Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil

OpenAIRE

Rocha, Thiago Augusto Hernandes; da Silva, N?bia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, Jo?o Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thum?, Elaine; Thomaz, Erika B?rbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A.; Vissoci, Jo?o Ricardo Nickenig

2017-01-01

Background Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. Methods The present work can be classified as a c...

Barriers to Real-Time Medical Direction via Cellular Communication for Prehospital Emergency Care Providers in Gujarat, India.

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Lindquist, Benjamin; Strehlow, Matthew C; Rao, G V Ramana; Newberry, Jennifer A

2016-07-08

Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care. We sought to identify obstacles in the cellular communication process among GVK Emergency Management and Research Institute (GVK EMRI) EMTs in Gujarat, India. A convenience sample of practicing EMTs in Gujarat, India were surveyed regarding the barriers to call initiation and completion. 108 EMTs completed the survey. Overall, ninety-seven (89.8%) EMTs responded that the most common reason they did not initiate a call with the call center physician was insufficient time. Forty-six (42%) EMTs reported that they were unable to call the physician one or more times during a typical workweek (approximately 5-6 twelve-hour shifts/week) due to their hands being occupied performing direct patient care. Fifty-eight (54%) EMTs reported that they were unable to reach the call center physician, despite attempts, at least once a week. This study identified multiple barriers to communication, including insufficient time to call for advice and inability to reach call center physicians. Identification of simple interventions and best practices may improve communication and ensure timely and appropriate prehospital care.

Emergent Behavior of Coupled Barrier Island - Resort Systems

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McNamara, D. E.; Werner, B. T.

2004-12-01

Barrier islands are attractive sites for resorts. Natural barrier islands experience beach erosion and island overwash during storms, beach accretion and dune building during inter-storm periods, and migration up the continental shelf as sea level rises. Beach replenishment, artificial dune building, seawalls, jetties and groins have been somewhat effective in protecting resorts against erosion and overwash during storms, but it is unknown how the coupled system will respond to long-term sea level rise. We investigate coupled barrier island - resort systems using an agent-based model with three components: natural barrier islands divided into a series of alongshore cells; resorts controlled by markets for tourism and hotel purchases; and coupling via storm damage to resorts and resort protection by government agents. Modeled barrier islands change by beach erosion, island overwash and inlet cutting during storms, and beach accretion, tidal delta growth and dune and vegetation growth between storms. In the resort hotel market, developer agents build hotels and hotel owning agents purchase them using predictions of future revenue and property appreciation, with the goal of maximizing discounted utility. In the tourism market, hotel owning agents set room rental prices to maximize profit and tourist agents choose vacation destinations maximizing a utility based on beach width, price and word-of-mouth. Government agents build seawalls, groins and jetties, and widen the beach and build up dunes by adding sand to protect resorts from storms, enhance beach quality, and maximize resort revenue. Results indicate that barrier islands and resorts evolve in a coupled manner to resort size saturation, with resorts protected against small-to-intermediate-scale storms under fairly stable sea level. Under extended, rapidly rising sea level, protection measures enhance the effect of large storms, leading to emergent behavior in the form of limit cycles or barrier submergence

Nationwide survey on barriers for dental research in India

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Kundendu Arya Bishen

2015-01-01

Full Text Available Objective: Research in the dental field is progressing at mightier speed worldwide, but an unfortunately representation of India at this platform is negligible. The present study was undertaken to unearth the barriers for dental research among dental professionals in Indian scenario. Materials and Methods: A cross-sectional questionnaire study was conducted on 1514 participant′s (Master of Dental Surgery and Bachelor of Dental Surgery staff and postgraduates in 40 dental colleges of India selected by multistage random sampling. The response rate was 75.7%. The survey was undertaken from July 2013 to December 2013. The survey instrument was 24-item, investigator developed, self-structured, close-ended, and self-administered questionnaire grouped into four categories that are, institutional/departmental support related barriers, financial/training support related barriers, time-related barriers, and general barriers. Results: Among all respondents 47.23% informed that they are administrative and educational work rather than research work as (P < 0.001. Overall 57.53% of study participants reported lack of administrative and technical support for research work as (P < 0.001. Overall 64.9% reported meager college funding was the barrier (P < 0.001. Overall 61.5% respondents reported lack of time to do research work due to clinical and teaching responsibilities (P < 0.001 was the barrier for research. Largely 80.25% agreed that, the lack of documentation and record maintenance are an obvious barrier for research (P < 0.001. Conclusions: Present study unearths certain barriers for research in an Indian scenario, which includes administrative overburden, lack of funds, and lack of documentation of the dental data. Governing authorities of dentistry in India have to make major interventions to make research non-intensive environment to research-friendly environment.

Barriers to formal emergency obstetric care services' utilization.

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Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

2011-06-01

Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

A research agenda for gender and substance use disorders in the emergency department.

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Choo, Esther K; Beauchamp, Gillian; Beaudoin, Francesca L; Bernstein, Edward; Bernstein, Judith; Bernstein, Steven L; Broderick, Kerryann B; Cannon, Robert D; D'Onofrio, Gail; Greenberg, Marna R; Hawk, Kathryn; Hayes, Rashelle B; Jacquet, Gabrielle A; Lippmann, Melanie J; Rhodes, Karin V; Watts, Susan H; Boudreaux, Edwin D

2014-12-01

For many years, gender differences have been recognized as important factors in the etiology, pathophysiology, comorbidities, and treatment needs and outcomes associated with the use of alcohol, drugs, and tobacco. However, little is known about how these gender-specific differences affect ED utilization; responses to ED-based interventions; needs for substance use treatment and barriers to accessing care among patients in the ED; or outcomes after an alcohol-, drug-, or tobacco-related visit. As part of the 2014 Academic Emergency Medicine consensus conference on "Gender-Specific Research in Emergency Care: Investigate, Understand and Translate How Gender Affects Patient Outcomes," a breakout group convened to generate a research agenda on priority questions related to substance use disorders. © 2014 by the Society for Academic Emergency Medicine.

Usage patterns and attitudes towards emergency contraception: the International Emergency Contraception Research Initiative.

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Krassovics, Miklós; Virágh, Gabriella

2016-08-01

The aim of the survey was to gain understanding of women's usage patterns and attitudes towards emergency contraception (i.e., the 'morning after pill') and to gain insight into the role and attitudes of pharmacists as providers of emergency contraception. As part of the International Emergency Contraception Research Initiative, approximately 6500 women (15-49 years) and nearly 500 pharmacists from 14 countries in Western, Central and Eastern Europe, and Central Asia completed questionnaires via web-based interrogation or computer-assisted/paper-assisted personal interviews. Common to almost all countries and cultures was that, while awareness of emergency contraception was high (≥84% of respondents, except in Kazakhstan), usage was generally low (4-18%). In Austria, the Czech Republic, Spain, and the UK, better underlying protection with hormonal contraceptives or male condoms would have meant less need for emergency contraception. In Bulgaria, Lithuania, Romania, and Russia, greater dependence on less reliable contraceptive methods such as calendar + withdrawal was associated with higher use of the emergency contraceptive pill (11-18%) but also with higher abortion rates (19-21%). Overt rejection of emergency contraception in the event of an accident was low, except in countries (e.g., Austria, Poland) where the misperception that it acts as an abortifacient was common. Except for Bulgaria, pharmacists elsewhere tended to have limited knowledge and moralistic attitudes towards emergency contraception. Improved educational efforts, probably country-specific, are required to increase the use of highly effective methods of regular contraception and overcome barriers to acceptance of emergency contraception as a suitable postcoital solution to avoid unwanted pregnancy or abortion.

The Uphill Battle of Performing Education Scholarship: Barriers Educators and Education Researchers Face.

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Jordan, Jaime; Coates, Wendy C; Clarke, Samuel; Runde, Daniel; Fowlkes, Emilie; Kurth, Jaqueline; Yarris, Lalena

2018-05-01

Educators and education researchers report that their scholarship is limited by lack of time, funding, mentorship, expertise, and reward. This study aims to evaluate these groups' perceptions regarding barriers to scholarship and potential strategies for success. Core emergency medicine (EM) educators and education researchers completed an online survey consisting of multiple-choice, 10-point Likert scale, and free-response items in 2015. Descriptive statistics were reported. We used qualitative analysis applying a thematic approach to free-response items. A total of 204 educators and 42 education researchers participated. Education researchers were highly productive: 19/42 reported more than 20 peer-reviewed education scholarship publications on their curricula vitae. In contrast, 68/197 educators reported no education publications within five years. Only a minority, 61/197 had formal research training compared to 25/42 education researchers. Barriers to performing research for both groups were lack of time, competing demands, lack of support, lack of funding, and challenges achieving scientifically rigorous methods and publication. The most common motivators identified were dissemination of knowledge, support of evidence-based practices, and promotion. Respondents advised those who seek greater education research involvement to pursue mentorship, formal research training, collaboration, and rigorous methodological standards. The most commonly cited barriers were lack of time and competing demands. Stakeholders were motivated by the desire to disseminate knowledge, support evidence-based practices, and achieve promotion. Suggested strategies for success included formal training, mentorship, and collaboration. This information may inform interventions to support educators in their scholarly pursuits and improve the overall quality of education research in EM.

Summary of NIH Medical-Surgical Emergency Research Roundtable held on April 30 to May 1, 2009.

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Kaji, Amy H; Lewis, Roger J; Beavers-May, Tony; Berg, Robert; Bulger, Eileen; Cairns, Charles; Callaway, Clifton; Camargo, Carlos A; Carcillo, Joseph; DeBiasi, Roberta; Diaz, Tania; Ducharme, Francine; Glickman, Seth; Heilpern, Katherine; Hickey, Robert; Hoek, Terry Vanden; Hollander, Judd; Janson, Susan; Jurkovich, Gregory; Kellermann, Arthur; Kingsmore, Stephen; Kline, Jeffrey; Kuppermann, Nathan; Lowe, Robert; McLario, David; Nathanson, Larry; Nichol, Graham; Peitzman, Andrew; Richardson, Lynne; Sanders, Arthur; Shah, Manish; Shapiro, Nathan; Silverman, Robert; Than, Martin; Wilber, Scott; Yealy, Donald M

2010-11-01

In 2003, the Institute of Medicine Committee on the Future of Emergency Care in the United States Health System convened and identified a crisis in emergency care in the United States, including a need to enhance the research base for emergency care. As a result, the National Institutes of Health (NIH) formed an NIH Task Force on Research in Emergency Medicine to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in 3 roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. The objectives of these discussions were to identify key research questions essential to advancing the scientific underpinnings of emergency care and to discuss the barriers and best means to advance research by exploring the role of research networks and collaboration between the NIH and the emergency care community. The Medical-Surgical Research Roundtable was convened on April 30 to May 1, 2009. Before the roundtable, the emergency care domains to be discussed were selected and experts in each of the fields were invited to participate in the roundtable. Domain experts were asked to identify research priorities and challenges and separate them into mechanistic, translational, and clinical categories. After the conference, the lists were circulated among the participants and revised to reach a consensus. Emergency care research is characterized by focus on the timing, sequence, and time sensitivity of disease processes and treatment effects. Rapidly identifying the phenotype and genotype of patients manifesting a specific disease process and the mechanistic reasons for heterogeneity in outcome are important challenges in emergency care research. Other research priorities include the need to elucidate the timing, sequence, and duration of causal molecular and cellular events involved in time-critical illnesses and injuries, and the development of treatments

Drug lag and key regulatory barriers in the emerging markets

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Harriet Wileman

2010-01-01

This work concludes that the overall relative drug lag in the emerging markets has decreased over time and that there are seven key regulatory barriers which need to be targeted in order to make further improvements; ′Western Approval′, local clinical development (LCD, Certificate of Pharmaceutical Product (CPP, Good Manufacturing Practice (GMP, pricing approval, document authentication and harmonisation.

Knowledge Exchange and Management Research: Barriers and Potentials

DEFF Research Database (Denmark)

Bager, Torben

2018-01-01

Purpose: The growing involvement of management researchers in knowledge exchange activities and collaborative research does not seem to be reflected in a growing academic output. The purpose of this paper is to explore barriers for academic output from these activities as well as the potential...... for ‘interesting’ papers. Design/methodology/approach: The paper uses secondary data and statistics as well as an illustrative case study to trace knowledge exchange activities and barriers for academic output based on these activities. Findings: The paper identifies a number of barriers for the turning of data...... derived from knowledge exchange activities and Mode 2 research into academic papers such as low priority of case study research in leading management journals, a growing practice orientation in the research funding systems, methodological challenges due to limited researcher control, and disincentives...

The Uphill Battle of Performing Education Scholarship: Barriers Educators and Education Researchers Face

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Wendy C. Coates

2018-03-01

Full Text Available Introduction: Educators and education researchers report that their scholarship is limited by lack of time, funding, mentorship, expertise, and reward. This study aims to evaluate these groups’ perceptions regarding barriers to scholarship and potential strategies for success. Methods: Core emergency medicine (EM educators and education researchers completed an online survey consisting of multiple-choice, 10-point Likert scale, and free-response items in 2015. Descriptive statistics were reported. We used qualitative analysis applying a thematic approach to free-response items. Results: A total of 204 educators and 42 education researchers participated. Education researchers were highly productive: 19/42 reported more than 20 peer-reviewed education scholarship publications on their curricula vitae. In contrast, 68/197 educators reported no education publications within five years. Only a minority, 61/197 had formal research training compared to 25/42 education researchers. Barriers to performing research for both groups were lack of time, competing demands, lack of support, lack of funding, and challenges achieving scientifically rigorous methods and publication. The most common motivators identified were dissemination of knowledge, support of evidence-based practices, and promotion. Respondents advised those who seek greater education research involvement to pursue mentorship, formal research training, collaboration, and rigorous methodological standards. Conclusion: The most commonly cited barriers were lack of time and competing demands. Stakeholders were motivated by the desire to disseminate knowledge, support evidence-based practices, and achieve promotion. Suggested strategies for success included formal training, mentorship, and collaboration. This information may inform interventions to support educators in their scholarly pursuits and improve the overall quality of education research in EM.

Research into Australian emergency services personnel mental health and wellbeing: An evidence map.

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Varker, Tracey; Metcalf, Olivia; Forbes, David; Chisolm, Katherine; Harvey, Sam; Van Hooff, Miranda; McFarlane, Alexander; Bryant, Richard; Phelps, Andrea J

2018-02-01

Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.

Barriers and challenges in researches by Iranian students of medical universities.

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Anbari, Zohreh; Mohammadbeigi, Abolfazl; Jadidi, Rahmatollah

2015-01-01

Health sciences research (HSR) is an essential part of improving health care which plays a critical role in the field of medicine and clinical practice. The aim of the current study was to assess barriers to the research by students of medical sciences as well as to find out effective strategies for management of student researches in Iranian universities. This study utilized a hybrid design with quantitative and qualitative analytical approaches conducted on 627 students in six schools of medical sciences in two universities in Central Province in Iran from April to December, 2012. Questionnaires were distributed among researcher and non-researcher students to find barriers to the research. These barriers were approved and validated by similar studies and strategies using the Delphi technique on 36 students. The most important barriers among researcher students were institutional barriers (3.3 ± 1.3), but in non-researcher students they were individual barriers (3.6 ± 1.7). The majority of barriers to involvement in the research among researcher students appeared to be time, lack of access to electronic resources and prolongation of the process of buying equipment. In addition, the greatest barriers among non-researcher students included the lack of time, scientific writing skills, and access to trained assistants. The results showed the issue of attitudes towards compulsory research as a component of critical scholarship in the curriculum of medical courses. Moreover, employment of the research experts can be helpful for research training in schools of medical sciences.

Breaking the Barriers to the Circular Economy

OpenAIRE

Kirchherr, J.W.; Hekkert, M.P.; Bour, Ruben; Huijbrechtse-Truijens, Anne; Kostense-Smit, Erica; Muller, Jennifer

2017-01-01

The Copernicus Institute of Sustainable Development, Utrecht University, the Netherlands and Deloitte have jointly carried out research on barriers to the Circular Economy (CE) in the European Union. For this research, a survey with 153 businesses, 55 government officials and expert interviews with forty-seven thought leaders on the circular economy from businesses, governments, academia and NGOs have been carried out. Two types of barriers emerged as main barriers Firstly, there are the cult...

Barriers and challenges in researches by Iranian students of medical universities

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Zohreh Anbari

2015-01-01

Full Text Available Background: Health sciences research (HSR is an essential part of improving health care which plays a critical role in the field of medicine and clinical practice. The aim of the current study was to assess barriers to the research by students of medical sciences as well as to find out effective strategies for management of student researches in Iranian universities. Materials and Methods: This study utilized a hybrid design with quantitative and qualitative analytical approaches conducted on 627 students in six schools of medical sciences in two universities in Central Province in Iran from April to December, 2012. Questionnaires were distributed among researcher and non-researcher students to find barriers to the research. These barriers were approved and validated by similar studies and strategies using the Delphi technique on 36 students. Results: The most important barriers among researcher students were institutional barriers (3.3 ± 1.3, but in non-researcher students they were individual barriers (3.6 ± 1.7. The majority of barriers to involvement in the research among researcher students appeared to be time, lack of access to electronic resources and prolongation of the process of buying equipment. In addition, the greatest barriers among non-researcher students included the lack of time, scientific writing skills, and access to trained assistants. Conclusion: The results showed the issue of attitudes towards compulsory research as a component of critical scholarship in the curriculum of medical courses. Moreover, employment of the research experts can be helpful for research training in schools of medical sciences.

Barriers and facilitators for implementing a new screening tool in an emergency department

DEFF Research Database (Denmark)

Kirk, Jeanette W.; Sivertsen, Ditte M.; Petersen, Janne

2016-01-01

Aim: The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team. Background: A high incidence of functional decline after hospitalisation for...... that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned....

Language barriers and qualitative nursing research: methodological considerations.

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Squires, A

2008-09-01

This review of the literature synthesizes methodological recommendations for the use of translators and interpreters in cross-language qualitative research. Cross-language qualitative research involves the use of interpreters and translators to mediate a language barrier between researchers and participants. Qualitative nurse researchers successfully address language barriers between themselves and their participants when they systematically plan for how they will use interpreters and translators throughout the research process. Experienced qualitative researchers recognize that translators can generate qualitative data through translation processes and by participating in data analysis. Failure to address language barriers and the methodological challenges they present threatens the credibility, transferability, dependability and confirmability of cross-language qualitative nursing research. Through a synthesis of the cross-language qualitative methods literature, this article reviews the basics of language competence, translator and interpreter qualifications, and roles for each kind of qualitative research approach. Methodological and ethical considerations are also provided. By systematically addressing the methodological challenges cross-language research presents, nurse researchers can produce better evidence for nursing practice and policy making when working across different language groups. Findings from qualitative studies will also accurately represent the experiences of the participants without concern that the meaning was lost in translation.

Why is it so difficult to recruit patients to research in emergency care? Lessons from the AHEAD study.

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Johnson, Rowena; Kuczawski, Maxine; Mason, Suzanne

2016-01-01

In February 2014, all 23 National Institute for Health Research medical research specialities were failing to meet recruitment targets, with 'Injuries and Emergencies' research performing particularly poorly. In this paper, the multicentre AHEAD study was used to explore issues surrounding recruitment in UK emergency departments. The AHEAD study investigated management and outcomes in over 3000 anticoagulated patients who suffered a head injury. Data from the study were used to compare patient recruitment at 33 Type-1 emergency departments. A questionnaire was sent to a research nurse at each of these sites and 30 replied (91% response rate). The survey investigated the difficulties encountered during patient recruitment and whether these were related to recruitment methods. More detailed interviews were conducted with three research nurses, to gain further insight into the barriers and facilitators involved. Overall recruitment varied widely between sites with an eightfold variation in recruitment rates. Population demographics and other uncontrollable factors will partly contribute to this variation. However, research nurses reported many problems, including site resources, lack of staff engagement and flaws in recruitment strategies, which could be improved. Many of the barriers to recruiting patients for research studies encountered by research nurses have previously been reported in the literature, but there remain consistent problems. Until solutions are found, researchers will continue to miss recruitment targets and this will have implications for the efficiency and quality of emergency medicine research in the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative study

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Graham Ian D

2009-10-01

Full Text Available Abstract Background Despite recent research supporting the use of metered dose inhalers with spacer devices (MDI/spacers in pediatric emergency departments (PEDs for acute exacerbations of asthma, uptake of this practice has been slow. The objectives of this study were to determine the barriers and supports to implementing MDI/spacer research and to identify factors associated with early and late adoption of MDI/spacers in Canadian PEDs. Methods Using a comparative case study design, we classified nine tertiary care pediatric hospital PEDs based on their stage of implementation. Data were collected using focus group interviews with physicians, registered nurses (RNs, and respiratory therapists (RTs, and individual interviews with both patient care and medical directors at each site. Initial coding was based on the Ottawa Model of Research Use (OMRU categories of elements known to influence the uptake of innovations. Results One hundred and fifty healthcare professionals from nine different healthcare institutions participated in this study. Lack of leadership in the form of a research champion, a lack of consensus about the benefits of MDI/spacers among staff, perceived resistance from patients/parents, and perceived increased cost and workload associated with MDI/spacer use were the most prevalent barriers to the adoption of the MDI/spacer. Common strategies used by early-adopting sites included the active participation of all professional groups in the adoption process in addition to a well-planned and executed educational component for staff, patients, and families. Early adopter sites were also more likely to have the MDI/spacer included in a clinical protocol/pathway. Conclusion Potential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study.

Screening and detection of elder abuse: Research opportunities and lessons learned from emergency geriatric care, intimate partner violence, and child abuse.

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Beach, Scott R; Carpenter, Christopher R; Rosen, Tony; Sharps, Phyllis; Gelles, Richard

2016-01-01

This article provides an overview of elder abuse screening and detection methods for community-dwelling and institutionalized older adults, including general issues and challenges for the field. Then, discussions of applications in emergency geriatric care, intimate partner violence (IPV), and child abuse are presented to inform research opportunities in elder abuse screening. The article provides descriptions of emerging screening and detection methods and technologies from the emergency geriatric care and IPV fields. We also discuss the variety of potential barriers to effective screening and detection from the viewpoint of the older adult, caregivers, providers, and the health care system, and we highlight the potential harms and unintended negative consequences of increased screening and mandatory reporting. We argue that research should continue on the development of valid screening methods and tools, but that studies of perceived barriers and potential harms of elder abuse screening among key stakeholders should also be conducted.

Conducting research in clinical psychology practice: Barriers, facilitators, and recommendations.

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Smith, Kirsten V; Thew, Graham R

2017-09-01

The combination of clinical psychologists' therapeutic expertise and research training means that they are in an ideal position to be conducting high-quality research projects. However, despite these skills and the documented benefits of research to services and service users, research activity in practice remains low. This article aims to give an overview of the advantages of, and difficulties in conducting research in clinical practice. We reviewed the relevant literature on barriers to research and reflected on our clinical and research experiences in a range of contexts to offer practical recommendations. We considered factors involved in the planning, sourcing support, implementation, and dissemination phases of research, and outline suggestions to improve the feasibility of research projects in post-qualification roles. We suggest that research leadership is particularly important within clinical psychology to ensure the profession's continued visibility and influence within health settings. Clinical implications Emerging evidence suggests that clinical settings that foster research are associated with better patient outcomes. Suggestions to increase the feasibility of research projects in clinical settings are detailed. Limitations The present recommendations are drawn from the authors' practical experience and may need adaptation to individual practitioners' settings. This study does not attempt to assess the efficacy of the strategies suggested. © 2017 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Overcoming Barriers to Frugal Innovation: Emerging Opportunities for Finnish SMEs in Brazilian Markets

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Mirva Hyypiä

2018-04-01

Full Text Available Frugal innovation has become a popular concept, in academia but also in industry at large. Although there has been a great deal of discussion about the relevance of frugal innovation to the developed world, the notion’s full acceptance within small and medium-sized enterprises (SMEs still seems far in the distance. The opportunities and barriers seen with practical implementation of frugal innovation during the development processes have received little attention. This article considers these opportunities and barriers in the context of Finnish SMEs, providing insight specifically into the approaches these companies take in Brazilian markets. Qualitative data were drawn from a case study forming part of an extensive action research-based development project called SCALA, aimed at creating suitable and scalable mobile learning services for global markets. The concepts of frugal innovation and proceeding from user needs – essential parts of the development processes – are examined by observing three Finnish SMEs and their top managers, with particular focus on their interaction with Brazilian partners. Development sessions and meetings shed light on how the companies perceived and responded to testing their products/services with six individual schools in Brazil. Although frugal innovation is seen as essential for guaranteeing long-term competitiveness of Finnish SMEs – and access to rapidly growing, unsaturated emerging markets such as Brazil can be a step in the right direction – our study highlights numerous barriers and ways to overcome them in the real-world implementation of frugality in SMEs’ development processes.

Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

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Ephrem Abebe

2018-02-01

Full Text Available Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach. Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures. Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts. Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors. Conflict of Interest We declare no conflicts of interest or

Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.

Science.gov (United States)

Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

2017-08-22

Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access

Barriers to the implementation of research perceived by nurses from Osakidetza.

Science.gov (United States)

Cidoncha-Moreno, M Ángeles; Ruíz de Alegría-Fernandez de Retana, Begoña

To understand the barriers to implementing nursing research findings into practice, as perceived by the nurses working in Osakidetza and to analyze if the workplace factor and time worked affect the perception of these barriers. Cross-sectional study. BARRIERS Scale questionnaire was given to a representative sample of 1,572 Basque Health Service nurses, stratified and randomized, according to scope of work and job responsibility (response rate: 43.76%). According to the research results, the first important barrier was "insufficient time on the job to implement new ideas". Nurses have perceived the organizational factor as the most important barrier in their practice. Nurses in "Special hospital departments" perceived more barriers in the "quality of research" factor than those working in "Primary Care". Years of service showed a slight influence. The nurses stated that external factors related to the organization principally interfered in implementing results into clinical practice. They placed lack of critical reading training second. Working environment and seniority mark differences in the perception of barriers. This study may help to develop strategies for planning training programs to facilitate the use of research in clinical practice, in order to provide quality care. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Closing the Gap between Research Evidence and Clinical Practice: Jordanian Nurses' Perceived Barriers to Research Utilisation

Science.gov (United States)

Al Khalaileh, Murad; Al Qadire, Mohammad; Musa, Ahmad S.; Al-Khawaldeh, Omar A.; Al Qudah, Hani; Alhabahbeh, Atalla

2016-01-01

Background: The nursing profession is a combination of theory and practical skill, and nurses are required to generate and develop knowledge through implementing research into clinical practice. Considerable number of barriers could hind implementing research findings into practice. Barriers to research utilisation are not identified in the…

Barriers to participation in mental health research: are there specific gender, ethnicity and age related barriers?

Directory of Open Access Journals (Sweden)

Howard Louise

2010-12-01

Full Text Available Abstract Background It is well established that the incidence, prevalence and presentation of mental disorders differ by gender, ethnicity and age, and there is evidence that there is also differential representation in mental health research by these characteristics. The aim of this paper is to a review the current literature on the nature of barriers to participation in mental health research, with particular reference to gender, age and ethnicity; b review the evidence on the effectiveness of strategies used to overcome these barriers. Method Studies published up to December 2008 were identified using MEDLINE, PsycINFO and EMBASE using relevant mesh headings and keywords. Results Forty-nine papers were identified. There was evidence of a wide range of barriers including transportation difficulties, distrust and suspicion of researchers, and the stigma attached to mental illness. Strategies to overcome these barriers included the use of bilingual staff, assistance with travel, avoiding the use of stigmatising language in marketing material and a focus on education about the disorder under investigation. There were very few evaluations of such strategies, but there was evidence that ethnically matching recruiters to potential participants did not improve recruitment rates. Educational strategies were helpful and increased recruitment. Conclusion Mental health researchers should consider including caregivers in recruitment procedures where possible, provide clear descriptions of study aims and describe the representativeness of their sample when reporting study results. Studies that systematically investigate strategies to overcome barriers to recruitment are needed.

Music therapists' research activity and utilization barriers: a survey of the membership.

Science.gov (United States)

Waldon, Eric G

2015-01-01

Music therapists have access to a rapidly expanding body of research supporting the use of music-based interventions. What is not known is the extent to which music therapists access these resources and what factors may prevent them from incorporating research findings into clinical work. After constructing the Music Therapists' Research Activity and Utilization Barrier (MTRAUB) database, the purposes of this study involved: assessing the extent to which American Music Therapy Association (AMTA) members engage in certain research-related activities; and identifying respondents' perceived barriers to integrating research into clinical practice. This study employed a quantitative, non-experimental approach using an online survey. Respondents included professional, associate, student/graduate student, retired, inactive, and honorary life members of AMTA. Instrumentation involved a researcher-designed Background Questionnaire as well as the Barriers to Research Utilization Scale (BARRIERS; Funk, Champagne, Wiese, & Tornquist, 1991), a tool designed to assess perceived barriers to incorporating research into practice. Of the 3,194 survey invitations distributed, 974 AMTA members replied (a response rate of 30%). Regarding research-related activities, descriptive findings indicate that journal reading is the most frequently reported research-related activity while conducting research is the least frequently reported activity. Results from the BARRIERS Scale indicated that Organizational and Communication factors are perceived as interfering most prominently with the ability to utilize research in clinical practice. Findings suggest that research-related activity and perceived barriers vary as a function of educational attainment, work setting, and occupational role. The author discusses these differential findings in detail, suggests supportive mechanisms to encourage increased research activity and utilization, and offers recommendations for further analysis of the

Barriers to evidence-based medicine: a systematic review.

Science.gov (United States)

Sadeghi-Bazargani, Homayoun; Tabrizi, Jafar Sadegh; Azami-Aghdash, Saber

2014-12-01

Evidence-based medicine (EBM) has emerged as an effective strategy to improve health care quality. The aim of this study was to systematically review and carry out an analysis on the barriers to EBM. Different database searching methods and also manual search were employed in this study using the search words ('evidence-based' or 'evidence-based medicine' or 'evidence-based practice' or 'evidence-based guidelines' or 'research utilization') and (barrier* or challenge or hinder) in the following databases: PubMed, Scopus, Web of Knowledge, Cochrane library, Pro Quest, Magiran, SID. Out of 2592 articles, 106 articles were finally identified for study. Research barriers, lack of resources, lack of time, inadequate skills, and inadequate access, lack of knowledge and financial barriers were found to be the most common barriers to EBM. Examples of these barriers were found in primary care, hospital/specialist care, rehabilitation care, medical education, management and decision making. The most common barriers to research utilization were research barriers, cooperation barriers and changing barriers. Lack of resources was the most common barrier to implementation of guidelines. The result of this study shows that there are many barriers to the implementation and use of EBM. Identifying barriers is just the first step to removing barriers to the use of EBM. Extra resources will be needed if these barriers are to be tackled. © 2014 John Wiley & Sons, Ltd.

Barrier performance researches for the safety evaluation

International Nuclear Information System (INIS)

Niibori, Yuichi

2004-01-01

So far, many researches were conducted to propose a scientific evidence (a safety case) for the realization of geological disposal in Japan. In order to regulate the geological disposal system of radioactive wastes, on the other hand, we need also a holistic approach to integrate various data related for the performance evaluations of the engineered barrier system and the natural barrier system. However, the scientific bases are not sufficient to establish the safety regulation for such a natural system. For example, we often apply the specific probability density function (PDF) to the uncertainty of barrier system due to the essential heterogeneity. However, the applicability is not clear in the regulation point of view. A viewpoint to understand such an applicability of PDFs has been presented. (author)

Barriers to Clinical Research in Latin America

OpenAIRE

Chomsky-Higgins, Kathryn; Miclau, Theodore A.; Mackechnie, Madeline C.; Aguilar, Dino; Avila, Jorge Rubio; dos Reis, Fernando Baldy; Balmaseda, Roberto; Barquet, Antonio; Ceballos, Alfredo; Contreras, Fernando; Escalante, Igor; Elias, Nelson; Vincenti, Sergio Iriarte; Lozano, Christian; Medina, Fryda

2017-01-01

Enhancing health research capacity in developing countries is a global health priority. Understanding the orthopedic burden of disease in Latin America will require close partnership between more-developed and less-developed countries. To this end, the Osteosynthesis and Trauma Care Foundation assembled a research consortium of Latin-American orthopedic leaders. Prior to the meeting, we surveyed attendees on perceived barriers to conducting research at their institutions. During the event, wo...

Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study.

Science.gov (United States)

Muñoz-Sánchez, Juan-Luis; Delgado, Carmen; Parra-Vidales, Esther; Franco-Martín, Manuel

2018-01-24

This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Although all

Facilitating Factors and Barriers to the Use of Emerging Technologies for Suicide Prevention in Europe: Multicountry Exploratory Study

Science.gov (United States)

Delgado, Carmen; Sánchez-Prada, Andrés; Parra-Vidales, Esther; de Leo, Diego; Franco-Martín, Manuel

2018-01-01

Background This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ

Qualitative Research on Emergency Medicine Physicians

DEFF Research Database (Denmark)

Paltved, Charlotte; Musaeus, Peter

2012-01-01

Aim: This study aims to systematically review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena. EM is a highly complex medical and social environment that can be investigated...... with qualitative research. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references...... and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigour in recent years and few...

Barriers to recognition of out-of-hospital cardiac arrest during emergency medical calls

DEFF Research Database (Denmark)

Alfsen, David; Møller, Thea Palsgaard; Egerod, Ingrid

2015-01-01

the dispatchers' recognition of OHCA, focusing on the communication during the emergency call. The purpose of this study is to identify factors affecting medical dispatchers' recognition of OHCA during emergency calls in a qualitative analysis of calls. METHODS: An investigator triangulated inductive thematic...... to an automated external defibrillator should be initiated. Previous studies have investigated barriers to recognition of OHCA, and found the caller's description of sign of life, the type of caller, caller's emotional state, an inadequate dialogue during the emergency call, and patient's agonal breathing...... as influential factors. Though many of these factors are included in the algorithms used by medical dispatchers, many OHCA still remain not recognised. Qualitative studies investigating the communication between the caller and dispatcher are very scarce. There is a lack of knowledge about what influences...

Benefits and Barriers of University Industry Collaborations from a Researcher's Perspective

DEFF Research Database (Denmark)

Kilian, Thomas; Schubert, Petra; Bjørn-Andersen, Niels

2015-01-01

parsimonious formative measures for the benefits and barriers of UIC and we found that academic and economic benefits positively influence the intention to conduct UIC in the future, while economic barriers negatively influence the intention to engage in UIC. A cluster analysis found five clusters (groups...... of researchers) that differ in their perception of benefits and barriers and the future intention to conduct UIC. However, the majority of the researchers have a very high intention to conduct UIC in the future....

Comprehensive Oncologic Emergencies Research Network (CONCERN)

Science.gov (United States)

The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established in March 2015 with the goal to accelerate knowledge generation, synthesis and translation of oncologic emergency medicine research through multi-center collaborations.

Barriers and Solutions to Conducting Large International, Interdisciplinary Research Projects

Science.gov (United States)

Pischke, Erin C.; Knowlton, Jessie L.; Phifer, Colin C.; Gutierrez Lopez, Jose; Propato, Tamara S.; Eastmond, Amarella; de Souza, Tatiana Martins; Kuhlberg, Mark; Picasso Risso, Valentin; Veron, Santiago R.; Garcia, Carlos; Chiappe, Marta; Halvorsen, Kathleen E.

2017-12-01

Global environmental problems such as climate change are not bounded by national borders or scientific disciplines, and therefore require international, interdisciplinary teamwork to develop understandings of their causes and solutions. Interdisciplinary scientific work is difficult enough, but these challenges are often magnified when teams also work across national boundaries. The literature on the challenges of interdisciplinary research is extensive. However, research on international, interdisciplinary teams is nearly non-existent. Our objective is to fill this gap by reporting on results from a study of a large interdisciplinary, international National Science Foundation Partnerships for International Research and Education (NSF-PIRE) research project across the Americas. We administered a structured questionnaire to team members about challenges they faced while working together across disciplines and outside of their home countries in Argentina, Brazil, and Mexico. Analysis of the responses indicated five major types of barriers to conducting interdisciplinary, international research: integration, language, fieldwork logistics, personnel and relationships, and time commitment. We discuss the causes and recommended solutions to the most common barriers. Our findings can help other interdisciplinary, international research teams anticipate challenges, and develop effective solutions to minimize the negative impacts of these barriers to their research.

Barriers and Solutions to Conducting Large International, Interdisciplinary Research Projects.

Science.gov (United States)

Pischke, Erin C; Knowlton, Jessie L; Phifer, Colin C; Gutierrez Lopez, Jose; Propato, Tamara S; Eastmond, Amarella; de Souza, Tatiana Martins; Kuhlberg, Mark; Picasso Risso, Valentin; Veron, Santiago R; Garcia, Carlos; Chiappe, Marta; Halvorsen, Kathleen E

2017-12-01

Global environmental problems such as climate change are not bounded by national borders or scientific disciplines, and therefore require international, interdisciplinary teamwork to develop understandings of their causes and solutions. Interdisciplinary scientific work is difficult enough, but these challenges are often magnified when teams also work across national boundaries. The literature on the challenges of interdisciplinary research is extensive. However, research on international, interdisciplinary teams is nearly non-existent. Our objective is to fill this gap by reporting on results from a study of a large interdisciplinary, international National Science Foundation Partnerships for International Research and Education (NSF-PIRE) research project across the Americas. We administered a structured questionnaire to team members about challenges they faced while working together across disciplines and outside of their home countries in Argentina, Brazil, and Mexico. Analysis of the responses indicated five major types of barriers to conducting interdisciplinary, international research: integration, language, fieldwork logistics, personnel and relationships, and time commitment. We discuss the causes and recommended solutions to the most common barriers. Our findings can help other interdisciplinary, international research teams anticipate challenges, and develop effective solutions to minimize the negative impacts of these barriers to their research.

The impact of communication barriers on diagnostic confidence and ancillary testing in the emergency department.

Science.gov (United States)

Garra, Gregory; Albino, Hiram; Chapman, Heather; Singer, Adam J; Thode, Henry C

2010-06-01

Communication barriers (CBs) compromise the diagnostic power of the medical interview and may result in increased reliance on diagnostic tests or incorrect test ordering. The prevalence and degree to which these barriers affect diagnosis, testing, and treatment are unknown. To quantify and characterize CBs encountered in the Emergency Department (ED), and assess the effect of CBs on initial diagnosis and perceived reliance on ancillary testing. This was a prospective survey completed by emergency physicians after initial adult patient encounters. CB severity, diagnostic confidence, and reliance on ancillary testing were quantified on a 100-mm Visual Analog Scale (VAS) from least (0) to most (100). Data were collected on 417 ED patient encounters. CBs were reported in 46%; with a mean severity of 50 mm on a 100-mm VAS with endpoints of "perfect communication and "no communication." Language was the most commonly reported form of CB (28%). More than one CB was identified in 6%. The 100-mm VAS rating of diagnostic confidence was lower in patients with perceived CBs (64 mm) vs. those without CBs (80 mm), p Communication barriers in our ED setting were common, and resulted in lower diagnostic confidence and increased perception that ancillary tests are needed to narrow the diagnosis. Copyright 2010 Elsevier Inc. All rights reserved.

Barriers to investment in emerging power markets

Energy Technology Data Exchange (ETDEWEB)

Beardsworth, Jr, J J [Hunton and Williams, Richmond, VA (United States)

1994-12-31

Investing in private power projects in developing countries is a very different issue from investment in the US or the UK. There are many investment barriers not present in developed nations. Firstly investment barriers need to be identified. Trouble may be encountered with legal authorization; the regulatory framework; government guarantees; fuel supply security; lender protection; labour laws and local commercial restrictions such as profits repatriation, currency convertibility, and taxes. Political barriers may also be encountered in the form of: government commitments and support; funding sources; political unrest; religion; and relationships with other countries. Investment barriers may be minimised by persuading the government to remove any legal barriers; the contract has then to be agreed. Factors in a successful contract include: power purchase agreements; fuel agreements; and implementation agreements. It is vital to have a source of information on local rules and customs, by working with local companies and employing local attorneys.

Rare disease research: Breaking the privacy barrier

Directory of Open Access Journals (Sweden)

Deborah Mascalzoni

2014-06-01

Full Text Available Due to the few patients affected, rare disease research has to count on international registries to exist in order to produce significant research outputs. Data sharing of registries is therefore a unique resource to allow rare disease research to flourish and any lost data will jeopardize the quality of an already extremely difficult research. The rules usually applied to research such as the right to withdraw or the need for specific consent for every use of data can be detrimental in order to get effective results. Privacy rights regulated through traditional informed consent mechanisms have been regarded as a major barrier in order to effectively share data worldwide. Some authors argue that this barrier hampers results that could be beneficial to the patients so that another right will be overstated: the right to quality healthcare. We argue in this paper that privacy has been often interpreted just one-sided as the right to secrecy but it can entail another meaning: the right to manage one's own private sphere. Managing it pertains, not only to the right to deny access, but also to the right to grant access. At the same time research on patient participation and transparency shows that new forms of IT-based informed consent can provide a good balance between the right of individuals to be in control of their data and the opportunity for science to pursue international research.

Strategies for addressing barriers to publishing pediatric quality improvement research.

Science.gov (United States)

Van Cleave, Jeanne; Dougherty, Denise; Perrin, James M

2011-09-01

Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

Research utilisation in sonographic practice: Attitudes and barriers

International Nuclear Information System (INIS)

Elliott, Vicki; Wilson, Stephanie E.; Svensson, Jon; Brennan, Patrick

2009-01-01

Statutory agents have stipulated that research activity is a fundamental component of the healthcare professional's activity. Whilst the College of Radiographers have emphasised the importance of imaging personnel embracing this research ethos, there is little available data on the level of research activity within sonographic practice or on the factors that influence a sonographer's involvement in research activities. This work attempts to address these deficiencies. A questionnaire was sent to 300 UK-based sonographers of whom 218 responded (72%). The questionnaire was specifically designed to establish the level of involvement in research, the utilisation of research findings, attitudes towards research and perceived barriers to active research involvement. Responses were analysed investigating any correlations with the population demographics. The data collected showed the majority of sonographers (89%) were enthusiastic about research but with only 33% and 60% currently or previously performing research, respectively, and 73% using research findings to modify their clinical practice. Certain barriers to an active research involvement were shown, with 63%, 55% and 40% citing lack of time, education and collegial support, respectively. A range of statistical findings were linked to particular sonographer groups. The importance of good organisational structures and effective support from fellow health professionals was highlighted. The results confirm sonographers' appreciation of the benefits of research and it is suggested that if this enthusiasm is translated into effective research strategies, research output from ultrasound and other clinical departments should be enhanced.

Microfluidic organ-on-chip technology for blood-brain barrier research.

Science.gov (United States)

van der Helm, Marinke W; van der Meer, Andries D; Eijkel, Jan C T; van den Berg, Albert; Segerink, Loes I

2016-01-01

Organs-on-chips are a new class of microengineered laboratory models that combine several of the advantages of current in vivo and in vitro models. In this review, we summarize the advances that have been made in the development of organ-on-chip models of the blood-brain barrier (BBBs-on-chips) and the challenges that are still ahead. The BBB is formed by specialized endothelial cells and separates blood from brain tissue. It protects the brain from harmful compounds from the blood and provides homeostasis for optimal neuronal function [corrected]. Studying BBB function and dysfunction is important for drug development and biomedical research. Microfluidic BBBs-on-chips enable real-time study of (human) cells in an engineered physiological microenvironment, for example incorporating small geometries and fluid flow as well as sensors. Examples of BBBs-on-chips in literature already show the potential of more realistic microenvironments and the study of organ-level functions. A key challenge in the field of BBB-on-chip development is the current lack of standardized quantification of parameters such as barrier permeability and shear stress. This limits the potential for direct comparison of the performance of different BBB-on-chip models to each other and existing models. We give recommendations for further standardization in model characterization and conclude that the rapidly emerging field of BBB-on-chip models holds great promise for further studies in BBB biology and drug development.

Using principles from emergency management to improve emergency response plans for research animals.

Science.gov (United States)

Vogelweid, Catherine M

2013-10-01

Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

Facilitators and barriers to screening for child abuse in the emergency department

Directory of Open Access Journals (Sweden)

Louwers Eveline CFM

2012-10-01

Full Text Available Abstract Background To identify facilitators of, and barriers to, screening for child abuse in emergency departments (ED through interviews with ED staff, members of the hospital Board, and related experts. Methods This qualitative study is based on semi-structured interviews with 27 professionals from seven Dutch hospitals (i.e. seven pediatricians, two surgeons, six ED nurses, six ED managers and six hospital Board members. The resulting list of facilitators/barriers was subsequently discussed with five experts in child abuse and one implementation expert. The results are ordered using the Child Abuse Framework of the Dutch Health Care Inspectorate that legally requires screening for child abuse. Results Lack of knowledge of child abuse, communication with parents in the case of suspected abuse, and lack of time for development of policy and cases are barriers for ED staff to screen for child abuse. For Board members, lack of means and time, and a high turnover of ED staff are impediments to improving their child abuse policy. Screening can be promoted by training ED staff to better recognize child abuse, improving communication skills, appointing an attendant specifically for child abuse, explicit support of the screening policy by management, and by national implementation of an approved protocol and validated screening instrument. Conclusions ED staff are motivated to work according to the Dutch Health Care Inspectorate requirements but experiences many barriers, particularly communication with parents of children suspected of being abused. Introduction of a national child abuse protocol can improve screening on child abuse at EDs.

Barriers to research utilisation among forensic mental health nurses.

Science.gov (United States)

Carrion, Maria; Woods, Phil; Norman, Ian

2004-08-01

This study used a cross-sectional, descriptive design to identify barriers to research utilisation among forensic mental health nurses. A postal questionnaire was sent to the total population of 88 registered nurses working in a forensic mental health hospital in the UK. Forty-seven responded representing a response rate of 53%. Results showed that the greatest barriers to research utilisation were those related to the characteristics of the setting in which nurses work or the personal characteristics of nurses themselves, which seems to be consistent with previous studies undertaken in the area. However, the nurses reported it especially difficult to trust what research shows because they feel that it is not always possible to apply those findings to their particular work environment. The main implications for policy are a need for an increase in support from management, programmes of advanced education to provide nurses with research skills, an improvement in accessibility and availability of research reports and an increase in time available to read and implement research. The main suggestions for future research are that qualitative studies should be carried out to attain a better understanding of mental health nurses' attitudes towards research utilisation. Copyright 2004 Elsevier Ltd.

quantification of emergency action levels for research reactor

International Nuclear Information System (INIS)

Wu Zhongwang; Qu Jingyuan; Liu Yuanzhong; Xi Shuren

2000-01-01

Emergency action level (EAL) technical criteria or parameters for emergency conditions classes. Reference methodology for development of EAL in foreign countries, in process of developed and reviewed emergency plan of home several research reactors, the author thought that should be taken initiating conditions which result in emergency conditions quantified some instrumental readings or alarm thresholds, in order to distinguish and confirm emergency conditions and provide technical bases for emergency response actions. Then based on this principle, revised or developed emergency plans of INET Tsinghua University, promote development of work for emergency plan of research reactors

Should we quit our jobs? Challenges, barriers and recommendations for interdisciplinary energy research

International Nuclear Information System (INIS)

Schuitema, Geertje; Sintov, Nicole D.

2017-01-01

Many plea for a better integration of social sciences in energy research, which would imply more comprehensive interdisciplinary energy research. We argue that in order to achieve this, institutional barriers and research challenges need to be recognised and addressed. We identify six challenges and barriers, and provide recommendations for working towards solutions. We conclude that to engage in interdisciplinary research implies extra costs and fewer rewards for all researchers, particularly early and mid-career academics. We propose a new conceptualisation of practices and incentive structures among academic institutions, funding agencies, and publication outlets, and urge all energy researchers to join this debate. - Highlights: • Interdisciplinary energy research currently does not reach its full potential. • Social sciences are underutilised in energy research. • Barriers and challenges need to be addressed to stimulate interdisciplinary energy research. • High costs and small rewards for interdisciplinary (early and mid-career) researchers.

Barriers to Research and Implications for Training Counselors

Directory of Open Access Journals (Sweden)

James R Ruby

2013-03-01

Full Text Available Research is an important part of quality clinical practice in the field of counseling. This study addresses the constraints that produce a gap in master’s level practitioner research among counselors in Illinois. Ninety-nine master’s level clinicians responded to surveys and answered a series of questions regarding what constrains them from being more involved in research. These respondents provided valuable feedback regarding possible recommendations for training that might encourage increased research activity for future master’s level counselors. Training improvements such as mentored research activity and training in less complex research methods were indicated. Keywords: Clinical practice, Implications, Barriers to research, less complex research

Health research barriers in the faculties of two medical institutions in India

Directory of Open Access Journals (Sweden)

Alamdari A

2012-08-01

Full Text Available A Alamdari,1 S Venkatesh,2 A Roozbehi,3 AT Kannan41Research Center of Factors Affecting Health, Faculty of Nursing and Midwifery, Yasouj University of Medical Sciences, Yasouj, Iran; 2National AIDS Control Organization, Janpath Road, Chandralok Building, New Delhi, India; 3Education Development Office, Yasouj University of Medical Sciences, Yasouj, Iran; 4Department of Community Medicine, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, IndiaBackground: Health policy formation refers to the design of a conceptual framework to find possibilities, facilitate feasibilities, and identify strong and weak points, as well as insufficiencies, by research. Doing research should clarify qualities and standards for policy and decision-making to enable the success of development of health care in a country. Evaluation of the impact of health interventions is particularly poorly represented in public health research. This study attempted to identify barriers and facilitators of health research among faculty members in two major institutions in India, ie, the All India Institute of Medical Sciences (AIIMS and the University College of Medical Sciences (UCMS and Guru Tegh Bahadur (GTB Hospital in Delhi.Methods: The participants were asked to fill in a questionnaire that canvassed individual characteristics, ie, years of experience, place of work, academic rank, final educational qualification, work setting, educational group, primary activity, and number of publications in the previous 5 years. Barriers and facilitators were categorized into personal, resources, access, and administration groups. The data were processed using SPSS version 16, independent t-tests, Chi-square tests, and multivariate logistic regression.Results: The total number of faculty members at both institutions was 599, 456 (76% of whom participated in this study. The primary activities reported by faculty at UCMS (teaching and Faculty at AIIMS reported

Qualitative Research in Emergency Care Part I: Research Principles and Common Applications.

Science.gov (United States)

Choo, Esther K; Garro, Aris C; Ranney, Megan L; Meisel, Zachary F; Morrow Guthrie, Kate

2015-09-01

Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. This article, Part I of a two-article series, provides an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field, including observation, individual interviews, and focus groups. In Part II of this series, we will outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. © 2015 by the Society for Academic Emergency Medicine.

Barriers to Effective Teamwork Relating to Pediatric Resuscitations: Perceptions of Pediatric Emergency Medicine Staff.

Science.gov (United States)

Sherman, Joshua M; Chang, Todd P; Ziv, Nurit; Nager, Alan L

2017-10-09

In the pediatric emergency department (PED), resuscitations require medical teams form ad hoc, rarely communicating beforehand. Literature has shown that the medical community has deficiencies in communication and teamwork. However, we as medical providers do not know or understand the perceived barriers of our colleagues. Physicians may perceive a barrier that is different from nurses, respiratory therapists, pharmacists, or technicians. Perhaps we do not know in which area of teamwork and communication we are deficient. Only when we understand the perceptions of our fellow coworkers can we take steps toward improvement in quality resuscitations and therefore patient safety. The primary objectives of this study were to describe and understand the perceived barriers to effective communication and teamwork among different disciplines forming spontaneous resuscitation teams at a tertiary urban PED and to determine if providers of different disciplines perceived these barriers differently. This was a mixed-methods study conducted in a single, tertiary care freestanding children's hospital emergency department. Survey questions were iteratively developed to measure the construct of barriers and best practices within resuscitation teamwork, which was administered to staff among 5 selected roles: physicians, nurses, respiratory technicians, PED technicians, and PED pharmacists. It contained open-ended questions to provide statements on specific barriers or goals in effective teamwork, as well as a priority ranking on 25 different statements on teamwork extracted from the literature. From the participant data, 9 core themes related to resuscitation teamwork were coalesced using affinity diagramming by the authors. All statements from the survey were coded to the 9 core themes by 2 authors, with high reliability (κ = 0.93). Descriptive statistics were used to summarize the prevalence of themes mentioned by survey participants. A χ test was used to determine differences

Motivators, enablers, and barriers to building allied health research capacity

Science.gov (United States)

Pager, Susan; Holden, Libby; Golenko, Xanthe

2012-01-01

Purpose A sound, scientific base of high quality research is needed to inform service planning and decision making and enable improved policy and practice. However, some areas of health practice, particularly many of the allied health areas, are generally considered to have a low evidence base. In order to successfully build research capacity in allied health, a clearer understanding is required of what assists and encourages research as well as the barriers and challenges. Participants and methods This study used written surveys to collect data relating to motivators, enablers, and barriers to research capacity building. Respondents were asked to answer questions relating to them as individuals and other questions relating to their team. Allied health professionals were recruited from multidisciplinary primary health care teams in Queensland Health. Eighty-five participants from ten healthcare teams completed a written version of the research capacity and culture survey. Results The results of this study indicate that individual allied health professionals are more likely to report being motivated to do research by intrinsic factors such as a strong interest in research. Barriers they identified to research are more likely to be extrinsic factors such as workload and lack of time. Allied health professionals identified some additional factors that impact on their research capacity than those reported in the literature, such as a desire to keep at the “cutting edge” and a lack of exposure to research. Some of the factors influencing individuals to do research were different to those influencing teams. These results are discussed with reference to organizational behavior and theories of motivation. Conclusion Supporting already motivated allied health professional individuals and teams to conduct research by increased skills training, infrastructure, and quarantined time is likely to produce better outcomes for research capacity building investment. PMID

Conducting a Multisite Education Research Project: Strategies to Overcome the Barriers to Achieve the Benefits.

Science.gov (United States)

Beischel, Kelly P; Hart, Julie; Turkelson, Sandra L

2016-01-01

Multisite education research projects have many benefits as well as perceived barriers. In this article, we share our experiences with a multisite education research project and the barriers we overcame to reap the benefits. The outcome of our research resulted in increased rigor, role-modeling professional collaboration, and promotion of future multisite education studies. The strategies presented in this article will help alleviate perceived barriers and ameliorate the process of conducting multisite education research studies.

Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review.

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Ramsbottom, Anna; O'Brien, Eleanor; Ciotti, Lucrezio; Takacs, Judit

2018-04-01

Public health emergency preparedness (PHEP) all too often focusses only on institutional capabilities, including their technical expertise and political influence, while overlooking community capabilities. However, the success of institutional emergency preparedness plans depends upon communities and institutions working together to ensure successful anticipation, response and recovery. Broader community engagement is therefore recommended worldwide. This literature review was carried out to identify enablers and barriers to community and institutional synergies in emergency preparedness. Searches were undertaken across bibliographic databases and grey literature sources. The literature identified was qualitative in nature. A qualitative, 'best fit' framework approach using a pre-existing framework was used to analyse the literature, whereby themes were added and changed as analysis progressed. A working definition of community was identified, based on a 'whole community' approach, inclusive of the whole multitude of stakeholders including community residents and emergency management staff. Given the diversity in community make-up, the types of emergencies that could be faced, the socio-economic, environmental and political range of communities, there are no set practices that will be effective for all communities. The most effective way of engaging communities in emergency preparedness is context-dependent and the review did draw out some important key messages for institutions to consider.

Barriers to Research and Evidence (Editorial

Directory of Open Access Journals (Sweden)

Alison Brettle

2013-06-01

Full Text Available I often find attending conferences or workshops a source of reflection or inspiration for editorials, and today I attended an event that proved to be no exception. The HEALER network is a UK grouping of professionals interested in health library research. It brings together those working in health information at an academic, practitioner or strategic capacity as well as those working in higher education, research and the NHS. (http://www.libraryservices.nhs.uk/healer/minutes.htmlThere were a number of interesting presentations, but one (and the subsequent interactive discussions left me with some worrying thoughts. Hannah Spring (2013 presented some of the findings from her PhD that found when health librarians were asked about their barriers to research they reported that they didn't know what research questions to ask! Alternatively if they had research questions they didn't think to engage with the literature or believed that there was no evidence to answer them! If we really don't have any research questions, and we really don't think to look at the literature or there really is no evidence, this is worrying indeed for the future of EBLIP. It's also a situation I don't recognize from being involved in the EBLIP journal and was left wondering whether it was the health librarians perceptions of “research” and “evidence” that was the issue; questions which are being examined in the LIRG Scan which was described in another presentation. The scan is a review of the evidence on: What practitioners understand by research; what kind of research is relevant to LIS practitioners? How do they use research and what are the barriers and facilitators to using research in practice? (https://sites.google.com/site/lirgweb/home/awards/lirg-scan-award The results will be used to help inform the Chartered Institute for Library and Information Professionals’ policy on research.The barrier which I’m much more familiar in terms of engaging with

Distributed academic leadership in emergent research organisations

NARCIS (Netherlands)

Kokkeler, Bernardus J.M.

2014-01-01

The thesis “distributed academic leadership in emergent research organizations" that Ben Kokkeler on October 29th 2014 successfully defended at the University of Twente, shows that a specific type of academic leadership developes, deep in the heart of the university, in emerging research institutes.

78 FR 40098 - Emerging Technology and Research Advisory Committee;

Science.gov (United States)

2013-07-03

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Assistant Secretary for Export Administration on emerging technology and research activities, including...

Priorities for emergency department syncope research

NARCIS (Netherlands)

Sun, Benjamin C.; Costantino, Giorgio; Barbic, Franca; Bossi, Ilaria; Casazza, Giovanni; Dipaola, Franca; McDermott, Daniel; Quinn, James; Reed, Matthew; Sheldon, Robert S.; Solbiati, Monica; Thiruganasambandamoorthy, Venkatesh; Krahn, Andrew D.; Beach, Daniel; Bodemer, Nicolai; Brignole, Michele; Casagranda, Ivo; Duca, Piergiorgio; Falavigna, Greta; Ippoliti, Roberto; Montano, Nicola; Olshansky, Brian; Raj, Satish R.; Ruwald, Martin H.; Shen, Win-Kuang; Stiell, Ian; Ungar, Andrea; van Dijk, J. Gert; van Dijk, Nynke; Wieling, Wouter; Furlan, Raffaello

2014-01-01

There is limited evidence to guide the emergency department (ED) evaluation and management of syncope. The First International Workshop on Syncope Risk Stratification in the Emergency Department identified key research questions and methodological standards essential to advancing the science of

Barriers in detecting elder abuse among emergency medical technicians.

Science.gov (United States)

Reingle Gonzalez, Jennifer M; Cannell, M Brad; Jetelina, Katelyn K; Radpour, Sepeadeh

2016-09-02

Elder abuse and neglect are highly under-reported in the United States. This may be partially attributed to low incidence of reporting among emergency medical technicians' (EMTs), despite state-mandated reporting of suspected elder abuse. Innovative solutions are needed to address under-reporting. The objective was to describe EMTs' experience detecting and reporting elder abuse. Qualitative data were collected from 11 EMTs and 12 Adult Protective Services (APS) caseworkers that participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders. Findings suggest a number of barriers prevent EMTs from reporting elder abuse to APS. Participants suggested that limited training on elder abuse detection or reporting has been provided to them. EMTs suggested that training, creation of an automated reporting system or brief screening tool could be used to enhance EMT's ability to detect and communicate suspected cases of elder abuse to APS. Results from the present study suggest that EMTs may be uniquely situated to serve as elder abuse and neglect surveillance personnel. EMTs are eager to work with APS to address the under-reporting of elder abuse and neglect, but training is minimal and current reporting procedures are time-prohibitive given their primary role as emergency healthcare providers. Future studies should seek to translate these findings into practice by identifying specific indicators predictive of elder abuse and neglect for inclusion on an automated reporting instrument for EMTs.

Overcoming barriers to recruiting ethnic minorities to mental health research: a typology of recruitment strategies.

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Waheed, Waquas; Hughes-Morley, Adwoa; Woodham, Adrine; Allen, Gill; Bower, Peter

2015-05-02

The ethnic minority population in developed countries is increasing over time. These groups are at higher risk of mental illness and demonstrate lower participation in research. Published evidence suggests that multiple factors like stigma, lack of trust, differences in explanatory models, logistical issues and lack of culturally aware researchers act as barriers to ethnic minority recruitment into mental health research. To reduce inequalities in participation, there is a need to devise innovative and culturally sensitive recruitment strategies. It is important that researchers share their experience of employing these strategies so that ethnic minority participation can be facilitated. We previously published a systematic review of barriers to recruiting ethnic minority participants into mental health research. The nine papers included in our prior review formed the basis for developing a typology of barriers to recruiting ethnic minorities into mental health research. This typology identified 33 barriers, described under five themes. We further extracted data on the strategies used to overcome these recruitment barriers, as described in the included studies. The strategies employed by the authors could be matched to all but two barriers (psychopathology/substance misuse and limited resource availability). There was evidence that multiple strategies were employed, and that these depended upon the population, clinical set-up and resources available. This typology of strategies to overcome barriers to recruiting ethnic minorities provides guidance on achieving higher rates of recruitment. It is important that researchers plan to deploy these strategies well in advance of initiating recruitment. Whilst adopting these strategies, the authors have not been able to quantify the positive impact of these strategies on recruitment. The typology should encourage researchers to employ these strategies in future research, refine them further and quantitatively evaluate their

Behavior of nine selected emerging trace organic contaminants in an artificial recharge system supplemented with a reactive barrier.

Science.gov (United States)

Valhondo, Cristina; Carrera, Jesús; Ayora, Carlos; Barbieri, Manuela; Nödler, Karsten; Licha, Tobias; Huerta, Maria

2014-10-01

Artificial recharge improves several water quality parameters, but has only minor effects on recalcitrant pollutants. To improve the removal of these pollutants, we added a reactive barrier at the bottom of an infiltration basin. This barrier contained aquifer sand, vegetable compost, and clay and was covered with iron oxide dust. The goal of the compost was to sorb neutral compounds and release dissolved organic carbon. The release of dissolved organic carbon should generate a broad range of redox conditions to promote the transformation of emerging trace organic contaminants (EOCs). Iron oxides and clay increase the range of sorption site types. In the present study, we examined the effectiveness of this barrier by analyzing the fate of nine EOCs. Water quality was monitored before and after constructing the reactive barrier. Installation of the reactive barrier led to nitrate-, iron-, and manganese-reducing conditions in the unsaturated zone below the basin and within the first few meters of the saturated zone. Thus, the behavior of most EOCs changed after installing the reactive barrier. The reactive barrier enhanced the removal of some EOCs, either markedly (sulfamethoxazole, caffeine, benzoylecgonine) or slightly (trimethoprim) and decreased the removal rates of compounds that are easily degradable under aerobic conditions (ibuprofen, paracetamol). The barrier had no remarkable effect on 1H-benzotriazole and tolyltriazole.

International entrepreneurship research in emerging economies : A critical review and research agenda

NARCIS (Netherlands)

Kiss, A.N.; Danis, W.D.; Cavusgil, S.T.

This article systematically reviews and critically examines international entrepreneurship research in emerging economies (IEEE research), and articulates its importance, timeliness and relevance in consideration of the growing influence of emerging markets in the global economy. A systematic

Barriers and facilitators to recruitment of South Asians to health research: a scoping review

Science.gov (United States)

Frimer, Leora; Janssen, Patricia A; Lamers, Yvonne

2017-01-01

Objectives People of South Asian ethnicity are under-represented in health research studies. The objectives of this scoping review were to examine the barriers and facilitators to recruitment of South Asians to health research studies and to describe strategies for improving recruitment. Design Scoping review Methods Using the Arksey and O’Malley framework for scoping reviews, we comprehensively searched electronic databases (MEDLINE via PubMed, Cochrane Library, CINAHL and PsycINFO). Studies that identified barriers and facilitators to recruitment, or recruitment strategies for South Asian populations were included. Recruitment barriers, facilitators and strategies were grouped thematically and summarised narratively. Synthesis Of 1846 potentially relevant articles, 15 met the inclusion criteria and were included in the thematic synthesis. Multiple facilitators and barriers to enrolment of South Asians in health research studies were identified; these most commonly related to logistical challenges, language and cultural barriers, concerns about adverse consequences of participating and mistrust of research. Several actionable strategies were discussed, the most common being engagement of South Asian communities, demonstration of cultural competency, provision of incentives and benefits, language sensitivity through the use of translators and translated materials and the development of trust and personal relationships. Conclusion There is a growing awareness of the barriers and facilitators to recruitment of South Asian participants to health research studies. Knowledge of effective recruitment strategies and implementation during the grant funding stages may reduce the risk of poor recruitment and representation of South Asians. PMID:28576896

Researching the barriers to HIV treatment and maternal health in ...

International Development Research Centre (IDRC) Digital Library (Canada)

2013-03-05

Mar 5, 2013 ... Researching the barriers to HIV treatment and maternal health in South Africa ... between IDRC, the Canadian International Development Agency, and the Canadian Institutes of Health Research. ... One study, based on interviews with women who used maternal services, ... Careers · Contact Us · Site map.

Refining the Enrolment Process in Emergency Medicine Research.

Science.gov (United States)

Sahan, Kate M; Channon, Keith M; Choudhury, Robin P; Kharbanda, Rajesh K; Lee, Regent; Sheehan, Mark

2016-04-01

Research in the emergency setting involving patients with acute clinical conditions is needed if there are to be advances in diagnosis and treatment. But research in these areas poses ethical and practical challenges. One of these is the general inability to obtain informed consent due to the patient's lack of mental capacity and insufficient time to contact legal representatives. Regulatory frameworks which allow this research to proceed with a consent 'waiver', provided patients lack mental capacity, miss important ethical subtleties. One of these is the varying nature of mental capacity among emergency medicine patients. Not only is their capacity variable and often unclear, but some patients are also likely to be able to engage with the researcher and the context to varying degrees. In this paper we describe the key elements of a novel enrolment process for emergency medicine research that refines the consent waiver and fully engages with the ethical rationale for consent and, in this context, its waiver. The process is verbal but independently documented during the 'emergent' stages of the research. It provides appropriate engagement with the patient, is context-sensitive and better addresses ethical subtleties. In line with regulation, full written consent for on-going participation in the research is obtained once the emergency is passed.

Emerging Technologies for Gut Microbiome Research

Science.gov (United States)

Arnold, Jason W.; Roach, Jeffrey; Azcarate-Peril, M. Andrea

2016-01-01

Understanding the importance of the gut microbiome on modulation of host health has become a subject of great interest for researchers across disciplines. As an intrinsically multidisciplinary field, microbiome research has been able to reap the benefits of technological advancements in systems and synthetic biology, biomaterials engineering, and traditional microbiology. Gut microbiome research has been revolutionized by high-throughput sequencing technology, permitting compositional and functional analyses that were previously an unrealistic undertaking. Emerging technologies including engineered organoids derived from human stem cells, high-throughput culturing, and microfluidics assays allowing for the introduction of novel approaches will improve the efficiency and quality of microbiome research. Here, we will discuss emerging technologies and their potential impact on gut microbiome studies. PMID:27426971

Internationalization as a strategy to overcome industry barriers-An assessment of the marine energy industry

International Nuclear Information System (INIS)

Lovdal, Nicolai; Neumann, Frank

2011-01-01

Research on conditions to develop new innovations within emerging renewable energy industries is often done with a national focus. However, recent research on international entrepreneurship has revealed that firms operate on international levels very early in their life time. Thus, based on former research on international entrepreneurship and case examples, we build the propositions that firms in the marine energy industry use internationalization as a strategy to overcome industry barriers. Our primary source of data is a unique dataset from a global survey of all the companies in the marine energy industry who are aiming to commercialize a wave or tidal energy device. This paper is organized in two steps: first we identified the most challenging industry barriers perceived by companies. Second we use these to form propositions which we assess through empirical data. The two most challenging barriers perceived by the companies are need for capital and need for supportive political schemes. Our findings reveal that internationalization certainly is a common strategy to access capital and attractive support schemes in foreign countries. The early internationalization has implications for researchers, managers and policy makers. - Research highlights: → Industry barriers identified as access to capital and supportive political schemes. → International entrepreneurship is used to overcome industry barriers. → Start-ups in emerging energy industries 'shop' national support schemes. → Future research to provide policy advice should adapt to the international reality. → Research based on a worldwide survey of wave and tidal energy device developers.

Internationalization as a strategy to overcome industry barriers-An assessment of the marine energy industry

Energy Technology Data Exchange (ETDEWEB)

Lovdal, Nicolai, E-mail: nicolai.lovdal@iot.ntnu.n [Industrial Economics and Technology Management, Norwegian University of Science and Technology, 7491 Trondheim (Norway); Neumann, Frank, E-mail: frank@wave-energy-centre.or [Wave Energy Centre, Av. Manuel Maia, 36, r/c Dto., 1000-201 Lisboa (Portugal)

2011-03-15

Research on conditions to develop new innovations within emerging renewable energy industries is often done with a national focus. However, recent research on international entrepreneurship has revealed that firms operate on international levels very early in their life time. Thus, based on former research on international entrepreneurship and case examples, we build the propositions that firms in the marine energy industry use internationalization as a strategy to overcome industry barriers. Our primary source of data is a unique dataset from a global survey of all the companies in the marine energy industry who are aiming to commercialize a wave or tidal energy device. This paper is organized in two steps: first we identified the most challenging industry barriers perceived by companies. Second we use these to form propositions which we assess through empirical data. The two most challenging barriers perceived by the companies are need for capital and need for supportive political schemes. Our findings reveal that internationalization certainly is a common strategy to access capital and attractive support schemes in foreign countries. The early internationalization has implications for researchers, managers and policy makers. - Research highlights: {yields} Industry barriers identified as access to capital and supportive political schemes. {yields} International entrepreneurship is used to overcome industry barriers. {yields} Start-ups in emerging energy industries 'shop' national support schemes. {yields} Future research to provide policy advice should adapt to the international reality. {yields} Research based on a worldwide survey of wave and tidal energy device developers.

Growing an Emerging Research University

Science.gov (United States)

Birx, Donald L.; Anderson-Fletcher, Elizabeth; Whitney, Elizabeth

2013-01-01

The emerging research college or university is one of the most formidable resources a region has to reinvent and grow its economy. This paper is the first of two that outlines a process of building research universities that enhance regional technology development and facilitate flexible networks of collaboration and resource sharing. Although the…

Changes in research on language barriers in health care since 2003: A cross-sectional review study.

Science.gov (United States)

Schwei, Rebecca J; Del Pozo, Sam; Agger-Gupta, Niels; Alvarado-Little, Wilma; Bagchi, Ann; Chen, Alice Hm; Diamond, Lisa; Gany, Francesca; Wong, Doreena; Jacobs, Elizabeth A

2016-02-01

Understanding how to mitigate language barriers is becoming increasingly important for health care providers around the world. Language barriers adversely affect patients in their access to health services; comprehension and adherence; quality of care; and patient and provider satisfaction. In 2003, the United States (US) government made a major change in national policy guidance that significantly affected limited English proficient patients' ability to access language services. The objectives of this paper are to describe the state of the language barriers literature inside and outside the US since 2003 and to compare the research that was conducted before and after a national policy change occurred in the US. We hypothesize that language barrier research would increase inside and outside the US but that the increase in research would be larger inside the US in response to this national policy change. We reviewed the research literature on language barriers in health care and conducted a cross sectional analysis by tabulating frequencies for geographic location, language group, methodology, research focus and specialty and compared the literature before and after 2003. Our sample included 136 studies prior to 2003 and 426 studies from 2003 to 2010. In the 2003-2010 time period there was a new interest in studying the providers' perspective instead of or in addition to the patients' perspective. The methods remained similar between periods with greater than 60% of studies being descriptive and 12% being interventions. There was an increase in research on language barriers inside and outside the US and we believe this was larger due to the change in the national policy. We suggest that researchers worldwide should move away from simply documenting the existence of language barriers and should begin to focus their research on documenting how language concordant care influences patient outcomes, providing evidence for interventions that mitigate language barriers

Barriers to, and emerging strategies for, HIV testing among adolescents in sub-Saharan Africa.

Science.gov (United States)

Chikwari, Chido D; Dringus, Stefanie; Ferrand, Rashida A

2018-05-01

HIV/AIDS is one of the leading causes of death among adolescents in sub-Saharan Africa and 40% of new HIV infections worldwide occur in this group. HIV testing and counselling (HTC) is the critical first step to accessing HIV treatment. The prevalence of undiagnosed HIV infection is substantially higher in adolescents compared with adults. We review barriers to HTC for adolescents and emerging HTC strategies appropriate to adolescents in sub-Saharan Africa. There are substantial individual, health system and legal barriers to HTC among adolescents, and stigma by providers and communities remains an important obstacle. There has been progress made in recent years in developing strategies that address some of these barriers, increase uptake of HTC and yield of HIV. These include targeted approaches focused on provision of HTC among those higher risk of being infected, for example, index-linked HTC and use of screening tools to identify those at risk of HIV. Community-based HIV-testing approaches including HIV self-testing and incentives have also been shown to increase uptake of HTC. In implementing HTC strategies, consideration must be given to scalability and cost-effectiveness. HTC approaches must be coupled with linkage to appropriate care and prevention services.

Operational Research during the Ebola Emergency.

LENUS (Irish Health Repository)

Fitzpatrick, Gabriel

2017-07-01

Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare. Importantly, operational research questions were decided to a large extent by returning volunteers who had first-hand knowledge of the immediate issues facing teams in the field. Such a method is appropriate for an emergency medical organization. Many challenges were also identified while carrying out operational research across 3 different countries, including the basic need for collecting data in standardized format to enable comparison of findings among treatment centers.

Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework.

Science.gov (United States)

Kirk, Jeanette W; Sivertsen, Ditte M; Petersen, Janne; Nilsen, Per; Petersen, Helle V

2016-10-01

The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team. A high incidence of functional decline after hospitalisation for acute medical illness has been shown in the oldest patients and those who are physically frail. In Denmark, more than 35% of older medical patients acutely admitted to the emergency department are readmitted within 90 days after discharge. A new screening tool for use in the emergency department aiming to identify patients at particularly high risk of functional decline and readmission was developed. Qualitative study based on semistructured interviews with nurses and a geriatric team in the emergency department and semistructured single interviews with their managers. The Theoretical Domains Framework guided data collection and analysis. Content analysis was performed whereby new themes and themes already existing within each domain were described. Six predominant domains were identified: (1) professional role and identity; (2) beliefs about consequences; (3) goals; (4) knowledge; (5) optimism and (6) environmental context and resources. The content analysis identified three themes, each containing two subthemes. The themes were professional role and identity, beliefs about consequences and preconditions for a successful implementation. Two different cultures were identified in the emergency department. These cultures applied to different professional roles and identity, different actions and sense making and identified how barriers and facilitators linked to the new screening tool were perceived. The results show that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned. © 2016 The Authors. Journal of Clinical Nursing Published by John

Affordances, Barriers, and Motivations: Engagement in Research Activity by Academics at the Research-Oriented University in Vietnam

Science.gov (United States)

Nguyen, Quy; Klopper, Christopher; Smith, Calvin

2016-01-01

The importance of academics undertaking research and publishing their research results is emphasised by universities. Engagement in research is recognised as an effective means to increase a university's profile. This study applied a qualitative approach to explore affordances, barriers, and motivations towards the engagement in research…

An Emergency Medicine Research Priority Setting Partnership to establish the top 10 research priorities in emergency medicine.

Science.gov (United States)

Smith, Jason; Keating, Liza; Flowerdew, Lynsey; O'Brien, Rachel; McIntyre, Sam; Morley, Richard; Carley, Simon

2017-07-01

Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An examination of how women and underrepresented racial/ethnic minorities experience barriers in biomedical research and medical programs

Science.gov (United States)

Chakraverty, Devasmita

Women in medicine and biomedical research often face challenges to their retention, promotion, and advancement to leadership positions (McPhillips et al., 2007); they take longer to advance their careers, tend to serve at less research-intensive institutions and have shorter tenures compared to their male colleagues (White, McDade, Yamagata, & Morahan, 2012). Additionally, Blacks and Hispanics are the two largest minority groups that are vastly underrepresented in medicine and biomedical research in the United States (AAMC, 2012; NSF, 2011). The purpose of this study is to examine specific barriers reported by students and post-degree professionals in the field through the following questions: 1. How do women who are either currently enrolled or graduated from biomedical research or medical programs define and make meaning of gender-roles as academic barriers? 2. How do underrepresented groups in medical schools and biomedical research institutions define and make meaning of the academic barriers they face and the challenges these barriers pose to their success as individuals in the program? These questions were qualitatively analyzed using 146 interviews from Project TrEMUR applying grounded theory. Reported gender-role barriers were explained using the "Condition-Process-Outcome" theoretical framework. About one-third of the females (across all three programs; majority White or Black between 25-35 years of age) reported gender-role barriers, mostly due to poor mentoring, time constraints, set expectations and institutional barriers. Certain barriers act as conditions, causing gender-role issues, and gender-role issues influence certain barriers that act as outcomes. Strategies to overcome barriers included interventions mostly at the institutional level (mentor support, proper specialty selection, selecting academia over medicine). Barrier analysis for the two largest URM groups indicated that, while Blacks most frequently reported racism, gender barriers

Hanford Site protective isolation surface barrier: Taking research and development to engineered application

International Nuclear Information System (INIS)

Myers, D.R.; Wing, N.R.

1994-01-01

The development of the Protective Isolation Surface Barrier has been an ongoing program since 1985. This development effort has focused on several technical areas. These technical areas include water infiltration, biointrusion, human intrusion, erosion/deposition, physical stability, barrier materials, computer modeling, long-term climate effects, natural analogs, and barrier design. This paper briefly reviews the results of the research and development in the technical areas and then explains how the results of this work have influenced the design features of the prototype barrier. A good example of this is to explain how the type and depth of the soil layer used in the barrier is related to water infiltration, biointrusion, modeling, climate, analogs, and barrier materials. Another good example is to explain the relationship of the barrier sideslopes (basalt riprap and native soil) with human intrusion, biointrusion, barrier materials, and barrier design. In general, the design features of the prototype barrier will be explained in terms of the results of the testing and development program. After the basis for prototype barrier design has been established, the paper will close by reviewing the construction of the prototype barrier, sharing the lessons learned during construction, and explaining the ongoing testing and monitoring program which will determine the success or failure of this barrier concept and the need for additional design modifications

Exploring the barriers to and facilitators of implementing research into practice.

Science.gov (United States)

Johnston, Bridget; Coole, Carol; Narayanasamy, Melanie; Feakes, Ruth; Whitworth, Gillian; Tyrell, Tracy; Hardy, Beth

2016-08-02

District and community nursing roles have changed rapidly in recent years. Community nurses are increasingly being tasked with carrying out multiple roles, which require them to put research into practice and use evidence-based tools and interventions. The implementation of interventions and tools needs to be developed from empirical research, requiring evidence, to be translated into practice. However, this process may be compromised or enhanced by a number of factors. This exploratory, descriptive qualitative study sought to identify barriers and facilitators to community nurses implementing research into practice. Four focus groups were conducted with registered community nurses and district nurses (n=22). Analysis identified four main themes: keeping up to date with evidence; using a clinical tool; education/training and implementation. Findings suggest that there are barriers at a personal, professional and organisational level. Strategies are suggested to overcome these obstacles.

Barriers to and Enablers of Contraceptive Use among Adolescent Females and their Interest in an Emergency Department-based Intervention

Science.gov (United States)

Chernick, Lauren S; Schnall, Rebecca; Higgins, Tracy; Stockwell, Melissa; Castaño, Paula; Santelli, John; Dayan, Peter S

2015-01-01

Objective Over 15 million adolescents, many at high risk for pregnancy, use emergency departments (ED) in the United States annually, but little is known regarding reasons for failure to use contraceptives in this population. The purpose of this study was to identify the barriers to and enablers of contraceptive use among adolescent females using the ED and determine their interest in an ED-based pregnancy prevention intervention. Study Design We conducted semi-structured, open-ended interviews with females in an urban ED. Eligible females were 14-19 years old, sexually active, presenting for reproductive health complaints, and at risk for pregnancy, defined as non-use of effective (per the World Health Organization) contraception. Interviews were recorded, transcribed, and coded based on thematic analysis. Enrollment continued until no new themes emerged. A modified Health Belief Model guided the organization of the data. Results Participants (n=14) were predominantly Hispanic (93%), insured (93%), and in a sexual relationship (86%). The primary barrier to contraceptive use was perceived health risk, including effects on menstruation, weight, and future fertility. Other barriers consisted of mistrust in contraceptives, ambivalent pregnancy intentions, uncertainty about the future, partner's desire for pregnancy, and limited access to contraceptives. Enablers of past contraceptive use included the presence of a school-based health clinic and clear plans for the future. All participants were receptive to ED-based pregnancy prevention interventions. Conclusions The identified barriers and enablers influencing hormonal contraceptive use can be used to inform the design of future ED-based adolescent pregnancy prevention interventions. PMID:25499588

Identification and analysis of reverse logistics barriers using fuzzy Delphi method and AHP

DEFF Research Database (Denmark)

Bouzon, Marina; Govindan, Kannan; Rodriguez, Carlos M Taboada

2016-01-01

enacted National Policy on solid waste. To bridge this gap, this paper identifies and evaluates the barriers for RL in the Brazilian context. An eleven-step research methodology is proposed. First, literature was thoroughly reviewed. fuzzy Delphi method (FDM) was used to obtain the critical list...... a systematic literature review process, a list of most common RL barriers accepted by Brazilian organizations, and a priority ranking of RL barriers for the electrical-electronic industry sector in Brazil. The "Economic related issues" category of barriers seems to be the first priority. The financial burden...... the reverse flow must be taken. However, most existing research on the barriers for RL implementation is focused on developed countries. Among the most important emerging economies, Brazil, the largest Latin America economy, faces challenges such as a deficient logistics infrastructure and the recently...

Measuring scientific research in emerging nano-energy field

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Guan, Jiancheng; Liu, Na

2014-04-01

The purpose of this paper is to comprehensively explore scientific research profiles in the field of emerging nano-energy during 1991-2012 based on bibliometrics and social network analysis. We investigate the growth pattern of research output, and then carry out across countries/regions comparisons on research performances. Furthermore, we examine scientific collaboration across countries/regions by analyzing collaborative intensity and networks in 3- to 4-year intervals. Results indicate with an impressively exponential growth pattern of nano-energy articles, the world share of scientific "giants," such as the USA, Germany, England, France and Japan, display decreasing research trends, especially in the USA. Emerging economies, including China, South Korea and India, exhibit a rise in terms of the world share, illustrating strong development momentum of these countries in nano-energy research. Strikingly, China displays a remarkable rise in scientific influence rivaling Germany, Japan, France, and England in the last few years. Finally, the scientific collaborative network in nano-energy research has expanded steadily. Although the USA and several major European countries play significantly roles on scientific collaboration, China and South Korea exert great influence on scientific collaboration in recent years. The findings imply that emerging economies can earn competitive advantages in some emerging fields by properly engaging a catch-up strategy.

An observational study of emergency department utilization among enrollees of Minnesota Health Care Programs: financial and non-financial barriers have different associations

OpenAIRE

Shippee, Nathan D; Shippee, Tetyana P; Hess, Erik P; Beebe, Timothy J

2014-01-01

Background Emergency department (ED) use is costly, and especially frequent among publicly insured populations in the US, who also disproportionately encounter financial (cost/coverage-related) and non-financial/practical barriers to care. The present study examines the distinct associations financial and non-financial barriers to care have with patterns of ED use among a publicly insured population. Methods This observational study uses linked administrative-survey data for enrollees of Minn...

Vocal Fold Epithelial Barrier in Health and Injury A Research Review

Science.gov (United States)

Levendoski, Elizabeth Erickson; Leydon, Ciara; Thibeault, Susan L.

2015-01-01

Purpose Vocal fold epithelium is composed of layers of individual epithelial cells joined by junctional complexes constituting a unique interface with the external environment. This barrier provides structural stability to the vocal folds and protects underlying connective tissue from injury while being nearly continuously exposed to potentially hazardous insults including environmental or systemic-based irritants such as pollutants and reflux, surgical procedures, and vibratory trauma. Small disruptions in the epithelial barrier may have a large impact on susceptibility to injury and overall vocal health. The purpose of this article is to provide a broad-based review of our current knowledge of the vocal fold epithelial barrier. Methods A comprehensive review of the literature was conducted. Details of the structure of the vocal fold epithelial barrier are presented and evaluated in the context of function in injury and pathology. The importance of the epithelial-associated vocal fold mucus barrier is also introduced. Results/Conclusions Information presented in this review is valuable for clinicians and researchers as it highlights the importance of this understudied portion of the vocal folds to overall vocal health and disease. Prevention and treatment of injury to the epithelial barrier is a significant area awaiting further investigation. PMID:24686981

Emerging Economies Research Dialogue | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

This grant will allow the Indian Council for Research on International Economic Relations to bridge the gap by organizing two research dialogues in the form of international conferences for emerging economy professionals, academics and policymakers on issues of contemporary relevance to the global economy and polity.

Communication barriers to applying federal research in support of land management in the United States

Science.gov (United States)

Vita Wright

2007-01-01

Barriers to effective communication between researchers and managers can ultimately result in barriers to the application of scientific knowledge and technology for land management. Both individual and organizational barriers are important in terms of how they affect the first three stages of the innovation-decision process: 1) knowledge, where an individual is exposed...

Future Research on Cyber-Physical Emergency Management Systems

Directory of Open Access Journals (Sweden)

Fang-Jing Wu

2013-06-01

Full Text Available Cyber-physical systems that include human beings and vehicles in a built environment, such as a building or a city, together with sensor networks and decision support systems have attracted much attention. In emergencies, which also include mobile searchers and rescuers, the interactions among civilians and the environment become much more diverse, and the complexity of the emergency response also becomes much greater. This paper surveys current research on sensor-assisted evacuation and rescue systems and discusses the related research issues concerning communication protocols for sensor networks, as well as several other important issues, such as the integrated asynchronous control of large-scale emergency response systems, knowledge discovery for rescue and prototyping platforms. Then, we suggest directions for further research.

Mixed methods research: a design for emergency care research?

Science.gov (United States)

Cooper, Simon; Porter, Jo; Endacott, Ruth

2011-08-01

This paper follows previous publications on generic qualitative approaches, qualitative designs and action research in emergency care by this group of authors. Contemporary views on mixed methods approaches are considered, with a particular focus on the design choice and the amalgamation of qualitative and quantitative data emphasising the timing of data collection for each approach, their relative 'weight' and how they will be mixed. Mixed methods studies in emergency care are reviewed before the variety of methodological approaches and best practice considerations are presented. The use of mixed methods in clinical studies is increasing, aiming to answer questions such as 'how many' and 'why' in the same study, and as such are an important and useful approach to many key questions in emergency care.

Perceived Barriers and Opportunities to the Linkage of Research ...

African Journals Online (AJOL)

Unknown User

science departments in the Faculty of Arts, Media and Social Sciences. (FAMSS) at the ... unexplored areas of new research and actively discouraged from replicating ... formulating research ideas might not emerge from any compelling.

Geochronologic evidence for a possible MIS-11 emergent barrier/beach-ridge in southeastern Georgia, USA

Science.gov (United States)

Markewich, H.W.; Pavich, M.J.; Schultz, A.P.; Mahan, S.A.; Aleman-Gonzalez, W. B.; Bierman, P.R.

2013-01-01

Predominantly clastic, off-lapping, transgressive, near-shore marine sediment packages that are morphologically expressed as subparallel NE-trending barriers, beach ridges, and associated back-barrier areas, characterize the near-surface stratigraphic section between the Savannah and the Ogeechee Rivers in Effingham County, southeastern Georgia. Each barrier/back-barrier (shoreline) complex is lower than and cut into a higher/older complex. Each barrier or shoreline complex overlies Miocene strata. No direct age data are available for these deposits. Previous researchers have disagreed on their age and provenance. Using luminescence and meteoric beryllium-10 (10Be) inventory analyses, we estimated a minimum age for the largest, westernmost, morphologically identifiable, and topographically-highest, barrier/beach-ridge (the Wicomico shoreline barrier) and constrained the age of a suite of younger barrier/beach-ridges that lie adjacent and seaward of the Wicomico shoreline barrier. At the study site, the near-shore marine/estuarine deposits underlying the Wicomico shoreline barrier are overlain by eolian sand and an intervening zone-of-mixing. Optically stimulated luminescence (OSL) data indicate ages of ≤43 ka for the eolian sand and 116 ka for the zone-of-mixing. Meteoric 10Be and pedostratigraphic data indicate minimum residence times of 33.4 ka for the eolian sand, 80.6 ka for the zone-of-mixing, and 247 ka for the paleosol. The combined OSL and 10Be age data indicate that, at this locality, the barrier/beach ridge has a minimum age of about 360 ka. This age for the Wicomico shoreline-barrier deposit is the first for any Pleistocene near-shore marine/estuarine deposit in southeast Georgia that is conclusively older than 80 ka. The 360-ka minimum age is in agreement with other geochronologic data for near-coastline deposits in Georgia and South Carolina. The geomorphic position of this barrier/beach-ridge is similar to deposits in South Carolina considered to be

Experiences, attitudes and barriers towards research amongst junior faculty of Pakistani medical universities

Directory of Open Access Journals (Sweden)

Kauser Samreen

2009-11-01

Full Text Available Abstract Background The developing world has had limited quality research and in Pakistan, research is still in its infancy. We conducted a study to assess the proportion of junior faculty involved in research to highlight their attitude towards research, and identify the factors associated with their research involvement. Methods A cross-sectional study was conducted in four medical universities/teaching hospitals in Pakistan, representing private and public sectors. A pre-tested, self-administered questionnaire was used to collect information from 176 junior faculty members of studied universities/hospitals. Logistic regression analysis was used to identify factors related to attitudes and barriers in research among those currently involved in research with those who were not. Results Overall, 41.5% of study subjects were currently involved in research. A highly significant factor associated with current research involvement was research training during the post-graduate period (p Conclusion Less than half of the study participants were currently involved in research. Research output may improve if identified barriers are rectified. Further studies are recommended in this area.

Barriers in implementing research among registered nurses working in the care of the elderly: a multicenter study in Spain.

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Sarabia-Cobo, C M; Sarabia-Cobo, A B; Pérez, V; Hermosilla, C; Nuñez, M J; de Lorena, P

2015-11-01

This study identified barriers to the utilization of research results perceived by nurses who work in nursing homes in Spain. An observational, cross-sectional, descriptive, and multicentre study was conducted in 126 nursing homes in different Spanish cities. The BARRIERS to Research Utilization Scale (BARRIERS scale) was used to identify barriers. A total of 756 nurses responded (92.48%). BARRIERS scale variables with the highest scores included Characteristics of the organization (mean=24.89, SD=4.37), followed by Professional features (mean=21.87, SD=4.85). The specific barriers that were rated the highest included "not enough time on the job to implement new ideas" (mean=3.89, SD=0.98), followed by "unknown nursing research" (mean=2.75; SD=1.22) and "Doctors do not cooperate in the implementation" (mean=3.01, SD=1.85). Geriatric nurses perceive time as the main barrier to implementing the results of research in practice. The number and nature of the barriers are consistent with studies from other countries. Knowledge of the barriers is crucial for institutions and educators to instigate measures that improve the implementation of nursing research, especially in an area like elderly care. To our knowledge, this is the first study conducted among geriatric nurses in Spain. Copyright © 2015 Elsevier Inc. All rights reserved.

The Technological Barriers of Using Video Modeling in the Classroom

Science.gov (United States)

Marino, Desha; Myck-Wayne, Janice

2015-01-01

The purpose of this investigation is to identify the technological barriers teachers encounter when attempting to implement video modeling in the classroom. Video modeling is an emerging evidence-based intervention method used with individuals with autism. Research has shown the positive effects video modeling can have on its recipients. Educators…

Expertise, Time, Money, Mentoring, and Reward: Systemic Barriers That Limit Education Researcher Productivity-Proceedings From the AAMC GEA Workshop.

Science.gov (United States)

Yarris, Lalena M; Juve, Amy Miller; Artino, Anthony R; Sullivan, Gail M; Rougas, Steven; Joyce, Barbara; Eva, Kevin

2014-09-01

To further evolve in an evidence-based fashion, medical education needs to develop and evaluate new practices for teaching, learning, and assessment. However, educators face barriers in designing, conducting, and publishing education research. To explore the barriers medical educators face in formulating, conducting, and publishing high-quality medical education research, and to identify strategies for overcoming them. A consensus workshop was held November 5, 2013, at the Association of American Medical Colleges annual meeting. A working group of education research experts and educators completed a preconference literature review focusing on barriers to education research. During the workshop, consensus-based and small group techniques were used to refine the broad themes into content categories. Attendees then ranked the most important barriers and strategies for overcoming them with the highest potential impact. Barriers participants faced in conducting quality education research included lack of (1) expertise, (2) time, (3) funding, (4) mentorship, and (5) reward. The strategy considered most effective in overcoming these barriers involved building communities of education researchers for collaboration and networking, and advocating for education researchers' interests. Other suggestions included trying to secure increased funding opportunities, developing mentoring programs, and encouraging mechanisms to ensure protected time. Barriers to education research productivity clearly exist. Many appear to result from feelings of isolation that may be overcome with systemic efforts to develop and enable communities of practice across institutions. Finally, the theme of "reward" is novel and complex and may have implications for education research productivity.

A bibliometric model for identifying emerging research topics

DEFF Research Database (Denmark)

Wang, Qi

2018-01-01

–1843, 2015), the most serious problems are the lack of an acknowledged definition of emergence and incomplete elaboration of the linkages between the definitions that are used and the indicators that are created. With these issues in mind, this study first adjusts the definition of an emerging technology...... that Rotolo et al. (2015) have proposed to accommodate the analysis. Next, a set of criteria for the identification of emerging topics is proposed according to the adjusted definition and attributes of emergence. Using two sets of parameter values, several emerging research topics are identified. Finally...

Barriers to Research Utilization among Registered Nurses in Traditional Chinese Medicine Hospitals: A Cross-Sectional Survey in China

Directory of Open Access Journals (Sweden)

Fen Zhou

2015-01-01

Full Text Available Background. As there might be relevant differences with regard to research utilization in the general hospitals, we aimed to study research utilization among registered nurses working in traditional Chinese medicine hospitals. Methods. A total of 648 registered nurses from 4 tertiary-level hospitals in China were recruited for participation. A modified BARRIERS Scale and self-designed questionnaires were used for data collection. Data were analyzed with descriptive statistics, t-tests, and one-way ANOVAs and Spearman correlation analysis. Results. Overall, items which belong to the subscale “Research” were identified as the most important barriers. Among the individual items, the lack of time on the job was ranked as the top barrier, followed by the lack of knowledgeable colleagues and by overwhelming research publications. Clinical experience, working pressure, job satisfaction, and research experience could be identified as associated factors for barriers to research utilization. Conclusions. Registered nurses in traditional Chinese medicine hospitals felt high barriers to research utilization. Reducing registered nurses’ working pressure, promoting their positive attitude to nursing, and improving research training might be helpful for increasing research utilization. Close cooperation between clinical and nursing schools or academic research centres might facilitate the necessary change in nursing education and routine.

Barriers and Motivators to Participating in mHealth Research Among African American Men.

Science.gov (United States)

James, Delores C S; Harville, Cedric

2017-11-01

Most African American (AA) men own a smartphone, which positions them to be targeted for a variety of programs, services, and health interventions using mobile devices (mHealth). The goal of this study was to assess AA men's use of technology and the barriers and motivators to participating in mHealth research. A self-administered survey was completed by 311 men. Multinomial logistic regression examined associations between three age groups (18-29 years, 30-50 years, and 51+ years), technology access, and motivators and barriers to participating in mHealth research. Sixty-five percent of men owned a smartphone and a laptop. Men aged 18 to 29 years were more likely willing to use a health app and smartwatch/wristband monitor than older men ( p motivated to participate for a free cell phone/upgraded data plan and contribution to the greater good ( p motivated to become more educated about the topic ( p < .05). Younger men were more likely than older ones to report lack of interest in the topic as a barrier to participating ( p < .01), while older men were more likely than younger ones to cite lack of research targeted to minority communities as a barrier ( p < .05). This study suggests that culturally tailored mHealth research using smartphones may be of interest to AA men interested in risk reduction and chronic disease self-management. Opportunities also exist to educate AA men about the topic at hand and why minority men are being targeted for the programs and interventions.

Review of Military Mountain Medicine Technology and Research Barriers

Science.gov (United States)

2011-09-01

2.4.5 Nutritional and Hydration Guidelines 7 3.0 Review of Militarily-Relevant Mountain Medicine Technology and 7 Research Barriers 3.1...Interventions ( nutritional , pharmaceutical) to improve troop performance and health during high altitude deployments. 3) Prepare a report that: REVIEW OF...Edema (HAPE). The signs and symptoms of AMS are headache accompanied by insomnia, unusual fatigue, dizziness, anorexia , and nausea. AMS is not

Perceived barriers to implementing screening and brief intervention for alcohol consumption by adolescents in hospital emergency department in Spain.

Science.gov (United States)

Falcón, María; Navarro-Zaragoza, Javier; García-Rodríguez, Rosa María; Nova-López, Daniel; González-Navarro, María Dulce; Mercadal, María; García-Algar, Oscar; Luna Ruiz-Cabello, Aurelio

2017-07-14

Screening for alcohol consumption in adolescents is widely justified in the health care field because of the particular vulnerability of this population, which starts drinking alcohol at a very early age and frequently consumes high levels of the same. Hospital emergency departments (ED) could be a good venue to manage early detection and carry out brief intervention (BI) programmes. The aim of this study was to identify perceived barriers for medical staff of three hospitals in Spain to successfully implement a protocol for alcohol detection and BI for minors in the ED. Exploratory qualitative analysis using focus groups with semi-structured, flexible and open-ended questions to explore beliefs, attitudes, and barriers perceived by professionals to screening alcohol consumption and implementing BI in adolescents attended at the ED. The main perceived barriers by health professionals were lack of time, work overload, mistrust, lack of validated and simple screening tools, lack of training/awareness and legal concerns about informed consent and confidentiality. Barriers to screening and intervention in ED are similar to those described previously. It is necessary to improve organization of time allocated for medical consultations, avoid limiting ED resources, motivate staff and provide appropriate training.

Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review.

Science.gov (United States)

Heydari, Abbas; Emami Zeydi, Amir

2014-12-01

Research utilization (RU), is an important strategy to promote the quality of patient care. The aim of this study was to present a comprehensive literature review describing barriers and facilitators of RU among Iranian nurses. Literature review was undertaken using the international databases including Pub Med/Medline, Scopus, Science Direct, and Google Scholar. Also, Persian electronic databases such as Magiran, SID and Iran Medex were searched up to May 2014. The search was limited to articles in the English and Persian languages that evaluate the barriers or facilitators of RU among Iranian nurses. A total of 11 articles were in the final dataset. The most important barriers to RU among Iranian nurses were related to the organization factors such as inadequate facilities; insufficient time on the job, lack of authority, physician cooperation, and administrative support. The most frequent facilitators of RU were education in enhancing nurses knowledge and skills in research evaluation, support from knowledgeable nursing colleagues and nursing faculty in the clinical setting, access to an expert committee for clinical appraisal, improving skills in English language and searching for articles, sufficient economic resources to carry out research, and having access to more facilities such as internet. Iranian nurses encounter with the same difficulties as to other countries regarding RU; while setting related barriers were the predominant obstacles to RU among them. Therefore, health managers are expected to plan appropriate strategies to smooth the progress of RU by nurses in their practice.

The Mela Study: exploring barriers to diabetes research in black and minority ethnic groups.

Science.gov (United States)

Hood, Gillian A; Chowdhury, Tahseen A; Griffiths, Christopher J; Hood, Rosie K E; Mathews, Christopher; Hitman, Graham A

2015-01-01

Black and minority ethnic (BME) groups are particularly susceptible to diabetes and its vascular complications in the United Kingdom and most western societies. To understand potential predisposition and tailor treatments accordingly, there is a real need to engage these groups in diabetes research. Despite this, BME participation in research studies continues to remain low in most countries and this may be a contributory factor to reduced health outcomes and poorer quality of life in these groups. This study explores the barriers BME groups may have towards participation in diabetes research in one area of East London, and includes local recommendations on how to improve this for the future. A questionnaire designed from previously reported exploratory work and piloted in several BME localities was distributed at the East London Bangladeshi Mela and similar cultural and religious events in London, UK. People were asked opportunistically to complete the survey themselves if they understood English, or discuss their responses with an advocate. The purpose of the questionnaire was to understand current local awareness with regards to diabetes, identify specific BME barriers and attitudes towards diabetes research by ethnicity, gender and age, and gain insight into how these barriers may be addressed. Of 1682 people surveyed (16-90 years; median age 40 years), 36.4% were South Asian, 25.9% White, and 11.1% Black and other ethnicities; 26.6% withheld their ethnicity. Over half cited language problems generally (54%) and lack of research awareness (56%) as main barriers to engaging in research. South Asian groups were more likely to cite research as too time consuming (42%) whereas Black groups were more concerned with potential drug side effects in research (39%). Participants expressed a general mistrust of research, and the need for researchers to be honest in their approach. Recommendations for increased participation in South Asian groups centred round both helping

Adapting to climate change by water management organisations: Enablers and barriers

Science.gov (United States)

Azhoni, Adani; Jude, Simon; Holman, Ian

2018-04-01

Climate change will be particularly experienced though the medium of water. Water organisations, that are managing societal and ecological needs for water, are therefore likely to experience the impact the most. This study reviews the current literature regarding adaptation to climate change by water management organisations and associated barriers. Literature on adaptive capacity is growing and a general consensus is emerging on the determinants of adaptive capacity, although variations exist regarding how it is to be evaluated, enhanced and applied to policy making due to its dynamic, contextual and latent nature. Since adaptive capacity is hard to measure and successful adaptation difficult to define, some studies focus on the existence of adaptation attributes of organisations. Studies reporting successful adaptation are minimal and barriers of adaptation are being discovered as adaptation research transitions into implementation. But the root causes of these barriers are often overlooked and the interconnectedness of the barriers is poorly addressed. Increasingly, combining top-down and bottom-up approaches to adaptation is being recommended due to the limitations of each. However, knowledge regarding how organisations operating at different scales can enhance adaptive capacity of other organisations operating at another scale is lacking due to the few studies of inter-organisational networks across scales. Social networks among actors are recognised as a key factor to enable adaptation. However, network studies generally focus on individual actors and rarely between public agencies/organisations. Moreover, the current literature is inadequate to understand the relationship between adaptation enabling characteristics, barriers and adaptation manifestation. The review demonstrates that research on understanding the emergence and sustenance of barriers is urgently required. Addressing these knowledge gaps will help to improve the design of adaptation strategies

Multi-level barriers to LTBI treatment: a research note.

Science.gov (United States)

Hill, Linda; Blumberg, Elaine; Sipan, Carol; Schmitz, Katharine; West, Joshua; Kelley, Norma; Hovell, Melbourne

2010-08-01

This study describes the barriers to effective and timely LTBI treatment encountered in a research study on INH adherence in Latino adolescents. Participant study logs were reviewed, results of continuing medical education pretests for medical providers were examined, and participating medical facilities were contacted in order to construct a profile of multi-level barriers to LTBI treatment. A total of 285 TST positive Latino (96%) high school students were recruited into the trial. We encountered a lack of understanding of the gravity of tuberculosis infection among both the public and providers of health care. Parents and adolescents cited competing priorities, transportation problems and financial constraints as reasons for non-compliance. Improved education of the public and physicians is needed regarding the gravity of the disease and the value of treatment, as well as public and financial support for LTBI treatment by both the government and the medical community.

Analysis of Emergency Information Management Research Hotspots Based on Bibliometric and Co-occurrence Analysis

Directory of Open Access Journals (Sweden)

Zou Qingyun

2017-04-01

Full Text Available [Purpose/significance] Emergency information management is an interdisciplinary field of emergency management and information management. Summarizing the major research output is helpful to strengthen the effective utilization of information resources in emergency management research, and to provide references for the follow-up development and practical exploration of emergency information management research. [Method/process] By retrieving concerned literature from CNKI, this paper used the bibliometric and co-word clustering analysis methods to analyze the domestic emergency management research output. [Result/conclusion] Domestic emergency information management research mainly focuses on five hot topics: disaster emergency information management, crisis information disclosure, emergency information management system, emergency response, wisdom emergency management. China should strengthen the emergency management information base for future theoretical research, and build the emergency information management theoretical framework.

Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

Science.gov (United States)

Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

2009-01-01

Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

Serious Games as Experiments for Emergency Management Research : A Review

NARCIS (Netherlands)

Van Ruijven, T.W.J.

2011-01-01

Serious games and virtual environments are increasingly used for emergency management training and research. The development of these technologies seems to contribute to a solution to some problems in the existing literature on emergency management which is mainly based on case study research.

Research on evacuation planning as nuclear emergency preparedness

International Nuclear Information System (INIS)

Yamamoto, Kazuya

2007-10-01

The International Atomic Energy Agency (IAEA) has introduced new concepts of precautionary action zone (PAZ) and urgent protective action planning zone (UPZ) in 'Preparedness and Response for a Nuclear or Radiological Emergency' (GS-R-2 (2002)), in order to reduce substantially the risk of severe deterministic health effects. Open literature based research was made to reveal problems on evacuation planning and the preparedness for nuclear emergency arising from introduction of PAZ into Japan that has applied the emergency planning zone (EPZ) concept currently. In regard to application of PAZ, it should be noted that the requirements for preparedness and response for a nuclear or radiological emergency are not only dimensional but also timely. The principal issue is implementation of evacuation of precautionary decided area within several hours. The logic of evacuation planning for a nuclear emergency and the methods of advance public education and information in the U.S. is effective for even prompt evacuation to the outside of the EPZ. As concerns evacuation planning for a nuclear emergency in Japan, several important issues to be considered were found, that is, selection of public reception centers which are outside area of the EPZ, an unique reception center assigned to each emergency response planning area, public education and information of practical details about the evacuation plan in advance, and necessity of the evacuation time estimates. To establish a practical evacuation planning guide for nuclear emergencies, further researches on application of traffic simulation technology to evacuation time estimates and on knowledge of actual evacuation experience in natural disasters and chemical plant accidents are required. (author)

CMHC research project: Testing of air barrier construction details, II: Report

Energy Technology Data Exchange (ETDEWEB)

1993-01-01

Air leakage control through the building envelope of wood framed houses is more important than ever. The leakage of air is controlled by the air barrier system. There are several new technologies to construct an air barrier system for the building envelope. These are the Poly Approach, the Air Drywall Approach and the EASE system. The development of these systems was undertaken primarily by the building community without significant research and development. The purpose of this study was to determine the actual performance of several different types of construction details for each of the different approaches. Each of these details was designed and constructed using one of the air barrier methods and tested in the laboratory. The test details included the sill plate, the partition wall, the stair stringer, the electrical outlets, the bathtub detail, the plumbing stack detail, the metal chimney detail, the bathroom fan detail and the EASE wall system.

Anticoncepção de emergência no Brasil: facilitadores e barreiras Emergency contraception in Brazil: facilitators and barriers

Directory of Open Access Journals (Sweden)

Ellen Hardy

2001-08-01

Full Text Available Realizou-se um estudo multicêntrico (Brasil, Chile e México, qualitativo, para avaliar a aceitabilidade da anticoncepção de emergência entre potenciais usuárias, possíveis provedores, autoridades e outras pessoas influentes, e identificar, de acordo com a percepção dos participantes, facilitadores e barreiras para a utilização do método no Brasil. Realizaram-se entrevistas semi-estruturadas, grupais e grupos de discussão, que foram gravados e transcritos para realização de análise temática. Os participantes manifestaram-se francamente favoráveis à disseminação da informação, provisão e uso da anticoncepção de emergência no Brasil. Consideraram que não existem barreiras significativas a sua aceitação pela sociedade brasileira em geral, e que seria mais apropriado adotar-se a estratégia de inseri-la em programas abrangentes de saúde reprodutiva. O método deveria ser oferecido como mais uma alternativa contraceptiva, em meio às demais, enfatizando a sua indicação em situações de emergência. Além disso, apontou-se como essencial que os profissionais de saúde sejam capacitados para proverem a informação e o método.A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability

Emerging themes in international business research

OpenAIRE

David A Griffith; Salih Tamer Cavusgil; Shichun Xu

2008-01-01

This study is motivated by two research questions: (1) Which recent contributions have been driving the research agenda in international business? (2) Which emerging themes in the literature are likely to set the stage for future work? To examine these questions, the study examined scholarly work in international business over the time period 1996–2006 in six leading international business journals (Journal of International Business Studies, Management International Review, Journal of World B...

Mediating role of critical thinking disposition in the relationship between perceived barriers to research use and evidence-based practice.

Science.gov (United States)

Kim, Sun-Ae; Song, Youngshin; Sim, Hee-Sook; Ahn, Eun-Kyong; Kim, Jung-Hee

2015-01-01

Despite the importance of critical thinking in clinical and educational settings, little is known about its role in evidence-based practice (EBP). This study examined whether critical thinking disposition (CTD) mediates the relationship between perceived barriers to research use and EBP in clinical nurses (N=409). A path diagram using structural equation modeling was used to estimate the direct and indirect effects of perceived barriers to research use on EBP, controlling for CTD as a mediator. CTD partially mediated the relationship between perceived barriers to research use and EBP. Furthermore, the hypothesized mediation model demonstrated an appropriate fit to the data. Individual and organizational efforts are needed to help nurses further improve their critical thinking skills. CTD is important as research barriers to engage effectively in EBP. Without the skills to evaluate evidence carefully, research utilization may be compromised.

Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients in Emergency Departments.

Science.gov (United States)

MacWilliams, Kate; Curran, Janet; Racek, Jakub; Cloutier, Paula; Cappelli, Mario

2017-12-01

This study sought to identify barriers and facilitators to the implementation of the HEADS-ED, a screening tool appropriate for use in the emergency department (ED) that facilitates standardized assessments, discharge planning, charting, and linking pediatric mental health patients to appropriate community resources. A qualitative theory-based design was used to identify barriers and facilitators to implementing the HEADS-ED tool. Focus groups were conducted with participants recruited from 6 different ED settings across 2 provinces (Ontario and Nova Scotia). The Theoretical Domains Framework was used as a conceptual framework to guide data collection and to identify themes from focus group discussions. The following themes spanning 12 domains were identified as reflective of participants' beliefs about the barriers and facilitators to implementing the HEADS-ED tool: knowledge, skills, beliefs about capabilities, social professional role and identity, optimism, beliefs about consequences, reinforcement, environmental context and resources, social influences, emotion, behavioral regulation and memory, and attention and decision process. The HEADS-ED has the potential to address the need for better discharge planning, complete charting, and standardized assessments for the increasing population of pediatric mental health patients who present to EDs. This study has identified potential barriers and facilitators, which should be considered when developing an implementation plan for adopting the HEADS-ED tool into practice within EDs.

Barriers to participation in mental health research: findings from the Genetics and Psychosis (GAP) Study.

Science.gov (United States)

Woodall, Anna; Howard, Louise; Morgan, Craig

2011-01-01

The aim of this study was to investigate why people with a first episode of psychosis choose or decline to participate in mental health research, using a qualitative study design. Participants were recruited via referrals from the Genetics and Psychosis (GAP) study. A total of 26 individuals with a first-episode of psychosis (nine of whom declined participation in the GAP study and 17 who participated) were individually interviewed and asked about their attitudes towards mental health research participation. Thematic analysis of interview transcripts was used to determine dominant themes and sub-themes on what constituted barriers and facilitators to participation. Reasons for research participation identified included a desire to help others, curiosity, and positive experiences with clinicians. Decisions to participate or not were also influenced by practical issues, including the timing of the approach, researchers' communication skills and whether individuals had concerns that it may be potentially harmful to their health. Other barriers to participation included patients' conceptualizations of mental health problems and the influence of other inpatients. Information on barriers and facilitators to recruitment in mental health research could inform recruitment strategies, thereby maximizing recruitment rates and minimizing the risk of selection biases.

Development of a productive research culture in emergency medicine: Report of the outcomes of a research forum.

Science.gov (United States)

Taylor, David McD; Cohen, Donna R; Epstein, Joseph; Freeman, Peter; Gosbell, Andrew D; Judkins, Simon; Mowatt, Elizabeth J M; O'Reilly, Gerard M; Vinen, John

2016-02-01

In recent years, the Australasian College for Emergency Medicine (ACEM) has increasingly focused on the need for high-quality research in emergency medicine (EM). One important initiative was the establishment of the ACEM Foundation, which among other responsibilities, is required to support clinical research through the provision of research funding and other measures. In February 2015, the Foundation held a Research Forum that was attended by the leading EM researchers from Australasia. The Forum aimed to determine how a productive research culture could be developed within the ACEM. Nine key objectives were determined including that research should be a core business of the ACEM and a core activity of the EM workforce, and that EM research should be sustainable and adequately supported. This report describes the background and conduct of the Forum, its recommendations and the way in which they could be implemented. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Experienced Barriers to Lean in Swedish Manufacturing and Health Care

Directory of Open Access Journals (Sweden)

Bengt Halling

2013-12-01

Full Text Available The purpose is to compare similarities and divergences in how the concepts of Lean and barriers to Lean are described by key informants at a production unit in a large manufacturing company and two emergency health care units in Sweden. Data was collected via semi-structured interviews and analyzed with the constant comparative method (CCM and Porras and Robertson’s (1992 change model. : In both organizations, the view of Lean changed from a toolbox to a human behavior view. Eight barriers were experienced in both organizations. Three barriers were unique to manufacturing or to health care, respectively. Nine barriers were elements of social factors; five were elements of organizing arrangements. Only people practically involved and responsible for the implementation at the two organizations participated in the study. Persons responsible for implementing Lean should consider organizational arrangements and social factors in order to limit barriers to successful implementation. Most research on Lean has been about successful Lean implementations. This study focuses on how Lean is viewed and what barriers personnel in manufacturing and health care have experienced. In comparing the barriers to Lean experienced in the two groups, common, archetypical, and unique barriers for manufacturing and health care can be identified, thus contributing to knowledge about barriers to Lean implementation.

Critical analysis of key determinants and barriers to digital innovation adoption among architectural organizations

Directory of Open Access Journals (Sweden)

Runddy Ramilo

2014-12-01

Full Text Available The development and use of design technology for architecture in the modern world have led to the emergence of various design methodologies. Current design research has focused on a computationally mediated design process. This method is essentially concerned with finding forms and building performance simulation, i.e., structural, environmental, constructional, and cost performance, by integrating physics and algorithms. From the emergence of this process, design practices have been increasingly aided by and dependent on the technology, which has resulted in a major paradigm shift. Advancement of the new technology has the potential to improve design and productivity dramatically. However, related literature shows that substantial technical and organizational barriers exist. These barriers inhibit the effective adoption of these technologies. The effect of these obstacles on architectural practice varies depending on the size of an architectural organization. To further understand the problem, we conducted an in-depth study on several small, medium, and large architectural organizations. This study involves in-depth evaluation of technological, financial, organizational, governmental, psychological, and process barriers encountered in the adoption of digital innovation. Results reveal relevant attributes and patterns of variables, which can be used to establish a framework for digital innovation adoption. Valuable findings of this study reveal that smaller architectural organizations present more barriers to digital innovation compared with their larger counterparts. This study is important because it contributes to the research on digital innovation in architecture and addresses the barriers faced by different sizes of architectural organizations.

Academics' Perceptions of the Challenges and Barriers to Implementing Research-Based Experiences for Undergraduates

Science.gov (United States)

Brew, Angela; Mantai, Lilia

2017-01-01

How can universities ensure that strategic aims to integrate research and teaching through engaging students in research-based experiences be effectively realised within institutions? This paper reports on the findings of a qualitative study exploring academics' perceptions of the challenges and barriers to implementing undergraduate research.…

Emergency nurses' knowledge of pain management principles.

Science.gov (United States)

Tanabe, P; Buschmann, M

2000-08-01

The purpose of this study was to determine areas of emergency nurses' knowledge deficit regarding pain management, and to identify barriers to pain management as perceived by emergency nurses. Data were collected anonymously in a mail survey using a 52-item knowledge questionnaire addressing pain management principles and asking emergency nurses (Illinois Emergency Nurses Association members) to rate various barriers as to how often they affect their practice. Questionnaires were mailed to all Illinois ENA members (n = 1000). Three hundred five emergency nurses' questionnaires were returned. A significant deficit existed on 2 domains of knowledge: understanding of the terms "addiction," "tolerance," and "dependence"; and knowledge of various pharmacologic analgesic principles. Nurses with a master's degree or higher, or those who attended a 1-day seminar on pain management, achieved statistically significantly higher scores. The 2 barriers identified by emergency nurses as the most common were the inability to administer medication until a diagnosis is made (53%), and inadequate assessment of pain and pain relief (48%) (the percentage indicates how often the emergency nurses believed the barrier was present in their practice). The data indicate that emergency nurses may not have a good understanding of the management of pain with drugs, or of such issues as risk of addiction.

Highlights in emergency medicine medical education research: 2008.

Science.gov (United States)

Farrell, Susan E; Coates, Wendy C; Khun, Gloria J; Fisher, Jonathan; Shayne, Philip; Lin, Michelle

2009-12-01

The purpose of this article is to highlight medical education research studies published in 2008 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine. Through a PubMed search of the English language literature in 2008, 30 medical education research studies were independently identified as hypothesis-testing investigations and measurements of educational interventions. Six reviewers independently rated and scored all articles based on eight anchors, four of which related to methodologic criteria. Articles were ranked according to their total rating score. A ranking agreement among the reviewers of 83% was established a priori as a minimum for highlighting articles in this review. Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Four of these employed experimental or quasi-experimental methodology. Although technology was not a component of the structured literature search employed to identify the candidate articles for this review, 14 of the articles identified, including four of the five highlighted articles, employed or studied technology as a focus of the educational research. Overall, 36% of the reviewed studies were supported by funding; three of the highlighted articles were funded studies. This review highlights quality medical education research studies published in 2008, with outcomes of relevance to teaching and education in emergency medicine. It focuses on research methodology, notes current trends in the use of technology for learning in emergency medicine, and suggests future avenues for continued rigorous study in education.

Ethics case reflection sessions: Enablers and barriers.

Science.gov (United States)

Bartholdson, Cecilia; Molewijk, Bert; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2018-03-01

In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included 'increased understanding', 'group strengthening' and 'decision grounding'. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions. The aim of this study was to explore conditions for clarifying perspectives during ECR sessions. Data were collected from observations and interviews and the results emerged from an inductive analysis using grounded theory. Participants and research context: Six observations during ECR sessions and 10 interviews were performed with healthcare professionals working in childhood cancer care and advanced paediatric homecare. Ethical considerations: The study was approved by a regional ethical review board. Participants were informed about their voluntary involvement and that they could withdraw their participation without explaining why. Two categories emerged: organizational enablers and barriers and team-related enablers and barriers. Organizational enablers and barriers included the following sub-categories: the timing of the ECR session, the structure during the ECR session and the climate during the ECR session. Sub-categories to team-related enablers and barriers were identified as space for inter-professional perspectives, varying levels of ethical skills and space for the patient's and the family's perspectives. Space for inter-professional perspectives included the dominance of a particular perspective that can result from hierarchical positions. The medical perspective is relevant for understanding the child's situation but should not dominate the ethical reflection. Conditions for ECR sessions have been explored and the new knowledge can be used when training

Over-the-counter access to emergency contraception without age restriction: an opinion of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy.

Science.gov (United States)

Rafie, Sally; McIntosh, Jennifer; Gardner, Debra K; Gawronski, Kristen M; Karaoui, Lamis R; Koepf, Erin R; Lehman, Katherine Joy; McBane, Sarah; Patel-Shori, Nima M

2013-05-01

Family planning remains a high priority area for the United States, with goals to increase the proportion of pregnancies that are intended, reduce pregnancy rates among adolescents, and increase contraceptive use prioritized in the Healthy People 2020 objectives. Contraception intended for use after unprotected intercourse, known as emergency contraception, remains underutilized. Levonorgestrel is one method of oral emergency contraception, which prevents fertilization and does not disrupt an already established pregnancy; thus, timing of administration is critical. Despite data demonstrating safety and efficacy, evidence-based decision making has been overshadowed by politically charged actions involving levonorgestrel emergency contraception for over a decade. The Women's Health Practice and Research Network of the American College of Clinical Pharmacy supports expanded access to levonorgestrel emergency contraception and removal of barriers such as age restrictions on the nonprescription drug product. Pharmacists remain a key provider of emergency contraceptive services and can help ensure timely access. In states where direct pharmacy access to emergency contraception is available, pharmacists are encouraged to participate. Education, research, and advocacy are other important responsibilities for pharmacists in this arena. © 2013 Pharmacotherapy Publications, Inc.

Sexual Diversity in the Judiciary in England and Wales; Research on Barriers to Judicial Careers

Directory of Open Access Journals (Sweden)

Leslie J. Moran

2013-12-01

Full Text Available Debates about the diversity of the judiciary in the UK have been dominated by gender, race and ethnicity. Sexuality is notable by its absence and is perceived to pose particular challenges. It is usually missing from the list of diversity categories. When present, its appearance is nominal. One effect of this has been a total lack of official data on the sexual composition of the judiciary. Another is the gap in research on the barriers to the goal of a more sexually diverse judiciary. In 2008 the Judicial Appointment Commission (JAC for England and Wales undertook research to better understand the challenges limiting progress towards judicial diversity. A central gaol of the project was to investigate barriers to application for judicial appointment across different groups defined by “sex, ethnicity and employment status”. Sexual orientation was again noticeable by its absence. Its absence was yet another missed opportunity to recognise and take seriously this strand of diversity. This study is based on a response to that absence. A stakeholder organisation, InterLaw Diversity Forum for lesbian gay bisexual and transgender networks in the legal services sector, with the JAC’s approval, used their questionnaire and for the first time asked lesbian, gay, bisexual and transgender lawyers about the perceptions and experiences of barriers to judicial appointment. This paper examines the findings of that unique research and considers them in the light of the initial research on barriers to judicial appointment and subsequent developments.

Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

Science.gov (United States)

Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

2017-09-01

communication barriers experienced by public health and health care personnel. Forty-eight studies provided evidence on how to create and sustain preparedness systems. Results included how to build social capital across organizations and citizens and how to develop sustainable and useful planning efforts that maintain flexibility and rely on available medical data. Twenty-six studies provided evidence on the usefulness of measurement efforts, such as community and organizational needs assessments, and new methods to learn from the response to critical incidents. In the United States, the field of public health emergency preparedness system research has been supported by the US Centers for Disease Control and Prevention since the release of the 2008 Institute of Medicine letter report. The first definition of public health emergency preparedness appeared in 2007, and before 2008 there was a lack of research and empirical evidence across all 4 research areas identified by the Institute of Medicine. This field can be considered relatively new compared with other research areas in public health; for example, tobacco control research can rely on more than 70 years of knowledge production. However, this review demonstrates that, during the past 7 years, public health emergency preparedness system research has evolved from generic inquiry to the analysis of specific interventions with more empirical studies. Public Health Implications: The results of this review provide an evidence base for public health practitioners responsible for enhancing key components of preparedness and response such as communication, training, and planning efforts.

78 FR 70917 - Emerging Technology and Research Advisory Committee; Notice of Open Meeting

Science.gov (United States)

2013-11-27

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Open Meeting The Emerging Technology and Research Advisory Committee (ETRAC) will meet... Secretary for Export Administration on emerging technology and research activities, including those related...

77 FR 39209 - Emerging Technology and Research Advisory Committee; Notice of Open Meeting

Science.gov (United States)

2012-07-02

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Open Meeting The Emerging Technology and Research Advisory Committee (ETRAC) will meet... Secretary for Export Administration on emerging technology and research activities, including those related...

77 FR 59374 - Emerging Technology and Research Advisory Committee; Notice of Open Meeting

Science.gov (United States)

2012-09-27

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Open Meeting The Emerging Technology and Research Advisory Committee (ETRAC) will meet... Secretary for Export Administration on emerging technology and research activities, including those related...

Surface barrier research at the Hanford Site

International Nuclear Information System (INIS)

Gee, G.W.; Ward, A.L.; Fayer, M.J.

1997-01-01

At the DOE Hanford Site, a field-scale prototype surface barrier was constructed in 1994 over an existing waste site as a part of a CERCLA treatability test. The above-grade barrier consists of a fine-soil layer overlying coarse layers of sands, gravels, basalt rock (riprap), and a low permeability asphalt layer. Two sideslope configurations, clean-fill gravel on a 10:1 slope and basalt riprap on a 2:1 slope, were built and are being tested. Design considerations included: constructability; drainage and water balance monitoring, wind and water erosion control and monitoring; surface revegetation and biotic intrusion; subsidence and sideslope stability, and durability of the asphalt layer. The barrier is currently in the final year of a three-year test designed to answer specific questions related to stability and long-term performance. One half of the barrier is irrigated such that the total water applied, including precipitation, is 480 mm/yr (three times the long-term annual average). Each year for the past two years, an extreme precipitation event (71 mm in 8 hr) representing a 1,000-yr return storm was applied in late March, when soil water storage was at a maximum. While the protective sideslopes have drained significant amounts of water, the soil cover (2-m of silt-loam soil overlying coarse sand and rock) has never drained. During the past year there was no measurable surface runoff or wind erosion. This is attributed to extensive revegetation of the surface. In addition, the barrier elevation has shown a small increase of 2 to 3 cm that is attributed to a combination of root proliferation and freeze/thaw activity. Testing will continue through September 1997. Performance data from the prototype barrier will be used by DOE in site-closure decisions at Hanford

Research Data Reusability: Conceptual Foundations, Barriers and Enabling Technologies

Directory of Open Access Journals (Sweden)

Costantino Thanos

2017-01-01

Full Text Available High-throughput scientific instruments are generating massive amounts of data. Today, one of the main challenges faced by researchers is to make the best use of the world’s growing wealth of data. Data (reusability is becoming a distinct characteristic of modern scientific practice. By data (reusability, we mean the ease of using data for legitimate scientific research by one or more communities of research (consumer communities that is produced by other communities of research (producer communities. Data (reusability allows the reanalysis of evidence, reproduction and verification of results, minimizing duplication of effort, and building on the work of others. It has four main dimensions: policy, legal, economic and technological. The paper addresses the technological dimension of data reusability. The conceptual foundations of data reuse as well as the barriers that hamper data reuse are presented and discussed. The data publication process is proposed as a bridge between the data author and user and the relevant technologies enabling this process are presented.

An ethical exploration of barriers to research on controlled drugs

Science.gov (United States)

ANDREAE, Michael H; RHODES, Evelyn; BOURGOISE, Tylor; CARTER, George; WHITE, Robert S.; INDYK, Debbie; SACKS, Henry; RHODES, Rosamond

2016-01-01

We examine the ethical, social and regulatory barriers that may hamper research on therapeutic potential of certain controversial controlled substances like marijuana, heroin or ketamine. Hazards for individuals and society, and their potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of certain substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may hinder research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns of undue inducement, informed consent, risk to participants, researchers and institutions, justice and liberty germane to the research with illicit and addictive substances. We debate the disparate research stakeholder perspectives and why they are likely to be infected with bias. We propose an empirical research agenda to provide a more evidentiary basis for ethical reasoning. PMID:26982922

Medical research in emergency research in the European Union member states: tensions between theory and practice.

Science.gov (United States)

Kompanje, Erwin J O; Maas, Andrew I R; Menon, David K; Kesecioglu, Jozef

2014-04-01

In almost all of the European Union member states, prior consent by a legal representative is used as a substitute for informed patient consent for non-urgent medical research. Deferred (patient and/or proxy) consent is accepted as a substitute in acute emergency research in approximately half of the member states. In 12 European Union member states emergency research is not mentioned in national law. Medical research in the European Union is covered by the Clinical Trial Directive 2001/20/EC. A proposal for a regulation by the European Commission is currently being examined by the European Parliament and the Council and will replace Directive 2001/20/EC. Deferred patient and/or proxy consent is allowed in the proposed regulation, but does not fit completely in the practice of emergency research. For example, deferred consent is only possible when legal representatives are not available. This criterion will delay inclusion of patients in acute life-threatening conditions in short time frames. As the regulation shall be binding in its entirety in all member states, emergency research in acute situations is still not possible as it should be.

A reactive barrier to enhance the removal of emerging organic compounds during artificial recharge of aquifers through infiltration basins

OpenAIRE

Valhondo, Cristina

2017-01-01

Artificial recharge of aquifers through infiltration basins (AR) improves water quality and in- creases groundwater resources, which make of it an appropriate technique for the renaturalization of waters affected directly or indirectly by wastewater effluents. Emerging organic compounds (EOCs), typically present in such waters, are mainly reduced during AR by sorption and biotrans- formation. We installed a reactive barrier in an infiltration basin (5000 m2) to enhance the removal of EOCs ...

Barriers to surge capacity of an overcrowded emergency department for a serious foodborne disease outbreak.

Science.gov (United States)

Lee, Wen-Huei; Ghee, Chew; Wu, Kuan-Han; Hung, Shih-Chiang

2010-10-01

The purpose of this study was to investigate barriers to surge capacity of an overcrowded emergency department (ED) for a foodborne disease outbreak (FBDO) and to identify solutions to the problems. The emergency response of an overcrowded ED to a serious FBDO with histamine fish poisoning was reviewed. The ED of a tertiary academic medical centre (study hospital) with 1600 acute beds in southern Taiwan. Among the 346 patients in the outbreak, 333 (96.2%) were transferred to the study hospital without prehospital management within about 2 h. The most common symptoms were dizziness (58.9%), nausea and vomiting (36.3%). 181 patients (54.4%) received intravenous fluid infusion and blood tests were ordered for 82 (24.6%). All patients were discharged except one who required admission. The prominent problems with surge capacity of the study hospital were shortage of spare space in the ED, lack of biological incident response plan, poor command system, inadequate knowledge and experience of medical personnel to manage the FBDO. Patients with FBDO could arrive at the hospital shortly after exposure without field triage and management. The incident command system and emergency operation plan of the study hospital did not address the clinical characteristics of the FBDO and the problem of ED overcrowding. Further planning and training of foodborne disease and surge capacity would be beneficial for hospital preparedness for an FBDO.

75 FR 18484 - Emerging Technology and Research Advisory Committee; Notice of Open Meeting

Science.gov (United States)

2010-04-12

... Emerging Technologies Analysis. 2. ETRAC Panel on Emerging Technologies. 3. History of the Laser. 4... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Open Meeting The Emerging Technology and Research Advisory Committee (ETRAC) [[Page...

Barriers to implementing the Sepsis Six guidelines in an acute hospital setting.

Science.gov (United States)

Breen, Sarah-Jane; Rees, Sharon

2018-05-10

To identify the barriers to implementation of the Sepsis Six pathway. Research has suggested that compliance with the Sepsis Six pathway remains low. A convenience sample of doctors and nurses from one emergency department, two medical wards and two surgical wards were asked to complete a survey questionnaire. Data from 108 respondents were available for analysis. Doctors and nurses agreed that lack of sepsis recognition during observation rounds and failure to associate sepsis with deranged temperature and blood results acted as barriers to the identification of sepsis. Doctors and nurses agreed that nursing delays and knowledge deficits were the top barriers leading to delay in sepsis treatment. Knowledge deficits, lack of resources and practical issues were barriers identified in this survey. This will inform the educational and process needs of both doctors and nurses in order to improve sepsis care.

Committee Opinion No 707: Access to Emergency Contraception.

Science.gov (United States)

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Barriers to Maori sole mothers’ primary health care access

Directory of Open Access Journals (Sweden)

Lee R

2013-12-01

Full Text Available INTRODUCTION: International research consistently shows that sole mothers experience poorer health and suboptimal health care access. New Zealand studies on sole mothers' health report similar findings. The aim of this exploratory research was to better understand the experiences of Maori sole mothers' access to health services, particularly primary health care, for personal health needs. METHODS: This qualitative study employed a general inductive design informed by a Kaupapa Maori approach, providing guidance on appropriate cultural protocols for recruiting and engaging Maori participants. Distributing written information and snowballing techniques were used to purposively recruit seven Maori sole mothers. Data collection involved semi-structured interviews which were digitally recorded and transcribed verbatim. Data were analysed using general inductive thematic analysis to identify commonalities and patterns in participants' experiences. FINDINGS: The dominant themes that emerged captured and described participants' experiences in accessing health care. The major barrier to access reported was cost. Compounding cost, transport difficulties and location or scheduling of services were additional barriers to health service accessibility. Child-related issues also posed a barrier, including prioritising children's needs and childcare over personal health needs. CONCLUSION: The findings illuminate Maori sole mothers' experiences of accessing health care and the complex socioeconomic inequalities affecting access options and uptake of services. Further investigation of barriers to access is needed. The study has implications for addressing barriers to access at policy, funding and practice levels to improve health outcomes and equitable health care access for Maori sole mothers.

Research awareness, attitudes and barriers among clinical staff in a regional cancer centre. Part 1: a quantitative analysis.

Science.gov (United States)

Caldwell, B; Coltart, K; Hutchison, C; McJury, M; Morrison, A; Paterson, C; Thomson, M

2017-09-01

Research is of key importance in delivering high-quality patient care through evidence-based practice. Attitude towards research and barriers to research can have an impact on research activity. A survey was conducted to establish the levels of research awareness and attitudes among clinical staff groups in this regional cancer centre and identify any barriers to participation in research. The survey consisted of 26 questions and was distributed electronically and completed online. The response rate was 22.3% (n = 123). All participants felt that clinical research will help the regional cancer centre develop and progress treatments in the future. A positive attitude towards research was evident and consistent across professional groups. The main identified barriers to research included lacking the required knowledge, skills and training, lacking support from managers, and lack of opportunity or time to be involved in research, in particular for allied health professionals. However, there appears to be the foundation of a healthy research culture for nurses supported by management. The results of the survey support the implementation of an action plan based on the recommendations of this journal article. © 2016 John Wiley & Sons Ltd.

Incentives and barriers to OER adoption: A qualitative analysis of faculty perceptions

Directory of Open Access Journals (Sweden)

Olga Maria Belikov

2016-08-01

Full Text Available In this paper, 218 U.S faculty responses regarding Open Educational Resources (OER were qualitatively analyzed. Ten categories emerged in the coding process. The top three categories that indicated barriers to the adoption of OER were need more information (faculty wanted more information before they would be willing to adopt OER, lack of discoverability (faculty wanted to be able to easily find repositories of OER, and confusing OER with digital resources (faculty were unaware of the difference between digital resources and OER. The top incentives identified in this analysis to overcome these barriers include student cost benefits (saving students money, student pedagogical benefits (faculty being able to make changes to OER to improve course content and instruction, and institutional support for the adoption of OER (whether in the form of course load reduction, curricular research assistance, or library support for finding and adopting OER. Future research is needed to better understand how to address and overcome these barriers to OER adoption.

Mapping the Landscape of Emerging Research Topics in Supply Chain Management

DEFF Research Database (Denmark)

Wieland, Andreas; Handfield, Robert B.; Durach, Christian F.

2014-01-01

The purpose of this article is to identify research topics that are emerging in the field of supply chain management [SCM]. The analysis is based on survey data collected from leading SCM researchers. It is found that big data analytics, sustainability, risk management, health care, emerging mark...

Performance of engineered barrier materials in near surface disposal facilities for radioactive waste. Results of a co-ordinated research project

International Nuclear Information System (INIS)

2001-11-01

The primary objectives of the CRP were to: promote the sharing of experiences of the Member States in their application of engineered barrier materials for near surface disposal facilities; help enhance their use of engineered barriers by improving techniques and methods for selecting, planning and testing performance of various types of barrier materials for near surface disposal facilities. The objective of this publication is to provide and overview of technical issues related to the engineered barrier systems and a summary of the major findings of each individual research project that was carried out within the framework of the CRP. This publication deals with a general overview of engineered barriers in near surface disposal facilities, key technical information obtained within the CRP and overall conclusions and recommendations for future research and development activities. Appendices presenting individual research accomplishments are also provided. Each of the 13 appendices was indexed separately

Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa-a systematic review protocol.

Science.gov (United States)

Geleto, Ayele; Chojenta, Catherine; Mussa, Abdulbasit; Loxton, Deborah

2018-04-16

Nearly 15% of all pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labor, and complications of abortion. Between 1990 and 2015, an estimated 10.7 million women died due to obstetric complications. Almost all of these deaths (99%) happened in developing countries, and 66% of maternal deaths were attributed to sub-Saharan Africa. The majority of cases of maternal mortalities can be prevented through provision of evidence-based potentially life-saving signal functions of emergency obstetric care. However, different factors can hinder women's ability to access and use emergency obstetric services in sub-Saharan Africa. Therefore, the aim of this review is to synthesize current evidence on barriers to accessing and utilizing emergency obstetric care in sub-Saharan African. Decision-makers and policy formulators will use evidence generated from this review in improving maternal healthcare particularly the emergency obstetric care. Electronic databases including MEDLINE, CINAHL, Embase, and Maternity and Infant Care will be searched for studies using predefined search terms. Articles published in English language between 2010 and 2017 with quantitative and qualitative design will be included. The identified papers will be assessed for meeting eligibility criteria. First, the articles will be screened by examining their titles and abstracts. Then, two reviewers will review the full text of the selected articles independently. Two reviewers using a standard data extraction format will undertake data extraction from the retained studies. The quality of the included papers will be assessed using the mixed methods appraisal tool. Results from the eligible studies will be qualitatively synthesized using the narrative synthesis approach and reported using the three delays model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be employed to present the findings. This

Nurses' barriers to learning: an integrative review.

Science.gov (United States)

Santos, Marion C

2012-07-01

This integrative review of the literature describes nurses' barriers to learning. Five major themes emerged: time constraints, financial constraints, workplace culture, access/relevance, and competency in accessing electronic evidence-based practice literature. The nurse educator must address these barriers for the staff to achieve learning and competency.

Facilitators and barriers to application of the Canadian C-spine rule by emergency department triage nurses.

Science.gov (United States)

Clement, Catherine M; Stiell, Ian G; Lowe, Maureen A; Brehaut, Jamie C; Calder, Lisa A; Vaillancourt, Christian; Perry, Jeffrey J

2016-07-01

We recently conducted a multicentre implementation study on the use of the Canadian C-Spine Rule (CCR) by emergency department (ED) nurses to clear the c-spine in alert and stable trauma patients (n = 4506). The objective of this study was to conduct a survey of nurses, physicians, and administrators to evaluate their views on the facilitators and barriers to the implementation of the CCR. We conducted both a paper-based and an electronic survey of the three different ED hospital staff groups of nine large teaching hospitals in Ontario, including six regional trauma centres. The content of this survey was informed by a qualitative evaluation of the opinions of the study nurses who had participated in the validation study. 57.5% (281/489) ED triage nurses, 50.2% ED physicians, and 82.8% of administrators responded. Nurse responses most often showed support from manager/educators and teamwork between physicians, nurses, and managers as being important facilitators to the use of the CCR. Physician responses most often identified the importance of a nurse leader/champion/educator, and presence of strong physician leaders. Administrator responses indicated the importance of nurse educators/champions, nurse engagement, and educational support. Barriers indicated by all three groups included busy department, lack of physician support, and lack of nursing support. Bringing about change in clinical practice is complex. Strong leadership, effective communication, and senior physician buy-in appear to be very important. Identification of system-specific barriers and facilitators are important components of successful knowledge translation. Copyright © 2015 Elsevier Ltd. All rights reserved.

76 FR 10004 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2011-02-23

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... the Assistant Secretary for Export Administration on emerging technology and research activities...

76 FR 54734 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2011-09-02

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... the Assistant Secretary for Export Administration on emerging technology and research activities...

76 FR 30647 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2011-05-26

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... the Assistant Secretary for Export Administration on emerging technology and research activities...

75 FR 41439 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2010-07-16

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... the Assistant Secretary for Export Administration on emerging technology and research activities...

The emergence and evolution of the research fronts in HIV/AIDS research.

Directory of Open Access Journals (Sweden)

David Fajardo-Ortiz

Full Text Available In this paper, we have identified and analyzed the emergence, structure and dynamics of the paradigmatic research fronts that established the fundamentals of the biomedical knowledge on HIV/AIDS. A search of papers with the identifiers "HIV/AIDS", "Human Immunodeficiency Virus", "HIV-1" and "Acquired Immunodeficiency Syndrome" in the Web of Science (Thomson Reuters, was carried out. A citation network of those papers was constructed. Then, a sub-network of the papers with the highest number of inter-citations (with a minimal in-degree of 28 was selected to perform a combination of network clustering and text mining to identify the paradigmatic research fronts and analyze their dynamics. Thirteen research fronts were identified in this sub-network. The biggest and oldest front is related to the clinical knowledge on the disease in the patient. Nine of the fronts are related to the study of specific molecular structures and mechanisms and two of these fronts are related to the development of drugs. The rest of the fronts are related to the study of the disease at the cellular level. Interestingly, the emergence of these fronts occurred in successive "waves" over the time which suggest a transition in the paradigmatic focus. The emergence and evolution of the biomedical fronts in HIV/AIDS research is explained not just by the partition of the problem in elements and interactions leading to increasingly specialized communities, but also by changes in the technological context of this health problem and the dramatic changes in the epidemiological reality of HIV/AIDS that occurred between 1993 and 1995.

75 FR 72792 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2010-11-26

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Office of the Assistant Secretary for Export Administration on emerging technology and research...

77 FR 70140 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2012-11-23

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Export Administration on emerging technology and research activities, including those related to deemed...

75 FR 5952 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2010-02-05

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Office of the Assistant Secretary for Export Administration on emerging technology and research...

76 FR 72902 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2011-11-28

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Office of the Assistant Secretary for Export Administration on emerging technology and research...

75 FR 62508 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2010-10-12

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Office of the Assistant Secretary for Export Administration on emerging technology and research...

78 FR 21346 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting

Science.gov (United States)

2013-04-10

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Office of the Assistant Secretary for Export Administration on emerging technology and research...

US-China Clean Energy Research Center on Building Energy Efficiency: Materials that Improve the Cost-Effectiveness of Air Barrier Systems

Energy Technology Data Exchange (ETDEWEB)

Hun, Diana E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2016-12-01

The US–China Clean Energy Research Center (CERC) was launched in 2009 by US Energy Secretary Steven Chu, Chinese Minister of Science and Technology Wan Gang, and Chinese National Energy Agency Administrator Zhang Guobao. This 5-year collaboration emerged from the fact that the United States and China are the world’s largest energy producers, energy consumers, and greenhouse gas emitters, and that their joint effort could have significant positive repercussions worldwide. CERC’s main goal is to develop and deploy clean energy technologies that will help both countries meet energy and climate challenges. Three consortia were established to address the most pressing energy-related research areas: Advanced Coal Technology, Clean Vehicles, and Building Energy Efficiency (BEE). The project discussed in this report was part of the CERC-BEE consortia; its objective was to lower energy use in buildings by developing and evaluating technologies that improve the cost-effectiveness of air barrier systems for building envelopes.

Catalyzing Cross-Disciplinary Research and Education Within and Beyond the Environmental and Geosciences to Address Emerging, Societally-Relevant Issues

Science.gov (United States)

Cak, A. D.; Vigdor, L. J.; Vorosmarty, C. J.; Giebel, B. M.; Santistevan, C.; Chasteau, C.

2017-12-01

Tackling emergent, societally-relevant problems in the environmental sciences is hardly confined to a single research discipline, but rather requires collaborations that bridge diverse domains and perspectives. While new technologies (e.g., Skype) can in theory unite otherwise geographically distributed participation in collaborative research, physical distance nevertheless raises the bar on intellectual dialogue. Such barriers may reveal perceptions of or real differences across disciplines, reflecting particular traditions in their histories and academic cultures. Individual disciplines are self-defined by their scientific, epistemologic, methodologic, or philosophical traditions (e.g., difficulties in understanding processes occurring at different scales, insufficient research funding for interdisciplinary work), or cultural and discursive hurdles (e.g., navigating a new field's jargon). Coupled with these challenges is a considerable deficiency in educating the next generation of scientists to help them develop a sufficient comfort level with thinking critically across multiple disciplinary domains and conceptual frameworks. To address these issues, the City University of New York (CUNY), the largest public urban university in the U.S., made a significant investment in advancing cross-disciplinary research and education, culminating in the opening of the CUNY Advanced Science Research Center (ASRC) in New York City (NYC) in late 2014. We report here on our experiences incubating new collaborative efforts to address environmental science-related research as it is interwoven with the ASRC's five research initiatives (Environmental Sciences, Neuroscience, Structural Biology, Photonics, and Nanoscience). We describe the ASRC's overall structure and function as both a stand-alone interdisciplinary center and one that collaborates more broadly with CUNY's network of twenty-four campuses distributed across NYC's five boroughs. We identify challenges we have faced so

A Review of Barriers to Minorities' Participation in Cancer Clinical Trials: Implications for Future Cancer Research.

Science.gov (United States)

Salman, Ali; Nguyen, Claire; Lee, Yi-Hui; Cooksey-James, Tawna

2016-04-01

To enhance nurses' awareness and competencies in practice and research by reporting the common barriers to participation of minorities in cancer clinical trials and discussing facilitators and useful strategies for recruitment. Several databases were searched for articles published in peer reviewed journals. Some of the barriers to minorities' participation in clinical trials were identified within the cultural social-context of cancer patients. The involvement of community networking was suggested as the most effective strategy for the recruitment of minorities in cancer clinical trials. Using culturally sensitive approaches to enhance ethnic minorities' participation is important for advancing cancer care and eliminating health disparities. Awareness of barriers and potential facilitators to the enrollment of ethnic minority cancer patients may contribute to enhancing nurses' competencies of recruiting ethnic minorities in nursing research, playing efficient roles in cancer clinical trials team, and providing culturally competent quality care.

Revised radiation emergency procedures at Pakistan research reactor PINSTECH

International Nuclear Information System (INIS)

Orfi, S.D.; Javed, M.; Ahmad, S.; Akhtar, K.M.; Mubarak, M.A.

1984-12-01

Necessary procedures have been laid down in this report to meet the radiation emergency at Pakistan Research Reactor PINSTECH. The Nuclear Safety Committee PINSTECH (NSCP) had also recommended a number of improvements in the existing procedures. Revision of the procedures was also considered necessary to incorporate into it new radiation units/limits and new emergency equipment available. Radiation emergency preparedness programme is of continuous nature. Latest developments else-where and local experience contribute to the improvement of the existing arrangements under this programme. (A.B.)

Specialist nurses’ perceptions of inviting patients to participate in clinical research studies: a qualitative descriptive study of barriers and facilitators

Directory of Open Access Journals (Sweden)

Caroline French

2016-08-01

Full Text Available Abstract Background Increasing the number of patients participating in research studies is a current priority in the National Health Service (NHS in the United Kingdom. The role of specialist nurses in inviting patients to participate is important, yet little is known about their experiences of doing so. The aim of this study was to explore the perceptions of barriers and facilitators held by specialist nurses with experience of inviting adult NHS patients to a wide variety of research studies. Methods A cross-sectional qualitative descriptive study was conducted between March and July 2015. Participants were 12 specialist nurses representing 7 different clinical specialties and 7 different NHS Trusts. We collected data using individual semi-structured interviews, and analysed transcripts using the Framework method to inductively gain a descriptive overview of barriers and facilitators. Results Barriers and facilitators were complex and interdependent. Perceptions varied among individuals, however barriers and facilitators centred on five main themes: i assessing patient suitability, ii teamwork, iii valuing research, iv the invitation process and v understanding the study. Facilitators to inviting patients to participate in research often stemmed from specialist nurses’ attitudes, skills and experience. Positive research cultures, effective teamwork and strong relationships between research and clinical teams at the local clinical team level were similarly important. Barriers were reported when specialist nurses felt they were providing patients with insufficient information during the invitation process, and when specialist nurses felt they did not understand studies to their satisfaction. Conclusion Our study offers several new insights regarding the role of specialist nurses in recruiting patients for research. It shows that strong local research culture and teamwork overcome some wider organisational and workload barriers reported in

Specialist nurses' perceptions of inviting patients to participate in clinical research studies: a qualitative descriptive study of barriers and facilitators.

Science.gov (United States)

French, Caroline; Stavropoulou, Charitini

2016-08-11

Increasing the number of patients participating in research studies is a current priority in the National Health Service (NHS) in the United Kingdom. The role of specialist nurses in inviting patients to participate is important, yet little is known about their experiences of doing so. The aim of this study was to explore the perceptions of barriers and facilitators held by specialist nurses with experience of inviting adult NHS patients to a wide variety of research studies. A cross-sectional qualitative descriptive study was conducted between March and July 2015. Participants were 12 specialist nurses representing 7 different clinical specialties and 7 different NHS Trusts. We collected data using individual semi-structured interviews, and analysed transcripts using the Framework method to inductively gain a descriptive overview of barriers and facilitators. Barriers and facilitators were complex and interdependent. Perceptions varied among individuals, however barriers and facilitators centred on five main themes: i) assessing patient suitability, ii) teamwork, iii) valuing research, iv) the invitation process and v) understanding the study. Facilitators to inviting patients to participate in research often stemmed from specialist nurses' attitudes, skills and experience. Positive research cultures, effective teamwork and strong relationships between research and clinical teams at the local clinical team level were similarly important. Barriers were reported when specialist nurses felt they were providing patients with insufficient information during the invitation process, and when specialist nurses felt they did not understand studies to their satisfaction. Our study offers several new insights regarding the role of specialist nurses in recruiting patients for research. It shows that strong local research culture and teamwork overcome some wider organisational and workload barriers reported in previous studies. In addition, and in contrast to common practice

Relativistic tunneling through two successive barriers

International Nuclear Information System (INIS)

Lunardi, Jose T.; Manzoni, Luiz A.

2007-01-01

We study the relativistic quantum mechanical problem of a Dirac particle tunneling through two successive electrostatic barriers. Our aim is to study the emergence of the so-called generalized Hartman effect, an effect observed in the context of nonrelativistic tunneling as well as in its counterparts and which is often associated with the possibility of superluminal velocities in the tunneling process. We discuss the behavior of both the phase (or group) tunneling time and the dwell time, and show that in the limit of opaque barriers the relativistic theory also allows the emergence of the generalized Hartman effect. We compare our results with the nonrelativistic ones and discuss their interpretation

Skin barrier function

DEFF Research Database (Denmark)

2016-01-01

Renowned experts present the latest knowledge Although a very fragile structure, the skin barrier is probably one of the most important organs of the body. Inward/out it is responsible for body integrity and outward/in for keeping microbes, chemicals, and allergens from penetrating the skin. Since...... the role of barrier integrity in atopic dermatitis and the relationship to filaggrin mutations was discovered a decade ago, research focus has been on the skin barrier, and numerous new publications have become available. This book is an interdisciplinary update offering a wide range of information...... on the subject. It covers new basic research on skin markers, including results on filaggrin and on methods for the assessment of the barrier function. Biological variation and aspects of skin barrier function restoration are discussed as well. Further sections are dedicated to clinical implications of skin...

Rice Research to Break Yield Barriers

Science.gov (United States)

Verma, Vivek; Ramamoorthy, Rengasamy; Kohli, Ajay; Kumar, Prakash P.

2015-10-01

The world’s population continues to expand and it is expected to cross 9 billion by 2050. This would significantly amplify the demand for food, which will pose serious threats to global food security. Additional challenges are being imposed due to a gradual decrease in the total arable land and global environmental changes. Hence, it is of utmost importance to review and revise the existing food production strategies by incorporating novel biotechnological approaches that can help to break the crop yield barriers in the near future. In this review, we highlight some of the concerns hampering crop yield enhancements. The review also focuses on modern breeding techniques based on genomics as well as proven biotechnological approaches that enable identification and utilization of candidate genes. Another aspect of discussion is the important area of research, namely hormonal regulation of plant development, which is likely to yield valuable regulatory genes for such crop improvement efforts in the future. These strategies can serve as potential tools for developing elite crop varieties for feeding the growing billions.

Committee Opinion No. 707 Summary: Access to Emergency Contraception.

Science.gov (United States)

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

ACOG Committee Opinion Number 542: Access to emergency contraception.

Science.gov (United States)

2012-11-01

Emergency contraception includes contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to access to emergency contraception remain. The purpose of this Committee Opinion is to examine the barriers to the use of oral emergency contraception methods and to highlight the importance of increasing access.

Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

Science.gov (United States)

Plint, Amy C; Stang, Antonia S; Calder, Lisa A

2015-01-01

Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

The research reactor radiation emergency countermeasure system in Korea

International Nuclear Information System (INIS)

Kim, Hee Reyoung; Choi, Geun-Sik; Lee, Wanno; Chung, Kun Ho; Kang, Mun Ja; Lee, Chang-Woo

2010-01-01

A disaster prevention system was established for a radiation emergency from an operation of a research reactor with a thermal power of 30 MW th in Korea. A national radiation disaster countermeasure organization was set up to cope with the radiation emergency classified into three cases whose effective doses were more than 1 mSv/h inside the nuclear facility, inside the site boundary and outside the site boundary. Its role consists of the proclamation and consequent withdrawal of a disaster, a general assessment, an emergency medical service, a field control, radiation protection, resident protection implement, an accident analysis, a security plan, a radiation environmental investigation plan and probe, a radiation environmental effect assessment, and others. The emergency planning zone (EPZ) was settled to be within a radius of 800 m, the average distance between the site boundary and the center of a research reactor in operation, as a quick and effective early countermeasure from the result of the radiation environmental effect assessment. The environmental probing zone was chosen to extend to a radius of 2 km from a research reactor according to the moving path of the radioactive cloud so that a densely populated area could be considered and would be extended to 10 km according to the radiation level of the research reactor and atmospheric diffusion. Practically, the environmental probing is implemented at 22 points inside the site and eight points outside the site considering the geography, population and the wind direction. The gamma radiation dose and atmospheric radioactivity are analyzed during an effluence, and the radioactivity of a ground surface deposit and an environmental sample are analyzed after an effluence. The environmental laboratory covers the analysis of the gamma radioisotopes, tritium, strontium, uranium, gross alpha and beta. It is estimated that the habitability can be recovered when the radiation dose rate is less than 1 mSv/h inside the

The emerging educator as leader and action researcher

Directory of Open Access Journals (Sweden)

Thomas G. RYAN

2009-06-01

Full Text Available The 320 pre-service educators in this inquiry were viewed as emerging classroom teacherswho were leading while grappling with new personal experiences which informed andguided each during the pre-service year. The written account evidence supported ourresulting inferences, discussion and conclusions and demonstrated the leadership requiredwithin pre-service. It was the analysis and synthesis of practicum reflections thatilluminated core beliefs, attitudes and needs of emerging action researchers as theydeveloped a professional and personal understanding of leadership, teaching and self.

Attitudes, experiences, and barriers to research and publishing among dental postgraduate students of Bengaluru City: A cross-sectional study

Directory of Open Access Journals (Sweden)

Aditi Hegde

2017-01-01

Full Text Available Background: Research experience not only enhances understanding but also instills evidence-based practice and improves skills. A natural successor to research is academic publishing. Unfortunately, student research itself is plagued by a number of barriers. Aim: To identify the attitudes, experiences, and barriers to research and publishing among dental postgraduate students of Bangalore city. Materials and Methods: A cross-sectional survey using purposive sampling technique was conducted among the dental postgraduate students of all specialties in Bengaluru city in the months of July–August 2015. A prevalidated, close-ended, self-administered questionnaire consisting of 26 questions was used. Data from 638 completed questionnaires were entered into and analyzed using Microsoft Excel 2013 and SPSS software version 14. Results: The majority of the students displayed a positive attitude towards research and stated that they would like more opportunities to take part in research (89%. Most students were positive toward publishing research; 94% agreed that it is important to publish, although only 43.7% had submitted an article for publication. The single most often stated barrier to conducting research was a lack of funding from the institution (15.7%, followed by workload and time constraints (15.0%. Lack of training and good mentorship was the most often (23.3% faced barrier to publishing, along with high publication fee for indexed journals (17.9%. Conclusion: Dental postgraduate students show an urge to conduct research and publish their results. Research-related workshops for teachers and students are suggestions for improving the status of research in dental colleges.

Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

Science.gov (United States)

Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

2014-12-01

Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

Science.gov (United States)

Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

2017-08-04

The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

3 CFR 13505 - Executive Order 13505 of March 9, 2009. Removing Barriers to Responsible Scientific Research...

Science.gov (United States)

2010-01-01

... Barriers to Responsible Scientific Research Involving Human Stem Cells 13505 Order 13505 Presidential... Scientific Research Involving Human Stem Cells By the authority vested in me as President by the Constitution.... Research involving human embryonic stem cells and human non-embryonic stem cells has the potential to lead...

Structural and Socio-cultural Barriers to Prenatal Care in a US Marshallese Community.

Science.gov (United States)

Ayers, Britni L; Purvis, Rachel S; Bing, Williamina Ioanna; Rubon-Chutaro, Jellesen; Hawley, Nicola L; Delafield, Rebecca; Adams, Ingrid K; McElfish, Pearl Anna

2018-02-22

Objectives Pacific Islanders are disproportionately burdened by poorer perinatal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care. The aim of this study is to examine Marshallese mothers' beliefs, perceptions, and experiences of prenatal care and to identify potential barriers. Methods Three focus groups were conducted with Marshallese mothers, who were 18 years or older, and living in Arkansas. Focus groups focused on mothers' beliefs, perceptions, and experiences of prenatal care. A thematic qualitative analysis was conducted to identify salient themes within the data. Results The results demonstrated that negotiating health insurance, transportation, and language barriers were all major structural barriers that constrain prenatal care. The social-cultural barriers that emerged included a lack of understanding of the importance of seeking early and consistent prenatal care, as well as how to navigate the healthcare process. The more complicated challenges that emerged were the feelings of shame and embarrassment due to the perception of their age or being unmarried during pregnancy not being acceptable in American culture. Furthermore, the participants described perceived discrimination from prenatal care providers. Lastly, the participants described fear as a barrier to seeking out prenatal care. Conclusions for Practice This study identified both structural and socio-cultural barriers that can be incorporated into suggestions for policy makers to aid in alleviating maternal health disparities among Pacific Islander women. Further research is needed to address the Marshallese mothers' perceived discrimination from maternal health care providers.

Barriers professional competence and its relationship with job satisfaction of nurses' moral distress and pre-hospital emergency city of Bam and Jiroft in 1393

Directory of Open Access Journals (Sweden)

Mohammadjavad Rahimzadeh

2016-05-01

Full Text Available In order to "protect the health of people" Several organizations have been founded and given its role in saving lives when seconds play, is formed Medical Center Emergency Management Whose duty is satisfactory service in the shortest possible time. Because one of the pre-hospital emergency center nurses work centers and first deal with critical diseases carried by nurses, so they are faced with numerous obstacles which could impact on their job satisfaction has less moral distress. In this study, efficient professional barriers and its relation to moral distress and job satisfaction are studied prehospital emergency nurses. This study is a descriptive - correlation of prehospital emergency personnel Bam on 82 Jiroft who were selected by census was conducted. Data gathering questionnaire, including demographic characteristics, barriers to efficient professional, moral distress, job satisfaction after obtaining the appropriate reliability and validity were used. Analysis of the data in this study using SPSS version 18, using measures of central tendency and dispersion, t-test, Pearson correlation coefficient, ANOVA and regression analysis were used. According to the non-normal distribution efficiency and moral distress two variables obstacles relationship between these two variables with Spearman nonparametric Kruskal-Wallis test other variables and for other variables that were normally distributed parametric tests and ANOVA were used Pearson correlation coefficient. A total of 82 patients with mean age (31.54± 5.66 participated in th e study showed. Results are73.4% married, work experience, most people (% 91.5 were under 15 years old. Most people (52% with traffic and pedestrians as factors impeding efficient professional, fully agreed, the average score of moral distress (o.48 ± 2.13, the level of moral distress was most mid-level and job satisfaction 52. 4% of them were average. The results showed that between moral distress and job

GPs' use of problem solving therapy for depression: a qualitative study of barriers to and enablers of evidence based care

Directory of Open Access Journals (Sweden)

Gunn Jane

2007-04-01

Full Text Available Abstract Background Depression is a major health concern, predominantly treated by general practitioners (GPs. Problem solving therapy (PST is recognised as an effective treatment for depression that is not widely used by GPs. This research aims to explore barriers and enablers that may influence GPs use of this treatment. Method Qualitative methodology was used including individual and focus group interviews of GPs, PST experts and consumers. Analysis was undertaken using the Theory of Planned Behaviour (TPB as a framework. Results A spectrum of potential influences, on GPs' use of PST emerged. Both barriers and enablers were identified. PST was perceived as being close to current practice approaches and potentially beneficial to both doctor and patient. In addition to a broadly positive attitude to PST, expressed by those with previous experience of its use, potential solutions to perceived barriers emerged. By contrast some GPs expressed fear that the use of PST would result in loss of doctor control of consultations and associated potential adverse patient outcomes. Patient expectations, which emerged as not always coinciding with GPs' perception of those expectations, were identified as a potential influence on GPs' decision concerning adoption of PST. In addition specific factors, including GP skill and confidence, consultation time constraints and technical issues related to PST were noted as potential concerns. Conclusion This research contributes to our knowledge of the factors that may influence GPs' decisions regarding use of PST as a treatment for depression. It recognises both barriers and enablers. It suggests that for many GPs, PST is viewed in a positive light, providing encouragement to those seeking to increase the provision of PST by GPs. In identifying a number of potential barriers, along with associated options to address many of these barriers, it provides insights which may assist in the planning of GP training in PST.

Self-reported financial barriers to care among patients with cardiovascular-related chronic conditions.

Science.gov (United States)

Campbell, David J T; King-Shier, Kathryn; Hemmelgarn, Brenda R; Sanmartin, Claudia; Ronksley, Paul E; Weaver, Robert G; Tonelli, Marcello; Hennessy, Deirdre; Manns, Braden J

2014-05-01

People with chronic conditions who do not achieve therapeutic targets have a higher risk of adverse health outcomes. Failure to meet these targets may be due to a variety of barriers. This article examines self-reported financial barriers to health care among people with cardiovascular-related chronic conditions. A population-based survey was administered to western Canadians with cardiovascular-related chronic conditions (n = 1,849). Associations between self-reported financial barriers and statin use, the likelihood of stopping use of prescribed medications, and emergency department visits or hospitalizations were assessed. More than 10% respondents reported general financial barriers (12%) and lack of drug insurance (14%); 4% reported financial barriers to accessing medications. Emergency department visits or hospitalizations were 70% more likely among those reporting a general financial barrier. Those reporting a financial barrier to medications were 50% less likely to take statins and three times more likely to stop using prescribed medications. Individuals without drug insurance were nearly 30% less likely to take statins. In this population, self-reported financial barriers were associated with lower medication use and increased likelihood of emergency department visits or hospitalization.

Public-private implementation of integrated emergency response services: Case study of GVK Emergency Management and Research Institute in Karnataka, India.

Science.gov (United States)

Sriram, Veena M; Gururaj, Gopalkrishna; Hyder, Adnan A

2017-12-01

Emergency medical services are important to the functioning of health systems, but these services tend to be neglected in low- and middle-income countries, such as India. In recent years, several models of pre-hospital emergency medical services have emerged in India. Research on these models holds important lessons for existing and future emergency medical service programs in low- and middle-income countries. Our objective was to provide a comprehensive description of the organizational structure and service delivery model of a public-private partnership in the southern Indian state of Karnataka, GVK Emergency Management and Research Institute, with a particular focus on its operations in Bengaluru. A case study methodology was used to explore systematically the organizational model of GVK Emergency Management and Research Institute in Karnataka. Qualitative data were collected through an in-person site visit to GVK Emergency Management and Research Institute headquarters in Bengaluru in July 2013. Three sources were used: in-depth, semistructured interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. The organization follows a standardized model across the states and union territories where they have contractual arrangements, including Karnataka. Processes for fleet maintenance, information systems/information technology and training, and deployment were well structured at the organizational level. The public-private partnership appears pro-poor in orientation; however, further demand-side research is required on the perspective of patients. Our study reveals a functional structure at the organizational level, which provides a key service at no cost to users. Detailed analyses of this nature can help inform global efforts for the development and strengthening of emergency medical services systems. Copyright © 2017 Elsevier Inc. All rights reserved.

Hempcrete Noise Barrier Wall for Highway Noise Insulation : Research & Construction

OpenAIRE

KC, Prabesh

2016-01-01

The purpose of this thesis was to study the possibility of Hempcrete or hemp-lime composite noise barrier walls in the highways and to construct the walls for the acoustic test according to the European Union Standards EN ISO 717-1 and ISO 10140-2 for air-borne sound insulation. The thesis was commissioned by the company Hemprefine Oy, and all the standard tests were performed in the HAMK-Ruukki Sheet Metal Centre in Hämeenlinna and the VTT Technical Research Centre of Finland Ltd in Espoo. ...

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

Science.gov (United States)

Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

2011-08-01

Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

CRNL research reactor retrofit Emergency Filtration System

International Nuclear Information System (INIS)

Philippi, H.M.

1990-01-01

This paper presents a brief history of NRX and NRU research reactor effluent air treatment systems before describing the selection and design of an appropriate retrofit Emergency Filtration System (EFS) to serve these reactors and the future MX-10 isotope production reactor. The conceptual design of the EFS began in 1984. A standby concrete shielding filter-adsorber system, sized to serve the reactor with the largest exhaust flow, was selected. The standby system, bypassed under normal operating conditions, is equipped with normal exhaust stream shutoff and diversion valves to be activated manually when an emergency is anticipated, or automatically when emergency levels of gamma radiation are detected in the exhaust stream. The first phase of the EFS installation, that is the construction of the EFS and the connection of NRU to the system, was completed in 1987. The second phase of construction, which includes the connection of NRX and provisions for the future connection of MX-10, is to be completed in 1990

Developing a national dental education research strategy: priorities, barriers and enablers.

Science.gov (United States)

Ajjawi, Rola; Barton, Karen L; Dennis, Ashley A; Rees, Charlotte E

2017-03-29

This study aimed to identify national dental education research (DER) priorities for the next 3-5 years and to identify barriers and enablers to DER. Scotland. In this two-stage online questionnaire study, we collected data with multiple dental professions (eg, dentistry, dental nursing and dental hygiene) and stakeholder groups (eg, learners, clinicians, educators, managers, researchers and academics). Eighty-five participants completed the Stage 1 qualitative questionnaire and 649 participants the Stage 2 quantitative questionnaire. Eight themes were identified at Stage 1. Of the 24 DER priorities identified, the top three were: role of assessments in identifying competence; undergraduate curriculum prepares for practice and promoting teamwork. Following exploratory factor analysis, the 24 items loaded onto four factors: teamwork and professionalism, measuring and enhancing performance, dental workforce issues and curriculum integration and innovation. Barriers and enablers existed at multiple levels: individual, interpersonal, institutional structures and cultures and technology. This priority setting exercise provides a necessary first step to developing a national DER strategy capturing multiple perspectives. Promoting DER requires improved resourcing alongside efforts to overcome peer stigma and lack of valuing and motivation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Perspectives on emerging zoonotic disease research and capacity building in Canada

Science.gov (United States)

Stephen, Craig; Artsob, Harvey; Bowie, William R; Drebot, Michael; Fraser, Erin; Leighton, Ted; Morshed, Muhammad; Ong, Corinne; Patrick, David

2004-01-01

Zoonoses are fundamental determinants of community health. Preventing, identifying and managing these infections must be a central public health focus. Most current zoonoses research focuses on the interface of the pathogen and the clinically ill person, emphasizing microbial detection, mechanisms of pathogenicity and clinical intervention strategies, rather than examining the causes of emergence, persistence and spread of new zoonoses. There are gaps in the understanding of the animal determinants of emergence and the capacity to train highly qualified individuals; these are major obstacles to preventing new disease threats. The ability to predict the emergence of zoonoses and their resulting public health and societal impacts are hindered when insufficient effort is devoted to understanding zoonotic disease epidemiology, and when zoonoses are not examined in a manner that yields fundamental insight into their origin and spread. Emerging infectious disease research should rest on four pillars: enhanced communications across disciplinary and agency boundaries; the assessment and development of surveillance and disease detection tools; the examination of linkages between animal health determinants of human health outcomes; and finally, cross-disciplinary training and research. A national strategy to predict, prevent and manage emerging diseases must have a prominent and explicit role for veterinary and biological researchers. An integrated health approach would provide decision makers with a firmer foundation from which to build evidence-based disease prevention and control plans that involve complex human/animal/environmental systems, and would serve as the foundation to train and support the new cadre of individuals ultimately needed to maintain and apply research capacity in this area. PMID:18159512

Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations.

Science.gov (United States)

Jensen, Jakob D; Ratcliff, Chelsea; Weaver, Jeremy; Krakow, Melinda M; Payton, William; Loewen, Sherrie

2015-11-01

In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion's perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40-74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.

Children's mental health emergencies-part 1: challenges in care: definition of the problem, barriers to care, screening, advocacy, and resources.

Science.gov (United States)

Baren, Jill M; Mace, Sharon E; Hendry, Phyllis L; Dietrich, Ann M; Grupp-Phelan, Jacqueline; Mullin, Jacqueline

2008-06-01

At a time when there has been a reduction in mental health resources nationwide, the incidence of mental health disorders in children has seen a dramatic increase for many reasons. A review of the literature was done to identify the epidemiology, barriers to care, useful emergency department (ED) screening methods, and resources regarding pediatric mental health disorders in the ED. Although there are many challenges to the provision of care for children with mental health emergencies, some resources are available. Furthermore, ED screening and intervention may be effective in improving patient outcomes. Collaborative efforts with multidisciplinary services can create a continuum of care, promote better identification of children and adolescents with mental health disorders, and promote early recognition and intervention, which are key to effective referral and treatment.

The emerging educator as leader and action researcher

Directory of Open Access Journals (Sweden)

Thomas G. Ryan

2009-06-01

Full Text Available The 320 pre-service educators in this inquiry were viewed as emerging classroom teachers who were leading while grappling with new personal experiences which informed and guided each during the pre-service year. The written account evidence supported our resulting inferences, discussion and conclusions and demonstrated the leadership required within pre-service. It was the analysis and synthesis of practicum reflections that illuminated core beliefs, attitudes and needs of emerging action researchers as they developed a professional and personal understanding of leadership, teaching and self

Breaking the Biological Barriers to Cellulosic Ethanol: A Joint Research Agenda

Energy Technology Data Exchange (ETDEWEB)

Houghton, John [Dept. of Energy (DOE), Washington DC (United States); Weatherwax, Sharlene [Dept. of Energy (DOE), Washington DC (United States); Ferrell, John [Dept. of Energy (DOE), Washington DC (United States)

2006-06-07

The Biomass to Biofuels Workshop, held December 7–9, 2005, was convened by the Department of Energy’s Office of Biological and Environmental Research in the Office of Science; and the Office of the Biomass Program in the Office of Energy Efficiency and Renewable Energy. The purpose was to define barriers and challenges to a rapid expansion of cellulosic-ethanol production and determine ways to speed solutions through concerted application of modern biology tools as part of a joint research agenda. Although the focus was ethanol, the science applies to additional fuels that include biodiesel and other bioproducts or coproducts having critical roles in any deployment scheme.

Online research article discussion board to increase knowledge translation during emergency medicine residency.

Science.gov (United States)

Stoneking, Lisa R; Grall, Kristi H; Min, Alice A; Panchal, Ashish R

2013-01-01

Many clinicians have difficulties reading current best practice journal articles on a regular basis. Discussion boards are one method of online asynchronous learning that facilitates active learning and participation. We hypothesized that an online repository of best practice articles with a discussion board would increase journal article reading by emergency medicine residents. PARTICIPANTS ANSWERED THREE QUESTIONS WEEKLY ON A DISCUSSION BOARD: What question does this study address? What does this study add to our knowledge? How might this change clinical practice? A survey regarding perceived barriers to participating was then distributed. Most participants completed an article summary once or twice in total (23/32, 71.9%). Only three were involved most weeks (3/32, 9.4%) whereas 5/32 (15.6%) participated monthly. The most common barriers were lack of time (20/32, 62.5%), difficulty logging on (7/32, 21.9%), and forgetting (6/32, 18.8%). Although subjects were provided weekly with an article link, email, and feedback, journal article reading frequency did not increase.

Barriers to Education for the Marginalized Adult Learner

Science.gov (United States)

Flynn, Sarah; Brown, Jason; Johnson, Andrew; Rodger, Susan

2011-01-01

This qualitative study examines barriers to adult education by the marginalized adult learner. We adopted an inclusive approach by interviewing potential adult learners who had not participated in adult education programs due to illiteracy. Five overlapping themes related to barriers emerged and were categorized as: family values and…

A cross sectional observational study of research activity of allied health teams: is there a link with self-reported success, motivators and barriers to undertaking research?

Science.gov (United States)

Wenke, Rachel J; Mickan, Sharon; Bisset, Leanne

2017-02-06

Team-based approaches to research capacity building (RCB) may be an efficient means to promote allied health research participation and activity. In order to tailor such interventions, a clearer understanding of current patterns of research participation within allied health teams is needed. Different self-report measures exist which evaluate a team's research capacity and participation, as well as associated barriers and motivators. However, it remains unclear how such measures are associated with a team's actual research activity (e.g., journal publications, funding received). In response, this observational study aimed to identify the research activity, self-reported success, and motivations and barriers to undertaking research of eight allied health professional (AHP) teams and to explore whether any relationships exist between the self-reported measures and actual research activity within each team. A total of 95 AHPs from eight teams completed the research capacity and culture survey to evaluate team success, barriers and motivators to undertaking research, and an audit of research activity from January 2013 to August 2014 was undertaken within each team. Kendell's correlation coefficients were used to determine the association between research activity (i.e., number of journal publications, ethically approved projects and funding received) and the self-reported measures. Seven out of eight teams rated their teams as having average success in research and demonstrated some form of research activity including at least two ethically approved projects. Research activity varied between teams, with funding received ranging from $0 to over $100,000, and half the teams not producing any journal publications. Team motivators demonstrated a stronger association with research activity compared to barriers, with the motivator "enhancing team credibility" being significantly associated with funding received. No significant association between self-reported research

Self-efficacy and barriers to disaster evacuation in Hong Kong.

Science.gov (United States)

Newnham, Elizabeth A; Balsari, Satchit; Lam, Rex Pui Kin; Kashyap, Shraddha; Pham, Phuong; Chan, Emily Y Y; Patrick, Kaylie; Leaning, Jennifer

2017-12-01

To investigate specific challenges to Hong Kong's capacity for effective disaster response, we assessed perceived barriers to evacuation and citizens' self-efficacy. Global positioning system software was used to determine random sampling locations across Hong Kong, weighted by population density. The resulting sample of 1023 participants (46.5% female, mean age 40.74 years) were invited to complete questionnaires on emergency preparedness, barriers to evacuation and self-efficacy. Latent profile analysis and multinomial logistic regression were used to identify self-efficacy profiles and predictors of profile membership. Only 11% of the sample reported feeling prepared to respond to a disaster. If asked to evacuate in an emergency, 41.9% of the sample cited significant issues that would preclude them from doing so. Self-efficacy was negatively associated with barriers to disaster response so that participants reporting higher levels of self-efficacy cited fewer perceived barriers to evacuation. Hong Kong has established effective strategies for emergency response, but concerns regarding evacuation and mobilisation remain. The findings indicate that improving self-efficacy for disaster response has potential to increase evacuation readiness.

Mediated Intercultural Communication Barrier in No Drama Zone! Group

OpenAIRE

Lizal, Valentino

2015-01-01

This research study aimed to describe the mediated intercultural communication barriers in the No Drama Zone! group. This study is a qualitative descriptive type of research, with case study method. By doing in depth interview and observation, researcher found two barriers that generates other barriers in the group's mediated intercultural communication. The two big barriers were: language and physical barriers. Language barriers in this group generated two barriers, emotional barrier and pe...

On the nature of barriers to climate change adaptation

NARCIS (Netherlands)

Biesbroek, G.R.; Klostermann, J.E.M.; Termeer, C.J.A.M.; Kabat, P.

2013-01-01

Considerable barriers can emerge in developing and implementing climate change adaptation strategies. Understanding the nature of barriers to adaptation is important so as to find strategic ways of dealing with them. However, our current understanding is limited and highly fragmented across the

Research on sever accident emergency simulation system for CPR1000

International Nuclear Information System (INIS)

Yang Zhifei; Liao Yehong; Liang Manchun; Li Ke; Yang Jie; Chen Yali

2015-01-01

The enhanced capability to nuclear power plant (NPP) severe accident management and emergency response depends heavily on exercises. Since the exercise scene is usually monotonous and not realistic, and conduct of exercise has a high cost, the effect of enhancing the capability is limited. Thus, the development of a Sever Accident Emergency Simulation System (SAESS) is necessary. SAESS is able to connect NPP simulator, and simulates the process of severe accident management, personnel evacuation, the dispersion of radioactive plume, and emergency response of emergency organizations. The system helps to design several of exercise scenes and optimize the disposal strategy in different severe accidents. In addition, the system reduces the cost of emergency exercise by computer simulation, benefits the research of exercise, increases the efficiency of exercise and enhances the emergency decision-making capability. This paper introduces the design and application of SAESS. (author)

77 FR 36231 - Americans With Disabilities Act (ADA) and Architectural Barriers Act (ABA) Accessibility...

Science.gov (United States)

2012-06-18

...-0004] RIN 3014-AA39 Americans With Disabilities Act (ADA) and Architectural Barriers Act (ABA... (ADA) and Architectural Barriers Act (ABA) Accessibility Guidelines to specifically address emergency... ensure that newly constructed and altered emergency transportable housing units covered by the ADA or ABA...

Current research into brain barriers and the delivery of therapeutics for neurological diseases

DEFF Research Database (Denmark)

Greenwood, John; Hammarlund-Udenaes, Margareta; Jones, Hazel C

2017-01-01

This is a report on the CNS barrier congress held in London, UK, March 22-23rd 2017 and sponsored by Kisaco Research Ltd. The two 1-day sessions were chaired by John Greenwood and Margareta Hammarlund-Udenaes, respectively, and each session ended with a discussion led by the chair. Speakers consi...

Estimation of biotransformation and sorption of emerging organic compounds (EOCs) during artificial recharge through a reactive barrier.

Science.gov (United States)

Valhondo, C.; Martinez-Landa, L.; Carrera, J.; Hidalgo, J. J.; Ayora, C.

2016-12-01

The reuse of lesser quality water such as effluents from wastewater treatment plants or effluent-receiving water bodies has been promoted due to the water shortages affecting many regions of the world. Artificial recharge through infiltration basins is known to improve several water quality parameters including the attenuation of emerging organic compounds (EOCs). Many of these contaminants exhibit redox dependent biotransformation because the redox state is one of the factors controlling microbial community development. Together with biotransformation, sorption also affects the behavior of EOCs in their passage through the soil. We studied EOCs attenuation in an infiltration system is located in Sant Vicenç dells Horts on the Llobregat delta (Barcelona, Spain), where the local water agency has an artificial recharge pilot project . The Llobregat river water used for the artificial recharge is affected by treatment plant effluents which contain EOCs. A reactive barrier consisting of vegetable compost, clay, and iron oxide was installed in the bottom of the infiltration basin to enhance biotransformation and sorption of EOCs. The barrier releases dissolved organic carbon, which favors the development of a broad range of redox environments, and supplies neutral, cationic, and anionic surfaces to favor sorption of different types of contaminants. Results were excellent, but quantitative evaluation of the EOCs attenuation requires knowledge of the residence time distribution of infiltrated water. A tracer test was performed by adding tracers to the infiltration water and interpreting the breakthrough curves at diverse monitoring points with a 2D multilayer numerical model. The calibrated model quantify degradation, as a first order law, and sorption through a linear distribution coefficient for ten selected EOCs. Results indicate higher degradation rates and sorption coefficients in the reactive barrier than in the rest of the aquifer for nine and eight of the ten

Use of non-emergency contraceptive pills and concoctions as emergency contraception among Nigerian University students: results of a qualitative study

Directory of Open Access Journals (Sweden)

Anthony Idowu Ajayi

2016-10-01

Full Text Available Abstract Background Emergency contraception (EC can significantly reduce the rate of unintended pregnancies and unsafe abortions especially in sub-Saharan Africa. Despite the increasing awareness of EC among educated young women in Nigeria, the rate of utilisation remains low. This study therefore explores the main barriers to the use of EC among female university students by analysing their knowledge of emergency contraception, methods ever used, perceived efficacy, and its acceptability. Methods This paper brings together the findings from several focus groups (N = 5 and in-depth interviews (N = 20 conducted amongst unmarried female undergraduate students in two Nigerian universities. Results Participants considered the use of condom and abstinence as the most effective methods of preventing unplanned pregnancy. However, many participants were misinformed about emergency contraception. Generally, participants relied on unconventional and unproven ECs; Ampiclox, “Alabukun”, salt water solution, and lime and potash and perceived them to be effective in preventing unplanned pregnancies. Furthermore, respondents’ narratives about methods of preventing unwanted pregnancies revealed that inadequate information on emergency contraception, reliance on unproven crude contraceptive methods, and misconception about modern contraception constitute barriers to the use of emergency contraception. Conclusions The findings suggested that female university students are misinformed about emergency contraception and their reliance on unproven ECs constitutes a barrier to the use of approved EC methods. These barriers have serious implications for prevention of unplanned pregnancies in the cohort. Behavioural interventions targeting the use of unproven emergency contraceptive methods and misperceptions about ECs would be crucial for this cohort in Nigeria.

Use of non-emergency contraceptive pills and concoctions as emergency contraception among Nigerian University students: results of a qualitative study.

Science.gov (United States)

Ajayi, Anthony Idowu; Nwokocha, Ezebunwa Ethelbert; Akpan, Wilson; Adeniyi, Oladele Vincent

2016-10-04

Emergency contraception (EC) can significantly reduce the rate of unintended pregnancies and unsafe abortions especially in sub-Saharan Africa. Despite the increasing awareness of EC among educated young women in Nigeria, the rate of utilisation remains low. This study therefore explores the main barriers to the use of EC among female university students by analysing their knowledge of emergency contraception, methods ever used, perceived efficacy, and its acceptability. This paper brings together the findings from several focus groups (N = 5) and in-depth interviews (N = 20) conducted amongst unmarried female undergraduate students in two Nigerian universities. Participants considered the use of condom and abstinence as the most effective methods of preventing unplanned pregnancy. However, many participants were misinformed about emergency contraception. Generally, participants relied on unconventional and unproven ECs; Ampiclox, "Alabukun", salt water solution, and lime and potash and perceived them to be effective in preventing unplanned pregnancies. Furthermore, respondents' narratives about methods of preventing unwanted pregnancies revealed that inadequate information on emergency contraception, reliance on unproven crude contraceptive methods, and misconception about modern contraception constitute barriers to the use of emergency contraception. The findings suggested that female university students are misinformed about emergency contraception and their reliance on unproven ECs constitutes a barrier to the use of approved EC methods. These barriers have serious implications for prevention of unplanned pregnancies in the cohort. Behavioural interventions targeting the use of unproven emergency contraceptive methods and misperceptions about ECs would be crucial for this cohort in Nigeria.

Barriers to fusion

International Nuclear Information System (INIS)

Berriman, A.C.; Butt, R.D.; Dasgupta, M.; Hinde, D.J.; Morton, C.R.; Newton, J.O.

1999-01-01

The fusion barrier is formed by the combination of the repulsive Coulomb and attractive nuclear forces. Recent research at the Australian National University has shown that when heavy nuclei collide, instead of a single fusion barrier, there is a set of fusion barriers. These arise due to intrinsic properties of the interacting nuclei such deformation, rotations and vibrations. Thus the range of barrier energies depends on the properties of both nuclei. The transfer of matter between nuclei, forming a neck, can also affect the fusion process. High precision data have been used to determine fusion barrier distributions for many nuclear reactions, leading to new insights into the fusion process

Physics education: Understanding the barriers for young women in Ontario

Science.gov (United States)

Mainhood, Lindsay Ann

In nearly all countries of the world, at every level of education, physics as a field of science is failing to recruit and retain women. This phenomenon is believed to relate to girls' educational experiences from K-12, but the reasons for the gender gap in physics are not fully understood. The purpose of this phenomenological research is to explore and understand the barriers encountered by Ontario female high school students during their physics education and the meanings attributed to those barriers by these young women. This research is guided by social cognitive career theory (SCCT) and uses the concept of physics identity as a lens through which the influence of contextual barriers can be understood. Nine participants, selected via snowball sampling from an Eastern Ontario university, together participated in four semi-structured focus group meetings and individually participated in a single in-depth, one-on-one interview. Audio data was transcribed verbatim and analyzed using a general inductive approach. Emergent themes are descriptively presented as the findings of the research study: perceiving the high school physics experience, experiencing high school physics education, and identity and gender in the high school physics experience. Sub-themes presented include limited prior experiences, negative perceptions of physics, images of physics learners, decision-making, reactions to pedagogy, learning needs, physics identity, gender-dependent influences, and making meaning of the experiences in high school physics. The shared experience of high school physics education for young women is understood as both a richly challenging and rewarding experience. Based on the findings of this research, recommendations are made for practical and research settings, and for future work in this area. Drawing on literature on underrepresentation of women in physics, this research contributes to the physics education research community and beyond; it offers voices of Ontario

Facilitators and barriers to doing workplace mental health research: Case study of acute psychological trauma in a public transit system.

Science.gov (United States)

Links, Paul S; Bender, Ash; Eynan, Rahel; O'Grady, John; Shah, Ravi

2016-03-10

The Acute Psychological Trauma (APT) Study was a collaboration between an acute care hospital, a specialized multidisciplinary program designed to meet the mental health needs of injured workers, and a large urban public transit system. The overall purpose was to evaluate a Best Practices Intervention (BPI) for employees affected by acute psychological trauma compared to a Treatment as Usual (TAU) group. The specific purpose is to discuss facilitators and barriers that were recognized in implementing and carrying out mental health research in a workplace setting. Over the course of the APT study, a joint implementation committee was responsible for day-to-day study operations and made regular observations on the facilitators and barriers that arose throughout the study. The facilitators to this study included the longstanding relationships among the partners, increased recognition for the need of mental health research in the workplace, and the existence of a community advisory committee. The significant barriers to doing this study of mental health research in the workplace included differences in organizational culture, inconsistent union support, co-interventions, and stigma. Researchers and funding agencies need to be flexible and provide additional resources in order to overcome the barriers that can exist doing workplace mental health research.

Barriers to first time parent groups: A qualitative descriptive study.

Science.gov (United States)

Barrett, Norma; Hanna, Lisa; Fitzpatrick, Owen Vincent

2018-06-19

First-time parents' groups are offered to new parents in Australia to support their transition to parenthood. Not all parents avail of the service, some cease attendance, and fathers are under-represented. In the present descriptive, qualitative study, we examined first-time mothers' perspectives on the barriers to parental participation in the groups. Semi-structured interviews were conducted with a sample of eight first-time mothers in a regional city in Victoria, Australia. Interviews revealed groups were perceived as sites strongly reinforcing traditional social norms of parenting. From this central theme, six gendered subthemes emerged as barriers to attendance. Barriers to mothers included non-normative mothering narratives, such as experiencing stillbirth or having a disabled child, perceived dissonance in parenting ethos, and group size. Barriers to fathers, as perceived by mothers, included groups as female spaces, dads as a minority, and female gatekeeping. A multi-faceted approach is required to change the common perception that groups are for mothers only. Groups need to be more inclusive of different parenting experiences and philosophies. Segregated groups might better address the needs of both parents. Further research is required to capture fathers' perspectives. © 2018 John Wiley & Sons Australia, Ltd.

Emergency planning and management in health care: priority research topics.

Science.gov (United States)

Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

2014-06-01

Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS

Directory of Open Access Journals (Sweden)

Mohammad Hossein Yarmohammadian

2011-01-01

Full Text Available Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS. Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational, barriers (internal and external of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Emerging search regimes: measuring co-evolutions among research, science, and society

NARCIS (Netherlands)

Heimeriks, G.; Leydesdorff, L.

2012-01-01

Scientometric data is used to investigate empirically the emergence of search regimes in biotechnology, genomics and nanotechnology. Complex regimes can emerge when three independent sources of variance interact. In our model, researchers can be considered as the nodes that carry the science system.

Barriers to healthcare for transgender individuals.

Science.gov (United States)

Safer, Joshua D; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae

2016-04-01

Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to healthcare for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them. Current research emphasizes sexual minorities' self-report of barriers, rather than using direct methods. The biggest barrier to healthcare reported by transgender individuals is lack of access because of lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers, and socioeconomic barriers. National research priorities should include rigorous determination of the capacity of the US healthcare system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical workforce across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care required, larger social structural barriers, and status of a framework to pay for appropriate care. As well, studies should propose and validate potential solutions to address identified gaps.

Barriers to modern contraceptive use in rural areas in DRC.

Science.gov (United States)

Muanda, Mbadu Fidèle; Ndongo, Gahungu Parfait; Messina, Lauren J; Bertrand, Jane T

2017-09-01

Recent research in the Democratic Republic of Congo (DRC) has shown that over a quarter of women have an unmet need for family planning and that modern contraceptive use is three times higher among urban than rural women. This study focuses on the reasons behind the choices of married men and women to use contraception or not. What are the barriers that have led to low levels of modern contraceptive use among women and men in DRC rural areas? The research team conducted 24 focus groups among women (non-users of any method, users of traditional methods and users of modern methods) and husbands (of non-users or users of traditional methods) in six health zones of three geographically dispersed provinces. The key barriers that emerged were poor spousal communication, sociocultural norms (especially the husband's role as primary decision-maker and the desire for a large family), fear of side-effects and a lack of knowledge. Despite these barriers, many women in the study indicated that they were open to adopting a modern family planning method in the future. These findings imply that programming must address mutual comprehension and decision-making among rural men and women alike in order to trigger positive changes in behaviour and perceptions relating to contraceptive use.

Barriers to Medicaid Participation among Florida Dentists

Science.gov (United States)

Logan, Henrietta L.; Catalanotto, Frank; Guo, Yi; Marks, John; Dharamsi, Shafik

2015-01-01

Background Finding dentists who treat Medicaid-enrolled children is a struggle for many parents. The purpose of this study was to identify non-reimbursement factors that influence the decision by dentists about whether or not to participate in the Medicaid program in Florida. Methods Data from a mailed survey was analyzed using a logistic regression model to test the association of Medicaid participation with the Perceived Barriers and Social Responsibility variables. Results General and pediatric dentists (n=882) who identified themselves as either Medicaid (14%) or Non-Medicaid (86%) participants responded. Five items emerged as significant predictors of Medicaid participation, with a final concordance index of 0.905. Two previously unreported barriers to participation in Medicaid emerged: 1) dentists’ perception of social stigma from other dentists for participating in Medicaid, and 2) the lack of specialists to whom Medicaid patients can be referred. Conclusions This study provides new information about non-reimbursement barriers to Medicaid participation. PMID:25702734

An observational study of emergency department utilization among enrollees of Minnesota Health Care Programs: financial and non-financial barriers have different associations.

Science.gov (United States)

Shippee, Nathan D; Shippee, Tetyana P; Hess, Erik P; Beebe, Timothy J

2014-02-08

Emergency department (ED) use is costly, and especially frequent among publicly insured populations in the US, who also disproportionately encounter financial (cost/coverage-related) and non-financial/practical barriers to care. The present study examines the distinct associations financial and non-financial barriers to care have with patterns of ED use among a publicly insured population. This observational study uses linked administrative-survey data for enrollees of Minnesota Health Care Programs to examine patterns in ED use-specifically, enrollee self-report of the ED as usual source of care, and past-year count of 0, 1, or 2+ ED visits from administrative data. Main independent variables included a count of seven enrollee-reported financial concerns about healthcare costs and coverage, and a count of seven enrollee-reported non-financial, practical barriers to access (e.g., limited office hours, problems with childcare). Covariates included health, health care, and demographic measures. In multivariate regression models, only financial concerns were positively associated with reporting ED as usual source of care, but only non-financial barriers were significantly associated with greater ED visits. Regression-adjusted values indicated notable differences in ED visits by number of non-financial barriers: zero non-financial barriers meant an adjusted 78% chance of having zero ED visits (95% C.I.: 70.5%-85.5%), 15.9% chance of 1(95% C.I.: 10.4%-21.3%), and 6.2% chance (95% C.I.: 3.5%-8.8%) of 2+ visits, whereas having all seven non-financial barriers meant a 48.2% adjusted chance of zero visits (95% C.I.: 30.9%-65.6%), 31.8% chance of 1 visit (95% C.I.: 24.2%-39.5%), and 20% chance (95% C.I.: 8.4%-31.6%) of 2+ visits. Financial barriers were associated with identifying the ED as one's usual source of care but non-financial barriers were associated with actual ED visits. Outreach/literacy efforts may help reduce reliance on/perception of ED as usual source of care

Interview-based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting.

Science.gov (United States)

Ranney, Megan L; Meisel, Zachary F; Choo, Esther K; Garro, Aris C; Sasson, Comilla; Morrow Guthrie, Kate

2015-09-01

Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. © 2015 by the Society for Academic Emergency Medicine.

76 FR 76937 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting-Room Change

Science.gov (United States)

2011-12-09

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting--Room Change The Emerging Technology and Research Advisory... emerging technology and research activities, including those related to deemed exports. Agenda Wednesday...

Port economics, policy and management : review of an emerging research field

NARCIS (Netherlands)

Pallis, A.A.; Vitsounis, T.K.; Langen, de P.W.

2010-01-01

This paper reviews research in port economics, policy and management during the period 1997-2008. In an increasingly international economy, research interest in ports is gradually emerging. This paper examines the developments, themes and characteristics of this research, by reviewing a

Emergency planning and preparedness of the Dalat Nuclear Research Institute

International Nuclear Information System (INIS)

Luong, B.V.

2001-01-01

The effectiveness of measures taken in case of accident or emergency to protect the site personnel, the general public and the environment will depend heavily on the adequacy of the emergency plan prepared in advance. For this reason, an emergency plan of the operating organization shall cover all activities planned to be carried out in the event of an emergency, allow for determining the level of the emergency and corresponding level of response according to the severity of the accident condition, and be based on the accidents analysed in the SAR as well as those additionally postulated for emergency planning purposes. The purpose of this paper is to present the practice of the emergency planning and preparedness in the Dalat Nuclear Research Institute (DNRI) for responding to accidents/incidents that may occur at the DNRI. The DNRI emergency plan and emergency procedures developed by the DNRI will be discussed. The information in the DNRI emergency plan such as the emergency organization, classification and identification of emergencies; intervention measures; the co-ordination with off-site organizations; and emergency training and drills will be described in detail. The emergency procedures in the form of documents and instructions for responding to accidents/incidents such as accidents in the reactor, accidents out of the reactor but with significant radioactive contamination, and fire and explosion accidents will be mentioned briefly. As analysed in the Safety Analysis Report for the DNRI, only the in-site actions are presented in the paper and no off-site emergency measures are required. (author)

New research opportunities for roadside safety barriers improvement

Science.gov (United States)

Cantisani, Giuseppe; Di Mascio, Paola; Polidori, Carlo

2017-09-01

Among the major topics regarding the protection of roads, restraint systems still represent a big opportunity in order to increase safety performances. When accidents happen, in fact, the infrastructure can substantially contribute to the reduction of consequences if its marginal spaces are well designed and/or effective restraint systems are installed there. Nevertheless, basic concepts and technology of road safety barriers have not significantly changed for the last two decades. The paper proposes a new approach to the study aimed to define possible enhancements of restraint safety systems performances, by using new materials and defining innovative design principles. In particular, roadside systems can be developed with regard to vehicle-barrier interaction, vehicle-oriented design (included low-mass and extremely low-mass vehicles), traffic suitability, user protection, working width reduction. In addition, thanks to sensors embedded into the barriers, it is also expected to deal with new challenges related to the guidance of automatic vehicles and I2V communication.

Contextual and interdependent causes of climate change adaptation barriers: Insights from water management institutions in Himachal Pradesh, India.

Science.gov (United States)

Azhoni, Adani; Holman, Ian; Jude, Simon

2017-01-15

Research on adaptation barriers is increasing as the need for climate change adaptation becomes evident. However, empirical studies regarding the emergence, causes and sustenance of adaptation barriers remain limited. This research identifies key contextual causes of adaptation barriers in water institutions in the mountainous Himalayan state of Himachal Pradesh in northern India. Semi-structured interviews were carried out with representatives from twenty-six key governmental, non-governmental, academic and research institutions in the State with responsibilities spanning domestic water supply, irrigation and hydropower generation, environmental monitoring and research. It identified low knowledge capacity and resources, policy implementation gaps, normative attitudes, and unavailability and inaccessibility of data and information compounded with weak interinstitutional networks as key adaptation barriers. Although these barriers are similar to those reported elsewhere, they have important locally-contextual root causes. For instance, inadequate resources result from fragmented resources allocation due to competing developmental priorities and the desire of the political leadership to please diverse electors, rather than climate scepticism. The identified individual barriers are found to be highly inter-dependent and closely intertwined which enables the identification of leverage points for interventions to maximise barrier removal. For instance, breaking down key barriers hindering accessibility to data and information, which are shaped by systemic bureaucracies and cultural attitudes, will involve attitudinal change through sensitisation to the importance of accurate and accessible data and information and the building trust between different actors, in addition to institutional structural changes through legislation and inter-institutional agreements. Approaching barriers as a system of contextually interconnected cultural, systemic, geographical and political

Knowledge, attitudes, practices, and barriers related to research utilization: a survey among pharmacists in Malaysia.

Science.gov (United States)

Tan, Sin Yee; Hatah, Ernieda

2017-04-01

Background Research utilization is part of evidence-based practice referring to the process of reviewing and critiquing scientific research and applying the findings to one's own clinical practice. Many studies on research utilization have been conducted with doctors and nurses, but to our knowledge, none have been investigated amongst pharmacists. Objective To assess research utilization and its barriers among pharmacists and identify potential influencing factors. Setting Malaysia. Methods This cross-sectional survey was administered online and by mail to a convenient sample of pharmacists working in hospitals, health clinics, and retail pharmacies in rural and urban areas. Main outcome measure Pharmacists' research utilization knowledge, attitudes, and practices. Results Six hundred surveys were mailed to potential respondents, and 466 were returned (77.7% response rate). Twenty-eight respondents completed the survey online. The respondents' research utilization knowledge, attitudes, and practices were found to be moderate. Research utilization was associated with respondents' knowledge and attitude scores (P < 0.001). When factors related to research utilization were modelled, higher educational level was associated with higher level of research utilization (P < 0.001) while less involvement in journal clubs, more years of service (3-7 years and more than 7 years) were associated with low and moderate research utilization, respectively. The main reported barrier to research utilization was lack of sufficient authority to change patient care procedures. Conclusion Pharmacists' research utilization knowledge, attitudes, and practices can be improved by encouraging pharmacists to pursue higher degrees, promoting active participation in institutions' journal clubs, and introducing senior clinical pharmacist specialization.

CMHC research project: Testing of air barriers construction details: Report

Energy Technology Data Exchange (ETDEWEB)

1991-01-01

This project was conducted to quantify the air leakage characteristics of the header joist, the electric outlets, and the window openings in wood-frame walls. The study evaluated the sealed internal membrane method, where polyethylene sheet and sealant provide the air barrier; the external air barrier method, which uses a continuous vapour permeable membrane (spun-bonded olefin film), sandwiched between two layers of external wall sheathing; and the airtight drywall method, where the interior gypsum board finish, together with framing materials and gaskets, are used as the air barrier. In addition, the traditional approach to wood-frame wall construction, where no special attention is given to achieving a continuous air barrier, was evaluated for comparison.

Gender- and sex-specific sports-related injury research in emergency medicine: a consensus on future research direction and focused application.

Science.gov (United States)

Raukar, Neha P; Zonfrillo, Mark R; Kane, Kathleen; Davenport, Moira; Espinoza, Tamara R; Weiland, Jessica; Franco, Vanessa; Vaca, Federico E

2014-12-01

Title IX, the commercialization of sports, the social change in sports participation, and the response to the obesity epidemic have contributed to the rapid proliferation of participation in both competitive organized sports and nontraditional athletic events. As a consequence, emergency physicians are regularly involved in the acute diagnosis, management, disposition, and counseling of a broad range of sports-related pathology. Three important and highly publicized mechanisms of injury in sports relevant to emergency medicine (EM) include concussion, heat illness, and sudden cardiac death. In conjunction with the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a consensus group consisting of experts in EM, emergency neurology, sports medicine, and public health convened to deliberate and develop research questions that could ultimately advance the field of sports medicine and allow for meaningful application in the emergency department (ED) clinical setting. Sex differences in injury risk, diagnosis, ED treatment, and counseling are identified in each of these themes. This article presents the consensus-based priority research agenda. © 2014 by the Society for Academic Emergency Medicine.

Application of Emergency Action Levels from Potential Release at Research Reactor HANARO

International Nuclear Information System (INIS)

Kim, Jongsoo; Lee, Goan Yub; Lee, Hae Choi; Kim, Bong Suk

2014-01-01

Execution of the protective action promptly is possible that Emergency Action Levels (EALs) must be established for a radiological release from nuclear facility. The EALs for electric power reactor are already developed and applied to recognize an emergency situation rapidly. Recently the IAEA published the safety report including the EALs for research reactor. This paper describes the EALs to apply for a potential release pathway at the research reactor HANARO. The results of table 1 and 2 will be higher than actual because the weather condition in real situation is difference. However, the EALs applying the potential stack release, ground release and site can be useful for research reactor HANARO making the emergency declaration. The EALs at the site boundary of the table 3 can be applied to protect the off-site public

Barriers to Asthma Management for School Nurses: An Integrative Review.

Science.gov (United States)

Hanley Nadeau, Ellen; Toronto, Coleen E

2016-04-01

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting. © The Author(s) 2015.

A Conceptual Framework to Measure Systems’ Performance during Emergency Preparedness Exercises

Directory of Open Access Journals (Sweden)

Elena Savoia

2014-09-01

Full Text Available Large-scale public health emergencies require a sophisticated, coordinated response involving multiple entities to protect health and minimize suffering. However, the rarity of such emergencies presents a barrier to gathering observational data about the effectiveness of the public health response before such events occur. For this reason, public health practitioners increasingly have relied on simulated emergencies, known as “exercises” as proxies to test their emergency capabilities. However, the formal evaluation of performance in these exercises, historically has been inconsistent, and there is little research to describe how data acquired from simulated emergencies actually support conclusions about the quality of the public health emergency response system. Over the past six years, we have designed and evaluated more than seventy public health emergency exercises, collaborating with public health agencies, hospitals and others to test a wide variety of systems and their capabilities. Using the data and experience that we gathered, we have developed a conceptual framework that describes the essential elements necessary to consider when applying performance measurement science to public health emergency exercises. We suggest that this framework may assist practitioners and researchers who wish to better measure performance in exercises and to improve public health emergency preparedness.

Extracurricular research activities among senior medical students in Kuwait: experiences, attitudes, and barriers

Directory of Open Access Journals (Sweden)

Al-Halabi B

2014-04-01

Full Text Available Becher Al-Halabi,1 Yousef Marwan,2 Mohammad Hasan,3 Sulaiman Alkhadhari41Department of Surgery, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait; 2Department of Orthopaedic Surgery, Al-Razi Hospital, Al-Sabah Medical Area, Ministry of Health, Kuwait; 3Department of Radiation Oncology, Kuwait Cancer Control Center, Al-Sabah Medical Area, Ministry of Health, Kuwait; 4Department of Psychiatry, Faculty of Medicine, Health Sciences Center, Kuwait University, KuwaitBackground: Research is the foundation of scientific advancement and improvement in quality of health care, which ensures the good health of the community. The aim of this study is to explore experiences, attitudes, and barriers of medical students in Kuwait University (KU in regards to extracurricular research.Methods: A questionnaire about extracurricular research activities (ie, any research activity that is not part of the required undergraduate curriculum, such as publishing a paper, research elective, etc was distributed to 175 senior medical students (years 6 and 7. Descriptive and chi-square analyses were used to analyze the responses, considering a P-value of <0.05 as the cut-off level for significance. The main outcome was defined as taking part in any of the extracurricular research activities.Results: Of the 150 participants (response rate = 85.7%, 26 (17.3%, 68 (45.3%, 52 (34.7%, and 17 (11.3% had published their required medical school research, presented abstracts in conferences, conducted extracurricular research, and completed a research elective/course, respectively; 99 (66.0% took part in any of these activities. Participants who read medical journals regularly (81; 54% reported higher participation in extracurricular research activities than those who did not read journals (P=0.003. Improving the availability of mentors for students' extracurricular research was ranked by the participants as the most important factor to improve their participation in

How are topics born? Understanding the research dynamics preceding the emergence of new areas

Directory of Open Access Journals (Sweden)

Angelo A. Salatino

2017-06-01

Full Text Available The ability to promptly recognise new research trends is strategic for many stakeholders, including universities, institutional funding bodies, academic publishers and companies. While the literature describes several approaches which aim to identify the emergence of new research topics early in their lifecycle, these rely on the assumption that the topic in question is already associated with a number of publications and consistently referred to by a community of researchers. Hence, detecting the emergence of a new research area at an embryonic stage, i.e., before the topic has been consistently labelled by a community of researchers and associated with a number of publications, is still an open challenge. In this paper, we begin to address this challenge by performing a study of the dynamics preceding the creation of new topics. This study indicates that the emergence of a new topic is anticipated by a significant increase in the pace of collaboration between relevant research areas, which can be seen as the ‘parents’ of the new topic. These initial findings (i confirm our hypothesis that it is possible in principle to detect the emergence of a new topic at the embryonic stage, (ii provide new empirical evidence supporting relevant theories in Philosophy of Science, and also (iii suggest that new topics tend to emerge in an environment in which weakly interconnected research areas begin to cross-fertilise.

Stem cell research ethics: consensus statement on emerging issues.

Science.gov (United States)

Caulfield, Timothy; Ogbogu, Ubaka; Nelson, Erin; Einsiedel, Edna; Knoppers, Bartha; McDonald, Michael; Brunger, Fern; Downey, Robin; Fernando, Kanchana; Galipeau, Jacques; Geransar, Rose; Griener, Glenn; Grenier, Glenn; Hyun, Insoo; Isasi, Rosario; Kardel, Melanie; Knowles, Lori; Kucic, Terrence; Lotjonen, Salla; Lyall, Drew; Magnus, David; Mathews, Debra J H; Nisbet, Matthew; Nisker, Jeffrey; Pare, Guillaume; Pattinson, Shaun; Pullman, Daryl; Rudnicki, Michael; Williams-Jones, Bryn; Zimmerman, Susan

2007-10-01

This article is a consensus statement by an international interdisciplinary group of academic experts and Canadian policy-makers on emerging ethical, legal and social issues in human embryonic stem cells (hESC) research in Canada. The process of researching consensus included consultations with key stakeholders in hESC research (regulations, stem cell researchers, and research ethics experts), preparation and distribution of background papers, and an international workshop held in Montreal in February 2007 to discuss the papers and debate recommendations. The recommendations provided in the consensus statement focus on issues of immediate relevance to Canadian policy-makers, including informed consent to hESC research, the use of fresh embryos in research, management of conflicts of interest, and the relevance of public opinion research to policy-making.

Cultural adaptation and validation of an instrument on barriers for the use of research results.

Science.gov (United States)

Ferreira, Maria Beatriz Guimarães; Haas, Vanderlei José; Dantas, Rosana Aparecida Spadoti; Felix, Márcia Marques Dos Santos; Galvão, Cristina Maria

2017-03-02

to culturally adapt The Barriers to Research Utilization Scale and to analyze the metric validity and reliability properties of its Brazilian Portuguese version. methodological research conducted by means of the cultural adaptation process (translation and back-translation), face and content validity, construct validity (dimensionality and known groups) and reliability analysis (internal consistency and test-retest). The sample consisted of 335 nurses, of whom 43 participated in the retest phase. the validity of the adapted version of the instrument was confirmed. The scale investigates the barriers for the use of the research results in clinical practice. Confirmatory factorial analysis demonstrated that the Brazilian Portuguese version of the instrument is adequately adjusted to the dimensional structure the scale authors originally proposed. Statistically significant differences were observed among the nurses holding a Master's or Doctoral degree, with characteristics favorable to Evidence-Based Practice, and working at an institution with an organizational cultural that targets this approach. The reliability showed a strong correlation (r ranging between 0.77 and 0.84, pcultura organizacional dirigida hacia tal aproximación. La fiabilidad presentó correlación fuerte (r variando entre 0,77 y 0,84, pcultura organizacional direcionada para tal abordagem. A confiabilidade apresentou correlação forte (r variando entre 0,77e 0,84, p<0,001) e a consistência interna foi adequada (alfa de Cronbach variando entre 0,77 e 0,82) . a versão para o português brasileiro do instrumento The Barriers Scale demonstrou-se válida e confiável no grupo estudado.

Active-learning instruction on emergency contraception counseling.

Science.gov (United States)

Young, Shardae; Griffin, Brooke; Vest, Kathleen

2013-06-12

To increase pharmacy students' knowledge of and confidence in counseling patients regarding emergency contraception and to identify any barriers to counseling patients about emergency contraception. Approximately 200 third-year pharmacy students participated in the Women's Health Therapeutics workshop at Midwestern University Chicago College of Pharmacy. Students observed a 5-minute skit of a counseling session on emergency contraception and then were asked to pair up with a classmate and practice counseling each other regarding the use of emergency contraception following a checklist of key points. One hundred eighty-nine students completed pre- and post-workshop survey instruments. Students' knowledge scores increased from 86% to 93% (pemergency contraception before completing the active-learning exercise compared to 58.5% after (pemergency contraception and significantly reduced several barriers to counseling identified prior to participation.

21 CFR 812.47 - Emergency research under § 50.24 of this chapter.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Emergency research under § 50.24 of this chapter. 812.47 Section 812.47 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN....47 Emergency research under § 50.24 of this chapter. (a) The sponsor shall monitor the progress of...

The emergency organization of the Federal Institute for Reactor Research

International Nuclear Information System (INIS)

Brunner, H.; Huerlimann, T.

1977-01-01

The organization and means of the emergency organization of the Federal Institute for Reactor Research (EIR), the eldest and largest nuclear installation in Switzerland, are described. It consists of a central command group and the following emergency teams: fire brigade, radiation protection, first aid, control, operating teams (reactors, hot laboratory etc.). The radiation protection team is formed by the Health Physics Division and is discussed in detail. A description of the alarm system and the first actions to be taken in case of an emergency is given. The importance of frequent and well-planned exercises and of radio communication between the teams and the command group is stressed and the emergency training programme of the EIR School for Radiation Protection, operated by the Health Physics Division, is presented. A fortunate lack of incidents at EIR is partly compensated for by experience gained from emergency team assistance operations during incidents outside the Institute. (author)

Investigating the complementary value of discrete choice experiments for the evaluation of barriers and facilitators in implementation research: A questionnaire survey

NARCIS (Netherlands)

D. van Helvoort-Postulart (Debby); T. van der Weijden (Trudy); B.G.C. Dellaert (Benedict); M. de Kok (Mascha); M.F. von Meyenfeldt (Maarten); C.D. Dirksen (Carmen)

2009-01-01

textabstractBackground. The potential barriers and facilitators to change should guide the choice of implementation strategy. Implementation researchers believe that existing methods for the evaluation of potential barriers and facilitators are not satisfactory. Discrete choice experiments (DCE) are

Investigating the complementary value of discrete choice experiments for the evaluation of barriers and facilitators in implementation research: a questionnaire survey.

NARCIS (Netherlands)

Helvoort-Postulart, D. van; Weijden, G.D.E.M. van der; Dellaert, B.G.; Kok, M. de; Meyenfeldt, M.F. von; Dirksen, C.D.

2009-01-01

ABSTRACT: BACKGROUND: The potential barriers and facilitators to change should guide the choice of implementation strategy. Implementation researchers believe that existing methods for the evaluation of potential barriers and facilitators are not satisfactory. Discrete choice experiments (DCE) are

New light on an old problem: Reflections on barriers and enablers of distributed energy

International Nuclear Information System (INIS)

Szatow, Anthony; Quezada, George; Lilley, Bill

2012-01-01

This viewpoint article, New light on an Old Problem, aims to stimulate thought and discussion on pathways to rapid emission reduction trajectories. It considers briefly the history of the Australian energy system and recent attempts to support emerging, distributed energy supply systems, before exploring the importance of new energy supply models and how they may emerge organically, ahead of further policy and regulatory shifts in Australia. The article is shaped by extensive primary research, literature review and engagement with policy makers, industry and community organisations, energy market institutions, colleagues and others over a period of four years. It outlines how new business models may reduce emissions ahead of policy and regulation, and the importance of keeping an open mind when considering ‘barriers’ to distributed energy. We hope this article will spark interest and dialogue with colleagues who may be experiencing and grappling with similar challenges. - Research highlights: ► We discuss documented barriers to distributed energy. ► We draw on socio-technical system literature and our research experience to outline a possible solution to distributed energy barriers. ► We describe a hypothetical energy service business model, led by the property sector, as a catalyst for energy market change. ► We outline reasons for our confidence in this property sector led energy services model.

Everyday couples' communication research: Overcoming methodological barriers with technology.

Science.gov (United States)

Reblin, Maija; Heyman, Richard E; Ellington, Lee; Baucom, Brian R W; Georgiou, Panayiotis G; Vadaparampil, Susan T

2018-03-01

Relationship behaviors contribute to compromised health or resilience. Everyday communication between intimate partners represents the vast majority of their interactions. When intimate partners take on new roles as patients and caregivers, everyday communication takes on a new and important role in managing both the transition and the adaptation to the change in health status. However, everyday communication and its relation to health has been little studied, likely due to barriers in collecting and processing this kind of data. The goal of this paper is to describe deterrents to capturing naturalistic, day-in-the-life communication data and share how technological advances have helped surmount them. We provide examples from a current study and describe how we anticipate technology will further change research capabilities. Copyright © 2017 Elsevier B.V. All rights reserved.

Solving problems in social-ecological systems: definition, practice and barriers of transdisciplinary research.

Science.gov (United States)

Angelstam, Per; Andersson, Kjell; Annerstedt, Matilda; Axelsson, Robert; Elbakidze, Marine; Garrido, Pablo; Grahn, Patrik; Jönsson, K Ingemar; Pedersen, Simen; Schlyter, Peter; Skärbäck, Erik; Smith, Mike; Stjernquist, Ingrid

2013-03-01

Translating policies about sustainable development as a social process and sustainability outcomes into the real world of social-ecological systems involves several challenges. Hence, research policies advocate improved innovative problem-solving capacity. One approach is transdisciplinary research that integrates research disciplines, as well as researchers and practitioners. Drawing upon 14 experiences of problem-solving, we used group modeling to map perceived barriers and bridges for researchers' and practitioners' joint knowledge production and learning towards transdisciplinary research. The analysis indicated that the transdisciplinary research process is influenced by (1) the amount of traditional disciplinary formal and informal control, (2) adaptation of project applications to fill the transdisciplinary research agenda, (3) stakeholder participation, and (4) functional team building/development based on self-reflection and experienced leadership. Focusing on implementation of green infrastructure policy as a common denominator for the delivery of ecosystem services and human well-being, we discuss how to diagnose social-ecological systems, and use knowledge production and collaborative learning as treatments.

Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine.

Science.gov (United States)

Forero, Roberto; Nahidi, Shizar; De Costa, Josephine; Mohsin, Mohammed; Fitzgerald, Gerry; Gibson, Nick; McCarthy, Sally; Aboagye-Sarfo, Patrick

2018-02-17

The main objective of this methodological manuscript was to illustrate the role of using qualitative research in emergency settings. We outline rigorous criteria applied to a qualitative study assessing perceptions and experiences of staff working in Australian emergency departments. We used an integrated mixed-methodology framework to identify different perspectives and experiences of emergency department staff during the implementation of a time target government policy. The qualitative study comprised interviews from 119 participants across 16 hospitals. The interviews were conducted in 2015-2016 and the data were managed using NVivo version 11. We conducted the analysis in three stages, namely: conceptual framework, comparison and contrast and hypothesis development. We concluded with the implementation of the four-dimension criteria (credibility, dependability, confirmability and transferability) to assess the robustness of the study, RESULTS: We adapted four-dimension criteria to assess the rigour of a large-scale qualitative research in the emergency department context. The criteria comprised strategies such as building the research team; preparing data collection guidelines; defining and obtaining adequate participation; reaching data saturation and ensuring high levels of consistency and inter-coder agreement. Based on the findings, the proposed framework satisfied the four-dimension criteria and generated potential qualitative research applications to emergency medicine research. We have added a methodological contribution to the ongoing debate about rigour in qualitative research which we hope will guide future studies in this topic in emergency care research. It also provided recommendations for conducting future mixed-methods studies. Future papers on this series will use the results from qualitative data and the empirical findings from longitudinal data linkage to further identify factors associated with ED performance; they will be reported

Aluminium oxide barrier films on polymeric web and their conversion for packaging applications

OpenAIRE

Struller, CF; Kelly, PJ; Copeland, NJ; Tobin, V; Assender, HE; Holliday, CW; Read, SJ

2013-01-01

In recent years, inorganic transparent barrier layers such as aluminium oxide or silicon oxide deposited onto polymer films have emerged as an attractive alternative to polymer based transparent barrier layers for flexible food packaging materials. For this application, barrier properties against water vapour and oxygen are critical. Aluminium oxide coatings can provide good barrier levels at thicknesses in the nanometre range, compared to several micrometres for polymer-based barrier layers....

Generic qualitative research: a design for qualitative research in emergency care?

OpenAIRE

Cooper, S; Endacott, R

2007-01-01

The frequency of qualitative studies in the Emergency Medicine Journal, while still low, has increased over the last few years. All take a generic approach and rarely conform to established qualitative approaches such as phenomenology, ethnography and grounded theory. This generic approach is no doubt selected for pragmatic reasons but can be weakened by a lack of rigor and understanding of qualitative research. This paper explores qualitative approaches and then focuses on “best practice” fo...

Virtual rehabilitation: what are the practical barriers for home-based research?

OpenAIRE

Threapleton, Kate; Drummond, Avril E.R.; Standen, Penny

2016-01-01

Virtual reality technologies are becoming increasingly accessible and affordable to deliver, and consequently the interest in applying virtual reality within rehabilitation is growing. This has resulted in the emergence of research exploring the utility of virtual reality and interactive video gaming interventions for home use by patients. The aim of this paper is to highlight the practical factors and difficulties that may be encountered in research in this area, and to make recommendations ...

Gender | Page 29 | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

The Health Gap identifies and addresses key gaps in gender and health research: women and AIDS, tropical disease, the working environment, barriers to quality health care, and the health of adolescent and older women. It also identifies new and emerging themes in women's health and sets priorities for future action.

Interview-Based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting

Science.gov (United States)

Ranney, Megan L.; Meisel, Zachary; Choo, Esther K.; Garro, Aris; Sasson, Comilla; Morrow, Kathleen

2015-01-01

Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. PMID:26284572

Application of fuzzy analytic network process for barrier evaluation in automotive parts remanufacturing towards cleaner production

DEFF Research Database (Denmark)

Govindan, Kannan; Shankar, Madan; Kannan, Devika

2016-01-01

to hidden facts. Many researchers have explored such hidden facts in auto parts remanufacturing in developing nations and their emerging economies. However, there is a huge gap in the state-of-the-art remanufacturing practices in India, despite India's strong advancements in the automobile industry. In fact......, India's automobile industry is rapidly approaching that of China's in recent years. Although some studies are available regarding remanufacturing implementation, current research has generally failed to offer a deep analysis of the factors and barriers that exist as hurdles to such implementation....... Consequently, this paper attempts to investigate the essential barrier to auto parts remanufacturing in an Indian scenario, and we also address vital interrelationships and interdependencies. To achieve the aim of the study, a model framework is proposed and applied to an Indian case industry. The data...

"Asthma can take over your life but having the right support makes that easier to deal with." Informing research priorities by exploring the barriers and facilitators to asthma control: a qualitative analysis of survey data.

Science.gov (United States)

Normansell, Rebecca; Welsh, Emma

2015-01-01

Involving patients and the public in research prioritisation is important. Cochrane Airways works with authors to produce systematic reviews of evidence related to chronic airways disease. Cochrane Airways has undertaken activities to identify research priorities, including workshops with stakeholders and consultation with experts. We present the findings of an online survey, designed to align our work with the priorities of people affected by asthma. We promoted a survey comprising open-ended questions via social media to people affected by asthma. We compiled the free-text responses and conducted an exploratory thematic analysis to identify important barriers and facilitators to asthma control. We triangulated findings with other research prioritisation activities to produce new review questions. We received 57 survey responses. Eight main themes emerged, most encompassing both facilitators and barriers: attitudes and knowledge; financial costs; environmental factors and triggers; healthcare systems; lifestyle factors; medication; self-care; and support. Barriers were more frequently mentioned than facilitators and many related to healthcare systems. These findings offer valuable insights into the challenges faced by individuals affected by asthma in the UK, and possibly further afield. We developed a list of priority reviews based on what was said by people in this survey and at a workshop. This demonstrates the real impact that people affected by asthma have on the research agenda of Cochrane Airways. Over the next 2-3 years we will produce reviews that address some of these questions hopefully leading to health benefits.

Healthcare barriers of refugees post-resettlement.

Science.gov (United States)

Morris, Meghan D; Popper, Steve T; Rodwell, Timothy C; Brodine, Stephanie K; Brouwer, Kimberly C

2009-12-01

The majority of refugees spend the greater part of their lives in refugee camps before repatriation or resettlement to a host country. Limited resources and stress during residence in refugee camps can lead to a variety of acute and chronic diseases which often persist upon resettlement. However, for most resettled refugees little is known about their health needs beyond a health assessment completed upon entry. We conducted a qualitative pilot-study in San Diego County, the third largest area in California, USA for resettling refugees, to explore health care access issues of refugees after governmental assistance has ended. A total of 40 guided in-depth interviews were conducted with a targeted sample of informants (health care practitioners, employees of refugee serving organizations, and recent refugee arrivals) familiar with the health needs of refugees. Interviews revealed that the majority of refugees do not regularly access health services. Beyond individual issues, emerging themes indicated that language and communication affect all stages of health care access--from making an appointment to filling out a prescription. Acculturation presented increased stress, isolation, and new responsibilities. Additionally, cultural beliefs about health care directly affected refugees' expectation of care. These barriers contribute to delayed care and may directly influence refugee short- and long-term health. Our findings suggest the need for additional research into contextual factors surrounding health care access barriers, and the best avenues to reduce such barriers and facilitate access to existing services.

Clinical priorities, barriers and solutions in end-of-life cancer care research across Europe. Report from a workshop

DEFF Research Database (Denmark)

Sigurdardottir, Katrin Ruth; Haugen, Dagny Faksvåg; van der Rijt, Carin C D

2010-01-01

The PRISMA project is aiming to co-ordinate research priorities, measurement and practice in end-of-life (EOL) care in Europe. As part of PRISMA we undertook a questionnaire survey and a subsequent workshop to (1) identify clinical priorities for EOL care research in Europe and propose a future...... research agenda and (2) identify barriers to EOL care research, and possibilities and solutions to improve the research....

Unified Model of Dynamic Forced Barrier Crossing in Single Molecules

Energy Technology Data Exchange (ETDEWEB)

Friddle, R W

2007-06-21

Thermally activated barrier crossing in the presence of an increasing load can reveal kinetic rate constants and energy barrier parameters when repeated over a range of loading rates. Here we derive a model of the mean escape force for all relevant loading rates--the complete force spectrum. Two well-known approximations emerge as limiting cases; one of which confirms predictions that single-barrier spectra should converge to a phenomenological description in the slow loading limit.

How and Why To Free All Refereed Research From Access- and Impact-Barriers Online, Now

CERN Document Server

Harnad, S; Brody, T

2001-01-01

Researchers publish their findings in order to make an impact on research, not in order to sell their words. Access-tolls are barriers to research impact. Authors can now free their refereed research papers from all access tolls immediately by self-archiving them on-line in their own institution's Eprint Archives. Free eprints.org software creates Archives compliant with the Open Archives Initiative metadata-tagging Protocol OAI 1.0. These distributed institutional Archives are interoperable and can hence be harvested into global "virtual" archives, citation-linked and freely navigable by all. Self-archiving should enhance research productivity and impact as well as providing powerful new ways of monitoring and measuring it.

Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

Science.gov (United States)

Safdar, Basmah; Greenberg, Marna R

2014-12-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the

Immune barriers of Ebola virus infection.

Science.gov (United States)

McElroy, Anita K; Mühlberger, Elke; Muñoz-Fontela, César

2018-02-01

Since its initial emergence in 1976 in northern Democratic Republic of Congo (DRC), Ebola virus (EBOV) has been a global health concern due to its virulence in humans, the mystery surrounding the identity of its host reservoir and the unpredictable nature of Ebola virus disease (EVD) outbreaks. Early after the first clinical descriptions of a disease resembling a 'septic-shock-like syndrome', with coagulation abnormalities and multi-system organ failure, researchers began to evaluate the role of the host immune response in EVD pathophysiology. In this review, we summarize how data gathered during the last 40 years in the laboratory as well as in the field have provided insight into EBOV immunity. From molecular mechanisms involved in EBOV recognition in infected cells, to antigen processing and adaptive immune responses, we discuss current knowledge on the main immune barriers of infection as well as outstanding research questions. Copyright © 2018 Elsevier B.V. All rights reserved.

Compositional Safety Analysis using Barrier Certificates

DEFF Research Database (Denmark)

Sloth, Christoffer; Pappas, George J.; Wisniewski, Rafael

2012-01-01

This paper proposes a compositional method for verifying the safety of a dynamical system, given as an interconnection of subsystems. The safety verification is conducted by the use of the barrier certificate method; hence, the contribution of this paper is to show how to obtain compositional...... conditions for safety verification. We show how to formulate the verification problem, as a composition of coupled subproblems, each given for one subsystem. Furthermore, we show how to find the compositional barrier certificates via linear and sum of squares programming problems. The proposed method makes...... it possible to verify the safety of higher dimensional systems, than the method for centrally computed barrier certificates. This is demonstrated by verifying the safety of an emergency shutdown of a wind turbine....

Generic Procedures for Response to a Nuclear or Radiological Emergency at Research Reactors

International Nuclear Information System (INIS)

2011-01-01

Under Article 5.a(ii) of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), one function of the IAEA is to collect and disseminate to States Parties and Member States information concerning methodologies, techniques and results of research relating to response to nuclear or radiological emergencies. The IAEA publishes the Emergency Preparedness and Response Series to fulfil that function. This publication is part of that series. IAEA Safety Standards Series No. GS-R-2 Preparedness and Response for a Nuclear or Radiological Emergency, contains the following requirement: 'To ensure that arrangements are in place for a timely, managed, controlled, coordinated and effective response at the scene...'. The IAEA General Conference, in resolution GC(53)/RES/10, continues to encourage Member States '...to enhance, where necessary, their own preparedness and response capabilities for nuclear and radiological incidents and emergencies, by improving capabilities to prevent accidents, to respond to emergencies and to mitigate any harmful consequences...'. This publication is intended to assist Member States meet the requirements of GS-R-2 and enhance their preparedness by providing guidance on the response by facility personnel to emergencies at research reactor facilities.

Generic Procedures for Response to a Nuclear or Radiological Emergency at Triga Research Reactors. Attachment 1 (2011)

International Nuclear Information System (INIS)

2011-01-01

The publication provides guidance for response to emergencies at TRIGA research reactors in Threat Category II and III. It contains information on the unique behaviour of TRIGA fuel during accident conditions; it describes design characteristics of TRIGA research reactors and provides specific symptom-based emergency classification for this type of research reactor. This publication covers the determination of the appropriate emergency class and protective actions for a nuclear or radiological emergency at TRIGA research reactors. It does not cover nuclear security at TRIGA research reactors. The term 'threat category' is used in this publication as described in Ref. [6] and for the purposes of emergency preparedness and response only; this usage does not imply that any threat, in the sense of an intention and capability to cause harm, has been made in relation to facilities, activities or sources. The threat category is determined by an analysis of potential nuclear and radiological emergencies and the associated radiation hazard that could arise as a consequence of those emergencies. STRUCTURE. The attachment consists of an introduction which defines the background, objective, scope and structure, two sections covering technical aspects and appendices. Section 2 describes the characteristics of TRIGA fuel in normal and accident conditions. Section 3 contains TRIGA research reactor specific emergency classification tables for Threat Category II and III. These tables should be used instead of the corresponding emergency classification tables presented in Ref. [1] while developing the emergency response arrangements at TRIGA research reactors. The appendices present some historical overview and typical general data for TRIGA research reactor projects and the list of TRIGA installations around the world. The terms used in this document are defined in the IAEA Safety Glossary and the IAEA Code of Conduct on the Safety of Research Reactors.

Developing Research Collaborations in an Academic Clinical Setting: Challenges and Lessons Learned.

Science.gov (United States)

Sahs, John A; Nicasio, Andel V; Storey, Joan E; Guarnaccia, Peter J; Lewis-Fernández, Roberto

2017-08-01

Research collaboration in "real world" practice settings may enhance the meaningfulness of the findings and reduce barriers to implementation of novel intervention strategies. This study describes an initiative to integrate research into a hospital-based outpatient psychiatric clinic within an academic medical center, focusing on collaborative processes across three research projects. We report on the varied outcomes of the projects and utilize data from two focus groups to identify the key elements that contributed to the challenges and successes. We identify barriers to practice-research collaborations that emerged even when the initial circumstances of the partnership were favorable. These barriers include the presence of varied agendas across clinicians and investigators, resource constraints, limited staff buy-in, and staff turnover. In highlighting the lessons learned in this collaborative process, we hope to facilitate successful partnerships in other clinical settings.

Physical activity barriers and facilitators among working mothers and fathers.

Science.gov (United States)

Mailey, Emily L; Huberty, Jennifer; Dinkel, Danae; McAuley, Edward

2014-06-27

The transition to parenthood is consistently associated with declines in physical activity. In particular, working parents are at risk for inactivity, but research exploring physical activity barriers and facilitators in this population has been scarce. The purpose of this study was to qualitatively examine perceptions of physical activity among working parents. Working mothers (n = 13) and fathers (n = 12) were recruited to participate in one of four focus group sessions and discuss physical activity barriers and facilitators. Data were analyzed using immersion/crystallization in NVivo 10. Major themes for barriers included family responsibilities, guilt, lack of support, scheduling constraints, and work. Major themes for facilitators included being active with children or during children's activities, being a role model for children, making time/prioritizing, benefits to health and family, and having support available. Several gender differences emerged within each theme, but overall both mothers and fathers reported their priorities had shifted to focus on family after becoming parents, and those who were fitting in physical activity had developed strategies that allowed them to balance their household and occupational responsibilities. The results of this study suggest working mothers and fathers report similar physical activity barriers and facilitators and would benefit from interventions that teach strategies for overcoming barriers and prioritizing physical activity amidst the demands of parenthood. Future interventions might consider targeting mothers and fathers in tandem to create an optimally supportive environment in the home.

Barriers and opportunities for enhancing patient recruitment and retention in clinical research: findings from an interview study in an NHS academic health science centre.

Science.gov (United States)

Adams, Mary; Caffrey, Louise; McKevitt, Christopher

2015-03-12

In the UK, the recruitment of patients into clinical research is a national health research and development policy priority. There has been limited investigation of how national level factors operate as barriers or facilitators to recruitment work, particularly from the perspective of staff undertaking patient recruitment work. The aim of this study is to identify and examine staff views of the key organisational barriers and facilitators to patient recruitment work in one clinical research group located in an NHS Academic Health Science Centre. A qualitative study utilizing in-depth, one-to-one semi-structured interviews with 11 purposively selected staff with particular responsibilities to recruit and retain patients as clinical research subjects. Thematic analysis classified interview data by recurring themes, concepts, and emergent categories for the purposes of establishing explanatory accounts. The findings highlight four key factors that staff perceived to be most significant for the successful recruitment and retention of patients in research and identify how staff located these factors within patients, studies, the research centre, the trust, and beyond the trust. Firstly, competition for research participants at an organisational and national level was perceived to undermine recruitment success. Secondly, the tension between clinical and clinical research workloads was seen to interrupt patient recruitment into studies, despite national funding arrangements to manage excess treatment costs. Thirdly, staff perceived an imbalance between personal patient burden and benefit. Ethical committee regulation, designed to protect patients, was perceived by some staff to detract from clarification and systematisation of incentivisation strategies. Finally, the structure and relationships within clinical research teams, in particular the low tacit status of recruitment skills, was seen as influential. The results of this case-study, conducted in an exemplary NHS

Barriers to Banking - Towards an Inclusive Banking Environment in South Africa.

Science.gov (United States)

Martinson, Estelle; Martinson, Johannes

2016-01-01

A recent study in South Africa on the barriers to banking which involved customers in three disability groups namely mobility, hearing and vision has highlighted that currently banking in South Africa is not accessible. Customers with a disability are unable to independently use banking services across a wide range of channels. Exclusion from something as fundamental as managing their own financial affairs raise serious human rights concerns and requires committed action from decision-makers to address this. The fact that solutions to all of the identified barriers have been successfully implemented in banks in other parts of the world for many years emphasize that this is not a technical challenge. While some solutions require complex or expensive changes such as removing physical access barriers and ensuring that digital channels meet internationally accepted standards of accessibility, there are many simple and low-cost solutions which can be implemented immediately and would make a world of difference to these customers and their experience of banking. One key barrier which emerged in all the focus groups and surveys is attitudinal barriers - staff who are unwilling to assist, impatient, interact with the customer's assistant instead of directly with them and lack basic skills on how to interact with someone who has a disability. A comprehensive framework of banking was used to identify a wide range of barriers. The barriers were classified as attitudinal, barriers to physical access, digital access barriers, barriers to information, communication barriers and some generic concerns such as safe evacuation during emergencies and alternative authentication. Both the barriers and the solutions where ranked by participants. From a theoretical perspective, the benefit of a customer-centric approach to understanding these barriers and the innovation potential of a Universal Design approach is affirmed by this study.

Emergency blood transfusion practices among anaemic children presenting to an urban emergency department of a tertiary hospital in Tanzania.

Science.gov (United States)

Shari, Catherine R; Sawe, Hendry R; Murray, Brittany L; Mwafongo, Victor G; Mfinanga, Juma A; Runyon, Michael S

2017-01-01

Severe anaemia contributes significantly to mortality, especially in children under 5 years of age. Timely blood transfusion is known to improve outcomes. We investigated the magnitude of anaemia and emergency blood transfusion practices amongst children under 5 years presenting to the Emergency Department (ED) of Muhimbili National Hospital (MNH) in Tanzania. This prospective observational study enrolled children under 5 years old with anaemia, over a 7-week period in August and September of 2015. Anaemia was defined as haemoglobin of MNH. Less than a quarter of children with indications for transfusion receive it in the EMD, the median time to transfusion is nearly 8 h, and those not transfused have nearly a 3-fold higher mortality. Future quality improvement and research efforts should focus on eliminating barriers to timely blood transfusion.

Experimental model for research on the blood-ocular barrier

Energy Technology Data Exchange (ETDEWEB)

Kim, Hak Jin; Jea, Seung Youn; Park, Jae Sung; Jung, Yeon Joo [Pusan National University, Pusan (Korea, Republic of); Kim, Yong Woo [Inje University, Kimhae (Korea, Republic of); Park, Byung Rae [Catholic University, Seoul (Korea, Republic of)

2006-03-15

The eyeball has 2 blood-ocular barriers, i.e, the blood-retinal and blood-aqueous barriers. The purpose of this study was to evaluate if triolein emulsion could disrupt the barriers, and we wanted to suggest as an experimental model for future blood-ocular barrier studies. The triolein emulsion was made of 0.1 ml triolein and 20 ml normal saline, and this was infused into the carotid artery of ten cats (the experimental group). As a control group, only normal saline was infused in another ten cats. Precontrast and postcontrast T1-weighted MR images were obtained at 30 minutes and 3 hours after embolization in both groups. The signal intensities were evaluate qualitatively and quantitatively in the anterior and posterior chambers and also in the vitreus fluid. Statistical analysis was performed by employing the Kruskal Wallist test, Dunn's Multiple Comparison test and the wilcoxon signed rank test. In the control group, no contrast enhancement was demonstrated in the anterior or posterior chamber or in the vitreus fluid of the ipsilateral or contralateral eyeball on the 30 minutes MR images. The anterior chambers of the ipsilateral and contralateral eyeballs revealed delayed contrast enhancement on the 3 hour MR images. In the experimental group, the 30 minute-postembolization MR images were not different from those of the control group. The 30 minute-postembolization MR images demonstrated delayed contrast enhancement in the anterior chamber of the ipsilateral and contralateral eyeballs and in the posterior chamber of the ipsilateral eyeball. The delayed contrast enhancement of the posterior chamber of the ipsilateral eyeball was statistically significant ({rho} < 0.05). The present study demonstrated significant contrast enhancement in the posterior chamber with infusion of the triolein emulsion, and this can serve as a model for blood-aqueous barrier studies.

Experimental model for research on the blood-ocular barrier

International Nuclear Information System (INIS)

Kim, Hak Jin; Jea, Seung Youn; Park, Jae Sung; Jung, Yeon Joo; Kim, Yong Woo; Park, Byung Rae

2006-01-01

The eyeball has 2 blood-ocular barriers, i.e, the blood-retinal and blood-aqueous barriers. The purpose of this study was to evaluate if triolein emulsion could disrupt the barriers, and we wanted to suggest as an experimental model for future blood-ocular barrier studies. The triolein emulsion was made of 0.1 ml triolein and 20 ml normal saline, and this was infused into the carotid artery of ten cats (the experimental group). As a control group, only normal saline was infused in another ten cats. Precontrast and postcontrast T1-weighted MR images were obtained at 30 minutes and 3 hours after embolization in both groups. The signal intensities were evaluate qualitatively and quantitatively in the anterior and posterior chambers and also in the vitreus fluid. Statistical analysis was performed by employing the Kruskal Wallist test, Dunn's Multiple Comparison test and the wilcoxon signed rank test. In the control group, no contrast enhancement was demonstrated in the anterior or posterior chamber or in the vitreus fluid of the ipsilateral or contralateral eyeball on the 30 minutes MR images. The anterior chambers of the ipsilateral and contralateral eyeballs revealed delayed contrast enhancement on the 3 hour MR images. In the experimental group, the 30 minute-postembolization MR images were not different from those of the control group. The 30 minute-postembolization MR images demonstrated delayed contrast enhancement in the anterior chamber of the ipsilateral and contralateral eyeballs and in the posterior chamber of the ipsilateral eyeball. The delayed contrast enhancement of the posterior chamber of the ipsilateral eyeball was statistically significant (ρ < 0.05). The present study demonstrated significant contrast enhancement in the posterior chamber with infusion of the triolein emulsion, and this can serve as a model for blood-aqueous barrier studies

From principles to action: Applying the National Research Council's principles for effective decision support to the Federal Emergency Management Agency's watch office

Directory of Open Access Journals (Sweden)

Alison M. Meadow

2016-03-01

Full Text Available The National Research Council (NRC proposed six principles for effective decision support in its 2009 report Informing Decisions in a Changing Climate. We structured a collaborative project between the Federal Emergency Management Agency Region R9 (FEMA R9, the Western Region Headquarters of the National Weather Service (WR-NWS, and the Climate Assessment of the Southwest (CLIMAS at the University of Arizona around the application of the NRC principles. The goal of the project was to provide FEMA R9's Watch Office with climate information scaled to their temporal and spatial interests to aid them in assessing the potential risk of flood disasters. We found that we needed specific strategies and activities in order to apply the principles effectively. By using a set of established collaborative research approaches we were better able to assess FEMA R9's information needs and WR-NWS's capacity to meet those needs. Despite our diligent planning of engagement strategies, we still encountered some barriers to transitioning our decision support tool from research to operations. This paper describes our methods for planning and executing a three-party collaborative effort to provide climate services, the decision support tool developed through this process, and the lessons we will take from this deliberate collaborative process to our future work and implications of the NRC principles for the broader field of climate services. Keywords: Climate services, Emergency management, Flood risk, Decision support

Pharmacists' views on involvement in pharmacy practice research: Strategies for facilitating participation.

Science.gov (United States)

Armour, Carol; Brillant, Martha; Krass, Ines

2007-01-01

In order for community pharmacy practice to continue to evolve, pharmacy practice research on potential new services is essential. This requires the active participation of community pharmacists. At present the level of involvement of community pharmacists in pharmacy practice research is minimal. To ascertain the attitudes of a group of research-experienced community pharmacists towards participating in research; to investigate the barriers and facilitators to participation; to identify potential strategies to increase the involvement of community pharmacists in research. A focus group was conducted with a purposive sample of 11 research-experienced community pharmacists. A pharmacist academic moderated the focus group using a semi-structured interview guide. The participants were asked about their attitudes towards research, previous involvement in research, barriers to their involvement and strategies to overcome these barriers. The session was audio-taped and notes were taken by an observer. Thematic analysis of the notes and audio-tape transcripts was conducted. Three themes emerged around pharmacists' attitudes towards research: pharmacists' perception of the purpose of research, pharmacists' motivation for involvement in research, and pharmacists' desired role in research. Barriers to research participation were grouped into four themes: pharmacists' mindset, communication, infrastructure (time, money and staff), and skills/knowledge. Strategies to address each of these barriers were suggested. Participants recognised the importance of research towards advancing their profession and this was a motivating factor for involvement in research. They perceived their role in research primarily as data collection. A series of practical strategies to overcome the barriers to participation were offered that researchers may wish to consider when promoting research outcomes and designing research projects.

Pharmacists’ views on involvement in pharmacy practice research: Strategies for facilitating participation.

Directory of Open Access Journals (Sweden)

Armour C

2007-06-01

Full Text Available In order for community pharmacy practice to continue to evolve, pharmacy practice research on potential new services is essential. This requires the active participation of community pharmacists. At present the level of involvement of community pharmacists in pharmacy practice research is minimal. Objectives: To ascertain the attitudes of a group of research-experienced community pharmacists towards participating in research; to investigate the barriers and facilitators to participation; to identify potential strategies to increase the involvement of community pharmacists in research. Methods: A focus group was conducted with a purposive sample of 11 research-experienced community pharmacists. A pharmacist academic moderated the focus group using a semi-structured interview guide. The participants were asked about their attitudes towards research, previous involvement in research, barriers to their involvement and strategies to overcome these barriers. The session was audio-taped and notes were taken by an observer. Thematic analysis of the notes and audio-tape transcripts was conducted.Results: Three themes emerged around pharmacists’ attitudes towards research: pharmacists’ perception of the purpose of research, pharmacists’ motivation for involvement in research, and pharmacists’ desired role in research. Barriers to research participation were grouped into four themes: pharmacists’ mindset, communication, infrastructure (time, money and staff, and skills/knowledge. Strategies to address each of these barriers were suggested.Conclusions: Participants recognised the importance of research towards advancing their profession and this was a motivating factor for involvement in research. They perceived their role in research primarily as data collection. A series of practical strategies to overcome the barriers to participation were offered that researchers may wish to consider when promoting research outcomes and designing research

The willingness to participate in health research studies of individuals with Turkish migration backgrounds: barriers and resources.

Science.gov (United States)

Dingoyan, D; Schulz, H; Mösko, M

2012-06-01

Lower participation rates of ethnic minorities in health research studies and potential participation barriers are commonly reported. Four semi-structured focus groups of individuals with Turkish migration backgrounds living in Germany were conducted to identify potential participation barriers. Documented statements and superscripted presentation cards by the participants were evaluated with a qualitative content analysis. The following eight potential reasons for the lower participation rates were identified: role of women, lack of knowledge, lack of interest, German-Turkish interactions, mistrust, anxiety, data privacy protection and benefits of the study. Additionally, the following recruitment strategies to enhance participation rates were found: public relations, especially word-of-mouth promotion and contacting Turkish key figures, (non-) tangible incentives and trust building through transparent communication of the project and its conditions. The findings provide a wide range of potential participation barriers and implications that should be considered to enhance the participation rates of minority populations. The willingness to participate in health research studies can be increased through particular efforts, which should be tailored to the recruitment of the underrepresented target population. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Emergence of Nordic nursing research: no position is an Island

DEFF Research Database (Denmark)

Larsen, Kristian; Adamsen, Lis

2009-01-01

. The interview agenda explored the participants' research activities and knowledge production. Our conclusion is that one cannot speak of nursing research in the Nordic countries as a fully developed and autonomous field. Yet we see the outlines of an emerging nursing research field with a common doxa. At least...... three distinct positions operate in Nordic nursing research: a clinical and applied oriented position, a profession and knowledge oriented position and a theoretical and concept oriented position. Epistemologically speaking the positions are of a 'spontaneous', 'cyclical' and 'break' character...

On the generalized Hartman effect for symmetric double-barrier point potentials

International Nuclear Information System (INIS)

Lee, Molly A; Manzoni, Luiz A; Nyquist, Erik A; Lunardi, José T

2015-01-01

We consider the scattering of a non-relativistic particle by a symmetrical arrangement of two identical barriers in one-dimension, with the barriers given by the well-known four-parameter family of point interactions. We calculate the phase time and the stationary Salecker-Wigner-Peres clock time for the particular cases of a double δ and a double δ' barrier and investigate the off-resonance behavior of these time scales in the limit of opaque barriers, addressing the question of emergence of the generalized Hartman effect

ENA study cites barriers to NPSG compliance.

Science.gov (United States)

2009-04-01

There are many barriers to compliance with the National Patient Safety Goals, as a recent study shows. However, emergency medicine experts say there are several strategies you can adopt to help overcome those barriers. Send the right message to your staff by establishing a culture of shared responsibility for safety. Establish scripts for talking with patients. Standardization will help ensure they are getting the correct information. Put standardized abbreviations on posters in your department, and list them on your medication reconciliation form.

Electron density in surface barrier discharge emerging at argon/water interface: quantification for streamers and leaders

Science.gov (United States)

Cvetanović, Nikola; Galmiz, Oleksandr; Synek, Petr; Zemánek, Miroslav; Brablec, Antonín; Hoder, Tomáš

2018-02-01

Optical emission spectroscopy, fast intensified CCD imaging and electrical measurements were applied to investigate the basic plasma parameters of surface barrier discharge emerging from a conductive water electrode. The discharge was generated at the triple-line interface of atmospheric pressure argon gas and conductive water solution at the fused silica dielectrics using a sinusoidal high-voltage waveform. The spectroscopic methods of atomic line broadening and molecular spectroscopy were used to determine the electron densities and the gas temperature in the active plasma. These parameters were obtained for both applied voltage polarities and resolved spatially. Two different spectral signatures were identified in the spatially resolved spectra resulting in electron densities differing by two orders of magnitude. It is shown that two discharge mechanisms take a place: the streamer and the leader one, with electron densities of 1014 and 1016 cm-3, respectively. This spectroscopic evidence is supported by the combined diagnostics of electrical current measurements and phase-resolved intensified CCD camera imaging.

The Pediatric Emergency Care Applied Research Network: a history of multicenter collaboration in the United States.

Science.gov (United States)

Tzimenatos, Leah; Kim, Emily; Kuppermann, Nathan

2015-01-01

In this article, we review the history and progress of a large multicenter research network pertaining to emergency medical services for children. We describe the history, organization, infrastructure, and research agenda of the Pediatric Emergency Care Applied Research Network and highlight some of the important accomplishments since its inception. We also describe the network's strategy to grow its research portfolio, train new investigators, and study how to translate new evidence into practice. This strategy ensures not only the sustainability of the network in the future but the growth of research in emergency medical services for children in general.

AskFuse Origins: System Barriers to Providing the Research That Public Health Practice and Policy Partners Say They Need

Science.gov (United States)

Rushmer, Rosemary; Shucksmith, Janet

2018-01-01

In this paper the development of askFuse is used as a case study to illustrate contextual and system barriers to universities providing useful, usable and timely research evidence in response to local practice and policy partners' stated public health research needs. Entrenched systems (research excellence framework, academic career pathways,…

Lowering the barriers to computational modeling of Earth's surface: coupling Jupyter Notebooks with Landlab, HydroShare, and CyberGIS for research and education.

Science.gov (United States)

Bandaragoda, C.; Castronova, A. M.; Phuong, J.; Istanbulluoglu, E.; Strauch, R. L.; Nudurupati, S. S.; Tarboton, D. G.; Wang, S. W.; Yin, D.; Barnhart, K. R.; Tucker, G. E.; Hutton, E.; Hobley, D. E. J.; Gasparini, N. M.; Adams, J. M.

2017-12-01

The ability to test hypotheses about hydrology, geomorphology and atmospheric processes is invaluable to research in the era of big data. Although community resources are available, there remain significant educational, logistical and time investment barriers to their use. Knowledge infrastructure is an emerging intellectual framework to understand how people are creating, sharing and distributing knowledge - which has been dramatically transformed by Internet technologies. In addition to the technical and social components in a cyberinfrastructure system, knowledge infrastructure considers educational, institutional, and open source governance components required to advance knowledge. We are designing an infrastructure environment that lowers common barriers to reproducing modeling experiments for earth surface investigation. Landlab is an open-source modeling toolkit for building, coupling, and exploring two-dimensional numerical models. HydroShare is an online collaborative environment for sharing hydrologic data and models. CyberGIS-Jupyter is an innovative cyberGIS framework for achieving data-intensive, reproducible, and scalable geospatial analytics using the Jupyter Notebook based on ROGER - the first cyberGIS supercomputer, so that models that can be elastically reproduced through cloud computing approaches. Our team of geomorphologists, hydrologists, and computer geoscientists has created a new infrastructure environment that combines these three pieces of software to enable knowledge discovery. Through this novel integration, any user can interactively execute and explore their shared data and model resources. Landlab on HydroShare with CyberGIS-Jupyter supports the modeling continuum from fully developed modelling applications, prototyping new science tools, hands on research demonstrations for training workshops, and classroom applications. Computational geospatial models based on big data and high performance computing can now be more efficiently

Emerging Science and Research Opportunities for Metals and Metallic Nanostructures

Science.gov (United States)

Handwerker, Carol A.; Pollock, Tresa M.

2014-07-01

During the next decade, fundamental research on metals and metallic nanostructures (MMNs) has the potential to continue transforming metals science into innovative materials, devices, and systems. A workshop to identify emerging and potentially transformative research areas in MMNs was held June 13 and 14, 2012, at the University of California Santa Barbara. There were 47 attendees at the workshop (listed in the Acknowledgements section), representing a broad range of academic institutions, industry, and government laboratories. The metals and metallic nanostructures (MMNs) workshop aimed to identify significant research trends, scientific fundamentals, and recent breakthroughs that can enable new or enhanced MMN performance, either alone or in a more complex materials system, for a wide range of applications. Additionally, the role that MMN research can play in high-priority research and development (R&D) areas such as the U.S. Materials Genome Initiative, the National Nanotechnology Initiative, the Advanced Manufacturing Initiative, and other similar initiatives that exist internationally was assessed. The workshop also addressed critical issues related to materials research instrumentation and the cyberinfrastructure for materials science research and education, as well as science, technology, engineering, and mathematics (STEM) workforce development, with emphasis on the United States but with an appreciation that similar challenges and opportunities for the materials community exist internationally. A central theme of the workshop was that research in MMNs has provided and will continue to provide societal benefits through the integration of experiment, theory, and simulation to link atomistic, nanoscale, microscale, and mesoscale phenomena across time scales for an ever-widening range of applications. Within this overarching theme, the workshop participants identified emerging research opportunities that are categorized and described in more detail in the

Sociology of International Education--An Emerging Field of Research

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Resnik, Julia

2012-01-01

This article points to international education in elementary and post-elementary schools as an emerging and promising field of enquiry. It describes the state of art of this new field and sets out the nature of the research. The rapid development of international networks in recent decades; the contribution of international education policies to…

Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China.

Science.gov (United States)

Lin, Lavinia; Brown, Katherine B; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M; Bodomo, Adams B; Yang, Ligang; Yang, Bin; Nehl, Eric J; Tucker, Joseph D; Wong, Frank Y

2015-10-01

Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.

Emerging Research Directions in Adult Congenital Heart Disease: A Report from a National Heart, Lung, and Blood Institute/Adult Congenital Heart Association Working Group

Science.gov (United States)

Gurvitz, Michelle; Burns, Kristin M.; Brindis, Ralph; Broberg, Craig S.; Daniels, Curt J.; Fuller, Stephanie M.P.N.; Honein, Margaret A.; Khairy, Paul; Kuehl, Karen S.; Landzberg, Michael J.; Mahle, William T.; Mann, Douglas L.; Marelli, Ariane; Newburger, Jane W.; Pearson, Gail D.; Starling, Randall C.; Tringali, Glenn R.; Valente, Anne Marie; Wu, Joseph C.; Califf, Robert M.

2016-01-01

Congenital heart disease (CHD) is the most common birth defect, affecting about 0.8% of live births. Advances in recent decades have allowed >85% of children with CHD to survive to adulthood, creating a growing population of adults with CHD. Little information exists regarding survival, demographics, late outcomes, and comorbidities in this emerging group, and multiple barriers impede research in adult CHD (ACHD). The National Heart, Lung, and Blood Institute and the Adult Congenital Heart Association convened a multidisciplinary Working Group to identify high-impact research questions in ACHD. This report summarizes the meeting discussions in the broad areas of CHD-related heart failure, vascular disease and multisystem complications. High-priority subtopics identified included heart failure in tetralogy of Fallot, mechanical circulatory support/transplantation, sudden cardiac death, vascular outcomes in coarctation of the aorta, late outcomes in single ventricle disease, cognitive and psychiatric issues, and pregnancy. PMID:27102511

Kontexte qualitativer Sozialforschung: Arts-Based Research, Mixed Methods und Emergent Methods

OpenAIRE

Schreier, Margrit

2017-01-01

In dem vorliegenden Beitrag werden drei Kontexte qualitativer Sozialforschung genauer dargestellt, die in den vergangenen Jahren zunehmend an Bedeutung gewonnen haben: Arts-Based Research, Mixed Methods und Emergent Methods. Es werden verschiedene Ansätze und Varianten von Arts-Informed und Arts-Based Research genauer beschrieben, und es wird argumentiert, dass Arts-Based Research eine eigenständige Forschungstradition darstellt, die der qualitativen Sozialforschung wichtige Impulse geben kan...

Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery.

Science.gov (United States)

Kilcullen, Meegan; Ireland, Susan

2017-05-11

Neonatology has made significant advances in the last 30 years. Despite the advances in treatments, not all neonates survive and a palliative care model is required within the neonatal context. Previous research has focused on the barriers of palliative care provision. A holistic approach to enhancing palliative care provision should include identifying both facilitators and barriers. A strengths-based approach would allow barriers to be addressed while also enhancing facilitators. The current study qualitatively explored perceptions of neonatal nurses about facilitators and barriers to delivery of palliative care and also the impact of the regional location of the unit. The study was conducted at the Townsville Hospital, which is the only regional tertiary neonatal unit in Australia. Semi-structured interviews were conducted with a purposive sample of eight neonatal nurses. Thematic analysis of the data was conducted within a phenomenological framework. Six themes emerged regarding family support and staff factors that were perceived to support the provision of palliative care of a high quality. Staff factors included leadership, clinical knowledge, and morals, values, and beliefs. Family support factors included emotional support, communication, and practices within the unit. Five themes emerged from the data that were perceived to be barriers to providing quality palliative care. Staff perceived education, lack of privacy, isolation, staff characteristics and systemic (policy, and procedure) factors to impact upon palliative care provision. The regional location of the unit also presented unique facilitators and barriers to care. This study identified and explored facilitators and barriers in the delivery of quality palliative care for neonates in a regional tertiary setting. Themes identified suggested that a strengths-approach, which engages and amplifies facilitating factors while identified barriers are addressed or minimized, would be successful in

Translating Research to Practice: Overcoming Barriers to Implementing Effective Off-Campus Party Intervention. Issues in Prevention

Science.gov (United States)

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

2012-01-01

This issue of "Issues in Prevention" focuses on overcoming barriers in implementing effective off-campus party intervention. This issue contains the following articles: (1) Confronting the Problems Associated With Off-Campus Parties With Evidence-Based Strategies (John D. Clapp); (2) Overview of Research on Effective Off-Campus Party…

Perceived facilitators of and barriers to healthful eating among university students.

Science.gov (United States)

Garcia, Alicia C; Sykes, Lesley; Matthews, June; Martin, Noelle; Leipert, Beverly

2010-01-01

Photovoice, an innovative qualitative research method in health care, has not been used to its full potential in nutrition/dietetics. We explored the use of Photovoice to determine perceived facilitators of and barriers to healthful eating among university students. The study included 28 students enrolled in a 2008 introductory nutrition class. The students participated in a camera orientation session to review ethics and privacy issues. They took photographs and selected two for discussion in a focus group moderated by a graduate student who used a semi-structured facilitation guide. Researchers coded the transcripts, analyzed the pictures and students' written comments about the project, and ensured data trustworthiness through credibility, dependability, confirmability, and transferability of data and methods. Six major themes emerged as facilitators and/or barriers: environment, nutrition knowledge, convenience foods, time, media influence, and food cost. More than one-third of the students thought the study "stimulated their critical thinking." They felt more empowered in sharing their perceptions and "getting their voices heard." Photovoice was a useful, "motivating," and "engaging" method for research on nutrition knowledge and dietary patterns of university students. Registered dietitians and other health professionals may benefit from the use of the Photovoice method when they are working with students.

Tritium/hydrogen barrier development

International Nuclear Information System (INIS)

Hollenberg, G.W.; Simonen, E.P.; Kalinen, G.; Terlain, A.

1994-06-01

A review of hydrogen permeation barriers that can be applied to structural metals used in fusion power plants is presented. Both implanted and chemically available hydrogen isotopes must be controlled in fusion plants. The need for permeation barriers appears strongest in Li17-Pb blanket designs, although barriers also appear necessary for other blanket and coolant systems. Barriers that provide greater than a 1000 fold reduction in the permeation of structural metals are desired. In laboratory experiments, aluminide and titanium ceramic coatings provide permeation reduction factors, PRFS, from 1000 to over 100,000 with a wide range of scatter. The rate-controlling mechanism for hydrogen permeation through these barriers may be related to the number and type of defects in the barriers. Although these barriers appear robust and resistant to liquid metal corrosion, irradiation tests which simulate blanket environments result in very low PRFs in comparison to laboratory experiments, i.e., <150. It is anticipated from fundamental research activities that the REID enhancement of hydrogen diffusion in oxides may contribute to the lower permeation reduction factors during in-reactor experiments

The barriers and facilitators to smoking cessation experienced by women's partners during pregnancy and the post-partum period: a systematic review of qualitative research.

Science.gov (United States)

Flemming, Kate; Graham, Hilary; McCaughan, Dorothy; Angus, Kathryn; Bauld, Linda

2015-09-03

Smoking in pregnancy can cause substantial harm and, while many women quit, others continue to smoke throughout pregnancy. The role of partners is an important but relatively under-researched factor in relation to women's smoking in pregnancy; partner's smoking status and attitudes to smoking cessation are important influences in a pregnant women's attempt to quit. Further understanding of how partners perceive the barriers and facilitators to smoking cessation in pregnancy is needed, particularly from qualitative studies where participants describe these issues in their own words. A synthesis of qualitative research of partners' views of smoking in pregnancy and post-partum was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2014 using terms for partner/household, pregnancy, post-partum, smoking, qualitative in seven electronic databases. The review was reported in accordance with the 'Enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) statement. Nine studies reported in 14 papers were included, detailing the experience of 158 partners; the majority were interviewed during the post-partum period. Partners were all male, with a single exception. Socioeconomic measures indicated that most participants were socially disadvantaged. The synthesis identified recurring smoking-related perceptions and experiences that hindered (barriers) and encouraged (facilitators) partners to consider quitting during the woman's pregnancy and into the post-partum period. These were represented in five lines of argument relating to: smoking being an integral part of everyday life; becoming and being a father; the couple's relationship; perceptions of the risks of smoking; and their harm reduction and quitting strategies. The cluster of identified barriers and facilitators to quitting offers pointers for policy and practice. The workplace emerges as an important space for and influence on partners' smoking habits

Educational Research Capacity Building in the European Union: A Critique of the Lived Experiences of Emerging Researchers

Science.gov (United States)

Hallet, Fiona; Fidalgo, Patricia

2014-01-01

The purpose of this article is to explore the extent to which European Union (EU) policies impact upon the activities of associations such as the European Educational Research Association (EERA) and the experiences of emerging researchers aligned to such associations. In essence, the authors explore potential tensions between policy and the lived…

Fostering Sustained Learning among Undergraduate Students: Emerging Research and Opportunities

Science.gov (United States)

Chemosit, Caroline; Rugutt, John; Rugutt, Joseph K.

2017-01-01

Keeping students engaged and receptive to learning can, at times, be a challenge. However, by the implementation of new methods and pedagogies, instructors can strengthen the drive to learn among their students. "Fostering Sustained Learning Among Undergraduate Students: Emerging Research and Opportunities" is an essential publication…

The assessment of barriers to research from the viewpoint of faculty members of Lorestan University of Medical Sciences and relationship to research performance of them

Directory of Open Access Journals (Sweden)

farzad Ebrahimzadeh

2016-05-01

Full Text Available Background: The first step in improving research conduction in society can be conceived as identifying the weak points of research. Given that faculty members of universities carry out most of the research activities, the present study attempts to study the relationship between barriers to research from the viewpoint of the faculty members of Lorestan University of Medical Sciences and the research activities of them. Materials and Methods: This cross-sectional study, using census method, assessed all of the faculty members of Lorestan university of medical sciences. A self-administered questionnaire analyzing the faculty members’ demographic variables, knowledge about and attitudes toward barriers to different steps of research was designed and the self-report questionnaires were filled out and their relationship with the annual assessment scores in research criteria were assessed by chi-square, Mann-Whitney and Kruskal-Wallis tests. Results: Variables such as the faculty members’ department, number of their modules, primary motivation for research conduction, knowledge about variables such as research methodologies, searching strategies in medical databases, putting forward proposals, research article writing and also, attitude towards vaiables such as approved research priorities, putting forward proposals, quality of research advice, approval of proposals in research councils,  research facilities, the process of peer review of national scientific articles, presenting papers in conferences and participating in theses were related to the research performance of them (p<0.05. Conclusion: If seems that giving special privileges to the faculty members of faculty of medicine,  those with many modules and those with no optimal knowledge and attitude, we can enhance their motivation to participate in research activities.

Emergence of Qualitative Research in Colombian Psychology: A Beginning that Still Does not End

Directory of Open Access Journals (Sweden)

Jorge Larreamendy-Joerns

2006-09-01

Full Text Available This article deals with the processes of emergence and evolution of qualitative research in psychology in Colombia. Two major arguments are advanced. First, these processes can only be fully understood in the light of the history of psychology in Colombia, and, at the same time, within the context of emergence and consolidation of the social sciences in Colombia. Second, the evolution of qualitative research in North American psychology coincides in some aspects with its corresponding path in Colombian psychology, even though the former exhibits some distinctive features. This article begins with a synthesis of some attempts to divide into historical periods the evolution of qualitative research in the United States. Then, it offers a historical view of psychology in Colombia. Finally, the article proposes three major historical periods to account for the emergence and evolution of qualitative research in our discipline. As a conclusion, the process of development of qualitative research in Colombia is compared to that in the United States and research challenges are proposed for Colombian scholars to address in the years to come. URN: urn:nbn:de:0114-fqs0604317

Experiences of Emerging Economy Firms

DEFF Research Database (Denmark)

Experiences of Emerging Economy Firms investigates the different elements of the experiences of emerging economy firms and sheds essential light on a large variety of aspects associated with their functioning in both home and host contexts. For example, firms must be able to overcome the liability...... of foreign and emerging issues when they expand their activities in various contexts, enter, exit, and re-enter overseas markets; they have to overcome institutional barriers, adapt the cultural challenges in foreign markets, undergo the impact of large multinational firms from developed economies...

Environmental Justice Research: Contemporary Issues and Emerging Topics.

Science.gov (United States)

Chakraborty, Jayajit; Collins, Timothy W; Grineski, Sara E

2016-11-01

Environmental justice (EJ) research seeks to document and redress the disproportionate environmental burdens and benefits associated with social inequalities. Although its initial focus was on disparities in exposure to anthropogenic pollution, the scope of EJ research has expanded. In the context of intensifying social inequalities and environmental problems, there is a need to further strengthen the EJ research framework and diversify its application. This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) incorporates 19 articles that broaden EJ research by considering emerging topics such as energy, food, drinking water, flooding, sustainability, and gender dynamics, including issues in Canada, the UK, and Eastern Europe. Additionally, the articles contribute to three research themes: (1) documenting connections between unjust environmental exposures and health impacts by examining unsafe infrastructure, substance use, and children's obesity and academic performance; (2) promoting and achieving EJ by implementing interventions to improve environmental knowledge and health, identifying avenues for sustainable community change, and incorporating EJ metrics in government programs; and (3) clarifying stakeholder perceptions of EJ issues to extend research beyond the documentation of unjust conditions and processes. Collectively, the articles highlight potentially compounding injustices and an array of approaches being employed to achieve EJ.

Environmental Justice Research: Contemporary Issues and Emerging Topics

Directory of Open Access Journals (Sweden)

Jayajit Chakraborty

2016-11-01

Full Text Available Environmental justice (EJ research seeks to document and redress the disproportionate environmental burdens and benefits associated with social inequalities. Although its initial focus was on disparities in exposure to anthropogenic pollution, the scope of EJ research has expanded. In the context of intensifying social inequalities and environmental problems, there is a need to further strengthen the EJ research framework and diversify its application. This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH incorporates 19 articles that broaden EJ research by considering emerging topics such as energy, food, drinking water, flooding, sustainability, and gender dynamics, including issues in Canada, the UK, and Eastern Europe. Additionally, the articles contribute to three research themes: (1 documenting connections between unjust environmental exposures and health impacts by examining unsafe infrastructure, substance use, and children’s obesity and academic performance; (2 promoting and achieving EJ by implementing interventions to improve environmental knowledge and health, identifying avenues for sustainable community change, and incorporating EJ metrics in government programs; and (3 clarifying stakeholder perceptions of EJ issues to extend research beyond the documentation of unjust conditions and processes. Collectively, the articles highlight potentially compounding injustices and an array of approaches being employed to achieve EJ.

Identifying climate risk perceptions, information needs, and barriers to information exchange among public land managers.

Science.gov (United States)

Peters, Casey B; Schwartz, Mark W; Lubell, Mark N

2018-03-01

Meeting ecosystem management challenges posed by climate change requires building effective communication channels among researchers, planners and practitioners to focus research on management issues requiring new knowledge. We surveyed resource managers within two regions of the western United States regions to better understand perceived risks and vulnerabilities associated with climate change and barriers to obtaining and using relevant climate science information in making ecosystem management decisions. We sought to understand what types of climate science information resource managers find most valuable, and the formats in which they prefer to receive climate science information. We found broad concern among natural resource managers in federal agencies that climate change will make it more difficult for them to achieve their management goals. Primary barriers to incorporating climate science into planning are distributed among challenges identifying, receiving, and interpreting appropriate science and a lack of direction provided by agency leadership needed to meaningfully use this emerging science in resource planning. Copyright © 2017 Elsevier B.V. All rights reserved.

International Conference on Emerging Research in Electronics, Computer Science and Technology

CERN Document Server

Sheshadri, Holalu; Padma, M

2014-01-01

PES College of Engineering is organizing an International Conference on Emerging Research in Electronics, Computer Science and Technology (ICERECT-12) in Mandya and merging the event with Golden Jubilee of the Institute. The Proceedings of the Conference presents high quality, peer reviewed articles from the field of Electronics, Computer Science and Technology. The book is a compilation of research papers from the cutting-edge technologies and it is targeted towards the scientific community actively involved in research activities.

TPACK: An Emerging Research and Development Tool for Teacher Educators

Science.gov (United States)

Baran, Evrim; Chuang, Hsueh-Hua; Thompson, Ann

2011-01-01

TPACK (technological pedagogical content knowledge) has emerged as a clear and useful construct for researchers working to understand technology integration in learning and teaching. Whereas first generation TPACK work focused upon explaining and interpreting the construct, TPACK has now entered a second generation where the focus is upon using…

Engineered barriers: current status

International Nuclear Information System (INIS)

Atkinson, A.; Marsh, G.P.

1988-01-01

This report summarises the current state of research relevant to assessing the performance of engineered barriers made of steel and concrete in radioactive waste repositories. The objective of these barriers is to contain the radionuclides within them by providing both physical and chemical impediment to their release. The physical barriers are of most value for highly soluble isotopes with relatively short half-lives (eg 137 Cs), since they can provide containment until a large fraction of the activity has decayed. In addition they can facilitate retrievability for some period after disposal. The chemical barriers operate by beneficial conditioning of the near field groundwater and providing sites for sorption of radionuclides. Both of these reduce the aqueous concentration of radionuclides in the near field. (author)

An hypnotic suggestion: review of hypnosis for clinical emergency care.

Science.gov (United States)

Iserson, Kenneth V

2014-04-01

Hypnosis has been used in medicine for nearly 250 years. Yet, emergency clinicians rarely use it in emergency departments or prehospital settings. This review describes hypnosis, its historical use in medicine, several neurophysiologic studies of the procedure, its uses and potential uses in emergency care, and a simple technique for inducing hypnosis. It also discusses reasons why the technique has not been widely adopted, and suggests methods of increasing its use in emergency care, including some potential research areas. A limited number of clinical studies and case reports suggest that hypnosis may be effective in a wide variety of conditions applicable to emergency medical care. These include providing analgesia for existing pain (e.g., fractures, burns, and lacerations), providing analgesia and sedation for painful procedures (e.g., needle sticks, laceration repair, and fracture and joint reductions), reducing acute anxiety, increasing children's cooperation for procedures, facilitating the diagnosis and treatment of acute psychiatric conditions, and providing analgesia and anxiolysis for obstetric/gynecologic problems. Although it is safe, fast, and cost-effective, emergency clinicians rarely use hypnosis. This is due, in part, to the myths surrounding hypnosis and its association with alternative-complementary medicine. Genuine barriers to its increased clinical use include a lack of assured effectiveness and a lack of training and training requirements. Based on the results of further research, hypnosis could become a powerful and safe nonpharmacologic addition to the emergency clinician's armamentarium, with the potential to enhance patient care in emergency medicine, prehospital care, and remote medical settings. Copyright © 2014 Elsevier Inc. All rights reserved.

The barriers associated with emergency medical service use for acute coronary syndrome: the awareness and influence of an Australian public mass media campaign.

Science.gov (United States)

Cartledge, Susie; Finn, Judith; Straney, Lahn; Ngu, Phillip; Stub, Dion; Patsamanis, Harry; Shaw, James; Bray, Janet

2017-07-01

Emergency medical services (EMS) transport to hospital is recommended in acute coronary syndrome (ACS) guidelines, but only half of patients with ACS currently use EMS. The recent Australian Warning Signs campaign conducted by the Heart Foundation addressed some of the known barriers against using EMS. Our aim was to examine the influence of awareness of the campaign on these barriers in patients with ACS. Interviews were conducted with patients admitted to an Australian tertiary hospital between July 2013 and April 2014 with a diagnosis of ACS. Patient selection criteria included: aged 35-75 years, competent to provide consent, English speaking, not in residential care and medically stable. Multivariable logistic regression was used to examine factors associated with EMS use. Only 54% of the 199 patients with ACS interviewed used EMS for transport to hospital. Overall 64% of patients recalled seeing the campaign advertising, but this was not associated with increased EMS use (52.0%vs56.9%, p=0.49) or in the barriers against using EMS. A large proportion of patients (43%) using other transport thought it would be faster. Factors associated with EMS use for ACS were: age >65 years, ST-elevation myocardial infarction, a sudden onset of pain and experiencing vomiting. In medically stable patients with ACS, awareness of the Australian Warning Signs campaign was not associated with increased use of EMS or a change in the barriers for EMS use. Future education strategies could emphasise the clinical role that EMS provide in ACS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

In-depth Review of Partnering Research Trends in Construction Journals

DEFF Research Database (Denmark)

Bohnstedt, Kristian Ditlev; Rasmussen, Arne P.; Faber, Lene

2017-01-01

Significant literature has been dedicated to research on partnering in construction, and a plethora of underlying theories and industrial practices on partnering application have been reported. The aim is to analyze and summarize the research trend of partnering research from leading construction...... shows that research on development and application of partnering is becoming moderately mature as exemplified by a decreasing amount of published papers after 2007, on the other hand, research on trust; feasibility; advantages; inducements of implementation and barriers to implementation is emerging...

Analysis of the Research Status and Topics on the Radionuclide Migration and Retardation in Natural Barriers

International Nuclear Information System (INIS)

Baik, Min Hoon; Park, Chung Kyun; Kim, Seung Soo; Lee, Seung Yeop; Lee, Jae Kwang

2008-12-01

In this report, recent research status for major developed countries in the high-level radioactive waste disposal including international organizations was investigated and analyzed in research topics for the radionuclide migration and retardation in natural barriers. Besides, recent research trends and future prospects were investigated for selected major 10 topics about the radionuclide migration and retardation processes. Based upon these investigations and analyses, future research goals and topics to be concentrated were presented. This report will be helpful for understanding our current research status and technical position and establishing future research direction and topics by analyzing domestic and foreign research status and trends. The results will also be utilized as basic information for establishing future policy and plans of the government for the high-level radioactive waste disposal

Analysis of the Research Status and Topics on the Radionuclide Migration and Retardation in Natural Barriers

Energy Technology Data Exchange (ETDEWEB)

Baik, Min Hoon; Park, Chung Kyun; Kim, Seung Soo; Lee, Seung Yeop; Lee, Jae Kwang [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2008-12-15

In this report, recent research status for major developed countries in the high-level radioactive waste disposal including international organizations was investigated and analyzed in research topics for the radionuclide migration and retardation in natural barriers. Besides, recent research trends and future prospects were investigated for selected major 10 topics about the radionuclide migration and retardation processes. Based upon these investigations and analyses, future research goals and topics to be concentrated were presented. This report will be helpful for understanding our current research status and technical position and establishing future research direction and topics by analyzing domestic and foreign research status and trends. The results will also be utilized as basic information for establishing future policy and plans of the government for the high-level radioactive waste disposal.

Emergent Themes from Recent Research Syntheses in Science Education and Their Implications for Research Design, Replication, and Reporting Practices

Science.gov (United States)

Taylor, Joseph; Furtak, Erin; Kowalski, Susan; Martinez, Alina; Slavin, Robert; Stuhlsatz, Molly; Wilson, Christopher

2016-01-01

This article draws upon the experiences of four recent efforts to synthesize the findings of quantitative studies in science education research. After establishing the need for research syntheses in advancing generalizable knowledge and causal effects research in our field, we identify a set themes that emerged in the process of conducting these…

Barriers and Facilitators of Prostate Cancer Screening among Filipino Men in Hawai’i

Science.gov (United States)

Conde, Francisco A.; Landier, Wendy; Ishida, Dianne; Bell, Rose; Cuaresma, Charlene F.; Misola, Jane

2013-01-01

Purpose/Objectives To examine perceptions, attitudes, and beliefs regarding barriers and facilitators to prostate cancer screening, and to identify potential interventional strategies to promote prostate cancer screening among Filipino men in Hawai’i. Design Exploratory, qualitative. Setting Community-based settings in Hawai’i. Sample 20 Filipino men, 40 years old or older Methods Focus group discussions were tape-recorded, transcribed, and content analysis performed for emergent themes. Main Research Variables Perceptions regarding prostate cancer, barriers and facilitators to prostate cancer screening, and culturally-relevant interventional strategies Findings Perceptions of prostate cancer included fatalism, hopelessness, and dread. Misconceptions regarding causes of prostate cancer, such as frequency of sexual activity, were identified. Barriers to prostate cancer screening included lack of awareness of the need for screening, reticence to seek healthcare when feeling well, fear of cancer diagnosis, financial issues, time constraints, and embarrassment. Presence of urinary symptoms, personal experience with family or friend who had cancer, and receiving recommendations from a healthcare provider regarding screening were facilitators for screening. Potential culturally-relevant interventional strategies to promote prostate cancer screening included screening recommendations from health professionals and cancer survivors; radio/television commercials and newspaper articles targeted to the Filipino community; informational brochures in Tagalog, Ilocano and/or English; and interactive, educational forums facilitated by Filipino multilingual, male healthcare professionals. Conclusions Culturally-relevant interventions are needed that address barriers to prostate cancer screening participation and misconceptions about causes of prostate cancer. Implications for Nursing Findings provide a foundation for future research regarding development of interventional

Factors Related to the Adoption of IT Emerging Technologies by Research and Non-Research Based Higher Education Institutions

Science.gov (United States)

Then, Keri Ann; Amaria, Pesi

2013-01-01

This study examined the adoption of information technology (IT) emerging technology by higher education institutions with a focus on non-research and research based institutions categorized by Carnegie Mellon classifications that are members of EDUCAUSE, a higher education non-profit organization, whose mission is the use of IT in higher…

Standard review plan for the review and evaluation of emergency plans for research and test reactors

International Nuclear Information System (INIS)

1983-10-01

This document provides a Standard Review Plan to assure that complete and uniform reviews are made of research and test reactor radiological emergency plans. The report is organized under ten planning standards which correspond to the guidance criteria in American National Standard ANSI/ANS 15.16 - 1982 as endorsed by Revision 1 to Regulatory Guide 2.6. The applicability of the items under each planning standard is indicated by subdivisions of the steady-state thermal power levels at which the reactors are licensed to operate. Standard emergency classes and example action levels for research and test reactors which should initiate these classes are given in an Appendix. The content of the emergency plan is as follows: the emergency plan addresses the necessary provisions for coping with radiological emergencies. Activation of the emergency plan is in response to the emergency action levels. In addition to addressing those severe emergencies that will fall within one of the standard emergency classes, the plan also discusses the necessary provisions to deal with radiological emergencies of lesser severity that can occur within the operations boundary. The emergency plan allows for emergency personnel to deviate from actions described in the plan for unusual or unanticipated conditions

Family presence during resuscitation (FPDR): Perceived benefits, barriers and enablers to implementation and practice.

Science.gov (United States)

Porter, Joanne E; Cooper, Simon J; Sellick, Ken

2014-04-01

There are a number of perceived benefits and barriers to family presence during resuscitation (FPDR) in the emergency department, and debate continues among health professionals regarding the practice of family presence. This review of the literature aims to develop an understanding of the perceived benefits, barriers and enablers to implementing and practicing FPDR in the emergency department. The perceived benefits include; helping with the grieving process; everything possible was done, facilitates closure and healing and provides guidance and family understanding and allows relatives to recognise efforts. The perceived barriers included; increased stress and anxiety, distracted by relatives, fear of litigation, traumatic experience and family interference. There were four sub themes that emerged from the literature around the enablers of FPDR, these included; the need for a designated support person, the importance of training and education for staff and the development of a formal policy within the emergency department to inform practice. In order to ensure that practice of FPDR becomes consistent, emergency personnel need to understand the need for advanced FPDR training and education, the importance of a designated support person role and the evidence of FPDR policy as enablers to implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

The economic role of the Emergency Department in the health care continuum: applying Michael Porter's five forces model to Emergency Medicine.

Science.gov (United States)

Pines, Jesse M

2006-05-01

Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.

Emerging medical informatics research trends detection based on MeSH terms.

Science.gov (United States)

Lyu, Peng-Hui; Yao, Qiang; Mao, Jin; Zhang, Shi-Jing

2015-01-01

The aim of this study is to analyze the research trends of medical informatics over the last 12 years. A new method based on MeSH terms was proposed to identify emerging topics and trends of medical informatics research. Informetric methods and visualization technologies were applied to investigate research trends of medical informatics. The metric of perspective factor (PF) embedding MeSH terms was appropriately employed to assess the perspective quality for journals. The emerging MeSH terms have changed dramatically over the last 12 years, identifying two stages of medical informatics: the "medical imaging stage" and the "medical informatics stage". The focus of medical informatics has shifted from acquisition and storage of healthcare data by integrating computational, informational, cognitive and organizational sciences to semantic analysis for problem solving and clinical decision-making. About 30 core journals were determined by Bradford's Law in the last 3 years in this area. These journals, with high PF values, have relative high perspective quality and lead the trend of medical informatics.

Barriers to female sex addiction treatment in the UK.

Science.gov (United States)

Dhuffar, Manpreet K; Griffiths, Mark D

2016-12-01

Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.

Comments on the current status and possible future directions of research on heavy-ion interactions near the Coulomb barrier

International Nuclear Information System (INIS)

Satchler, G.R.

1990-01-01

This paper contains comments on the current status and possible future directions of research on heavy-ion interactions near the Coulomb barrier. Fusion reactions, elastic and inelastic scattering and transfer reactions are discussed

Barriers in the management of cancer-related pain and strategies to overcome them: findings of a qualitative research involving physicians and nurses in Italy

Directory of Open Access Journals (Sweden)

Cesarina Prandi

2015-03-01

Full Text Available Introduction and aims. There are many barriers and obstacles that even today lead to an inadequate treatment of cancer-related pain. The aim is to describe the experiences of a group of Italian physicians and nurses as far as the nature of these barriers is concerned and the possible tools to be used to overcome them. Material and method. We run 5 focus groups with 42 healthcare professionals (11 physicians, 31 nurses working in 5 hospitals in Italy. The findings of the focus groups were analysed according to the “Content Analysis” method. Results. Five main items emerged: the importance of communication, the need for education regarding pain therapy, the ethnic/cultural/religious differences, the mutual trust and support within the working group, the daily challenges. Conclusion. In harmony with the most recent literature, physicians and nurses voice above all their need for an education more directly aimed at overcoming the prevailing barriers rooted in ignorance, prejudice and fears.

On-site and off-site emergency planning at Cekmece Nuclear Research and Training Centre

International Nuclear Information System (INIS)

Soyberk, O.A.

1986-01-01

An emergency plan was prepared for minimizing the consequences of any unforeseen radiation accident in Cekmece Nuclear Research and Training Centre (CNAEM) in Istanbul, Turkey. CNAEM is situated near Kucukcekmece Lake, which is about 30 km to the west of Istanbul. It includes two pool-type research reactors of 1 MW(th) and 5 MW(th). The population in the nearest inhabited areas varies from 1000 to 50,000. Accidents are classified, according to their severity, into three categories at CNAEM: (a) local emergency, (b) on-site emergency, (c) off-site emergency. During local emergency situations evacuation is not necessary. An on-site emergency situation requires the evacuation of personnel from the plant. Personnel hearing the emergency alarm should move directly to the preselected place as soon as possible. An off-site emergency is any accident that leads to widespread contamination outside the boundary. In this situation the Turkish Atomic Energy Authority and governmental authorities are notified immediately. The emergency organization group consists of: (a) Plant Superintendent, (b) Emergency Director, (c) Reactor Supervisor, (d) Senior Health Physicist, (e) Reactor Shift Operator, (f) Health Physicists. The administration building will be used as the Emergency Control Centre. The emergency teams working under the direction of the Emergency Director consist of: (a) Health Physics, (b) Fire and Rescue, (c) First Aid and Decontamination, (d) Transportation, (e) Security and Patrol. The emergency situation is evaluated in three phases at CNAEM. The first phase is the first few hours after the beginning of the accident. The second phase is between 8-10 hours or more following the first phase. The third phase is the recovery phase. The integrated doses over periods of two hours and two days are calculated according to the situation of the core, i.e. total or partial melting, and weather conditions. The results of the calculated parameters can be adapted to possible

Tutorials on emerging methodologies and applications in operations research

CERN Document Server

2005-01-01

Operations Research emerged as a quantitative approach to problem-solving in World War II. Its founders, who were physicists, mathematicians, and engineers, quickly found peace-time uses for this new field. Moreover, we can say that Operations Research (OR) was born in the same incubator as computer science, and through the years, it has spawned many new disciplines, including systems engineering, health care management, and transportation science. Fundamentally, Operations Research crosses discipline domains to seek solutions on a range of problems and benefits diverse disciplines from finance to bioengineering. Many disciplines routinely use OR methods. Many scientific researchers, engineers, and others will find the methodological presentations in this book useful and helpful in their problem-solving efforts. OR’s strengths are modeling, analysis, and algorithm design. It provides a quantitative foundation for a broad spectrum of problems, from economics to medicine, from environmental control to sports,...

Regional differences as barriers to body mass index screening described by Ohio school nurses.

Science.gov (United States)

Stalter, Ann M; Chaudry, Rosemary V; Polivka, Barbara J

2011-08-01

Body mass index (BMI) screening is advocated by the National Association of School Nurses (NASN). Research identifying barriers to BMI screening in public elementary school settings has been sparse. The purpose of the study was to identify barriers and facilitating factors of BMI screening practices among Ohio school nurses working in suburban, rural, and urban public elementary schools. This descriptive study used focus groups with 25 school nurses in 3 geographic regions of Ohio. An adapted Healthy People 2010 model guided the development of semistructured focus group questions. Nine regional themes related to BMI screening emerged specific to suburban, rural, and/or urban school nurses' experiences with BMI screening practice, policy, school physical environment, school social environment, school risk/protection, and access to quality health care. Key facilitating factors to BMI screening varied by region. Key barriers to BMI screening were a lack of privacy, time, policy, and workload of school nurses. Regionally specific facilitating factors to BMI screening in schools provide opportunities for schools to accentuate the positive and to promote school health. © 2011, American School Health Association.

Breastfeeding: What are the Barriers? Why Women Struggle to Achieve Their Goals.

Science.gov (United States)

Sriraman, Natasha K; Kellams, Ann

2016-07-01

Despite recognized health benefits for both mothers and infants, significant disparities still exist in the rates of breastfeeding in the United States. Major organizations representing the health of women and children (including the Centers for Disease Control and Prevention [CDC], American Academy of Pediatrics [AAP], American Congress of Obstetrics and Gynecology [ACOG], American Academy of Family Physicians [AAFP], United Nations International Children's Emergency Fund (UNICEF), the World Health Organization [WHO], and the United States Public Health Service [PHS]) recommend exclusive breastfeeding, but statistics show that although many women initiate breastfeeding, few meet the recommended goals for duration and exclusivity. This article reviews the evidence related to barriers (prenatal, medical, societal, hospital, and sociocultural) that many mothers face, and explore the known barriers and the impact they have on a woman's ability to breastfeed her infant. Strategies will be discussed to address (and potentially overcome) some of the most common barriers women face along with a list of resources that can be useful in this effort. Gaps in care and areas that need further research will be noted. This article is targeted toward physicians and other healthcare providers who work with women and who can assist with and advocate for the removal of barriers and thereby improve the health of women and children by increasing the rates of breastfeeding initiation, duration, and exclusivity in the United States.

Qualitative evaluation of a deferred consent process in paediatric emergency research: a PREDICT study.

Science.gov (United States)

Furyk, Jeremy; McBain-Rigg, Kristin; Watt, Kerrianne; Emeto, Theophilus I; Franklin, Richard C; Franklin, Donna; Schibler, Andreas; Dalziel, Stuart R; Babl, Franz E; Wilson, Catherine; Phillips, Natalie; Ray, Robin

2017-11-15

A challenge of conducting research in critically ill children is that the therapeutic window for the intervention may be too short to seek informed consent prior to enrolment. In specific circumstances, most international ethical guidelines allow for children to be enrolled in research with informed consent obtained later, termed deferred consent (DC) or retrospective consent. There is a paucity of data on the attitudes of parents to this method of enrolment in paediatric emergency research. To explore the attitudes of parents to the concept of DC and to expand the knowledge of the limitations to informed consent and DC in these situations. Children presenting with uncomplicated febrile seizures or bronchiolitis were identified from three separate hospital emergency department databases. Parents were invited to participate in a semistructured telephone interview exploring themes of limitations of prospective informed consent, acceptability of the DC process and the most appropriate time to seek DC. Transcripts underwent inductive thematic analysis with intercoder agreement, using Nvivo 11 software. A total of 39 interviews were conducted. Participants comprehended the limitations of informed consent under emergency circumstances and were generally supportive of DC. However, they frequently confused concepts of clinical care and research, and support for participation was commonly linked to their belief of personal benefit. Participants acknowledged the requirement for alternatives to prospective informed consent in emergency research, and were supportive of the concept of DC. Our results suggest that current research practice seems to align with community expectations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Defining European preparedness and research needs regarding emerging infectious animal diseases: results from a Delphi expert consultation.

Science.gov (United States)

Wentholt, M T A; Cardoen, S; Imberechts, H; Van Huffel, X; Ooms, B W; Frewer, L J

2012-02-01

Emerging and major infectious animal diseases can have significant international impact on social, economic and environmental level, and are being driven by various factors. Prevention and control measures should be prepared at both national and international level to mitigate these disease risks. Research to support such policy development is mostly carried out at national level and dedicated transnational research programmes are still in its infancy. This research reports on part of a process to develop a common strategic research agenda on emerging and major infectious diseases of livestock in Europe, covering a 5-15-year time span. A two round online Delphi study was conducted to explore the views of experts on issues relating to research needs on emerging infectious diseases of livestock in Europe. Drivers that may influence the incidence of emerging infectious animal diseases in both the short (next 5 years) and medium term (10-15 years) were identified. Drivers related to regulatory measures and biological science developments were thought to decrease the incidence, and socio-economic factors to increase the incidence of emerging infectious animal diseases. From the first round a list of threats to animal health was compiled and participants combined these threats with relevant drivers in the second round. Next to identifying threats to animal health, also possible mitigatory actions to reduce the negative impact of these threats were identified. Participants emphasised that interdisciplinary research is needed to understand drivers of emerging infectious animal diseases, as well as to develop prevention and control measures which are both socio-economic and technical. From this it can be concluded that interdisciplinary research combining both natural and social research themes is required. Some of the European member states research budget needs to be allocated so that effective prevention and mitigation strategies can be developed. Copyright © 2011

Creatiing a Collaborative Research Network for Scientists

Science.gov (United States)

Gunn, W.

2012-12-01

This abstract proposes a discussion of how professional science communication and scientific cooperation can become more efficient through the use of modern social network technology, using the example of Mendeley. Mendeley is a research workflow and collaboration tool which crowdsources real-time research trend information and semantic annotations of research papers in a central data store, thereby creating a "social research network" that is emergent from the research data added to the platform. We describe how Mendeley's model can overcome barriers for collaboration by turning research papers into social objects, making academic data publicly available via an open API, and promoting more efficient collaboration. Central to the success of Mendeley has been the creation of a tool that works for the researcher without the requirement of being part of an explicit social network. Mendeley automatically extracts metadata from research papers, and allows a researcher to annotate, tag and organize their research collection. The tool integrates with the paper writing workflow and provides advanced collaboration options, thus significantly improving researchers' productivity. By anonymously aggregating usage data, Mendeley enables the emergence of social metrics and real-time usage stats on top of the articles' abstract metadata. In this way a social network of collaborators, and people genuinely interested in content, emerges. By building this research network around the article as the social object, a social layer of direct relevance to academia emerges. As science, particularly Earth sciences with their large shared resources, become more and more global, the management and coordination of research is more and more dependent on technology to support these distributed collaborations.

Research on environmental impacts of nuclear power and emergency preparedness

International Nuclear Information System (INIS)

Vuori, S.

1994-01-01

The future needs of nuclear energy research in Finland have been recently reviewed by an expert group. Concerning the research on environmental impacts and emergency preparedness, the group recommended the establishment of a common coordination group for the different projects in this field. The main objectives in this field include efficient accident management and mitigation of off-site consequences with appropriate countermeasures and more reliable real time prediction tools for atmospheric dispersion and radiation dose evaluations as well as efficient and fast real time surveillance and measurement systems. (orig.)

Can emergency medicine research benefit from adaptive design clinical trials?

Science.gov (United States)

Flight, Laura; Julious, Steven A; Goodacre, Steve

2017-04-01

Adaptive design clinical trials use preplanned interim analyses to determine whether studies should be stopped or modified before recruitment is complete. Emergency medicine trials are well suited to these designs as many have a short time to primary outcome relative to the length of recruitment. We hypothesised that the majority of published emergency medicine trials have the potential to use a simple adaptive trial design. We reviewed clinical trials published in three emergency medicine journals between January 2003 and December 2013. We determined the proportion that used an adaptive design as well as the proportion that could have used a simple adaptive design based on the time to primary outcome and length of recruitment. Only 19 of 188 trials included in the review were considered to have used an adaptive trial design. A total of 154/165 trials that were fixed in design had the potential to use an adaptive design. Currently, there seems to be limited uptake in the use of adaptive trial designs in emergency medicine despite their potential benefits to save time and resources. Failing to take advantage of adaptive designs could be costly to patients and research. It is recommended that where practical and logistical considerations allow, adaptive designs should be used for all emergency medicine clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Understanding the value of mixed methods research: the Children’s Safety Initiative-Emergency Medical Services

Science.gov (United States)

Hansen, Matthew; O’Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

2016-01-01

Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children’s Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. PMID:26949970

Barriers to nurse-patient communication in cardiac surgery wards: a qualitative study.

Science.gov (United States)

Shafipour, Vida; Mohammad, Eesa; Ahmadi, Fazlollah

2014-08-15

An appropriate and effective nurse-patient communication is of the most important aspect of caring. The formation and continuation of such a relationship depends on various factors such as the conditions and context of communication and a mutual understanding between the two. A review of the literature shows that little research is carried out on identification of such barriers in hospital wards between the patients and the healthcare staff. The present study was therefore conducted to explore the experiences of nurses and patients on communication barriers in hospital cardiac surgery wards. This qualitative research was carried out using a content analysis method (Graneheim & Lundman, 2004). The participants were selected by a purposeful sampling and consist of 10 nurses and 11 patients from the cardiac surgery wards of three teaching hospitals in Tehran, Iran. Data was gathered by unstructured interviews. All interviews were audio-taped and transcribed verbatim. Findings were emerged in three main themes including job dissatisfaction (with the sub-themes of workload tension and decreased motivation), routine-centered care (with the sub-themes of habitual interventions, routinized and technical interventions, and objective supervision), and distrust in competency of nurses (with the sub-themes of cultural contrast, less responsible nurses, and their apathy towards the patients). Compared to other studies, our findings identified different types of communication barriers depending on the nursing settings. These findings can be used by the ward clinical nursing managers at cardiac surgery wards to improve the quality of nursing care.

Feasibility study of tank leakage mitigation using subsurface barriers

International Nuclear Information System (INIS)

Treat, R.L.; Peters, B.B.; Cameron, R.J.; McCormak, W.D.; Trenkler, T.; Walters, M.F.; Rouse, J.K.; McLaughlin, T.J.; Cruse, J.M.

1994-01-01

The US Department of Energy (DOE) has established the Tank Waste Remediation System (TWRS) to satisfy manage and dispose of the waste currently stored in the underground storage tanks. The retrieval element of TWRS includes a work scope to develop subsurface impermeable barriers beneath SSTs. The barriers could serve as a means to contain leakage that may result from waste retrieval operations and could also support site closure activities by facilitating cleanup. Three types of subsurface barrier systems have emerged for further consideration: (1) chemical grout, (2) freeze walls, and (3) desiccant, represented in this feasibility study as a circulating air barrier. This report contains analyses of the costs and relative risks associated with combinations retrieval technologies and barrier technologies that from 14 alternatives. Eight of the alternatives include the use of subsurface barriers; the remaining six nonbarrier alternative are included in order to compare the costs, relative risks and other values of retrieval with subsurface barriers. Each alternative includes various combinations of technologies that can impact the risks associated with future contamination of the groundwater beneath the Hanford Site to varying degrees. Other potential risks associated with these alternatives, such as those related to accidents and airborne contamination resulting from retrieval and barrier emplacement operations, are not quantitatively evaluated in this report

Social workers' perceptions of barriers to interpersonal therapy implementation for treating postpartum depression in a primary care setting in Israel.

Science.gov (United States)

Bina, Rena; Barak, Adi; Posmontier, Barbara; Glasser, Saralee; Cinamon, Tali

2018-01-01

Research on evidence-based practice (EBP) implementation in social work often neglects to include evaluation of application barriers. This qualitative study examined social workers' perspectives of provider- and organisational-related barriers to implementing a brief eight-session interpersonal therapy (IPT) intervention, a time-limited EBP that addresses reducing depressive symptoms and improving interpersonal functioning. Implementation took place in a primary care setting in Israel and was aimed at treating women who have postpartum depression (PPD) symptoms. Using purposeful sampling, 25 primary care licensed social workers were interviewed between IPT training and implementation regarding their perceived barriers to implementing IPT in practice. Data analysis was facilitated using a phenomenological approach, which entails identifying the shared themes and shared experiences of research participants regarding barriers to implementing IPT. Three themes emerged from the analysis of interviews: Perceived lack of flexibility of IPT intervention in comparison with more familiar methods social workers previously applied, specifically regarding the number of sessions and therapeutic topics included in the IPT protocol; insecurity and hesitance to gain experience with a new method of intervention; and organisational barriers, including difficulties with referrals, the perception of HMOs as health facilities not suitable for therapy, and time constraints. Addressing perceived barriers of social workers toward implementing EBPs, such as IPT for postpartum depression, during the training phase is crucial for enabling appropriate implementation. Future training should include examining practitioners' attitudes toward implementation of EBPs, as part of standardised training protocols. © 2017 John Wiley & Sons Ltd.

Barriers Against Implementing Blunt Abdominal Trauma Guidelines in a Hospital: A Qualitative Study.

Science.gov (United States)

Zaboli, Rouhollah; Tofighi, Shahram; Aghighi, Ali; Shokouh, Seyyed Javad Hosaini; Naraghi, Nader; Goodarzi, Hassan

2016-08-01

Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital. This study was conducted as a qualitative and phenomenology study in the Family Hospital in Tehran (Iran) in 2015. The research population included eight experts and key people in the area of blunt abdominal trauma clinical practice guidelines. Sampling was based on purposive and nonrandom methods. A semistructured interview was done for the data collection. A framework method was applied for the data analysis by using Atlas.ti software. After framework analyzing and various reviewing and deleting and combining the codes from 251 codes obtained, 15 families and five super families were extracted, including technical knowledge barriers, economical barriers, barriers related to deployment and monitoring, political will barriers, and managing barriers. Structural reform is needed for eliminating the defects available in the healthcare system. As with most of the codes, subconcepts and concepts are classified into the field of human resources; it seems that the education and knowledge will be more important than other resources such as capital and equipment.

Permeable Reactive Barriers: a multidisciplinary approach of a new emerging sustainable groundwater treatment technology

Energy Technology Data Exchange (ETDEWEB)

Diels, L.; Bastiaens, L. [Vito, Mol (BL); O' Hannessin, S. [EnviroMetal Technologies Inc., Ontario (Canada); Cortina, J.L. [Univ. Politecnica de Catalunya, Barcelona (Spain). Dept. d' Enginyeria Quimica; Alvarez, P.J. [Univ. of Iowa, Iowa-City (United States). Center for Biocatalysis and Bioprocessing; Ebert, M. [Christian-Albrechts Univ. Kiel (Germany). Inst. fuer Geowissenschaften; Schad, H. [I.M.E.S. GmbH, Amtzell (Germany)

2003-07-01

Permeable reactive barriers or zones are becoming an interesting sustainable and cost-effective technology for in situ treatment of contaminated groundwater. The technology is based on chemical processes as the dehalogenating activity of zerovalent iron, biological processes in bioscreens or reactive zones and on sorption technology (e.g. heavy metal adsorption or adsorption on granular activated carbon). Three technical sessions will be devoted to this nowadays becoming mature technology. This special session intends to pay attention to the discussion about some questions related to PRBs. These include the sustainability (e.g. life time and clogging) especially for zerovalent iron barriers, the need and quality of feasibility tests, drawbacks and restrictions of PRBs. Combined with long term performance monitoring os these systems will be discussed. Further attention will be paid to cost evaluation and the relationship between zerovalent barriers and bacterial growth. Also attention will be paid to new reactive materials (e.g. activated carbon for organics and inorganic materials for heavy metals) and consequences (e.g. environmental impact). Finally the session will combine al these approaches in a discussion about combined barriers or multibarriers for treatment of mixed pollution (e.g. landfill leachates contaminated groundwater). Specialists involved in these subjects will introduce these topics and allow for a large and intensive discussion to improve future applications of this technology. (orig.)

Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services.

Science.gov (United States)

Hansen, Matthew; O'Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

2016-07-01

Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children's Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Barriers and opportunities for integrating social science into natural resource management: lessons from National Estuarine Research Reserves.

Science.gov (United States)

Robinson, Patrick; Genskow, Ken; Shaw, Bret; Shepard, Robin

2012-12-01

The need for cross-disciplinary scientific inquiries that facilitate improved natural resource management outcomes through increased understanding of both the biophysical and human dimensions of management issues has been widely recognized. Despite this broad recognition, a number of obstacles and barriers still sometimes challenge the successful implementation of cross-disciplinary approaches. Improving understanding of these challenges and barriers will help address them and thereby foster appropriate and effective utilization of cross-disciplinary approaches to solve natural resource management challenges. This research uses a case study analysis of the United States National Estuarine Research Reserve System to improve understanding of the critical factors that influence practitioners' decisions related to incorporating social science into their natural resource management work. The case study research is analyzed and evaluated within a Theory of Planned Behavior framework to (1) determine and describe the factors that predict practitioners' intent to incorporate social science into their natural resource related activities and (2) recommend potential strategies for encouraging and enabling cross-disciplinary approaches to natural resource management. The results indicate that National Estuarine Research Reserve practitioners' decisions related to incorporating social science are primarily influenced by (1) confidence in their own capability to incorporate social science into their work and (2) beliefs about whether the outcomes of incorporating social science into their work would be valuable or beneficial.

Global health and emergency care: a resuscitation research agenda--part 1

NARCIS (Netherlands)

Aufderheide, Tom P.; Nolan, Jerry P.; Jacobs, Ian G.; van Belle, Gerald; Bobrow, Bentley J.; Marshall, John; Finn, Judith; Becker, Lance B.; Bottiger, Bernd; Cameron, Peter; Drajer, Saul; Jung, Julianna J.; Kloeck, Walter; Koster, Rudolph W.; Huei-Ming Ma, Matthew; Shin, Sang Do; Sopko, George; Taira, Breena R.; Timerman, Sergio; Eng Hock Ong, Marcus

2013-01-01

At the 2013 Academic Emergency Medicine global health consensus conference, a breakout session on a resuscitation research agenda was held. Two articles focusing on cardiac arrest and trauma resuscitation are the result of that discussion. This article describes the burden of disease and outcomes,

Demonstration of close-coupled barriers for subsurface containment of buried waste

International Nuclear Information System (INIS)

Dwyer, B.P.; Heiser, J.; Stewart, W.

1996-01-01

The primary objective of this project is to develop and demonstrate a close-coupled barrier for the containment of subsurface waste or contaminant migration. A close-coupled barrier is produced by first installing a conventional cement grout curtain followed by a thin inner lining of a polymer grout. The resultant barrier is a cement polymer composite that has economic benefits derived from the cement and performance benefits from the durable and resistant polymer layer. Close-coupled barrier technology is applicable for final, interim, or emergency containment of subsurface waste forms. Consequently, when considering the diversity of technology application, the construction emplacement and material technology maturity, general site operational requirements, and regulatory compliance incentives, the close-coupled barrier system provides an alternative for any hazardous or mixed waste remediation plan. This paper discusses the installation of a close-coupled barrier and the subsequent integrity verification

Team knowledge research: emerging trends and critical needs.

Science.gov (United States)

Wildman, Jessica L; Thayer, Amanda L; Pavlas, Davin; Salas, Eduardo; Stewart, John E; Howse, William R

2012-02-01

This article provides a systematic review of the team knowledge literature and guidance for further research. Recent research has called attention to the need for the improved study and understanding of team knowledge. Team knowledge refers to the higher level knowledge structures that emerge from the interactions of individual team members. We conducted a systematic review of the team knowledge literature, focusing on empirical work that involves the measurement of team knowledge constructs. For each study, we extracted author degree area, study design type, study setting, participant type, task type, construct type, elicitation method, aggregation method, measurement timeline, and criterion domain. Our analyses demonstrate that many of the methodological characteristics of team knowledge research can be linked back to the academic training of the primary author and that there are considerable gaps in our knowledge with regard to the relationships between team knowledge constructs, the mediating mechanisms between team knowledge and performance, and relationships with criteria outside of team performance, among others. We also identify categories of team knowledge not yet examined based on an organizing framework derived from a synthesis of the literature. There are clear opportunities for expansion in the study of team knowledge; the science of team knowledge would benefit from a more holistic theoretical approach. Human factors researchers are increasingly involved in the study of teams. This review and the resulting organizing framework provide researchers with a summary of team knowledge research over the past 10 years and directions for improving further research.

SOME OBSERVATIONS ON THE DESIGN OF NOISE BARRIERS

OpenAIRE

Arkadiusz BOCZKOWSKI

2013-01-01

The issue connected with effectiveness of noise barriers has been the subject of numerous considerations among acousticians. On the one hand, noise barriers are still the most popular and the most frequently used protection against traffic noise, on the other hand, however, the excessive number of noise barriers and the results of research focusing on effectiveness of the existing barriers make us reflect whether it is reasonable to use them. Very often low effectiveness of noise barriers is ...

Research Opportunities from Emerging Atmospheric Observing and Modeling Capabilities.

Science.gov (United States)

Dabberdt, Walter F.; Schlatter, Thomas W.

1996-02-01

The Second Prospectus Development Team (PDT-2) of the U.S. Weather Research Program was charged with identifying research opportunities that are best matched to emerging operational and experimental measurement and modeling methods. The overarching recommendation of PDT-2 is that inputs for weather forecast models can best be obtained through the use of composite observing systems together with adaptive (or targeted) observing strategies employing both in situ and remote sensing. Optimal observing systems and strategies are best determined through a three-part process: observing system simulation experiments, pilot field measurement programs, and model-assisted data sensitivity experiments. Furthermore, the mesoscale research community needs easy and timely access to the new operational and research datasets in a form that can readily be reformatted into existing software packages for analysis and display. The value of these data is diminished to the extent that they remain inaccessible.The composite observing system of the future must combine synoptic observations, routine mobile observations, and targeted observations, as the current or forecast situation dictates. High costs demand fuller exploitation of commercial aircraft, meteorological and navigation [Global Positioning System (GPS)] satellites, and Doppler radar. Single observing systems must be assessed in the context of a composite system that provides complementary information. Maintenance of the current North American rawinsonde network is critical for progress in both research-oriented and operational weather forecasting.Adaptive sampling strategies are designed to improve large-scale and regional weather prediction but they will also improve diagnosis and prediction of flash flooding, air pollution, forest fire management, and other environmental emergencies. Adaptive measurements can be made by piloted or unpiloted aircraft. Rawinsondes can be launched and satellites can be programmed to make

3rd International Conference on "Emerging Research in Computing, Information, Communication and Applications"

CERN Document Server

Prasad, NH; Nalini, N

2015-01-01

This proceedings volume covers the proceedings of ERCICA 2015. ERCICA provides an interdisciplinary forum for researchers, professional engineers and scientists, educators, and technologists to discuss, debate and promote research and technology in the upcoming areas of  Computing, Information, Communication and their Applications. The contents of this book cover emerging research areas in fields of Computing, Information, Communication and Applications. This will prove useful to both researchers and practicing engineers.

Global teaching and training initiatives for emerging cohort studies

Directory of Open Access Journals (Sweden)

Jessica K. Paulus

2012-09-01

Full Text Available A striking disparity exists across the globe, with essentially no large-scale longitudinal studies ongoing in regions that will be significantly affected by the oncoming non-communicable disease epidemic. The successful implementation of cohort studies in most low-resource research environments presents unique challenges that may be aided by coordinated training programs. Leaders of emerging cohort studies attending the First World Cohort Integration Workshop were surveyed about training priorities, unmet needs and potential cross-cohort solutions to these barriers through an electronic pre-workshop questionnaire and focus groups. Cohort studies representing India, Mexico, Nigeria, South Africa, Sweden, Tanzania and Uganda described similar training needs, including on-the-job training, data analysis software instruction, and database and bio-bank management. A lack of funding and protected time for training activities were commonly identified constraints. Proposed solutions include a collaborative cross-cohort teaching platform with web-based content and interactive teaching methods for a range of research personnel. An international network for research mentorship and idea exchange, and modifying the graduate thesis structure were also identified as key initiatives. Cross-cohort integrated educational initiatives will efficiently meet shared needs, catalyze the development of emerging cohorts, speed closure of the global disparity in cohort research, and may fortify scientific capacity development in low-resource settings.

Valuing Professional Development Components for Emerging Undergraduate Researchers

Science.gov (United States)

Cheung, I.

2015-12-01

In 2004 the Hatfield Marine Science Center (HMSC) at Oregon State University (OSU) established a Research Experience for Undergraduates (REU) program to engage undergraduate students in hands-on research training in the marine sciences. The program offers students the opportunity to conduct research focused on biological and ecological topics, chemical and physical oceanography, marine geology, and atmospheric science. In partnership with state and federal government agencies, this ten-week summer program has grown to include 20+ students annually. Participants obtain a background in the academic discipline, professional development training, and research experience to make informed decisions about careers and advanced degrees in marine and earth system sciences. Professional development components of the program are designed to support students in their research experience, explore career goals and develop skills necessary to becoming a successful young marine scientist. These components generally include seminars, discussions, workshops, lab tours, and standards of conduct. These componentscontribute to achieving the following professional development objectives for the overall success of new emerging undergraduate researchers: Forming a fellowship of undergraduate students pursuing marine research Stimulating student interest and understanding of marine research science Learning about research opportunities at Oregon State University "Cross-Training" - broadening the hands-on research experience Exploring and learning about marine science careers and pathways Developing science communication and presentation skills Cultivating a sense of belonging in the sciences Exposure to federal and state agencies in marine and estuarine science Academic and career planning Retention of talented students in the marine science Standards of conduct in science Details of this program's components, objectives and best practices will be discussed.

LGBT communities are emerging across Africa in 2012. Many are ...

African Journals Online (AJOL)

LGBT communities are emerging across Africa in 2012. Many are emerging in the context of the continents severe HIV epidemic. Homophobia is a barrier to social acceptance and to health and other social services, but African communities are showing reliance.

Attitudes and barriers to evidence-based practice in optometry educators.

Science.gov (United States)

Suttle, Catherine M; Challinor, Kirsten L; Thompson, Rachel E; Pesudovs, Konrad; Togher, Leanne; Chiavaroli, Neville; Lee, Adrian; Junghans, Barbara; Stapleton, Fiona; Watt, Kathleen; Jalbert, Isabelle

2015-04-01

Evidence-based practice (EBP) is an essential component of good quality, patient-centered health care. This requires practitioners to acquire EBP skills and knowledge during undergraduate and continuing education. Evidence-based practice education exists in a range of health care disciplines, including optometry. Evidence-based practice education, however, depends on relevant skills and knowledge in educators. Courses and workshops exist for the development of EBP teaching skills in some areas of health care but not in optometry. Here, we describe a pilot workshop designed to enhance the teaching of EBP and to investigate the perspectives of optometric educators on EBP including their attitudes and perceived barriers to EBP and its teaching. Twenty-seven optometric educators including 8 facilitators participated. Of these, 14 were academics (including the 8 facilitators) and 13 were practitioners. Evidence-based practice attitudes were assessed using the Evidence-Based Practice Attitude Scale-50 with appropriate modifications for optometry. Workshop design incorporated strategies to trigger discussion among participants. A nominal group technique was used to identify, prioritize, and reach consensus on barriers to EBP. Although some participants expressed reservations about EBP, a common understanding of the contemporary definition of EBP emerged in educators. Thirty-five barriers to EBP were identified; "time" was selected in the top five barriers by most participants and attracted the highest total score, well above any other barrier (negative attitude to EBP, volume of evidence, integration with clinical practice, and lack of lifelong learning mind-set). Attitudes toward EBP were generally positive and negatively correlated with age and time since graduation, respectively. A group of optometrists and academics new to implementing education in EBP displayed positive attitudes to EBP but considered that its application and teaching could be significantly hindered

Research on the application of active sound barriers for the transformer noise abatement

Directory of Open Access Journals (Sweden)

Hu Sheng

2016-01-01

Full Text Available Sound barriers are a type of measure most commonly used in the noise abatement of transformers. In the noise abatement project of substations, the design of sound barriers is restrained by the portal frames which are used to hold up outgoing lines from the main transformers, which impacts the noise reduction effect. If active sound barriers are utilized in these places, the noise diffraction of sound barriers can be effectively reduced. At a 110kV Substation, an experiment using a 15-channel active sound barrier has been carried out. The result of the experiment shows that the mean noise reduction value (MNRV of the noise measuring points at the substation boundary are 1.5 dB (A. The effect of the active noise control system is impacted by the layout of the active noise control system, the acoustic environment on site and the spectral characteristic of the target area.

Near-Surface Engineered Environmental Barrier Integrity

International Nuclear Information System (INIS)

Piet, S.J.; Breckenridge, R.P.

2002-01-01

The INEEL Environmental Systems Research and Analysis (ESRA) program has launched a new R and D project on Near-Surface Engineered Environmental Barrier Integrity to increase knowledge and capabilities for using engineering and ecological components to improve the integrity of near-surface barriers used to confine contaminants from the public and the environment. The knowledge gained and the capabilities built will help verify the adequacy of past remedial decisions and enable improved solutions for future cleanup decisions. The research is planned to (a) improve the knowledge of degradation mechanisms (weathering, biological, geological, chemical, radiological, and catastrophic) in times shorter than service life, (b) improve modeling of barrier degradation dynamics, (c) develop sensor systems to identify degradation prior to failure, and (d) provide a better basis for developing and testing of new barrier systems to increase reliability and reduce the risk of failure. Our project combine s selected exploratory studies (benchtop and field scale), coupled effects accelerated aging testing and the meso-scale, testing of new monitoring concepts, and modeling of dynamic systems. The performance of evapo-transpiration, capillary, and grout-based barriers will be examined

Structural barriers to HIV prevention among men who have sex with men (MSM) in Vietnam: Diversity, stigma, and healthcare access.

Science.gov (United States)

Philbin, Morgan M; Hirsch, Jennifer S; Wilson, Patrick A; Ly, An Thanh; Giang, Le Minh; Parker, Richard G

2018-01-01

Men who have sex with men (MSM) in Vietnam experience disproportionate rates of HIV infection. To advance understanding of how structural barriers may shape their engagement with HIV prevention services, we draw on 32 in-depth interviews and four focus groups (n = 31) conducted with MSM in Hanoi between October 2015- March 2016. Three primary factors emerged: (1) Diversity, both in relation to identity and income; Vietnamese MSM described themselves as segregated into Bóng kín (hidden, often heterosexually-identified MSM) and Bóng lộ ('out,' transgender, or effeminate MSM). Lower-income, 'hidden' MSM from rural areas were reluctant to access MSM-targeted services; (2) Stigma: MSM reported being stigmatized by the healthcare system, family, and other MSM; and (3) Healthcare access: this was limited due to economic barriers and lack of MSM-friendly services. Our research suggests the need for multiple strategies to reach diverse types of MSM as well as to address barriers in access to health services such as stigma and costs. While a great deal has been written about the diversity of MSM in relation to gender performance and sexual identities, our research points to the substantial structural-level barriers that must be addressed in order to achieve meaningful and effective HIV prevention for MSM worldwide.

Barriers and facilitators experienced in collaborative prospective research in orthopaedic oncology

DEFF Research Database (Denmark)

Rendon, J S; Swinton, M; Bernthal, N

2017-01-01

by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. METHODS: All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss......: The 13 surgeons who participated in the discussion represented orthopaedic oncology practices from seven countries (Argentina, Brazil, Italy, Spain, Denmark, United States and Canada). Four categories and associated themes emerged from the discussion: the need for collaboration in the field...... of orthopaedic oncology due to the rarity of the tumours and the need for high level evidence to guide treatment; motivational factors for participating in collaborative research including establishing proof of principle, learning opportunity, answering a relevant research question and being part...

Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

Science.gov (United States)

Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

2014-12-01

Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

Barriers to the Integration and Adoption of iPads in Schools

DEFF Research Database (Denmark)

Khalid, Md. Saifuddin; Kilic, Gökce; Christoffersen, Jeanette

2015-01-01

iPad, with its Apple platform and interoperability-dependent material conditions, bring complex barriers in its adoption and integration in secondary education system as a learning tool. In the schools’ context, it is an emerging educational technology for its affordances supporting collaborative...... learning. This systematic literature review on the barriers to the integration of iPad in primary and secondary schools is based on 13 peer-reviewed and full-text articles. The paper discusses what are the challenges in using iPad as a learning tool in primary and secondary educational settings....... The identified barriers are discussed in three broad categories or stages of innovation process in an educational context: basic challenges with the tool, barriers to the integration of the iPad in a school setting, and barriers in the use of the iPad....

Barriers and facilitators to accessing skilled birth attendants in Afar region, Ethiopia.

Science.gov (United States)

King, Rosemary; Jackson, Ruth; Dietsch, Elaine; Hailemariam, Asseffa

2015-05-01

to explore barriers and facilitators that enable women to access skilled birth attendance in Afar Region, Ethiopia. researchers used a Key Informant Research approach (KIR), whereby Health Extension Workers participated in an intensive training workshop and conducted interviews with Afar women in their communities. Data was also collected from health-care workers through questionnaires, interviews and focus groups. fourteen health extension workers were key informants and interviewers; 33 women and eight other health-care workers with a range of experience in caring for Afar childbearing women provided data as individuals and in focus groups. participants identified friendly service, female skilled birth attendants (SBA) and the introduction of the ambulance service as facilitators to SBA. There are many barriers to accessing SBA, including women׳s low status and restricted opportunities for decision making, lack of confidence in health-care facilities, long distances, cost, domestic workload, and traditional practices which include a preference for birthing at home with a traditional birth attendant. many Afar men and women expressed a lack of confidence in the services provided at health-care facilities which impacts on skilled birth attendance utilisation. ambulance services that are free of charge to women are effective as a means to transfer women to a hospital for emergency care if required and expansion of ambulance services would be a powerful facilitator to increasing institutional birth. Skilled birth attendants working in institutions need to ensure their practice is culturally, physically and emotionally safe if more Afar women are to accept their midwifery care. Adequate equipping and staffing of institutions providing emergency obstetric and newborn care will assist in improving community perceptions of these services. Most importantly, mutual respect and collaboration between traditional birth attendants (Afar women׳s preferred caregiver), health

Gender differences in neurological emergencies part II: a consensus summary and research agenda on traumatic brain injury.

Science.gov (United States)

Wright, David W; Espinoza, Tamara R; Merck, Lisa H; Ratcliff, Jonathan J; Backster, Anika; Stein, Donald G

2014-12-01

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. There is strong evidence that gender and sex play an important role across the spectrum of TBI, from pathophysiology to clinical care. In May 2014, Academic Emergency Medicine held a consensus conference "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A TBI working group was formed to explore what was known about the influence of sex and gender on TBI and to identify gaps for future research. The findings resulted in four major recommendations to guide the TBI research agenda. © 2014 by the Society for Academic Emergency Medicine.

Demonstration of close-coupled barriers for subsurface containment of buried waste

International Nuclear Information System (INIS)

Heiser, J.; Dwyer, B.

1995-01-01

The primary objective of this project is to develop and demonstrate a close-coupled barrier for the containment of subsurface waste or contaminant migration. A close-coupled barrier is produced by first installing a conventional cement grout curtain followed by a thin lining of a polymer grout. The resultant barrier is a cement polymer composite that has economic benefits derived from the cement and performance benefits from the durable and resistant polymer layer. Close-coupled barrier technology is applicable for final, interim, or emergency containment of subsurface waste forms. Consequently, when considering the diversity of technology application, the construction emplacement and material technology maturity, general site operational requirements, and regulatory compliance incentives, the close-coupled barrier system provides an alternative for any hazardous or mixed waste remediation plan. This paper will discuss the installation of a close-coupled barrier and the subsequent integrity verification. The demonstration will take place at a cold site at the Hanford Geotechnical Test Facility, 400 Area, Hanford, Washington

Promoting the Utilization of Science in Healthcare (PUSH) Project: A Description of the Perceived Barriers and Facilitators to Research Utilization Among Pediatric Nurses.

Science.gov (United States)

Cline, Genieveve J; Burger, Kristina J; Amankwah, Ernest K; Goldenberg, Neil A; Ghazarian, Sharon R

The purpose of this descriptive study was to identify the perceived barriers and facilitators to research utilization and evidence-based practice among nurses employed in a tertiary care children's hospital. Results revealed seven facilitator and six barrier themes that contribute to the understanding of the problem. The themes can be utilized by nursing professional development specialists to customize organizational infrastructure and educational programs.

Towards an integrated approach to emergency management: interdisciplinary challenges for research and practice

Directory of Open Access Journals (Sweden)

Christian Webersik

2015-10-01

Full Text Available This article presents an interdisciplinary vision for large-scale integrated emergency management that has been inspired by the transition from platform centric to inte-grated operations in the oil and gas fields, which uses remote emergency control centres collaborating virtually with local responders. The article discusses some of the most salient research challenges for integrated emergency management, including the role of mobile technology, human-centred sensing, citizen participation and social media, and the socio-cultural determinants of disaster management. The purpose of this article is to frame an integrated emergency management approach that adopts a multi-disciplinary approach, including human computer interaction, information systems, computer science, development studies and organization science employing different methodologies.Most importantly, we need to better understand the socio-cultural determinants of how people prepare to, respond and perceive disasters, in order to evaluate whether and what kind of information and communication technology (ICT support is appropriate. There is need for more research as to why in some regions local people ignore official orders to evacuate, and rather follow the advice of local leaders, elders or religious leaders. In other instances, disasters are seen as 'acts of God' thus shaping disaster preparedness and response.

"People will say that I am proud": a qualitative study of barriers to bed net use away from home in four Ugandan districts.

Science.gov (United States)

Monroe, April; Harvey, Steven A; Lam, Yukyan; Muhangi, Denis; Loll, Dana; Kabali, Asaph Turinde; Weber, Rachel

2014-03-06

Despite increased access and ownership, barriers to insecticide-treated bed net (ITN) use persist. While barriers within the home have been well documented, the challenges to net use when sleeping away from home remain relatively unexplored. This study examines common situations in which people sleep away from home and the barriers to ITN use in those situations. To explore these issues, a group of researchers conducted 28 in-depth interviews and four focus groups amongst adults from net-owning households in four Ugandan districts. In addition to sleeping outside during hot season, participants identified social events, livelihood activities, and times of difficulty as circumstances in which large numbers of people sleep away from home. Associated challenges to ITN use included social barriers such as fear of appearing proud, logistical barriers such as not having a place to hang a net, and resource limitations such as not having an extra net with which to travel. Social disapproval emerged as an important barrier to ITN use in public settings. Unique barriers to ITN use exist when people spend the night away from home. It is essential to identify and address these barriers in order to reduce malaria exposure in such situations. For events like funerals or religious "crusades" where large numbers of people sleep away from home, alternative approaches, such as spatial repellents may be more appropriate than ITNs. Additional research is required to identify the acceptability and feasibility of alternative prevention strategies in situations where ITNs are unlikely to be effective.

Barriers and facilitating factors related to use of early warning scores among acute care nurses

DEFF Research Database (Denmark)

Petersen, John Asger; Rasmussen, Lars S; Rydahl Hansen, Susan

2017-01-01

to patients with an elevated EWS, and 3) call for the medical emergency team. METHODS: Focus groups were conducted with nurses from medical and surgical acute care wards, and content analysis was used to identify barriers and facilitating factors in relation to the research questions. RESULTS: Adherence...... was problematic, since many nurses found the team to have negative attitudes. CONCLUSION: EWS reduces complex clinical conditions to a single number, with the inherent risk to overlook clinical cues and subtle changes in patients' condition. The study showed that identifying and treating deteriorating patients...

Research Ethics in Emerging Forms of Online Learning: Issues Arising from a Hypothetical Study on a MOOC

Science.gov (United States)

Esposito, Antonella

2012-01-01

This paper is concerned with how research ethics is evolving along with emerging online research methods and settings. In particular, it focuses on ethics issues implied in a hypothetical virtual ethnography study aiming to gain insights on participants' experience in an emergent context of networked learning, namely a MOOC--Massive Online Open…

Learning experiences on role-emerging placements: an exploration from the students' perspective.

Science.gov (United States)

Dancza, Karina; Warren, Alison; Copley, Jodie; Rodger, Sylvia; Moran, Monica; McKay, Elizabeth; Taylor, Ann

2013-12-01

Occupational therapy educators are challenged to provide students with practical experiences which prepare them for ever changing health-care contexts on graduation. Role-emerging placements have been widely used internationally to help meet this challenge, but research into the learning experiences of students during these innovative placements is limited. This research investigated the enablers and barriers to learning from the perspectives of students on such placements from two European universities. Two separate qualitative studies tracked 10 final year students. Interviews explored their learning experiences prior to, during and after an eight- or 10-week role-emerging placement in a range of settings. Four themes emerged, which were (1) adapting to less doing, more thinking and planning; (2) understanding the complexity of collaboration and making it work; (3) emotional extremes; and (4) realising and using the occupational therapy perspective. These placements presented a 'roller coaster' of authentic learning experiences which created the opportunity for students to use occupation in practice and develop skills for collaborative working in an interprofessional environment. Whereas students viewed their role-emerging placement experiences positively, challenges included the emotional responses of students and placement pace. Findings suggest the need for supportive student placement experiences in both established and role-emerging areas to prepare students for a range of opportunities in an uncertain future. © 2013 Occupational Therapy Australia.

Barriers and facilitators of prostate cancer screening among Filipino men in Hawaii.

Science.gov (United States)

Conde, Francisco A; Landier, Wendy; Ishida, Dianne; Bell, Rose; Cuaresma, Charlene F; Misola, Jane

2011-03-01

To examine perceptions, attitudes, and beliefs regarding barriers and facilitators to prostate cancer screening, and to identify potential interventional strategies to promote prostate cancer screening among Filipino men in Hawaii. Exploratory, qualitative. Community-based settings in Hawaii. 20 Filipino men age 40 years or older. Focus group discussions were tape recorded and transcribed, and content analysis was performed for emergent themes. Perceptions regarding prostate cancer, barriers and facilitators to prostate cancer screening, and culturally relevant interventional strategies. Perceptions of prostate cancer included fatalism, hopelessness, and dread. Misconceptions regarding causes of prostate cancer, such as frequency of sexual activity, were identified. Barriers to prostate cancer screening included lack of awareness of the need for screening, reticence to seek health care when feeling well, fear of cancer diagnosis, financial issues, time constraints, and embarrassment. Presence of urinary symptoms, personal experience with family or friends who had cancer, and receiving recommendations from a healthcare provider regarding screening were facilitators for screening. Potential culturally relevant interventional strategies to promote prostate cancer screening included screening recommendations from healthcare professionals and cancer survivors; radio or television commercials and newspaper articles targeting the Filipino community; informational brochures in Tagalog, Ilocano, or English; and interactive, educational forums facilitated by multilingual Filipino male healthcare professionals. Culturally relevant interventions are needed that address barriers to prostate cancer screening participation and misconceptions about causes of prostate cancer. Findings provide a foundation for future research regarding development of interventional strategies to promote prostate cancer screening among Filipino men.

Engineered barriers: current status 1989

International Nuclear Information System (INIS)

Atkinson, A.; Marsh, G.B.

1989-06-01

This report summarises the current state of research relevant to assessing the performance of engineered barriers made of steel and concrete in radioactive waste repositories. The objective of these barriers is to contain substantially the radionuclides within them by providing both physical and chemical impediment to their release. The physical barriers are of most value for highly soluble isotopes with relatively short half-lives (eg 137 Cs), since they can provide a measure of containment until a large fraction of the activity has decayed. In addition they can facilitate retrievability for some period after disposal. The chemical barriers operate by beneficial conditioning of the near field groundwater and providing sites for sorption of radionuclides. Both of these reduce the aqueous concentration of radionuclides in the near field. (author)

Facilitators of and Barriers to mHealth Adoption in Older Adults With Heart Failure.

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Cajita, Maan Isabella; Hodgson, Nancy A; Lam, Katherine Wai; Yoo, Sera; Han, Hae-Ra

2018-05-04

The purpose of this descriptive, exploratory study was to assess the perceptions of older adults with heart failure regarding the use of mobile technology and to identify potential facilitators of and barriers to mHealth adoption. Semistructured interviews were used to collect data. Transcripts were analyzed using qualitative content analysis. The findings indicated that older adults do not base their intention to use mHealth solely on perceived ease of use and perceived usefulness, as outlined in the Technology Acceptance Model. The following themes emerged from the content analysis: facilitators included previous experience with mobile technology, willingness to learn mHealth, ease of use, presence of useful features, adequate training, free equipment, and doctor's recommendation; barriers included lack of knowledge regarding how to use mHealth, decreased sensory perception, lack of need for technology, poorly designed interface, cost of technology, and limited/fixed income. Overall, the findings suggest that older adults are willing to use mobile health technology, albeit with reservations. Future researchers who seek to implement mHealth-based interventions should address person-related, technology-related, and contextual barriers, and simultaneously capitalize on the influence of potential facilitators, such as a physician's recommendation, to promote mHealth adoption.

Barriers to Nurse-Patient Communication in Cardiac Surgery Wards: A Qualitative Study

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Shafipour, Vida; Mohammad, Eesa; Ahmadi, Fazlollah

2014-01-01

Background: An appropriate and effective nurse-patient communication is of the most important aspect of caring. The formation and continuation of such a relationship depends on various factors such as the conditions and context of communication and a mutual understanding between the two. A review of the literature shows that little research is carried out on identification of such barriers in hospital wards between the patients and the healthcare staff. Objectives: The present study was therefore conducted to explore the experiences of nurses and patients on communication barriers in hospital cardiac surgery wards. Design and Methods: This qualitative research was carried out using a content analysis method (Graneheim & Lundman, 2004). The participants were selected by a purposeful sampling and consist of 10 nurses and 11 patients from the cardiac surgery wards of three teaching hospitals in Tehran, Iran. Data was gathered by unstructured interviews. All interviews were audio-taped and transcribed verbatim. Results: Findings were emerged in three main themes including job dissatisfaction (with the sub-themes of workload tension and decreased motivation), routine-centered care (with the sub-themes of habitual interventions, routinized and technical interventions, and objective supervision), and distrust in competency of nurses (with the sub-themes of cultural contrast, less responsible nurses, and their apathy towards the patients). Conclusions: Compared to other studies, our findings identified different types of communication barriers depending on the nursing settings. These findings can be used by the ward clinical nursing managers at cardiac surgery wards to improve the quality of nursing care. PMID:25363126

What are the barriers to scaling up health interventions in low and middle income countries? A qualitative study of academic leaders in implementation science

Directory of Open Access Journals (Sweden)

Yamey Gavin

2012-05-01

Full Text Available Abstract Background Most low and middle income countries (LMICs are currently not on track to reach the health-related Millennium Development Goals (MDGs. One way to accelerate progress would be through the large-scale implementation of evidence-based health tools and interventions. This study aimed to: (a explore the barriers that have impeded such scale-up in LMICs, and (b lay out an “implementation research agenda”—a series of key research questions that need to be addressed in order to help overcome such barriers. Methods Interviews were conducted with fourteen key informants, all of whom are academic leaders in the field of implementation science, who were purposively selected for their expertise in scaling up in LMICs. Interviews were transcribed by hand and manually coded to look for emerging themes related to the two study aims. Barriers to scaling up, and unanswered research questions, were organized into six categories, representing different components of the scaling up process: attributes of the intervention; attributes of the implementers; scale-up approach; attributes of the adopting community; socio-political, fiscal, and cultural context; and research context. Results Factors impeding the success of scale-up that emerged from the key informant interviews, and which are areas for future investigation, include: complexity of the intervention and lack of technical consensus; limited human resource, leadership, management, and health systems capacity; poor application of proven diffusion techniques; lack of engagement of local implementers and of the adopting community; and inadequate integration of research into scale-up efforts. Conclusions Key steps in expanding the evidence base on implementation in LMICs include studying how to: simplify interventions; train “scale-up leaders” and health workers dedicated to scale-up; reach and engage communities; match the best delivery strategy to the specific health problem and

Identifying barriers to glycemic control in patients with type 2 diabetes after completion of an accredited education program.

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Gildea, Chris M; Lantaff, Wendy M; Olenik, Nicole L

The objective of this study was to identify patient-perceived barriers to achieving A1C targets after receiving instruction in an accredited diabetes education program. Qualitative research using semistructured interviews and thematic analyses. One pharmacist-run diabetes center located within an independent community pharmacy in a suburban region of southern Indiana. A total of 17 participants between the ages of 41-78 were interviewed in March and April 2016. Not applicable. Patient-perceived barriers to attaining glycemic control after completion of a pharmacist-taught diabetes self-management education (DSME) program accredited by the American Association of Diabetes Educators. Participants reported a variety of perceived barriers to glycemic control subsequent to the receipt of structured education. Seven major themes emerged: 1) health care provider factors; 2) self-identified indiscretions; 3) psychological barriers and poor social support; 4) knowledge deficits; 5) personal injury or adverse drug events; 6) time constraints and competing life demands; and 7) financial constraints. Participants reported a variety of perceived barriers to achieving A1C targets after completing DSME. Incorporation of solutions and coping mechanisms to these barriers into diabetes education programs may help patients attain glycemic control. Other factors may require individualized attention outside of DSME in follow-up episodes of diabetes care. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Update on emergency contraception.

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Fok, Wing Kay; Blumenthal, Paul D

2016-12-01

Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG. Repeated use of both LNG and ulipristal acetate (UPA) is well tolerated. Hormonal contraception can be immediately started following LNG use, but should be delayed for 5 days after UPA use to avoid dampening the efficacy of UPA. The copper intrauterine device (IUD) is the only IUD approved for emergency contraception (and the most effective method of emergency contraception), but use of LNG IUD as emergency contraception is currently being investigated. Accurate knowledge about emergency contraception remains low both for patients and healthcare providers. Emergency contraception is an important yet underutilized tool available to women to prevent pregnancy. Current options including copper IUD and emergency contraceptive pills are safe and well tolerated. Significant gaps in knowledge of emergency contraception on both the provider and user level exist, as do barriers to expedient access of emergency contraception.

CMHC [Canada Mortgage and Housing Corporation] research project: Testing of air barrier construction details 2

Energy Technology Data Exchange (ETDEWEB)

1993-03-31

Air leakage control through the building envelope of wood framed houses is more important than ever. This is because owners expect better temperature control, higher indoor humidity in winter, low energy consumption and building durability. The leakage of air is controlled by the air barrier system. There are several new technologies to construct an air barrier system for the building envelope. These are the Poly Approach, the Air Drywall Approach (ADA) and the EASE system. The development of these systems was undertaken primarily by the building community without significant research and development. While it is believed that these methods improve airtightness it is not known if the improvement is marginal or significant. A study was conducted to determine actual performace of several different types of construction details for each of the different approaches. Each of these details was designed and constructed using one of the air barrier methods and tested in the laboratory. The test details included sill plate, the partition wall, the stair stringer, the electrical outlets, the bathtub detail, the plumbing stack detail, the metal chimney detail, the bathroom fan detail and the EASE wall system. The test results revealed that the Poly, ADA and EASE approaches reduce air leakage by a factor of six, if applied with a modest degree of workmanship. Further, certain Poly details are to be reconsidered because they lack adequate support against design wind load pressures. 37 figs., 12 tabs.

Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

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Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

2017-04-28

Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

Overcoming Barriers to Public Engagement through a Multi-Institution Consortium

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Lambert, K. F.; Weiss, M.; Garlick, S.

2016-12-01

A growing body of evidence suggests that public engagement with science (PES) can enhance the relevance and impact of science on society. At the same time, advances in our understanding of public engagement suggest that greater skills, resources, and time horizons are often required to create effective programs. Consequently, despite a proliferation of training programs, many scientists still face the challenge of balancing the demands of public engagement with the requirements of their disciplinary research. Novel institutions are emerging that bring together interdisciplinary networks of principle investigators with PES practitioners to overcome barriers to effective and sustained public engagement in the environmental sciences. We will use the Science Policy Exchange (SPE), a consortium housed at the Harvard Forest, Harvard University, to illustrate how PIs and PES practitioners can collaborate to design public engagement processes, conduct policy-relevant scientific syntheses, and implement science communication strategies. Results from two SPE case studies demonstrate how multi-institutional consortia can help scientists overcome barriers such as lack of knowledge of evidence-based PES approaches, limits on time and funding to implement PES projects, and the need to integrate PES activities with research. The case studies also show how SPE strives to achieve credibility, saliency, and legitimacy in different public policy contexts: (1) engagement between scientists and local stakeholders to develop scenarios of landscape change; and (2) engagement between scientists and policy makers to understand the relationship between power plant emission standards, and air quality, human health and ecosystem function. The presentation will conclude with examples of how SPE programs have led to institutional change (staffing and budget), cultural change (attitudes and expectations of senior leaders), and research change (development of research questions, funding proposals

A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.

Science.gov (United States)

George, Siân; Daniels, Katy; Fioratou, Evridiki

2018-04-03

Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The "Health Care Access Barriers" (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre's family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB's themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals' attitudes and discrimination and the vulnerable population's lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a

Children's views on research without prior consent in emergency situations: a UK qualitative study.

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Roper, Louise; Sherratt, Frances C; Young, Bridget; McNamara, Paul; Dawson, Angus; Appleton, Richard; Crawley, Esther; Frith, Lucy; Gamble, Carrol; Woolfall, Kerry

2018-06-09

We explored children's views on research without prior consent (RWPC) and sought to identify ways of involving children in research discussions. Qualitative interview study. Participants were recruited through a UK children's hospital and online advertising. 16 children aged 7-15 years with a diagnosis of asthma (n=14) or anaphylaxis (n=2) with recent (<12 months) experience of emergency care. Children were keen to be included in medical research and viewed RWPC as acceptable in emergency situations if trial interventions were judged safe. Children trusted that doctors would know about their trial participation and act in their best interests. All felt that children should be informed about the research following their recovery and involved in discussions with a clinician or their parent(s) about the use of data already collected as well as continued participation in the trial (if applicable). Participants suggested methods to inform children about their trial participation including an animation. Children supported, and were keen to be involved in, clinical trials in emergency situations. We present guidance and an animation that practitioners and parents might use to involve children in trial discussions following their recovery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Exploration of Textual Interactions in CALL Learning Communities: Emerging Research and Opportunities

Science.gov (United States)

White, Jonathan R.

2017-01-01

Computer-assisted language learning (CALL) has greatly enhanced the realm of online social interaction and behavior. In language classrooms, it allows the opportunity for students to enhance their learning experiences. "Exploration of Textual Interactions in CALL Learning Communities: Emerging Research and Opportunities" is an ideal…

Identifying the barriers and enablers for a triage, treatment, and transfer clinical intervention to manage acute stroke patients in the emergency department: a systematic review using the theoretical domains framework (TDF).

Science.gov (United States)

Craig, Louise E; McInnes, Elizabeth; Taylor, Natalie; Grimley, Rohan; Cadilhac, Dominique A; Considine, Julie; Middleton, Sandy

2016-11-28

Clinical guidelines recommend that assessment and management of patients with stroke commences early including in emergency departments (ED). To inform the development of an implementation intervention targeted in ED, we conducted a systematic review of qualitative and quantitative studies to identify relevant barriers and enablers to six key clinical behaviours in acute stroke care: appropriate triage, thrombolysis administration, monitoring and management of temperature, blood glucose levels, and of swallowing difficulties and transfer of stroke patients in ED. Studies of any design, conducted in ED, where barriers or enablers based on primary data were identified for one or more of these six clinical behaviours. Major biomedical databases (CINAHL, OVID SP EMBASE, OVID SP MEDLINE) were searched using comprehensive search strategies. The barriers and enablers were categorised using the theoretical domains framework (TDF). The behaviour change technique (BCT) that best aligned to the strategy each enabler represented was selected for each of the reported enablers using a standard taxonomy. Five qualitative studies and four surveys out of the 44 studies identified met the selection criteria. The majority of barriers reported corresponded with the TDF domains of "environmental, context and resources" (such as stressful working conditions or lack of resources) and "knowledge" (such as lack of guideline awareness or familiarity). The majority of enablers corresponded with the domains of "knowledge" (such as education for physicians on the calculated risk of haemorrhage following intravenous thrombolysis [tPA]) and "skills" (such as providing opportunity to treat stroke cases of varying complexity). The total number of BCTs assigned was 18. The BCTs most frequently assigned to the reported enablers were "focus on past success" and "information about health consequences." Barriers and enablers for the delivery of key evidence-based protocols in an emergency setting have

Forum on Emerging Infectious Diseases Highlights Leading-Edge Research | Poster

Science.gov (United States)

Scientists and professionals from multiple governmental agencies recently gathered at NCI at Frederick for a forum on newly emerging infectious diseases, threats to public health, and ongoing efforts to study high-risk pathogens. During the one-day event, which was sponsored by the National Interagency Confederation for Biological Research’s Scientific Interaction Subcommittee, nine speakers from four agencies shared their research and their agencies’ endeavors to address current and future biological threats.

The Gendered International School: Barriers to Women Managers' Progression

Science.gov (United States)

Sanderson, Ruth Elizabeth; Whitehead, Stephen

2016-01-01

Purpose: The purpose of this paper is to examine the barriers women identify to their promotion in international schools and also the ways in which women can overcome these barriers. Design/methodology/approach: The field of enquiry is international schools, with the study drawing on qualitative research. The researchers interviewed 11 women from…

BREASTFEEDING AND SOCIAL, CULTURAL, GEOPOLITICAL EMBODIED BARRIERS

Directory of Open Access Journals (Sweden)

Miriam Castaldo

2016-01-01

Full Text Available This study in medical anthropology was conducted at the National Institute for Health, Migration and Poverty (INMP, in Rome, Italy, and was carried out in 2013-2014 as part of the project “Clinical and social evaluation of medical practices in the treatment of infectious diseases in paediatrics for children of vulnerable populations”. At the end of the project, it was possible to ensure diagnostic accuracy, the proper prescription of antibiotic therapy and improve family care of children affected by pharyngotonsillitis. In addition, it was possible to acquire knowledge of the health of children with respect for certain social determinants. The anthropological research targeted mother’s of children and adolescents from the age of 3 to the age of 17 immigrated to Rome from Africa: sub-Saharan and North; furthermore from Asia: Indian subcontinent, West Asia, Eurasia, Middle East, Arabian peninsula; South-East Europe; Centre and South America. In this article we’ll consider only mother’s of 39 children and adolescents from Latin America (Argentina, Brazil, Colombia, Ecuador, El Salvador, Honduras, Nicaragua, Paraguay, Peru, Dominican Republic, Uruguay and Venezuela. The study aimed at analysing the formation and the socio-cultural representation, which emerged from interviews of women regarding barriers to breastfeeding; the effects of breastfeeding on the psychological and physical health of infants; the social and domestic consequences, which affect women who did not stop breastfeeding when they feel they should have. In Italy, as in other destination countries for global migrations, barriers that prevent the access to the healthcare system must be removed, barriers that are accentuated by linguistic and cultural incomprehension, through adequate multidisciplinary healthcare settings such as the one we are presenting, composed of a medical doctor, an anthropologist and a cultural mediator.

Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols.