-01-01

    Children in immigrant families are more likely than children in native-born families to face a number of risk factors for poor developmental outcomes, including higher poverty rates, lower household incomes, and linguistic isolation, (for example, when older children and adults in a household have difficulty speaking English). Previous research…

  12. First liver transplant in Qatar: an evolving program facing many challenges.

    Science.gov (United States)

    Khalaf, Hatem; Derballa, Moataz; Elmasry, Mohammed; Khalil, Ahmed; Yakoob, Rafie; Almohannadi, Muneera; Almaslamani, Muna; Fadhil, Riadh; Al-Kaabi, Saad; Al-Ansari, Abdulla; Almaslamani, Yousuf

    2013-10-01

    Beginning to do liver transplants in a developing country is challenging. We report on the first few liver transplants performed in Qatar and discuss future exceptions and challenges facing our program. The first liver transplant was performed in Qatar on December 6, 2011. Since starting the program, 4 deceased-donor liver transplants have been performed in Qatar. All recipients underwent a standard deceased-donor liver transplant procedure, which included a duct-to-duct biliary anastomosis without a veno-venous bypass. All liver transplants were performed at the Hamad Medical Corporation by a local team of surgeons without external assistance. The 4 patients were all men, with a median age of 56 years (age range, 46-63 y). Indications for liver transplant included hepatitis C cirrhosis in 2 patients, and 1 patient with hepatitis B cirrhosis with hepatocellular carcinoma, and the other patient with cryptogenic liver cirrhosis. Median amount of blood transfused was 6 units (range, 0-10 U); median time spent in the intensive care unit was 2 days (range, 2-5 d); median amount of time spent in the hospital was 10 days (range, 9-16 d). All 4 recipients have survived after a median follow-up of 438 days (range, 33-602 d) and are enjoying a healthy life, with no significant posttransplant complications. A deceased-donor liver transplant can be performed in Qatar with no external assistance. However, a severe organ shortage remains the biggest obstacle facing us. Efforts should be directed toward improving the number and quality of available deceased donors in Qatar. Meanwhile, live-donor liver transplant may be the only way for us, going forward, to prevent deaths on the waiting list.

  13. Exploring career advancement challenges people with disabilities are facing in the South African work context

    Directory of Open Access Journals (Sweden)

    Ingrid L. Potgieter

    2017-02-01

    Full Text Available Orientation: South Africa has faced a number of discriminatory practices in the past. Most of these practices are still present today. Although a considerate amount of attention has been given to discrimination based on gender, race and religion, limited emphasis has been placed on discrimination based on disability, specifically within the workplace. Research purpose: The objective of the study was to explore the perceptions of individuals living with a disability with regards to career advancement challenges they face in the South African workplace. Motivation for study: The research literature shows that irrespective of employment equity legislation, employees with disabilities have restricted opportunities to advance in their careers. Research is needed to assist these employees with their career development. Research design, approach and method: A qualitative research design with an exploratory approach was followed. Probability, purposeful and snowballing sampling techniques were applied in this study on 15 employed individuals with declared disabilities. The data were collected by means of semi-structured interviews and the verbatim transcriptions were analysed by content analysis. Main findings/results: The findings indicated that people with disabilities generally experience career advancement challenges and reach career plateau. Managers and colleagues’ lack of knowledge about disability has an adverse impact on the careers of people living with a disability. The study found that human resource practices, especially promotion opportunities, discriminate against employees with disabilities. Furthermore, the study further indicated that there is prejudice against invisible disabilities, and as a result, employees are reluctant to declare their disability. Practical implications: Human resource practitioners and managers need to recognise the influence that disabilities have on the career advancement of individuals living with a

  14. United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    Science.gov (United States)

    Updike, Randall G.; Ellis, Eugene G.; Page, William R.; Parker, Melanie J.; Hestbeck, Jay B.; Horak, William F.

    2013-01-01

    Along the nearly 3,200 kilometers (almost 2,000 miles) of the United States–Mexican border, in an area known as the Borderlands, we are witnessing the expression of the challenges of the 21st century. This circular identifies several challenge themes and issues associated with life and the environment in the Borderlands, listed below. The challenges are not one-sided; they do not originate in one country only to become problems for the other. The issues and concerns of each challenge theme flow in both directions across the border, and both nations feel their effects throughout the Borderlands and beyond. The clear message is that our two nations, the United States and Mexico, face the issues in these challenge themes together, and the U.S. Geological Survey (USGS) understands it must work with its counterparts, partners, and customers in both countries.Though the mission of the USGS is not to serve as land manager, law enforcer, or code regulator, its innovation and creativity and the scientific and technical depth of its capabilities can be directly applied to monitoring the conditions of the landscape. The ability of USGS scientists to critically analyze the monitored data in search of signals and trends, whether they lead to negative or positive results, allows us to reach significant conclusions—from providing factual conclusions to decisionmakers, to estimating how much of a natural resource exists in a particular locale, to predicting how a natural hazard phenomenon will unfold, to forecasting on a scale from hours to millennia how ecosystems will behave.None of these challenge themes can be addressed strictly by one or two science disciplines; all require well-integrated, cross-discipline thinking, data collection, and analyses. The multidisciplinary science themes that have become the focus of the USGS mission parallel the major challenges in the border region between Mexico and the United States. Because of this multidisciplinary approach, the USGS

  15. From Toques to Tokes: Two challenges facing nationwide legalization of cannabis in Canada.

    Science.gov (United States)

    Bear, Daniel

    2017-04-01

    In 2015, a new Liberal Government came to power in Canada, elected on a platform that included legalization and regulation of cannabis for recreational purposes. Their legislation, based on recommendations from a Federal Task Force on Marijuana Legalization and Regulation, is due in early April 2017. This commentary utilizes Canadian Federal policy papers, previous literature, and internal and international agreements to examine two key areas critical to the development of a nationwide regulated market for cannabis in Canada; the need to overcome restrictions to legalizing cannabis in United Nations' drug control treaties, and the unique challenges that non-medical cannabis creates for navigating interprovincial trade policies in Canada. Irrespective of UN conventions that appear to prohibit legalization of cannabis the Government is preparing to bring forward legislation as this article goes to print. At the same time significant squabbles impede the selling of even beer and wine inter-provincially in Canada. This paper identifies the challenges facing Canadian legalization efforts, but also shows how the legalization legislation may provide opportunities to engender significant change beyond the simple legalization of a specific drug. This commentary does not argue for any specific course of action for Canada, but rather explores the nuance of legalization absent from the declaration in the Liberal party platform. The paper argues that Canada's efforts may hasten the dismantling of the UN drug control structure, and provide renewed opportunities for intern-provincial trade in Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. THE CHALLENGES FACED BY THE MALE GENDER EXECUTIVE SECRETARY PROFESSIONAL IN CONTEMPORARY ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Conceição de Maria Pinheiro Barros

    2011-10-01

    Full Text Available The Professional Executive Secretary has been occupying space increasingly evident in the labor market and organizational structure, both because of market demand, the needs of dynamism in the modern administration that demonstrates the growth of the reference to it. It has sought in his field vision and attitude of performance excellence with fulfilling its role with its own characteristics. This study aims to investigate the general challenges for the Executive Secretariat professional male in contemporary organizations. We defined the following objectives: to analyze the insertion of the male in the profession of Executive Secretary and identify the challenges faced by the Executive Secretary of the males to their development and professional growth. To this end, we performed a literature search, followed by a field survey. It is a qualitative research because data collected, and then make a qualitative analysis of results from selected literature. The survey was conducted in organizations from the public and private, state of Ceará. The sample was represented by professional male graduates in the executive secretariat at the Federal University of Ceará and working in the area. After analyzing the data it was concluded that despite the obstacles to be overcome, the tendency is that these opportunities work for the professional male grow, requiring that all actors in the field to seek gender equity in the profession.

  17. Challenges facing the insurance industry since the modernisation of the international nuclear third party liability regime

    International Nuclear Information System (INIS)

    Quere, Alain

    2014-01-01

    events illustrate some of the challenges facing the world of insurance following the modernisation of the international nuclear third party liability regime: - Will the insurance industry be able to find funds corresponding to the new amounts that have been set? - Do the additional damages covered by the revised conventions provide adequate cover for existing risks and will private insurance be able and willing to cover such risks? Nevertheless, the insurance world has changed a great deal since 2004 and there are many additional issues that have arisen since that time. For example, the economic crisis and the introduction of the European Solvency II Directive require insurers to take a more stringent line with their commitments. Moreover, after the Fukushima Daiichi accident, a number of questions have resurfaced: are the new insurance amounts sufficient? The age of 'nuclear renaissance' has long gone and some countries are distancing themselves from nuclear power in light of its questionable costs; are operators paying a fair price in light of the risks incurred? Finally, Europe is keen to play its part and impose its own rules; what will be the consequences of this development? This article reconsiders these challenges in light of the 2004 Protocol (which has not entered into force), by focusing in particular on the situation in Europe. Section I looks back at the history behind the conventions and the key principles they set down. Section II highlights the changes made to the Paris Convention as amended by the 2004 Protocol and the problems facing the insurance industry. Section III provides an overview of the various actors involved in the insurance industry and redefines the necessary insurance foundations to cover the challenges described in Section IV. Finally, Section IV covers all the challenges facing the insurance industry since the modernisation of the international nuclear third party liability regime. (author)

  18. Are we facing new health challenges and diseases in reindeer in Fennoscandia?

    Directory of Open Access Journals (Sweden)

    Morten Tryland

    2013-03-01

    Full Text Available A large number of semi-domesticated reindeer is lost every year. Predators are the single most important factor for these losses, whereas restrictions on food availability some years also may cause high mortality. In the past, reindeer herding was challenged by severe infectious diseases, killing hundreds and thousands of animals, and having huge economic and social impact on reindeer herding in Fennoscandia. The general zoo-sanitary situation in Fennoscandia is very favourable for the time being, but reindeer herding is sometimes challenged by disease outbreaks, and diseases play an important role for survival and fitness of reindeer. Reindeer herding is also facing changes and challenges, which also may impact reindeer health and the disease status. Introduction of infectious agents not commonly present in the reindeer population may take place through import of animals, as well as by contact between reindeer, livestock and wildlife. Further, changes in the herding, such as increased feeding, transport, size of herds, animal density and stress load on the animals, may affect the animals ability to cope with infectious diseases. Also changes in weather conditions and climate, such as increased precipitation and mean temperature, may over time lead to restricted availability of pastures, changes in vegetation and changed conditions for parasites and insect vectors. These changes might be especially important for the reproductive success, including fitness of the calves during their first winter. To be able to cope with these changes and their potential impact on reindeer health, increased efforts should be made to gather reference data on health and disease parameters from the different reindeer herding districts, along with epidemiological risk factor analysis. This would increase the ability for the reindeer herding to cope with changes and to continue to produce quality meat products for the market.

  19. Challenges faced by caregivers of children on antiretroviral therapy at Mutale Municipality selected healthcare facilities, Vhembe District, Limpopo Province.

    Science.gov (United States)

    Mafune, Rhudzani V; Lebese, Rachel T; Nemathaga, Livhuwani H

    2017-08-28

    Children depend solely on caregivers who can be either parents or guardians for drug administration to enhance adherence to antiretroviral treatment (ART), which might pose any number of challenges. The purpose of this study was to explore and describe the challenges faced by caregivers of children on ART at Mutale Municipality, Vhembe District, Limpopo Province. The research design was qualitative, explorative, descriptive and contextual in nature. The population consisted of 16 caregivers who were 18 years of age and above, and mentally capable, irrespective of educational qualifications, caring for children aged between 0 and 15 years who were on ART between April 2013 and October 2014. Non-probability, purposive sampling was used to select the 16 caregivers. Required permission, approval and ethical clearance were obtained from the University of Venda Higher Degree Committee, Limpopo Provincial Health Department and relevant institutions. An in-depth, individual, unstructured interview method was used to collect data. One central question was asked: 'What are the challenges you experience when caring for a child on antiretroviral treatment?' Subsequent questions were based on the participants' responses to the central question. Qualitative data were analysed by means of Tesch's open-coding method. The findings of this study revealed that participants, that is, caregivers of children on ART, experienced financial burdens because of transport costs needed to comply with follow-up dates and insufficient of money for food, clothing the child in need of care, pocket money for lunch boxes during school hours and time lost while waiting for consultations. Participants reported some level of stigmatisation against children on ART by family members, especially the husbands or in-laws of the secondary caregivers. Many primary and secondary caregivers seemed to have given up seeking support from government and community structures. The conclusions drawn from this research

  20. Tolerance to spatial-relational transformations in unfamiliar faces: A further challenge to a configural processing account of identity recognition.

    Science.gov (United States)

    Lorenzino, Martina; Caminati, Martina; Caudek, Corrado

    2018-05-25

    One of the most important questions in face perception research is to understand what information is extracted from a face in order to recognize its identity. Recognition of facial identity has been attributed to a special sensitivity to "configural" information. However, recent studies have challenged the configural account by showing that participants are poor in discriminating variations of metric distances among facial features, especially for familiar as opposed to unfamiliar faces, whereas a configural account predicts the opposite. We aimed to extend these previous results by examining classes of unfamiliar faces with which we have different levels of expertise. We hypothesized an inverse relation between sensitivity to configural information and expertise with a given class of faces, but only for neutral expressions. By first matching perceptual discriminability, we measured tolerance to subtle configural transformations with same-race (SR) versus other-race (OR) faces, and with upright versus upside-down faces. Consistently with our predictions, we found a lower sensitivity to at-threshold configural changes for SR compared to OR faces. We also found that, for our stimuli, the face inversion effect disappeared for neutral but not for emotional faces - a result that can also be attributed to a lower sensitivity to configural transformations for faces presented in a more familiar orientation. The present findings question a purely configural account of face processing and suggest that the role of spatial-relational information in face processing varies according to the functional demands of the task and to the characteristics of the stimuli. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Challenges faced by primary care physicians when prescribing for patients with chronic diseases in a teaching hospital in Malaysia: a qualitative study.

    Science.gov (United States)

    Sellappans, Renukha; Lai, Pauline Siew Mei; Ng, Chirk Jenn

    2015-08-27

    The aim of this study was to identify the challenges faced by primary care physicians (PCPs) when prescribing medications for patients with chronic diseases in a teaching hospital in Malaysia. 3 focus group discussions were conducted between July and August 2012 in a teaching primary care clinic in Malaysia. A topic guide was used to facilitate the discussions which were audio-recorded, transcribed verbatim and analysed using a thematic approach. PCPs affiliated to the primary care clinic were purposively sampled to include a range of clinical experience. Sample size was determined by thematic saturation of the data. 14 family medicine trainees and 5 service medical officers participated in this study. PCPs faced difficulties in prescribing for patients with chronic diseases due to a lack of communication among different healthcare providers. Medication changes made by hospital specialists, for example, were often not communicated to the PCPs leading to drug duplications and interactions. The use of paper-based medical records and electronic prescribing created a dual record system for patients' medications and became a problem when the 2 records did not tally. Patients sometimes visited different doctors and pharmacies for their medications and this resulted in the lack of continuity of care. PCPs also faced difficulties in addressing patients' concerns, and dealing with patients' medication requests and adherence issues. Some PCPs lacked time and knowledge to advise patients about their medications and faced difficulties in managing side effects caused by the patients' complex medication regimen. PCPs faced prescribing challenges related to patients, their own practice and the local health system when prescribing for patients with chronic diseases. These challenges must be addressed in order to improve chronic disease management in primary care and, more importantly, patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not

  2. Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries

    OpenAIRE

    Rajanbir Kaur; Kanwaljit Kaur; Rajinder Kaur

    2018-01-01

    Menstruation and menstrual practices still face many social, cultural, and religious restrictions which are a big barrier in the path of menstrual hygiene management. In many parts of the country especially in rural areas girls are not prepared and aware about menstruation so they face many difficulties and challenges at home, schools, and work places. While reviewing literature, we found that little, inaccurate, or incomplete knowledge about menstruation is a great hindrance in the path of p...

  3. Accounting research in family firms: Theoretical and empirical challenges

    NARCIS (Netherlands)

    Prencipe, A.; Bar-Yosef, S.; Dekker, H.C.

    2014-01-01

    Family firms play a significant role in the global economy. Consistently, over the last two decades academia has turned its attention to the family dimension as a determinant of business phenomena, and this interest has increased over time. While family business research has reached an age of

  4. Values in Conflict: Challenges to Family Therapists' Thinking.

    Science.gov (United States)

    Bograd, Michele

    1992-01-01

    Contends that familiar and comfortable family therapy theories were not designed to deal with violence and may help maintain collective avoidance of the issue of violence among family therapists. Explores limitations of therapeutic neutrality and dangers inherent in some interventions. Concludes that effective amelioration of family violence…

  5. New Challenges Facing Small Undergraduate Departments And The Role Of Faculty And Administrators.

    Science.gov (United States)

    El-Shazly, A. K.

    2003-12-01

    Small geoscience departments with 5 faculty members or less in undergraduate institutions are facing serious challenges that will have a profound impact on their future, as well as the future of geoscience education. In addition to past and future budget cuts that affect all departments, small departments are more vulnerable to such problems as (i) decreased enrollments in introductory level classes, (ii) small number of geology majors, (iii) small number of graduates per year (iv) lack or paucity of equipment necessary for faculty and student research, (v) limited opportunities for external funding, (vi) need to offer upper division classes on an alternate year basis, (vii) difficulty in recruiting and retaining students, (viii) high teaching loads for faculty, and (ix) designing rigorous curricula based on 120 credit hours with a significant component of liberal art classes. These problems pose new challenges for faculty, department chairs and administrators. Faculty need to design curricula tailored to the need of the job market, without compromising rigor or the quality of the program. New classes/ concentrations in environmental science, hydrogeology and geographical information systems should be offered, and traditional classes in petrology, geophysics and tectonics should be maintained. Classes in Physics, Chemistry and Math should be core requirements. Student involvement in research should be encouraged at an early stage (sophomore/ junior levels). Department chairs need to assign duties in their department carefully to capitalize on the strengths of their faculty: faculty with strong research backgrounds should be helped in their efforts to pursue external funding opportunities, whereas those with strong teaching abilities should be evaluated primarily on their performance in the classroom. Student credit hour production should not be used as a criterion for evaluating faculty. Administrators should evaluate programs and departments based on the success

  6. Is sustainable development attainable? Challenges facing forestry and the forest products industry

    International Nuclear Information System (INIS)

    Wrist, P.E.

    1991-01-01

    The challenges that face the forest industry in achieving sustainable development are reviewed. Sustainable development is not the same as sustained yield forest management. While sustained yield limits harvesting to an estimate of a forest's incremental annual growth, it is a policy which neither takes into account how improved forest management practices can increase future growth rates nor gives guidance on how multiple uses for the forest resource can be made compatible with periodic harvesting of that resource. Forests, in addition to meeting demands for timber production, must also meet demands for watershed management, recreation, preservation of wildlife and genetic diversity, moderation of climates, carbon sequestration, and land reclamation. Information is lacking from which to develop improved forest management programs that take these demands into account. Questions remain about such matters as the role of plantations in sustainable forestry and the maintenance of natural diversity. Some recent research being undertaken to generate better information for future forestry decision making is outlined, including work on gene pool maintenance, the interdependence of forest ecology and climate, the symbiotic role of mycorrhiza, forest fertilization, and the interdependence of sustainable forestry and sustainable fisheries. In the forest products industry, engineered wood products have been developed that meet tight specifications and require less raw material, and process changes have been introduced that greatly reduce pollutants from pulp manufacture

  7. Polycentrism in Global Health Governance Scholarship Comment on "Four Challenges That Global Health Networks Face".

    Science.gov (United States)

    Tosun, Jale

    2017-05-23

    Drawing on an in-depth analysis of eight global health networks, a recent essay in this journal argued that global health networks face four challenges to their effectiveness: problem definition, positioning, coalition-building, and governance. While sharing the argument of the essay concerned, in this commentary, we argue that these analytical concepts can be used to explicate a concept that has implicitly been used in global health governance scholarship for quite a few years. While already prominent in the discussion of climate change governance, for instance, global health governance scholarship could make progress by looking at global health governance as being polycentric. Concisely, polycentric forms of governance mix scales, mechanisms, and actors. Drawing on the essay, we propose a polycentric approach to the study of global health governance that incorporates coalitionbuilding tactics, internal governance and global political priority as explanatory factors. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  8. Challenges facing post-war tourism development: the case of Iran

    Directory of Open Access Journals (Sweden)

    Jamal Mohammadi

    2015-12-01

    Full Text Available This study presents an empirical investigation to study the post-war tourism in sought west region of Iran. This region is the host of many Iranian who wish remember the events of War between Iran and Iraq. Many high school or university students travel to the region through cultural as well as religious communities. This paper tries to analyze the challenges facing these people when they travel to province of Khozestan, Iran. The study designs a questionnaire in Likert scale and distributes it among some randomly selected people who visited the region. The implementation of Pearson correlation test has determined that “Weakness of tourism infrastructure facilities and services” is to be blamed the most followed by “Underdevelopment of decision making centers”. Moreover, path analysis has been implemented to detect direct and indirect effects of different factors on development of tourism in the region. In our survey, marketing, culture and weakness in infrastructures have been determined the most important factors influencing on development of the region.

  9. Challenges faced in the treatment of acute lymphoblastic leukemia in adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Levine SR

    2016-02-01

    Full Text Available Selena R Levine,1 Jennifer L McNeer,2 Michael S Isakoff1 1Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center and University of Connecticut School of Medicine, Hartford, CT, 2Section of Pediatric Hematology/Oncology, University of Chicago Comer Children's Hospital, Chicago, IL, USA Abstract: The survival rate for children with acute lymphoblastic leukemia (ALL has dramatically improved over the last 50 years. However, for those in the adolescent and young adult (AYA age-group of 15–30 years with ALL, there has not been the same degree of improvement. Historically, pediatric and adult providers have utilized different treatment approaches based on clinical trials. However, studies that have compared the outcome of AYA patients with ALL treated on pediatric or adult clinical trials have generally shown substantially better outcomes for this patient population treated with the pediatric trials. Additionally, hematopoietic stem cell transplantation has been considered as part of intensified therapy for AYA patients with ALL. Herein, we review the outcomes with chemotherapy alone and with hematopoietic stem cell transplantation, and explore the challenges faced in determining the ideal therapy for the AYA population of patients. Keywords: adolescent young adult oncology, leukemia, hematopoietic stem cell transplantation

  10. 'Shedding light' on the challenges faced by Palestinian maternal health-care providers.

    Science.gov (United States)

    Hassan-Bitar, Sahar; Narrainen, Sheila

    2011-04-01

    to explore the challenges and barriers faced by Palestinian maternal health-care providers (HCPs) to the provision of quality maternal health-care services through a case study of a Palestinian public referral hospital in the Occupied Palestinian Territory. descriptive qualitative study. The data are from a broader study, conducted in 2005 at the same hospital as part of a baseline assessment of maternal health services. 31 maternal HCPs; nine midwives and 14 nurses and eight doctors. the quality of care provided for women and infants at this Palestinian public hospital is substandard. The maternal HCPs work within a difficult and resource-constrained environment. ISSUES INCLUDE: high workload, poor compensation, humiliation in the workplace, suboptimal supervision and the absence of professional support and guidance. Midwives are perceived to be at the bottom of the health professional hierarchy. there is a need for managers and policy makers to enable maternal HCPs to provide better quality care for women and infants during childbirth, through facilitating the roles of midwives and nurses and creating a more positive and resourceful environment. Palestinian midwives need to increase their knowledge and use evidence-based practices during childbirth. They need to unite and create their own circle of professional support in the form of a Palestinian midwifery professional body. Copyright © 2009 Elsevier Ltd. All rights reserved.

  11. A bio-ecological interpretation of the relationship challenges in the context of the reconstituted family

    OpenAIRE

    Ebersohn, S; Bouwer, AC

    2015-01-01

    From an educational psychology perspective, family life - as a child's primary educational situation - is changing drastically as divorces increase worldwide. Various challenges to relationships accompany the restructuring of family systems after divorce. When remarriage occurs, children's shared membership of two family microsystems and the resultant complexity of the mesosystem cause the reconstituted family situation to come to differ radically from that of a nuclear family. The purpose of...

  12. Access to energy sources in the face of climate change: Challenges faced by women in rural communities

    Directory of Open Access Journals (Sweden)

    Mphemelang J. Ketlhoilwe

    2018-04-01

    Full Text Available Access to energy is a challenge to rural communities, especially among women who are the prime household energy users. This article is based on research carried out in the Tswapong villages in Botswana where energy sources particularly wood, are slowly getting depleted while electricity connection costs remain unaffordable for the poor. The article provides constructivist analysis of experiences in real-life situations among women. Data were generated through observations, documents analysis, interviews and focus group discussions. It has emerged from the research that majority of the respondents use firewood as energy source. Firewood and gas are mainly used for cooking while electricity is mainly used for lighting. The demand for firewood has led to firewood commercialisation, the depletion of preferred firewood tree species and increase in the impact of climate change. The article recommends economic diversification and subsidies to empower the majority of the rural poor to connect to the national electric grid and reduce on firewood dependence. These could be complemented by harnessing of solar energy and low-cost, energy-saving technologies. Subsidies to enable women access to energy services would contribute immensely to the decade of Sustainable Energy for All and to the attainment of the post 2015 sustainable development goal on energy.

  13. Challenges facing the veterinary profession in Ireland: 3. emergency and casualty slaughter certification.

    Science.gov (United States)

    Magalhães-Sant'Ana, Manuel; More, Simon J; Morton, David B; Hanlon, Alison J

    2017-01-01

    Veterinarians are faced with significant conflicts of interest when issuing certificates for the transport and slaughter of acutely injured and casualty livestock. In a recent Policy Delphi study, emergency and casualty slaughter certification was a key concern identified by veterinary professionals in Ireland. In this case study (the third in a series of three resulting from a research workshop exploring challenges facing the veterinary profession in Ireland; the other two case studies investigate clinical veterinary services and the on-farm use of veterinary antimicrobials), we aim to provide a value-based reflection on the constraints and opportunities for best practice in emergency and casualty slaughter certification in Ireland. Using a qualitative focus group approach, this study gathered evidence from relevant stakeholders, namely a representative from the regulatory body, local authority veterinarians with research experience in emergency slaughter, an animal welfare research scientist, official veterinarians from the competent authority, a private veterinary practitioner, and a member of a farming organisation. Results revealed a conflict between the responsibility of private veterinary practitioners (PVPs) to safeguard the welfare of acutely injured bovines on-farm and the client's commercial concerns. As a consequence, some PVPs may feel under pressure to certify, for example, an acutely injured animal for casualty slaughter instead of recommending either on-farm emergency slaughter or disposal by the knackery service. Among Official Veterinarians, there are concerns about the pressure within processing plants to accept acutely injured livestock as casualty animals. Confusion pertaining to legislation and definition of fitness to travel also contribute to these dilemmas. Conflicts of interest arise due to the gap between governance and provision to facilitate on-farm emergency slaughter of livestock. Increased availability and acceptance of on

  14. Co-Creating Desired Outcomes and Strengthening the Resilience of Multi-Challenged Families

    Science.gov (United States)

    Mešl, Nina; Kodele, Tadeja

    2016-01-01

    Families facing poverty suffer from many other stresses, with children's school performance being one of the common topics. A life of poverty and the related unfavourable circumstances should not define children's life stories. Ensuring this is not the case is partly the responsibility of professionals working with families. It is important to…

  15. Autism in Brazil: a systematic review of family challenges and coping strategies

    Directory of Open Access Journals (Sweden)

    Paulyane T.M. Gomes

    2015-03-01

    Full Text Available Objective: To describe the challenges faced by families caring for children with autism spectrum disorder (ASD in Brazil and the coping strategies employed. Sources: Systematic review of articles published until September of 2013, without language restrictions, using quality appraisal (AMSTAR and CASP/Oxford instruments. Summary of the findings: The literature shows parental emotional overload as one of the main challenges faced by families, especially mothers. The main stressors were diagnostic postponement, difficulty dealing with the diagnosis and associated symptoms, and poor access to health services and social support. The predominant coping strategies found included information exchange between affected families and integrated healthcare network for patient and family support. Conclusion: ASD exerts strong influence on family dynamics, resulting in caregiver overload, especially in mothers. The Brazilian Unified Health System needs to provide comprehensive, continuous, and coordinated care to strengthen the patient-family dyad and promote the full development and societal inclusion of children with ASD. Resumo: Objetivo: Descrever os desafios encontrados pelas famílias na convivência com crianças portadoras de transtorno do espectro autista (TEA no Brasil e as estratégias de superação empregadas. Fonte dos dados: Revisão sistemática da literatura com inclusão de artigos publicados até setembro de 2013, sem restrições de idioma. Os artigos incluídos foram submetidos à avaliação de qualidade metodológica através do AMSTAR e CASP/Oxford. Síntese dos dados: Inclui-se estudos provenientes de São Paulo e Rio Grande do Sul com alta e moderada qualidade metodológica. A literatura mostra sobrecarga emocional dos pais como um dos principais desafios encontrados pelas famílias, inclusive com grande tensão sobre as mães. Dentre os fatores relacionados ao estresse estão: postergação diagnóstica, dificuldade de lidar com o

  16. Meeting the Needs of Children and Families: Opportunities and Challenges for School Psychology Training Programs.

    Science.gov (United States)

    Curtis, Michael J.; Batsche, George M.

    1991-01-01

    Notes that graduate training programs face challenges, as well as opportunities, in fulfillment of their responsibilities to prepare school psychologists for entry into professional practice. Examines nature and origins of potential changes facing school psychology and discusses adequacy of current training programs. Discusses future implications…

  17. Knowledge Production and Transmission in a Changing Society: Challenges Facing Law Lecturers in a Distance Education Environment in South Africa

    Science.gov (United States)

    Scott, Susan

    2006-01-01

    In this article I highlight the challenges facing a law lecturer in a multicultural society in transformation where the student is being prepared to serve society in different occupational fields as a professional person. I indicate that the law itself cannot effect change. For this we need properly trained lawyers. For an effective transformation…

  18. Challenges Faced by Development Partners in Supporting the Growth and Development of Commercial Enterprises in Lira District, Northern Uganda

    Science.gov (United States)

    Eton, Marus; Mwirumubi, Richard; Edaku, Charles

    2017-01-01

    Entrepreneurship is defined as the process where an individual discovers, evaluates and exploit opportunities independently. Most countries have embraced entrepreneurship development as ways of creating employment and economic growth and development. The objective of the study was to examine the challenges faced by commercial enterprises in Lira…

  19. Challenges faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe: The case of Chitungwiza town

    Directory of Open Access Journals (Sweden)

    Tafadzwa Rugoho

    2017-05-01

    Conclusion: The government, in partnership with other stakeholders, should address challenges faced by women with disabilities when accessing sexual and reproductive health services. Non-government, private hospitals and profit-making organisations should join hands with government in funding health requirements for women with disabilities.

  20. Challenges Facing Managers in Managing Conflict in Schools in the South and South Central Regions of Botswana

    Science.gov (United States)

    Morake, Nnior Machomi; Monobe, Ratau John; Dingwe, Stephonia

    2011-01-01

    The purpose of this study was to examine the challenges facing managers in managing conflict in schools of South and South Central Regions of Botswana. In this study, the schedule of interview was used to collect empirical data. A random sample of 50 school managers and deputy school managers was selected for interviews. Major findings of the…

  1. Using an Iterative Mixed-Methods Research Design to Investigate Schools Facing Exceptionally Challenging Circumstances within Trinidad and Tobago

    Science.gov (United States)

    De Lisle, Jerome; Seunarinesingh, Krishna; Mohammed, Rhoda; Lee-Piggott, Rinnelle

    2017-01-01

    In this study, methodology and theory were linked to explicate the nature of education practice within schools facing exceptionally challenging circumstances (SFECC) in Trinidad and Tobago. The research design was an iterative quan>QUAL-quan>qual multi-method research programme, consisting of 3 independent projects linked together by overall…

  2. Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

    Science.gov (United States)

    Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin

    2015-12-01

    Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

  3. A Bio-Ecological Interpretation of the Relationship Challenges in the Context of the Reconstituted Family

    Science.gov (United States)

    Ebersohn, S.; Bouwer, A. C.

    2015-01-01

    From an educational psychology perspective, family life--as a child's primary educational situation--is changing drastically as divorces increase worldwide. Various challenges to relationships accompany the restructuring of family systems after divorce. When remarriage occurs, children's shared membership of two family microsystems and the…

  4. Maintaining family life balance while facing a child's imminent death-A mixed methods study.

    Science.gov (United States)

    Eskola, Katri; Bergstraesser, Eva; Zimmermann, Karin; Cignacco, Eva

    2017-10-01

    To understand parents' experiences and needs during a child's end-of-life care at home and to identify systemic factors that influence its provision. A child's end-of-life phase is an extremely difficult time for the whole family. Parents have specific needs, especially when they care for a dying child at home. Concurrent embedded mixed methods design. This sub-study of the nationwide survey, 'Paediatric End-of-Life Care Needs in Switzerland' (2012-2015) included 47 children who received EOL care at home from 2011-2012. We extracted quantitative data from patients' medical charts and obtained information via parental questionnaire and then compared parents whose child died at home or in hospital by computing generalized estimation equations. We thematically analysed interviews with parents who provided EOL care at home. Parents created an intimate lifeworld and a sense of normality for the child at home. They constantly balanced the family's lifeworld with the requirements and challenges posed by the outside world. This work exhausted parents. Parental 'readiness' and social support drove EOL care for children at home. Parents needed practical help with housekeeping and had negative experiences when dealing with insurance. In only 34.8% of cases was a child's EOL home care supported by paediatric palliative care team. Paediatric end-of-life care at home is only feasible if parents make extraordinary efforts. If family-centred end-of-life home care is provided by a hospital-based paediatric palliative home care team, which includes paid housekeeping help and psychological support, parents' needs could be better met. © 2017 John Wiley & Sons Ltd.

  5. The Work/Family Challenge: A Key Career Development Issue.

    Science.gov (United States)

    Kahnweiler, William M; Kahnweiler, Jennifer B.

    1992-01-01

    A few corporations are responding to the impact of family structural changes on workers' ability to balance their roles with flexible benefits and schedules and with training. Work/family issues are an integral part of career and life decision making and must be incorporated into the career development process. (SK)

  6. The challenge of unravelling family resemblance related to illness behaviour.

    NARCIS (Netherlands)

    Cardol, M.; Groenewegen, P.P.; Spreeuwenberg, P.; Dijk, L. van; Bosch, W. van den; Bakker, D.H. de

    2005-01-01

    Background: Efforts to promote health or prevent disease may conflict with patients’ habits at home. Irrespective of the national setting, families are important social contexts in which illness occurs and resolves. Family members resemble each other in their illness behaviour, even across

  7. Child-to-Parent Violence: Challenging Perspectives on Family Violence

    Science.gov (United States)

    Coogan, Declan

    2011-01-01

    Until relatively recently, the focus of research, policy and intervention responses to abuse and violence within families has been almost exclusively on the behaviour of adults rather than on the violence within families carried out by children and adolescents. As a consequence, the aggressive and violent behaviour of children and adolescents at…

  8. Family violence in Addis Ababa: Challenges of reconciling culture ...

    African Journals Online (AJOL)

    Family violence includes physical, psychological and sexual violations such as pinching, beating, hitting, scolding, yelling and coerced sex. Wife beating and child corporal punishment are major family/domestic violence in Ethiopia. This study focused on wife beating (battering). It has attempted to find out the main causes ...

  9. Conference on wind power development in the face of landscape and local project acceptability challenges

    International Nuclear Information System (INIS)

    Victoire Lejzerzon; Sauron, Claire; Villot, Marie; Ratzbor, Guenter; Tausch, Christian; Cagneaux, Bertrand; Jouneau, Agathe; Stemmer, Boris; Huebner, Gundula; Orozco-Souel, Paola; Lhermitte, Charles; Ferus, Elisabeth; Benezech, Philippe; Gunzelmann, Thomas

    2015-01-01

    The French-German office for Renewable energies (OFAEnR) organised a conference on n wind power development in the face of landscape and local project acceptability challenges. In the framework of this French-German exchange of experience, participants addressed the following points: the conciliation between landscape protection and wind power development, the definition of landscape environmental quality criteria, the needs and usages of the departments in charge of the treatment of landscape studies in France, the socio-psychological approach of the local acceptability of wind farm projects, the re-powering tool for the improvement of the wind farm integration in the landscape, and the conciliation between the monuments maintenance and wind power development. This document brings together the available presentations (slides) made during this event: 1 - Conciliating landscape protection and wind power development goals in France (Marie Villot); 2 - Wind turbines: Conflicts between development goals, landscape and acceptance - Perception and criteria (Guenter Ratzbor); 3 - Bayern's wind power atlas: a planning tool which takes into account the landscape aspects (Christian Tausch); 4 - Landscape assessment in wind farms projects: what and how to do in French administrative procedures? (Bertrand Cagneaux); 5 - Methods for evaluation of landscape for wind farms projects - A French project developer's feedback (Agathe Jouneau); 6 - Landscape Assessment: Methods from German Landscape Practice (Boris Stemmer); 7 - Acceptance of Wind Turbines - Social Psychological Research (Gundula Huebner); 8 - Local consultation: who to involve, when and how? (Paola Orozco-Souel); 9 - Local acceptability: what dialogue concepts and strategies, and how to manage wind energy objection (Charles Lhermitte); 10 - Re-powering and landscape: chances and limits (Elisabeth Ferus); 11 - Wind power and cultural heritage: consultation and dialogue to succeed (Philippe Benezech); 12

  10. DATING AND SEXUAL CHALLENGES FACED BY HIV-POSITIVE PEOPLE IN KWAZULU-NATAL, SOUTH AFRICA

    Directory of Open Access Journals (Sweden)

    Mulqueeny, Delarise

    2013-05-01

    Full Text Available According to the 2010 UNAIDS Report, an estimated 320 000 (or 20% fewer people died of AIDS-related causes in 2009 when compared to figures in 2004 in sub-Saharan Africa, when antiretroviral therapy was markedly expanded (UNAIDS, 2010. This decreased mortality rate offers hope for HIV-infected people to plan a future, part of which will include dating and sexual relationships. The Report cites KwaZulu-Natal in South Africa as being at the heart of the HIV/AIDS epidemic; this article is based on research on dating and sexuality among HIV-positive people in KwaZulu-Natal. Dating and sexuality are an integral part of living. Yet HIV-positive persons are denied intimacy at a time when this is most needed (Kasiram in Kasiram, Partab & Dano, 2006. Little is known about the full range of sexual adaptations that HIV-infected individuals choose (Schiltz & Sandfort, 2000. Kasiram, Partab, Dano and Van Greunen (2003:9 cite interaction and intimacy among HIV-positive persons as a neglected research focus, while Painter (2001 adds that insufficient attention is afforded to couple relationships for infected people. An important reason that motivated this study on dating and sexual challenges faced by HIV-positive people was the first author’s (the main researcher’s personal experience of being HIV positive and counselling and life coaching HIV-positive people. She is confronted regularly with variations of the question “Will I be normal?”, which often translates to: “Will I be able to date and have sex.

  11. Challenges Faced by Graduate Business Education in Southern Africa: Perceptions of MBA Participants

    Science.gov (United States)

    Temtime, Zelealem T.; Mmereki, Rebana N.

    2011-01-01

    Purpose: The purpose of this paper is to examine the degree of satisfaction and perceived relevance of the Graduate Business Education (GBE) programme at the University of Botswana. Design/methodology/approach: A self-administered questionnaire and face to face interviews were used to collect data from Master of Business Administration (MBA)…

  12. Challenges in diagnosis and counseling of a family with two ...

    African Journals Online (AJOL)

    Heba S. Abd-Elkhalek

    2015-12-29

    Dec 29, 2015 ... Genetics Unit, Childrens' Hospital, Ain Shams University, Cairo, Egypt. Available online 29 ... normal milestones of development in the first 6 months of life .... most important clue in family history that indicated the pres- ence of ...

  13. Williams Syndrome: Daily Challenges and Positive Impact on the Family

    Science.gov (United States)

    Scallan, Susan; Senior, Joyce; Reilly, Colin

    2011-01-01

    Background: Despite the distinctive physical, cognitive, personality and behavioural characteristics associated with Williams syndrome, few studies to date have examined parental experiences of raising a child with this genetic syndrome. Methods: This explorative pilot study employed predominantly qualitative methodologies via face-to-face…

  14. Subdivide or silviculture: choices facing family forest owners in the redwood region

    Science.gov (United States)

    William Stewart; Shasta Ferranto; Gary Nakamura; Christy Getz; Lynn Huntsinger; Maggi. Kelly

    2012-01-01

    Families or family businesses own nearly all of the private redwood forestland in California. Family forest owners have practiced both subdivision and silviculture for decades but the dominant theme for most family owners is environmental stewardship. Parcel size is more important than expressed values as a predictor of resource management activities. All landowners...

  15. Facing the challenge of stakeholders involvement: the Argentine nuclear regulatory case

    International Nuclear Information System (INIS)

    Acosta, Gabriela M.; Arnaud, Marta I.; Cesario, Pablo A.

    2010-01-01

    The Nuclear Regulatory Authority of Argentina (ARN) is an autonomous body reporting to the Presidency of Argentina, empowered to regulate and control the nuclear activity with regards to radiation and nuclear safety, physical protection and nuclear non-proliferation issues. Under the executive decree 1172/2003, which makes reference to the accessibility of public information to increase transparency of government actions and specially to promote public involvement, ARN has the legal obligation to inform of its activities in an accurate, comprehensive and understandable manner. The re-launching of the nuclear plan in 2006 and the repercussions this provoked on society highlighted the need to reinforce the legitimacy of the regulatory role and the promotion of confidence on its works to ensure the safety of the people. Therefore it was considered necessary to involve the society further in this programme by achieving greater public understanding and awareness of the nuclear regulatory activities. The more the public is conscious of the role of the regulator, conceiving it as a trustworthy and autonomous authority, the easier it is for the regulator to fulfil its obligations. As ARN has a strong commitment with society and considering that communication with the general public, as an external stakeholder, is a means to establishing and maintaining public trust and confidence, the implementation of a new communication programme became a key issue. In this scenario, ARN faced a challenge it was not prepared to handle and thus created a Division to deal with institutional communication and allow and ease the interaction with society. Within this Division, one of the methods chosen to achieve a better interaction with society was the use of a technological tool to attend possible inquiries, increasing and facilitating a greater involvement of the stakeholders. With this in mind a 'Mail-Info' was established because it allows a fast, accessible, easy and informal way of

  16. Facing the challenge of stakeholders involvement: the Argentine nuclear regulatory case

    Energy Technology Data Exchange (ETDEWEB)

    Acosta, Gabriela M.; Arnaud, Marta I.; Cesario, Pablo A. [Nuclear Affairs and Institutional Communication Department, Autoridad Regulatoria Nuclear, Av. del Libertador 8250, C1429BNP (Argentina)

    2010-07-01

    The Nuclear Regulatory Authority of Argentina (ARN) is an autonomous body reporting to the Presidency of Argentina, empowered to regulate and control the nuclear activity with regards to radiation and nuclear safety, physical protection and nuclear non-proliferation issues. Under the executive decree 1172/2003, which makes reference to the accessibility of public information to increase transparency of government actions and specially to promote public involvement, ARN has the legal obligation to inform of its activities in an accurate, comprehensive and understandable manner. The re-launching of the nuclear plan in 2006 and the repercussions this provoked on society highlighted the need to reinforce the legitimacy of the regulatory role and the promotion of confidence on its works to ensure the safety of the people. Therefore it was considered necessary to involve the society further in this programme by achieving greater public understanding and awareness of the nuclear regulatory activities. The more the public is conscious of the role of the regulator, conceiving it as a trustworthy and autonomous authority, the easier it is for the regulator to fulfil its obligations. As ARN has a strong commitment with society and considering that communication with the general public, as an external stakeholder, is a means to establishing and maintaining public trust and confidence, the implementation of a new communication programme became a key issue. In this scenario, ARN faced a challenge it was not prepared to handle and thus created a Division to deal with institutional communication and allow and ease the interaction with society. Within this Division, one of the methods chosen to achieve a better interaction with society was the use of a technological tool to attend possible inquiries, increasing and facilitating a greater involvement of the stakeholders. With this in mind a 'Mail-Info' was established because it allows a fast, accessible, easy and informal

  17. An assessment for technical, economic, and environmental challenges facing renewable energy strategy in Egypt

    International Nuclear Information System (INIS)

    Abd El Aziz Mohi El Din, Ehab Mohamed Farouk

    2011-01-01

    Securing energy demand for next generations is one of the most challenges aspects facing any sustained development plans, due to the growing electric energy demand and Egypt as a country of limited fossil fuel resources has to diversify its energy portfolio by utilization of its renewable energy resources, mainly wind due to its economic potential and solar as proved by Egypt's wind and solar atlases. In the year 2009/2010, the total installed capacity in Egypt was 24726 MW with electricity generation 139,000 GWh, of which 89 % was delivered by thermal plants and about 10% from Hydro power with total installed 2800 MW and electricity generated is about 12863 GWh and 1% from Wind energy with total installed 550 MW and electricity generated 1542 GWh. In the solar energy field, the first solar thermal power plant of 140 MW with a solar share of 20 MW using parabolic trough technology was started the initial work since the 1 st of July with estimated total energy generated of 852GWh/year. Recently, Egypt has adopted an ambitious plan to cover 20% of the generated electricity by renewable energy by 2020, including a 12% contribution from wind energy, translating more than 7200 MW grid-connected wind farms. Such plan gives a room enough to the private investment to play the major role in realizing this goal. The plan includes also a 100 MW Solar thermal energy CSP with parabolic trough technology in Kom Ombo city, and also two PV plants in Hurgada and Kom Ombo with a total installed capacity 20 MW each. Due to the high investment cost of solar energy technologies, still limited in spread all over the world on the other hand wind energy has an economic potential and becomes a commercial technology but the future potential for solar energy due to the limited land for wind energy. Current study will evaluate the Egyptian strategy for renewable energy up to 2020 and find how much the planned projects from the Egyptian government will fulfill its target, the economic study

  18. A long hard road? Urban freight transport challenges facing South Africa

    CSIR Research Space (South Africa)

    Ittmann, HW

    2008-05-01

    Full Text Available shown very little interest in the increasingly severe freight transport problems facing urban areas, there is now growing interest in the logistics of collection and delivery services in towns and city centres....

  19. Challenges for future family policies in the Nordic countries

    DEFF Research Database (Denmark)

    responsibility of parents, but also a responsibility to be shared with society. Moreover, the Nordic welfare model goes hand-in-hand with the women’s movement by offering opportunities for women, as well as men, to also participate in education and employment. The question remains how more recent trends...... such as New Public Management principles and increased focus on children’s positions and rights affect family policies in the Nordic countries? The authors, who come from all five Nordic countries, discuss the following topics: issues related to family demographics, children’s position in society...

  20. Work-family life balance: future trends and challenges

    OpenAIRE

    Fagnani, Jeanne

    2011-01-01

    The aim of this paper is to offer a holistic forward-looking, and multi level analysis of pressing contemporary topics related to work/life balance policies for families with smaller children and to show how they interact with parents' attitudes and practices. The paper is structured as follows: the first chapter presents a brief overview of current trends in the work/family life related areas. Then the main key drivers of change over the last decade are identified and described. Emphasis is ...

  1. Positive parenting in ethnic minority families : challenges and outcomes

    NARCIS (Netherlands)

    Emmen, Rosalia Antonia Grada (Rosanneke)

    2014-01-01

    The overall goal of the current dissertation is to uncover predictors and outcomes of positive parenting in ethnic minority families. Chapter 2 provides an overview of commonly used observational instruments to measure sensitivity, showing the versatility and scientific importance of the construct.

  2. Challenging Social Hierarchy: Playing with Oppositional Identities in Family Talk

    Science.gov (United States)

    Bani-Shoraka, Helena

    2008-01-01

    This study examines how bilingual family members use language choice and language alternation as a local scheme of interpretation to distinguish different and often contesting social identities in interaction. It is argued that the playful creation of oppositional identities in interaction relieves the speakers from responsibility and creates a…

  3. FAMILY HEALTH PROGRAM: CHALLENGES AND POTENTIALITIES REGARDING DRUGS USE

    Directory of Open Access Journals (Sweden)

    Marcelle Aparecida de Barros

    2006-04-01

    Full Text Available ABSTRACT: Epidemiological studies on drugs use point towards this phenomenon as a public health problem. Nowadays, the Family Health Program (FHP is presented by the Health Ministry as a model to restructure primary health care and aims to offer family-centered care, permeated by integrality, problem solving and community bonds. This article aims to discuss action possibilities of Family Health Care professionals involving drugs patients. It is evident that, as opposed to other actions already developed by FHP professionals in other health care areas, which has appeared clearly and objectively. This fact is observed in the daily activities of FHP professionals, which give little attention to drugs-related problems. However, research emphasizes that there exists a broad range of action possibilities for FHP professionals. Although other studies evidence this team’s fragilities in terms of care for drugs users, these can be overcome by investing in the training and valuation of these professionals. KEY WORDS: Family Health Program; Street drugs; Health Knowledge, Attitudes, Practice.

  4. Constructing the "Ideal" Family for Family-Centred Practice: Challenges for Delivery

    Science.gov (United States)

    Dodd, Jenny; Saggers, Sherry; Wildy, Helen

    2009-01-01

    Family-centred practice positions families as the key decision-makers, central to and experts in the wants and needs of their child. This paper discusses how families interviewed for a Western Australian study describe their relationships with a range of allied health professionals in the paediatric disability sector. The allied health…

  5. Engaging with Families Is a Challenge: Beliefs among Healthcare Professionals in Forensic Psychiatric Care

    Science.gov (United States)

    Hörberg, Ulrica; Erlingsson, Christen; Syrén, Susanne

    2015-01-01

    Being healthcare professionals in the complex field of forensic psychiatry care (FPC) seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer's philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient's care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one's own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family's resources. PMID:26448874

  6. The Nigerian Economy in the Face of Socio-Political Challenges: A Retrospective View and Ways Forward

    Directory of Open Access Journals (Sweden)

    Tomola M Obamuyi

    2016-04-01

    Full Text Available This paper examines the Nigerian economy and the tendency for its growth in the face of several socio-political challenges facing the country, which have hampered the rate of economic development in spite of the tremendous human and material resources inherent. The paper identifies the socio-political challenges to include corruption, poverty, unemployment, insecurity, politics and governance, among others. The central argument of the paper is that steady economic growth can be achieved and financial crisis mitigated in Nigeria, if the effects of socio-political challenges, which are the key factors that have contributed to the high poverty, unemployment and economic instability in the country, are minimised. To ensure economic growth and move the country forward politically and economically, government must be more accountable in managing the nation’s resources in order to avoid wastage, poverty and unemployment. Close attention should be given to those socio-political challenges in the formulation of policies that aimed at maintaining economic growth at a level commensurate with the country’s growth rate. This study put forward that government must be proactive in all issues relating to the socio-political challenges to prevent resource mismanagement, poverty, unemployment, insecurity and slow economic growth in future.

  7. Challenges facing the advertising world in the digital era :  A comparison between Dutch and Swedish advertising agencies

    OpenAIRE

    Rozenveld, Marc; Heinonen, Tapio

    2013-01-01

    Date: June 7th of 2013 Level: Master thesis in marketing, 15 ECTS Institution: School of Business, Society and Engineering, Mälardalen University Authors: Tapio Heinonen & Marc Rozenveld 18 thof November 1988 & 16th of June 1990 Title: Challenges facing the advertising world in the digital era. Subtitle: A comparison between Dutch and Swedish advertising agencies. Tutor: Peter Selegård Keywords: media logic, advertising industry, advertising agencies, advertising and digital ma...

  8. Meeting the challenges of the new energy industry: The driving forces facing electric power generators and the natural gas industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    The proceedings of the IGT national conference on meeting the challenges of the New Energy Industry: The driving forces facing Electric Power Generators and the Natural Gas Industry are presented. The conference was held June 19-21, 1995 at the Ambassador West Hotel in Downtown Chicago, Illinois. A separate abstract and indexing for each of the 18 papers presented for inclusion in the Energy Science and Technology Database.

  9. Meeting the challenges of the new energy industry: The driving forces facing electric power generators and the natural gas industry

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The proceedings of the IGT national conference on meeting the challenges of the New Energy Industry: The driving forces facing Electric Power Generators and the Natural Gas Industry are presented. The conference was held June 19-21, 1995 at the Ambassador West Hotel in Downtown Chicago, Illinois. A separate abstract and indexing for each of the 18 papers presented for inclusion in the Energy Science and Technology Database

  10. Challenges in diagnosis and counseling of a family with two recessive neurometabolic disorders

    Directory of Open Access Journals (Sweden)

    Heba S. Abd-Elkhalek

    2016-07-01

    In this case report, we present the challenges that we met in diagnosis and counseling of a family with both Tay–Sachs and maple syrup urine disease depending mainly on history, clinical data and a few diagnostic investigations.

  11. Hyper-realistic face masks: a new challenge in person identification.

    Science.gov (United States)

    Sanders, Jet Gabrielle; Ueda, Yoshiyuki; Minemoto, Kazusa; Noyes, Eilidh; Yoshikawa, Sakiko; Jenkins, Rob

    2017-01-01

    We often identify people using face images. This is true in occupational settings such as passport control as well as in everyday social environments. Mapping between images and identities assumes that facial appearance is stable within certain bounds. For example, a person's apparent age, gender and ethnicity change slowly, if at all. It also assumes that deliberate changes beyond these bounds (i.e., disguises) would be easy to spot. Hyper-realistic face masks overturn these assumptions by allowing the wearer to look like an entirely different person. If unnoticed, these masks break the link between facial appearance and personal identity, with clear implications for applied face recognition. However, to date, no one has assessed the realism of these masks, or specified conditions under which they may be accepted as real faces. Herein, we examined incidental detection of unexpected but attended hyper-realistic masks in both photographic and live presentations. Experiment 1 (UK; n = 60) revealed no evidence for overt detection of hyper-realistic masks among real face photos, and little evidence of covert detection. Experiment 2 (Japan; n = 60) extended these findings to different masks, mask-wearers and participant pools. In Experiment 3 (UK and Japan; n = 407), passers-by failed to notice that a live confederate was wearing a hyper-realistic mask and showed limited evidence of covert detection, even at close viewing distance (5 vs. 20 m). Across all of these studies, viewers accepted hyper-realistic masks as real faces. Specific countermeasures will be required if detection rates are to be improved.

  12. Convergence in France facing Big Data era and Exascale challenges for Climate Sciences

    Science.gov (United States)

    Denvil, Sébastien; Dufresne, Jean-Louis; Salas, David; Meurdesoif, Yann; Valcke, Sophie; Caubel, Arnaud; Foujols, Marie-Alice; Servonnat, Jérôme; Sénési, Stéphane; Derouillat, Julien; Voury, Pascal

    2014-05-01

    The presentation will introduce a french national project : CONVERGENCE that has been funded for four years. This project will tackle big data and computational challenges faced by climate modeling community in HPC context. Model simulations are central to the study of complex mechanisms and feedbacks in the climate system and to provide estimates of future and past climate changes. Recent trends in climate modelling are to add more physical components in the modelled system, increasing the resolution of each individual component and the more systematic use of large suites of simulations to address many scientific questions. Climate simulations may therefore differ in their initial state, parameter values, representation of physical processes, spatial resolution, model complexity, and degree of realism or degree of idealisation. In addition, there is a strong need for evaluating, improving and monitoring the performance of climate models using a large ensemble of diagnostics and better integration of model outputs and observational data. High performance computing is currently reaching the exascale and has the potential to produce this exponential increase of size and numbers of simulations. However, post-processing, analysis, and exploration of the generated data have stalled and there is a strong need for new tools to cope with the growing size and complexity of the underlying simulations and datasets. Exascale simulations require new scalable software tools to generate, manage and mine those simulations ,and data to extract the relevant information and to take the correct decision. The primary purpose of this project is to develop a platform capable of running large ensembles of simulations with a suite of models, to handle the complex and voluminous datasets generated, to facilitate the evaluation and validation of the models and the use of higher resolution models. We propose to gather interdisciplinary skills to design, using a component-based approach, a

  13. Maritime Education and Research to Face the XXI-st Century Challenges in Gdynia Maritime University’s Experience Part I – Maritime Universities Facing Today and Tomorrow’s Challenges

    Directory of Open Access Journals (Sweden)

    Janusz Mindykowski

    2013-12-01

    Full Text Available In the paper, divided into two parts, a problem of advancements in maritime education and research facing the 21st century challenges, based on the case study of the Gdynia Maritime University (GMU experience is discussed. Part I is devoted to the main directions of advances in the maritime education and research towards the challenges in a global meaning. In this context, the education and research potential of the Gdynia Maritime University, as one of the world-leading maritime universities, is shortly presented. Part II is dedicated to the Gdynia Maritime University experiencing the 21st century challenges. The GMU’s contribution and good practices concerning the participation in modification of the processes of the IMO STCW 78/2010 convention, adoption of programmes into the international and national qualification frameworks’ standards and procedures, as well as the development of research addressed to a new technological and organizational solution are described and analyzed.

  14. 'Being appropriately unusual': a challenge for nurses in health-promoting conversations with families.

    Science.gov (United States)

    Benzein, Eva Gunilla; Hagberg, Margaretha; Saveman, Britt-Inger

    2008-06-01

    This study describes the theoretical assumptions and the application for health-promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family-focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families' resources, and the relationship between the family and its environment. By posing reflective questions, reflection is made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co-creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced.

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

    Science.gov (United States)

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

    2012-12-01

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

  16. Engaging with Families Is a Challenge: Beliefs among Healthcare Professionals in Forensic Psychiatric Care

    Directory of Open Access Journals (Sweden)

    Ulrica Hörberg

    2015-01-01

    Full Text Available Being healthcare professionals in the complex field of forensic psychiatry care (FPC seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer’s philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient’s care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one’s own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family’s resources.

  17. Family relations, mental health and adherence to nutritional guidelines in patients facing dialysis initiation.

    Science.gov (United States)

    Untas, Aurélie; Rascle, Nicole; Idier, Laetitia; Lasseur, Catherine; Combe, Christian

    2012-01-01

    This study investigated the effect of family relations on patients' adjustment to dialysis. The two main aims were to develop a family typology, and to explore the influence of family profile on the patient's anxiety, depression and adherence to nutritional guidelines. The sample consisted of 120 patients (mean age 63 years; 67.5% of men). They completed several measures 1, 6 and 12 months after dialysis initiation. The scales used were the Family Relationship Index and the Hospital Anxiety and Depression Scale. Perceived adherence to nutritional guidelines was assessed using two visual analogical scales. Results showed that family relations remained stable over time. Cluster analysis yielded three family profiles, which were named conflict, communicative and supportive families. Patients belonging to conflict families perceived themselves as less adhering to nutritional guidelines. For these patients, anxiety and depressive moods increased significantly over time, whereas mental health remained stable over time for communicative and supportive families. This research underlines that family relations are essential in global consideration of the care of patients treated by dialysis. Conflict families seem especially at risk. They should be identified early to help them adapt to this stressful treatment.

  18. Challenges Facing Chinese Academic Staff in a UK University in Terms of Language, Relationships and Culture

    Science.gov (United States)

    Hsieh, Hui-hua

    2012-01-01

    The recruitment of international academic staff is viewed as one of the strategies to internationalise the universities. International academic staff, however, usually encounter many challenges when in a foreign context. This study aims to investigate the challenges of Chinese academic staff teaching in the UK in terms of language, relationships…

  19. Strategies to Address English Language Writing Challenges Faced by International Graduate Students in the US

    Science.gov (United States)

    Ravichandran, Swathi; Kretovics, Mark; Kirby, Kara; Ghosh, Ankita

    2017-01-01

    Since 2000, there has been a 72% increase in the number of international students attending US institutions of higher education. The increase, specifically of international graduate students, has brought to light the writing challenges experienced by this population of students. This study explored specific writing challenges experienced by…

  20. Challenges Faced by Second Language Doctoral Student Writers in Hong Kong and Their Writing Strategies

    Science.gov (United States)

    Hyland, Fiona

    2016-01-01

    Writing at the doctoral level presents many challenges for second language writers. This paper reports on a longitudinal study investigating English as a second language (ESL) doctoral students' writing problems and the strategies they developed to meet these challenges. Eight students were interviewed four times over a two-year period during…

  1. An Exploratory Study of Distinguishing Challenges Faced by Mid-Life Teacher Candidates

    Science.gov (United States)

    Tanksley, James F.

    2012-01-01

    The United States public education system is facing a possible shortage of several hundred thousand teachers over the next decade. To overcome the projected shortfall in teacher supply, schools of education of state university and college systems may need to look to the fastest growing segment of the college student population, the non-traditional…

  2. Creating Linkages between Private and Public: Challenges Facing Woman Principals in South Africa

    Science.gov (United States)

    Moorosi, Pontso

    2007-01-01

    In trying to understand some of the gendered discourses that shape the management of schools as organisations in South Africa, I analyse woman principals' experiences as they try to navigate a balance between their home and work responsibilities. After their appointment as principals, some South African women face difficulties in striking the…

  3. The (Mal)Practice of Dowry in Contemporary India. A Challenge to Marriage and Family Ministry

    OpenAIRE

    Jainus Xavier, Nixen Raj; Jainus Xavier, Nixen Raj; Knieps-Port le Roi, Thomas

    2012-01-01

    The author explores the (mal)practice of dowry in contemporary India and the challenge it presents to marriage and family ministry. He explains how originally harmless and well-intended dowry customs changed under the influence of historical circumstances that turned them into a business-like family strategy aimed at rising families’ social status, wealth and power. This evolution had dramatic consequences for Indian marriage and family life and especially for women. Dowry-related violence an...

  4. Antituberculosis Drug-Induced Liver Injury with Autoimmune Features: Facing Diagnostic and Treatment Challenges

    Directory of Open Access Journals (Sweden)

    Maria Adriana Rangel

    2017-01-01

    Full Text Available The authors present a case report of antituberculosis drug-induced liver injury that offered diagnostic challenges (namely, the possibility of drug-induced autoimmune hepatitis and treatment difficulties.

  5. Challenges facing the food industry: Examples from the baked goods sector

    DEFF Research Database (Denmark)

    Hansen, Zaza Nadja Lee; Jacobsen, Peter

    2013-01-01

    This paper investigates the challenges in the food industry, illustrated by a case study from the baked goods sector in Denmark. The paper proposes key elements this sector needs to address in order to limit waste, improve productivity and increase profitability.......This paper investigates the challenges in the food industry, illustrated by a case study from the baked goods sector in Denmark. The paper proposes key elements this sector needs to address in order to limit waste, improve productivity and increase profitability....

  6. Challenges faced by parents of children with learning disabilities in Opuwo, Namibia

    Directory of Open Access Journals (Sweden)

    Clever Taderera

    2017-07-01

    Conclusion: The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main challenges emanate from financial instability, as well as lack of knowledge regarding services and programmes for children with learning disabilities. This lack of knowledge on the part of participants could indicate poor policy education by policy implementers at grass-roots level.

  7. Systems approach to waste governance: unpacking the challenges facing local government

    CSIR Research Space (South Africa)

    Godfrey, Linda K

    2008-09-01

    Full Text Available and Tourism (DEAT, 2007) highlighted the obstacles that are faced by local government in achieving service delivery for waste. The three identified obstacles included Financial Capacity; Institutional Capacity; Technical Capacity. 2 Opportunity cost... the systems diagrams show (Figure 2), is that without intervention by national government departments, e.g. National Treasury, Department of Provincial and Local Government, or Department of Environmental Affairs and Tourism, municipalities will be unable...

  8. Defense Weather Satellites: DOD Faces Acquisition Challenges for Addressing Capability Needs

    Science.gov (United States)

    2016-07-07

    and compare the operational effectiveness and life cycle costs of potential solutions. This testimony is based on a report GAO issued in March...Technology, House of Representatives For Release on Delivery Expected at 10 a.m. ET Thursday, July 7, 2016 GAO-16-769T United States...Environment, Committee on Science, Space, and Technology, House of Representatives July 2016 DEFENSE WEATHER SATELLITES DOD Faces Acquisition

  9. A New World for Museum Marketing? Facing the Old Dilemmas while Challenging New Market Opportunities

    OpenAIRE

    Tanja Komarac

    2014-01-01

    Museums are part of a wider cultural and entertainment environment, which is ruled by highly demanding visitors who seek immersive experiences (edutainment) and time-saving arrangement. This has encouraged and, in some opinions, forced museums to turn their focus from collections to visitors. In addition, museums have faced competition and new technologies in the form of virtual museums and virtual reality. This has emphasized the need to accept marketing as a survival tool and to make it int...

  10. Facing up to 'challenging behaviour': a model for training in staff-client interaction.

    Science.gov (United States)

    Farrell, Gerald A; Shafiei, Touran; Salmon, Peter

    2010-07-01

    This paper draws on theory and evidence to develop a conceptual staff training model for the management of 'challenging behaviour'. Staff working with clients who are experienced as challenging commonly report negative feelings such as anxiety, anger, guilt, fear, self-blame and powerlessness, as well as dissatisfaction with their jobs. Current training programmes in challenging behaviour offer a 'smorgasbord' of content, without a clearly defined conceptual framework. Medline and PsychInfo were searched for papers in English from 1998 to 2008, linking 'nurs*' to 'challenging behavio*' and its related terms. Additional hand-searching identified informative papers from disciplines outside nursing older than the search period. We developed an applied model for training educators in respect of challenging behaviours. The model directs educators to consider: the influence of the nurse, including their values, emotional processes and behavioural skills; features of the client; and features of the situation in which the behaviour occurs, including its culture and working practices and physical environment. The most striking implication of the model is that it explicitly recognizes the importance of domains of learning other than skill. This enables educators to find educationally appropriate responses to resource limitations that inevitably constrain training. Challenging behaviour should be considered as a product of several intertwined factors: the actors involved - nurses, clients and others - and the situation in which the behaviour occurs, including its culture and working practices and physical environment.

  11. The Cinematic Depiction of Conflict Resolution in the Immigrant Chinese Family: The Wedding Banquet and Saving Face

    Directory of Open Access Journals (Sweden)

    Qijun Han

    2013-12-01

    Full Text Available Both emphasising dilemmas that have been confronted by the Chinese-American family, Ang Lee’s The Wedding Banquet (1993 and Alice Wu’s Saving Face (2004 highlight the image of homosexuality as incompatible with traditional Chinese family values. Through detailed narrative analyses of these two films with a focus on the structure of the plot, the key characters, and camera work, this article aims to answer the questions of how traditional Chinese culture continues to play into and conflict with the experiences of modern Chinese American families and how each film presents and resolves the tensions arising from a culture in transition. The article argues that the importance of studying the ways in which the protagonists try to come to terms with incompatible value systems, lies in the capacity of film to reveal the complex negotiation between tradition and modernity, as well as the socio-cultural specificity of the conceptions of modernity.

  12. A bio-ecological interpretation of the relationship challenges in the context of the reconstituted family

    Directory of Open Access Journals (Sweden)

    S Ebersohn

    2015-05-01

    Full Text Available From an educational psychology perspective, family life - as a child's primary educational situation - is changing drastically as divorces increase worldwide. Various challenges to relationships accompany the restructuring of family systems after divorce. When remarriage occurs, children's shared membership of two family microsystems and the resultant complexity of the mesosystem cause the reconstituted family situation to come to differ radically from that of a nuclear family. The purpose of this article is to extend Bronfenbrenner's bio-ecological model in order to construct a deeper understanding of the relationship challenges in the context of the reconstituted family, specifically noting the importance of effective parenting at mesosystemic level. Data from two separate qualitative studies was interpreted, based on Bronfenbrenner's bio-ecological model, to form an integrated understanding of the complexity and influence of the mesosystem. The findings indicate that sound proximal interactive processes in the primary and secondary family microsystems depend on an effective mesosystem, and hence, on at least a functionally co-operative relationship between the biological parents after a divorce. Since the biological parents primarily control the effectiveness of the mesosystem, Bronfenbrenner's extended bio-ecological model can be fruitfully applied in all professions dealing with the contextual relationship challenges of reconstituted families.

  13. Exploring morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones.

    Science.gov (United States)

    Gammon, D; Christiansen, E K; Wynn, R

    2009-07-01

    Patient self-management of disease is increasingly supported by technologies that can monitor a wide range of behavioural and biomedical parameters. Incorporated into everyday devices such as cell phones and clothes, these technologies become integral to the psychosocial aspects of everyday life. Many technologies are likely to be marketed directly to families with ill members, and families may enlist the support of clinicians in shaping use. Current ethical frameworks are mainly conceptualised from the perspective of caregivers, researchers, developers and regulators in order to ensure the ethics of their own practices. This paper focuses on families as autonomous decision-makers outside the regulated context of healthcare. We discuss some morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones. An example - remote parental monitoring of adolescent blood glucose - is presented and discussed through the lens of two contrasting accounts of ethics; one reflecting the predominant focus on health outcomes within the health technology assessment (HTA) framework and the other that attends to the broader sociocultural contexts shaping technologies and their implications. Issues discussed include the focus of assessments, informed consent and child assent, and family co-creation of system characteristics and implications. The parents' decisions to remotely monitor their child has relational implications that are likely to influence conflict levels and thus also health outcomes. Current efforts to better integrate outcome assessments with social and ethical assessments are particularly relevant for informed decision-making about health monitoring technologies in families.

  14. Self-management strategies of family caregivers faced with relatives with dementia.

    NARCIS (Netherlands)

    Francke, A.L.; Huis in het Veld, J.; Verkaik, R.; Meijel, B. van; Verkade, P.J.; Werkman, W.; Hertogh, C.

    2016-01-01

    Background: Self-management is not only important for patients, but also for family caregivers. The aim of this presentation is to give insight into what makes dealing with behavior and mood changes stressful for family caregivers, and which self-management strategies they use in such situations.

  15. Different families, same love: Challenges of the 2008

    Directory of Open Access Journals (Sweden)

    Mršević Zorica

    2009-01-01

    Full Text Available The year 2008 by all means will be remembered by several events, which contributed to significant progress in the domain of legal recognition of various aspects of same sex communities. There were also several initiatives contributing to making the political will necessary for legal changes. The most visible one probably was the May recognition of same sex marriage by the Supreme Court of California, which was valid only 5 months before it was cancelled by the referendum held in November 2008. Since this American state has 38 million inhabitants, more than the whole Balkan region, the event was visible by the whole world. The paper provides further analysis of mostly European events, e.g. decisions of European courts in Strasbourg and Luxembourg, political interventions by the EU Parliament Intercrop, releases of the ILGA-Europe, gay pride marches, other public activities, e.g. exhibition in the EU Parliament regarding the International Day of Human Rights, adoption of various documents relevant for the EU member states and permanent changes in internal legal provisions of the member states. The UN Declaration against discrimination on the ground of sexual orientation and gender identity concluded the year. The paper also comprises analysis of a few typical cases of implementation of family relations among same sex partners.

  16. Challenges in mental health care in the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Consuelo Helena Aires de Freitas

    2011-06-01

    Full Text Available Objective: To discuss the practice of mental health care performed by healthcare professionals from the Family Health Strategy in Fortaleza-CE, Brazil. Methods: This is a critical and reflective study conducted in six Basic Health Units in Fortaleza-Ce. The study subjects were 12 health workers of the following professions: doctor, nurse, community health agents and technical and/or nursing assistant. Semi-structured interviews, systematic observationand questionnaire were used for data collection. The empirical analysis was based on an understanding of the discourses through critical hermeneutics. Results: It was evident that the mental health services are developed by some health workers in the ESF, such as, matrix support, relational technologies, home visits and community group therapy. However, there is still deficiency in training/coaching by most professionals in primary care, due to anenduring model of pathological or curative health care. Conclusion: Mental health care is still occasionally held by some workers in primary care. However, some progresses are already present as matrix support, relational technologies in health care, home visits andcommunity therapy.

  17. Challenges faced by professional nurses when implementing the Expanded Programme on Immunisation at rural clinics in Capricorn District, Limpopo

    Directory of Open Access Journals (Sweden)

    Tebogo M. Mothiba

    2016-05-01

    Full Text Available Background: Immunisation is the cornerstone of primary healthcare. Apart from the provision of safe water, immunisation remains the most cost-effective public health intervention currently available. Immunisation prevents infectious conditions that are debilitating, fatal and have the potential to cause huge public health burdens, both financially and socially, in South Africa. Aim: To determine the challenges faced by professional nurses when implementing the Expanded Programme on Immunisation (EPI at rural clinics in Capricorn District, Limpopo Province, South Africa. Setting: The study was conducted in selected primary healthcare clinics of Capricorn District, Limpopo Province. Methods: A qualitative explorative descriptive contextual research design was used to gather data related to the challenges faced by professional nurses when implementing EPI at rural clinics in Capricorn District. Results: The findings revealed that professional nurses had knowledge of the programme, but that they experienced several challenges during implementation of EPI that included staff shortages and problems related to maintenance of the vaccines’ potency. Conclusions: The Department of Health as well as the nursing administration should monitor policies and guidelines, and especially maintenance of a cold chain for vaccines, to ensure that they are practised throughout Limpopo Province. The problem of staff shortages also needs to be addressed so that the EPI can achieve its targeted objectives. Keywords: Professional nurse, knowledge, EPI-SA, immunisation

  18. Factors influencing men entering the nursing profession, and understanding the challenges faced by them: Iranian and developed countries' perspectives.

    Science.gov (United States)

    Zamanzadeh, Vahid; Valizadeh, Leila; Negarandeh, Reza; Monadi, Morteza; Azadi, Arman

    2013-12-01

    Men entering the nursing profession have been investigated from several different perspectives. Due to male gender characteristics and existing public image, nursing is often not considered as a career choice by men. Whether nursing would benefit from increased number of men is a key question in the literature. The purpose of this integrative review of the literature was to identify factors influencing men to enter the nursing profession. In addition, it sought to understand the challenges they are confronted within this profession. A systematic search of the existing literature was performed using an Internet search with broad keywords to access related articles in both Persian and English databases. Finally, 34 studies (written between 2000 and early 2013) were selected and surveyed. Most of the studies were conducted in developed counties. The review identified reasons why males choose nursing, and other challenges facing men entering and working in nursing. Themes that emerged from the literature include educational and societal barriers experienced by men in nursing, recruitment, career choice, and role strain. Regarding men's influences on professional development, and also the importance of gender-based caring, policies for recruitment and retention of men in nursing must be followed hastily. However, there is a need for further research regarding the challenges faced by men entering nursing, in both Iran and other developing countries.

  19. HIV / AIDS is a challenge we have to face -- Colin Hollis.

    Science.gov (United States)

    2000-01-01

    On July 21, 2000, the Asian Forum of Parliamentarians on Population and Development (AFPPD) Malaysia, in cooperation with the UN Population Fund and the UN Development Program (Malaysia), organized the National HIV/AIDS Seminar for Parliamentarians in Kuala Lumpur, Malaysia. During the seminar, Mr. Colin Hollis, secretary general of AFPPD, spoke about the challenge posed by HIV/AIDS on the government. He noted that the epidemic is a part of life and these figures should not only challenge the assumptions of legislators but for them to act as well. He further informed that AFPPD would organize the Asia-Africa Meeting of Parliamentarians and Asia European Dialogue.

  20. How to overcome some of the challenges that African scholars are facing in conducting informetrics research

    Directory of Open Access Journals (Sweden)

    Isola Ajiferuke

    2011-01-01

    Full Text Available This article provides evidence to show that the contributions of African researchers to the informetrics literature are minimal. The three main challenges identified as limiting the contributions of African scholars to the informetrics literature are lack of appropriate skills, inadequate data collection sources, and unaffordable analytical tools. To overcome these challenges, it is suggested that regular pre-conference workshops on informetrics should be organized, an African Citation Index should be developed, and the use of free analytical tools should be encouraged.

  1. International challenges without borders: a descriptive study of family physicians' educational needs in the field of diabetes

    Directory of Open Access Journals (Sweden)

    Posel Peter

    2011-05-01

    Full Text Available Abstract Background The optimal care of persons with diabetes by general practitioners and family physicians (GP/FP is complex and requires multiple competencies. This is a fairly unrecognized key challenge in the healthcare systems. In some cases, local and national Continuous Professional Development (CPD initiatives target these challenges; however there have been few international initiatives, possibly because challenges emerging from different studies have not been linked across national boundaries. In this context, the authors have compiled data about gaps and/or barriers inherent to GP/FP care of persons with type 2 diabetes from Austria, Canada, Germany and the United Kingdom. Methods Secondary analyzes of pre-existing studies were conducted to identify challenges in the care of patients with type 2 diabetes as faced by GPs/FPs. Two sources of data were reviewed: unpublished research data from collaborating organizations and articles from a literature search (in English and German. Articles retrieved were scanned by the research team for relevance to the study objectives and to extract existing gaps and barriers. The identified challenges were then categorized along three major axes: (1 phase of the continuum of care {from screening to management}; (2 learning domain {knowledge, skills, attitudes, behavior, context}; and (3 by country/region. Compilation and categorization were performed by qualitative researchers and discrepancies were resolved through discussion until concordance was achieved. Results and discussion Thirteen challenges faced by GPs/FPs in the care for patients with type 2 diabetes were common in at least 3 of the 4 targeted countries/regions. These issues were found across the entire continuum of care and included: pathophysiology of diabetes, diagnostic criteria, treatment targets assessment, drugs' modes of action, decision-making in therapies, treatment guidelines, insulin therapy, adherence, management of

  2. Staff-family relationships in nursing home care: a typology of challenging behaviours.

    Science.gov (United States)

    Bauer, Michael

    2007-09-01

    Aim.  This paper draws on data from a study which investigated how Australian nursing home staff constructed staff-family relationships. Background.  Working with the family in aged care to provide the best care possible is consistent with modern nursing philosophy which espouses holistic care. The quality and enjoyment of the experience however, is frequently fraught with problems and challenges for both the staff and the family involved. Design.  A qualitative constructivist design as described by Guba and Lincoln [Fourth Generation Evaluation. Sage Publications, London.] was used. Method.  Thirty paid caregivers drawn from eight nursing homes were interviewed about their experiences of working with residents' families. A constant comparative method of data analysis was used to arrive at the findings. Results.  This paper reports on seven themes under the category of 'unacceptable behaviours'. These themes describe a range of attitudes and behaviours exhibited by families which staff members found undesirable. Conclusions.  Staff members found a number of family behaviours challenging. Nursing home staff perceives the family as subordinate to their needs and want to retain control of the work environment. Relevance to clinical practice.  Nursing home staff need to move away from custodial models of care focused on 'getting the work done' and develop more family friendly work practices that are inclusive of the needs of the family and view them as equal partners in care.

  3. Solution for Data Security Challenges Faced by Smart Grid Evolution - Video

    Science.gov (United States)

    level, and then we can get into the discussion with Dataguise. The security of data is important at generated. So, all of these non-functional attributes of data security are very important, and all of them Text Version | Energy Systems Integration Facility | NREL Solution for Data Security Challenges

  4. Food challenges facing people living with HIV/AIDS in Zimbabwe ...

    African Journals Online (AJOL)

    The findings of the study indicate that the economic situation in the country coupled with the lack of adequate rainfall has posed challenges to the ability of HIV/AIDS patients to maintain a healthy diet. In addition, there were concerns about the departure of non-government organisations which used to provide them with food ...

  5. Vic: The Challenges Facing Schools in a Small, Newly Diverse, Catalan City

    Science.gov (United States)

    Simo, Nuria; Telford, Jon

    2012-01-01

    The arrival over the last 15 years of a substantial number of pupils of immigrant origin has presented Catalan schools with significant challenges. The schools in Vic (70 km north of Barcelona) have been at the forefront of attempts to adjust to this new multicultural reality. This article describes the results of three studies carried out by the…

  6. Metro Profile: A Familiar Name with an Economy Facing Familiar Challenges

    OpenAIRE

    Fernandez Laris, Georgette A; Gascon, Charles S.

    2015-01-01

    Springfield, Mo., a city with a common name, has an economy with familiar successes and challenges. The health care sector is booming, and the cost of living is somewhat low, as are wages. But labor productivity seems to be subpar, and the poverty rate is above average.

  7. Challenges Faced by Cantonese Speakers in a UK University Mandarin Course

    Science.gov (United States)

    Lo, Lan

    2016-01-01

    After Hong Kong returned to China in 1997, those in the Chinese migrant community in the UK who anticipated returning to China saw the significant benefits of learning Mandarin. The challenges are not only related to the social and cultural differences between the Cantonese and Mandarin migrant groups, but also the intrinsic linguistic differences…

  8. Current Challenges Facing Secondary Education and Transition Services: What Research Tells Us.

    Science.gov (United States)

    Johnson, David R.; Stodden, Robert A.; Emanuel, Ellen J.; Luecking, Richard; Mack, Mary

    2002-01-01

    The transition challenges discussed are to ensure that (1) students have access to the full range of curriculum options and learning experiences; (2) high school graduation decisions are based on meaningful indicators of learning; (3) students have access to postsecondary education, employment, and independent living options; (4) student and…

  9. Challenges Faced by Key Stakeholders Using Educational Online Technologies in Blended Tertiary Environments

    Science.gov (United States)

    Tuapawa, Kimberley

    2016-01-01

    Traditional learning spaces have evolved into dynamic blended tertiary environments (BTEs), providing a modern means through which tertiary education institutes (TEIs) can augment delivery to meet stakeholder needs. Despite the significant demand for web-enabled learning, there are obstacles concerning the use of EOTs, which challenge the…

  10. Teaching in the globalised university - how do we face the challenges of the multicultural classroom?

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.

    Changing demographics, internationalisation of higher education, and migration has resulted in much more diverse student cohorts than it has previously been the case in higher education. While this provides new opportunities, many educators also find that there are new challenges to be met...

  11. The Delicate Balancing Act: Challenges and Successes Facing College Student Women in Formal Leadership Roles

    Science.gov (United States)

    Haber-Curran, Paige

    2013-01-01

    This qualitative study focused on the successes and challenges experienced by four undergraduate college women while holding top leadership roles in student organizations. Interpretive and descriptive qualitative research methods were employed with aspects of case study and phenomenological approaches of inquiry. Data were collected through…

  12. The Role of Rigidity in Adaptive and Maladaptive Families Assessed by FACES IV: The Points of View of Adolescents.

    Science.gov (United States)

    Everri, Marina; Mancini, Tiziana; Fruggeri, Laura

    Previous studies using Olson's Circumplex Model and FACES IV, the self-report assessing family functioning, did not clarify the role of rigidity, a dimension of this model. Rigidity emerged as ambiguous: it was considered either as a functional or as a dysfunctional dimension. Building upon the results of previous studies, we provided a contribution intended to disambiguate the role of rigidity considering adolescents' perceptions and using a non-a priori classification analysis. 320 Italian adolescents (13-21 years) participated in this study and responded to a questionnaire containing scales of the study variables. A latent class analysis was performed to identify the association of rigidity with the other dimensions of Olson's model and with indicators of adaptive family functioning in adolescence: parental monitoring and family satisfaction. We found six clusters corresponding to family typologies and having different levels of functioning. Rigidity emerged as adaptive in the typologies named rigidly balanced and flexibly oscillating; it was associated with positive dimensions of family functioning, i.e. flexibility, cohesion, parental monitoring, and high levels of family satisfaction. Differently, when rigidity was associated with disengagement, low cohesion and flexibility, and lack of parental supervision, emerged as maladaptive. This was the case of two typologies: the rigidly disengaged and the chaotically disengaged. Adolescents of these families reported the lowest levels of satisfaction. In the two last typologies, the flexibly chaotic and the cohesively disorganized, rigidity indicated a mid-range functionality as these families were characterized by emotional connectedness but lack of containment. Clinical implications are discussed.

  13. [Political challenges facing the consolidation of the Sistema Único de Saúde: a historical approach].

    Science.gov (United States)

    Rodrigues, Paulo Henrique de Almeida

    2014-01-01

    This article investigates the circumstances in which Brazil’s sanitation reform was conceived and the Sistema Único de Saúde (SUS) was constructed. A brief analysis is conducted of Brazil’s political transition to democracy, focusing on three political challenges facing the consolidation of SUS: its weak support base amongst workers, competition with the private sector, and the fragmentation of its administration caused by its municipalization. Finally, the changes in the scenario caused by the weakening of neoliberalism since the 2008 crisis, the reemergence of a multipolar political scenario internationally, and the financing conditions of the Brazilian State are described.

  14. "It's not that straightforward": when family support is challenging for mothers living with mental illness.

    Science.gov (United States)

    Perera, Dinali N; Short, Liz; Fernbacher, Sabin

    2014-09-01

    Mental health service providers often have limited or problematic understanding of parents' support needs or experiences and family relationships. Moreover, the impact of family life and relationships for mothers with mental illness, and whether these relationships are experienced as positive or negative, have been largely underinvestigated. This article aims to increase understanding about the complexity of family relationships and support for mothers. Findings may be useful for services when considering family involvement, and for how to better meet the needs of mothers with mental illness and support their recovery. Semistructured interviews were conducted with 8 mothers with mental illness and 11 mental health service providers. This article presents a grounded theory analysis of the complexity of family relationships and support for mothers with mental illness. Family relationships of mothers with mental illness can be complex, potentially difficult, and challenging. Problems in relationships with partners and families, and experiences of abuse, can have harmful consequences on parenting, on mothers' and children's well-being, and on the support mothers receive. This project highlights a need to recognize and work with positive aspects and difficulties in family relationships as part of mental health service provision. Policies can be reviewed to increase the likelihood that mental health care will combine family-sensitive practice with practice that acknowledges difficult family relationships and experiences of family violence in order to maximize support to mothers with mental illness and their children. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  15. Understanding and Facing Discipline-Related Challenges in the English as a Foreign Language Classroom at Public Schools

    Directory of Open Access Journals (Sweden)

    Josefina Quintero Corzo

    2011-07-01

    Full Text Available Complying with school regulations and teachers' instructions is a basic principle of an excellent class; both novice and experienced teachers face challenging situations when getting into real classrooms, especially those related to classroom management. There are various reasons that explain discipline problems in public schools, as well as varied strategies beginning teachers create and try when coping with those challenges. This article reports an action research study on how this methodology helped a group of teacher-trainees overcome indiscipline in English as a foreign language classrooms at public schools, and align with professional development initiatives which focus on reflection and decision-making processes that the new Colombian policies demand from new teachers seeking a higher quality of education.

  16. Overview of the critical disaster management challenges faced during Van 2011 earthquakes.

    Science.gov (United States)

    Tolon, Mert; Yazgan, Ufuk; Ural, Derin N; Goss, Kay C

    2014-01-01

    On October 23, 2011, a M7.2 earthquake caused damage in a widespread area in the Van province located in eastern Turkey. This strong earthquake was followed by a M5.7 earthquake on November 9, 2011. This sequence of damaging earthquakes led to 644 fatalities. The management during and after these earthquake disaster imposed many critical challenges. In this article, an overview of these challenges is presented based on the observations by the authors in the aftermath of this disaster. This article presents the characteristics of 2011 Van earthquakes. Afterward, the key information related to the four main phases (ie, preparedness, mitigation, response, and recovery) of the disaster in Van is presented. The potential strategies that can be taken to improve the disaster management practice are identified, and a set of recommendations are proposed to improve the existing situation.

  17. The changing face of nanomaterials: Risk assessment challenges along the value chain.

    Science.gov (United States)

    Mattsson, Mats-Olof; Simkó, Myrtill

    2017-03-01

    Risk assessment (RA) of manufactured nanomaterials (MNM) is essential for regulatory purposes and risk management activities. Similar to RA of "classical" chemicals, MNM RA requires knowledge about exposure as well as of hazard potential and dose response relationships. What makes MNM RA especially challenging is the multitude of materials (which is expected to increase substantially in the future), the complexity of MNM value chains and life cycles, the accompanying possible changes in material properties over time and in contact with various environmental and organismal milieus, and the difficulties to obtain proper exposure data and to consider the proper dose metric. This article discusses these challenges and also critically overviews the current state of the art regarding MNM RA approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Positioning Industrial Design Education within Higher Education: How to face increasingly challenging market forces?

    Directory of Open Access Journals (Sweden)

    André Liem

    2014-05-01

    Full Text Available This paper discusses how Industrial Design Education should be adapted to pressing future challenges of higher education with respect to promoting high quality mentorship and scholarship, as well as being more economically self-sufficient through stronger collaborative engagements with industry. The four (4 following trends will be presented on how prospective design programs are to be developed: (1 Mass-education and rationalisation, (2 Links between education and research, (3 Globalisation and internationalisation, and (4 Collaboration with industry and research commercialisation.Given the challenges of market forces within academia, a consensus within the design education community should be established in order to expose students more to “active learning” and to vice-versa commute from generic to specialist and from abstract to concrete modes of working. Comprehensive and collaborative studio projects should be implemented as platforms, where social, interdisciplinary and inquiry-based learning can be developed in line with selected design themes, processes and methods.

  19. Trade Unions facing the dual challenge of globalising work division and globalising environmental degradation

    OpenAIRE

    Räthzel, N; Uzzell, David

    2011-01-01

    This paper presents results of a project aimed at investigating the ways in which trade unions in the “Global North” and the “Global South” respond to the dual challenge of a globalising work division and globalising environmental degradation, and whether and under what conditions trade unions perceive and address these issues as connected. While globalising corporations are forming new international relations of power, trade unions are lagging behind in unifying their efforts to counter glob...

  20. Issues and Challenges Facing Flexible Lithium-Ion Batteries for Practical Application.

    Science.gov (United States)

    Cha, Hyungyeon; Kim, Junhyeok; Lee, Yoonji; Cho, Jaephil; Park, Minjoon

    2017-12-27

    With the advent of flexible electronics, lithium-ion batteries have become a key component of high performance energy storage systems. Thus, considerable effort is made to keep up with the development of flexible lithium-ion batteries. To date, many researchers have studied newly designed batteries with flexibility, however, there are several significant challenges that need to be overcome, such as degradation of electrodes under external load, poor battery performance, and complicated cell preparation procedures. In addition, an in-depth understanding of the current challenges for flexible batteries is rarely addressed in a systematical and practical way. Herein, recent progress and current issues of flexible lithium-ion batteries in terms of battery materials and cell designs are reviewed. A critical overview of important issues and challenges for the practical application of flexible lithium-ion batteries is also provided. Finally, the strategies are discussed to overcome current limitations of the practical use of flexible lithium-based batteries, providing a direction for future research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Challenges faced by gay, lesbian, bisexual and transgender (glbt students at a South African university

    Directory of Open Access Journals (Sweden)

    Sello Sithole

    2015-12-01

    Full Text Available This article explores the academic and social challenges experienced by students from the gay, lesbian, bisexual and transgender (glbt community on campus at a South African university. A qualitative study to investigate some of these academic and social challenges experienced by glbt students at a university campus was conducted. The population of the study was all students from glbt community on campus and a purposive sample of twelve (12 respondents was constituted and a semi-structured interview guide was designed and administered to all twelve (12 participants. Data were audio recorded and transcribed. Content analysis which is a method used to systematically analyse the meaning of communications was used to analyse data. Of central interest were the core themes that speakers referred to, the information or messages that they wanted to pass on to their audience. The findings suggest that glbt students grapple with issues such as labelling, sexual abuse, discrimination/marginalisation and unfairness in the allocation of resources such as accommodation. In response to these cancerous societal ills, the helping professions exhort practitioners to empower vulnerable populations, promote social justice, support client self-determination and keep abreast of current knowledge relevant to professional practice. This article concludes with a set of recommendations on some of the strategies to address the identified socio-academic challenges.

  2. 21st century challenges faced by nursing faculty in educating for compassionate practice: embodied interpretation of phenomenological data.

    Science.gov (United States)

    Curtis, Katherine

    2013-07-01

    Nursing faculty are facing challenges in facilitating student learning of complex concepts such as compassionate practice. Compassion is a stated expectation of Registered Nurse (RN) and student nurse practice, and yet how it is enabled and learned within the challenging environments of university and health service provider organisations are not yet understood. There is currently an international concern that student nurses are not being adequately prepared for compassion to flourish and for compassionate practice to be sustained upon professional qualification. In order to investigate the experiences of nursing faculty in their preparation of student nurses for compassionate practice, an exploratory aesthetic phenomenological research study was undertaken using in depth interviews with five nurse teachers in the North of England. Findings from this study were analysed and presented using embodied interpretation, and indicate that nurse teachers recognise the importance of the professional ideal of compassionate practice alongside specific challenges this expectation presents. They have concerns about how the economically constrained and target driven practice reality faced by RNs promotes compassionate practice, and that students are left feeling vulnerable to dissonance between learned professional ideals and the RNs' practice reality they witness. Nurse teachers also experience dissonance within the university setting, between the pressures of managing large student groups and the time and opportunity required for small group discussion with students that enables compassion to develop in a meaningful and emotionally sustainable way. Teachers also express discomfort due to a perceived promotion of an 'unachievable utopia' within practice, identifying how the constraints within practice could be better managed to support professional ideals. The nurse teachers within this exploratory study identify the need for strong nurse leadership in practice to challenge

  3. Long-Term Impacts Faced by Patients and Families After Harmful Healthcare Events.

    Science.gov (United States)

    Ottosen, Madelene J; Sedlock, Emily W; Aigbe, Aitebureme O; Bell, Sigall K; Gallagher, Thomas H; Thomas, Eric J

    2018-01-17

    Patients and families report experiencing a multitude of harms from medical errors resulting in physical, emotional, and financial hardships. Little is known about the duration and nature of these harms and the type of support needed to promote patient and family healing after such events. We sought to describe the long-term impacts (LTIs) reported by patients and family members who experienced harmful medical events 5 or more years ago. We performed a content analysis on 32 interviews originally conducted with 72 patients or family members about their views of the factors contributing to their self-reported harmful event. Interviews selected occurred 5 or more years after the harmful event and were grouped by time since event, 5 to 9 years (22 interviews) or 10 or more years (10 interviews) for analysis. We analyzed these interviews targeting spontaneous references of ongoing impacts experienced by the participants. Participants collectively described the following four LTIs: psychological, social/behavioral, physical, and financial. Most cited psychological impacts with half-reporting ongoing anger and vivid memories. More than half reported ongoing physical impacts and one-third experienced ongoing financial impacts. Long-term social and behavioral impacts such as alterations in lifestyle, self-identity, and healthcare seeking behaviors were the most highly reported. These patients and families experienced many profound LTIs after their harmful medical event. For some, these impacts evolved into secondary harms ongoing 10 years and more after the event. Our results draw attention to the persistent impacts patients and families may experience long after harmful events and the need for future research to understand and support affected patients and families.

  4. Challenges to parenting in a new culture: Implications for child and family welfare.

    Science.gov (United States)

    Lewig, Kerry; Arney, Fiona; Salveron, Mary

    2010-08-01

    Increasing numbers of families arriving through Australia's humanitarian settlement scheme are coming into contact with Australian child protection systems. A large number of these families come from African and Middle Eastern countries and have common experiences of trauma, dislocation, loss and many are victims of genocide, war, and torture. Pre-migration experiences together with the considerable challenges of settling into a new country can significantly affect family well-being and parenting practices. It is therefore important that child and family welfare service planners are well informed about how best to support refugee families using culturally competent family intervention and community development practices. This paper draws on the findings of a research project designed to examine why recently arrived families from refugee backgrounds are presenting in the South Australian child protection system and to identify culturally appropriate strategies for intervention. The paper presents findings from the project that relate to (1) refugee parents', community members' and child protection practitioners' perspectives on the challenges to being a refugee parent in Australia and (2) strategies and resources relevant to prevention and early intervention in refugee families before statutory child protection intervention becomes necessary. Copyright (c)2009 Elsevier Ltd. All rights reserved.

  5. Family caregiving challenges in advanced colorectal cancer: patient and caregiver perspectives.

    Science.gov (United States)

    Mosher, Catherine E; Adams, Rebecca N; Helft, Paul R; O'Neil, Bert H; Shahda, Safi; Rattray, Nicholas A; Champion, Victoria L

    2016-05-01

    Family caregivers of advanced colorectal cancer patients may be at increased risk for psychological distress. Yet their key challenges in coping with the patient's illness are not well understood. Soliciting both patient and caregiver perspectives on these challenges would broaden our understanding of the caregiving experience. Thus, the purpose of this research was to identify caregivers' key challenges in coping with their family member's advanced colorectal cancer from the perspective of patients and caregivers. Individual, semi-structured qualitative interviews were conducted with 23 advanced colorectal cancer patients and 23 primary family caregivers. Interview data were analyzed via thematic analysis. In nearly all cases, patient and caregiver reports of the caregiver's key challenge were discrepant. Across patient and caregiver reports, caregivers' key challenges included processing emotions surrounding the patient's initial diagnosis or recurrence and addressing the patient's practical and emotional needs. Other challenges included coping with continual uncertainty regarding the patient's potential functional decline and prognosis and observing the patient suffer from various physical symptoms. Findings suggest that eliciting the perspectives of both patients and caregivers regarding caregivers' challenges provides a more comprehensive understanding of their experience. Results also point to the need to assist caregivers with the emotional and practical aspects of caregiving.

  6. Post-Traumatic Stress Symptoms in Post-ICU Family Members: Review and Methodological Challenges.

    Science.gov (United States)

    Petrinec, Amy B; Daly, Barbara J

    2016-01-01

    Family members of intensive care unit (ICU) patients are at risk for symptoms of post-traumatic stress disorder (PTSD) following ICU discharge. The aim of this systematic review is to examine the current literature regarding post-ICU family PTSD symptoms with an emphasis on methodological issues in conducting research on this challenging phenomenon. An extensive review of the literature was performed confining the search to English language studies reporting PTSD symptoms in adult family members of adult ICU patients. Ten studies were identified for review published from 2004 to 2012. Findings demonstrate a significant prevalence of family PTSD symptoms in the months following ICU hospitalization. However, there are several methodological challenges to the interpretation of existing studies and to the conduct of future research including differences in sampling, identification of risk factors and covariates of PTSD, and lack of consensus regarding the most appropriate PTSD symptom measurement tools and timing. © The Author(s) 2014.

  7. Facilitators and Challenges in Psychosocial Adaptation to Being at Increased Familial Risk of Breast Cancer.

    Science.gov (United States)

    Heiniger, Louise; Price, Melanie A; Charles, Margaret; Butow, Phyllis N

    2015-12-01

    Little is known about the process of psychosocial adaptation to familial risk in tested and untested individuals at increased familial risk of cancer. This paper presents findings from a qualitative study of 36 women participating in the Kathleen Cuningham Consortium for Research into Familial Breast cancer (kConFab) Psychosocial study. Facilitators and challenges in psychosocial adaptation were identified through semi-structured interviews. The women, who were either tested (carriers or non-carriers of breast cancer susceptibility mutations) or untested (ineligible for testing or eligible but delayed or declined testing), described personal, support network and healthcare characteristics that impacted on the adaptation process. Challenges in one domain could be overcome by facilitators in other domains and key differences relating to whether women had undergone testing, or not, were identified. Tested and untested women with an increased familial risk of breast cancer may benefit from support tailored to their mutation testing status in order to enhance adaptation.

  8. Nurses as family caregivers - barriers and enablers facing nurses caring for children, parents or both.

    Science.gov (United States)

    Clendon, Jill; Walker, Léonie

    2017-03-01

    To examine the dual caregiving and nursing responsibilities of nurses in New Zealand with a view to identifying potential strategies, policies and employment practices that may help to retain nurses with caregiving responsibilities in the workplace. As the nursing workforce ages, child-bearing is delayed and older family members are living longer, family caregiving responsibilities are impacting more on the working life of nurses. This may complicate accurate workforce planning assumptions. An explorative, descriptive design using interviews and focus groups with 28 registered nurses with family caregiving responsibilities. A depth of (largely hidden) experience was exposed revealing considerable guilt, physical, emotional and financial hardship. Regardless of whether the nurse chose to work or had to for financial reasons, family always came first. Demographic and societal changes related to caregiving may have profound implications for nursing. Workplace support is essential to ensure that nurses are able to continue to work. Increased awareness, support, flexibility and specific planning are required to retain nurses with family caregiving responsibilities. © 2016 John Wiley & Sons Ltd.

  9. Child Health and Nutrition: Getting better and facing new challenges in China

    Directory of Open Access Journals (Sweden)

    Shougang Wei

    2011-03-01

    Full Text Available BackgroundChild healthcare practices in China over the last 60 yearshave extensively improved children’s health and growth, yetnew challenges lie ahead. This review aims to summarisethe successful experiences and the newly identifiedproblems in child healthcare in China.MethodInformation, available to the public, was obtained fromChinese databases and Chinese Government websites,chiefly the Chinese National Knowledge Infrastructuredatabase, the Chinese Biomedical Literature database, theMinistry of Health website and the National WorkingCommittee on Children and Women website.ResultsDuring its poverty-stricken 1950s–1970s, China protectedchildren’s health mainly through prevention and control ofcommon infectious diseases and severe malnutrition withina comprehensive healthcare system. After the subsequent30 years of rapid socio-economic development, China hasachieved great success in reducing childhood mortality ratesand promoting child growth, meeting the MillenniumDevelopment Goal 4 targets and the WHO child growthstandards. Meanwhile, new challenges for children’shealthcare emerged, including: large disparities in thehealth, growth and nutritional status of children, and in theaccessibility and quality of child healthcare, between urbanand rural areas and across different regions of China; thenutritional and healthcare concerns of the fast-expandingpopulation of migrant children and rural left-behindchildren; the burgeoning epidemic of childhood obesity inurban and economically developed areas; micronutrientdeficiencies such as calcium, iron, zinc and vitamin A; andincreasing prevalence of mental and behavioural disorders.ConclusionUnder poor economic conditions, healthcare plays a keyrole in protecting children against diseases. With thedevelopment of social economy, new challenges present tohealthcare services, specifically, to comprehensivelypromote and optimise childrens’ health and nutrition.

  10. E-LEARNING AND THE GLOBAL DIVIDE: The Challenges Facing Distance Education in Africa

    Directory of Open Access Journals (Sweden)

    Bamidele A. OJO

    2009-07-01

    Full Text Available This paper examines the question of distance education and its pivotal role in promoting social change and development in Africa. It also discussed within the context of the global digital divide and the ongoing need for collaborative effort at global education, the limitation imposed by the socio-economic and political environment on the continent. The paper in its findings conclude that the crisis within African societies constitutes a serious challenge to the implementation of and the effectiveness of distance education in Africa and therefore contributes to the widening of the digital divide rather than reducing it.

  11. The 'PEARL' Data Warehouse: Initial Challenges Faced with Semantic and Syntactic Interoperability.

    Science.gov (United States)

    Mahmoud, Samhar; Boyd, Andy; Curcin, Vasa; Bache, Richard; Ali, Asad; Miles, Simon; Taweel, Adel; Delaney, Brendan; Macleod, John

    2017-01-01

    Data about patients are available from diverse sources, including those routinely collected as individuals interact with service providers, and those provided directly by individuals through surveys. Linking these data can lead to a more complete picture about the individual, to inform either care decision making or research investigations. However, post-linkage, differences in data recording systems and formats present barriers to achieving these aims. This paper describes an approach to combine linked GP records with study observations, and reports initial challenges related to semantic and syntactic interoperability issues.

  12. Facing the challenges of ventricular hypertrophy: the eyes don't lie.

    Science.gov (United States)

    Rodrigues, Patrícia; Santos, Mário; Marinho, António; Cabral, Sofia; Vieira, Miguel; Reis, Hipólito; Palma, Paulo; Torres, Severo

    2014-10-01

    We describe the case of a 47-year-old man with new-onset heart failure who was found to have severe biventricular wall thickening. We present comprehensive data from invasive and non-invasive multimodality imaging, genetic and histologic tests, and briefly describe their importance in the final diagnosis. To our knowledge, this is the first case of the Portuguese variant of familial amyloid polyneuropathy presenting with heart failure in the fifth decade of life. This is an unusual case report, but also an illustration of how to approach any patient with suspected infiltrative cardiomyopathy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  13. A Cross-Cultural Perspective on Challenges Facing Comparative Cancer Survivorship Research

    International Nuclear Information System (INIS)

    Syse, A.; Syse, A.; Geller, B.

    2011-01-01

    Cancer survivorship research includes the study of physical, psychosocial, and economic consequences of cancer diagnosis and treatment among pediatric and adult cancer survivors. Historically, the majority of cancer survivorship studies were from the United States, but survivorship issues are increasingly being addressed in other developed countries. Cross-cultural studies remain, however, scarce. The degree to which knowledge attained may or may not be transferred across cultures, countries, or regions is not known. Some important challenges for comparative research are therefore discussed in a cross-cultural perspective. Several substantive and methodological challenges that complicate the execution of cross-cultural cancer survivorship research are presented with examples and discussed to facilitate comparative research efforts in the establishment of new survivorship cohorts and in the planning and implementation of survivorship studies. Comparative research is one key to understanding the nature of cancer survivorship, distinguishing modifiable from non modifiable factors at individual, hospital, societal, and system levels and may thus guide appropriate interventions. Lastly, suggested future courses of action within the field of comparative cancer survivorship research are provided.

  14. CHALLENGES AND OPPORTUNITIES TH E INSURANCE INDU STRY FACING WITH IN RELATION TO CLIMATE CHANGE

    Directory of Open Access Journals (Sweden)

    Fekete Mária FARKASNÉ

    2010-07-01

    Full Text Available Apart from the financial risk the insurance industry are facing with in association with climate change, there are also opportun ities to the sector to develop new markets and provide coverage against weather related risks. This study presents a possible method to examine the potential for introducing a new insurance product, namely an agricultural flood insurance scheme in the United Kingdom. The investigation included the calculation of agricultural flood damage costs, the possible changes in flood risk, the description of farmers’ risk attitude and interests in insurance. In a small scale survey, farmers were asked their experiences related to flooding, farm management practices and thei r willingness to pay for flood insurance using a contingent valuation method. Using statistical analysis it was found the insurance demand is positively correlated with the damage cost predicted and association is likely between farm types and WTP for insurance. Linear regression model suggests that the demand for flood insurance is low amongst farmers in the present risk level. The findi ngs of this research highlight that there is little evidence for the viability of a farmer financed agricultural flood insurance scheme at the moment in the United Kingdom.

  15. Establishing a Conceptual Foundation for Addressing Challenges Facing Food-Energy-Water Management

    Science.gov (United States)

    Goldsby, M.; Padowski, J.; Katz, S.; Brady, M.; Hampton, S. E.

    2017-12-01

    Ensuring the security of food, energy and water in the face of a changing environment is a top societal priority. In order to make sound policy decisions aimed at meeting those needs, policy-makers need decision-relevant information. As such, considerable effort and resources have recently been devoted to investigating the Food-Energy-Water (FEW) Nexus in order to better provide that information. However, despite the increased research activity into FEW systems and FEW problems, little attention has been devoted to the fundamental conceptual issues underlying contemporary FEW systems. Consequently, this inattention has led to conceptual confusion about what is and what is not a FEW system. This project aims to fill that lacuna in order to better facilitate the FEW research agenda. Toward that end, we identify three features that distinguish FEW problems from other resource management problems: (1) the production and management of the resources in each sector of a FEW system is specialized to its own sector; (2) interdependencies exist between sectors such that overproduction in one sector, for example, may have impacts on other sectors; and (3) there are real limits to FEW resource availability as well as limits on the ability to transact across sector boundaries. We contend that once armed with this distinction, one can model the stocks and flows of FEW capital in a conceptually rigorous way that may lead to operational innovations of FEW management.

  16. Economic and Market Challenges Facing the U.S. Nuclear Commercial Fleet

    Energy Technology Data Exchange (ETDEWEB)

    Szilard, Ronaldo [Idaho National Lab. (INL), Idaho Falls, ID (United States); Sharpe, Phil [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kee, Edward [Nuclear Economics Consulting Group, Washington, DC (United States); Davis, Edward [Nuclear Economics Consulting Group, Washington, DC (United States); Grecheck, Eugene [Grecheck Consulting LLC, Midlothian, VA (United States)

    2016-09-01

    This report identifies underlying economic and electricity market factors that have led to early retirements of U.S. operating nuclear power plants, assesses the Gap between operating revenues and operating costs for selected nuclear power plants, and discusses a range of actions that might be taken to stop early retirement of operating nuclear power plants. The Kewaunee and Vermont Yankee nuclear power plants were retired early for economic and financial reasons. Early retirement has been announced or proposed for Clinton and Quad Cities in Illinois, Fitzpatrick and Ginna in New York, Fort Calhoun in Nebraska. Other nuclear power plants, including Palisades, Davis-Besse, Prairie Island, and Three Mile Island Unit 1, have been identified as facing financial stress that might lead to early retirement. The early retirement of operating nuclear power plants will mean the loss of a large amount of zero-emission electricity, inconsistent with the goal of reducing carbon emissions in the electricity sector. This report provides a high-level view of the major factors driving early retirement: • The U.S. market and private ownership approach to the electricity sector; • Low electricity market prices resulting from low natural gas prices, low demand growth, increased penetration of renewable generation, and negative electricity market prices; and • No compensation to nuclear power plants for public benefits including zero-emission electricity.

  17. Economic and Market Challenges Facing the U.S. Nuclear Commercial Fleet

    International Nuclear Information System (INIS)

    Szilard, Ronaldo; Sharpe, Phil; Kee, Edward; Davis, Edward; Grecheck, Eugene

    2016-01-01

    This report identifies underlying economic and electricity market factors that have led to early retirements of U.S. operating nuclear power plants, assesses the Gap between operating revenues and operating costs for selected nuclear power plants, and discusses a range of actions that might be taken to stop early retirement of operating nuclear power plants. The Kewaunee and Vermont Yankee nuclear power plants were retired early for economic and financial reasons. Early retirement has been announced or proposed for Clinton and Quad Cities in Illinois, Fitzpatrick and Ginna in New York, Fort Calhoun in Nebraska. Other nuclear power plants, including Palisades, Davis-Besse, Prairie Island, and Three Mile Island Unit 1, have been identified as facing financial stress that might lead to early retirement. The early retirement of operating nuclear power plants will mean the loss of a large amount of zero-emission electricity, inconsistent with the goal of reducing carbon emissions in the electricity sector. This report provides a high-level view of the major factors driving early retirement: • The U.S. market and private ownership approach to the electricity sector; • Low electricity market prices resulting from low natural gas prices, low demand growth, increased penetration of renewable generation, and negative electricity market prices; and • No compensation to nuclear power plants for public benefits including zero-emission electricity.

  18. A Tractor or an Automobile? A 1920s Farm Family Faces a Decision.

    Science.gov (United States)

    Kunze, Joel P.

    1991-01-01

    Outlines a lesson plan in which students role play a 1920s farm family deciding whether to buy an automobile or a tractor. Other students act as automobile and tractor sales groups. Explains how the lesson illuminates relationships between technological advance and social history. Includes handouts identifying benefits of purchasing cars or…

  19. Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India.

    Science.gov (United States)

    Koschorke, Mirja; Padmavati, R; Kumar, Shuba; Cohen, Alex; Weiss, Helen A; Chatterjee, Sudipto; Pereira, Jesina; Naik, Smita; John, Sujit; Dabholkar, Hamid; Balaji, Madhumitha; Chavan, Animish; Varghese, Mathew; Thara, R; Patel, Vikram; Thornicroft, Graham

    2017-04-01

    Stigma associated with schizophrenia significantly affects family caregivers, yet few studies have examined the nature and determinants of family stigma and its relationship to their knowledge about the condition. This paper describes the experiences and determinants of stigma reported by the primary caregivers of people living with schizophrenia (PLS) in India. The study used mixed methods and was nested in a randomised controlled trial of community care for people with schizophrenia. Between November 2009 and October 2010, data on caregiver stigma and functional outcomes were collected from a sample of 282 PLS-caregiver dyads. In addition, 36 in-depth-interviews were conducted with caregivers. Quantitative findings indicate that 'high caregiver stigma' was reported by a significant minority of caregivers (21%) and that many felt uncomfortable to disclose their family member's condition (45%). Caregiver stigma was independently associated with higher levels of positive symptoms of schizophrenia, higher levels of disability, younger PLS age, household education at secondary school level and research site. Knowledge about schizophrenia was not associated with caregiver stigma. Qualitative data illustrate the various ways in which stigma affected the lives of family caregivers and reveal relevant links between caregiver-stigma related themes ('others finding out', 'negative reactions' and 'negative feelings and views about the self') and other themes in the data. Findings highlight the need for interventions that address both the needs of PLS and their family caregivers. Qualitative data also illustrate the complexities surrounding the relationship between knowledge and stigma and suggest that providing 'knowledge about schizophrenia' may influence the process of stigmatisation in both positive and negative ways. We posit that educational interventions need to consider context-specific factors when choosing anti-stigma-messages to be conveyed. Our findings suggest

  20. Cyber crime: can a standard risk analysis help in the challenges facing business continuity managers?

    Science.gov (United States)

    Vande Putte, Danny; Verhelst, Marc

    Risk management has never been easy. Finding efficient mitigating measures is not always straightforward. Finding measures for cyber crime, however, is a really huge challenge because cyber threats are changing all the time. As the sophistication of these threats is growing, their impact increases. Moreover, society and its economy have become increasingly dependent on information and communication technologies. Standard risk analysis methodologies will help to score the cyber risk and to place it in the risk tolerance matrix. This will allow business continuity managers to figure out if there is still a gap with the maximum tolerable outage for time-critical business processes and if extra business continuity measures are necessary to fill the gap.

  1. Facing the challenges of distribution systems operation with high wind power penetration

    DEFF Research Database (Denmark)

    Das, Kaushik; Altin, Müfit; Hansen, Anca Daniela

    2017-01-01

    power flow in 60kV distribution networks through controlling the ability of wind power plants (WPPs) to generate or absorb reactive power. This paper aims to understand the characteristics of a distribution network with high penetration of distributed generation. A detailed analysis of the active...... and reactive power flows in a real distribution network under different wind and load conditions based on actual measurements is performed in order to understand the correlation between the consumption, wind power production, and the network losses. Conclusive remarks are presented, briefly expressing......This paper addresses the challenges associated with the operation of a distribution system with high penetration of wind power. The paper presents some preliminary investigations of an ongoing Danish research work, which has as main objective to reduce the network losses by optimizing the reactive...

  2. Challenges, uncertainties and issues facing gas production from gas hydrate deposits

    Energy Technology Data Exchange (ETDEWEB)

    Moridis, G.J.; Collett, T.S.; Pooladi-Darvish, M.; Hancock, S.; Santamarina, C.; Boswell, R.; Kneafsey, T.; Rutqvist, J.; Kowalsky, M.; Reagan, M.T.; Sloan, E.D.; Sum, A.K.; Koh, C.

    2010-11-01

    The current paper complements the Moridis et al. (2009) review of the status of the effort toward commercial gas production from hydrates. We aim to describe the concept of the gas hydrate petroleum system, to discuss advances, requirement and suggested practices in gas hydrate (GH) prospecting and GH deposit characterization, and to review the associated technical, economic and environmental challenges and uncertainties, including: the accurate assessment of producible fractions of the GH resource, the development of methodologies for identifying suitable production targets, the sampling of hydrate-bearing sediments and sample analysis, the analysis and interpretation of geophysical surveys of GH reservoirs, well testing methods and interpretation of the results, geomechanical and reservoir/well stability concerns, well design, operation and installation, field operations and extending production beyond sand-dominated GH reservoirs, monitoring production and geomechanical stability, laboratory investigations, fundamental knowledge of hydrate behavior, the economics of commercial gas production from hydrates, and the associated environmental concerns.

  3. Social question and social work: contemporary challenges facing the profession in Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo José Teixeira

    2017-12-01

    Full Text Available This article offers an analysis of the intrinsic relationship between the social question and Social Work. The analysis of the social question starts from the meticulous and rigorous reading of the labor theory of value and the Critique of Political Economy written by Karl Marx. It is from this analysis that we try to justify the genesis of the profession linked to the role of the state and the bourgeoisie in the consolidation of monopoly capitalism. It starts from the analysis of Social Work as a profession inserted in the social and technical division of labor that by its own action, in the contradictory movement of the capitalist reality, defends the interests of capital and labor. In addition, the article presents, in a succinct way, the trajectory of Social Work in Brazil and its ethical and political project in relation to the working class challenges to guarantee this direction in times of dismantling social policies and financial capitalism. 

  4. Perception Challenges Faced by Al-Qaeda on the Battlefield of Influence Warfare

    Directory of Open Access Journals (Sweden)

    James J.F. Forest

    2012-03-01

    Full Text Available Many kinds of entities—including terrorists and insurgents—seek to influence perceptions and behavior among various target audiences, and have become increasingly reliant on the Internet in their efforts, incorporating social media, blogging, public video sharing and other online tools. This article is focused on the ideological messages that terrorist groups use to convey with these tools. Drawing from a study of Al-Qaeda, this discussion illustrates how ideologies of violence have certain vulnerabilities that can be exploited in order to degrade a terrorist group’s ability to achieve its objectives. While crafting and disseminating counter-narratives can be a critical part of a counterterrorism strategy, it is also important to identify ways in which terrorists undermine their own central narratives and exacerbate pre-existing “influence warfare” challenges

  5. The Office of Site Closure: Progress in the Face of Challenges

    International Nuclear Information System (INIS)

    Fiore, J. J.; Murphie, W. E.; Meador, S. W.

    2002-01-01

    The Office of Site Closure (OSC) was formed in November 1999 when the Department of Energy's (DOE's) Office of Environmental Management (EM) reorganized to focus specifically on site cleanup and closure. OSC's objective is to achieve safe and cost-effective cleanups and closures that are protective of our workers, the public, and the environment, now and in the future. Since its inception, OSC has focused on implementing a culture of safe closure, with emphasis in three primary areas: complete our responsibility for the Closure Sites Rocky Flats, Mound, Fernald, Ashtabula, and Weldon Spring; complete our responsibility for cleanup at sites where the DOE mission has been completed (examples include Battelle King Avenue and Battelle West Jefferson in Columbus, and General Atomics) or where other Departmental organizations have an ongoing mission (examples include the Brookhaven, Livermore, or Los Alamos National Laboratories, and the Nevada Test Site); and create a framework a nd develop specific business closure tools that will help sites close, such as guidance for and decisions on post-contract benefit liabilities, records retention, and Federal employee incentives for site closure. This paper discusses OSC's 2001 progress in achieving site cleanups, moving towards site closure, and developing specific business closure tools to support site closure. It describes the tools used to achieve progress towards cleanup and closure, such as the application of new technologies, changes in contracting approaches, and the development of agreements between sites and with host states. The paper also identifies upcoming challenges and explores options for how Headquarters and the sites can work together to address these challenges. Finally, it articulates OSC's new focus on oversight of Field Offices to ensure they have the systems in place to oversee contractor activities resulting in site cleanups and closures

  6. Radiation doses in pediatric computed tomography procedures: challenges facing new technologies

    International Nuclear Information System (INIS)

    Cotelo, E.; Padilla, M.; Dibarboure, L.

    2008-01-01

    Despite the fact that in recent years an increasing number of radiologists and radiological technologists have been applying radiation dose optimization techniques in paediatric Computed Tomography (CT) examinations, dual and multi -slice CT (MSCT) scanners present a new challenge in Radiation Protection (RP). While on one hand these scanners are provided with Automatic Exposure Control (AEC) devices, dose reduction modes and dose estimation software, on the other hand Quality Control (QC) tests and CT Kerma Index (C) measurements and patient dose estimation present specific difficulties and require changes or adaptations of traditional QC protocols. This implies a major challenge in most developing countries where Quality Assurance Programmes (QAP) have not been implemented yet and there is a shortage in the number of medical physicists This paper analyses clinical and technical protocols as well as patient doses in 204 CT body procedures performed in 154 children. The investigation was carried out in a paediatric reference hospital of Uruguay, where are performed an average of 450 paediatric CT examinations per month in a sole CT dual scanner. Besides, C VOL reported from the scanner display was registered in order to be related with the same dosimetric quantity derived from technical parameters and C values published on tables. Results showed that not all the radiologists applied the same protocol in similar clinical situations delivering unnecessary patient dose with no significant differences in image quality. Moreover, it was found that dose reduction modes represent a drawback in order to estimate patient dose when mA changes according to tissue attenuation, in most cases in each rotation. The study concluded on the importance of QAP that must include education on RP of radiologists and technologists, as well as in the need of medical physicists to perform QC tests and patient dose estimations and measurements. (author)

  7. Philippines. Church vs. state: Fidel Ramos and family planning face "Catholic Power".

    Science.gov (United States)

    1994-08-24

    Catholic groups and individuals united in a public rally in Manila's Rizal Park to decry a "cultural dictatorship," which promotes abortion, homosexuality, lesbianism, sexual perversion, condoms, and artificial contraception. Government spokesmen responded that condoms and contraception were part of government policy to spread family planning knowledge and informed choices among the population. Cardinal Jaime Sin and former president Corazon Aquino joined forces to lead the movement against the national family planning program in the largest demonstration since the ouster of Ferdinand Marcos in 1986. Also criticized was the 85-page draft action plan for the International Conference on Population and Development (ICPD) scheduled for September 1994. Cardinal Sin accused President Clinton of using the action plan to promote worldwide abortion. Under the administration of President Fidel Ramos, family planning funding has quintupled and the number of family planning workers has increased from 200 to 8000. President Ramos has gone the farthest of any administration in opposing the Church's positions on contraception and abortion, although years ago Fidel Ramos and Cardinal Sin were allies in the effort to push out Ferdinand Marcos. The population of the Philippines is 85% Catholic, and laws reflect the Church's doctrine against divorce and abortion. The current growth rate is 2.3%, and the goal is to reduce growth to 2.0% by 1998, the end of Ramos's term in office. The population target is in accord with demographic goals proposed in the UN draft action plan. The Vatican has opposed the language in the plan and may have encouraged other religious leaders to join those opposed to the "war against our babies and children." Sin said that contraceptive distribution was "intrinsically evil" and should be stopped now. Ramos's administration stated that their policies and programs are not "in the hands of the devil" and there is support for the Church on family values and

  8. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

    Science.gov (United States)

    Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

    2018-01-01

    Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013–14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014–2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

  9. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges.

    Science.gov (United States)

    Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

    2018-03-21

    Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013-14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014-2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

  10. Subjective face recognition difficulties, aberrant sensibility, sleeping disturbances and aberrant eating habits in families with Asperger syndrome

    Directory of Open Access Journals (Sweden)

    Källman Tiia

    2005-04-01

    Full Text Available Abstract Background The present study was undertaken in order to determine whether a set of clinical features, which are not included in the DSM-IV or ICD-10 for Asperger Syndrome (AS, are associated with AS in particular or whether they are merely a familial trait that is not related to the diagnosis. Methods Ten large families, a total of 138 persons, of whom 58 individuals fulfilled the diagnostic criteria for AS and another 56 did not to fulfill these criteria, were studied using a structured interview focusing on the possible presence of face recognition difficulties, aberrant sensibility and eating habits and sleeping disturbances. Results The prevalence for face recognition difficulties was 46.6% in individuals with AS compared with 10.7% in the control group. The corresponding figures for subjectively reported presence of aberrant sensibilities were 91.4% and 46.6%, for sleeping disturbances 48.3% and 23.2% and for aberrant eating habits 60.3% and 14.3%, respectively. Conclusion An aberrant processing of sensory information appears to be a common feature in AS. The impact of these and other clinical features that are not incorporated in the ICD-10 and DSM-IV on our understanding of AS may hitherto have been underestimated. These associated clinical traits may well be reflected by the behavioural characteristics of these individuals.

  11. Stereotype Threat: A Qualitative Study of the Challenges Facing Female Undergraduate Engineering Students

    Science.gov (United States)

    Entsminger, J. R., II

    From a sociocultural point of view, this qualitative case study explored how upper-level, female undergraduate engineering students perceived the possibility of or experience with stereotype threat as shaping their experiences. The study also investigated how these students explained their reasons for choosing their engineering major, the challenges they encountered in the major, and their reasons for persevering in spite of those challenges. Using Steele and Aronson's (1995) stereotype threat theory as a framework, and considering the documented underrepresentation of females in engineering, the study sought to examine how stereotype threat shaped the experiences of these students and if stereotype threat could be considered a valid reason for the underrepresentation. The study was conducted at a large, four-year public university. First, students in the College of Engineering and Engineering Technology completed the Participant Screening Survey. Based on responses from the survey, six female engineering students from the college were identified and invited to participate in the study. The participants came from the following majors: Electrical Engineering, Industrial and Systems Engineering, and Mechanical Engineering. After receiving the study consent letter and agreeing to participate, the students were involved in a 90-minute focus group meeting, a 45-minute one-on-one interview, and a 30-minute follow-up interview. After conducting the data collection methods, the data were then transcribed, analyzed, and coded for theme development. The themes that emerged coincided with each research question. The themes highlighted the complex interactions and experiences shared by the female engineering majors. The female students were enveloped in an environment where there existed an increased risk for activating stereotype threat. In addition, the female students described feeling pushed to prove to themselves and to others that the negative stereotype that 'females

  12. Facing tomorrow's challenges: U.S. Geological Survey science in the decade 2007-2017

    Science.gov (United States)

    ,

    2007-01-01

    In order for the U.S. Geological Survey (USGS) to respond to evolving national and global priorities, it must periodically reflect on, and optimize, its strategic directions. This report is the first comprehensive science strategy since the early 1990s to examine critically major USGS science goals and priorities. The development of this science strategy comes at a time of global trends and rapidly evolving societal needs that pose important natural-science challenges. The emergence of a global economy affects the demand for all resources. The last decade has witnessed the emergence of a new model for managing Federal lands-ecosystem-based management. The U.S. Climate Change Science Program predicts that the next few decades will see rapid changes in the Nation's and the Earth's environment. Finally, the natural environment continues to pose risks to society in the form of volcanoes, earthquakes, wildland fires, floods, droughts, invasive species, variable and changing climate, and natural and anthropogenic toxins, as well as animal-borne diseases that affect humans. The use of, and competition for, natural resources on the global scale, and natural threats to those resources, has the potential to impact the Nation's ability to sustain its economy, national security, quality of life, and natural environment. Responding to these national priorities and global trends requires a science strategy that not only builds on existing USGS strengths and partnerships but also demands the innovation made possible by integrating the full breadth and depth of USGS capabilities. The USGS chooses to go forward in the science directions proposed here because the societal issues addressed by these science directions represent major challenges for the Nation's future and for the stewards of Federal lands, both onshore and offshore. The six science directions proposed in this science strategy are listed as follows. The ecosystems strategy is listed first because it has a dual nature

  13. Northern Eurasia Future Initiative: Facing the Challenges of Global Change in the 21st century

    Science.gov (United States)

    Groisman, Pavel; Gutman, Garik; Gulev, Sergey; Maksyutov, Shamil; Qi, Jiaguo

    2016-04-01

    foci emerged in discussions within the NEESPI community during the past 20 months. Presentation will provide justification of these foci and approach examples addressing them. The societal challenges, particularly the socio-economic challenges are the top priority in most of them. Throughout the NEESP Initiative duration, support for it studies has been provided by different national and international Agencies of the United States (in particular, the NASA Land Cover and Land Use Change Program), the Russian Federation (in particular, the Ministry of Education and Science, e.g., mega-grant 14.B25.31.0026), European Union, Japan, and China. After the NEFI White Paper release, we anticipate a similar kind of support for this new Initiative.

  14. Challenges Facing the Sacramento–San Joaquin Delta: Complex, Chaotic, or Simply Cantankerous?

    Directory of Open Access Journals (Sweden)

    Samuel N. Luoma

    2015-09-01

    Full Text Available doi: http://dx.doi.org/10.15447/sfews.2015v13iss3art7Freshwater is a scarce and precious resource in California; its overall value is being made clear by the current severe drought. The Sacramento–San Joaquin Delta is a critical node in a complex water supply system that extends throughout much of the western U.S. wherein demand is exceeding supply. The Delta also underpins a major component of the U.S. economy, helps feed a substantial part of the country, is a unique and valuable ecological resource, and is a place with a rich cultural heritage. Sustaining the Delta is a problem that manifests itself in many dimensions including the physical structure of the Delta, the conflicting demands for water, changing water quality, rapidly evolving ecological character, and high institutional complexity. The problems of the California Delta are increasingly complex, sometimes chaotic, and always contentious. There is general agreement that current management will sustain neither the Delta ecosystem nor high-quality water exports, as required under the Delta Reform Act, so there is a renewed urgency to address all dimensions of the problem aggressively. Sustainable management of the Delta ecosystem and California’s highly variable water supply, in the face of global climate change, will require bold political decisions that include adjustments to the infrastructure but give equal emphasis to chronic overuse and misuse of water, promote enhanced efficiency of water use, and facilitate new initiatives for ecosystem recovery. This new approach will need to be underpinned by collaborative science that supports ongoing evaluation and re-adjustment of actions. Problems like the Delta are formally “wicked" problems that cannot be “solved” in the traditional sense, but they can be managed with appropriate knowledge and flexible institutions. Where possible, it is advisable to approach major actions incrementally, with an eye toward avoiding

  15. About Face

    Medline Plus

    Full Text Available ... not feeling better, you may have PTSD (posttraumatic stress disorder). Watch the intro This is AboutFace In these videos, Veterans, family members, and clinicians share their experiences with PTSD ...

  16. Statut familial et inégalités face à la scolarisation à Madagascar

    Science.gov (United States)

    Delaunay, Valérie; Gastineau, Bénédicte; Andriamaro, Frédérique

    2013-12-01

    The impact of family status in Madagascar on inequalities in schooling - In this article, in the context of generalised access to primary education and parity between girls and boys, we analyse data from the Demographic and Health Survey (DHS) 2009 in Madagascar to examine inequalities in schooling related to children's status in the family. The results confirm the protective benefit for children of living with their biological parents. Fostered children are disadvantaged, especially and increasingly so depending on whether they live with an uncle or aunt, with a distant relative or a non-relative. Conversely, children who reside in the home of a brother or sister are not disadvantaged, a result which reflects the role of elder children in family education strategies. Grandparents play a moderately positive role in schooling. The death of the father is an important factor in dropping out. Finally, children whose parent or parents are not household heads are disadvantaged in terms of schooling compared to children of household heads.

  17. An opportunity and an imperative: Chapter 11 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    Science.gov (United States)

    Updike, Randall G.; Page, William R.

    2013-01-01

    Along the nearly 3,200 kilometers (almost 2,000 miles) of the United States–Mexican border, we are witnessing the expression of the challenges of the 21st century. The Borderlands have become a microcosm for the entire United States and Mexico; the issues faced in that region are felt throughout both nations—water availability and quality, ecosystem health, natural resource needs, safety from natural hazards, and human socioeconomic well-being. If these issues were not challenging enough, we now recognize that the difficulties of addressing them are exacerbated by the onset of climate change, and as we come to better understand the complexities of the components of these challenge themes, we discover that each part is inextricably intertwined with other overarching issues. Further, because we are a creative and progressive society, we all seek to understand and appreciate the natural environments associated with the Borderlands while at the same time benefitting from the region’s many social and economic values. It is little wonder that we as a society find it increasingly difficult to ask the right questions, much less find suitable answers to the questions we do ask. For the many scientists who have worked in the Borderlands and contributed to the preceding chapters, this circular is a way to describe to the two nations of the region the capabilities the U.S. Geological Survey can provide to assist in that quest for knowledge and understanding in preparation for the future.

  18. Challenges faced by China compared with the US in developing wind power

    Science.gov (United States)

    Lu, Xi; McElroy, Michael B.; Peng, Wei; Liu, Shiyang; Nielsen, Chris P.; Wang, Haikun

    2016-06-01

    In the 21st Conference of the Parties held in Paris in December 2015, China pledged to peak its carbon emissions and increase non-fossil energy to 20% by 2030 or earlier. Expanding renewable capacity, especially wind power, is a central strategy to achieve these climate goals. Despite greater capacity for wind installation in China compared to the US (145.1 versus 75.0 GW), less wind electricity is generated in China (186.3 versus 190.9 TWh). Here, we quantify the relative importance of the key factors accounting for the unsatisfactory performance of Chinese wind farms. Different from the results in earlier qualitative studies, we find that the difference in wind resources explains only a small fraction of the present China-US difference in wind power output (-17.9% in 2012); the curtailment of wind power, differences in turbine quality, and delayed connection to the grid are identified as the three primary factors (respectively -49.3%, -50.2%, and -50.3% in 2012). Improvements in both technology choices and the policy environment are critical in addressing these challenges.

  19. Ethics Guidelines in Environmental Epidemiology: Their Development and Challenges We Face.

    Science.gov (United States)

    Kramer, Shira; Soskolne, Colin L

    2017-06-01

    This review integrates historical developments and key events in bringing ethics into epidemiology in general and into environmental epidemiology in particular. The goal is to provide context for and discern among the various approaches and motivations that drive the need for ethical conduct in support of the public interest. The need for ethics guidelines in epidemiology is different from developments in other biomedical-related fields by virtue of its focus on populations rather than on individuals. The need for ethics guidelines in environmental epidemiology as a subspecialty of epidemiology stems from the larger scale of its mission than that of epidemiology per se. Ethics guidelines in the field of environmental epidemiology have been established. They articulate not only the profession's core values and mission, but more specifically, they address the environmental epidemiologist's obligations to the participants in research, to colleagues, and to employers. They are the product of consensus, scholarship, and diligent stewardship over several decades. The next challenge is ensuring their value and impact. The forces that support professional and institutional success, and the power of special interests, are the major threats to achieving the goals of ethical conduct and research for the public good. In environmental epidemiology, these threats have global implications.

  20. Challenges, uncertainties, and issues facing gas production from gas-hydrate deposits

    Science.gov (United States)

    Moridis, G.J.; Collett, T.S.; Pooladi-Darvish, M.; Hancock, S.; Santamarina, C.; Boswel, R.; Kneafsey, T.; Rutqvist, J.; Kowalsky, M.B.; Reagan, M.T.; Sloan, E.D.; Sum, A.K.; Koh, C.A.

    2011-01-01

    The current paper complements the Moridis et al. (2009) review of the status of the effort toward commercial gas production from hydrates. We aim to describe the concept of the gas-hydrate (GH) petroleum system; to discuss advances, requirements, and suggested practices in GH prospecting and GH deposit characterization; and to review the associated technical, economic, and environmental challenges and uncertainties, which include the following: accurate assessment of producible fractions of the GH resource; development of methods for identifying suitable production targets; sampling of hydrate-bearing sediments (HBS) and sample analysis; analysis and interpretation of geophysical surveys of GH reservoirs; well-testing methods; interpretation of well-testing results; geomechanical and reservoir/well stability concerns; well design, operation, and installation; field operations and extending production beyond sand-dominated GH reservoirs; monitoring production and geomechanical stability; laboratory investigations; fundamental knowledge of hydrate behavior; the economics of commercial gas production from hydrates; and associated environmental concerns. ?? 2011 Society of Petroleum Engineers.

  1. The Challenges Facing the Multilateral Trading System in Addressing Global Public Policy Objectives

    Directory of Open Access Journals (Sweden)

    Christophe Bellmann

    2013-02-01

    Full Text Available Despite a record-breaking 14.5 per cent increase in world merchandise exports, the effects of the financial crisis and global recession are still hampering faster economic recovery. Relatively high oil prices combined with persistent unemployment and measures designed to reduce budget deficits have undermined short-term growth prospects. While South–South trade continues to explode, trade imbalances – i.e. the gap between exports and imports – widened in 2010 compared to 2009 (though smaller than pre-crisis levels. Meanwhile, trade negotiations under the Doha Round have reached an impasse, generating uncertainties about the future of the World Trade Organization (WTO as a negotiating forum. Under these circumstances, should the system rethink its decision-making process founded upon the predominance of member states, the principle of consensus and the notion of single undertaking, as some critics have suggested? And, if so, how could such a reform agenda be initiated at the WTO? Moreover, beyond the negotiating function of the WTO, the paralysis of the system also raises urgent questions about the ability of the system to respond to pressing challenges of our times, such as trade and climate change, or food security and price volatility.

  2. Potential challenges facing distributed leadership in health care: evidence from the UK National Health Service.

    Science.gov (United States)

    Martin, Graeme; Beech, Nic; MacIntosh, Robert; Bushfield, Stacey

    2015-01-01

    The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  3. Ecosystem-based management of coastal zones in face of climate change impacts: Challenges and inequalities.

    Science.gov (United States)

    Fernandino, Gerson; Elliff, Carla I; Silva, Iracema R

    2018-06-01

    Climate change effects have the potential of affecting both ocean and atmospheric processes. These changes pose serious threats to the millions of people that live by the coast. Thus, the objective of the present review is to discuss how climate change is altering (and will continue to alter) atmospheric and oceanic processes, what are the main implications of these alterations along the coastline, and which are the ecosystem-based management (EBM) strategies that have been proposed and applied to address these issues. While ocean warming, ocean acidification and increasing sea level have been more extensively studied, investigations on the effects of climate change to wind and wave climates are less frequent. Coastal ecosystems and their respective natural resources will respond differently according to location, environmental drivers and coastal processes. EBM strategies have mostly concentrated on improving ecosystem services, which can be used to assist in mitigating climate change effects. The main challenge for developing nations regards gaps in information and scarcity of resources. Thus, for effective management and adaptive EBM strategies to be developed worldwide, information at a local level is greatly needed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Challenge theme 2: assuring water availability and quality in the 21st century: Chapter 4 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    Science.gov (United States)

    Callegary, James; Langeman, Jeff; Leenhouts, Jim; Martin, Peter

    2013-01-01

    Along the United States–Mexican border, the health of communities, economies, and ecosystems is inextricably intertwined with the availability and quality of water, but effective water management in the Borderlands is complicated. Water users compete for resources, and their needs are increasing. Managers are faced with issues such as finding a balance between agriculture and rapidly growing cities or maintaining public supplies while ensuring sufficient resources for aquatic ecosystems. In addition to human factors, the dry climate of the Borderlands, as compared to more temperate regions, also increases the challenge of balancing water supplies between humans and ecosystems. Warmer, drier, and more variable conditions across the southwestern United States—the projected results of climate change (Seager and others, 2007)—would further stress water supplies.

  5. International conference on challenges faced by technical and scientific support organizations in enhancing nuclear safety. Contributed papers and presentations

    International Nuclear Information System (INIS)

    2007-01-01

    Over the past two decades, the IAEA has conducted a series of major conferences that have addressed topical issues and strategies critical to nuclear safety for consideration by the world's nuclear regulators. More recently, the IAEA organized the International Conference on Effective Nuclear Regulatory Systems - Facing Safety and Security Challenges, held in Moscow in 2006. The Moscow conference was the first of its kind, because it brought together senior regulators of nuclear safety, radiation safety and security from around the world to discuss how to improve regulatory effectiveness with the objective of improving the protection of the public and the users of nuclear and radioactive material. The International Conference on Challenges Faced by Technical and Scientific Support Organizations in Enhancing Nuclear Safety was held in Aix-en-Provence, France, from 23 to 27 April 2007. This conference, again, was the first of its kind, because it was the first to address technical and scientific support organizations (TSOs), the role they play in supporting either the national regulatory bodies or the industry in making optimum safety decisions and the challenges they face in providing this support. This conference provided a forum for the TSOs to discuss these and other issues with the organizations to which they provide this support - that is, the regulators and the operators/industry - as well as with other stakeholders such as research organizations and public authorities. This conference can also be considered to have a link to the Moscow conference. The Moscow conference concluded that effective regulation of nuclear safety is vital for the safe use of nuclear energy and associated technologies, both now and in the future, and is an essential prerequisite for establishing an effective Global Nuclear Safety Regime. The Moscow conference also highlighted the importance of continued and improved international cooperation in the area of nuclear safety. These

  6. Positive Family Intervention for Severe Challenging Behavior I: A Multisite Randomized Clinical Trial

    Science.gov (United States)

    Durand, V. Mark; Hieneman, Meme; Clarke, Shelley; Wang, Mo; Rinaldi, Melissa L.

    2013-01-01

    The present study was a multisite randomized clinical trial assessing the effects of adding a cognitive-behavioral intervention to positive behavior support (PBS). Fifty-four families who met the criteria of (a) having a child with a developmental disability, (b) whose child displayed serious challenging behavior (e.g., aggression, self-injury,…

  7. Managing challenging interactions with family caregivers in the cancer setting: Guidelines for clinicians (TRIO Guidelines-2).

    Science.gov (United States)

    Laidsaar-Powell, Rebekah; Butow, Phyllis; Boyle, Frances; Juraskova, Ilona

    2018-06-01

    Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Investigating Challenges Facing Self-Management Empowerment Education in Adolescents and Youths with Major Thalassemia

    Directory of Open Access Journals (Sweden)

    Razzazan

    2014-10-01

    Full Text Available Background Thalassemia is considered an important public health problem worldwide, especially in developing and poor countries. Although several advanced techniques have been developed for prevention of thalassemia in the recent years, many adolescents and youths are still living with this disease. Independence from parents, decisions about high-risk behaviors, uncovering the identity, and adapting to mental and physical effects of the disease occur together in adolescents. Objectives This study was conducted to explore challenges of self-management empowerment in adolescents and youths with major thalassemia. Materials and Methods This was a descriptive-exploratory study. The study population consisted of adolescents and youths with major thalassemia who had medical records in the Bushehr Thalassemia Center, affiliated with Bushehr University of Medical Sciences. The study samples were purposively selected. Demographic information questionnaire and empowerment questionnaire were used to collect data from the semistructured interview. We analyzed qualitative data by content analysis method and quantitative data by descriptive (mean, standard deviation and analytical (Student's t-test, ANOVA and Pearson’s correlation coefficient statistical methods, using the statistical software SPSS 18. Results In qualitative part of the study, data from semistructured in-depth interviews with 15 participants were coded and summarized in five themes including: 1 awareness of personal changes; 2 need for adaptation; 3 maintaining independence and self-management; 4 uncovering the identity and role playing; and 5 sense of control and satisfaction. Results of the quantitative part showed that the overall score of participants on empowerment was 92.46 of 149 scores, which showed a moderate situation in the empowerment of these individuals. In addition, the empowerment score showed no statistically significant correlation with demographic characteristics

  9. Perceptions of patients, families, physicians and nurses regarding challenges in cancer disclosure: A descriptive qualitative study.

    Science.gov (United States)

    Ehsani, Maryam; Taleghani, Fariba; Hematti, Simin; Abazari, Parvaneh

    2016-12-01

    The findings of numerous studies have illustrated that there is still a high proportion of cancer patients in Eastern and Middle-East countries including Iran, who are not properly informed of their disease due to the concealment atmosphere which still prevails. This descriptive qualitative study is aimed at exploring perceptions of patients, patients' family members, physicians and nurses regarding cancer disclosure challenges. Thirty-five participants (15 patients, 6 family members, 9 physicians, and 5 nurses) were selected through purposive sampling. The data were collected through in-depth interviews; after which they were analyzed using a qualitative content analysis with an inductive approach. Data analysis revealed the following three categories: first, challenges related to healthcare system which deals with the deficiencies, strains and concerns in medical setting and healthcare team training; second, challenges related to family insistence on concealment which includes their fear of cancer disclosure and its negative impact on the patients; and third, challenges related to policy making which consists of deficiencies in legislative and supportive institutions for advocacy of truth telling. Successful move from concealment to effective disclosure attitude in cancer patients in Iran requires a national determination for resolving challenges in medical education as well as other different social, cultural and policy making dimensions. Copyright © 2016. Published by Elsevier Ltd.

  10. FATHER TO SON: THE COMPLEXITY AND THE CHALLENGES OF MANAGEMENT OF THE FAMILY BUSINESS

    Directory of Open Access Journals (Sweden)

    Ernani Cesar de Freitas

    2012-05-01

    Full Text Available For his contribution to the Brazilian economy, family businesses occupy a prominent position within the business. Many large companies in the country are, or have already been familiar in its essence, that number could be even higher if not for the complexities faced by these organizations during their generations. Thus, this paper addresses the issue of family business management in order to study the characteristics of management and governance, professional and organizational culture, pointing thus contributions to the huge network of family businesses in Brazil - the most common type of organization in the country. Thus, the objective of this study was to investigate and analyze these theoretical main characteristics in family businesses small and medium-sized segmented in trade of the Vale do Sinos/RS. For this, the present study was based from various authors, such as Davis and Frezza (2005, Bornholdt (2005, Casillas, Vazquez and Diaz (2007 and Adams (2009. We used this exploratory work through multiple case study, by means of data collection done through unstructured interview. It was found that some changes occur not only in terms of professional appearance, but by way of management and business decision-making. Some of these processes are often performed more and more worked on some family business focus of this study, however, pointed out that all these aspects should be part of the organizational dynamics of family organizations object of this study.

  11. Challenges for Ecosystem Services Provided by Coral Reefs In the Face of Climate Change

    Science.gov (United States)

    Kikuchi, R. K.; Elliff, C. I.

    2014-12-01

    to increase resilience and guarantee the adaptation of this ecosystem to climate change. Thus, considering that the majority of the marine ecosystem services we benefit from are provided from coastal habitats, of which coral reefs play an important role, the challenge at hand is in fact the interaction between local factors and climate change

  12. Professional development for teachers of students who are deaf or hard of hearing: facing the assessment challenge.

    Science.gov (United States)

    Cawthon, Stephanie

    2009-01-01

    Teachers of students with low-incidence disabilities, such as students who are deaf or hard of hearing, face unique challenges in putting education policy into practice. The present article presents professional development findings from the Third Annual National Survey of Accommodations and Assessment for Students Who Are Deaf or Hard of Hearing (Cawthon, Hersh, Kim, & Online Research Lab, in press). A total of 391 participants described professional development they had experienced related to assessment of students who are deaf or hard of hearing. Teachers reported greater exposure to topics in school/district sessions and discussion with their colleagues than in their preparation programs. Teaching at a school for the deaf or teaching students in high school were significant predictors of an increased prevalence of professional development opportunities on assessment-related topics for students who are deaf or hard of hearing.

  13. Development of Critical Thinking Skills through Writing Tasks: Challenges Facing Maritime English Students at Aqaba College, AlBalqa Applied University, Jordan

    Science.gov (United States)

    Alidmat, Ali Odeh Hammoud; Ayassrah, Mohamed Ayed

    2017-01-01

    Teaching English for Special Purposes (ESP) in a context where English is taught as a Foreign Language (EFL) is no easy task. There is in fact extensive research reporting on challenges facing both teacher and student in the Foreign Language classroom where language skills must be learnt outside their usual context. Even more challenging is…

  14. Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon.

    Science.gov (United States)

    Schmitt, Margaret L; Clatworthy, David; Ratnayake, Ruwan; Klaesener-Metzner, Nicole; Roesch, Elizabeth; Wheeler, Erin; Sommer, Marni

    2017-01-01

    There is a significant gap in empirical evidence on the menstrual hygiene management (MHM) challenges faced by adolescent girls and women in emergency contexts, and on appropriate humanitarian response approaches to meet their needs in diverse emergency contexts. To begin filling the gap in the evidence, we conducted a study in two diverse contexts (Myanmar and Lebanon), exploring the MHM barriers facing girls and women, and the various relevant sectoral responses being conducted (e.g. water, sanitation and hygiene (WASH), Protection, Health, Education and Camp Management). Two qualitative assessments were conducted: one in camps for internally displaced populations in Myanmar, and one with refugees living in informal settlements and host communities in Lebanon. Key informant interviews were conducted with emergency response staff in both sites, and focus group discussion and participatory mapping activities conducted with adolescent girls and women. Key findings included that there was insufficient access to safe and private facilities for MHM coupled with displacement induced shifts in menstrual practices by girls and women. Among staff, there was a narrow interpretation of what an MHM response includes, with a focus on supplies; significant interest in understanding what an improved MHM response would include and acknowledgement of limited existing MHM guidance across various sectors; and insufficient consultation with beneficiaries, related to discomfort asking about menstruation, and limited coordination between sectors. There is a significant need for improved guidance across all relevant sectors for improving MHM response in emergency context, along with increased evidence on effective approaches for integrating MHM into existing responses.

  15. "Members of the same club": challenges and decisions faced by US IRBs in identifying and managing conflicts of interest.

    Science.gov (United States)

    Klitzman, Robert

    2011-01-01

    Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be "indirect financial" conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves

  16. Issues Faced by Family Caregivers of Hospice Patients with Head and Neck Cancers.

    Science.gov (United States)

    McMillan, Susan C; Rodriguez, Carmen; Wang, Hsiao-Lan; Elliott, Amanda

    2015-01-01

    The purpose of this study was to explore issues reported by caregivers of Head and Neck cancer (HNC) patients newly admitted to hospice homecare. 26 caregivers providing hospice homecare to patients with HNC were induded. Caregiver depressive symptoms, social support and perceived health data were analyzed. The caregivers reported few depressive symptoms, good perceived social support, and good perceived health; however, there was large variation in the group with some individuals having significant problems. Caregivers appeared to be doing well physically, emotionally and socially, but baseline data were used, so follow-up data are needed. Further research is warranted. Family caregivers also are affected by the experience of cancer and may have depressive symptoms needing assessment and management. Hospice patients with HNC have a variety of symptoms specific to their disease and treatment that need assessment and management by their family caregivers. Caregivers of HNC patients in hospice and palliative care need and deserve attention from hospice providers as they care for patients.

  17. The Challenges and Benefits of Unschooling, According to 232 Families Who Have Chosen that Route

    Directory of Open Access Journals (Sweden)

    Peter GRAY

    2013-12-01

    Full Text Available Unschooling families (families that dont send their children to school and dont school them at home were invited to participate in a survey about their unschooling practices. Two hundred and thirty two self-identified unschooling families, with at least one child over five years old, completed and returned the questionnaire. Qualitative analyses revealed considerable variability in the routes to unschooling and in the ways in which the parents saw themselves as involved in their childrens education. The biggest challenge expressed was that of overcoming feelings of criticism, or social pressure, that came from others who disapproved and from their own culturally-ingrained, habitual ways of thinking about education. The reported benefits of unschooling were numerous; they included improved learning, better attitudes about learning, and improved psychological and social wellbeing for the children; and increased closeness, harmony, and freedom for the whole family.

  18. An Integrative, Multilevel, and Transdisciplinary Research Approach to Challenges of Work, Family, and Health

    Science.gov (United States)

    Bray, Jeremy W.; Kelly, Erin L.; Hammer, Leslie B.; Almeida, David M.; Dearing, James W.; King, Rosalind B.; Buxton, Orfeu M.

    2013-01-01

    Recognizing a need for rigorous, experimental research to support the efforts of workplaces and policymakers in improving the health and wellbeing of employees and their families, the National Institutes of Health and the Centers for Disease Control and Prevention formed the Work, Family & Health Network (WFHN). The WFHN is implementing an innovative multisite study with a rigorous experimental design (adaptive randomization, control groups), comprehensive multilevel measures, a novel and theoretically based intervention targeting the psychosocial work environment, and translational activities. This paper describes challenges and benefits of designing a multilevel and transdisciplinary research network that includes an effectiveness study to assess intervention effects on employees, families, and managers; a daily diary study to examine effects on family functioning and daily stress; a process study to understand intervention implementation; and translational research to understand and inform diffusion of innovation. Challenges were both conceptual and logistical, spanning all aspects of study design and implementation. In dealing with these challenges, however, the WFHN developed innovative, transdisciplinary, multi-method approaches to conducting workplace research that will benefit both the research and business communities. PMID:24618878

  19. Challenges in providing culturally-competent care to patients with metastatic brain tumours and their families.

    Science.gov (United States)

    Longo, Lianne; Slater, Serena

    2014-01-01

    Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities.

  20. Examining the Role of Primary Care Physicians and Challenges Faced When Their Patients Transition to Home Hospice Care.

    Science.gov (United States)

    Shalev, Ariel; Phongtankuel, Veerawat; Lampa, Katherine; Reid, M C; Eiss, Brian M; Bhatia, Sonica; Adelman, Ronald D

    2018-04-01

    The transition into home hospice care is often a critical time in a patient's medical care. Studies have shown patients and caregivers desire continuity with their physicians at the end of life (EoL). However, it is unclear what roles primary care physicians (PCPs) play and what challenges they face caring for patients transitioning into home hospice care. To understand PCPs' experiences, challenges, and preferences when their patients transition to home hospice care. Nineteen semi-structured phone interviews with PCPs were conducted. Study data were analyzed using standard qualitative methods. Participants included PCPs from 3 academic group practices in New York City. Measured: Physician recordings were transcribed and analyzed using content analysis. Most PCPs noted that there was a discrepancy between their actual role and ideal role when their patients transitioned to home hospice care. Primary care physicians expressed a desire to maintain continuity, provide psychosocial support, and collaborate actively with the hospice team. Better establishment of roles, more frequent communication with the hospice team, and use of technology to communicate with patients were mentioned as possible ways to help PCPs achieve their ideal role caring for their patients receiving home hospice care. Primary care physicians expressed varying degrees of involvement during a patient's transition to home hospice care, but many desired to be more involved in their patient's care. As with patients, physicians desire to maintain continuity with their patients at the EoL and solutions to improve communication between PCPs, hospice providers, and patients need to be explored.

  1. Coping in old age with extreme childhood trauma: aging Holocaust survivors and their offspring facing new challenges.

    Science.gov (United States)

    Fridman, Ayala; Bakermans-Kranenburg, Marian J; Sagi-Schwartz, Abraham; Van IJzendoorn, Marinus H

    2011-03-01

    The Holocaust has become an iconic example of immense human-made catastrophes, and survivors are now coping with normal aging processes. Childhood trauma may leave the survivors more vulnerable when they are facing stress related to old age, whereas their offspring might have a challenging role of protecting their own parents from further pain. Here we examine the psychological adaptation of Holocaust survivors and their offspring in light of these new challenges, examining satisfaction with life, mental health, cognitive abilities, dissociative symptoms, and physical health. Careful matching of female Holocaust survivors and comparison subjects living in Israel was employed to form a case-control study design with two generations, including four groups: 32 elderly female Holocaust survivors and 47 daughters, and 33 elderly women in the comparison group, and 32 daughters (total N = 174). Participants completed several measures of mental and physical health, and their cognitive functioning was examined. The current study is a follow-up of a previous study conducted 11 years ago with the same participants. Holocaust survivors showed more dissociative symptomatology (odds = 2.39) and less satisfaction with their life (odds = 2.79) as compared to a matched group. Nonetheless, adult offspring of Holocaust survivors showed no differences in their physical, psychological, and cognitive functioning as compared to matched controls. Holocaust survivors still display posttraumatic stress symptoms almost 70 years after the trauma, whereas no intergenerational transmission of trauma was found among the second generation.

  2. Informational Support in Pediatric Oncology: Review of the Challenges Among Arab Families.

    Science.gov (United States)

    Otmani, Naïma; Khattab, Mohammed

    2016-11-18

    Childhood cancer and its invasive treatment is a distressing life experience for the child and his family. Providing informational support is an essential part of community care, and defining parent's burden is an important part of this goal. However, providing such information can be particularly challenging in Arab countries where beliefs, traditions, religion, and socioeconomic factors influence parents' needs and their priorities of needs. This article presents a review of these specificities among Arab families. Implications of health-care providers are also discussed.

  3. Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study

    Science.gov (United States)

    Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

    2016-01-01

    Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and

  4. Social, Cultural, and Environmental Challenges Faced by Children on Antiretroviral Therapy in Zimbabwe: a Mixed-Method Study

    Science.gov (United States)

    Macherera, Margaret; Moyo, Lindani; Ncube, Mkhanyiseli; Gumbi, Angella

    2012-01-01

    Objectives Despite the advent of antiretroviral therapy (ART), many children, particularly in the rural communities of Zimbabwe, remain vulnerable. The purpose of this study was to determine the factors and challenges facing children on antiretroviral therapy (ART) in Brunapeg area of Mangwe District, Zimbabwe. Methods A mixed-method approach involving interviewer-guided focus group discussions and piloted semi-structured questionnaires was utilized to collect data from different key population groups. The data obtained were analyzed through content coding procedures based on a set of predetermined themes of interest. Results A number of challenges emerged as barriers to the success of antiretroviral therapy for children. Primary care givers were less informed about HIV and AIDS issues for people having direct impact on the success of antiretroviral therapy in children whilst some were found to be taking the antiretroviral drugs meant for the children. It also emerged that some primary care givers were either too young or too old to care for the children while others had failed to disclose to the children why they frequently visited the Opportunistic Infections (OI) clinic. Most primary care givers were not the biological parents of the affected children. Other challenges included inadequate access to health services, inadequate food and nutrition and lack of access to clean water, good hygiene and sanitation. The lack of community support and stigma and discrimination affected their school attendance and hospital visits. All these factors contributed to non-adherence to antiretroviral drugs. Conclusions and Public Health Implications Children on ART in rural communities in Zimbabwe remain severely compromised and have unique problems that need multi-intervention strategies both at policy and programmatic levels. Effective mitigating measures must be fully established and implemented in rural communities of developing countries in the fight for universal

  5. Social, Cultural, and Environmental Challenges Faced by Children on Antiretroviral Therapy in Zimbabwe: a Mixed Method Study

    Directory of Open Access Journals (Sweden)

    Margaret Macherera, MSc

    2012-11-01

    Full Text Available Objectives:Despite the advent of antiretroviral therapy (ART, many children, particularly in the rural communities of Zimbabwe, remain vulnerable. The purpose of this study was to determine the factors and challenges facing children on antiretroviral therapy (ART in Brunapeg area of Mangwe District, Zimbabwe.Methods:A mixed-method approach involving interviewer-guided focus group discussions and piloted semi-structured questionnaires was utilized to collect data from different key population groups. The data obtained were analyzed through content coding procedures based on a set of predetermined themes of interest.Results:A number of challenges emerged as barriers to the success of antiretroviral therapy for children. Primary care givers were less informed about HIV and AIDS issues for people having direct impact on the success of antiretroviral therapy in children whilst some were found to be taking the antiretroviral drugs meant for the children. It also emerged that some primary care givers were either too young or too old to care for the children while others had failed to disclose to the children why they frequently visited the Opportunistic Infections (OI clinic. Most primary care givers were not the biological parents of the affected children. Other challenges included inadequate access to health services, inadequate food and nutrition and lack of access to clean water, good hygiene and sanitation. The lack of community support and stigma and discrimination affected their school attendance and hospital visits. All these factors contributed to non-adherence to antiretroviral drugs.Conclusions and Public Health Implications:Children on ART in rural communities in Zimbabwe remain severely compromised and have unique problems that need multi-intervention strategies both at policy and programmatic levels. Effective mitigating measures must be fully established and implemented in rural communities of developing countries in the fight for

  6. Uncertainty in the family business facing the process of internationalization: Literature review and future research agenda

    Directory of Open Access Journals (Sweden)

    Quico Marin

    2014-12-01

    Full Text Available Purpose: This article analyses the Family Business (FB within the process of globalization that has been taking place in recent decades.Design / methodology / approach: To achieve this we undertake a description of the importance of FB in the global economy and contrast this with a systematic review of the academic literature, which demonstrates the growing academic interest in the internationalization of the FB.Findings: The literature review highlights the importance of agency and stewardship theories when analyzing the aspects that affect the process of internationalization. These theoretical frameworks require a variety of assumptions and explain how ownership and control of an FB may explain different attitudes towards some short term risks, which could be due to FB politics of internationalization.Research limitations / implications: Finally, we mark out future research lines which will focus on the effect the ownership structure has on the type of internationalization that is undertaken by the FB.Originality / value: This article outlines new lines of literature review in the FB internationalization field, suggesting to the future authors the outstanding journals and topics in this research field.

  7. Challenges faced by NRCs

    International Nuclear Information System (INIS)

    Longoria, L.C.

    2001-01-01

    The Mexican Nuclear Research Institute (ININ) played an important role in setting up of nuclear power plants (two) and development of fuel technology. However, with no current plans for expansion of this programme, the Institute is looking mainly into multi-cycle fuel management and life extension issues. The Institute focuses on programmes related to radioisotope and radiation applications and on the use of nuclear technologies for non-nuclear applications. The ININ is the major provider of radioisotopes for medical uses. It also promotes and uses nuclear analytical techniques for addressing a variety of problems. In non-nuclear areas some R and D examples include: the use of thermal plasma for hazardous waste incineration, biodegradation of polymers and development of separation techniques for treating industrial effluents. For preservation of knowledge, the Institute has instituted PhD. programmes in materials science, medical physics and nuclear science in collaboration with a university. (author)

  8. A method comparison of photovoice and content analysis: research examining challenges and supports of family caregivers.

    Science.gov (United States)

    Faucher, Mary Ann; Garner, Shelby L

    2015-11-01

    The purpose of this manuscript is to compare methods and thematic representations of the challenges and supports of family caregivers identified with photovoice methodology contrasted with content analysis, a more traditional qualitative approach. Results from a photovoice study utilizing a participatory action research framework was compared to an analysis of the audio-transcripts from that study utilizing content analysis methodology. Major similarities between the results are identified with some notable differences. Content analysis provides a more in-depth and abstract elucidation of the nature of the challenges and supports of the family caregiver. The comparison provides evidence to support the trustworthiness of photovoice methodology with limitations identified. The enhanced elaboration of theme and categories with content analysis may have some advantages relevant to the utilization of this knowledge by health care professionals. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries.

    Science.gov (United States)

    Kaur, Rajanbir; Kaur, Kanwaljit; Kaur, Rajinder

    2018-01-01

    Menstruation and menstrual practices still face many social, cultural, and religious restrictions which are a big barrier in the path of menstrual hygiene management. In many parts of the country especially in rural areas girls are not prepared and aware about menstruation so they face many difficulties and challenges at home, schools, and work places. While reviewing literature, we found that little, inaccurate, or incomplete knowledge about menstruation is a great hindrance in the path of personal and menstrual hygiene management. Girls and women have very less or no knowledge about reproductive tract infections caused due to ignorance of personal hygiene during menstruation time. In rural areas, women do not have access to sanitary products or they know very little about the types and method of using them or are unable to afford such products due to high cost. So, they mostly rely on reusable cloth pads which they wash and use again. Needs and requirements of the adolescent girls and women are ignored despite the fact that there are major developments in the area of water and sanitation. Women manage menstruation differently when they are at home or outside; at homes, they dispose of menstrual products in domestic wastes and in public toilets and they flush them in the toilets without knowing the consequences of choking. So, there should be a need to educate and make them aware about the environmental pollution and health hazards associated with them. Implementation of modern techniques like incineration can help to reduce the waste. Also, awareness should be created to emphasize the use of reusable sanitary products or the natural sanitary products made from materials like banana fibre, bamboo fibre, sea sponges, water hyacinth, and so on.

  10. Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries

    Directory of Open Access Journals (Sweden)

    Rajanbir Kaur

    2018-01-01

    Full Text Available Menstruation and menstrual practices still face many social, cultural, and religious restrictions which are a big barrier in the path of menstrual hygiene management. In many parts of the country especially in rural areas girls are not prepared and aware about menstruation so they face many difficulties and challenges at home, schools, and work places. While reviewing literature, we found that little, inaccurate, or incomplete knowledge about menstruation is a great hindrance in the path of personal and menstrual hygiene management. Girls and women have very less or no knowledge about reproductive tract infections caused due to ignorance of personal hygiene during menstruation time. In rural areas, women do not have access to sanitary products or they know very little about the types and method of using them or are unable to afford such products due to high cost. So, they mostly rely on reusable cloth pads which they wash and use again. Needs and requirements of the adolescent girls and women are ignored despite the fact that there are major developments in the area of water and sanitation. Women manage menstruation differently when they are at home or outside; at homes, they dispose of menstrual products in domestic wastes and in public toilets and they flush them in the toilets without knowing the consequences of choking. So, there should be a need to educate and make them aware about the environmental pollution and health hazards associated with them. Implementation of modern techniques like incineration can help to reduce the waste. Also, awareness should be created to emphasize the use of reusable sanitary products or the natural sanitary products made from materials like banana fibre, bamboo fibre, sea sponges, water hyacinth, and so on.

  11. Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009-2013).

    Science.gov (United States)

    de Lesquen, Henri; Beranger, Fabien; Berbis, Julie; Boddaert, Guillaume; Poichotte, Antoine; Pons, Francois; Avaro, Jean-Philippe

    2016-09-01

    This study reports the challenges faced by French military surgeons in the management of thoracic injury during the latest Afghanistan war. From January 2009 to April 2013, all of the civilian, French and Coalition casualties admitted to French NATO Combat Support Hospital situated on Kabul were prospectively recorded in the French Military Health Service Registry (OPEX(®)). Only penetrating and blunt thoracic trauma patients were retrospectively included. Eighty-nine casualties were included who were mainly civilian (61%) and men (94%) with a mean age of 27.9 years old. Surgeons dealt with polytraumas (78%), severe injuries (mean Injury Severity Score=39.2) and penetrating wounds (96%) due to explosion in 37%, gunshot in 53% and stabbing in 9%. Most of casualties were first observed or drained (n=56). In this non-operative group more than 40% of casualties needed further actions. In the operative group, Damage Control Thoracotomy (n=22) was performed to stop ongoing bleeding and air leakage and Emergency Department Thoracotomy (n=11) for agonal patient. Casualties suffered from hemothorax (60%), pneumothorax (39%), diaphragmatic (37%), lung (35%), heart or great vessels (20%) injuries. The main actions were diaphragmatic sutures (n=25), lung resections (wedge n=6, lobectomy n=4) and haemostasis (intercostal artery ligation n=3, heart injury repairs n=5, great vessels injury repairs n=5). Overall mortality was 11%. The rate of subsequent surgery was 34%. The analysis of the OPEX(®) registry reflects the thoracic surgical challenges of general (visceral) surgeons serving in combat environment during the latest Afghanistan War. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention.

    Science.gov (United States)

    Jortberg, Bonnie T; Rosen, Raquel; Roth, Sarah; Casias, Luke; Dickinson, L Miriam; Coombs, Letoynia; Awadallah, Nida S; Bernardy, Meaghann K; Dickinson, W Perry

    2016-01-01

    Childhood obesity has increased dramatically over several decades, and the American Academy of Pediatrics has recommended primary care practices as ideal sites for the identification, education, and implementation of therapeutic interventions. The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care-based childhood obesity intervention. A single-intervention pilot project that trains primary care practices on childhood obesity guidelines and implementation of a family-focused behavior modification curriculum. A total of 29 family medicine and pediatric community practices in Colorado participated. Participants included 290 patients, aged 6 to 12 years, with a body mass index (BMI) above the 85th percentile. The main outcome measure included the feasibility of implementation of a childhood obesity program in primary care; secondary outcomes were changes in BMI percentile, BMI z-scores, blood pressure, and changes in lifestyle factors related to childhood obesity. Implementation of FFC is feasible, statically significant changes were seen for decreases in BMI percentile and BMI z-scores for participants who completed 9 to 15 months of follow-up; lifestyle factors related to childhood obesity in proved Spanish-speaking families and food insecurity were associated with less follow-up time (P childhood obesity intervention may result in significant clinical and lifestyle changes. © Copyright 2016 by the American Board of Family Medicine.

  13. Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.

    Science.gov (United States)

    Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita

    2015-09-01

    The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia.

  14. The Family Challenge of Caring for the Chronically Mentally Ill: A Phenomenological Study.

    Science.gov (United States)

    Shamsaei, Farshid; Cheraghi, Fatemeh; Esmaeilli, Ravanbakhsh

    2015-09-01

    Family caregiving for patients with chronic mental illness is influenced by various factors such as political, socioeconomic, and cultural contexts as well as related policies and health services. The purpose of this study was to explore the challenges with which the family caregivers of patients with chronic mental illness have to contend. The research design was qualitative with a phenomenological approach. The research population consisted of 16 long-term carers expressing interest in participating in the project. The carers were the family members of mentally ill relatives who collected their monthly medications at Farshchian Psychiatry Hospital in Hamadan in 2012. Purposive sampling was used to draw the sample. Data were collected by individual in-depth semi-structured interviews, which were tape-recorded and analyzed via Colaizzi's phenomenological method. Rigor was assessed regarding credibility, dependability, conformability, and transferability. Our findings highlighted 4 main themes, namely stress and emotional distress, need for education and information, socioeconomic effects and support, and physical strain. Families experience frustrations when providing support and care to their mentally ill relatives. They, therefore, need appropriate support and intervention by mental health services.

  15. C-A1-04: Challenges Faced as New Members of the HMO Research Network Virtual Data Warehouse

    Science.gov (United States)

    Godwin, Debbie; Mahajan, Bhushan; Silcott, Monica; Kjar, Dean

    2011-01-01

    Background/Aims This presentation will focus on challenges faced by new HMO Research Network (HMORN) sites and their experiences with the Virtual Data Warehouse (VDW) tables for version 3 specifications. The step-by-step procedure developed by Scott and White will be showcased to provide a head start for new incoming sites. Sharing lessons learned during our one year in the HMORN VDW, our objective is to provide best practices regarding resources, time allocation, priorities, schedules, financing, backups, and possible available alternatives. Methods The comprehensive procedure followed by Scott & White to build VDW V3 tables: Setting up your SAS Environment Establishing an architecture and components Analyzing and forecasting server specifications; Identifying and understanding the multiple data sorces embedded in your organization Claims data EMR Lab Pharmacy Other; Detailed variable mapping of sources to VDW specifications; Assessment of source data availability; Getting your site’s first feed from the source and following through with quality checks; Methods for building transformation logic for the table; Choosing the methodology to approach table-building. Results We will showcase Scott & White metrics for building a VDW starting with version 3 and best practices used. We improved the validity and completeness of the data through person-to-person interactions with claims personnel who often were disinterested in the needs of research. Having strong advocates who think of research as a part of the institutional mission was helpful. The VDW data team included a sole programmer for the first 6 months along with the Site Data Manager; adding a second programmer improved the rate of progress. Conclusions A structured, step-by-step, approach is recommended for new incoming sites joining the HMORN. This approach will optimize efficiency and effectiveness. The more information and guidance the existing members can provide, the better the achieved results will be

  16. Benign Tumors of the Pancreas-Radical Surgery Versus Parenchyma-Sparing Local Resection-the Challenge Facing Surgeons.

    Science.gov (United States)

    Beger, Hans G

    2018-03-01

    Pancreaticoduodenectomy and left-sided pancreatectomy are the surgical treatment standards for tumors of the pancreas. Surgeons, who are requested to treat patients with benign tumors, using standard oncological resections, face the challenge of sacrificing pancreatic and extra-pancreatic tissue. Tumor enucleation, pancreatic middle segment resection and local, duodenum-preserving pancreatic head resections are surgical procedures increasingly used as alternative treatment modalities compared to classical pancreatic resections. Use of local resection procedures for cystic neoplasms and neuro-endocrine tumors of the pancreas (panNETs) is associated with an improvement of procedure-related morbidity, when compared to classical Whipple OP (PD) and left-sided pancreatectomy (LP). The procedure-related advantages are a 90-day mortality below 1% and a low level of POPF B+C rates. Most importantly, the long-term benefits of the use of local surgical procedures are the preservation of the endocrine and exocrine pancreatic functions. PD performed for benign tumors on preoperative normo-glycemic patients is followed by the postoperative development of new onset of diabetes mellitus (NODM) in 4 to 24% of patients, measured by fasting blood glucose and/or oral/intravenous glucose tolerance test, according to the criteria of the international consensus guidelines. Persistence of new diabetes mellitus during the long-term follow-up after PD for benign tumors is observed in 14.5% of cases and after surgery for malignant tumors in 15.5%. Pancreatic exocrine insufficiency after PD is found in the long-term follow-up for benign tumors in 25% and for malignant tumors in 49%. Following LP, 14-31% of patients experience postoperatively NODM; many of the patients subsequently change to insulin-dependent diabetes mellitus (IDDM). The decision-making for cystic neoplasms and panNETs of the pancreas should be guided by the low surgical risk and the preservation of pancreatic metabolic

  17. Meeting Cathala-Letort named: the challenges of the processes engineering facing the hydrogen-energy; Journee Cathala-Letort intitulee: les defis du genie des procedes face a l'hydrogene-energie

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This document provides the presentations proposed during the day Cathala-Letort on the challenges of the processes engineering facing the hydrogen-energy. In the context of the greenhouse effect increase and the fossil energies resources decrease, it brings information on researches on hydrogen technologies, carbon dioxide sequestration, hydrogen supply, production, storage and distribution and the thermo-chemical cycles. (A.L.B.)

  18. Reflecting on impact, changes and continuities: restructuring workplace cultures: the ultimate work-family challenge.

    OpenAIRE

    Lewis, Suzan

    2010-01-01

    Purpose – The purpose of this paper is to reflect on the paper “Restructuring workplace cultures: the ultimate work-family challenge?” is published in Women in Management Review, Vol. 16 No. 1, 2001, pp. 21-9. \\ud \\ud Design/methodology/approach – The impact of the paper is considered within a framework that takes account of national discursive and political contexts in the UK in 2001 and in the present and uses a gendered organisation lens. \\ud \\ud Findings – The 2001 paper demonstrates that...

  19. Maternal Disrupted Communication During Face-to-Face Interaction at 4 months: Relation to Maternal and Infant Cortisol Among at-Risk Families.

    Science.gov (United States)

    Crockett, Erin E; Holmes, Bjarne M; Granger, Douglas A; Lyons-Ruth, Karlen

    2013-11-01

    The study evaluated the association between maternal disrupted communication and the reactivity and regulation of the psychobiology of the stress response in infancy. Mothers and infants were recruited via the National Health Service from the 20% most economically impoverished data zones in a suburban region of Scotland. Mothers ( N = 63; M age = 25.9) and their 4-month-old infants (35 boys, 28 girls) were videotaped interacting for 8 min, including a still-face procedure as a stress inducer and a 5-min coded recovery period. Saliva samples were collected from the dyads prior to, during, and after the still-face procedure and later assayed for cortisol. Level of disruption in maternal communication with the infant was coded from the 5-min videotaped interaction during the recovery period which followed the still-face procedure. Severely disrupted maternal communication was associated with lower levels of maternal cortisol and a greater divergence between mothers' and infants' cortisol levels. Results point to low maternal cortisol as a possible mechanism contributing to the mother's difficulty in sensitively attuning to her infant's cues, which in turn has implications for the infant's reactivity to and recovery from a mild stressor in early infancy.

  20. Growing families in a shrinking world: legal and ethical challenges in cross-border surrogacy.

    Science.gov (United States)

    Crockin, Susan L

    2013-12-01

    Crossing national borders to have children is a rapidly growing phenomenon, fuelled by restrictions on access and technologies in some countries and for some patients, by high costs in others, and all generating a burgeoning multibillion dollar international industry. Cross-border gestational surrogacy is one form of family building that challenges legal, policy and ethical norms between countries and puts both intended parents and gestational surrogates at risk, and can leave the offspring of these arrangements vulnerable in a variety of ways, including parent-child, immigration and citizenship status. The widely varying political, religious and legal views amongst countries make line drawing and rule making challenging. This article reviews recent court decisions about and explores the legal dimensions of cross-border surrogacy. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Women in the Teaching Profession: Impacts and Challenges

    OpenAIRE

    A. M. Sultana; Norhirdawati. M. Zahir; Norzalan. H. Yaacob

    2014-01-01

    Recently in Malaysia, women's participation in teaching profession has increased. The increasing trend of women’s participation in the teaching profession poses challenges in families, especially in the developing countries like Malaysia. One of these challenges, concerns in balancing their role between family and job responsibility that faced by many women teachers. The purpose of this study is to discover how women teachers' impact on family happiness and the challenges faced by them in bal...

  2. Nonverbal Learning Disabilities : What kind of communication challenges do parents face when communicating with their children with Nonverbal Learning Disabilities, and what kind of strategies the parents use to overcome the challenges?

    OpenAIRE

    Ramos, Alexandra Jacinta

    2011-01-01

    This is a qualitative study that explores and tries to understand what kind of communicational challenges do parents face when communicating with their children with Nonverbal Learning Disabilities, and to comprehend what kind of strategies these parents use to overcome these challenges. The designation of the Nonverbal Learning Disabilities (NLD) was formerly proposed by Johnson and Myklebust. NLD were firstly described by Myklebust as an inability to read and understand nonverbal aspect...

  3. Family members facilitating community re-integration and return to productivity following traumatic brain injury - motivations, roles and challenges.

    Science.gov (United States)

    Gagnon, Alicia; Lin, Jenny; Stergiou-Kita, Mary

    2016-01-01

    This study explores the experiences of family members in supporting community re-integration and return to productive occupations of the traumatic brain injury (TBI) survivor in order to: (i) describe family members' supportive roles, (ii) determine challenges family members experience in supporting the TBI survivor; and (iii) identify supports that family members require to maintain and enhance their roles. This qualitative descriptive study involved 14 interviews with immediate family members of TBI survivors. Data was analyzed using thematic analysis. Family members expressed strong motivation and engaged in six key roles to support TBI survivors: researcher, case manager, advocate, coach, activities of daily living (ADL)/instrumental ADLs and emotional supporter. Personal and family stressors and challenges navigating the health care system were perceived as challenges in meeting demands of their supportive roles. Stigma also presented a barrier to successful community and vocational re-integration. Subsequently, family members desired more education related to the functional implications of TBI, to be connected to health care and community resources, and sought a greater family-centred care approach. Family members require on-going counseling and community supports to prevent burnout and allow for their continued engagement in their supportive roles. Further education on how to navigate the health care system, access community programs and rights to workplace accommodation is also warranted. Family members are strongly motivated to support survivors' return to productive occupation following a traumatic brain injury, but require counseling and community support to enable their on-going engagement and prevent burnout. Family members can be further empowered through the implementation of family-centred care. Family members requested further education on the long-term functional implications of TBI, how to navigate the health care system, how to access community

  4. About Face

    Medline Plus

    Full Text Available ... at first. But if it's been months or years since the trauma and you're not feeling better, you may have PTSD (posttraumatic stress disorder). Watch the intro This is AboutFace In these videos, Veterans, family members, ...

  5. There Are No Children Here: The Case of an Inner-City School Addressing Issues Facing Children and Families Living in Poverty

    Science.gov (United States)

    Sallee, Mariel; Boske, Christa

    2013-01-01

    This case is based on real-life experiences of community school members within Horner School--an inner-city public school. Specifically, the case explores challenges faced by Cathleen, a 1st-year, White, female principal, who was hired by central office to "revamp a charter school" to promote a quality education for all children. The case raises…

  6. Northern Eurasia Future Initiative (NEFI): facing the challenges and pathways of global change in the twenty-first century

    Science.gov (United States)

    Groisman, Pavel; Shugart, Herman; Kicklighter, David; Henebry, Geoffrey; Tchebakova, Nadezhda; Maksyutov, Shamil; Monier, Erwan; Gutman, Garik; Gulev, Sergey; Qi, Jiaguo; Prishchepov, Alexander; Kukavskaya, Elena; Porfiriev, Boris; Shiklomanov, Alexander; Loboda, Tatiana; Shiklomanov, Nikolay; Nghiem, Son; Bergen, Kathleen; Albrechtová, Jana; Chen, Jiquan; Shahgedanova, Maria; Shvidenko, Anatoly; Speranskaya, Nina; Soja, Amber; de Beurs, Kirsten; Bulygina, Olga; McCarty, Jessica; Zhuang, Qianlai; Zolina, Olga

    2017-12-01

    During the past several decades, the Earth system has changed significantly, especially across Northern Eurasia. Changes in the socio-economic conditions of the larger countries in the region have also resulted in a variety of regional environmental changes that can have global consequences. The Northern Eurasia Future Initiative (NEFI) has been designed as an essential continuation of the Northern Eurasia Earth Science Partnership Initiative (NEESPI), which was launched in 2004. NEESPI sought to elucidate all aspects of ongoing environmental change, to inform societies and, thus, to better prepare societies for future developments. A key principle of NEFI is that these developments must now be secured through science-based strategies co-designed with regional decision-makers to lead their societies to prosperity in the face of environmental and institutional challenges. NEESPI scientific research, data, and models have created a solid knowledge base to support the NEFI program. This paper presents the NEFI research vision consensus based on that knowledge. It provides the reader with samples of recent accomplishments in regional studies and formulates new NEFI science questions. To address these questions, nine research foci are identified and their selections are briefly justified. These foci include warming of the Arctic; changing frequency, pattern, and intensity of extreme and inclement environmental conditions; retreat of the cryosphere; changes in terrestrial water cycles; changes in the biosphere; pressures on land use; changes in infrastructure; societal actions in response to environmental change; and quantification of Northern Eurasia's role in the global Earth system. Powerful feedbacks between the Earth and human systems in Northern Eurasia (e.g., mega-fires, droughts, depletion of the cryosphere essential for water supply, retreat of sea ice) result from past and current human activities (e.g., large-scale water withdrawals, land use, and governance

  7. The Challenges, Emotions, Coping, and Gains of Family Caregivers Caring for Patients With Advanced Cancer in Singapore: A Qualitative Study.

    Science.gov (United States)

    Leow, Mabel Q H; Chan, Sally W C

    Caring for a family member with advanced cancer at home is demanding as the ill family member is likely to have complex physical and emotional needs. There is a paucity of studies on the experience of home family caregivers of people with advanced cancer in the Asian region. The aim of this study was to describe the experiences of family caregivers caring for a person with advanced cancer at home in Singapore. This was a qualitative study; data were collected by semistructured interviews and analyzed using content analysis. A purposive sample of 19 family caregivers who were taking care of a family member with advanced cancer were recruited from home hospice care services in Singapore. Most of the caregivers were female (n = 14), ranging in age from 21 to 64 years (mean, 46.4 [SD, 10.5] years). Four themes were generated from the data: (1) caregiving challenges, (2) negative emotions, (3) ways of coping, and (4) positive gains of caregiving. This study generated insights into the challenges, emotions, and coping of Asian family caregivers caring for patients with advanced cancer. Such understanding could help in developing appropriate intervention for caregivers to reduce their burden and stress. Caregivers require knowledge on resolving family conflicts and about communicating and enhancing closeness with the ill family member. Support from healthcare professionals is essential even if caregivers have support from family members and friends; nurses can make conscious efforts to show concern for caregivers as well as for patients.

  8. Implicações sociais enfrentadas pelas famílias que possuem pacientes com sarcoma ósseo Social implications faced by bone sarcoma patients' families

    Directory of Open Access Journals (Sweden)

    Virginia Pinheiro Stolagli

    2008-01-01

    -qualitative approach. Among the respondents, 68% were females including 44% of mothers; 76% worked, and 28% of these had formal jobs. 60% had a family income amounting 2-5 minimum wages. After diagnosis, 92% faced increased expenses; 80% reported challenges with the chemotherapy; 56% mention transportation as the major factor affecting compliance to treatment. 100% feel desperate when they first know they have cancer. Cancer causes changes in family members' roles. There is always the fear of recurrence, which ultimately lead the family to fear death, thus requiring a joint effort with a multidisciplinary team.

  9. The contribution of youth work to address the challenges young people are facing, in particular the transition from education to employment

    DEFF Research Database (Denmark)

    Louw, Arnt Vestergaard

    The findings of the expert group detail the role of youth work and its specific contribution to addressing the challenges young people face, in particular the transition from education to employment. In this context, youth work is defined as 'actions directed towards young people regarding activi...... activities where they take part voluntarily, designed for supporting their personal and social development through non-formal and informal learning'....

  10. A major challenge. Entrepreneurship characterizes the work of the Soviet Family Health Association.

    Science.gov (United States)

    Manuilova, I A

    1991-09-01

    The work of the Soviet Family Health Association (SFHA) is described. Created in January, 1989, the organization boasts 25 state-paid workers, and as of June 1991, membership of 15,000 corporate and individual members. Individual annual membership fee is 5 rubles, and entitles members to counseling and family planning (FP) services. The SFHA works in cooperation with the Commission on Family Planning Problems of the USSR's Academy of Sciences, and has been a member of the International Planned Parenthood Federation (IPPF) since 1990. Association activities include lectures for students, newly-weds, adolescents, and working women on modern contraceptive methods; research on attitude regarding sex, sex behaviors, and the perceived need for effective contraception; clinical trials of contraceptive suitability for women; and the training of doctors in FP and contraceptives. Problems central to the SFHA's operations include insufficient service and examination equipment, a shortage of hard currency, and the small number of FP specialists in the country. Solutions to these obstacles are sought through collaboration with the government, non-governmental organizations in the Soviet Union, and international groups. The SFHA has a series of activities planned for 1991 designed to foster wider acceptance of FP. Increased FP services at industrial enterprises, establishing more FP centers throughout the Soviet Union, and studying FP programs in other countries are among Association targets for the year. Research on and promotion of contraceptives has been virtually stagnant since abortion was declared illegal in 1936. Catching up on these lost decades and remaining self-reliant are challenges to the SPHA.

  11. Understanding Family Caregiver Communication to Provide Family-Centered Cancer Care.

    Science.gov (United States)

    Wittenberg, Elaine; Buller, Haley; Ferrell, Betty; Koczywas, Marianna; Borneman, Tami

    2017-12-01

    To describe a family caregiver communication typology and demonstrate identifiable communication challenges among four caregiver types: Manager, Carrier, Partner, and Lone. Case studies based on interviews with oncology family caregivers. Each caregiver type demonstrates unique communication challenges that can be identified. Recognition of a specific caregiver type will help nurses to adapt their own communication to provide tailored support. Family-centered cancer care requires attention to the communication challenges faced by family caregivers. Understanding the challenges among four family caregiver communication types will enable nurses to better address caregiver burden and family conflict. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. European cinema: face to face with Hollywood

    NARCIS (Netherlands)

    Elsaesser, T.

    2005-01-01

    In the face of renewed competition from Hollywood since the early 1980s and the challenges posed to Europe's national cinemas by the fall of the Wall in 1989, independent filmmaking in Europe has begun to re-invent itself. European Cinema: Face to Face with Hollywood re-assesses the different

  13. Differences in neural and cognitive response to emotional faces in middle-aged dizygotic twins at familial risk of depression

    DEFF Research Database (Denmark)

    Miskowiak, K W; Svendsen, A M B; Harmer, C J

    2017-01-01

    -twin history of depression (high-risk) and 20 were without co-twin history of depression (low-risk). During fMRI, participants viewed fearful and happy faces while performing a gender discrimination task. After the scan, they were given a faces dot-probe task, a facial expression recognition task......BACKGROUND: Negative bias and aberrant neural processing of emotional faces are trait-marks of depression but findings in healthy high-risk groups are conflicting. METHODS: Healthy middle-aged dizygotic twins (N = 42) underwent functional magnetic resonance imaging (fMRI): 22 twins had a co...... the amygdala and ventral prefrontal cortex and pregenual anterior cingulate. This was accompanied by greater fear-specific fronto-temporal response and reduced fronto-occipital response to all emotional faces relative to baseline. The risk groups showed no differences in mood, subjective state or coping...

  14. Responding with Care to Students Facing Trauma

    Science.gov (United States)

    Souers, Kristin

    2018-01-01

    Exposure to trauma--which many experts view as include ongoing life stressors like poverty, parents divorcing, death of a family member, or drug abuse in the home--is prevalent among school-aged children. Teachers know that facing trauma impedes students' ability to focus and learn, but it can be challenging to keep responding caringly to a…

  15. ESCALA DE EVALUACIÓN DEL FUNCIONAMIENTO FAMILIAR FACES III: ¿MODELO DE DOS O TRES FACTORES? ( Family Functioning Evaluation Scale FACES III: Model of two or three factors?

    Directory of Open Access Journals (Sweden)

    Ana Laura Maglio

    2010-04-01

    Full Text Available The Family Adaptability and Cohesion Evaluation Scale (FACES III by Olson, Portner and Lavee was developed to assess two of Circumplex Model of Marital and Family Systems dimensions: the family cohesion and flexibility. The aim of this research is to contribute to determine the family functioning dimensions assessed by this instrument and to provide information about the structural validity of the scale for its application in Argentina population. Seven hundred and eighty-five parents (M = 41; SD = 5.8 and six-hundred adolescents (M = 16.3, SD = 1.7 from the City of Buenos Aires and Gran Buenos Aires participated in this study. The results showed that a two factor structure is not completely accurate while a three factor model –Cohesion, Flexibility 1 and Flexibility 2- fits data well. According to these results, the dimension Flexibility is probably composed of, at least, two interconnected constructs. Results from the present research are discussed considering previous evidence obtained in other countries with different versions of the scale.

  16. Challenges that face cultural tourism development in conflict and post-conflict regions: the case of Kurdistan

    OpenAIRE

    Braim, Kadhim Magdid; McCabe, Scott; Rickly, Jillian; Gadi, Mohamed

    2016-01-01

    Tourism has multiple economic benefits for host countries that receive tourists. Policy makers are becoming more and more aware of the importance that appropriate tourism management has to maximise the benefits that tourism flows can bring. However, many developing countries suffer from a lack of an integrated tourism policy. Particular issues are faced in those countries that are dealing with local conflicts (sometimes over many years). These countries often lack investment in tourism resour...

  17. Principals, Parents and Pregnancy: A Case Study of School Leadership Practices Designed to Engage Families Facing Pregnancy

    Science.gov (United States)

    Fowler, Carla Deirdre

    2016-01-01

    This qualitative case study focused on contemporary school leadership and parental interrelationships, exploring the relationship, if any, between school leaders and the families of pregnant and parenting urban African American teen mothers in a northeastern city. The social, emotional, academic, and medical perspectives of ways families can…

  18. Face to Face The Challenge Of Thor

    Indian Academy of Sciences (India)

    IAS Admin

    knowledge the potential of thorium as a fuel source for the future. Notable .... especially one oft criticized for its lack of transparency and accountability? Some of the ... secondary school education was all in Hindi and in college it was English.

  19. Reconnecting Youth from Migrant Farmworker Families.

    Science.gov (United States)

    Cranston-Gingras, Ann

    2003-01-01

    This article summarizes the educational challenges facing students from migrant farmworker families. A university-based dropout recovery program has been successful at helping their students leave behind the label of "dropout." (Contains 10 references.) (Author)

  20. Challenges faced by caregivers of children on antiretroviral therapy at Mutale Municipality selected healthcare facilities, Vhembe District, Limpopo Province

    Directory of Open Access Journals (Sweden)

    Rhudzani V. Mafune

    2017-08-01

    Conclusion: The conclusions drawn from this research are that caregivers hardly receive any support from family members or the community. Fear of disclosing the HIV-positive status of children resulted in the delay of financial support from the government, thus leading to serious financial burden on the caregivers.

  1. Healthy Teens: Facing the Challenges of Young Lives. A Practical Guide for Parents, Caregivers, Educators, and Health Professionals. Third Edition.

    Science.gov (United States)

    McCarthy, Alice R.

    This monograph is a guide to teen development and the world of 11-18 year olds in contemporary America. It provides practical suggestions to parents and other concerned adults as they guide children through adolescence. The 12 chapters are: (1) "Healthy Bodies, Healthy Minds"; (2) "Teens, Families, and Schools"; (3) "Teens…

  2. The Human Face of Digital Preservation: Organizational and Staff Challenges, and Initiatives at the Bibliothèque nationale de France

    Directory of Open Access Journals (Sweden)

    Emmanuelle Bermès

    2011-03-01

    Full Text Available The process of setting up a digital preservation repository in compliance with the OAIS model is not only a technical challenge: libraries also need to develop and maintain appropriate skills and organizations. Digital activities, including digital preservation, are nowadays moving into the mainstream activity of the Library and are integrated in its workflows.The Bibliothèque nationale de France (BnF has been working on the definition of digital preservation activities since 2003. This paper aims at presenting the organizational and human resources challenges that have been faced by the library in this context, and those that are still awaiting us.The library has been facing these challenges through a variety of actions at different levels: organizational changes, training sessions, dedicated working group and task forces, analysis of skills and processes, etc. The results of these actions provide insights on how a national library is going digital, and what is needed to reach this longstanding goal.

  3. The Role of the Adult with Disabilities’ Family in the Labor Inclusion Processes: A Challenge for Special Education in Costa Rica

    Directory of Open Access Journals (Sweden)

    Ana Magaly Madrigal-Lizano

    2015-05-01

    Full Text Available The following essay presents the author’s thoughts regarding positive and negative family impacts of the process of including the adult with disabilities. It also discusses the significance and challenges faced by those teachers and schools in charge of special education based on the responsibility of establishing the most mechanisms possible to provide, along with their families, a free environment when it comes to decision making for the population with disabilities in regards to their job future and the special skills needed to provide a free independent lifestyle.  The essay focuses on a social model in an inclusive paradigm based on a human rights perspective. In accordance with Vargas (2012, it suggests a social model that highlights social barriers and their environment with a holistic view, which does not exclude individual intervention but emphasizes the inclusion of this population in a world which has been designed by and for people that do not experience any disability.  When shifting from the medical model to the social one, responsibility is also transferred to the social and political aspects, hence making the family a relevant pillar to be considered in different training and information environments in support of the adult with disabilities who needs and deserves the opportunity of having a job as a way to be autonomous and independent.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. STEM Is Elementary: Challenges Faced by Elementary Teachers in the Era of the Next Generation Science Standards

    Science.gov (United States)

    Isabelle, Aaron D.

    2017-01-01

    For students to achieve the goals of the Next Generation Science Standards (NGSS) by Grade 12, thinking and acting like scientists and engineers must begin in the elementary grades. However, elementary teachers may find this challenging -because language arts and mathematics still dominate many classrooms--often at the expense of science. This…

  6. Facing the Challenge--Developing an Instructional Plan for Portuguese as Foreign Language in Brazil Based on Multiliteracy

    Science.gov (United States)

    Schlindwein, Ana Flora

    2013-01-01

    Adopting the multiliteracy concept and embracing the challenge of developing meaningful and captivating classes for Portuguese as Foreign Language in Brazil, this paper proposes an approach which includes the use of different technologies to learn and teach Portuguese, the reading of graphic novel adaptations of Brazilian literature classics and…

  7. An Insight into the Challenges Faced by Academic Women with Pre-School Age Children in Academic Life

    Science.gov (United States)

    Günçavdi, Gizem; Göktürk, Söheyda; Bozoglu, Oguzhan

    2017-01-01

    This study aimed to explore the challenges academic women, especially those who were mothers of pre-school age children, went through. The main guiding question of this study was "How do academic mothers with pre-school age children survive in the academia from pregnancy through all the various stages of parenting and motherhood?". This…

  8. High-risk medical devices, children and the FDA: regulatory challenges facing pediatric mechanical circulatory support devices.

    Science.gov (United States)

    Almond, Christopher S D; Chen, Eric A; Berman, Michael R; Less, Joanne R; Baldwin, J Timothy; Linde-Feucht, Sarah R; Hoke, Tracey R; Pearson, Gail D; Jenkins, Kathy; Duncan, Brian W; Zuckerman, Bram D

    2007-01-01

    Pediatric mechanical circulatory support is a critical unmet need in the United States. Infant- and child-sized ventricular assist devices are currently being developed largely through federal contracts and grants through the National Heart, Lung, and Blood Institute (NHLBI). Human testing and marketing of high-risk devices for children raises epidemiologic and regulatory issues that will need to be addressed. Leaders from the US Food and Drug Administration (FDA), NHLBI, academic pediatric community, and industry convened in January 2006 for the first FDA Workshop on the Regulatory Process for Pediatric Mechanical Circulatory Support Devices. The purpose was to provide the pediatric community with an overview of the federal regulatory process for high-risk medical devices and to review the challenges specific to the development and regulation of pediatric mechanical circulatory support devices. Pediatric mechanical circulatory support present significant epidemiologic, logistic, and financial challenges to industry, federal regulators, and the pediatric community. Early interactions with the FDA, shared appreciation of challenges, and careful planning will be critical to avoid unnecessary delays in making potentially life-saving devices available for children. Collaborative efforts to address these challenges are warranted.

  9. Emotion talk in the context of young people self?harming: facing the feelings in family therapy

    OpenAIRE

    Rogers, Alice; Schmidt, Petra

    2016-01-01

    This article describes the use of emotion talk in the context of using a manualised approach to family therapy where the presenting problem is self?harm. Whilst we understand that there is an internal aspect to emotion, we also consider emotions to be socially purposeful, culturally constructed and interactional. We found that within the presenting families, negative emotions were often talked about as located within the young person. Through using ?emotion talk? (Fredman, 2004) in deconstruc...

  10. Screening and identification of putative allergens in berry fruits of the Rosaceae family: technical challenges.

    Science.gov (United States)

    Marzban, Gorji; Maghuly, Fatemeh; Herndl, Anita; Katinger, Hermann; Laimer, Margit

    2008-01-01

    Cross-reactive proteins in small fruits of the Rosaceae family like strawberry, raspberry and blackberry revealed an unexpected complex IgE-reactivity pattern. Several copies of PR-10 and PR-14 proteins were detected by Southern blots in strawberry, raspberry and blackberry. In raspberry, the highest similarity at the DNA level for PR-10 and PR-14 (Rub i 1 and Rub i 3) was detected to strawberry sequences of Fra a 1 and Fra a 3. At the protein level, Rub i 1 and Rub i 3 showed more than 70% identity with homologous proteins of rosaceous fruits. Furthermore, raspberries contained additional putative allergens, e.g. class III acidic chitinases and cyclophilins. Blackberries were shown to share at least two well-known major fruit allergens with other rosaceous fruits, namely PR-10s and PR-14s homologous proteins. However the IgE-reactive proteins of small fruits are still not extensively investigated. The main challenges in studying small fruit allergens are the complexity of the fruit matrix, the diversity of physico-chemical properties of fruit proteins, the lack of appropriate protein extraction procedures and the missing information about the influence of processing treatments on food components.

  11. [An assessment of the Family Health Program in municipalities of Northeast Brazil: old and new challenges].

    Science.gov (United States)

    Rocha, Paulo de Medeiros; Uchoa, Alice da Costa; Rocha, Nadja de Sá Pinto Dantas; Souza, Elizabethe Cristina Fagundes de; Rocha, Marconi de Lima; Pinheiro, Themis Xavier de Albuquerque

    2008-01-01

    This article presents part of the results from the Baseline Studies, an evaluative research conducted in 21 municipalities with more than 100,000 inhabitants each, in three States of Northeast Brazil. The overall objective was to assess experiences in the implementation of the Family Health Program (FHP), with a focus on inductions in the PROESF. An implementation analysis was performed, using the case study method. The analysis focused on these dimensions: political-institutional, health organization, and comprehensive care. Outstanding advances included: prioritize the FHP in high-risk areas; institutional learning, with qualification of managers and teams; definition of institutional levels for regulating the FHP; and health team-user bonds and positive perceptions concerning the program. Challenges included: strengthening of local policy and decision-making capacity; allocation of primary care resources; greater employment security for human resources; effective implementation of the health care network; strengthening of social participation; upgrading of monitoring and evaluation for decision-making; receptivity; waiting lines for tests, appointments, and hospital admissions; implementation of teamwork; health promotion and inter-sector activities.

  12. Proceeding of the Fourth Scientific Presentation on Nuclear Fuel Cycle: Technology of Nuclear Fuel Cycle facing the Challenge of Energy Need on the 21-st Century

    International Nuclear Information System (INIS)

    Suripto, A.; Sajuti, D.; Aiman, S.; Yuwono, I.; Fathurrachman; Suwarno, H.; Suwardi; Amini, S.; Widjaksana

    1999-03-01

    The proceeding contains papers presented in the Fourth Scientific Presentation on Nuclear Fuel Element Cycle with theme of Technology of Nuclear Fuel Cycle facing the Challenge of Energy Need on the 21 s t Century, held on 1-2 December in Jakarta, Indonesia. These papers were divided by three groups that are technology of exploration, processing, purification and analysis of nuclear materials; technology of nuclear fuel elements and structures; and technology of waste management, safety and management of nuclear fuel cycle. There are 36 papers indexed individually. (ID)

  13. An investigation into the challenges facing the future provision of continuing professional development for allied health professionals in a changing healthcare environment

    International Nuclear Information System (INIS)

    Gibbs, Vivien

    2011-01-01

    This paper outlines current challenges facing healthcare providers and education providers in trying to ensure Allied Health Professionals (AHPs) are fit for practice, in a climate driven by financial constraints and service improvement directives from the Department of Health (DH). Research was undertaken in 2009 to investigate the current provision of Continuing Professional Development (CPD) in the southwest region of England. The purpose was to define exactly what problems existed with this provision, and to propose changes which could be implemented in order to ensure that the provision meets the needs of stakeholders in future years.

  14. Proceedings of a USGS Workshop on Facing Tomorrow's Challenges Along the U.S.-Mexico Border - Monitoring, Modeling, and Forecasting Change Within the Arizona-Sonora Transboundary Watersheds

    Science.gov (United States)

    Norman, Laura M.; Hirsch, Derrick D.; Ward, A. Wesley

    2008-01-01

    INTRODUCTION TO THE WORKSHOP PROCEEDINGS Competition for water resources, habitats, and urban areas in the Borderlands has become an international concern. In the United States, Department of Interior Bureaus, Native American Tribes, and other State and Federal partners rely on the U.S. Geological Survey (USGS) to provide unbiased science and leadership in the Borderlands region. Consequently, the USGS hosted a workshop, ?Facing Tomorrow?s Challenges along the U.S.-Mexico Border,? on March 20?22, 2007, in Tucson, Ariz., focused specifically on monitoring, modeling, and forecasting change within the Arizona-Sonora Transboundary Watersheds

  15. Juggling Higher Education Study and Family Life

    Science.gov (United States)

    Webber, Louise

    2017-01-01

    Women with families face particular challenges when they undertake Higher Education. Questions arise about coping with the demands of study, new family routines, and the changed identity when mother becomes student: Can I manage it all? How will my family react? Will they give me the time and support I need? The author, herself a mother and…

  16. Strengthening Adoption Practice, Listening to Adoptive Families

    Science.gov (United States)

    Atkinson, Anne; Gonet, Patricia

    2007-01-01

    In-depth interviews with 500 adoptive families who received postadoption services through Virginia's Adoptive Family Preservation (AFP) program paint a richly detailed picture of the challenges adoptive families face and what they need to sustain adoption for many years after finalization. Findings document the need for support in a variety of…

  17. Using Support Mechanisms to Balance Work and Family Life: How Mid and Senior Level Student Affairs Administrators Overcome Challenges

    Science.gov (United States)

    Cassell, Aba DeLynda

    2012-01-01

    Female student affairs leaders who also have family responsibilities find that a primary challenge they encounter is society's expectations concerning their roles and responsibilities in both realms. Research discovers that women experience internal and external barriers that hinder their advancement opportunities however; women's…

  18. Context of Latino Students' Family Separation during and after Immigration: Perspectives, Challenges, and Opportunities for Collaborative Efforts

    Science.gov (United States)

    González, Jeremiah J.; Kula, Stacy M.; González, Verónica V.; Paik, Susan J.

    2017-01-01

    This article discusses the challenges and consequences of family separation and reunification during immigration from Latin America to the U.S. The historical pattern of paternal immigration as well as the recent rise in maternal immigration are discussed. The article addresses the impact of length of separation and how separation impacts family…

  19. Family Resilience in the Military

    Science.gov (United States)

    Meadows, Sarah O.; Beckett, Megan K.; Bowling, Kirby; Golinelli, Daniela; Fisher, Michael P.; Martin, Laurie T.; Meredith, Lisa S.; Osilla, Karen Chan

    2016-01-01

    Abstract Military life presents a variety of challenges to military families, including frequent separations and relocations as well as the risks that service members face during deployment; however, many families successfully navigate these challenges. Despite a recent emphasis on family resilience, the U.S. Department of Defense (DoD) does not have a standard and universally accepted definition of family resilience. A standard definition is a necessary for DoD to more effectively assess its efforts to sustain and improve family resilience. RAND authors reviewed the literature on family resilience and, in this study, recommend a definition that could be used DoD-wide. The authors also reviewed DoD policies related to family resilience, reviewed models that describe family resilience and identified key family resilience factors, and developed several recommendations for how family-resilience programs and policies could be managed across DoD. PMID:28083409

  20. Additional Insights Into Problem Definition and Positioning From Social Science Comment on "Four Challenges That Global Health Networks Face".

    Science.gov (United States)

    Quissell, Kathryn

    2017-09-10

    Commenting on a recent editorial in this journal which presented four challenges global health networks will have to tackle to be effective, this essay discusses why this type of analysis is important for global health scholars and practitioners, and why it is worth understanding and critically engaging with the complexities behind these challenges. Focusing on the topics of problem definition and positioning, I outline additional insights from social science theory to demonstrate how networks and network researchers can evaluate these processes, and how these processes contribute to better organizing, advocacy, and public health outcomes. This essay also raises multiple questions regarding these processes for future research. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  1. The challenges of implementing advanced access for residents in family medicine in Quebec. Do promising strategies exist?

    Science.gov (United States)

    Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Breton, Mylaine

    2018-12-01

    The advanced access (AA) model is a highly recommended innovation to improve timely access to primary healthcare. Despite that many studies have shown positive impacts for healthcare professionals, and for patients, implementing this model in clinics with a teaching mission for family medicine residents poses specific challenges. To identify these challenges within these clinics, as well as potential strategies to address them. The authors adopted a qualitative multiple case study design, collected data in 2016 using semi-structured interviews (N = 40) with healthcare professionals and clerical staff in four family medicine units in Quebec, and performed a thematic analysis. They validated results through a discussion workshop, involving many family physicians and residents practicing in different regions Results: Five challenges emerged from the data: 1) choosing, organizing residents' patient; 2) managing and balancing residents' appointment schedules; 3) balancing timely access with relational continuity; 4) understanding the AA model; 5) establishing collaborative practices with other health professionals. Several promising strategies were suggested to address these challenges, including clearly defining residents' patient panels; adopting a team-based care approach; incorporating the model into academic curriculum and clinical training; proactive and ongoing education of health professionals, residents, and patients; involving residents in the change process and in adjustment strategies. To meet the challenges of implementing AA, decision-makers should consider exposing residents to AA during academic training and clinical internships, involving them in team work on arrival, engaging them as key actors in the implementation and in intra- and inter-professional collaborative models.

  2. Narrative Therapy in the Co-Construction of Experience and Family Coping when Facing an ADHD Diagnosis

    Directory of Open Access Journals (Sweden)

    Steve Fernando Pedraza-Vargas**

    2009-12-01

    Full Text Available The narrative therapy establishes that people give sense and meaning to their life and relations relating their experiences, and interacting with others in a meaning full way, modeling like this their own life and relations. This investigation/intervention pretended to understand the organization of the experience and family confront surrounding the possible Attention Deficit Hyperactivity Disorder (ADHD of a child under age from the narratives built by the family system in a therapy context. The new methodological design included four moments and 12 sceneries of investigation/intervention the process was developed with 3 families participating with reflexive team, the complex comprehension of the neuropsychological diagnosis and the co-construction of the alternative narratives. The results showed how the families built dominant narratives about the manifest symptoms in the child from prejudices and beliefs, and tend to evidence a coalition between the child and the person in charge of the child and the guiltiness between parents. The therapeutic dialogue helps the co-construction of other suitable meanings for the integration and cooperation among the family system and the participation of the wide systems.

  3. Solidarity in family medicine in Brazil and in Italy: reflecting on ethical issues and contemporary challenges

    OpenAIRE

    Rita de Cássia Gabrielli Souza Lima; Marta Inez Machado Verdi

    2010-01-01

    This study reflects on solidarity in the practice of family medicine in two realities. The objective is to search for solidarity as an ethical principle in the relationship between family doctor and subject. It is a descriptive exploratory research carried out in Florianópolis, state of Santa Catarina, Brazil, and in the Province of Rome, Lazio Region, Italy. It included fourteen Brazilian family doctors and fifteen Italian family doctors. The theoretical framework consisted of Pierre Bourdie...

  4. Challenges Raising a Gifted Child: Stress and Resilience Factors within the Family

    Science.gov (United States)

    Renati, Roberta; Bonfiglio, Natale Salvatore; Pfeiffer, Steven

    2017-01-01

    The research on families of the gifted is extremely limited. In the past, families of the gifted have been studied mainly for two reasons: to discover how family life creates or supports giftedness or eminence, or to understand how one gifted child affects siblings. Few studies, however, have examined the impact of gifted children on the lives of…

  5. Potentials and challenges of family literacy interventions: the question of implementation quality

    NARCIS (Netherlands)

    McElvany, N.; van Steensel, R.

    2009-01-01

    Literacy interventions in the family context have great potential to promote reading development in children. However, the results of meta-analyses indicate that family-based approaches tend not to be as effective as expected. Although the effectiveness of family literacy interventions can be

  6. Family Connections: Visual Supports for Promoting Social Skills in Young Children--A Family Perspective

    Science.gov (United States)

    Moody, Amelia K.

    2012-01-01

    Family members of children with autism spectrum disorders (ASDs) often face social, emotional, and behavioral challenges in the home. Difficulty communicating with family members, forming relationships with friends, and responding appropriately to others can cause significant challenges in the home (Diagnostic and Statistical Manual of Mental…

  7. The ethical leadership challenge: creating a culture of patient- and family-centered care in the hospital setting.

    Science.gov (United States)

    Piper, Llewellyn E

    2011-01-01

    The growing number of medical errors and resulting preventable deaths in hospitals presents an ethical dilemma that must be addressed by health care leaders and managers. These medical errors and deaths raise questions about safety and quality issues resulting in rising public mistrust and patient dissatisfaction. Many of these medical errors and deaths could have been avoided by including the patient and family in the care. The ethical challenge for leadership is creating a culture of patient- and family-centered care as a means to improve quality, safety, patient satisfaction, and public trust. This article addresses ways to improve safety, quality, patient satisfaction, and cost and thereby reduce medical errors and deaths by implementing a patient- and family-centered care culture. The first critical step for improvement is for hospital leaders and managers to answer the ethical call to create a culture centered on patient- and family-centered care in the hospital setting.

  8. Exercise persistence in the face of varying exercise challenges: a test of self-efficacy theory in working mothers.

    Science.gov (United States)

    Jung, Mary E; Brawley, Lawrence R

    2011-07-01

    Self-regulatory efficacy (SRE) should influence persistence towards goals. Mothers attempting to exercise while managing work and young children (N = 49, M(age) = 35.69, M(children) = 1.88) were stratified into high or low concurrent SRE groups, then randomized to read a hypothetical scenario detailing numerous or minimal exercise barrier conditions. Consistent with self-efficacy theory, when exercise barriers were numerous, mothers with higher concurrent SRE demonstrated greater persistence towards exercise goals, and perceived concurrent management of exercise with their other valued goals as more positively challenging, than mothers with lower concurrent SRE.

  9. The challenges forensic nurses face when their patient is comatose: addressing the needs of our most vulnerable patient population.

    Science.gov (United States)

    Pierce-Weeks, Jennifer; Campbell, Polly

    2008-01-01

    Since 1996, the American Nurses Association has recognized forensic nursing as a formal specialty. Despite this recognition, Sexual Assault Nurse Examiners and Emergency Department nurses struggle with incorporating evidence collection into the care they give the unconscious or comatose patient they suspect has been sexually assaulted. Through case example, this article provides an abbreviated review of the circumstances under which these patients present for care, current challenges, and barriers in upholding the standard of forensic nursing care, as well as proposed interventions for the practicing forensic nurse.

  10. Challenge theme 6: Natural hazard risks in the Borderlands: Chapter 8 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    Science.gov (United States)

    Page, William R.; Parcher, Jean W.; Stefanov, Jim

    2013-01-01

    Natural hazards such as earthquakes, landslides and debris flows, wildfires, hurricanes, and intense storm-induced flash floods threaten communities to varying degrees all along the United States–Mexican border. The U.S. Geological Survey (USGS) collaborates with Federal, State, and local agencies to minimize the effects of natural hazards by providing timely, unbiased science information to emergency response officials, resource managers, and the public to help reduce property damage, injury, and loss of life. The USGS often mobilizes response efforts during and after a natural hazard event to provide technical and scientific counsel on recovery and response, and it has a long history of deploying emergency response teams to major disasters in both domestic and international locations. This chapter describes the challenges of natural hazards in the United States–Mexican border region and the capabilities of the USGS in the fields of hazard research, monitoring, and assessment, as well as preventative mitigation and post-disaster response.

  11. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Mburu, Grace; George, Gavin

    2017-07-31

    Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. South Africa's HRH strategy for the Health Sector 2012/13-2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

  12. Emotion talk in the context of young people self-harming: facing the feelings in family therapy.

    Science.gov (United States)

    Rogers, Alice; Schmidt, Petra

    2016-04-01

    This article describes the use of emotion talk in the context of using a manualised approach to family therapy where the presenting problem is self-harm. Whilst we understand that there is an internal aspect to emotion, we also consider emotions to be socially purposeful, culturally constructed and interactional. We found that within the presenting families, negative emotions were often talked about as located within the young person. Through using 'emotion talk' (Fredman, 2004) in deconstructing and tracking emotions and exploring how emotions connected to family-of-origin and cultural contexts, we developed an interactional understanding of these emotions. This led to better emotional regulation within the family and offered alternative ways of relating. The article discusses the use of relational reflexivity, and using the therapist and team's emotions to enable the therapeutic process, encouraging reflexivity on the self of the therapist in relation to work with emotions. Emotions can be seen as both a reflection of feelings experienced by the individual and as a communication.An interactional understanding of emotions can be used therapeutically.Therapists should explore emotional displays and track the interactional patterns within the therapeutic system.Therapists should self-reflexive about ways of doing emotions and use this awareness in practice.

  13. A community-based qualitative study of intergenerational resilience with Palestinian refugee families facing structural violence and historical trauma.

    Science.gov (United States)

    Atallah, Devin G

    2017-06-01

    The purpose of this study was to explore resilience processes in Palestinian refugee families living under Israeli occupation for multiple generations. Qualitative methods, critical postcolonial theories, and community-based research approaches were used to examine intergenerational protective practices and to contribute to reconceptualizations of resilience from indigenous perspectives. First, the researcher developed a collaborative partnership with a nongovernmental organization (NGO) in a UN refugee camp in the occupied West Bank. Then, with the support of this NGO, semistructured group and individual interviews were completed with a total of 30 participants ( N = 30) ranging in age from 18 to 90 years old coming from 5 distinct extended family networks. Using grounded theory situational analysis, the findings were organized in a representation entitled Palestinian Refugee Family Trees of Resilience (PRFTR). These findings explain resilience in terms of three interrelated themes: (a) Muqawama/resistance to military siege and occupation; (b) Awda/return to cultural roots despite historical and ongoing settler colonialism; and (c) Sumoud/perseverance through daily adversities and accumulation of trauma. The study findings shed light on how Palestinian families cultivate positive adaptation across generations and highlight how incorporating community-based perspectives on the historical trauma and violent social conditions of everyday life under occupation may be critical for promoting resilience. Results may be relevant to understanding the transgenerational transmission of trauma and resilience within other displaced communities internationally.

  14. Hydrologic analysis of the challenges facing water resources and sustainable development of Wadi Feiran basin, southern Sinai, Egypt

    Science.gov (United States)

    Ahmed, Ayman A.; Diab, Maghawri S.

    2018-04-01

    Wadi Feiran basin is one of the most promising areas in southern Sinai (Egypt) for establishing new communities and for growth in agriculture, tourism, and industry. The present challenges against development include water runoff hazards (flash flooding), the increasing water demand, and water scarcity and contamination. These challenges could be mitigated by efficient use of runoff and rainwater through appropriate management, thereby promoting sustainable development. Strategies include the mitigation of runoff hazards and promoting the natural and artificial recharge of aquifers. This study uses a watershed modeling system, geographic information system, and classification scheme to predict the effects of various mitigation options on the basin's water resources. Rainwater-harvesting techniques could save more than 77% of the basin's runoff (by volume), which could be used for storage and aquifer recharge. A guide map is provided that shows possible locations for the proposed mitigation options in the study basin. Appropriate measures should be undertaken urgently: mitigation of groundwater contamination (including effective sewage effluent management); regular monitoring of the municipal, industrial and agricultural processes that release contaminants; rationalization and regulation of the application of agro-chemicals to farmland; and regular monitoring of contaminants in groundwater. Stringent regulations should be implemented to prevent wastewater disposal to the aquifers in the study area.

  15. Overseas territories facing the challenge of climate change - Report to the Prime Minister and to the Parliament

    International Nuclear Information System (INIS)

    Verges, Paul; Galliot, Michel; Mondon, Sylvain; Reysset, Bertrand; Zilli, Dario; Bourcier, Vincent; Duvernoy, Jerome; Omarjee, Younous; Duvat, Virginie; Mossot, Gabrielle; Magnan, Alexandre; Allenbach, Michel; Bocquet, Aurelie; Bonnardot, Francois; Dandin, Philippe; Palany, Philippe; Pontaud, Marc; Porcher, Michel; Delalande, Daniel

    2012-12-01

    This report identifies the social-environmental challenges associated with climate change for French overseas territories, proposes an analysis of the impact of activities of the different economic sectors on the environment, and proposes some principles for action. After an introduction which outlines the importance of addressing climate change and adaptation, and describes the situation of French overseas territories in front of climate change, a first part identifies and discusses the main social-environmental challenges associated with climate change (climate evolution, role of climate change in a context of economic development, the territory as a resource system, climate change considered as an impact chain, the relative weight of climatic uncertainties). Then, the report analyses the potential impacts of climate change on biodiversity, on tourism, on fishing and aquaculture, on agriculture and breeding, on forestry, on health, and on the energy sector. For each of them, the economic weight is indicated and commented, expected impacts are discussed, and adaptation possibilities and implementation modalities are commented. The issue of coastal planning and risks related to climate change is also addressed

  16. The Borderlands and climate change: Chapter 10 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    Science.gov (United States)

    Fitzpatrick, Joan; Gray, Floyd; Dubiel, Russell; Langman, Jeff; Moring, J. Bruce; Norman, Laura M.; Page, William R.; Parcher, Jean W.

    2013-01-01

    The prediction of global climate change in response to both natural forces and human activity is one of the defining issues of our times. The unprecedented observational capacity of modern earth-orbiting satellites coupled with the development of robust computational representations (models) of the Earth’s weather and climate systems afford us the opportunity to observe and investigate how these systems work now, how they have worked in the past, and how they will work in the future when forced in specific ways. In the most recent report on global climate change by the Intergovernmental Panel on Climate Change (IPCC; Solomon and others, 2007), analyses using multiple climate models support recent observations that the Earth’s climate is changing in response to a combination of natural and human-induced causes. These changes will be significant in the United States–Mexican border region, where the process of climate change affects all of the Borderlands challenge themes discussed in the preceding chapters. The dual possibilities of both significantly-changed climate and increasing variability in climate make it challenging to take full measure of the potential effects because the Borderlands already experience a high degree of interannual variability and climatological extremes.

  17. Iranian family caregivers' challenges and issues in caring of multiple sclerosis patients: A descriptive explorative qualitative study.

    Science.gov (United States)

    Masoudi, Reza; Abedi, Heidar Ali; Abedi, Parvin; Mohammadianinejad, Seyed Ehsan

    2014-07-01

    The broad spectrum of problems caused by multiple sclerosis (MS) imposes heavy responsibility to caregivers in caring of their patients. Therefore, they encounter many issues and challenges in this situation. The purpose of this study was to explore the experiences and challenges of MS family caregivers. A qualitative design, based on a thematic analysis approach, was used to reach the study aim. Data were collected and analyzed concurrently through in-depth unstructured interviews, field notes, and observations that were held with 23 participants (14 family caregivers and 9 MS patients) at two referral centers in Ahvaz, Iran. THREE MAJOR THEMES WERE EXTRACTED FROM THE ANALYSIS OF THE TRANSCRIPTS: "emotional exhaustion of caregivers," "uncertain atmosphere of caring," and "insularity care." The first theme consisted of three subthemes: "stressful atmosphere of caring," "conflict and animism," and "continuing distress affecting the caregiver." The second theme consisted of three subthemes: "unstable and complicacy of disease," "caring with trial and error," and "frequent hospitalization of patients," and the third theme consisted of two subthemes: "caring gap and disintegration" and "lack of sufficient support." This study will be useful to healthcare system for managing the challenges of MS patients' family caregivers. Improving the conditions and performance of family caregivers is crucial in order to provide high-quality care to people with MS.

  18. Challenges faced on Cacimbas-Catu gas pipeline (Gascac) construction and the technologies applied to achieve success

    Energy Technology Data Exchange (ETDEWEB)

    Ruschi, Allan; Cardos, Celina; Soares, Felipe; Mariot, Guilherme; Loureiro, Regis R [Petroleo Brasileiro S/A, Petrobras Engineering, Rio de Janeiro/ RJ (Brazil)

    2010-07-01

    The GASENE project is the largest gas pipeline constructed in Brazil in the past 10 years, it interconnects the southeast to the northeast of Brazil. The Cacimbas Catu Gas Pipeline (GASCAC) is a part of the project; it has a 28 inch diameter and is 958 km long. The aim of this paper is to present the construction and assembly process undertaken to meet the deadline and complete the GASCAC to a high quality standard. The main challenges of this project were its length, the short period for completion and the numerous geological and man-made features along the pipeline route. To overcome these difficulties, technologies that had never been used in Brazil before were employed, such as vacuum pipe lifting, bag weights and automatic welding. The GASCAC project was completed in time and with to a high standard of quality, demonstrating that strategic planning and the use of new technologies can increase productivity, quality and safety.

  19. Facing the challenge of Arctic fisheries management within a context of spatially differentiated ecological-economic externalities

    DEFF Research Database (Denmark)

    Kaiser, Brooks; Fernandez, Linda; Sundet, Jan

    inherent in these species’ introductions. The challenges of effectively managing these species are particularly high, mainly due to their twofold role as invasive species and market commodities. Part of the balancing act needed for a solution to the spread of the RKC has been directed at spatial...... less open to the spread of invasive species are now responsible for the expansiveness of the problem. At stake are unique species and co-evolved systems that have taken millennia to develop. Even small-scale disturbances in the pristine Arctic ecosystems are likely to have outsized impacts both...... on an ecological and on an economic level. This work discusses optimal management approaches regarding threats from invasive species on an international scale in order to delineate international policy characteristics that may reduce overall damages and costs. The purposeful introduction of the Red King Crab (RKC...

  20. Challenge theme 7: Information support for management of border security and environmental protection: Chapter 9 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

    Science.gov (United States)

    Parcher, Jean W.; Page, William R.

    2013-01-01

    Historically, international borders were located far from the major political and economic capitals of their countries and rarely received adequate planning or infrastructure development. Today, as a result of global economics and increased movement of goods between nations, border regions play a much greater role in commerce, tourism, and transportation. For example, Mexico is the second largest destination for United States exports (Woodrow Wilson Center Mexico Institute, 2009). The rapid population and economic growth along the United States–Mexican border, undocumented human border crossings, and the unique natural diversity of resources in the Borderlands present challenges for border security and environmental protection. Assessing risks and implementing sustainable growth policies to protect the environment and quality of life greatly increase in complexity when the issues cross an international border, where social services, environmental regulations, lifestyles, and cultural beliefs are unique for each country. Shared airsheds, water and biological resources, national security issues, and disaster management needs require an integrated binational approach to assess risks and develop binational management strategies.

  1. Past, Present, and Future of Informed Consent in Pain and Genomics Research: Challenges Facing Global Medical Community.

    Science.gov (United States)

    Compagnone, Christian; Schatman, Michael E; Rauck, Richard L; Van Zundert, Jan; Kraus, Monika; Primorac, Dragan; Williams, Frances; Allegri, Massimo; Saccani Jordi, Gloria; Fanelli, Guido

    2017-01-01

    In recent decades, there has been a revision of the role of institutional review boards with the intention of protecting human subjects from harm and exploitation in research. Informed consent aims to protect the subject by explaining all of the benefits and risks associated with a specific research project. To date, there has not been a review published analyzing issues of informed consent in research in the field of genetic/Omics in subjects with chronic pain, and the current review aims to fill that gap in the ethical aspects of such investigation. Despite the extensive discussion on ethical challenges unique to the field of genetic/Omics, this is the first attempt at addressing ethical challenges regarding Informed Consent Forms for pain research as the primary focus. We see this contribution as an important one, for while ethical issues are too often ignored in pain research in general, the numerous arising ethical issues that are unique to pain genetic/Omics suggest that researchers in the field need to pay even greater attention to the rights of subjects/patients. This article presents the work of the Ethic Committee of the Pain-Omics Group (www.painomics.eu), a consortium of 11 centers that is running the Pain-Omics project funded by the European Community in the 7th Framework Program theme (HEALTH.2013.2.2.1-5-Understanding and controlling pain). The Ethic Committee is composed of 1 member of each group of the consortium as well as key opinion leaders in the field of ethics and pain more generally. © 2016 The Authors. Pain Practice published by Wiley Periodicals, Inc. on behalf of World Institute of Pain.

  2. Working with Families Living with Autism: Potential Contributions of Marriage and Family Therapists

    Science.gov (United States)

    Neely, Jason; Amatea, Ellen S.; Echevarria-Doan, Silvia; Tannen, Tina

    2012-01-01

    This article introduces marriage and family therapists (MFT) to some of the common issues faced by families that have a child with autism spectrum disorder (ASD). First, autism is defined and common myths surrounding it are discussed. Next, relational challenges are presented that families report experiencing during early childhood through the…

  3. Testing the adaptation to poverty-related stress model: predicting psychopathology symptoms in families facing economic hardship.

    Science.gov (United States)

    Wadsworth, Martha E; Raviv, Tali; Santiago, Catherine Decarlo; Etter, Erica M

    2011-01-01

    This study tested the Adaptation to Poverty-related Stress Model and its proposed relations between poverty-related stress, effortful and involuntary stress responses, and symptoms of psychopathology in an ethnically diverse sample of low-income children and their parents. Prospective Hierarchical Linear Modeling analyses conducted with 98 families (300 family members: 136 adults, 82 adolescents and preadolescents, 82 school-age children) revealed that, consistent with the model, primary and secondary control coping were protective against poverty-related stress primarily for internalizing symptoms. Conversely, disengagement coping exacerbated externalizing symptoms over time. In addition, involuntary engagement stress responses exacerbated the effects of poverty-related stress for internalizing symptoms, whereas involuntary disengagement responses exacerbated externalizing symptoms. Age and gender effects were found in most models, reflecting more symptoms of both types for parents than children and higher levels of internalizing symptoms for girls.

  4. Family Attitudes in the Face of Cultural Otherness. My Dad Doesn’t Want Me to Hang out with Him!

    Directory of Open Access Journals (Sweden)

    Antonio Rodríguez Fuentes

    2016-12-01

    Full Text Available Education takes off and displays in the family, and lands and continues at school, where it is combined with teaching, which contributes strongly. Attitudes are the base and predisposition for action; they gestate in the family and reinforced in school. Attitudes towards diversity are no an exception, start from the familiar structure and are molded in the school. This study analyzes the attitudes of parents towards cultural diversity in their children’s secondary and high school classrooms. To do this they have interviewed 14 mothers and 8 parents, using a battery of questions (18 questions validated by experts from different educational levels (3 secondary and high schools and 3 University, whose answers have been treated qualitatively (content analysis and quantitatively (trend analysis, and differential percentage. Since the group has been considered as a case (case study, the results give a glimpse of the attitudinal pattern showing to cultural diversity in the classroom.

  5. Families in the Military

    Science.gov (United States)

    ... family that loses the active presence of a parent through separation faces significant challenges and stress. During the parent's ... children can and do adjust successfully to the separation and stress involved when a parent in the military is deployed. Visit AACAP's Military ...

  6. Emotion talk in the context of young people self‐harming: facing the feelings in family therapy

    Science.gov (United States)

    Schmidt, Petra

    2016-01-01

    This article describes the use of emotion talk in the context of using a manualised approach to family therapy where the presenting problem is self‐harm. Whilst we understand that there is an internal aspect to emotion, we also consider emotions to be socially purposeful, culturally constructed and interactional. We found that within the presenting families, negative emotions were often talked about as located within the young person. Through using ‘emotion talk’ (Fredman, 2004) in deconstructing and tracking emotions and exploring how emotions connected to family‐of‐origin and cultural contexts, we developed an interactional understanding of these emotions. This led to better emotional regulation within the family and offered alternative ways of relating. The article discusses the use of relational reflexivity, and using the therapist and team's emotions to enable the therapeutic process, encouraging reflexivity on the self of the therapist in relation to work with emotions. Practitioner points Emotions can be seen as both a reflection of feelings experienced by the individual and as a communication.An interactional understanding of emotions can be used therapeutically.Therapists should explore emotional displays and track the interactional patterns within the therapeutic system.Therapists should self‐reflexive about ways of doing emotions and use this awareness in practice. PMID:27667879

  7. Cultural-social and human resource challenges facing development of information technology in Iran's higher education in viewpoint of graduate students

    Directory of Open Access Journals (Sweden)

    M. Rahmanpoor

    2017-06-01

    Full Text Available The aim of the this study was survey of cultural-social and human recourses  challenges facing development of information technology in higher education in Iran. The population of this study was all graduate students studying in the Department of the State University in academic year 2010-2011. In first stage, Tehran, Allameh-Tabatabaee, San’ati-Sharif, Isfahan, Shiraz and Kurdistan Universities were selected as samples. Among these universities, 460 patients were randomly selected in proportion. Data were collected via a questionnaire. Reliability using Cronbach's alpha coefficient respectively 0/94, and its validity was confirmed by several professors. The data were calculated using SPSS statistical software and then analyzed. In Descriptive statistics level, indicators of frequency, percentage and standard deviation, and in inferential statistics level, T test, ANOVA and post hoc test was used. The results showed that in cultural-social  dimension including the important challenges were the high ratio of computers to students, poor students searching spirit, and lack of English language teachers and students. In human resource dimension are also unfamiliar of the students with the how access to information in databases, shortage or lack of professional expertise in information technology, faculty and administrators do not understand the capabilities of information technology, were most important challenges Information technology in Iran's higher education.

  8. Energy in a dialog. The challenges facing Germany's power industry as a result of the energy turnaround

    International Nuclear Information System (INIS)

    Gueldner, Ralf

    2012-01-01

    The challenges posed by the energy turnaround in Germany to the power industry and the national economy after the Fukushima events were the topic of the ''Energy in a Dialog'' meeting organized by the Deutsches Atomforum in Berlin on December 14, 2011. Dr. Ralf Gueldner, President of the Deutsches Atomforum, opened the conference by drawing attention to the real purposes of the energy turnaround, namely to prevent severe climate changes and, thus, also carbon emissions. Both nationally in Germany and worldwide, nuclear power made major contributions to achieving these goals. Referring to developments in many neighboring countries, he underlined that opting out of the use of nuclear power in Germany was not tantamount to the end of nuclear power. Reality in energy policy had to be accepted, however, namely that nuclear power played, and would go on playing, an important role in Europe. Other contributions by Dr. Juergen Grossmann (Chief Executive Officer of RWE AG), Stefan Kohler (Chairman of the Board of Management of the German Energy Agency - dena), and Prof.Dr. Felix Muesgens (Brandenburg Technical University of Cottbus, Chair of Power Economics) dealt with political and other boundary conditions required for the energy turnaround, and with the consequences and burdens on the power industry and the national economy. A final panel discussion chaired by Henning Krumrey (Wirtschaftswoche) was attended by F. Muesgens and Prof. Dr. Hans-Werner Sinn (President of the Munich-based Info Institute) and Prof. Dr. Michael Huether (German Business Institute). (orig.)

  9. [Team work and interdiciplinarity: challenges facing the implementation of comprehensive outpatient care for people with HIV/Aids in Pernambuco].

    Science.gov (United States)

    Borges, Maria Jucineide Lopes; Sampaio, Aletheia Soares; Gurgel, Idê Gomes Dantas

    2012-01-01

    The complexity of providing healthcare to people with HIV/Aids requires investment in comprehensive action and care, constituting a challenge for the multidisciplinary work teams to build an interdisciplinary practice. This study sought to analyze comprehensive healthcare in the Specialized Assistance Services for HIV/Aids (SAE-HIV/Aids) in Recife, in the State of Pernambuco, starting with the process and organization of team work. This is a case study developed in three SAE-HIV/Aids units, based on a qualitative approach using different research techniques. The results show that SAE-HIV/Aids have complied with most of the Brazilian Health Ministry recommendations in terms of basic infrastructure, though none of them had a team of appropriate size. These services have shown signs of fragmentation and difficulty in establishing a systematic intersectorial and interdisciplinary practice, with failings in ensuring the reference and counter-reference flow. It was seen that there was little appreciation of the role of the manager as team leader. The need to perceive the user as a whole was identified, as well as for the team to work in a coordinated manner in order to ensure communicative and relational activities.

  10. Standards for Radiation Effects Testing: Ensuring Scientific Rigor in the Face of Budget Realities and Modern Device Challenges

    Science.gov (United States)

    Lauenstein, J M.

    2015-01-01

    An overview is presented of the space radiation environment and its effects on electrical, electronic, and electromechanical parts. Relevant test standards and guidelines are listed. Test standards and guidelines are necessary to ensure best practices, minimize and bound systematic and random errors, and to ensure comparable results from different testers and vendors. Test standards are by their nature static but exist in a dynamic environment of advancing technology and radiation effects research. New technologies, failure mechanisms, and advancement in our understanding of known failure mechanisms drive the revision or development of test standards. Changes to standards must be weighed against their impact on cost and existing part qualifications. There must be consensus on new best practices. The complexity of some new technologies exceeds the scope of existing test standards and may require development of a guideline specific to the technology. Examples are given to illuminate the value and limitations of key radiation test standards as well as the challenges in keeping these standards up to date.

  11. Effective Recruitment Challenges Faced by the Hospitality Industry in Bangladesh: A Study on Selected Star Rated Residential Hotels

    Directory of Open Access Journals (Sweden)

    Kazi HUDA

    2014-12-01

    Full Text Available In Human Resource Management (HRM, Recruitment is the first and foremost issue to be considered with full of sincerity, because its role is to create a positive impression about the employer in the job market by ensuring effective stimuli for the job seekers. At the beginning, the study sets a picture that focuses on the importance of effective recruitment in the hospitality sector of Bangladesh and then the study details obligatory determinants of attracting efficient human resource for the development of this sector. The main objective of the paper is to study the status and the scopes of recruitment function in hospitality industry with focus towards star rated residential hotels. This study is based on primary data collection through a formal questionnaire. The questionnaire was of mixed mode with most questions in likert-type scale and few were dichotomous in nature. The key finding of the study is that recruitment is a highly challenging task in hospitality and it is quite evident that attractive compensation package is the key factor to attract potential employees. The need and scope to modernize the recruitment practices along with the line of company and employer branding ideas are also recommended in details. There is a long way to go on the way of conceptualizing and actualizing recruitment functions and practices. A paper like this can help to discuss and debate on the necessity of developing better recruitment cultural and conceptual change in these sectors.

  12. VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM.

    Directory of Open Access Journals (Sweden)

    Claudia Marotta

    2017-10-01

    Full Text Available Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population’ health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP as “the process of enabling people to increase control over and to improve their health and well-being”. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society’s sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics.

  13. Challenging Childhoods: Young People's Accounts of "Getting By" in Families with Substance Use Problems

    Science.gov (United States)

    Backett-Milburn, Kathryn; Wilson, Sarah; Bancroft, Angus; Cunningham-Burley, Sarah

    2008-01-01

    Concern is increasing about children growing up in families where there are substance use problems but relatively little is known about the perspectives of the children themselves. This article reports on a qualitative study with young people who grew up in such families, exploring their accounts of their daily lives at home, school and leisure.…

  14. The humble in a context of "greatness": challenges facing the regeneration of Barrio Antiguo in Monterrey, Nuevo Leon

    Directory of Open Access Journals (Sweden)

    Prieto Gonzalez, Jose Manuel

    2016-03-01

    Full Text Available The current “Barrio Antiguo” (Old Quarter of Monterrey (Mexico, formerly known as "Cathedral Quarter", is a postmodern product arising from the intervention between 1988 and 1994 in a sector called First Square, shortly after the construction of the “Macroplaza” (1979-1985 destroyed a significant part of that same sector. Thus, “Barrio Antiguo” became an example of consciousness cleansing experience. The area is a part of what would become the center of Monterrey, whose physical and conceptual boundaries are still undefined. After a harsh period of degradation in the quarter, especially profound in the context of organized crime and its resulting violence in recent years, the Municipal Institute for Planning and Coexistence of Monterrey (IMPLANC has undertaken the task of regenerating the area. The aim of this lecture is to reveal the difficulties faced by the previously mentioned regeneration, starting with the "inferiority complex" that stirs up among the Monterrey population –traditionally-identified with the official discourse of "greatness"– due to the humility of both the architecture and the vernacular northeastern atmosphere of the quarter, especially when comparisons are made with national historic centers which are World Heritage Sites. El actual Barrio Antiguo de Monterrey, antaño conocido como “Barrio de Catedral”, es un producto posmoderno que surge de la intervención realizada entre 1988 y 1994 en un sector del llamado Primer Cuadro de la ciudad, poco después de que las obras de la Macroplaza (1979-85 destruyeran una parte importante de ese mismo sector. Barrio Antiguo vino a ser así una especie de lavado de conciencia. La zona es una parte de lo que sería el centro histórico de Monterrey, cuyos límites físicos y conceptuales aún están sin definir. Después de una dura etapa de degradación del Barrio, especialmente intensa en el contexto de la ola de violencia de los últimos años, el Instituto

  15. Challenges Facing Early Phase Trials Sponsored by the National Cancer Institute: An Analysis of Corrective Action Plans to Improve Accrual.

    Science.gov (United States)

    Massett, Holly A; Mishkin, Grace; Rubinstein, Larry; Ivy, S Percy; Denicoff, Andrea; Godwin, Elizabeth; DiPiazza, Kate; Bolognese, Jennifer; Zwiebel, James A; Abrams, Jeffrey S

    2016-11-15

    Accruing patients in a timely manner represents a significant challenge to early phase cancer clinical trials. The NCI Cancer Therapy Evaluation Program analyzed 19 months of corrective action plans (CAP) received for slow-accruing phase I and II trials to identify slow accrual reasons, evaluate whether proposed corrective actions matched these reasons, and assess the CAP impact on trial accrual, duration, and likelihood of meeting primary scientific objectives. Of the 135 CAPs analyzed, 69 were for phase I trials and 66 for phase II trials. Primary reasons cited for slow accrual were safety/toxicity (phase I: 48%), design/protocol concerns (phase I: 42%, phase II: 33%), and eligibility criteria (phase I: 41%, phase II: 35%). The most commonly proposed corrective actions were adding institutions (phase I: 43%, phase II: 85%) and amending the trial to change eligibility or design (phase I: 55%, phase II: 44%). Only 40% of CAPs provided proposed corrective actions that matched the reasons given for slow accrual. Seventy percent of trials were closed to accrual at time of analysis (phase I = 48; phase II = 46). Of these, 67% of phase I and 70% of phase II trials met their primary objectives, but they were active three times longer than projected. Among closed trials, 24% had an accrual rate increase associated with a greater likelihood of meeting their primary scientific objectives. Ultimately, trials receiving CAPs saw improved accrual rates. Future trials may benefit from implementing CAPs early in trial life cycles, but it may be more beneficial to invest in earlier accrual planning. Clin Cancer Res; 22(22); 5408-16. ©2016 AACRSee related commentary by Mileham and Kim, p. 5397. ©2016 American Association for Cancer Research.

  16. The strategies, experiences and future challenges of the information component in the Indonesian Family Planning Programme.

    Science.gov (United States)

    Suyono, H

    1988-12-01

    In 1957, the Indonesian Planned Parenthood Federation was established. In 1970, the National Family Planning Board (BKKBN) was created. The current contraceptive prevalence rate is 45-50%. The family planning program began with a health-oriented approach. To promote acceptance, religious leaders were asked to provide legitimacy to the program. Through their efforts, it became possible to include all the means and medication used for family planning services within the program. In developing an IEC strategy to encourage couples to accept family planning, 3 main factors were studied: 1) the types of innovations that were to be introduced, 2) the characteristics of the Indonesian community, and 3) the need for an IEC strategy to convey the programs messages the community and make the community itself the agent of the innovation being introduced. The elements of the strategy were introduced stage by stage to avoid unnecessary debate. Another strategic step was the introduction of family planning using a community approach. A 3rd strategic step was a shift from couples as family planning acceptors to the introduction of the norm of a small, happy, and prosperous family. The 1st stage, expansion of program coverage, 1) promoted the need for and desirability of family planning to make the small and happy family the norm and 2) supplied contraceptives and information about contraceptives throughout Indonesia. The 2nd stage, the program maintenance approach, included 1) an increase in the frequency of visits to villages by mobile family planning teams, 2) the integration of family planning activities with other health-related activities, and 3) giving people a wider choice of methods and helping them to choose the most suitable method for them. The 3rd stage made family planning a community activity, integrated within the economic and social fabric of community life. The general strategy of the IEC program is to make the various target groups full family planning

  17. A novel organizational model to face the challenge of multimorbid elderly patients in an internal medicine setting: a case study from Parma Hospital, Italy.

    Science.gov (United States)

    Meschi, Tiziana; Ticinesi, Andrea; Prati, Beatrice; Montali, Arianna; Ventura, Antonio; Nouvenne, Antonio; Borghi, Loris

    2016-08-01

    Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients. The unit is partitioned into smaller wards, each with a specific intensity level of care, including a rapid-turnover ward (mean length of stay model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view.

  18. The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges.

    Science.gov (United States)

    Phillips, Charles D

    2015-01-01

    Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.

  19. Challenges facing use of energy in the tourism and hospitality industry in Zimbabwe and policies that can promote the sustainable use of renewable energy and tourism development

    Directory of Open Access Journals (Sweden)

    Marunda, E.

    2013-06-01

    Full Text Available This article analyses the various challenges facing use of energy for sustainable tourism development in Zimbabwe on the backdrop of Zimbabwe’s reliance mainly on non-renewable energy sources such as fossil fuels and wood whilst very little use is being made of the abundant renewable sources of energy for instance the sun and wind technologies. It is based on the research carried out with the objective of establishing policies that can promote the sustainable use of renewable energy sources in the country. The findings reveal that stakeholders in the tourism and hospitality industry are largely in favour of formulating and expanding policies that encourage use of solar and wind technologies, at the same time mitigating environmental degradation. The article summarises the findings and duly recommends policies than can be used in Zimbabwe to promote the sustainable use of renewable energy employing solar and wind among others for tourism development.

  20. Difficulties facing physician mothers in Japan.

    Science.gov (United States)

    Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

    2011-11-01

    Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. © 2011 Tohoku University Medical Press