WorldWideScience

Sample records for reflect current challenges

  1. Challenging Narcissus, or Reflecting on Reflecting.

    Science.gov (United States)

    Achilles, C. M.

    The concept of reflective practice and teaching people to be reflective practitioners is examined. The document begins with a look at professional knowledge according to three prominent professionals in the educational administration field: Schon, Schein, and Achilles. "Reflective" strategies that could be incorporated into courses and…

  2. Osteomyelitis: a current challenge

    Directory of Open Access Journals (Sweden)

    Luciana Souza Jorge

    Full Text Available Over the last 30 years, the pathogenesis of osteomyelitis has almost been totally elucidated, and many factors responsible for the persistence of this infection have been identified. Numerous antimicrobial agents with distinct spectrums of action, pharmacokinetics, and pharmacodynamics have been used in its treatment. Surgical techniques, including muscle grafts, the Ilizarov technique, and antibiotic bone cements, have been applied. However, bone infections are still a challenge. Despite the importance of isolation and identification of microorganisms to determine the antimicrobial treatment of bone infections, there are few systematic national studies about the etiological profile of these diseases. This article describes the current knowledge of osteomyelitis and summarizes published national data based on the experience of different Orthopedic and Traumatology Services. In general, S. aureus was described as an important etiological agent; however, the difference in design of national studies makes a comparison between the prevalence of bone infection, the associated risk factors, and the different therapeutic approaches difficult. In conclusion, effort is necessary in order to stimulate systematic national studies in different Orthopedics and Traumatology Services to obtain a better consensus on preventive measures and therapies of bone infections.

  3. Fostering Reflection through Challenging Practica

    Science.gov (United States)

    Nickel, Jodi; Sutherby, Linda; Garrow-Oliver, Susan

    2010-01-01

    This article describes challenging practicum situations that provided three early childhood education students with leadership opportunities to promote best practices in child care centers. Using excerpts from student journals and meetings, the article documents students' initial discouragement at practices observed, inspiration through…

  4. Current Challenges in Cancer Treatment.

    Science.gov (United States)

    Zugazagoitia, Jon; Guedes, Cristiano; Ponce, Santiago; Ferrer, Irene; Molina-Pinelo, Sonia; Paz-Ares, Luis

    2016-07-01

    In this review, we highlight the current concepts and discuss some of the current challenges and future prospects in cancer therapy. We frequently use the example of lung cancer. We conducted a nonsystematic PubMed search, selecting the most comprehensive and relevant research articles, clinical trials, translational papers, and review articles on precision oncology and immuno-oncology. Papers were prioritized and selected based on their originality and potential clinical applicability. Two major revolutions have changed cancer treatment paradigms in the past few years: targeting actionable alterations in oncogene-driven cancers and immuno-oncology. Important challenges are still ongoing in both fields of cancer therapy. On the one hand, druggable genomic alterations are diverse and represent only small subsets of patients in certain tumor types, which limits testing their clinical impact in biomarker-driven clinical trials. Next-generation sequencing technologies are increasingly being implemented for molecular prescreening in clinical research, but issues regarding clinical interpretation of large genomic data make their wide clinical use difficult. Further, dealing with tumor heterogeneity and acquired resistance is probably the main limitation for the success of precision oncology. On the other hand, long-term survival benefits with immune checkpoint inhibitors (anti-programmed death cell protein-1/programmed death cell ligand-1[PD-1/L1] and anti-cytotoxic T lymphocyte antigen-4 monoclonal antibodies) are restricted to a minority of patients, and no predictive markers are yet robustly validated that could help us recognize these subsets and optimize treatment delivery and selection. To achieve long-term survival benefits, drug combinations targeting several molecular alterations or cancer hallmarks might be needed. This will probably be one of the most challenging but promising precision cancer treatment strategies in the future. Targeting single molecular

  5. Current challenges in autonomous driving

    Science.gov (United States)

    Barabás, I.; Todoruţ, A.; Cordoş, N.; Molea, A.

    2017-10-01

    Nowadays the automotive industry makes a quantum shift to a future, where the driver will have smaller and smaller role in driving his or her vehicle ending up being totally excluded. In this paper, we have investigated the different levels of driving automatization, the prospective effects of these new technologies on the environment and traffic safety, the importance of regulations and their current state, the moral aspects of introducing these technologies and the possible scenarios of deploying the autonomous vehicles. We have found that the self-driving technologies are facing many challenges: a) They must make decisions faster in very diverse conditions which can include many moral dilemmas as well; b) They have an important potential in reducing the environmental pollution by optimizing their routes, driving styles by communicating with other vehicles, infrastructures and their environment; c) There is a considerable gap between the self-drive technology level and the current regulations; fortunately, this gap shows a continuously decreasing trend; d) In case of many types of imminent accidents management there are many concerns about the ability of making the right decision. Considering that this field has an extraordinary speed of development, our study is up to date at the submission deadline. Self-driving technologies become increasingly sophisticated and technically accessible, and in some cases, they can be deployed for commercial vehicles as well. According to the current stage of research and development, it is still unclear how the self-driving technologies will be able to handle extreme and unexpected events including their moral aspects. Since most of the traffic accidents are caused by human error or omission, it is expected that the emergence of the autonomous technologies will reduce these accidents in their number and gravity, but the very few currently available test results have not been able to scientifically underpin this issue yet. The

  6. Challenges for current University management

    Directory of Open Access Journals (Sweden)

    Pedro Rodríguez Vargas

    2016-03-01

    Full Text Available The Ecuadorian university through a change of era, this complex pathway mediated by globalization imposes imminently. The aim of this paper is to present a review of literature on the main aspects of management that are generated for the interaction University - context. This scan was performed on secondary sources, and grounded in scienti?c data abstraction. College education is an information and training process that allows the scientific, technological, economic, political, social and cultural development of a region or country; however, some phenomena such as globalization, technological revolution or multiculturalism are key to this, same that can be considered as a problem or a challenge.

  7. Reflections of a Faraday Challenge Day Leader

    Science.gov (United States)

    Sewell, Keira

    2014-01-01

    Keira Sewell has just finished her second year as a Challenge Leader for the Faraday Challenge, a STEM-based scheme run by the Institution of Engineering and Technology. Aimed at 12-13 year-old students, its purpose is to engage students in future careers in engineering. Each year, a new challenge is held in over sixty schools and universities…

  8. Safety analysis - current and future regulatory challenges

    Energy Technology Data Exchange (ETDEWEB)

    Jamieson, T., E-mail: Terry.Jamieson@cnsc-ccsn.gc.ca [Canadian Nuclear Safety Commission, Ottawa, ON (Canada)

    2015-07-01

    'Full text:' The current and future regulatory challenges associated with deterministic safety analysis are reviewed, including: 1. The CNSC's and safety control areas. 2. Traditional safety analysis approach. 3. Experience gained and impact. 4. Current analysis and regulatory approaches. 5. Current status. 6. Complexity and challenges In particular, the technical, regulatory and strategic aspects of these challenges are discussed. (author)

  9. Safety analysis - current and future regulatory challenges

    International Nuclear Information System (INIS)

    Jamieson, T.

    2015-01-01

    'Full text:' The current and future regulatory challenges associated with deterministic safety analysis are reviewed, including: 1. The CNSC's and safety control areas. 2. Traditional safety analysis approach. 3. Experience gained and impact. 4. Current analysis and regulatory approaches. 5. Current status. 6. Complexity and challenges In particular, the technical, regulatory and strategic aspects of these challenges are discussed. (author)

  10. Women principals' reflections of curriculum management challenges ...

    African Journals Online (AJOL)

    This study reports the reflections of grade 6 rural primary principals in Mpumalanga province. A qualitative method of inquiry was used in this article, where data were collected using individual interviews with three principals and focus group discussions with the school management teams (SMTs) of three primary schools.

  11. Reflections and challenges in Networked Learning

    DEFF Research Database (Denmark)

    Bonderup Dohn, Nina; Sime, Julie-Ann; Cranmer, Susan

    2018-01-01

    with a short presentation of each of the chapters. This leads us to identify broader themes which point out significant perspectives and challenges for future research and practice. Among these are social justice, criticality, mobility, new forms of openness and learning in the public arena (all leading themes...

  12. Women scientists reflections, challenges, and breaking boundaries

    CERN Document Server

    Hargittai, Magdolna

    2015-01-01

    Magdolna Hargittai uses over fifteen years of in-depth conversation with female physicists, chemists, biomedical researchers, and other scientists to form cohesive ideas on the state of the modern female scientist. The compilation, based on sixty conversations, examines unique challenges that women with serious scientific aspirations face. In addition to addressing challenges and the unjustifiable underrepresentation of women at the higher levels of academia, Hargittai takes a balanced approach by discussing how some of the most successful of these women have managed to obtain professional success and personal happiness. Women Scientists portrays scientists from different backgrounds, different geographical regions-eighteen countries from four continents-and leaders from a variety of professional backgrounds, including eight Nobel laureate women. The book is divided into three sections: "Husband and Wife Teams," "Women at the Top," and "In High Positions." Hargittai uses her own experience to introduce her fi...

  13. Challenges for QCD theory: some personal reflections

    International Nuclear Information System (INIS)

    Sjöstrand, T

    2013-01-01

    At the LHC all processes are QCD ones, whether ‘signal’ or ‘background’. In this review the frontiers of current QCD research are addressed, towards increased understanding, improved calculational precision, and role in potential future discoveries. Issues raised include: - the limits of perturbative QCD calculations and parton distribution usage,; - the nature of multiparton interactions,; - the impact of colour reconnection on physical observables,; - the need for progress on hadronization modelling,; - the improvements of parton showers and their combination with the matrix-element description,; - the use of QCD concepts in Beyond-the-Standard-Model scenarios and; - the key position of event generators and other software in the successful exploration of LHC physics. On the way, several questions are posed, where further studies are needed. (paper)

  14. Montessori Elementary Philosophy Reflects Current Motivation Theories

    Science.gov (United States)

    Murray, Angela

    2011-01-01

    Montessori's theories, developed more than 100 years ago, certainly resonate with current psychological research on improving education. Autonomy, interest, competence, and relatedness form the foundation for three contemporary efforts to organize the vast literature on motivation into a parsimonious theory. These four elements also comprise…

  15. Microwave Photonics: current challenges towards widespread application.

    Science.gov (United States)

    Capmany, José; Li, Guifang; Lim, Christina; Yao, Jianping

    2013-09-23

    Microwave Photonics, a symbiotic field of research that brings together the worlds of optics and radio frequency is currently facing several challenges in its transition from a niche to a truly widespread technology essential to support the ever-increasing values for speed, bandwidth, processing capability and dynamic range that will be required in next generation hybrid access networks. We outline these challenges, which are the subject of the contributions to this focus issue.

  16. Learning design: reflections upon the current landscape

    Directory of Open Access Journals (Sweden)

    Brock Craft

    2012-08-01

    Full Text Available The mounting wealth of open and readily available information and the accelerated evolution of social, mobile and creative technologies call for a re-conceptualisation of the role of educators: from providers of knowledge to designers of learning. This call is reverberated by the rising trend of research in learning design (LD. Addressing this, the Art and Science of Learning Design workshop brought together leading voices in the field, and provided a forum for discussing its key issues. It focused on three major themes: (1 practices, methods and methodologies, (2 tools and resources and (3 theoretical frameworks. This paper proposes a definition of LD, reviews the main contributions from the workshop, and suggests some challenges for future research.

  17. The current challenges of teaching ESP

    Science.gov (United States)

    Fălăuş, A.

    2017-05-01

    Although the status of lingua franca can easily be claimed by English nowadays, there are always plenty of challenges involved in the process of teaching a foreign language. The simple mastering of the four skills (reading, writing, listening and speaking) and the acquisition of general grammar and vocabulary may not be enough in some circumstances. ESP focuses on the specific needs of the learners, concentrating more on language in context and on the students’ need to acquire a set of professional skills and particular job-related functions. This paper, consequently, focuses on identifying the current challenges that teachers and students may encounter in the process of teaching and learning English for Specific Purposes.

  18. Challenges in mental health nursing: current opinion

    Directory of Open Access Journals (Sweden)

    Sabella D

    2014-01-01

    Full Text Available Donna Sabella, Theresa Fay-Hillier College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA Abstract: The current mental health care system in the US continues to struggle with providing adequate care and services to all that require it due to limited resources, biases from both other professions and the public, and the complexities of treatment of many of those individuals or populations that suffer from mental illness. Mental health nurses, also referred to as psychiatric nurses, are impacted by those same biases, limited resources, and complexities in their role. This paper provides a brief history of mental health nursing and a discussion of the current challenges faced within the profession. It will also include how the public's perception of both those who have mental illness and those who treat it is based on the sensationalism of those who are violent, and misunderstanding of current treatments. It is imperative that mental health nurses continue to define and educate other health care professionals as well as the general public of the role of the mental health nurse and those who suffer from mental illness. Unfortunately, some of the same bias that was present in the 1930s remains today, but perhaps with perseverance and education it will not continue into the future. Keywords: mental health, psychiatric nursing, pre- licensure, post-licensure challenges, professional obstacles, public perception

  19. Current challenges in autonomous vehicle development

    Science.gov (United States)

    Connelly, J.; Hong, W. S.; Mahoney, R. B., Jr.; Sparrow, D. A.

    2006-05-01

    The field of autonomous vehicles is a rapidly growing one, with significant interest from both government and industry sectors. Autonomous vehicles represent the intersection of artificial intelligence (AI) and robotics, combining decision-making with real-time control. Autonomous vehicles are desired for use in search and rescue, urban reconnaissance, mine detonation, supply convoys, and more. The general adage is to use robots for anything dull, dirty, dangerous or dumb. While a great deal of research has been done on autonomous systems, there are only a handful of fielded examples incorporating machine autonomy beyond the level of teleoperation, especially in outdoor/complex environments. In an attempt to assess and understand the current state of the art in autonomous vehicle development, a few areas where unsolved problems remain became clear. This paper outlines those areas and provides suggestions for the focus of science and technology research. The first step in evaluating the current state of autonomous vehicle development was to develop a definition of autonomy. A number of autonomy level classification systems were reviewed. The resulting working definitions and classification schemes used by the authors are summarized in the opening sections of the paper. The remainder of the report discusses current approaches and challenges in decision-making and real-time control for autonomous vehicles. Suggested research focus areas for near-, mid-, and long-term development are also presented.

  20. Return Stroke Current Reflections in Rocket-Triggered Lightning

    Science.gov (United States)

    Caicedo, J.; Uman, M. A.; Jordan, D.; Biagi, C. J.; Hare, B.

    2015-12-01

    In the six years from 2009 to 2014, there have been eight triggered flashes at the ICLRT, from a total of 125, in which a total of ten return stroke channel-base currents exhibited a dip 3.0 to 16.6 μs after the initial current peak. Close range electric field measurements show a related dip following the initial electric field peak, and electric field derivative measurements show an associated bipolar pulse, confirming that this phenomenon is not an instrumentation effect in the current measurement. For six of the eight flashes, high-speed video frames show what appears to be suspended sections of unexploded triggering wire at heights of about 150 to 300 m that are illuminated when the upward current wave reaches them. The suspended wire can act as an impedance discontinuity, perhaps as it explodes, and cause a downward reflection of some portion of the upward-propagating current wave. This reflected wave travels down the channel and causes the dip in the measured channel-base current when it reaches ground and reflects upward. The modified transmission line model with exponential decay (MTLE) is used to model the close electric field and electric field derivatives of the postulated initial and reflected current waves, starting with the measured channel base current, and the results are compared favorably with measurements made at distances ranging from 92 to 444 m. From the measured time between current impulse initiation and the time the current reflection reaches the channel base and the current dip initiates, along with the reflection height from the video records, we find the average return stroke current speed for each of the ten strokes to be from 0.28 to 1.9×108 ms-1, with an error of ±0.01×108 ms-1 due to a ±0.1 μs uncertainty in the measurement. This represents the first direct measurement of return stroke current speed, all previous return stroke speed measurements being derived from the luminosity of the process.

  1. Evolution and current challenges of laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    XU Dahua.

    2013-03-01

    Full Text Available Since its introduction at the end of the 20th century, laparoscopic cholecystectomy has evolved into a safe and convenient minimally invasive surgical method, which is now the gold standard therapy for cholelithiasis worldwide. Physicians have continued to improve upon the procedure, creating methods that further minimize the related scarring and pain, such as the laproendoscopic single-site cholecystectomy and the gasless-lift laparoscopy. Additionally, the primary challenge of limited operative space in these procedures remains a key feature requiring improvement. In this review, the development and progression of laparoscopic cholecystectomy over the past 26 years is discussed, highlighting the current advantages and disadvantages that need to be addressed by practicing physicians to maximize the clinical value of this important therapy.

  2. Energy access. Current situation, challenges and outlook

    International Nuclear Information System (INIS)

    2014-07-01

    Globally over 1.3 billion people do not have access to electricity and 2.6 billion people rely on the traditional use of biomass for cooking. Energy access is one of the major challenges of the 21. century as it is a lever for both economic and human development, at individual and national level. Moreover, energy access represents a high-potential market and offers a lot of opportunities for private companies and industrials. In this publication, ENEA lays out the current situation of energy access (actors, actual and future needs, existing technological solutions, markets). The publication addresses the main issues energy access has to face: energy price, equipment financing, distribution, scale-up, and environmental performances

  3. Pediatric neurocysticercosis: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Singhi P

    2016-03-01

    Full Text Available Pratibha Singhi, Arushi Gahlot SainiDepartment of Pediatrics, Pediatric Neurology and Neurodevelopment Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaAbstract: Neurocysticercosis (NCC is an acquired infection of the nervous system caused by encysted larvae of Taenia solium. It is a major cause of epilepsy in the tropics and the commonest cause of focal seizures in North Indian children. T. solium teniasis-cysticercosis is considered a parasitic “Neglected Tropical Diseases” endemic throughout Southeast Asia. NCC in children has pleomorphic manifestations depending on the location, number and viability of the cysts, and host response. Even with advancing knowledge of the disease manifestations, many aspects related to diagnosis and treatment, particularly in children, still remain controversial and pose challenges to clinical practice. There is no gold standard test to diagnose NCC and the management recommendations are still emerging. This review provides an overview of diagnosis of NCC in children and its management with special focus on current challenges and future prospects.Keywords: neurocysticercosis, children, epilepsy, ring enhancing lesions, pigs

  4. CURRENT SITUATION OF MEDICINE III AND CHALLENGES

    Directory of Open Access Journals (Sweden)

    Lydia Masako Ferreira

    Full Text Available Objective: Describe the current situation of the area Medicine III of CAPES and detect challenges for the next four years of evaluation. Methods: The area's documents and reports of meetings were read from 2004 to 2013 Medicine III Capes as well as reports and evaluation form of each Postgraduate Program (PPG of the area and the sub-page of the area from the Capes website. The data relating to the evaluation process, the assessment form and faculty, student and scientific production data of all of Post-Graduate Programs of Medicine III were computed and analyzed. From these data were detected the challenges of the area for the next four years (2013-2016. Results: Among the 3,806 PPG, Medicine III had 41 PPG during last triennial evaluation and progressed from 18% to 43% of PPG very good or more concept (triennium 2001-2003 and 2010-2012. Most PPG were located in the South-East region (32, three in the South and two in the North-East. There was no PPG in North or Central-West regions. In 2013 and 2014 there were four approved Professional Master Degree Programs and one Master (M and Doctorate (PhD. The average of permanent professors was 558 teachers with about three students/professor. The number of PhD graduates has increased as well as the reason PhD/MD. The proportion of in high impact periodicals (A1, A2, B1 and B2 jumped from 30% to 50% demonstrating positive community response to the policy area. The challenges identified were: decrease regional asymmetry, increase the number of masters and doctors of excellence, reassessment of Brazilian journals, stimulate and set internationalization indicators, including post-doctors and definition of its indicators, the PPG nucleation analysis, PPG 3x3, include primary and secondary education, professional master and indicators of technological scientific production and solidarity. Conclusion: Medicine III has been scientifically consolidated and their scientific researchers demonstrated maturity

  5. Contextualization and diversification. Current challenges Technologist training in accounting

    Directory of Open Access Journals (Sweden)

    Fidel Andy Lucín-Preciado

    2017-07-01

    Full Text Available This paper addresses a topic of keen interest to those teachers who are responsible for training professionals in the accounting area whenever the current society is characterized by rapid changes acting on the system, affecting different ways to institutions and individuals. From this idea the objective is aimed to reflect on the current challenges of training professionals in accounting. The result is directed to perform some educational proposals that allow conceive the differences that occur in students and the current reality of the new productive matrix in Ecuador to structure the best training strategies in terms of achieving the skills required in professional alluded. The methodology is based primarily on observation, document review and interviews with experts.

  6. The challenge of diagnosing seborrheic keratosis by reflectance confocal microscopy.

    Science.gov (United States)

    Guo, A; Chen, J; Yang, C; Ding, Y; Zeng, Q; Tan, L

    2018-05-24

    Seborrheic keratosis (SK) is one of the most common skin tumors seen by dermatologists. It should be differentiated with many diseases, especially skin tumors. Reflectance confocal microscopy (RCM) has been applied for evaluation of SK. There are a few studies that describe the RCM of SK. The aim of the study was to find the challenge of diagnosing seborrheic keratosis by reflectance confocal microscopy. A total of 390 patients with a clinical suspicious diagnosis of seborrheic keratosis were enrolled in this study, and lesions from each patient were imaged with RCM. Thirty-seven of these patients performed a biopsy in order to be given a histological diagnosis. We retrospectively analyzed the outcomes of RCM diagnosis and histological diagnosis, and then found the RCM characteristics of biopsy-proven lesions. According to RCM images, 258 of 390 (66.2%) patients were diagnosed with SK, 97 of 390 (24.9%) patients could not be diagnosed by the dermatologist according to RCM. Of all 37 biopsied lesions, 23 were SK, 6 were actinic keratosis, 2 were basal cell carcinoma, and 2 were squamous cell carcinoma. It is challenge to diagnose seborrheic keratosis by reflectance confocal microscopy. It may due to the variable clinical and RCM appearances of SK, and limited depth of RCM. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Postmodernism and the hermeneutical challenge: some theological reflections

    Directory of Open Access Journals (Sweden)

    G.J. Pillay

    1999-08-01

    Full Text Available How can one achieve the critical tension between contextual relevance in a post-modem world and "responsibility before history"? What is the justification for theological method as critical reflection within a tradition? What is the relation between ground texts that have historical authority (Scripture, the infonning tradition of interpretation of these texts (Church History, and the interpretive communities that read them (context? Raising these questions, the article argues that for all its useful insights, postmodemism fundamentally challenges theological (and historical reflection. Theology has always contextualised itself ever since its origins. What is different in this encounter is that we are dealing with an intractable ideology that not only undercuts the fundamentals but disallows the "long view" (the infonning and continually renewing tradition and the communicativeness of theology (proclamation.

  8. ILRS: Current Status and Future Challenges

    Science.gov (United States)

    Pearlman, M. R.; Bianco, G.; Merkowitz, S.; Noll, C. E.; Pavlis, E. C.; Shargorodsky, V.; Zhongping, Z.

    2016-12-01

    The International Laser Ranging Service (ILRS) is expanding its ground tracking capability with new stations and upgrades to current stations. Our Russian colleagues have installed new stations in Brasilia and South Africa, and have several other sites in process or in planning. The NASA Space Geodesy Program is preparing equipment for U.S. sites (McDonald and Haleakala) and with the Norwegian National Mapping Agency in Ny Ålesund; further deployments are planned. Upgrades continue at sites in China, and new sites are underway or planned in Europe and India. Stations are moving to higher repetition rates and more efficient detection to enhance satellite interleaving capability; some stations have already implemented automated processes that could lead to around-the-clock operation to increase temporal coverage and to make more efficient use of personnel. The ILRS roster of supported satellites continues to grow with the addition of the LARES satellite to augment tracking for the improvement of the ITRF. New GNSS constellations and geosynchronous satellites now bring the total roster to over 80 satellites - so much so, that new tracking strategies and time and location multiplexing are under consideration. There continues to be strong interest in Lunar Ranging. New applications of one-way and two-way laser ranging include ps-accurate time transfer, laser transponders for interplanetary ranging, and tracking of space debris. New laser ranging data products are being developed, including satellite orbit products, satellite orientation, gravity field products, and products to characterize the quality of data and station performance. This talk will give a brief summary of recent progress, current challenges and a view of the path ahead.

  9. HIV vaccines: current challenges and future directions.

    Science.gov (United States)

    Avrett, Sam; Collins, Chris

    2002-07-01

    Volume seven of the Review will mark the tenth anniversary of the Canadian HIV/AIDS Legal Network with a series of articles that describe past developments and future directions in several areas of policy and law related to HIV/AIDS. The following article is the first of these, discussing current challenges and future directions in the development of and access to HIV vaccines. It argues that governments are under public health, ethical, and legal obligations to develop and provide access to HIV vaccines. It further explains what is required for governments to fulfill their obligations: additional commitment and resources for HIV vaccine development in the context of increased global research and development regarding diseases of the poor; increased support and advocacy for partnerships to develop HIV vaccines; enhanced regulatory capacity in every country to review, approve, and monitor HIV vaccines; and assurance of global supply of, procurement of, delivery of, and access to vaccines in the context of efforts to increase global access to public health measures and technologies.

  10. Current overview on challenges in regenerative endodontics

    Science.gov (United States)

    Bansal, Ramta; Jain, Aditya; Mittal, Sunandan

    2015-01-01

    Introduction: Regenerative endodontics provides hope of converting the non-vital tooth into vital once again. It focuses on substituting traumatized and pathological pulp with functional pulp tissue. Current regenerative procedures successfully produce root development but still fail to re-establish real pulp tissue and give unpredictable results. There are several drawbacks that need to be addressed to improve the quality and efficiency of the treatment. Aim: The aim of this review article is to discuss major priorities that ought to be dealt before applications of regenerative endodontics flourish the clinical practice. Materials and Methods: A web-based research on MEDLINE was done using filter terms Review, published in the last 10 years and Dental journals. Keywords used for research were “regenerative endodontics,” “dental stem cells,” “growth factor regeneration,” “scaffolds,” and “challenges in regeneration.” This review article screened about 150 articles and then the relevant information was compiled. Results: Inspite of the impressive growth in regenerative endodontic field, there are certain loopholes in the existing treatment protocols that might sometimes result in undesired and unpredictable outcomes. Conclusion: Considerable research and development efforts are required to improve and update existing regenerative endodontic strategies to make it an effective, safe, and biological mode to save teeth. PMID:25657518

  11. CURRENT SITUATION OF MEDICINE III AND CHALLENGES.

    Science.gov (United States)

    Ferreira, Lydia Masako

    2015-01-01

    Describe the current situation of the area Medicine III of CAPES and detect challenges for the next four years of evaluation. The area's documents and reports of meetings were read from 2004 to 2013 Medicine III Capes as well as reports and evaluation form of each Postgraduate Program (PPG) of the area and the sub-page of the area from the Capes website. The data relating to the evaluation process, the assessment form and faculty, student and scientific production data of all of Post-Graduate Programs of Medicine III were computed and analyzed. From these data were detected the challenges of the area for the next four years (2013-2016). Among the 3,806 PPG, Medicine III had 41 PPG during last triennial evaluation and progressed from 18% to 43% of PPG very good or more concept (triennium 2001-2003 and 2010-2012). Most PPG were located in the South-East region (32), three in the South and two in the North-East. There was no PPG in North or Central-West regions. In 2013 and 2014 there were four approved Professional Master Degree Programs and one Master (M) and Doctorate (PhD). The average of permanent professors was 558 teachers with about three students/professor. The number of PhD graduates has increased as well as the reason PhD/MD. The proportion of in high impact periodicals (A1, A2, B1 and B2) jumped from 30% to 50% demonstrating positive community response to the policy area. The challenges identified were: decrease regional asymmetry, increase the number of masters and doctors of excellence, reassessment of Brazilian journals, stimulate and set internationalization indicators, including post-doctors and definition of its indicators, the PPG nucleation analysis, PPG 3x3, include primary and secondary education, professional master and indicators of technological scientific production and solidarity. Medicine III has been scientifically consolidated and their scientific researchers demonstrated maturity reaching a high level and matched to areas of greatest

  12. Sustainable Biomaterials: Current Trends, Challenges and Applications

    Directory of Open Access Journals (Sweden)

    Girish Kumar Gupta

    2015-12-01

    Full Text Available Biomaterials and sustainable resources are two complementary terms supporting the development of new sustainable emerging processes. In this context, many interdisciplinary approaches including biomass waste valorization and proper usage of green technologies, etc., were brought forward to tackle future challenges pertaining to declining fossil resources, energy conservation, and related environmental issues. The implementation of these approaches impels its potential effect on the economy of particular countries and also reduces unnecessary overburden on the environment. This contribution aims to provide an overview of some of the most recent trends, challenges, and applications in the field of biomaterials derived from sustainable resources.

  13. Sustainable Biomaterials: Current Trends, Challenges and Applications.

    Science.gov (United States)

    Kumar Gupta, Girish; De, Sudipta; Franco, Ana; Balu, Alina Mariana; Luque, Rafael

    2015-12-30

    Biomaterials and sustainable resources are two complementary terms supporting the development of new sustainable emerging processes. In this context, many interdisciplinary approaches including biomass waste valorization and proper usage of green technologies, etc., were brought forward to tackle future challenges pertaining to declining fossil resources, energy conservation, and related environmental issues. The implementation of these approaches impels its potential effect on the economy of particular countries and also reduces unnecessary overburden on the environment. This contribution aims to provide an overview of some of the most recent trends, challenges, and applications in the field of biomaterials derived from sustainable resources.

  14. Special Education in Arab Countries: Current Challenges

    Science.gov (United States)

    Hadidi, Muna S.; Al Khateeb, Jamal M.

    2015-01-01

    Arab countries have undertaken various measures to develop special education programmes and services over the last three decades; nevertheless, major challenges remain regarding the expansion of these programmes and services and improving their quality. "This article provides an update on disability and special education in Arab…

  15. Rising to the challenges-Reflections on Future-oriented Technology Analysis

    OpenAIRE

    Georghiou, Luke; Cassingena Harper, Jennifer

    2013-01-01

    Drawing upon the presentations made at the fourth conference on Future-oriented Technology Analysis, this essay reflects on the implications of the current period of instability and discontinuity for the practice of FTA or foresight. In the past the demand environment for foresight on research and innovation policy favoured application to priority-setting and articulation of demand. New tendencies include a heightened search for breakthrough science and a focus on grand societal challenges. B...

  16. Current Challenges in Radiation Protection in Medicine

    International Nuclear Information System (INIS)

    KASE, K.R.

    2008-01-01

    Radiation protection professionals in medical facilities and practices are being challenged by new imaging technologies that use x-rays or radioactive materials. These include faster computerized tomography (CT) scanners, new interventional techniques that use extended fluoroscopy time, increased use of positron emission tomography (PET), and digital imaging techniques. More frequently these technologies are being fused into a single procedure, such as combined CT and PET scanning. Radiation Protection professionals are challenged to (1) be aware of developing technologies and clinical techniques, (2) analyze the potential radiation risks to patients and staff, (3) initiate necessary radiation safety training for medical staff, and (4) be involved in planning, dose measurement and optimization of the procedure to achieve appropriate dose control and ALARA

  17. Planetary Cartography - Activities and Current Challenges

    Science.gov (United States)

    Nass, Andrea; Di, Kaichang; Elgner, Stephan; van Gasselt, Stephan; Hare, Trent; Hargitai, Henrik; Karachevtseva, Irina; Kereszturi, Akos; Kersten, Elke; Kokhanov, Alexander; Manaud, Nicolas; Roatsch, Thomas; Rossi, Angelo Pio; Skinner, James, Jr.; Wählisch, Marita

    2018-05-01

    Maps are one of the most important tools for communicating geospatial information between producers and receivers. Geospatial data, tools, contributions in geospatial sciences, and the communication of information and transmission of knowledge are matter of ongoing cartographic research. This applies to all topics and objects located on Earth or on any other body in our Solar System. In planetary science, cartography and mapping have a history dating back to the roots of telescopic space exploration and are now facing new technological and organizational challenges with the rise of new missions, new global initiatives, organizations and opening research markets. The focus of this contribution is to introduce the community to the field of planetary cartography and its historic foundation, to highlight some of the organizations involved and to emphasize challenges that Planetary Cartography has to face today and in the near future.

  18. Micromachining process – current situation and challenges

    Directory of Open Access Journals (Sweden)

    Lalakiya Meet Rajeshkumar

    2015-01-01

    Full Text Available The rapid progress in the scientific innovations and the hunt for the renewable energy increases the urge for producing the bio electronic products, solar cells, bio batteries, nano robots, MEMS, blood less surgical tools which can be possible with the aid of the micromachining. This article helps us to understand the evolution and the challenges faced by the micromachining process. Micro machining is an enabling technology that facilitates component miniaturization and improved performance characteristics. Growing demand for less weight, high accuracy, high precision, meagre lead time, reduced batch size, less human interference are the key drivers for the micromachining than the conventional machining process.

  19. Bordetella pertussis pathogenesis: current and future challenges

    Science.gov (United States)

    Melvin, Jeffrey A.; Scheller, Erich V.; Miller, Jeff F.; Cotter, Peggy A.

    2014-01-01

    Pertussis, or whooping cough, has recently reemerged as a major public health threat despite high levels of vaccination against the etiological agent, Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into virulence factor function. We also discuss the changing epidemiology of pertussis and the challenges of vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies. PMID:24608338

  20. Current Challenges in Social Media Management

    DEFF Research Database (Denmark)

    Tørning, Kristian; Jaffari, Zeshan Ali; Vatrapu, Ravi

    2015-01-01

    and sales, customer support, product innovation etc. To investigate current social media managerial practices, we conducted a multiple case study, employing structured in-depth interviews with social media managers at some of the leading multi-national companies headquartered in Denmark (LEGO®, Mærsk...

  1. German General Staff Officer Education and Current Challenges

    National Research Council Canada - National Science Library

    Groeters, Thomas

    2006-01-01

    "German General Staff Officer Education and Current Challenges" examines the institutional education of German General Staff Officers, as experienced by the author, and offers a "Conceptual Competency...

  2. Vocational Literacy in Mozambique: Historical Development, Current Challenges and Contradictions

    Directory of Open Access Journals (Sweden)

    Oleg Popov

    2016-03-01

    Full Text Available The study analyses the historical development of vocational literacy in basic education and Non-Formal Vocational Education (NFVE in Mozambique, as well as current challenges and contradictions. The theoretical lens of Cultural-Historical Activity Theory (CHAT is employed in the study. Methodologically the study was executed through an analysis of oral, printed and e-resources produced by the main stakeholders and also the reflective experiences of the authors in their extensive educational work in the country. The findings reveal poorly developed vocational literacy education in schools and non-formal settings in spite of recurrent political declarations about its importance. There is a strong dependence by formal and particularly NFVE sectors on the technical and financial support provided by international organisations. Vocational literacy courses are characterized by a lack of adequate equipment and poor practice. As a consequence, theoretical or elementary forms of vocational knowledge are dominant in the courses, resulting in the dissatisfaction of both learners and educators. Vocational literacy development proved to be a complex field that faces many challenges and ischaracterised by diverse internal contradictions.

  3. Hyperthermia: Clinical promise and current challenges

    International Nuclear Information System (INIS)

    Kapp, D.S.

    1987-01-01

    Local-regional hyperthermia (HT) when used in conjunction with radiation therapy (XRT), has been shown in numerous clinical trials to result in considerable improvement in response rates and local tumor control rates when compared with treatment by XRT alone. Although considerable progress has been made in understanding the biological basis for hyperthermia induced cytotoxicity and radiosensitization, additional research remains in establishing the optimal treatment schedules for the clinical utilization of HT-XRT. The number of HT treatments; the sequencing of HT and XRT; the frequency of administration of HT; and the ideal temperature-time parameters all remain to be better defined for the clinical setting. The role of tumor blood flow on the thermal distributions also warrants further investigation. In addition, considerable effort is needed to improve hyperthermia equipment in order to provide more uniform therapeutic temperature distributions (temperatures ≥42.5%C). Better heating equipment is particularly needed for the treatment of deep seeted tumors. Pertinent clinical literature will be presented summarizing the clinical promise of hyperthermia and the above mentioned clinical challenges

  4. Enamel Regeneration - Current Progress and Challenges

    Science.gov (United States)

    Baswaraj; H.K, Navin; K.B, Prasanna

    2014-01-01

    Dental Enamel is the outermost covering of teeth. It is hardest mineralized tissue present in the human body. Enamel faces the challenge of maintaining its integrity in a constant demineralization and remineralization within the oral environment and it is vulnerable to wear, damage, and decay. It cannot regenerate itself, because it is formed by a layer of cells that are lost after the tooth eruption. Conventional treatment relies on synthetic materials to restore lost enamel that cannot mimic natural enamel. With advances in material science and understanding of basic principles of organic matrix mediated mineralization paves a way for formation of synthetic enamel. The knowledge of enamel formation and understanding of protein interactions and their gene products function along with the isolation of postnatal stem cells from various sources in the oral cavity, and the development of smart materials for cell and growth factor delivery, makes possibility for biological based enamel regeneration. This article will review the recent endeavor on biomimetic synthesis and cell based strategies for enamel regeneration. PMID:25386548

  5. [Cardiac rehabilitation: current status and future challenges].

    Science.gov (United States)

    Hahmann, H W

    2012-02-01

    The goal of cardiac rehabilitation is to support heart patients using a multidisciplinary team in order to obtain the best possible physical and mental health and achieve long-term social reintegration. In addition to improving physical fitness, cardiac rehabilitation restores self-confidence, thus better equipping patients to deal with mental illness and improving their social reintegration ("participation"). Once the causes of disease have been identified and treated as effectively as possible, drug and lifestyle changes form the focus of cardiac rehabilitation measures. In particular diseases, rehabilitation offers the opportunity for targeted educational courses for diabetics or drug dose escalation, as well as special training for heart failure patients. A nationwide network of outpatient heart groups is available for targeted follow-up. Cardiac patients predominantly rehabilitated in follow-up rehabilitation are older and have greater morbidity than in the past; moreover, they generally come out of acute clinical care earlier and are discharged from hospital more quickly. The proportion of severely ill and multimorbid patients presents a diagnostic and therapeutic challenge in cardiac rehabilitation, although cardiac rehabilitation was not initially conceived for this patient group. The benefit of cardiac rehabilitation has been a well documented reduction in morbidity and mortality. However, hurdles remain, partly due to the patients themselves, partly due to the health insurers. Some insurance providers still refuse rehabilitation for non-ST-segment elevation infarction. In principle rehabilitation can be carried out in an inpatient or an outpatient setting. Specific allocation criteria have not yet been established, but the structure and process quality of outpatient rehabilitation should correspond to that of the inpatient setting. The choice between the two settings should be based on pragmatic criteria. Both settings should be possible for an individual

  6. Current Challenges to Teacher Education in Denmark

    DEFF Research Database (Denmark)

    Staugaard, Hans Jørgen; Rasmussen, Palle

    and other subjects. But the university colleges are not part of the regular university sector, so teacher education is still generally separated from the research-based university tradition. Currently this fact is much debated. Two main types of arguments are being put forward for relocating teacher...... education to universities. One is that it will improve the subject knowledge of teacher and thus enable them to raise the skill levels of Danish students in core subjects. This is deemed necessary in the wake of international comparative surveys of achievement (like the PISA). Another argument is that many......Until recently, teacher education in Denmark for primary and lower secondary school (the Folkeskole) was organised in separate teacher training colleges. During the last ten years two comprehensive reforms of the system of medium cycle higher education have been implemented, first the act...

  7. Development of indigenous irradiator - current progress and challenges

    International Nuclear Information System (INIS)

    Anwar A Rahman; Mohd Arif Hamzah; Muhd Nor Atan; Aznor Hassan; Fadil Ismail; Julia A Karim; Rosli Darmawan

    2009-01-01

    The development of indigenous irradiator is one of Prototype Development Center main project to support Nuclear Malaysia services. Three (3) projects have been identified and currently the status is in final stage of design. There are some issues and challenges encountered, which delayed the project progress. The paper will discuss the current progress of development and challenges faced in designing the irradiator. (Author)

  8. Pulp regeneration: Current approaches and future challenges

    Directory of Open Access Journals (Sweden)

    Jingwen eYANG

    2016-03-01

    Full Text Available Regenerative endodontics aims to replace inflamed/necrotic pulp tissues with regenerated pulp-like tissues to revitalize teeth and improve life quality. Pulp revascularization case reports, which showed successful clinical and radiographic outcomes, indicated the possible clinical application of pulp regeneration via cell homing strategy. From a clinical point of view, functional pulp-like tissues should be regenerated with the characterization of vascularization, re-innervation, and dentin deposition with a regulated rate similar to that of normal pulp. Efficient root canal disinfection and proper size of the apical foramen are the two requisite preconditions for pulp regeneration. Progress has been made on pulp regeneration via cell homing strategies. This review focused on the requisite preconditions and cell homing strategies for pulp regeneration. In addition to the traditionally used mechanical preparation and irrigation, antibiotics, irrigation assisted with EndoVac apical negative-pressure system, and ultrasonic and laser irradiation are now being used in root canal disinfection. In addition, pulp-like tissues could be formed with the apical foramen less than 1 mm, although more studies are needed to determine the appropriate size. Moreover, signaling molecules including stromal cell derived factor (SDF-1α, basic Fibroblast Growth Factor (bFGF, Platelet Derived Growth Factor (PDGF, stem cell factor (SCF, and Granulocyte Colony-Stimulating Factor (G-CSF were used to achieve pulp-like tissue formation via a cell homing strategy. Studies on the cell sources of pulp regeneration might give some indications on the signaling molecular selection. The active recruitment of endogenous cells into root canals to regenerate pulp-like tissues is a novel concept that may offer an unprecedented opportunity for the near-term clinical translation of current biology-based therapies for dental pulp regeneration.

  9. Current challenges in quantifying preferential flow through the vadose zone

    Science.gov (United States)

    Koestel, John; Larsbo, Mats; Jarvis, Nick

    2017-04-01

    In this presentation, we give an overview of current challenges in quantifying preferential flow through the vadose zone. A review of the literature suggests that current generation models do not fully reflect the present state of process understanding and empirical knowledge of preferential flow. We believe that the development of improved models will be stimulated by the increasingly widespread application of novel imaging technologies as well as future advances in computational power and numerical techniques. One of the main challenges in this respect is to bridge the large gap between the scales at which preferential flow occurs (pore to Darcy scales) and the scale of interest for management (fields, catchments, regions). Studies at the pore scale are being supported by the development of 3-D non-invasive imaging and numerical simulation techniques. These studies are leading to a better understanding of how macropore network topology and initial/boundary conditions control key state variables like matric potential and thus the strength of preferential flow. Extrapolation of this knowledge to larger scales would require support from theoretical frameworks such as key concepts from percolation and network theory, since we lack measurement technologies to quantify macropore networks at these large scales. Linked hydro-geophysical measurement techniques that produce highly spatially and temporally resolved data enable investigation of the larger-scale heterogeneities that can generate preferential flow patterns at pedon, hillslope and field scales. At larger regional and global scales, improved methods of data-mining and analyses of large datasets (machine learning) may help in parameterizing models as well as lead to new insights into the relationships between soil susceptibility to preferential flow and site attributes (climate, land uses, soil types).

  10. [Reflections on Occupational Health Nursing in Taiwan: Challenges and Perspectives].

    Science.gov (United States)

    Wu, Fei-Ling; Tsai, Hsiu-Min; Liou, Yiing-Mei; Chou, Yen-Fang; Chang, Tsai-Hsiu; Shiao, Shu-Chu Judith

    2018-04-01

    The development of the occupational health nursing profession has promoted stable and healthy human resources in Taiwan. In order to improve the occupational safety, health, and healthcare of workers, the professional core competencies and role functions of occupational health nursing is of utmost importance. This article investigated the current status of occupational health nursing education, role functions, practice scope, and the development and responsibilities of professional associations and proposed the challenges to and the future prospects of the development of occupational health nursing in Taiwan. The key findings include: (1) the role functions and practice scope of occupational health nursing; (2) occupational health nursing courses should be included in the required credits of Department of Nursing and master and doctor programs in occupational health nursing should be established; (3) a certification system of occupational health nursing should be established as soon as possible; (4) the professional associations for occupational health nursing should take responsibility for continuing education and training; and (5) interdisciplinary collaborations among relevant occupational health professionals should be strengthened.

  11. The Rise of International Relations Programs in the Brazilian Federal Universities: Curriculum Specificities and Current Challenges

    Science.gov (United States)

    Ferreira, Marcos Alan S. V.

    2016-01-01

    The aim of this reflection is to study the new international relations (IR) programs introduced by Brazilian federal universities, looking comparatively at their curriculum specificities and current challenges. In recent years, Brazil has seen an increase of IR programs launched in several regions. Since 2003, the Ministry of Education is in the…

  12. A reflective teaching challenge to motivate educational innovation.

    Science.gov (United States)

    Edwards, Roger A; Kirwin, Jennifer; Gonyeau, Michael; Matthews, S James; Lancaster, Jason; DiVall, Margarita

    2014-06-17

    To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

  13. The Future Entering: Reflections on and Challenges to Ethical Leadership

    Science.gov (United States)

    Reilly, Elizabeth C.

    2006-01-01

    To enter a future that waits to be born, educational leaders must continually assess their own ethical stance as well as that of the organizations they serve. Three frames form a model for examining the ethics of both individual and organization, with internal monologue and engaged conversation as the means for reflection and action.

  14. Journaling: identification of challenges and reflection on strategies.

    Science.gov (United States)

    Hayman, Brenda; Wilkes, Lesley; Jackson, Debra

    2012-01-01

    To identify the challenges associated with using journaling as a method of data collection and to offer strategies for effectively managing those challenges. While journaling can be used for a variety of reasons, in the context of this paper, journaling refers to the process of participants sharing thoughts, ideas, feelings and experiences through writing and/or other media. Journaling is used in phenomenological research studies to record participant experiences in their natural contexts. The findings are based on the experiences of the researchers during a qualitative study that explored the experiences of lesbian mothers and used journaling as one method of data collection. This is a methodological paper. Three main challenges affect journaling as a method of data collection: poor participation, feeling exposed and staying on track. Six strategies to promote participation in journaling are: coaching participants, limiting the journaling period, providing follow-up contact, promoting comfort, ensuring safety and providing clear content expectations. Each strategy is discussed and methods of implementing the strategies are offered. Journaling as a method of data collection has long been accepted as a valid method of accessing rich qualitative data. By acknowledging the common challenges associated with the process of journaling that are experienced by the participants, researchers employing this data collection method can promote constructive and valuable participation. Further research examining participants' experiences of journaling as a method of qualitative data collection would be useful in determining challenges, barriers and benefits of the method.

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

    Science.gov (United States)

    Lent, ReLeah Cossett

    2008-01-01

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

  16. Advising in austerity reflections on challenging times for advice agencies

    CERN Document Server

    Kirwan, Samuel

    2016-01-01

    Advising in austerity provides a lively and thought-provoking account of the conditions, consequences and challenges of advice work in the UK. It examines how advisors negotiate the private troubles of those who come to Citizens Advice Bureaux (CAB) and construct ways forward.

  17. Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

    Science.gov (United States)

    Bakshi, Fatma A.; Jaka, Hyasinta

    2018-01-01

    Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention. PMID:29666656

  18. Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

    OpenAIRE

    Kilonzo, Semvua B.; Gunda, Daniel W.; Mpondo, Bonaventura C. T.; Bakshi, Fatma A.; Jaka, Hyasinta

    2018-01-01

    Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatm...

  19. Ethical and legal challenges of vaccines and vaccination: Reflections.

    Science.gov (United States)

    Jesani, Amar; Johari, Veena

    2017-01-01

    Vaccines and vaccination have emerged as key medical scientific tools for prevention of certain diseases. Documentation of the history of vaccination shows that the initial popular resistance to universal vaccination was based on false assumptions and eventually gave way to acceptance of vaccines and trust in their ability to save lives. The successes of the global eradication of smallpox, and now of polio, have only strengthened the premier position occupied by vaccines in disease prevention. However, the success of vaccines and public trust in their ability to eradicate disease are now under challenge, as increasing numbers of people refuse vaccination, questioning the effectiveness of vaccines and the need to vaccinate.

  20. Reflections on Competition, Competition Regulation and the Current Crises

    DEFF Research Database (Denmark)

    Buch-Hansen, Hubert; Wigger, Angela

    2013-01-01

    competition came to enjoy such an exalted status in Europe and then challenges conventional wisdom by bringing into focus the downsides of competition. It argues that excessive competition and neoliberal competition regulation have contributed to intensify the economic, political, social and environmental...

  1. Some current experimental challenges in elementary particle physics

    Energy Technology Data Exchange (ETDEWEB)

    Cline, D.B. (California Univ., Los Angeles (USA). Dept. of Physics)

    1990-06-01

    We describe three experimental challenges for experimental elementary particle physics: (1) the ongoing search for flavor changing weak neutral currents, including future prospect for a anti BB factory, (2) the status of the tests of the standard model in the W, Z and t quark sectors and (3) some current search for physics beyond the standard model, to include the possibility of searching for CPT violation using a {Phi} factory. (orig.).

  2. Critical reflections on the currently leading definition of sustainable employability.

    Science.gov (United States)

    Fleuren, Bram Bi; de Grip, Andries; Jansen, Nicole Wh; Kant, Imjert; Zijlstra, Fred Rh

    2016-06-01

    claims can be made, such relationships need to be tested with SE as criterion. This is, however, impossible within the approach van der Klink et al provides. (1), as SE is equated with its predictor(s). Therefore, similar to the first conceptual issue, it seems unlikely that the capability set adequately reflects SE. Fourth, the definition by van der Klink et al (1) suggests that SE only applies to individuals who are employed. In the Abma et al publication (9), which accompanies van der Klink's definition paper as a validation paper, this is shown by the way in which capabilities are measured. Moreover, the definition also suggests this because individuals can only be considered to be sustainably employable if their work context enables them to achieve tangible opportunities. However, individuals who are not currently working can still be highly employable and even sustainably so, but just be between jobs. It is therefore not required for individuals to be enabled by their employer to be sustainably employable. Consequently, in line with our aforementioned points on improving the definition, being enabled by an employer to achieve value may be an important predictor of SE, but it is not necessarily part of SE itself. Moreover, future approaches to SE should define the concept in such a way that it is applicable to every individual regardless of employment status. Finally, the definition and operationalization of SE in the form of a capability set do not include any specification on how the longitudinal aspect of SE should be captured. The definition rightfully acknowledges the longitudinal dimension of SE, but its operationalization focuses solely on achieving value. Although achieving value at work may be an important predictor of SE, a complete operationalization and definition should include its longitudinal nature as well. Outlook In conclusion, while van der Klink et al's definition of SE (1) does have strong merits, it requires further improvement. The approach

  3. Current opportunities and challenges in skeletal muscle tissue engineering

    NARCIS (Netherlands)

    Koning, Merel; Harmsen, Martin C; van Luyn, Marja J A; Werker, Paul M N

    The purpose of this article is to give a concise review of the current state of the art in tissue engineering (TE) of skeletal muscle and the opportunities and challenges for future clinical applicability. The endogenous progenitor cells of skeletal muscle, i.e. satellite cells, show a high

  4. Capacity Building for School Development: Current Problems and Future Challenges

    Science.gov (United States)

    Ho, Dora; Lee, Moosung

    2016-01-01

    This article offers a theoretical discussion on the current problems and future challenges of school capacity building in early childhood education (ECE), aiming to highlight some key areas for future research. In recent years, there has been a notable policy shift from monitoring quality through inspection to improving quality through school…

  5. The current state of the challenges for VET in Denmark

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms

    The aim of this report is to analyse the way the Danish VET system has been coping with four challenges in the last decades. First the report describes key features of the institutional architecture of the current Danish VET-system. In the next two sections priority is given to the challenges....... The report examines how the VET systems connects with the labour market and explores the patterns of transition of the students from VET to the labour market and describes indications of their mobility and employability. In the following section the report focusses on the second challenge for vocational...... the suc-cess of subsequent reforms of VET in improving the connections between VET and higher educa-tion, latest with the reform in 2013. The next challenge to be examined is that of social inclusion. This is mainly a question of raising the retention of students in the vocational programmes, where...

  6. Evaluation and comparison of current fetal ultrasound image segmentation methods for biometric measurements: a grand challenge.

    Science.gov (United States)

    Rueda, Sylvia; Fathima, Sana; Knight, Caroline L; Yaqub, Mohammad; Papageorghiou, Aris T; Rahmatullah, Bahbibi; Foi, Alessandro; Maggioni, Matteo; Pepe, Antonietta; Tohka, Jussi; Stebbing, Richard V; McManigle, John E; Ciurte, Anca; Bresson, Xavier; Cuadra, Meritxell Bach; Sun, Changming; Ponomarev, Gennady V; Gelfand, Mikhail S; Kazanov, Marat D; Wang, Ching-Wei; Chen, Hsiang-Chou; Peng, Chun-Wei; Hung, Chu-Mei; Noble, J Alison

    2014-04-01

    This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.

  7. HAMAS AND HEZBOLLAH: REFLECTIONS OF RESISTANCE, CHALLENGES FOR DEMOCRACY

    Directory of Open Access Journals (Sweden)

    Stuart Reigeluth

    2011-04-01

    Full Text Available In the Arab-Israeli conflict, the creation and maintaining of resistance groups, as well as their recurring confrontations with Israel, take place with greater intensity in the Palestinian territories and Lebanon. In the same way that the Palestine Islamic Resistance Movement (Hamas was born out of the military occupation of the West Bank, Jerusalem and the Gaza Strip, the Lebanese Party of God (Hezbollah emerged to counteract the presence of Israel and her allies in the south of Lebanon. The pressure exerted on Israel to leave the south of Lebanon (2000 and the Gaza Strip (2005 engendered massive popular support which resulted in victories in both municipal and national elections. Both armed Islamist groups shifted towards increasingly passive policies, though at the same time they continue to be condemned to ostracism by the United States and Europe, the rupture with the secular parties became deeper, and thus the solution was deferred: the creation of coalition governments respected by their own peoples. Today, this continues to be the greatest challenge to establishing democracy in the Middle East; in no other place is this more acute than in Palestine and the Lebanon.

  8. Current and future multimodal learning analytics data challenges

    DEFF Research Database (Denmark)

    Spikol, Daniel; Prieto, Luis P.; Rodriguez-Triana, M.J.

    2017-01-01

    Multimodal Learning Analytics (MMLA) captures, integrates and analyzes learning traces from different sources in order to obtain a more holistic understanding of the learning process, wherever it happens. MMLA leverages the increasingly widespread availability of diverse sensors, high......-frequency data collection technologies and sophisticated machine learning and artificial intelligence techniques. The aim of this workshop is twofold: first, to expose participants to, and develop, different multimodal datasets that reflect how MMLA can bring new insights and opportunities to investigate complex...... learning processes and environments; second, to collaboratively identify a set of grand challenges for further MMLA research, built upon the foundations of previous workshops on the topic....

  9. Impedimetric biosensors for medical applications current progress and challenges

    CERN Document Server

    Rushworth, Jo V; Goode, Jack A; Pike, Douglas J; Ahmed, Asif; Millner, Paul

    2014-01-01

    In this monograph, the authors discuss the current progress in the medical application of impedimetric biosensors, along with the key challenges in the field. First, a general overview of biosensor development, structure and function is presented, followed by a detailed discussion of impedimetric biosensors and the principles of electrochemical impedance spectroscopy. Next, the current state-of-the art in terms of the science and technology underpinning impedance-based biosensors is reviewed in detail. The layer-by-layer construction of impedimetric sensors is described, including the design of electrodes, their nano-modification, transducer surface functionalization and the attachment of different bioreceptors. The current challenges of translating lab-based biosensor platforms into commercially-available devices that function with real patient samples at the POC are presented; this includes a consideration of systems integration, microfluidics and biosensor regeneration. The final section of this monograph ...

  10. The Current Teacher Education Programs in Ethiopia: Reflection on Practice

    Science.gov (United States)

    Mekonnen, Geberew Tulu

    2017-01-01

    This study threw light on the current practice of Postgraduate Diploma in Teaching Program at Addis Ababa University, Ethiopia. The study focused on the enrolment, graduation and attrition proportion of Postgraduate Diploma in Teaching candidates in the year 2011 and 2015. The 2011 and 2015 academic years have been purposively selected because the…

  11. Hepatitis B Virus Infection in Tanzania: Current Status and Challenges

    Directory of Open Access Journals (Sweden)

    Semvua B. Kilonzo

    2018-01-01

    Full Text Available Hepatitis B is one of the most common infectious diseases in the world with high prevalence in most of sub-Saharan Africa countries. The complexity in its diagnosis and treatment poses a significant management challenge in the resource-limited settings including Tanzania, where most of the tests and drugs are either unavailable or unaffordable. This mini review aims at demonstrating the current status of the disease in the country and discussing the concomitant challenges in diagnosis, treatment, and prevention.

  12. The Consumer Behavior Challenge: Designing an Assignment to Motivate Student Reflection and Self-Growth

    Science.gov (United States)

    Gravois, Renée; Lopez, Tará Burnthorne; Budden, Michael C.

    2017-01-01

    The tension caused by change pushes students to reflect on their new situation, examine preconceived ideas, and synthesize new with existing knowledge. In the Consumer Behavior Challenge, students are challenged to step outside of their comfort zone by changing a behavior or trying something new for a period of time. Through guided reflection…

  13. Microbial production of hyaluronic acid: current state, challenges, and perspectives

    Directory of Open Access Journals (Sweden)

    Liu Long

    2011-11-01

    Full Text Available Abstract Hyaluronic acid (HA is a natural and linear polymer composed of repeating disaccharide units of β-1, 3-N-acetyl glucosamine and β-1, 4-glucuronic acid with a molecular weight up to 6 million Daltons. With excellent viscoelasticity, high moisture retention capacity, and high biocompatibility, HA finds a wide-range of applications in medicine, cosmetics, and nutraceuticals. Traditionally HA was extracted from rooster combs, and now it is mainly produced via streptococcal fermentation. Recently the production of HA via recombinant systems has received increasing interest due to the avoidance of potential toxins. This work summarizes the research history and current commercial market of HA, and then deeply analyzes the current state of microbial production of HA by Streptococcus zooepidemicus and recombinant systems, and finally discusses the challenges facing microbial HA production and proposes several research outlines to meet the challenges.

  14. Arrhythmogenic KCNE gene variants: current knowledge and future challenges

    Directory of Open Access Journals (Sweden)

    Shawn M Crump

    2014-01-01

    Full Text Available There are twenty-five known inherited cardiac arrhythmia susceptibility genes, all of which encode either ion channel pore-forming subunits or proteins that regulate aspects of ion channel biology such as function, trafficking and localization. The human KCNE gene family comprises five potassium channel regulatory subunits, sequence variants in each of which are associated with cardiac arrhythmias. KCNE gene products exhibit promiscuous partnering and in some cases ubiquitous expression, hampering efforts to unequivocally correlate each gene to specific native potassium currents. Likewise, deducing the molecular etiology of cardiac arrhythmias in individuals harboring rare KCNE gene variants, or more common KCNE polymorphisms, can be challenging. In this review we provide an update on putative arrhythmia-causing KCNE gene variants, and discuss current thinking and future challenges in the study of molecular mechanisms of KCNE-associated cardiac rhythm disturbances.

  15. Challenges of implementing fibromyalgia treatment guidelines in current clinical practice.

    Science.gov (United States)

    Arnold, Lesley M; Clauw, Daniel J

    2017-09-01

    The current diagnostic and treatment pathway for patients with fibromyalgia (FM) is lengthy, complex, and characterized by multiple physician visits with an average 2-year wait until diagnosis. It is clear that effective identification and appropriate treatment of FM remain a challenge in current clinical practice. Ideally, FM management involves a multidisciplinary approach with the preferable patient pathway originating in primary care but supported by a range of health care providers, including referral to specialist care when necessary. After the publication of individual clinical studies, high-quality reviews, and meta-analyses, recently published FM treatment guidelines have transitioned from an expert consensus to an evidence-based approach. Evidence-based guidelines provide a framework for ensuring early diagnosis and timely adoption of appropriate treatment. However, for successful outcomes, FM treatments must adopt a more holistic approach, which addresses more than just pain. Impact on the associated symptoms of fatigue and cognitive problems, sleep and mood disturbances, and lowered functional status are also important in judging the success of FM therapy. Recently published guidelines recommend the adoption of a symptom-based approach to guide pharmacologic treatment. Emerging treatment options for FM may be best differentiated on the basis of their effect on comorbid symptoms that are often associated with pain (e.g. sleep disturbance, mood, fatigue). The current review discusses the most recently published Canadian guidelines and the implications of the recent European League Against Rheumatism (EULAR) recommendations, with a focus on the challenges of implementing these guidelines in current clinical practice.

  16. Current trends and challenges in power engineering education

    Directory of Open Access Journals (Sweden)

    Dorin Bică

    2009-12-01

    Full Text Available The ‘Energy’ thematic area has grown into an extremely challenging topic lately, due to its impact on economic, social, technical, environmental and even political levels. This large field involves the pawns of the scientific research - the most important generator of knowledge and education - one of the main beneficiaries of research findings. Consequently the power engineering education becomes a significant pillar with direct outcome in the general as well as specific competences that future graduates acquire. This paperwork aims to discourse on and highlight the methods of implementation and promotion of new topics and modern educational forms-energy software, within study programmes. This is of course a permanent process and reflects our efforts and interest in the improvement of power engineering educational quality.

  17. Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges

    Science.gov (United States)

    Salem, Haitham; Nagpal, Caesa; Pigott, Teresa; Teixeira, Antonio Lucio

    2017-01-01

    Background: Akathisia continues to be a significant challenge in current neurological and psychiatric practice. Prompt and accurate detection is often difficult and there is a lack of consensus concerning the neurobiological basis of akathisia. No definitive treatment has been established for akathisia despite numerous preclinical and clinical studies. Method: We reviewed antipsychotic-induced akathisia including its clinical presentation, proposed underlying pathophysiology, current and under investigation therapeutic strategies. Conclusion: Despite the initial promise that second generation antipsychotics would be devoid of akathisia effects, this has not been confirmed. Currently, there are limited therapeutic options for the clinical practice and the evidence supporting the most widely used treatments (beta blockers, anticholinergic drugs) is still absent or inconsistent. PMID:27928948

  18. Nonlocal Andreev reflection and spin current in a three-terminal Aharonov–Bohm interferometer

    International Nuclear Information System (INIS)

    Ju, Peng; Hua-Ling, Yu; Zhi-Guo, Wang

    2009-01-01

    This paper theoretically reports the nonlocal Andreev reflection and spin current in a normal metal-ferromagnetic metal-superconducting Aharonov–Bohm interferometer. It is found that the electronic current and spin current are sensitive to systematic parameters, such as the gate voltage of quantum dots and the external magnetic flux. The electronic current in the normal metal lead results from two competing processes: quasiparticle transmission and nonlocal Andreev reflection. The appearance of zero spin-up electronic current (or spin-down electronic current) signals the existence of nonlocal Andreev reflection, and the presence of zero electronic current results in the appearance of pure spin current. (condensed matter: electronic structure, electrical, magnetic, and optical properties)

  19. Smart wearable systems: current status and future challenges.

    Science.gov (United States)

    Chan, Marie; Estève, Daniel; Fourniols, Jean-Yves; Escriba, Christophe; Campo, Eric

    2012-11-01

    Extensive efforts have been made in both academia and industry in the research and development of smart wearable systems (SWS) for health monitoring (HM). Primarily influenced by skyrocketing healthcare costs and supported by recent technological advances in micro- and nanotechnologies, miniaturisation of sensors, and smart fabrics, the continuous advances in SWS will progressively change the landscape of healthcare by allowing individual management and continuous monitoring of a patient's health status. Consisting of various components and devices, ranging from sensors and actuators to multimedia devices, these systems support complex healthcare applications and enable low-cost wearable, non-invasive alternatives for continuous 24-h monitoring of health, activity, mobility, and mental status, both indoors and outdoors. Our objective has been to examine the current research in wearable to serve as references for researchers and provide perspectives for future research. Herein, we review the current research and development of and the challenges facing SWS for HM, focusing on multi-parameter physiological sensor systems and activity and mobility measurement system designs that reliably measure mobility or vital signs and integrate real-time decision support processing for disease prevention, symptom detection, and diagnosis. For this literature review, we have chosen specific selection criteria to include papers in which wearable systems or devices are covered. We describe the state of the art in SWS and provide a survey of recent implementations of wearable health-care systems. We describe current issues, challenges, and prospects of SWS. We conclude by identifying the future challenges facing SWS for HM. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Social power and social class: conceptualization, consequences, and current challenges.

    Science.gov (United States)

    Rucker, Derek D; Galinsky, Adam D

    2017-12-01

    This article offers a primer on social power and social class with respect to their theoretical importance, conceptual distinction, and empirical relationship. We introduce and define the constructs of social power, social class, and one's psychological sense of power. We next explore the complex relationship between social power and social class. Because social class can produce a sense of power within an individual, studies on social power can inform theory and research on social class. We conclude with a discussion of the current challenges and future opportunities for the study of social power and social class. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Review: New Vaccine Against Tuberculosis: Current Developments and Future Challenges

    Science.gov (United States)

    Liu, Jun

    2009-04-01

    Tuberculosis (TB) continues to be a global health threat. BCG was developed as an attenuated live vaccine for tuberculosis control nearly a century ago. Despite being the most widely used vaccine in human history, BCG is not an ideal vaccine and has two major limitations: its poor efficacy against adult pulmonary TB and its disconcerting safety in immunocompromised individuals. A safer and more effective TB vaccine is urgently needed. This review article discusses current strategies to develop the next generation of TB vaccines to replace BCG. While some progresses have been made in the past decade, significant challenges lie ahead.

  2. Regional power marketing opportunities : current challenges and future outlooks

    International Nuclear Information System (INIS)

    Stiers, M.

    1998-01-01

    The North American demand for electric power and natural gas by sector was described and a comparison was made between the number of FERC certified electric power marketers versus natural gas marketing companies between 1986 and 1997 to illustrate the extent of changes that occurred during the decade. Regional opportunities for energy marketers were reviewed. By way of current challenges, the author identified (1) regulatory impediments, (2) divestiture of assets, (3) creation of an effective ISO, (4) establishment of effective pricing mechanisms, (5) customer systems and infrastructure, (6) forcing legislative reform, and (7) stranded cost recovery, as the most important. figs

  3. Reflection and identity of civilizations (notes to the "Challenge-and-Response” conception

    Directory of Open Access Journals (Sweden)

    Yuri V. Popkov

    2016-07-01

    Full Text Available The subject-matter of the analysis is A. Toynbee’s challenge-and-response” concept which he used as an explanatory means for studying the interaction of civilizations. The paper provides arguments for its limitations and offers justification for a conception of reflection of civilizations with a better heuristic potential for solving this problem. It is shown that the discourse of reflection sets the grounds for defining civilizational identity.

  4. Reflections on the challenges and possibilities of journal publication in science education

    Science.gov (United States)

    Milne, Catherine; Siry, Christina; Mueller, Michael

    2015-12-01

    In this editorial we reflect on the intersections between the review and publishing policies of Cultural Studies of Science Education (CSSE) and the challenges and possibilities in global science education publishing. In particular we discuss the tensions associated with open or closed review policies, the hegemony of English as a language of publication, and reflect on some of the common challenges experienced by editors and authors from different contexts. We draw on the paper set in this issue consisting of five papers focused on publishing in various contexts, and elaborate several central questions for the field of science education and the dissemination of knowledges.

  5. Student reflections on learning with challenging tasks: `I think the worksheets were just for practice, and the challenges were for maths'

    Science.gov (United States)

    Russo, James; Hopkins, Sarah

    2017-09-01

    The current study considered young students' (7 and 8 years old) experiences and perceptions of mathematics lessons involving challenging (i.e. cognitively demanding) tasks. We used the Constant Comparative Method to analyse the interview responses ( n = 73) regarding what work artefacts students were most proud of creating and why. Five themes emerged that characterised student reflections: enjoyment, effort, learning, productivity and meaningful mathematics. Overall, there was evidence that students embraced struggle and persisted when engaged in mathematics lessons involving challenging tasks and, moreover, that many students enjoyed the process of being challenged. In the second section of the paper, the lesson structure preferences of a subset of participants ( n = 23) when learning with challenging tasks are considered. Overall, more students preferred the teach-first lesson structure to the task-first lesson structure, primarily because it activated their cognition to prepare them for work on the challenging task. However, a substantial minority of students (42 %) instead endorsed the task-first lesson structure, with several students explaining they preferred this structure precisely because it was so cognitively demanding. Other reasons for preferring the task-first structure included that it allowed the focus of the lesson to be on the challenging task and the subsequent discussion of student work. A key implication of these combined findings is that, for many students, work on challenging tasks appeared to remain cognitively demanding irrespective of the structure of the lesson.

  6. Sleep medicine in Saudi Arabia: Current problems and future challenges

    Science.gov (United States)

    BaHammam, Ahmed S.

    2011-01-01

    Sleep medicine is a relatively new specialty in the medical community. The practice of sleep medicine in Saudi Arabia (KSA) began in the mid to late nineties. Since its inception, the specialty has grown, and the number of specialists has increased. Nevertheless, sleep medicine is still underdeveloped in the KSA, particularly in the areas of clinical service, education, training and research. Based on available data, it appears that sleep disorders are prevalent among Saudis, and the demand for sleep medicine service is expected to rise significantly in the near future. A number of obstacles have been defined that hinder the progress of the specialty, including a lack of trained technicians, specialists and funding. Awareness about sleep disorders and their serious consequences is low among health care workers, health care authorities, insurance companies and the general public. A major challenge for the future is penetrating the educational system at all levels to demonstrate the high prevalence and serious consequences of sleep disorders. To attain adequate numbers of staff and facilities, the education and training of health care professionals at the level of sleep medicine specialists and sleep technologists is another important challenge that faces the specialty. This review discusses the current position of sleep medicine as a specialty in the KSA and the expected challenges of the future. In addition, it will guide clinicians interested in setting up new sleep medicine services in the KSA or other developing countries through the potential obstacles that may face them in this endeavor. PMID:21264164

  7. Sleep medicine in Saudi Arabia: Current problems and future challenges

    Directory of Open Access Journals (Sweden)

    BaHammam Ahmed

    2011-01-01

    Full Text Available Sleep medicine is a relatively new specialty in the medical community. The practice of sleep medicine in Saudi Arabia (KSA began in the mid to late nineties. Since its inception, the specialty has grown, and the number of specialists has increased. Nevertheless, sleep medicine is still underdeveloped in the KSA, particularly in the areas of clinical service, education, training and research. Based on available data, it appears that sleep disorders are prevalent among Saudis, and the demand for sleep medicine service is expected to rise significantly in the near future. A number of obstacles have been defined that hinder the progress of the specialty, including a lack of trained technicians, specialists and funding. Awareness about sleep disorders and their serious consequences is low among health care workers, health care authorities, insurance companies and the general public. A major challenge for the future is penetrating the educational system at all levels to demonstrate the high prevalence and serious consequences of sleep disorders. To attain adequate numbers of staff and facilities, the education and training of health care professionals at the level of sleep medicine specialists and sleep technologists is another important challenge that faces the specialty. This review discusses the current position of sleep medicine as a specialty in the KSA and the expected challenges of the future. In addition, it will guide clinicians interested in setting up new sleep medicine services in the KSA or other developing countries through the potential obstacles that may face them in this endeavor.

  8. Reflections from challenges of working with HIV/Aids affected and infected orphans in Malawi

    Directory of Open Access Journals (Sweden)

    Zainab Lognwe

    2015-03-01

    Full Text Available Karen Healy uses the term reflection in action to refer to processes of refining knowledge in action so as to promote new ways of responding to the problems we encounter in practice. Thus, social work entails working with different people with different non routine challenges that needs reflective action to be dealt with effectively. The importance of reflection in social work cannot be overtly emphasised. After experiencing an emotional circumstance or situation, in reflecting, and through these experiences we can ably find valuable options for professional development. This process is very much in line with critical incident method. This method is described as both an emotional and cognitive process, proceeding from lower to higher levels of reflection, from analysing the experiences to conceptualizing new knowledge.

  9. Current limitations and challenges in nanowaste detection, characterisation and monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Part, Florian; Zecha, Gudrun [Department of Water-Atmosphere-Environment, University of Natural Resources and Life Sciences, Institute of Waste Management, Muthgasse 107, 1190 Vienna (Austria); Causon, Tim [Department of Chemistry, Division of Analytical Chemistry, University of Natural Resources and Life Sciences, Muthgasse 18, 1190 Vienna (Austria); Sinner, Eva-Kathrin [Department of Nanobiotechnology, Institute for Synthetic Bioarchitectures, University of Natural Resources and Life Sciences, Muthgasse 11/II, 1190 Vienna (Austria); Huber-Humer, Marion, E-mail: marion.huber-humer@boku.ac.at [Department of Water-Atmosphere-Environment, University of Natural Resources and Life Sciences, Institute of Waste Management, Muthgasse 107, 1190 Vienna (Austria)

    2015-09-15

    Highlights: • First review on detection of nanomaterials in complex waste samples. • Focus on nanoparticles in solid, liquid and gaseous waste samples. • Summary of current applicable methods for nanowaste detection and characterisation. • Limitations and challenges of characterisation of nanoparticles in waste. - Abstract: Engineered nanomaterials (ENMs) are already extensively used in diverse consumer products. Along the life cycle of a nano-enabled product, ENMs can be released and subsequently accumulate in the environment. Material flow models also indicate that a variety of ENMs may accumulate in waste streams. Therefore, a new type of waste, so-called nanowaste, is generated when end-of-life ENMs and nano-enabled products are disposed of. In terms of the precautionary principle, environmental monitoring of end-of-life ENMs is crucial to allow assessment of the potential impact of nanowaste on our ecosystem. Trace analysis and quantification of nanoparticulate species is very challenging because of the variety of ENM types that are used in products and low concentrations of nanowaste expected in complex environmental media. In the framework of this paper, challenges in nanowaste characterisation and appropriate analytical techniques which can be applied to nanowaste analysis are summarised. Recent case studies focussing on the characterisation of ENMs in waste streams are discussed. Most studies aim to investigate the fate of nanowaste during incineration, particularly considering aerosol measurements; whereas, detailed studies focusing on the potential release of nanowaste during waste recycling processes are currently not available. In terms of suitable analytical methods, separation techniques coupled to spectrometry-based methods are promising tools to detect nanowaste and determine particle size distribution in liquid waste samples. Standardised leaching protocols can be applied to generate soluble fractions stemming from solid wastes, while

  10. Water management: Current and future challenges and research directions

    Science.gov (United States)

    Cosgrove, William J.; Loucks, Daniel P.

    2015-06-01

    Water distinguishes our planet compared to all the others we know about. While the global supply of available freshwater is more than adequate to meet all current and foreseeable water demands, its spatial and temporal distributions are not. There are many regions where our freshwater resources are inadequate to meet domestic, economic development and environmental needs. In such regions, the lack of adequate clean water to meet human drinking water and sanitation needs is indeed a constraint on human health and productivity and hence on economic development as well as on the maintenance of a clean environment and healthy ecosystems. All of us involved in research must find ways to remove these constraints. We face multiple challenges in doing that, especially given a changing and uncertain future climate, and a rapidly growing population that is driving increased social and economic development, globalization, and urbanization. How best to meet these challenges requires research in all aspects of water management. Since 1965, the journal Water Resources Research has played an important role in reporting and disseminating current research related to managing the quantity and quality and cost of this resource. This paper identifies the issues facing water managers today and future research needed to better inform those who strive to create a more sustainable and desirable future.

  11. Drugs in development for toxoplasmosis: advances, challenges, and current status.

    Science.gov (United States)

    Alday, P Holland; Doggett, Joseph Stone

    2017-01-01

    Toxoplasma gondii causes fatal and debilitating brain and eye diseases. Medicines that are currently used to treat toxoplasmosis commonly have toxic side effects and require prolonged courses that range from weeks to more than a year. The need for long treatment durations and the risk of relapsing disease are in part due to the lack of efficacy against T. gondii tissue cysts. The challenges for developing a more effective treatment for toxoplasmosis include decreasing toxicity, achieving therapeutic concentrations in the brain and eye, shortening duration, eliminating tissue cysts from the host, safety in pregnancy, and creating a formulation that is inexpensive and practical for use in resource-poor areas of the world. Over the last decade, significant progress has been made in identifying and developing new compounds for the treatment of toxoplasmosis. Unlike clinically used medicines that were repurposed for toxoplasmosis, these compounds have been optimized for efficacy against toxoplasmosis during preclinical development. Medicines with enhanced efficacy as well as features that address the unique aspects of toxoplasmosis have the potential to greatly improve toxoplasmosis therapy. This review discusses the facets of toxoplasmosis that are pertinent to drug design and the advances, challenges, and current status of preclinical drug research for toxoplasmosis.

  12. Economic evaluations of personalized medicine: existing challenges and current developments

    Directory of Open Access Journals (Sweden)

    Shabaruddin FH

    2015-06-01

    Full Text Available Fatiha H Shabaruddin,1 Nigel D Fleeman,2 Katherine Payne3 1Department of Pharmacy, University of Malaya, Kuala Lumpur, Malaysia; 2Liverpool Reviews and Implementation Group (LRiG, University of Liverpool, Liverpool, UK; 3Institute of Population Health, The University of Manchester, Manchester, UK Abstract: Personalized medicine, with the aim of safely, effectively, and cost-effectively targeting treatment to a prespecified patient population, has always been a long-time goal within health care. It is often argued that personalizing treatment will inevitably improve clinical outcomes for patients and help achieve more effective use of health care resources. Demand is increasing for demonstrable evidence of clinical and cost-effectiveness to support the use of personalized medicine in health care. This paper begins with an overview of the existing challenges in conducting economic evaluations of genetics- and genomics-targeted technologies, as an example of personalized medicine. Our paper illustrates the complexity of the challenges faced by these technologies by highlighting the variations in the issues faced by diagnostic tests for somatic variations, generally referring to genetic variation in a tumor, and germline variations, generally referring to inherited genetic variation in enzymes involved in drug metabolic pathways. These tests are typically aimed at stratifying patient populations into subgroups on the basis of clinical effectiveness (response or safety (avoidance of adverse events. The paper summarizes the data requirements for economic evaluations of genetics and genomics-based technologies while outlining that the main challenges relating to data requirements revolve around the availability and quality of existing data. We conclude by discussing current developments aimed to address the challenges of assessing the cost-effectiveness of genetics and genomics-based technologies, which revolve around two central issues that are

  13. Didactic Friction--Challenges and Reflections on Interlinking PBL and Discipline-Specific Tuition Practices

    Science.gov (United States)

    Bejder, Anne Kirkegaard; Larsen, Gunvor Riber; Wind, Simon

    2017-01-01

    This is a discussion paper based on didactic reflections of three junior academics at the Architecture and Urban Design (A&UD) programme at Aalborg University. The discussion unfolds "didactic friction", where principles of PBL come into contact with architectural didactics, causing challenging teaching situations. This discussion of…

  14. Dynamic Tensions: Early Reflections from MDRC's Evaluation of the Innovative Professional Development Challenge

    Science.gov (United States)

    MDRC, 2015

    2015-01-01

    In the Innovative Professional Development (iPD) Challenge, the Bill & Melinda Gates Foundation has invested in helping school districts and networks redesign their instructional support systems to better support educators in increasing student success. This Issue Focus, the second in a series, presents early reflections from MDRC's evaluation…

  15. Waste management in Greenland: current situation and challenges

    DEFF Research Database (Denmark)

    Eisted, Rasmus; Christensen, Thomas Højlund

    2011-01-01

    Waste management in Greenland (56 000 inhabitants) is characterized by landfilling, incineration and export to Denmark of small quantities of metals and hazardous waste. The annual amount of waste is estimated to about 50 000 tons but actual data are scarce. Data on the waste composition is basic...... are small and equipped with only moderate flue gas cleaning technology. This report summarizes the current waste management situation in Greenland and identifies important challenges in improving the waste management....... is basically lacking. The scattered small towns and settlements, the climate and the long transport distances between towns and also to recycling industries abroad constitute a complex situation with respect to waste management. The landfills have no collection of gas and leachate and the incinerators...

  16. Current Challenges and Achievements in Maternal Immunization Research

    Directory of Open Access Journals (Sweden)

    Flor M. Munoz

    2018-03-01

    Full Text Available Maternal immunization has the potential to significantly improve maternal and child health worldwide by reducing maternal and infant morbidity and mortality associated with disease caused by pathogens that are particularly relevant in the perinatal period and in early life, and for which no alternative effective preventive strategies exist. Research on all aspects related to vaccines for administration during pregnancy is ongoing with support of multiple stakeholders and global participation. Substantial progress has been made, and the availability of new vaccines licensed exclusively for use in pregnant women to protect their infants has become an achievable goal. This review provides an update of the current challenges and achievements in maternal immunization research, focusing on recent milestones that advance the field and the prospects to make maternal immunization a feasible and accessible strategy to improve global health.

  17. Global panorama of energy access: Current situation, challenges and outlook

    Energy Technology Data Exchange (ETDEWEB)

    Galichon, Ines; Lacroix, Olivier; Wiedmer, Damien

    2014-07-15

    Globally 1.3 billion people do not have access to electricity. If this figure is projected to decline 1 billion by 2030, the global population who relies on the traditional use of biomass for cooking is expected to substantially increase, from 2.6 billion to 2.7 billion people. In its commitment to energy access, ENEA published a synthesis on the current situation and the further development perspectives of energy access worldwide, a crucial issue of human and economic development and an opportunity for the private sector. This synthesis present the ecosystem of the actors involved in the improvement of energy access and the technical solutions that serve the needs of this high-potential market. The five main challenges energy access has to address are presented in this publication: energy prices, equipment financing, distribution, change of scale and environmental performances.

  18. Current limitations and challenges in nanowaste detection, characterisation and monitoring.

    Science.gov (United States)

    Part, Florian; Zecha, Gudrun; Causon, Tim; Sinner, Eva-Kathrin; Huber-Humer, Marion

    2015-09-01

    Engineered nanomaterials (ENMs) are already extensively used in diverse consumer products. Along the life cycle of a nano-enabled product, ENMs can be released and subsequently accumulate in the environment. Material flow models also indicate that a variety of ENMs may accumulate in waste streams. Therefore, a new type of waste, so-called nanowaste, is generated when end-of-life ENMs and nano-enabled products are disposed of. In terms of the precautionary principle, environmental monitoring of end-of-life ENMs is crucial to allow assessment of the potential impact of nanowaste on our ecosystem. Trace analysis and quantification of nanoparticulate species is very challenging because of the variety of ENM types that are used in products and low concentrations of nanowaste expected in complex environmental media. In the framework of this paper, challenges in nanowaste characterisation and appropriate analytical techniques which can be applied to nanowaste analysis are summarised. Recent case studies focussing on the characterisation of ENMs in waste streams are discussed. Most studies aim to investigate the fate of nanowaste during incineration, particularly considering aerosol measurements; whereas, detailed studies focusing on the potential release of nanowaste during waste recycling processes are currently not available. In terms of suitable analytical methods, separation techniques coupled to spectrometry-based methods are promising tools to detect nanowaste and determine particle size distribution in liquid waste samples. Standardised leaching protocols can be applied to generate soluble fractions stemming from solid wastes, while micro- and ultrafiltration can be used to enrich nanoparticulate species. Imaging techniques combined with X-ray-based methods are powerful tools for determining particle size, morphology and screening elemental composition. However, quantification of nanowaste is currently hampered due to the problem to differentiate engineered from

  19. Reflecting reflection in supervision

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    associated with reflection and an exploration of alternative conceptions that view reflection within the context of settings which have a more group- and team-based orientation. Drawing on an action research project on health care supervision, the paper questions whether we should reject earlier views...... of reflection, rehabilitate them in order to capture broader connotations or move to new ways of regarding reflection that are more in keeping with not only reflective but also emotive, normative and formative views on supervision. The paper presents a critical perspective on supervision that challenge...... the current reflective paradigm I supervision and relate this to emotive, normative and formative views supervision. The paper is relevant for Nordic educational research into the supervision and guidance...

  20. Current challenges for education of nuclear engineers. Beyond nuclear basics

    International Nuclear Information System (INIS)

    Schoenfelder, Christian

    2014-01-01

    In past decades, curricula for the education of nuclear engineers (either as a major or minor subject) have been well established all over the world. However, from the point of view of a nuclear supplier, recent experiences in large and complex new build as well as modernization projects have shown that important competences required in these projects were not addressed during the education of young graduates. Consequently, in the past nuclear industry has been obliged to either accept long periods for job familiarization, or to develop and implement various dedicated internal training measures. Although the topics normally addressed in nuclear engineering education (like neutron and reactor physics, nuclear materials or thermohydraulics and the associated calculation methods) build up important competences, this paper shows that the current status of nuclear applications requires adaptations of educational curricula. As a conclusion, when academic nuclear engineering curricula start taking into account current competence needs in nuclear industry, it will be for the benefit of the current and future generation of nuclear engineers. They will be better prepared for their future job positions and career perspectives, especially on an international level. The recommendations presented should not only be of importance for the nuclear fission field, but also for the fusion community. Here, the Horizon 2020 Roadmap to Fusion as published in 2012 now is focusing on ITER and on a longer-term development of fusion technology for a future demonstration reactor DEMO. The very challenging work program is leading to a strong need for exactly those skills that are described in this article.

  1. Current challenges for education of nuclear engineers. Beyond nuclear basics

    Energy Technology Data Exchange (ETDEWEB)

    Schoenfelder, Christian [AREVA GmbH, Offenbach (Germany). Training Center

    2014-07-15

    In past decades, curricula for the education of nuclear engineers (either as a major or minor subject) have been well established all over the world. However, from the point of view of a nuclear supplier, recent experiences in large and complex new build as well as modernization projects have shown that important competences required in these projects were not addressed during the education of young graduates. Consequently, in the past nuclear industry has been obliged to either accept long periods for job familiarization, or to develop and implement various dedicated internal training measures. Although the topics normally addressed in nuclear engineering education (like neutron and reactor physics, nuclear materials or thermohydraulics and the associated calculation methods) build up important competences, this paper shows that the current status of nuclear applications requires adaptations of educational curricula. As a conclusion, when academic nuclear engineering curricula start taking into account current competence needs in nuclear industry, it will be for the benefit of the current and future generation of nuclear engineers. They will be better prepared for their future job positions and career perspectives, especially on an international level. The recommendations presented should not only be of importance for the nuclear fission field, but also for the fusion community. Here, the Horizon 2020 Roadmap to Fusion as published in 2012 now is focusing on ITER and on a longer-term development of fusion technology for a future demonstration reactor DEMO. The very challenging work program is leading to a strong need for exactly those skills that are described in this article.

  2. Adapting a regularized canopy reflectance model (REGFLEC) for the retrieval challenges of dryland agricultural systems

    KAUST Repository

    Houborg, Rasmus

    2016-08-20

    A regularized canopy reflectance model (REGFLEC) is applied over a dryland irrigated agricultural system in Saudi Arabia for the purpose of retrieving leaf area index (LAI) and leaf chlorophyll content (Chll). To improve the robustness of the retrieved properties, REGFLEC was modified to 1) correct for aerosol and adjacency effects, 2) consider foliar dust effects on modeled canopy reflectances, 3) include spectral information in the red-edge wavelength region, and 4) exploit empirical LAI estimates in the model inversion. Using multi-spectral RapidEye imagery allowed Chll to be retrieved with a Mean Absolute Deviation (MAD) of 7.9 μg cm− 2 (16%), based upon in-situ measurements conducted in fields of alfalfa, Rhodes grass and maize over the course of a growing season. LAI and Chll compensation effects on canopy reflectance were largely avoided by informing the inversion process with ancillary LAI inputs established empirically on the basis of a statistical machine learning technique. As a result, LAI was reproduced with good accuracy, with an overall MAD of 0.42 m2 m− 2 (12.5%). Results highlighted the considerable challenges associated with the translation of at-sensor radiance observations to surface bidirectional reflectances in dryland environments, where issues such as high aerosol loadings and large spatial gradients in surface reflectance from bright desert soils to dark vegetated fields are often present. Indeed, surface reflectances in the visible bands were reduced by up to 60% after correction for such adjacency effects. In addition, dust deposition on leaves required explicit modification of the reflectance sub-model to account for its influence. By implementing these model refinements, REGFLEC demonstrated its utility for within-field characterization of vegetation conditions over the challenging landscapes typical of dryland agricultural regions, offering a means through which improvements can be made in the management of these globally

  3. Current Trends and Challenges in Satellite Laser Ranging

    Science.gov (United States)

    Appleby, Graham M.; Bianco, Giuseppe; Noll, Carey E.; Pavlis, Erricos C.; Pearlman, Michael R.

    2016-12-01

    Satellite Laser Ranging (SLR) is used to measure accurately the distance from ground stations to retro-reflectors on satellites and on the Moon. SLR is one of the fundamental space-geodetic techniques that define the International Terrestrial Reference Frame (ITRF), which is the basis upon which many aspects of global change over space, time, and evolving technology are measured; with VLBI the two techniques define the scale of the ITRF; alone the SLR technique defines its origin (geocenter). The importance of the reference frame has recently been recognized at the inter-governmental level through the United Nations, which adopted in February 2015 the Resolution "Global Geodetic Reference Frame for Sustainable Development." Laser Ranging provides precision orbit determination and instrument calibration and validation for satellite-borne altimeters for the better understanding of sea level change, ocean dynamics, ice mass-balance, and terrestrial topography. It is also a tool to study the dynamics of the Moon and fundamental constants and theories. With the exception of the currently in-orbit GPS constellation, all GNSS satellites now carry retro-reflectors for improved orbit determination, harmonization of reference frames, and in-orbit co-location and system performance validation; the next generation of GPS satellites due for launch from 2019 onwards will also carry retro-reflectors. The ILRS delivers weekly realizations that are accumulated sequentially to extend the ITRF and the Earth Orientation Parameter series with a daily resolution. SLR technology continues to evolve towards the next-generation laser ranging systems and it is expected to successfully meet the challenges of the GGOS2020 program for a future Global Space Geodetic Network. Ranging precision is improving as higher repetition rate, narrower pulse lasers, and faster detectors are implemented within the network. Automation and pass interleaving at some stations is expanding temporal coverage and

  4. Rift Valley fever: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Himeidan YE

    2016-03-01

    , handle, or live close to livestock, and focusing on areas with populations at high risk of an epidemic are desirable. Consideration of prevention methods as a first-line strategy against RVF is practical owing to the absence of a human vaccine, particularly under the current high environmental risks and expanding global travel and animal trade. Universal platforms are needed to support coordinated efforts; alert and response operations; exchange of expertise; and disease detection, diagnosis, control, and prevention. Keywords: RVFV, outbreaks, current challenges, future prospects

  5. The Challenges of Participant Photography: A Critical Reflection on Methodology and Ethics in Two Cultural Contexts.

    Science.gov (United States)

    Murray, Linda; Nash, Meredith

    2017-05-01

    Photovoice and photo-elicitation are two common methods of participant photography used in health research. Although participatory photography has many benefits, this critical reflection provides fellow researchers with insights into the methodological and ethical challenges faced when using such methods. In this article, we critically reflect on two studies that used participatory photography in different cultural contexts. The first study used photo-elicitation to investigate mothers' experiences of infant settling in central Vietnam. The second study used photovoice to explore pregnant embodiment in Australia. Following a discussion of the literature and a detailed overview of the two studies, we examine the methodological challenges in using participant photography before, during and after each study. This is followed by a discussion of ethical concerns that arose in relation to the burden of participation, confidentiality, consent, and the photographing of families and children. To conclude, we highlight implications for using participatory photography in other settings.

  6. Medicinal mushroom science: Current perspectives, advances, evidences, and challenges

    Directory of Open Access Journals (Sweden)

    Solomon P Wasser

    2014-12-01

    Full Text Available The main target of the present review is to draw attention to the current perspectives, advances, evidences, challenges, and future development of medicinal mushroom science in the 21 st century. Medicinal mushrooms and fungi are thought to possess approximately 130 medicinal functions, including antitumor, immunomodulating, antioxidant, radical scavenging, cardiovascular, anti-hypercholesterolemic, antiviral, antibacterial, anti-parasitic, antifungal, detoxification, hepatoprotective, and antidiabetic effects. Many, if not all, higher Basidiomycetes mushrooms contain biologically active compounds in fruit bodies, cultured mycelium, and cultured broth. Special attention is paid to mushroom polysaccharides. The data on mushroom polysaccharides and different secondary metabolites are summarized for approximately 700 species of higher hetero- and homobasidiomycetes. Numerous bioactive polysaccharides or polysaccharide-protein complexes from the medicinal mushrooms described appear to enhance innate and cell-mediated immune responses, and exhibit antitumor activities in animals and humans. Whilst the mechanism of their antitumor actions is still not completely understood, stimulation and modulation of key host immune responses by these mushroom compounds appear central. Polysaccharides and low-molecular-weight secondary metabolites are particularly important due to their antitumor and immunostimulating properties. Several of the mushroom compounds have been subjected to Phase I, II, and III clinical trials, and are used extensively and successfully in Asia to treat various cancers and other diseases. Special attention is given to many important unsolved problems in the study of medicinal mushrooms.

  7. Live attenuated vaccines: Historical successes and current challenges

    Energy Technology Data Exchange (ETDEWEB)

    Minor, Philip D., E-mail: Philip.Minor@nibsc.org

    2015-05-15

    Live attenuated vaccines against human viral diseases have been amongst the most successful cost effective interventions in medical history. Smallpox was declared eradicated in 1980; poliomyelitis is nearing global eradication and measles has been controlled in most parts of the world. Vaccines function well for acute diseases such as these but chronic infections such as HIV are more challenging for reasons of both likely safety and probable efficacy. The derivation of the vaccines used has in general not been purely rational except in the sense that it has involved careful clinical trials of candidates and subsequent careful follow up in clinical use; the identification of the candidates is reviewed. - Highlights: • Live vaccines against human diseases caused by viruses have been very successful. • They have been developed by empirical clinical studies and problems identified in later use. • It can be difficult to balance ability to cause disease and ability to immunise for a strain. • There is currently no reliable basis for predicting success from pure virological studies. • Vaccinia, which eradicated smallpox, is the paradigm for all successes and issues.

  8. Preimplantation genetic diagnosis and screening: Current status and future challenges

    Directory of Open Access Journals (Sweden)

    Hsin-Fu Chen

    2018-02-01

    Full Text Available Preimplantation genetic diagnosis (PGD is a clinically feasible technology to prevent the transmission of monogenic inherited disorders in families afflicted the diseases to the future offsprings. The major technical hurdle is it does not have a general formula for all mutations, thus different gene locus needs individualized, customized design to make the diagnosis accurate enough to be applied on PGD, in which the quantity of DNA is scarce, whereas timely result is sometimes requested if fresh embryo transfer is desired. On the other hand, preimplantation genetic screening (PGS screens embryo with aneuploidy and was also known as PGD-A (A denotes aneuploidy in order to enhance the implantation rates as well as livebirth rates. In contrasts to PGD, PGS is still under ferocious debate, especially recent reports found that euploid babies were born after transferring the aneuploid embryos diagnosed by PGS back to the womb and only very few randomized trials of PGS are available in the literature. We have been doing PGD and/or PGS for more than 10 years as one of the core PGD/PGS laboratories in Taiwan. Here we provide a concise review of PGD/PGS regarding its current status, both domestically and globally, as well as its future challenges.

  9. The mining sector of Liberia: current practices and environmental challenges.

    Science.gov (United States)

    Wilson, Samuel T K; Wang, Hongtao; Kabenge, Martin; Qi, Xuejiao

    2017-08-01

    Liberia is endowed with an impressive stock of mineral reserves and has traditionally relied on mining, namely iron ore, gold, and diamonds, as a major source of income. The recent growth in the mining sector has the potential to contribute significantly to employment, income generation, and infrastructure development. However, the development of these mineral resources has significant environmental impacts that often go unnoticed. This paper presents an overview of the Liberian mining sector from historical, current development, and economic perspectives. The efforts made by government to address issues of environmental management and sustainable development expressed in national and international frameworks, as well as some of the environmental challenges in the mining sector are analyzed. A case study was conducted on one of the iron ore mines (China Union Bong Mines Investment) to analyze the effects of the water quality on the local water environment. The results show that the analyzed water sample concentrations were all above the WHO and Liberia water standard Class I guidelines for drinking water. Finally the paper examines the application of water footprint from a life cycle perspective in the Liberian mining sector and suggests some policy options for water resources management.

  10. Adult-onset Still's disease: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Siddiqui M

    2016-03-01

    Full Text Available Mariam Siddiqui,1 Michael S Putman,2 Anisha B Dua,11Department of Rheumatology, 2Department of Internal Medicine, The University of Chicago Medical Center, Chicago, IL, USA Abstract: Adult-onset Still's disease (AOSD – a multi-systemic inflammatory condition characterized by high fevers, polyarthritis, an evanescent rash, and pharyngitis – has been a challenging condition to diagnose expediently and treat effectively. Questions remain regarding the underlying pathophysiology and etiology of AOSD. Pathognomonic diagnostic tests and reliable biomarkers remain undiscovered. Over the past decade, important progress has been made. Diagnostic criteria employing glycosylated ferritin have improved specificity. More important, novel biologic therapies have offered important clues to AOSD's underlying pathophysiology. Cytokine-specific biologic therapies have been instrumental in providing more effective treatment for disease refractory to conventional treatment. While IL-1 therapy has demonstrated efficacy in refractory disease, novel therapies targeting IL-6 and IL-18 show great promise and are currently under investigation. Keywords: adult-onset Still's disease, biomarkers, therapeutics

  11. Adjuvant chemotherapy for gastric cancer: Current evidence and future challenges

    Science.gov (United States)

    Miceli, Rosalba; Tomasello, Gianluca; Bregni, Giacomo; Di Bartolomeo, Maria; Pietrantonio, Filippo

    2014-01-01

    Gastric cancer still represents one of the major causes of cancer mortality worldwide. Patients survival is mainly related to stage, with a high proportion of patients with metastatic disease at presentation. Thus, the cure rate largely depend upon surgical resection. Despite the additional, albeit small, benefit of adjuvant chemotherapy has been clearly demonstrated, no general consensus has been reached on the best treatment option. Moreover, the narrow therapeutic index of adjuvant chemotherapy (i.e., limited survival benefit with considerable toxicity) requires a careful assessment of expected risks and benefits for individual patients. Treatment choices vary widely based on the different geographic areas, with chemotherapy alone more often preferred in Europe or Asia and chemoradiotherapy in the United States. In the present review we discuss the current evidence and future challenges regarding adjuvant chemotherapy in curatively resected gastric cancer with particular emphasis on the recently completed landmark studies and meta-analyses. The most recent patient-level meta-analysis demonstrated the benefit of adjuvant chemotherapy over curative surgery; the same Authors also showed that disease-free survival may be used as a surrogate end-point for overall survival. We finally discuss future research issues such as the need of economic evaluations, development of prognostic or predictive biomarkers, and the unmet clinical need of trials comparing perioperative chemotherapy with adjuvant treatment. PMID:24782604

  12. Live attenuated vaccines: Historical successes and current challenges

    International Nuclear Information System (INIS)

    Minor, Philip D.

    2015-01-01

    Live attenuated vaccines against human viral diseases have been amongst the most successful cost effective interventions in medical history. Smallpox was declared eradicated in 1980; poliomyelitis is nearing global eradication and measles has been controlled in most parts of the world. Vaccines function well for acute diseases such as these but chronic infections such as HIV are more challenging for reasons of both likely safety and probable efficacy. The derivation of the vaccines used has in general not been purely rational except in the sense that it has involved careful clinical trials of candidates and subsequent careful follow up in clinical use; the identification of the candidates is reviewed. - Highlights: • Live vaccines against human diseases caused by viruses have been very successful. • They have been developed by empirical clinical studies and problems identified in later use. • It can be difficult to balance ability to cause disease and ability to immunise for a strain. • There is currently no reliable basis for predicting success from pure virological studies. • Vaccinia, which eradicated smallpox, is the paradigm for all successes and issues

  13. Alfven Wave Reflection Model of Field-Aligned Currents at Mercury

    Science.gov (United States)

    Lyatsky, Wladislaw; Khazanov, George V.; Slavin, James

    2010-01-01

    An Alfven Wave Reflection (AWR) model is proposed that provides closure for strong field-aligned currents (FACs) driven by the magnetopause reconnection in the magnetospheres of planets having no significant ionospheric and surface electrical conductance. The model is based on properties of the Alfven waves, generated at high altitudes and reflected from the low-conductivity surface of the planet. When magnetospheric convection is very slow, the incident and reflected Alfven waves propagate along approximately the same path. In this case, the net field-aligned currents will be small. However, as the convection speed increases. the reflected wave is displaced relatively to the incident wave so that the incident and reflected waves no longer compensate each other. In this case, the net field-aligned current may be large despite the lack of significant ionospheric and surface conductivity. Our estimate shows that for typical solar wind conditions at Mercury, the magnitude of Region 1-type FACs in Mercury's magnetosphere may reach hundreds of kilo-Amperes. This AWR model of field-aligned currents may provide a solution to the long-standing problem of the closure of FACs in the Mercury's magnetosphere. c2009 Elsevier Inc. All rights reserved.

  14. Nuclear Fuel Cycle Technologies: Current Challenges and Future Plans - 12558

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, Andrew [U.S. Department of Energy, Washington, DC (United States)

    2012-07-01

    The mission of the Office of Nuclear Energy's Fuel Cycle Technologies office (FCT program) is to provide options for possible future changes in national nuclear energy programs. While the recent draft report of the Blue Ribbon Commission on America's Nuclear Future stressed the need for organization changes, interim waste storage and the establishment of a permanent repository for nuclear waste management, it also recognized the potential value of alternate fuel cycles and recommended continued research and development in that area. With constrained budgets and great expectations, the current challenges are significant. The FCT program now performs R and D covering the entire fuel cycle. This broad R and D scope is a result of the assignment of new research and development (R and D) responsibilities to the Office of Nuclear Energy (NE), as well as reorganization within NE. This scope includes uranium extraction from seawater and uranium enrichment R and D, used nuclear fuel recycling technology, advanced fuel development, and a fresh look at a range of disposal geologies. Additionally, the FCT program performs the necessary systems analysis and screening of fuel cycle alternatives that will identify the most promising approaches and areas of technology gaps. Finally, the FCT program is responsible for a focused effort to consider features of fuel cycle technology in a way that promotes nonproliferation and security, such as Safeguards and Security by Design, and advanced monitoring and predictive modeling capabilities. This paper and presentation will provide an overview of the FCT program R and D scope and discuss plans to analyze fuel cycle options and support identified R and D priorities into the future. The FCT program is making progress in implanting a science based, engineering driven research and development program that is evaluating options for a sustainable fuel cycle in the U.S. Responding to the BRC recommendations, any resulting legislative

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

    Science.gov (United States)

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

    2010-05-01

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

  16. Multiple endocrine neoplasia type 2: achievements and current challenges

    Directory of Open Access Journals (Sweden)

    Andreas Machens

    2012-01-01

    Full Text Available Incremental advances in medical technology, such as the development of sensitive hormonal assays for routine clinical care, are the drivers of medical progress. This principle is exemplified by the creation of the concept of multiple endocrine neoplasia type 2, encompassing medullary thyroid cancer, pheochromocytoma, and primary hyperparathyroidism, which did not emerge before the early 1960s. This review sets out to highlight key achievements, such as joint biochemical and DNA-based screening of individuals at risk of developing multiple endocrine neoplasia type 2, before casting a spotlight on current challenges which include: (i ill-defined upper limits of calcitonin assays for infants and young children, rendering it difficult to implement the biochemical part of the integrated DNA-based/biochemical concept; (ii our increasingly mobile society in which different service providers are caring for one individual at various stages in the disease process. With familial relationships disintegrating as a result of geographic dispersion, information about the history of the origin family may become sketchy or just unavailable. This is when DNA-based gene tests come into play, confirming or excluding an individual's genetic predisposition to multiple endocrine neoplasia type 2 even before there is any biochemical or clinical evidence of the disease. However, the unrivaled molecular genetic progress in multiple endocrine neoplasia type 2 does not come without a price. Screening may uncover unknown gene sequence variants representing either harmless polymorphisms or pathogenic mutations. In this setting, functional characterization of mutant cells in vitro may generate helpful ancillary evidence with regard to the pathogenicity of gene variants in comparison with established mutations.

  17. Dengue vaccines: Challenges, development, current status and prospects

    Directory of Open Access Journals (Sweden)

    A Ghosh

    2015-01-01

    Full Text Available Infection with dengue virus (DENV is the most rapidly spreading mosquito-borne viral disease in the world. The clinical spectrum of dengue, caused by any of the four serotypes of DENV, ranges from mild self-limiting dengue fever to severe dengue, in the form dengue hemorrhagic fever (DHF and dengue shock syndrome (DSS. Increased rates of hospitalization due to severe dengue, during outbreaks, result in massive economic losses and strained health services. In the absence of specific antiviral therapy, control of transmission of DENV by vector management is the sole method available for decreasing dengue-associated morbidity. Since vector control strategies alone have not been able to satisfactorily achieve reduction in viral transmission, the implementation of a safe, efficacious and cost-effective dengue vaccine as a supplementary measure is a high public health priority. However, the unique and complex immunopathology of dengue has complicated vaccine development. Dengue vaccines have also been challenged by critical issues like lack of animal models for the disease and absence of suitable markers of protective immunity. Although no licensed dengue vaccine is yet available, several vaccine candidates are under phases of development, including live attenuated virus vaccines, live chimeric virus vaccines, inactivated virus vaccines, subunit vaccines, DNA vaccines and viral-vectored vaccines. Although some vaccine candidates have progressed from animal trials to phase II and III in humans, a number of issues regarding implementation of dengue vaccine in countries like India still need to be addressed. Despite the current limitations, collaborative effects of regulatory bodies like World Health Organization with vaccine manufacturers and policy makers, to facilitate vaccine development and standardize field trials can make a safe and efficacious dengue vaccine a reality in near future.

  18. The Informal Economy in Kosovo: Characteristics, Current Trends and Challenges

    OpenAIRE

    Florentina XHELILI KRASNIQI; Rahmije MUSTAFA TOPXHIU

    2012-01-01

    The informal economy is present in all countries, but its consequences reflect in different countries with different intensity. Types and scale of informal economic activities reflect the specificities of socio-economic context and the integration of the countries into the wider local-regional economy. The informal economy represents an important potential of labor and incomes, therefore there is a need for better understanding, since on this will depend the direction of the path for safer ad...

  19. LENDING IN FOREIGN CURRENCY AND CURRENT CHALLENGES AT EUROPEAN LEVEL

    Directory of Open Access Journals (Sweden)

    ȘARGU Alina Camelia

    2012-12-01

    comparatively underline, based on the example of the panel countries, a few stylized facts about lending in foreign currency, and also the main factors which determined the growing share of loans in foreign currency, the risks for financial stability generated by the loans denominated in foreign currencies and the challenges that arise for the monetary-financial authorities, both at national and European level, in the current context and in the post crisis period. The methodology used in our paper starts with an extensive literature review in order to underline the importance of the research theme approached. The analysis is based on information and statistical data provided mainly by the official statistics of the ECB, IMF, EBRD, Raiffeisen Research, different reports, studies and researches. Through the content of our research we want to underline the crucial importance of a rigorous monitoring of the foreign lending activities undertaken by the central banks and the supervisory authorities in order to limit the risks and to ensure the financial stability at EU level.

  20. Current Status and Challenges in Wind Energy Assessment

    DEFF Research Database (Denmark)

    Gryning, Sven-Erik; Badger, Jake; Hahmann, Andrea N.

    2014-01-01

    Here we discuss the status and challenges in the development of atlases for the assessment of the regional and global wind resources. The text more specifically describes a methodology that is under development at DTU Wind Energy in Denmark. As the wind assessment is based on mesoscale modelling,......, some of the specific challenges in mesoscale modelling for wind energy purposes are discussed such as wind profiles and long-term statistics of the wind speed time series. Solutions to these challenges will help secure an economic and effective deployment of wind energy....

  1. Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

    Science.gov (United States)

    Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

    2016-11-01

    Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

  2. How do new innovation paradigms challenge current innovation policy perspectives

    DEFF Research Database (Denmark)

    Knudsen, Mette Præst; Tanev, Stoyan; Bisgaard, Tanja

    2012-01-01

    Successful firms today are forced to deal with new competitive realities by being globally present, innovatively resourceful and internationally competitive on multiple markets across the world. The new competitive realities challenge firms to open their innovation processes by adopting new...

  3. Current Challenges in the First Principle Quantitative Modelling of the Lower Hybrid Current Drive in Tokamaks

    Science.gov (United States)

    Peysson, Y.; Bonoli, P. T.; Chen, J.; Garofalo, A.; Hillairet, J.; Li, M.; Qian, J.; Shiraiwa, S.; Decker, J.; Ding, B. J.; Ekedahl, A.; Goniche, M.; Zhai, X.

    2017-10-01

    The Lower Hybrid (LH) wave is widely used in existing tokamaks for tailoring current density profile or extending pulse duration to steady-state regimes. Its high efficiency makes it particularly attractive for a fusion reactor, leading to consider it for this purpose in ITER tokamak. Nevertheless, if basics of the LH wave in tokamak plasma are well known, quantitative modeling of experimental observations based on first principles remains a highly challenging exercise, despite considerable numerical efforts achieved so far. In this context, a rigorous methodology must be carried out in the simulations to identify the minimum number of physical mechanisms that must be considered to reproduce experimental shot to shot observations and also scalings (density, power spectrum). Based on recent simulations carried out for EAST, Alcator C-Mod and Tore Supra tokamaks, the state of the art in LH modeling is reviewed. The capability of fast electron bremsstrahlung, internal inductance li and LH driven current at zero loop voltage to constrain all together LH simulations is discussed, as well as the needs of further improvements (diagnostics, codes, LH model), for robust interpretative and predictive simulations.

  4. Reflecting on impact, changes and continuities: restructuring workplace cultures: the ultimate work-family challenge.

    OpenAIRE

    Lewis, Suzan

    2010-01-01

    Purpose – The purpose of this paper is to reflect on the paper “Restructuring workplace cultures: the ultimate work-family challenge?” is published in Women in Management Review, Vol. 16 No. 1, 2001, pp. 21-9. \\ud \\ud Design/methodology/approach – The impact of the paper is considered within a framework that takes account of national discursive and political contexts in the UK in 2001 and in the present and uses a gendered organisation lens. \\ud \\ud Findings – The 2001 paper demonstrates that...

  5. Reflections on New Challenges to Television Research in Today’s Digital Media Environment

    DEFF Research Database (Denmark)

    Schenk, Susan; Ohme, Jakob; Seifert, Claudia

    Past research has discussed the change to a new digital media environment for almost a decade. But still, research on television usage and television’s effects does not seem to be up to date: the measurement of watching television in recent studies still focuses traditional television usage......’s effects, this paper intends to reflect changes focusing on the following four challenges for television research: 1. Television needs to be conceptualized differently. 2. Television is becoming more individual. 3. Television is becoming more social. 4. Television needs a new individualized concept...... for media effects....

  6. [Leadership in critical care settings: reflections and challenges for the Brazilian Nursing].

    Science.gov (United States)

    Gelbcke, Francine Lima; Souza, Lúcia Amante de; Dal Sasso, Grace M; Nascimento, Eliane; Bulb, Maria Bettina Camargo

    2009-01-01

    The objective of this study was to reflect on the leadership, especially in the intensive care nursing, based on the prospect of nurses, teachers, nursing students and in the literature on the subject. The leadership of the nurse in intensive care units faces challenges and paradoxes and is present in the planning of care, in the moments of ethical and bioethical conflicts, in the supervision of care, in capacity of making decisions quickly and safety, in knowing deal with the issues involving the process of living and dying.

  7. Understanding Teenage Motherhood through Feminist Research: A reflection on the challenges

    Directory of Open Access Journals (Sweden)

    Kyla Ellis-Sloan

    2014-12-01

    Full Text Available This paper draws on an ethnographic study with teenage mothers. It discusses how the research incorporated feminist political goals and ethical concerns. The paper focuses in particular on one key concern for feminist researchers, that of hierarchical power in the research setting in order to demonstrate the challenges and advantages of feminist research. A number of approaches were taken to mitigate power relationships and these are discussed and reflected upon here. The paper then goes on to interrogate the author’s position as an ‘insider researcher’. It is demonstrated here how feminist research enabled the position of the researcher to be acknowledged, analysed and critiqued thus ensuring that research which challenges conventional notions of objectivity is robust.

  8. Deliberative democracy in health care: current challenges and future prospects.

    Science.gov (United States)

    Safaei, Jalil

    2015-01-01

    There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM), patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care. This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries. Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care. Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature. Seeking deliberative democracy in health care is both challenging and rewarding. The challenges have been more or less identified. However, its prospects are potentially significant. Such prospects are more likely to materialize if deliberative democracy is

  9. National health inequality monitoring: current challenges and opportunities.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne; Boerma, Ties

    National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

  10. Soil Contamination and Remediation Strategies. Current research and future challenge

    Science.gov (United States)

    Petruzzelli, G.

    2012-04-01

    eliminating the source of pollution, but also on blocking the pathways from contaminants to receptors or reducing the exposure to contaminants,. Future challenge integration of sustainability into remediation decision-making. Soil is not a waste! There is a growing interest in the clean up approaches that maintain soil quality after remediation treatments. This issue is of great importance in the U.S.A. where the EPA from 2009 is promoting innovative clean-up strategies (Green Remediation). Green remediation is defined as the practice of considering all environmental effects of remedy and incorporating options to maximize environmental benefit of cleanup actions . These remediation strategies restore contaminated sites to productive use with a great attention to the global environmental quality, including the preservation of soil functionality according to the following principles: use minimally invasive technologies; use passive energy technologies such as bioremediation and phytoremediation as primary remedies or finishing steps where possible and effective; minimize soil and habitat disturbance; minimize bioavailability of contaminants trough adequate contaminant source and plume control If we move from the current definition of remedial targets based on total concentrations, technologies with low impact on the environment can be utilized reducing the wrong choice to disposal soil in landfill destroying quickly a not renewable essential resource.

  11. Current challenges in medical education in Nigeria | Ezeanolue ...

    African Journals Online (AJOL)

    Medical education may be classified into 3 sectors viz, (a) basic medical education; (b) postgraduate medical education/Residency Training and (c) continuing professional development (CPD). There are challenges in establishing an ideal medical educational system that educates, develops and enhances the skills and ...

  12. Current Challenges in Commercially Producing Biofuels from Lignocellulosic Biomass

    Science.gov (United States)

    Balan, Venkatesh

    2014-01-01

    Biofuels that are produced from biobased materials are a good alternative to petroleum based fuels. They offer several benefits to society and the environment. Producing second generation biofuels is even more challenging than producing first generation biofuels due the complexity of the biomass and issues related to producing, harvesting, and transporting less dense biomass to centralized biorefineries. In addition to this logistic challenge, other challenges with respect to processing steps in converting biomass to liquid transportation fuel like pretreatment, hydrolysis, microbial fermentation, and fuel separation still exist and are discussed in this review. The possible coproducts that could be produced in the biorefinery and their importance to reduce the processing cost of biofuel are discussed. About $1 billion was spent in the year 2012 by the government agencies in US to meet the mandate to replace 30% existing liquid transportation fuels by 2022 which is 36 billion gallons/year. Other countries in the world have set their own targets to replace petroleum fuel by biofuels. Because of the challenges listed in this review and lack of government policies to create the demand for biofuels, it may take more time for the lignocellulosic biofuels to hit the market place than previously projected. PMID:25937989

  13. Deliberative democracy in health care: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Safaei J

    2015-12-01

    Full Text Available Jalil Safaei Department of Economics, University of Northern British Columbia, Prince George, BC, CanadaBackground: There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM, patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care.Objective: This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries.Method: Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care.Results: Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature.Conclusion: Seeking deliberative democracy in health care is both challenging and rewarding. The

  14. Can pervasive sensing address current challenges in global healthcare?

    Directory of Open Access Journals (Sweden)

    Louis Atallah

    2012-03-01

    Full Text Available Important challenges facing global healthcare include the increase in the number of people affected by escalating healthcare costs, chronic and infectious diseases, the need for better and more affordable elderly care and expanding urbanisation combined with air and water pollution. Recent advances in pervasive sensing technologies have led to miniaturised sensor networks that can be worn or integrated within the living environment without affecting a person’s daily patterns. These sensors promise to change healthcare from snapshot measurements of physiological parameters to continuous monitoring enabling clinicians to provide guidance on a daily basis. This article surveys several of the solutions provided by these sensor platforms from elderly care to neonatal monitoring and environmental mapping. Some of the opportunities available and the challenges facing the adoption of such technologies in large-scale epidemiological studies are also discussed.

  15. Tumor and target delineation: current research and future challenges

    International Nuclear Information System (INIS)

    Austin-Seymour, Mary; Chen, George T.Y.; Rosenman, Julian; Michalski, Jeff; Lindsley, Karen; Goitein, Michael

    1995-01-01

    In the past decade, significant progress has been made in the imaging of tumors, three dimensional (3D) treatment planning, and radiation treatment delivery. At this time one of the greatest challenges for conformal radiation therapy is the accurate delineation of tumor and target volumes. The physician encounters many uncertainties in the process of defining both tumor and target. The sources of these uncertainties are discussed, as well as the issues requiring study to reduce these uncertainties

  16. Inclusive Education in Georgia: Current Progress and Challenges

    Directory of Open Access Journals (Sweden)

    Nikoloz Kavelashvili

    2017-05-01

    Full Text Available Purpose and Originality: The paper provides a realistic picture about how the implementation process of inclusive education in Georgia is developing, about the problems that are encountered together with what needs are to be fulfilled for stimulating the process. Today’s challenge in the country is to make inclusive practices available to everybody, everywhere and all the time. This article discusses the status of the efforts being made to meet this challenge. In the course of that discussion, some comprehensive changes will be described that systemic efforts of school improvement must achieve to continue making progress towards fully inclusive learning. Method: The study was conducted in Georgia. A qualitative research design was employed along with closed-ended and open-ended questionnaires, which allowed participants to express their point of views, skills and knowledge. Data collection methods were applied: semi-structured interviews and observation on respondents. Results: The study uncovers those challenges that obstruct the implementation process: indifferent attitudes of teachers and parents towards inclusion, absence of self-awareness to the issue amongst educators, slightest involvement of parents and need to infrastructural development. Society: The results should raise the awareness of the population of Georgia as well as increase the understanding of the problem. Limitations / further research: There were quite enough informants on the school level (special teachers, principals, however, there are still many other possible respondents who could add something valuable to a better understanding of the process of inclusion at schools. The theoretical approach employed in the study and the empirical research could be validated.

  17. The value of information: Current challenges in surveillance implementation.

    Science.gov (United States)

    Stärk, Katharina D C; Häsler, Barbara

    2015-11-01

    Animal health surveillance is a complex activity that involves multiple stakeholders and provides decision support across sectors. Despite progress in the design of surveillance systems, some technical challenges remain, specifically for emerging hazards. Surveillance can also be impacted by political interests and costly consequences of case reporting, particularly in relation to international trade. Constraints on surveillance can therefore be of technical, economic and political nature. From an economic perspective, both surveillance and intervention are resource-using activities that are part of a mitigation strategy. Surveillance provides information for intervention decisions and thereby helps to offset negative effects of animal disease and to reduce the decision uncertainty associated with choices on disease control. It thus creates monetary and non-monetary benefits, both of which may be challenging to quantify. The technical relationships between surveillance, intervention and loss avoidance have not been established for most hazards despite being important consideration for investment decisions. Therefore, surveillance cannot just be maximised to minimise intervention costs. Economic appraisals of surveillance need to be done on a case by case basis for any hazard considering both surveillance and intervention performance, the losses avoided and the values attached to them. This can be achieved by using an evaluation approach which provides a systematic investigation of the worth or merit of surveillance activities. Evaluation is driven by a specific evaluation question which for surveillance systems commonly considers effectiveness, efficiency, implementation and/or compliance issues. More work is needed to provide guidance on the appropriate selection of evaluation attributes and general good practice in surveillance evaluation. Due to technical challenges, economic constraints and variable levels of capacity, the implementation of surveillance systems

  18. Current challenges and trends in the discovery of agrochemicals.

    Science.gov (United States)

    Lamberth, Clemens; Jeanmart, Stephane; Luksch, Torsten; Plant, Andrew

    2013-08-16

    Crop protection chemistry has come a long way from its "alchemic" beginnings in the late 19th century to a high-tech science that supports the sustainable production of food, feed, and fiber for a rapidly growing population. Cutting-edge developments in the design and synthesis of agrochemicals help to tackle today's challenges of weed and pest resistance, higher regulatory safety margins, and higher cost of goods with the invention of selective, environmentally benign, low use rate, and cost-effective active ingredients.

  19. Freeform Optics: current challenges for future serial production

    Science.gov (United States)

    Schindler, C.; Köhler, T.; Roth, E.

    2017-10-01

    One of the major developments in optics industry recently is the commercial manufacturing of freeform surfaces for optical mid- and high performance systems. The loss of limitation on rotational symmetry enables completely new optical design solutions - but causes completely new challenges for the manufacturer too. Adapting the serial production from radial-symmetric to freeform optics cannot be done just by the extension of machine capabilities and software for every process step. New solutions for conventional optics productions or completely new process chains are necessary.

  20. Reflections

    Directory of Open Access Journals (Sweden)

    Joanne Embree

    2001-01-01

    Full Text Available Ideally, editorials are written one to two months before publication in the Journal. It was my turn to write this one. I had planned to write the first draft the evening after my clinic on Tuesday, September 11. It didn't get done that night or during the next week. Somehow, the topic that I had originally chosen just didn't seem that important anymore as I, along my friends and colleagues, reflected on the changes that the events of that day were likely to have on our lives.

  1. Nitriding and Nitrocarburizing; Current Status and Future Challenges

    DEFF Research Database (Denmark)

    Somers, Marcel A. J.

    , aspects of low temperature surface hardening of stainless steels in a gaseous environment will be addressed. Here, the developed case consists of expanded austenite and/or expanded martensite, which essentially is a super saturated solid solution of nitrogen/carbon in austenite/martensite. The current......This contribution addresses the current understanding of gaseous nitriding and nitrocarburizing. Aspects of thermodynamics, kinetics and microstructure development in iron and heat treatable steel will be explained. In these materials the nitrided/ nitrocarburized case can be subdivided...

  2. Current status and challenges for automotive battery production technologies

    Science.gov (United States)

    Kwade, Arno; Haselrieder, Wolfgang; Leithoff, Ruben; Modlinger, Armin; Dietrich, Franz; Droeder, Klaus

    2018-04-01

    Production technology for automotive lithium-ion battery (LIB) cells and packs has improved considerably in the past five years. However, the transfer of developments in materials, cell design and processes from lab scale to production scale remains a challenge due to the large number of consecutive process steps and the significant impact of material properties, electrode compositions and cell designs on processes. This requires an in-depth understanding of the individual production processes and their interactions, and pilot-scale investigations into process parameter selection and prototype cell production. Furthermore, emerging process concepts must be developed at lab and pilot scale that reduce production costs and improve cell performance. Here, we present an introductory summary of the state-of-the-art production technologies for automotive LIBs. We then discuss the key relationships between process, quality and performance, as well as explore the impact of materials and processes on scale and cost. Finally, future developments and innovations that aim to overcome the main challenges are presented.

  3. Business process compliance checking : current state and future challenges

    NARCIS (Netherlands)

    El Kharbili, M.; Alves De Medeiros, A.K.; Stein, S.; Aalst, van der W.M.P.; Loos, P.; Nüttgens, M.; Turowski, K.; Werth, D.

    2008-01-01

    Regulatory compliance sets new requirements for business process management (BPM). Companies seek to enhance their corporate governance processes and are required to put in place measures for ensuring compliance to regulations. In this sense, this position paper (i) reviews the current work in the

  4. Combating piracy off the coast of Somalia: current legal challenges

    NARCIS (Netherlands)

    Fink, M.D.; Galvin, R.J.

    2009-01-01

    The ongoing maritime operations against piracy off the coast of Somalia have not only put naval enforcement against piracy at sea in the spotlight, but also the legal aftermath of what to do with pirates after their capture. While warships at sea within the current legal framework of UNCLOS and the

  5. Inclusive Education in Georgia: Current Trends and Challenges

    Science.gov (United States)

    Tchintcharauli, Tinatin; Javakhishvili, Nino

    2017-01-01

    This article presents the first comprehensive study of the Georgian inclusive education system launched nationwide in 2006. An internationally recognised tool, the "Pathway to Inclusion--Barometer of Inclusive Education", was applied within the country to highlight the current position of inclusive education in Georgia. The collected…

  6. CT of pulmonary emphysema - current status, challenges, and future directions

    International Nuclear Information System (INIS)

    Litmanovich, Diana; Boiselle, Phillip M.; Bankier, Alexander A.

    2009-01-01

    Pulmonary emphysema is characterized by irreversible destruction of lung parenchyma. Emphysema is a major contributor to chronic obstructive pulmonary disease (COPD), which by itself is a major cause of morbidity and mortality in the western world. Computed tomography (CT) is an established method for the in-vivo analysis of emphysema. This review first details the pathological basis of emphysema and shows how the subtypes of emphysema can be characterized by CT. The review then shows how CT is used to quantify emphysema, and describes the requirements and foundations for quantification to be accurate. Finally, the review discusses new challenges and their potential solution, notably focused on multi-detector-row CT, and emphasizes the open questions that future research on CT of pulmonary emphysema will have to address. (orig.)

  7. Proteomic evaluation of genetically modified crops: current status and challenges.

    Science.gov (United States)

    Gong, Chun Yan; Wang, Tai

    2013-01-01

    Hectares of genetically modified (GM) crops have increased exponentially since 1996, when such crops began to be commercialized. GM biotechnology, together with conventional breeding, has become the main approach to improving agronomic traits of crops. However, people are concerned about the safety of GM crops, especially GM-derived food and feed. Many efforts have been made to evaluate the unintended effects caused by the introduction of exogenous genes. "Omics" techniques have advantages over targeted analysis in evaluating such crops because of their use of high-throughput screening. Proteins are key players in gene function and are directly involved in metabolism and cellular development or have roles as toxins, antinutrients, or allergens, which are essential for human health. Thus, proteomics can be expected to become one of the most useful tools in safety assessment. This review assesses the potential of proteomics in evaluating various GM crops. We further describe the challenges in ensuring homogeneity and sensitivity in detection techniques.

  8. Proteomic evaluation of genetically modified crops: current status and challenges

    Directory of Open Access Journals (Sweden)

    Chun Yan Gong

    2013-03-01

    Full Text Available Hectares of genetically modified (GM crops have increased exponentially since 1996, when such crops began to be commercialized. GM biotechnology, together with conventional breeding, has become the main approach to improving agronomic traits of crops. However, people are concerned about the safety of GM crops, especially GM-derived food and feed. Many efforts have been made to evaluate the unintended effects caused by the introduction of exogenous genes. Omics techniques have advantages over targeted analysis in evaluating such crops because of their use of high-throughput screening. Proteins are key players in gene function and are directly involved in metabolism and cellular development or have roles as toxins, antinutrients or allergens, which are essential for human health. Thus, proteomics can be expected to become one of the most useful tools in safety assessment. This review assesses the potential of proteomics in evaluating various GM crops. We further describe the challenges in ensuring homogeneity and sensitivity in detection techniques.

  9. Current challenges in organic photovoltaic solar energy conversion.

    Science.gov (United States)

    Schlenker, Cody W; Thompson, Mark E

    2012-01-01

    Over the last 10 years, significant interest in utilizing conjugated organic molecules for solid-state solar to electric conversion has produced rapid improvement in device efficiencies. Organic photovoltaic (OPV) devices are attractive for their compatibility with low-cost processing techniques and thin-film applicability to flexible and conformal applications. However, many of the processes that lead to power losses in these systems still remain poorly understood, posing a significant challenge for the future efficiency improvements required to make these devices an attractive solar technology. While semiconductor band models have been employed to describe OPV operation, a more appropriate molecular picture of the pertinent processes is beginning to emerge. This chapter presents mechanisms of OPV device operation, based on the bound molecular nature of the involved transient species. With the intention to underscore the importance of considering both thermodynamic and kinetic factors, recent progress in elucidating molecular characteristics that dictate photovoltage losses in heterojunction organic photovoltaics is also discussed.

  10. Current state and challenges in developing oral vaccines.

    Science.gov (United States)

    Vela Ramirez, Julia E; Sharpe, Lindsey A; Peppas, Nicholas A

    2017-05-15

    While vaccination remains the most cost effective strategy for disease prevention, communicable diseases persist as the second leading cause of death worldwide. There is a need to design safe, novel vaccine delivery methods to protect against unaddressed and emerging diseases. Development of vaccines administered orally is preferable to traditional injection-based formulations for numerous reasons including improved safety and compliance, and easier manufacturing and administration. Additionally, the oral route enables stimulation of humoral and cellular immune responses at both systemic and mucosal sites to establish broader and long-lasting protection. However, oral delivery is challenging, requiring formulations to overcome the harsh gastrointestinal (GI) environment and avoid tolerance induction to achieve effective protection. Here we address the rationale for oral vaccines, including key biological and physicochemical considerations for next-generation oral vaccine design. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Rapid prototyping for biomedical engineering: current capabilities and challenges.

    Science.gov (United States)

    Lantada, Andrés Díaz; Morgado, Pilar Lafont

    2012-01-01

    A new set of manufacturing technologies has emerged in the past decades to address market requirements in a customized way and to provide support for research tasks that require prototypes. These new techniques and technologies are usually referred to as rapid prototyping and manufacturing technologies, and they allow prototypes to be produced in a wide range of materials with remarkable precision in a couple of hours. Although they have been rapidly incorporated into product development methodologies, they are still under development, and their applications in bioengineering are continuously evolving. Rapid prototyping and manufacturing technologies can be of assistance in every stage of the development process of novel biodevices, to address various problems that can arise in the devices' interactions with biological systems and the fact that the design decisions must be tested carefully. This review focuses on the main fields of application for rapid prototyping in biomedical engineering and health sciences, as well as on the most remarkable challenges and research trends.

  12. Materials challenges for ITER - Current status and future activities

    Energy Technology Data Exchange (ETDEWEB)

    Barabash, V. [ITER International Team, Boltsmannstrasse 2, 85748 Garching (Germany)]. E-mail: valdimir.barabash@iter.org; Peacock, A. [EFDA Close Support Unit, 85748 Garching (Germany); Fabritsiev, S. [D.V. Efremov Scientific Research Institute, 196641 St. Petersburg (Russian Federation); Kalinin, G. [ENES, P.O. Box 788, 101000 Moscow (Russian Federation); Zinkle, S. [Metals and Ceramics Division, ORNL, P.O. Box 2008, Oak Ridge, TN 37831-6138 (United States); Rowcliffe, A. [Metals and Ceramics Division, ORNL, P.O. Box 2008, Oak Ridge, TN 37831-6138 (United States); Rensman, J.-W. [NRG, P.O. Box 25, 1755 ZG Petten (Netherlands); Tavassoli, A.A. [Commissariat a l' Energie Atomique, CEA/Saclay, 91191 Gif sur Yvette cedex (France); Marmy, P. [CRPP, EPFL, Association EURATOM-Confederation Suisse, 5232, Villigen PSI (Switzerland); Karditsas, P.J. [EURATOM/UKAEA Fusion Association, Abingdon, Oxon OX14 3DB (United Kingdom); Gillemot, F. [AEKI Atomic Research Institute, 1121 Budapest, (Hungary); Akiba, M. [JAEA, Naka-machi, Naka-gun, Ibaraki-ken 311-0193 (Japan)

    2007-08-01

    ITER will be the first experimental fusion facility, which brings together the key physical, material and technological issues related to development of fusion reactors. The design of ITER is complete and the construction will start soon. This paper discusses the main directions of the project oriented materials activity and main challenges related to selection of materials for the ITER components. For each application in ITER the main materials issues were identified and these issues were addressed in the dedicated ITER R and D program. The justification of materials performance was fully documented, which allows traceability and reliability of design data. Several examples are given to illustrate the main achievements and recommendations from the recently updated ITER Materials Properties Handbook. The main ongoing and future materials activities are described.

  13. THE ADMINISTRATIVE JUSTICE IN SPAIN: CURRENT SITUATION AND CHALLENGES

    Directory of Open Access Journals (Sweden)

    R.J. Sánchez

    2016-01-01

    Full Text Available Since the Spanish Constitution of 1978 there has been a full and effective administrative justice. The citizens have the possibility to request a judicial review of decisions taken by the public Administrations, while being either the owners of a subjective right or of a legitimate interest. The interim judicial protection is not limited to the suppression of the act or general provision and the Courts are invested with direct powers to enforce their sentences. However, different problematic issues about the inactivity of the public Administrations and the enforcement of sentences are the new challenges to ensure the administrative justice. To this it must be added that there are problems regarding the inefficient work of Courts.

  14. Live attenuated vaccines: Historical successes and current challenges.

    Science.gov (United States)

    Minor, Philip D

    2015-05-01

    Live attenuated vaccines against human viral diseases have been amongst the most successful cost effective interventions in medical history. Smallpox was declared eradicated in 1980; poliomyelitis is nearing global eradication and measles has been controlled in most parts of the world. Vaccines function well for acute diseases such as these but chronic infections such as HIV are more challenging for reasons of both likely safety and probable efficacy. The derivation of the vaccines used has in general not been purely rational except in the sense that it has involved careful clinical trials of candidates and subsequent careful follow up in clinical use; the identification of the candidates is reviewed. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

  15. A reading of the crisis of prevention activities: current paradoxes and future challenges

    Directory of Open Access Journals (Sweden)

    Rodolfo Andrade de Gouveia Vilela

    2017-12-01

    Full Text Available Introduction: The activity of occupational health and safety professionals is in a paradoxical situation considering, among other aspects, the productivity context, which gives low priority to safety and health, the limitation imposed by the hegemonic conceptual references in the field, the limitation of these professionals’ power to act and the highly conflicting and complex character of the occupational world. Objective: In essay form, the article, in dialog with the literature of the field, proposes to reflect on the impasses and challenges of the prevention field. Method: The reflections are based on the experience of the authors both in the practical area as also in research, teaching and extension activities in the field of health surveillance and workers’ safety. Results: Even though this field of activity has been recognized as a specialized and legal area for more than 40 years in the country, the magnitude of the data concerning occupational and industrial accidents reveals the limitations and difficulties that these professionals face, and justifies the importance of the analysis of current practices in order to understand the contradictions that lie at the root of the difficulties to achieve prevention. Conclusion: Citizens could pressure corporations to improve their safety practices and concepts. State can also be pressured to create new safety policies.

  16. Current eugenics: A brand new challenge for scientific disciplines

    Directory of Open Access Journals (Sweden)

    María de las Mercedes O´Lery

    2006-01-01

    Full Text Available Until now, the parameters that distinguish the current eugenic practices form those encased in classic eugenics have been the private, individual and therapeutic characteristics of the first as opposed to the collective, coercive and improvement nature of the second. However, the present ethical debate over biotechnologies (particularly, criticism of liberal eugenics by such authors as Jürgen Habermas has given rise to the need to consider, in the future, genetic treatment as an object of the redistribution in order to avoid the discrimination implied in the impossibility of access to such treatment. The present paper attempts to show that this pretension would lead to the future dissolution of those very characteristics of current eugenics that distinguish it from the classic form. we therefore propose an epistemological analysis of present and/or future scientific practices in order to redefine those parameters that prevent their identification with the eugenic movement of the past century.

  17. Measurement in Marketing: Current Scenario, Recommendations and Challenges

    Directory of Open Access Journals (Sweden)

    Felipe Zambaldi

    2014-05-01

    Full Text Available The purpose of this article is to discuss about construct measurement in Marketing by summarizing the main considerations about the subject. First, it discusses the origins of the debates about the theme since the 1970s and describes its main consolidated models (the classical Churchill’s model, the COARSE model and the formative measurement model. Then it presents current concerns about the classical approach with relevant recommendations (particularly regarding multi-item measurement, single-item measurement, rating scales and cross-cultural aspects. At the end, it presents considerations about measurement trends in Marketing with emphasis on the Item Response Theory (IRT, Bayesian estimators and Partial Least Squares (PLS. The article updates the debate on the theme and contributes to Marketing experts and researchers who demand a current view about measurement and recommendations for research development. 

  18. Current Treatment Options in Challenging Oral Diseases: Burning Mouth Syndrome

    OpenAIRE

    Bilgen Erdoğan; Murat Yılmaz

    2012-01-01

    Burning mouth syndrome is a chronic condition characterized by burning pain without any signs of an oral mucosal pathology, that usually affects postmenopausal women. Burning sensation is often accompanied by dysgeusia and xerostomia. The pathogenesis of the disease is unknown and an effective treatment option for most of the patients has not been defined yet. The aim of this review is to present current pharmacological and physicological treatments of burning mouth syndrome.

  19. Current Treatment Options in Challenging Oral Diseases: Burning Mouth Syndrome

    Directory of Open Access Journals (Sweden)

    Bilgen Erdoğan

    2012-12-01

    Full Text Available Burning mouth syndrome is a chronic condition characterized by burning pain without any signs of an oral mucosal pathology, that usually affects postmenopausal women. Burning sensation is often accompanied by dysgeusia and xerostomia. The pathogenesis of the disease is unknown and an effective treatment option for most of the patients has not been defined yet. The aim of this review is to present current pharmacological and physicological treatments of burning mouth syndrome.

  20. At the Crossroads of Nanotoxicology: Past Achievements and Current Challenges

    Science.gov (United States)

    2015-01-01

    in ROS generation, loss of mitochondrial integrity, and increased secretion of pro - inflammatory cytokines. However, some exceptions have been noted...OELs), which are set in place by agencies such as OSHA and the National Institute for Occupational Safety and Health (NIOSH). Currently, limited...was suggested as a means to estimate OELs (Warheit, 2009). Following the con - clusion of this workshop, the major outcomes were made avail- able to

  1. Challenges to Global Implementation of Infrared Thermography Technology: Current Perspective

    OpenAIRE

    Michael Shterenshis

    2017-01-01

    Medical infrared thermography (IT) produces an image of the infrared waves emitted by the human body as part of the thermoregulation process that can vary in intensity based on the health of the person. This review analyzes recent developments in the use of infrared thermography as a screening and diagnostic tool in clinical and nonclinical settings, and identifies possible future routes for improvement of the method. Currently, infrared thermography is not considered to be a fully reliable d...

  2. Useful global-change scenarios: current issues and challenges

    International Nuclear Information System (INIS)

    Parson, E A

    2008-01-01

    Scenarios are increasingly used to inform global-change debates, but their connection to decisions has been weak and indirect. This reflects the greater number and variety of potential users and scenario needs, relative to other decision domains where scenario use is more established. Global-change scenario needs include common elements, e.g., model-generated projections of emissions and climate change, needed by many users but in different ways and with different assumptions. For these common elements, the limited ability to engage diverse global-change users in scenario development requires extreme transparency in communicating underlying reasoning and assumptions, including probability judgments. Other scenario needs are specific to users, requiring a decentralized network of scenario and assessment organizations to disseminate and interpret common elements and add elements requiring local context or expertise. Such an approach will make global-change scenarios more useful for decisions, but not less controversial. Despite predictable attacks, scenario-based reasoning is necessary for responsible global-change decisions because decision-relevant uncertainties cannot be specified scientifically. The purpose of scenarios is not to avoid speculation, but to make the required speculation more disciplined, more anchored in relevant scientific knowledge when available, and more transparent.

  3. Vascular Complications and Diabetes: Current Therapies and Future Challenges

    Directory of Open Access Journals (Sweden)

    Abbott L. Willard

    2012-01-01

    Full Text Available Diabetic retinal complications, including macular edema (DME and proliferative diabetic retinopathy (PDR, are the leading cause of new cases of blindness among adults aged 20–74. Chronic hyperglycemia, considered the underlying cause of diabetic retinopathy, is thought to act first through violation of the pericyte-endothelial coupling. Disruption of microvascular integrity leads to pathologic consequences including hypoxia-induced imbalance in vascular endothelial growth factor (VEGF signaling. Several anti-VEGF medications are in clinical trials for use in arresting retinal angiogenesis arising from DME and PDR. Although a review of current clinical trials shows promising results, the lack of large prospective studies, head-to-head therapeutic comparisons, and potential long-term and systemic adverse events give cause for optimistic caution. Alternative therapies including targeting pathogenic specific angiogenesis and mural-cell-based therapeutics may offer innovative solutions for currently intractable clinical problems. This paper describes the mechanisms behind diabetic retinal complications, current research supporting anti-VEGF medications, and future therapeutic directions.

  4. Challenges of recruiting ESL immigrants into cancer education studies: reflections from practice notes.

    Science.gov (United States)

    Thomson, Maria D; Hoffman-Goetz, Laurie

    2011-03-01

    Changing population demographics and immigration patterns have resulted in increasing numbers of Canadians who report speaking a language other than French or English. Inclusion of English-as-a-second-language (ESL) immigrants in cancer education research is critical if disparities in access and use of preventive health care services are to be addressed. This article describes the challenges experienced recruiting and interviewing older ESL immigrant women for a colon cancer prevention study. Factors influencing the recruitment and interview of ESL immigrant women were identified through regular team meetings, interviews, and reflective practice notes. Issues included the importance of community contacts, language barriers, and the motivations of the women for participating. Recommendations for recruitment and inclusion of ESL immigrants in cancer education research are provided.

  5. Reflections

    Indian Academy of Sciences (India)

    2004-04-01

    Apr 1, 2004 ... journal Current Science, Vol 61, 1991, pp.594-600. It is an ... could be explained as mere imperfections in the fossil record. .... would almost seem that exposure to the rigours of the climate had quickened the pace ... would be interesting to know whether this telescoping effect is the outward manifesta-.

  6. Past, Current, and Future Challenges in Linking Data to Publications

    Science.gov (United States)

    Hanson, B.

    2015-12-01

    Data are the currency of science and assure the integrity of published research. As the ability to collect, analyze, and visualize data has grown beyond what could be included in a publication, and as the value of the data become more clear (or the lack of availability of data was criticized), publishers and the scientific community developed several solutions to enhance access to underlying data. Most leading journals now require authors to agree as a condition of submission that underlying data will be included or made available; indeed, publication is the key leverage point in exposing much scholarly data. Most journals allow PDF or other supplements and links to data sets hosted by authors or labs, or better, data repositories such as Dryad, and some have banned "data not shown" or any reference to unpublished work. Many of these solutions have proven problematic and recent studies have found that large fraction of data are undiscoverable even a few years after publication. The best solution has been dedicated domain repositories collectively supported by publishers, funders, and the scientific community and where deposition is required before or at the time of publication. These provide quality control and curation and facilitate reuse. However, expanding these beyond a few key repositories and developing standardized workflows and functionality among repositories and between them and publishers has been problematic. Addressing these and other data challenges requires collaborative efforts among funders, publishers, repositories, societies, and researchers. One example is the Coalition on Publishing Data in the the Earth and space sciences, where most major publishers and repositories have signed a joint statement of commitment (COPDESS.org), and are starting work to direct and link published data to domain repositories. Much work remains to be done. Major challenges include establishing data curation practices into the workflow of science from data collection

  7. Current progress and technical challenges of flexible liquid crystal displays

    Science.gov (United States)

    Fujikake, Hideo; Sato, Hiroto

    2009-02-01

    We focused on several technical approaches to flexible liquid crystal (LC) display in this report. We have been developing flexible displays using plastic film substrates based on polymer-dispersed LC technology with molecular alignment control. In our representative devices, molecular-aligned polymer walls keep plastic-substrate gap constant without LC alignment disorder, and aligned polymer networks create monostable switching of fast-response ferroelectric LC (FLC) for grayscale capability. In the fabrication process, a high-viscosity FLC/monomer solution was printed, sandwiched and pressed between plastic substrates. Then the polymer walls and networks were sequentially formed based on photo-polymerization-induced phase separation in the nematic phase by two exposure processes of patterned and uniform ultraviolet light. The two flexible backlight films of direct illumination and light-guide methods using small three-primary-color light-emitting diodes were fabricated to obtain high-visibility display images. The fabricated flexible FLC panels were driven by external transistor arrays, internal organic thin film transistor (TFT) arrays, and poly-Si TFT arrays. We achieved full-color moving-image displays using the flexible FLC panel and the flexible backlight film based on field-sequential-color driving technique. Otherwise, for backlight-free flexible LC displays, flexible reflective devices of twisted guest-host nematic LC and cholesteric LC were discussed with molecular-aligned polymer walls. Singlesubstrate device structure and fabrication method using self-standing polymer-stabilized nematic LC film and polymer ceiling layer were also proposed for obtaining LC devices with excellent flexibility.

  8. Observing the Agulhas Current with sea surface temperature and altimetry data: challenges and perspectives

    CSIR Research Space (South Africa)

    Krug, Marjolaine, J

    2014-06-01

    Full Text Available The Agulhas Current is a challenging region for satellite remote sensing observations. Strong evaporation rates above the current core and the Retroflection reduce the number of cloud-free observations from Infra-Red sensors, while microwave...

  9. Challenges to Global Implementation of Infrared Thermography Technology: Current Perspective.

    Science.gov (United States)

    Shterenshis, Michael

    2017-01-01

    Medical infrared thermography (IT) produces an image of the infrared waves emitted by the human body as part of the thermoregulation process that can vary in intensity based on the health of the person. This review analyzes recent developments in the use of infrared thermography as a screening and diagnostic tool in clinical and nonclinical settings, and identifies possible future routes for improvement of the method. Currently, infrared thermography is not considered to be a fully reliable diagnostic method. If standard infrared protocol is established and a normative database is available, infrared thermography may become a reliable method for detecting inflammatory processes.

  10. Challenges to Global Implementation of Infrared Thermography Technology: Current Perspective

    Directory of Open Access Journals (Sweden)

    Michael Shterenshis

    2017-10-01

    Full Text Available Medical infrared thermography (IT produces an image of the infrared waves emitted by the human body as part of the thermoregulation process that can vary in intensity based on the health of the person. This review analyzes recent developments in the use of infrared thermography as a screening and diagnostic tool in clinical and nonclinical settings, and identifies possible future routes for improvement of the method. Currently, infrared thermography is not considered to be a fully reliable diagnostic method. If standard infrared protocol is established and a normative database is available, infrared thermography may become a reliable method for detecting inflammatory processes.

  11. Semiconductor photocatalysts for water oxidation: current status and challenges.

    Science.gov (United States)

    Yang, Lingling; Zhou, Han; Fan, Tongxiang; Zhang, Di

    2014-04-21

    Artificial photosynthesis is a highly-promising strategy to convert solar energy into hydrogen energy for the relief of the global energy crisis. Water oxidation is the bottleneck for its kinetic and energetic complexity in the further enhancement of the overall efficiency of the artificial photosystem. Developing efficient and cost-effective photocatalysts for water oxidation is a growing desire, and semiconductor photocatalysts have recently attracted more attention due to their stability and simplicity. This article reviews the recent advancement of semiconductor photocatalysts with a focus on the relationship between material optimization and water oxidation efficiency. A brief introduction to artificial photosynthesis and water oxidation is given first, followed by an explanation of the basic rules and mechanisms of semiconductor particulate photocatalysts for water oxidation as theoretical references for discussions of componential, surface structure, and crystal structure modification. O2-evolving photocatalysts in Z-scheme systems are also introduced to demonstrate practical applications of water oxidation photocatalysts in artificial photosystems. The final part proposes some challenges based on the dynamics and energetics of photoholes which are fundamental to the enhancement of water oxidation efficiency, as well as on the simulation of natural water oxidation that will be a trend in future research.

  12. Current approaches to challenging scenarios in myeloproliferative neoplasms.

    Science.gov (United States)

    Zimran, Eran; Hoffman, Ronald; Kremyanskaya, Marina

    2018-06-01

    The Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia and primary myelofibrosis are clonal hematological malignancies that originate at the level of the hematopoietic stem cell, and are characterized by excessive proliferation of cells belonging to one or more of the myeloid lineages. Central to the pathogenesis of the MPNs is constitutive activation of the JAK/STAT signaling pathway due to a family of driver mutations affecting JAK2, CALR or MPL. These disorders share common clinical and laboratory features, a significant burden of systemic symptoms, increased risk of developing arterial and venous thrombotic events, and the potential to progress to myelofibrosis and acute leukemia. Areas covered: We identified four clinical situations which represent challenging management dilemmas for patients with MPNs. Our conclusions and recommendations are based on a literature search using MEDLINE and recent meeting abstracts using the keywords, focusing on publications directly addressing these scenarios and on recent contributions to the field. Expert commentary: Multi-center efforts to study large cohorts of MPN patients have led to more uniform and evidence-based approaches to key aspects in MPN management. However, treatment strategies to deal with specific clinical scenarios are lacking.

  13. Proteomic evaluation of genetically modified crops: current status and challenges

    Science.gov (United States)

    Gong, Chun Yan; Wang, Tai

    2013-01-01

    Hectares of genetically modified (GM) crops have increased exponentially since 1996, when such crops began to be commercialized. GM biotechnology, together with conventional breeding, has become the main approach to improving agronomic traits of crops. However, people are concerned about the safety of GM crops, especially GM-derived food and feed. Many efforts have been made to evaluate the unintended effects caused by the introduction of exogenous genes. “Omics” techniques have advantages over targeted analysis in evaluating such crops because of their use of high-throughput screening. Proteins are key players in gene function and are directly involved in metabolism and cellular development or have roles as toxins, antinutrients, or allergens, which are essential for human health. Thus, proteomics can be expected to become one of the most useful tools in safety assessment. This review assesses the potential of proteomics in evaluating various GM crops. We further describe the challenges in ensuring homogeneity and sensitivity in detection techniques. PMID:23471542

  14. Genetic transformation of fruit trees: current status and remaining challenges.

    Science.gov (United States)

    Gambino, Giorgio; Gribaudo, Ivana

    2012-12-01

    Genetic transformation has emerged as a powerful tool for genetic improvement of fruit trees hindered by their reproductive biology and their high levels of heterozygosity. For years, genetic engineering of fruit trees has focussed principally on enhancing disease resistance (against viruses, fungi, and bacteria), although there are few examples of field cultivation and commercial application of these transgenic plants. In addition, over the years much work has been performed to enhance abiotic stress tolerance, to induce modifications of plant growth and habit, to produce marker-free transgenic plants and to improve fruit quality by modification of genes that are crucially important in the production of specific plant components. Recently, with the release of several genome sequences, studies of functional genomics are becoming increasingly important: by modification (overexpression or silencing) of genes involved in the production of specific plant components is possible to uncover regulatory mechanisms associated with the biosynthesis and catabolism of metabolites in plants. This review focuses on the main advances, in recent years, in genetic transformation of the most important species of fruit trees, devoting particular attention to functional genomics approaches and possible future challenges of genetic engineering for these species in the post-genomic era.

  15. Current situation and challenge of registry in China.

    Science.gov (United States)

    Zhang, Yang; Feng, Yuji; Qu, Zhi; Qi, Yali; Zhan, Siyan

    2014-09-01

    Increasing emphasis has been placed on registries for an organized system used in developing clinical research to improve health care. China has sufficient data that can be applied broadly, but the heterogeneity and irregularity of registries limit their applicability. This article aims to describe the status of registries in China and the related challenges. Patient registries for observational studies were retrieved from the International Clinical Trials Registry to quantitatively evaluate the number of comparatively high-quality registries in China. A literature search was also performed to provide support and updates. A total of 64 patient registries were retrieved from ClinicalTrials.gov using disease, product, and health service as criteria. The sample sizes ranged from 15 to 30,400, with only 12 registries marked as completed. This article describes and compares the detailed information in many aspects. The efficient use of registries has already made considerable progress in China; however, registries still require standardization, high-quality transition, and coordinated development.

  16. Current and New Approaches in GMO Detection: Challenges and Solutions

    Directory of Open Access Journals (Sweden)

    Marie-Alice Fraiture

    2015-01-01

    Full Text Available In many countries, genetically modified organisms (GMO legislations have been established in order to guarantee the traceability of food/feed products on the market and to protect the consumer freedom of choice. Therefore, several GMO detection strategies, mainly based on DNA, have been developed to implement these legislations. Due to its numerous advantages, the quantitative PCR (qPCR is the method of choice for the enforcement laboratories in GMO routine analysis. However, given the increasing number and diversity of GMO developed and put on the market around the world, some technical hurdles could be encountered with the qPCR technology, mainly owing to its inherent properties. To address these challenges, alternative GMO detection methods have been developed, allowing faster detections of single GM target (e.g., loop-mediated isothermal amplification, simultaneous detections of multiple GM targets (e.g., PCR capillary gel electrophoresis, microarray, and Luminex, more accurate quantification of GM targets (e.g., digital PCR, or characterization of partially known (e.g., DNA walking and Next Generation Sequencing (NGS or unknown (e.g., NGS GMO. The benefits and drawbacks of these methods are discussed in this review.

  17. Current and new approaches in GMO detection: challenges and solutions.

    Science.gov (United States)

    Fraiture, Marie-Alice; Herman, Philippe; Taverniers, Isabel; De Loose, Marc; Deforce, Dieter; Roosens, Nancy H

    2015-01-01

    In many countries, genetically modified organisms (GMO) legislations have been established in order to guarantee the traceability of food/feed products on the market and to protect the consumer freedom of choice. Therefore, several GMO detection strategies, mainly based on DNA, have been developed to implement these legislations. Due to its numerous advantages, the quantitative PCR (qPCR) is the method of choice for the enforcement laboratories in GMO routine analysis. However, given the increasing number and diversity of GMO developed and put on the market around the world, some technical hurdles could be encountered with the qPCR technology, mainly owing to its inherent properties. To address these challenges, alternative GMO detection methods have been developed, allowing faster detections of single GM target (e.g., loop-mediated isothermal amplification), simultaneous detections of multiple GM targets (e.g., PCR capillary gel electrophoresis, microarray, and Luminex), more accurate quantification of GM targets (e.g., digital PCR), or characterization of partially known (e.g., DNA walking and Next Generation Sequencing (NGS)) or unknown (e.g., NGS) GMO. The benefits and drawbacks of these methods are discussed in this review.

  18. Intradermal delivery of vaccines: potential benefits and current challenges

    Science.gov (United States)

    Hickling, JK; Jones, KR; Friede, M; Chen, D; Kristensen, D

    2011-01-01

    Abstract Delivery of vaccine antigens to the dermis and/or epidermis of human skin (i.e. intradermal delivery) might be more efficient than injection into the muscle or subcutaneous tissue, thereby reducing the volumes of antigen. This is known as dose-sparing and has been demonstrated in clinical trials with some, but not all, vaccines. Dose-sparing could be beneficial to immunization programmes by potentially reducing the costs of purchase, distribution and storage of vaccines; increasing vaccine availability and effectiveness. The data obtained with intradermal delivery of some vaccines are encouraging and warrant further study and development; however significant gaps in knowledge and operational challenges such as reformulation, optimizing vaccine presentation and development of novel devices to aid intradermal vaccine delivery need to be addressed. Modelling of the costs and potential savings resulting from intradermal delivery should be done to provide realistic expectations of the potential benefits and to support cases for investment. Implementation and uptake of intradermal vaccine delivery requires further research and development, which depends upon collaboration between multiple stakeholders in the field of vaccination. PMID:21379418

  19. Microbial production of nattokinase: current progress, challenge and prospect.

    Science.gov (United States)

    Cai, Dongbo; Zhu, Chengjun; Chen, Shouwen

    2017-05-01

    Nattokinase (EC 3.4.21.62) is a profibrinolytic serine protease with a potent fibrin-degrading activity, and it has been produced by many host strains. Compared to other fibrinolytic enzymes (urokinase, t-PA and streprokinase), nattokinase shows the advantages of having no side effects, low cost and long life-time, and it has the potential to be used as a drug for treating cardiovascular disease and served as a functional food additive. In this review, we focused on screening of producing strains, genetic engineering, fermentation process optimization for microbial nattokinase production, and the extraction and purification of nattokinase were also discussed in this particular chapter. The selection of optimal nattokinase producing strain was the crucial starting element for improvement of nattokinase production. Genetic engineering, protein engineering, fermentation optimization and process control have been proved to be the effective strategies for enhancement of nattokinase production. Also, extraction and purification of nattokinase are critical for the quality evaluation of nattokinase. Finally, the prospect of microbial nattokinase production was also discussed regarding the recent progress, challenge, and trends in this field.

  20. Mental health literacy as theory: current challenges and future directions.

    Science.gov (United States)

    Spiker, Douglas A; Hammer, Joseph H

    2018-02-13

    Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include additional constructs, but no consensus has yet been reached on what constructs should be included as part of MHL. The purpose of this paper is to (i) elucidate how the expansion of the MHL construct has impeded the growth of MHL research and (ii) through the lens of construct and theory development, highlight how these challenges might be remedied. An inclusive search of the literature was undertaken to identify MHL studies. The principles of construct and theory development guided a critical analysis of MHL. The review of the literature found that MHL violates many principles of what constitutes an acceptable construct definition. To address these concerns, we proposed conceptualizing MHL as a theory and recommended principles of theory development that should be taken into consideration. A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships. For practitioners, a theory of MHL can help inform how to improve MHL at both the individual and community level.

  1. Current and new challenges in occupational lung diseases

    Directory of Open Access Journals (Sweden)

    Sara De Matteis

    2017-11-01

    Full Text Available Occupational lung diseases are an important public health issue and are avoidable through preventive interventions in the workplace. Up-to-date knowledge about changes in exposure to occupational hazards as a result of technological and industrial developments is essential to the design and implementation of efficient and effective workplace preventive measures. New occupational agents with unknown respiratory health effects are constantly introduced to the market and require periodic health surveillance among exposed workers to detect early signs of adverse respiratory effects. In addition, the ageing workforce, many of whom have pre-existing respiratory conditions, poses new challenges in terms of the diagnosis and management of occupational lung diseases. Primary preventive interventions aimed to reduce exposure levels in the workplace remain pivotal for elimination of the occupational lung disease burden. To achieve this goal there is still a clear need for setting standard occupational exposure limits based on transparent evidence-based methodology, in particular for carcinogens and sensitising agents that expose large working populations to risk. The present overview, focused on the occupational lung disease burden in Europe, proposes directions for all parties involved in the prevention of occupational lung disease, from researchers and occupational and respiratory health professionals to workers and employers.

  2. Current applications of human pluripotent stem cells: possibilities and challenges.

    Science.gov (United States)

    Ho, Pai-Jiun; Yen, Men-Luh; Yet, Shaw-Fang; Yen, B Linju

    2012-01-01

    Stem cells are self-renewable cells with the differentiation capacity to develop into somatic cells with biological functions. This ability to sustain a renewable source of multi- and/or pluripotential differentiation has brought new hope to the field of regenerative medicine in terms of cell therapy and tissue engineering. Moreover, stem cells are invaluable tools as in vitro models for studying diverse fields, from basic scientific questions such as developmental processes and lineage commitment, to practical application including drug screening and testing. The stem cells with widest differentiation potential are pluripotent stem cells (PSCs), which are rare cells with the ability to generate somatic cells from all three germ layers. PSCs are considered the most optimal choice for therapeutic potential of stem cells, bringing new impetus to the field of regenerative medicine. In this article, we discuss the therapeutic potential of human PSCs (hPSCs) including human embryonic stem cells (hESCs) and human induced pluripotent stem cells (hiPSCs), reviewing the current preclinical and clinical data using these stem cells. We describe the classification of different sources of hPSCs, ongoing research, and currently encountered clinical obstacles of these novel and versatile human stem cells.

  3. Cytomegalovirus infection after liver transplantation: Current concepts and challenges

    Institute of Scientific and Technical Information of China (English)

    Raymund Rabe Razonable

    2008-01-01

    Cytomegalovirus(CMV)is a common viral pathogen that influences the outcome of liver transplantation.In addition to the direct effects of CMV syndrome and tissue-invasive diseases,CMV is associated with an increased predisposition to acute and chronic allograft rejection,accelerated hepatitis C recurrence,and other opportunistic infections,as well as reduced overall patient and allograft survival.Risk factors for CMV disease are often interrelated,and include CMV D+/R-serostatus,acute rejection,female gender,age,use of high-dose mycophenolate mofetil and prednisone,and the overall state of immunity.In addition to the role of CHV-specific CD4+ and CD8+ T lymphocytes,there are data to suggest that functionality of the innate immune system contributes to CMV disease pathogenesis.In one study,liver transplant recipients with a specific polymorphism in innate immune molecules known as Toll-like receptors were more likely to develop higher Ievels of CMV replication and clinical disease.Because of the direct and indirect adverse effects of CMV disease,its prevention,whether through antiviral prophylaxis or preemptive therapy,is an essential component in improving the outcome of liver transplantation.In the majority of transplant centers,antiviral prophylaxis is the preferred strategy over preemptive therapy for the prevention of CMV disease in CMV-seronegative recipients of liver allografts from CMV-seropositive donors(D+/R-).However,the major drawback of antiviral prophylaxis is the occurrence of delayed-onset primary CMV disease.In several prospective and retrospective studies,the incidence of delayed-onset primary CMV disease ranged from 16% to 47% of CMV D+/R-liver transplant recipients.Current data suggests that delayed-onset CMV disease is associated with increased mortality after liver transplantation.Therefore,optimized strategies for prevention and novel drugs with unique modes of action are needed.Currently,a randomized controlled clinical trial is being

  4. Prenatal screening: current practice, new developments, ethical challenges.

    Science.gov (United States)

    de Jong, Antina; Maya, Idit; van Lith, Jan M M

    2015-01-01

    Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. Recent developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing (NIPT) that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent 'reproductive autonomy' is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. © 2014 John Wiley & Sons Ltd.

  5. Current status of syphilis vaccine development: need, challenges, prospects.

    Science.gov (United States)

    Cameron, Caroline E; Lukehart, Sheila A

    2014-03-20

    Syphilis is a multistage disease caused by the invasive spirochete Treponema pallidum subsp. pallidum. Despite inexpensive and effective antibiotic therapy, syphilis remains a prevalent disease in developing countries and has re-emerged as a public health threat in developed nations. In addition to the medical burden imparted by infectious syphilis, congenital syphilis is considered the most significant infectious disease affecting fetuses and newborns worldwide, and individuals afflicted with syphilis have an enhanced risk for HIV transmission and acquisition. The global disease burden of syphilis and failure of decades of public health efforts to stem the incidence of disease highlight the need for an effective syphilis vaccine. Although challenges associated with T. pallidum research have impeded understanding of this pathogen, the existence of a relevant animal model has enabled insight into the correlates of disease protection. Complete protection against infection has been achieved in the animal model using an extended immunization regimen of γ-irradiated T. pallidum, demonstrating the importance of treponemal surface components in generation of protective immunity and the feasibility of syphilis vaccine development. Syphilis is a prime candidate for development of a successful vaccine due to the (1) research community's accumulated knowledge of immune correlates of protection; (2) existence of a relevant animal model that enables effective pre-clinical analyses; (3) universal penicillin susceptibility of T. pallidum which enhances the attractiveness of clinical vaccine trials; and (4) significant public health benefit a vaccine would have on reduction of infectious/congenital syphilis and HIV rates. Critical personnel, research and market gaps need to be addressed before the goal of a syphilis vaccine can be realized, including recruitment of additional researchers to the T. pallidum research field with a proportional increase in research funding

  6. Worksite health promotion research: challenges, current state and future directions

    Directory of Open Access Journals (Sweden)

    Georg F. Bauer

    2007-12-01

    Full Text Available

    Background: Worksite health promotion (WHP addresses diverse individual and work-related health determinants. Thus, multiple, non-standardized interventions as well as company outcomes other than health have to be considered in WHP research.

    Methods: The article builds primarily on published research reviews in WHP and related fields. It discusses key practical and research challenges of the workplace setting. The evidence available on the effectiveness of WHP is summarised and conclusions are drawn for future WHP practice and research.

    Results: WHP research on health-oriented, behavioural interventions shows that the level of evidence ranges from suggestive to acceptable for key prevention areas such as physical activity, nutrition, fitness, smoking, alcohol and stress. Such interventions are effective if key conditions are met. Future research is needed on long-term effects, on multi-component programs and on programs, which address environmental determinants of health behaviour as well. Research on work-related determinants of health shows the economic and public health relevance of WHP interventions. Reviews of work-oriented, organisational interventions show that they produce a range of individual and organisational outcomes. However, due to the complexity of the organisational context, the generalisability and predictability of such outcomes remain limited.

    Conclusions: WHP research shows success factors of WHP and provides evidence of its effectiveness. In future, the evidence base should be expanded by developing adaptive, company-driven intervention approaches which allow for continuous optimisation of companies from a health perspective. Also, approaches for active dissemination of such a systemic-salutogenic occupational health management approach should be developed to increase the public health impact of WHP.

  7. Current challenges for clinical trials of cardiovascular medical devices.

    Science.gov (United States)

    Zannad, Faiez; Stough, Wendy Gattis; Piña, Ileana L; Mehran, Roxana; Abraham, William T; Anker, Stefan D; De Ferrari, Gaetano M; Farb, Andrew; Geller, Nancy L; Kieval, Robert S; Linde, Cecilia; Redberg, Rita F; Stein, Kenneth; Vincent, Alphons; Woehrle, Holger; Pocock, Stuart J

    2014-07-15

    Several features of cardiovascular devices raise considerations for clinical trial conduct. Prospective, randomized, controlled trials remain the highest quality evidence for safety and effectiveness assessments, but, for instance, blinding may be challenging. In order to avoid bias and not confound data interpretation, the use of objective endpoints and blinding patients, study staff, core labs, and clinical endpoint committees to treatment assignment are helpful approaches. Anticipation of potential bias should be considered and planned for prospectively in a cardiovascular device trial. Prospective, single-arm studies (often referred to as registry studies) can provide additional data in some cases. They are subject to selection bias even when carefully designed; thus, they are generally not acceptable as the sole basis for pre-market approval of high risk cardiovascular devices. However, they complement the evidence base and fill the gaps unanswered by randomized trials. Registry studies present device safety and effectiveness in day-to-day clinical practice settings and detect rare adverse events in the post-market period. No single research design will be appropriate for every cardiovascular device or target patient population. The type of trial, appropriate control group, and optimal length of follow-up will depend on the specific device, its potential clinical benefits, the target patient population and the existence (or lack) of effective therapies, and its anticipated risks. Continued efforts on the part of investigators, the device industry, and government regulators are needed to reach the optimal approach for evaluating the safety and performance of innovative devices for the treatment of cardiovascular disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. The human gut microbiome: current knowledge, challenges, and future directions.

    Science.gov (United States)

    Dave, Maneesh; Higgins, Peter D; Middha, Sumit; Rioux, Kevin P

    2012-10-01

    The Human Genome Project was completed a decade ago, leaving a legacy of process, tools, and infrastructure now being turned to the study of the microbes that reside in and on the human body as determinants of health and disease, and has been branded "The Human Microbiome Project." Of the various niches under investigation, the human gut houses the most complex and abundant microbial community and is an arena for important host-microbial interactions that have both local and systemic impact. Initial studies of the human microbiome have been largely descriptive, a testing ground for innovative molecular techniques and new hypotheses. Methods for studying the microbiome have quickly evolved from low-resolution surveys of microbial community structure to high-definition description of composition, function, and ecology. Next-generation sequencing technologies combined with advanced bioinformatics place us at the doorstep of revolutionary insight into the composition, capability, and activity of the human intestinal microbiome. Renewed efforts to cultivate previously "uncultivable" microbes will be important to the overall understanding of gut ecology. There remain numerous methodological challenges to the effective study and understanding of the gut microbiome, largely relating to study design, sample collection, and the number of predictor variables. Strategic collaboration of clinicians, microbiologists, molecular biologists, computational scientists, and bioinformaticians is the ideal paradigm for success in this field. Meaningful interpretation of the gut microbiome requires that host genetic and environmental influences be controlled or accounted for. Understanding the gut microbiome in healthy humans is a foundation for discovering its influence in various important gastrointestinal and nutritional diseases (eg, inflammatory bowel disease, diabetes, and obesity), and for rational translation to human health gains. Copyright © 2012 Mosby, Inc. All rights

  9. Yemen in a Time of Cholera: Current Situation and Challenges.

    Science.gov (United States)

    Al-Mekhlafi, Hesham M

    2018-03-19

    Since early 2015, Yemen has been in the throes of a grueling civil war, which has devastated the health system and public services, and created one of the world's worst humanitarian disasters. The country is currently facing a cholera epidemic the world's largest on record, surpassing one million (1,061,548) suspected cases, with 2,373 related deaths since October 2016. Cases were first confirmed in Sana'a city and then spread to almost all governorates except Socotra Island. Continued efforts are being made by the World Health Organization and international partners to contain the epidemic through improving water, sanitation and hygiene, setting up diarrhea treatment centers, and improving the population's awareness about the disease. The provision of clean water and adequate sanitation is imperative as an effective long-term solution to prevent the further spread of this epidemic. Cholera vaccination campaigns should also be conducted as a preventive measure.

  10. The cooperative identity in the cuban constitution. Currents challenges

    Directory of Open Access Journals (Sweden)

    Orestes Rodríguez Musa

    2013-12-01

    Full Text Available The work contribute with some valuations about the conception of the cooperative in the Cuban constitutionalism, with the purpose that the constitution can guide -like it corresponds- the legal implementation of the figure toward an integral perspective. To accomplish this goal, this article offers a characterization of the institution that illustrates about its identity. Then it analyzed the juridical dimension of the cooperative, pondering the different doctrinal postures that have tried to define its nature. Lastly, it argue that the current laws of the Cuban Constitution, influenced by a reduced conception of the institution, suffers some limitations that block the good use of the figure in a socioeconomic context in which it is called to transcend.

  11. Policies for second generation biofuels: current status and future challenges

    Energy Technology Data Exchange (ETDEWEB)

    Egger, Haakan; Greaker, Mads; Potter, Emily

    2011-07-01

    Current state-of-the-art knowledge concludes that green house gas (GHG) emissions must be controlled and reduced within the next 30-40 years. The transport sector contributes almost a fifth of the current global emissions, and its share is likely to increase in the future. The US and a number of European countries have therefore introduced various support schemes for research and development (RandD) of low emission fuels that can potentially replace the current fossil fuels. One such alternative is biofuels. The advantage of biofuels are that it is easy to introduce into the transport sector. On the other hand, recent research papers question whether the supply of feedstock is sufficient, and to what extent biofuels lead to GHG emission reductions. This report reviews the current status of second generation biofuels. Second generation biofuels are made from cellulose, which according to our survey of the literature, is in more abundant supply than the first generation biofuels feedstocks. Furthermore, it seems to have the potential to reduce GHG emissions from the transport sector without leading to devastating land use changes, which recent critique has held against first generation biofuels. Given that governments have decided to support RandD of low emission fuels, we ask the following questions: Should second generation biofuels receive RandD support to the same extent as other low emission fuels like hydrogen? How should support schemes for second generation biofuels be designed? Second generation biofuels can be divided according to the production process into thermo-chemical and bio-chemical. With respect to the thermo-chemical process the potential for cost reductions seems to be low. On the other hand, ethanol made from cellulose using the biochemical conversion process is far from a ripe technology. Expert reports point to several potential technological breakthroughs which may reduce costs substantially. Hence, cellulosic ethanol, should receive direct

  12. Current Conceptual Challenges in the Study of Rhythm Processing Deficits

    Directory of Open Access Journals (Sweden)

    Pauline eTranchant

    2015-06-01

    Full Text Available Interest in the study of rhythm processing deficits (RPD is currently growing in the cognitive neuroscience community, as this type of investigation constitutes a powerful tool for the understanding of normal rhythm processing. Because this field is in its infancy, it still lacks a common conceptual vocabulary to facilitate effective communication between different researchers and research groups. In this commentary, we provide a brief review of recent reports of RPD through the lens of one important empirical issue: the method by which beat perception is measured, and the consequences of method selection for the researcher’s ability to specify which mechanisms are impaired in RPD. This critical reading advocates for the importance of matching measurement tools to the putative neurocognitive mechanisms under study, and reveals the need for effective and specific assessments of the different aspects of rhythm perception and synchronization.

  13. Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions.

    Science.gov (United States)

    Trusty, Phillip M; Slesnick, Timothy C; Wei, Zhenglun Alan; Rossignac, Jarek; Kanter, Kirk R; Fogel, Mark A; Yoganathan, Ajit P

    2018-04-01

    The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed. Future efforts to automate the surgical planning process will reduce the individual expertise needed and encourage use in the clinic by clinicians. As post-operative physiologic predictions improve, Fontan surgical planning will become an more effective tool to accurately model patient-specific hemodynamics.

  14. Recent advancements in bioremediation of dye: Current status and challenges.

    Science.gov (United States)

    Vikrant, Kumar; Giri, Balendu Shekhar; Raza, Nadeem; Roy, Kangkan; Kim, Ki-Hyun; Rai, Birendra Nath; Singh, Ram Sharan

    2018-04-01

    The rampant industrialization and unchecked growth of modern textile production facilities coupled with the lack of proper treatment facilities have proliferated the discharge of effluents enriched with toxic, baleful, and carcinogenic pollutants including dyes, heavy metals, volatile organic compounds, odorants, and other hazardous materials. Therefore, the development of cost-effective and efficient control measures against such pollution is imperative to safeguard ecosystems and natural resources. In this regard, recent advances in biotechnology and microbiology have propelled bioremediation as a prospective alternative to traditional treatment methods. This review was organized to address bioremediation as a practical option for the treatment of dyes by evaluating its performance and typical attributes. It further highlights the current hurdles and future prospects for the abatement of dyes via biotechnology-based remediation techniques. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Does Contralateral Delay Activity Reflect Working Memory Storage or the Current Focus of Spatial Attention within Visual Working Memory?

    Science.gov (United States)

    Berggren, Nick; Eimer, Martin

    2016-12-01

    During the retention of visual information in working memory, event-related brain potentials show a sustained negativity over posterior visual regions contralateral to the side where memorized stimuli were presented. This contralateral delay activity (CDA) is generally believed to be a neural marker of working memory storage. In two experiments, we contrasted this storage account of the CDA with the alternative hypothesis that the CDA reflects the current focus of spatial attention on a subset of memorized items set up during the most recent encoding episode. We employed a sequential loading procedure where participants memorized four task-relevant items that were presented in two successive memory displays (M1 and M2). In both experiments, CDA components were initially elicited contralateral to task-relevant items in M1. Critically, the CDA switched polarity when M2 displays appeared on the opposite side. In line with the attentional activation account, these reversed CDA components exclusively reflected the number of items that were encoded from M2 displays, irrespective of how many M1 items were already held in working memory. On trials where M1 and M2 displays were presented on the same side and on trials where M2 displays appeared nonlaterally, CDA components elicited in the interval after M2 remained sensitive to a residual trace of M1 items, indicating that some activation of previously stored items was maintained across encoding episodes. These results challenge the hypothesis that CDA amplitudes directly reflect the total number of stored objects and suggest that the CDA is primarily sensitive to the activation of a subset of working memory representations within the current focus of spatial attention.

  16. Methane hydrates in nature - Current knowledge and challenges

    Science.gov (United States)

    Collett, Timothy S.

    2014-01-01

    Recognizing the importance of methane hydrate research and the need for a coordinated effort, the United States Congress enacted the Methane Hydrate Research and Development Act of 2000. At the same time, the Ministry of International Trade and Industry in Japan launched a research program to develop plans for a methane hydrate exploratory drilling project in the Nankai Trough. India, China, the Republic of Korea, and other nations also have established large methane hydrate research and development programs. Government-funded scientific research drilling expeditions and production test studies have provided a wealth of information on the occurrence of methane hydrates in nature. Numerous studies have shown that the amount of gas stored as methane hydrates in the world may exceed the volume of known organic carbon sources. However, methane hydrates represent both a scientific and technical challenge, and much remains to be learned about their characteristics and occurrence in nature. Methane hydrate research in recent years has mostly focused on: (1) documenting the geologic parameters that control the occurrence and stability of methane hydrates in nature, (2) assessing the volume of natural gas stored within various methane hydrate accumulations, (3) analyzing the production response and characteristics of methane hydrates, (4) identifying and predicting natural and induced environmental and climate impacts of natural methane hydrates, (5) analyzing the methane hydrate role as a geohazard, (6) establishing the means to detect and characterize methane hydrate accumulations using geologic and geophysical data, and (7) establishing the thermodynamic phase equilibrium properties of methane hydrates as a function of temperature, pressure, and gas composition. The U.S. Department of Energy (DOE) and the Consortium for Ocean Leadership (COL) combined their efforts in 2012 to assess the contributions that scientific drilling has made and could continue to make to advance

  17. Complications and challenges associated with polycystic ovary syndrome: current perspectives

    Science.gov (United States)

    Palomba, Stefano; Santagni, Susanna; Falbo, Angela; La Sala, Giovanni Battista

    2015-01-01

    Polycystic ovary syndrome (PCOS) represents the most common endocrine dysfunction in fertile women and it is considered a heterogeneous and multifaceted disorder, with multiple reproductive and metabolic phenotypes which differently affect the early- and long-term syndrome’s risks. Women with PCOS present an adverse reproductive profile, including a high risk of pregnancy-induced hypertension, preeclampsia, and gestational diabetes mellitus. Patients with PCOS present not only a higher prevalence of classic cardiovascular risk factors, such as hypertension, dyslipidemia, and type-2 diabetes mellitus, but also of nonclassic cardiovascular risk factors, including mood disorders, such as depression and anxiety. Moreover, at the moment, clinical data on cardiovascular morbidity and mortality in women with PCOS are controversial. Finally, women with PCOS show an increased risk of endometrial cancer compared to non-PCOS healthy women, particularly during premenopausal period. Currently, we are unable to clarify if the increased PCOS early- and long-term risks are totally due to PCOS per se or mostly due to obesity, in particular visceral obesity, that characterized the majority of PCOS patients. In any case, the main endocrine and gynecological scientific societies agree to consider women with PCOS at increased risk of obstetric, cardiometabolic, oncology, and psychological complications throughout life, and it is recommended that these women be accurately assessed with periodic follow-up. PMID:26261426

  18. Effect-directed analysis: Current status and future challenges

    Science.gov (United States)

    Hong, Seongjin; Giesy, John P.; Lee, Jung-Suk; Lee, Jong-Hyeon; Khim, Jong Seong

    2016-09-01

    Effect-directed analysis (EDA) has become useful for identification of toxicant(s) that occur in mixtures in the environment, especially those that are causative agents of specific adverse effects. Here, we summarize and review EDA methodology including preparation of samples, biological analyses, fractionations, and instrumental analyses, highlighting key scientific advancements. A total of 63 documents since 1999 (Scopus search) including 46 research articles, 13 review papers, and 4 project descriptions, have been collected and reviewed in this study. At the early stage (1999-2010), most studies that applied EDA focused on organic extracts of freshwater and coastal contaminated sediments and wastewater. Toxic effects were often measured using cell-based bioassays ( in vitro) and the causative chemicals were identified by use of low resolution gas chromatography with mass selective detector (GCMSD). More recently (2010-present), EDA has been extended to various matrices such as biota, soil, crude oil, and suspended solids and techniques have been improved to include determination of bioavailability in vivo. In particular, methods for non-target screenings of organic chemicals in environmental samples using cutting-edge instrumentation such as time of flight-mass spectrometry (ToF-MS), Fourier transform-ion cyclotron resonance (FT-ICR), and Orbitrap mass spectrometer have been developed. This overview provides descriptions of recent improvements of EDA and suggests future research directions based on current understandings and limitations.

  19. Clinical proteomics: Current status, challenges, and future perspectives

    Directory of Open Access Journals (Sweden)

    Shyh-Horng Chiou

    2011-01-01

    Full Text Available This account will give an overview and evaluation of the current advances in mass spectrometry (MS-based proteomics platforms and technology. A general review of some background information concerning the application of these methods in the characterization of molecular sizes and related protein expression profiles associated with different types of cells under varied experimental conditions will be presented. It is intended to provide a concise and succinct overview to those clinical researchers first exposed to this foremost powerful methodology in modern life sciences of postgenomic era. Proteomic characterization using highly sophisticated and expensive instrumentation of MS has been used to characterize biological samples of complex protein mixtures with vastly different protein structure and composition. These systems are then used to highlight the versatility and potential of the MS-based proteomic strategies for facilitating protein expression analysis of various disease-related organisms or tissues of interest. Major MS-based strategies reviewed herein include (1 matrix-assisted laser desorption ionization-MS and electron-spray ionization proteomics; (2 one-dimensional or two-dimensional gel-based proteomics; (3 gel-free shotgun proteomics in conjunction with liquid chromatography/tandem MS; (4 Multiple reaction monitoring coupled tandem MS quantitative proteomics and; (5 Phosphoproteomics based on immobilized metal affinity chromatography and liquid chromatography-MS/MS.

  20. P300 brain computer interface: current challenges and emerging trends

    Science.gov (United States)

    Fazel-Rezai, Reza; Allison, Brendan Z.; Guger, Christoph; Sellers, Eric W.; Kleih, Sonja C.; Kübler, Andrea

    2012-01-01

    A brain-computer interface (BCI) enables communication without movement based on brain signals measured with electroencephalography (EEG). BCIs usually rely on one of three types of signals: the P300 and other components of the event-related potential (ERP), steady state visual evoked potential (SSVEP), or event related desynchronization (ERD). Although P300 BCIs were introduced over twenty years ago, the past few years have seen a strong increase in P300 BCI research. This closed-loop BCI approach relies on the P300 and other components of the ERP, based on an oddball paradigm presented to the subject. In this paper, we overview the current status of P300 BCI technology, and then discuss new directions: paradigms for eliciting P300s; signal processing methods; applications; and hybrid BCIs. We conclude that P300 BCIs are quite promising, as several emerging directions have not yet been fully explored and could lead to improvements in bit rate, reliability, usability, and flexibility. PMID:22822397

  1. High-density matter: current status and future challenges

    Directory of Open Access Journals (Sweden)

    Stone J. R.

    2015-01-01

    Full Text Available There are many fascinating processes in the Universe which we observe in more and more in detail thanks to increasingly sophisticated technology. One of the most interesting phenomena is the life cycle of stars, their birth, evolution and death. If the stars are massive enough, they end their lives in the core-collapse supernova explosion, the one of the most violent events in the Universe. As the result, the densest objects in the Universe, neutron stars and/or black holes are created. Naturally, the physical basis of these events should be understood in line with observation. The current status of our knowledge of processes in the life of stars is far from adequate for their true understanding. We show that although many models have been constructed their detailed ability to describe observations is limited or non-existent. Furthermore the general failure of all models means that we cannot tell which are heading in the right direction. A possible way forward in modeling of high-density matter is outlined, exemplified by the quark-meson-coupling model (QMC. This model has a natural explanation for the saturation of nuclear forces and depends on very few adjustable parameters, strongly constrained by the underlying physics. Latest QMC results for compact objects and finite nuclei are presented.

  2. Blood transfusion safety; current status and challenges in Nigeria

    Directory of Open Access Journals (Sweden)

    John C Aneke

    2017-01-01

    Full Text Available The attainment of blood transfusion safety in Nigeria (and probably the rest of Sub-Saharan Africa remains an uphill task due to a number of factors, ranging from shortage of blood, poor implementation of blood transfusion guidelines, infrastructural deficits to high prevalence of transfusion-transmissible infections (TTIs, particularly hepatitis and human immune deficiency viruses. We reviewed available data on blood transfusion practices and safety in Nigeria using the PubMed, PubMed Central, Google Scholar, and African Index Medicus search engines, through a combination of word and phrases relevant to the subject. The World Health Organization has been in the forefront of efforts to establish safe, available, and affordable blood transfusion services in most parts of Africa through encouraging adequate blood donor recruitment, donor blood testing, and collection as well developing strategies for the rational use of blood. Even though modest improvement has been recorded, particularly with regards to donor blood screening for common TTIs, considerable efforts are needed in the form of robust public enlightenment campaigns (on blood donation and continuous system improvement to drive the current transfusion practices in the country toward safety and self-sustenance.

  3. A review of current challenges for the identification of gemstones

    Science.gov (United States)

    Shigley, James E.

    2008-01-01

    A variety of treated and synthetic gem materials are encountered today in the jewelry marketplace in increasing quantities. Although normally entering into the market with correct information, in some cases these materials are sold with incorrect or inaccurate information on their identity. In some cases, they exhibit appearances that correspond closely to those of valuable untreated, natural gemstones. Although they can display certain distinctive gemological characteristics, some treated and synthetic gem materials can be difficult for jewelers to recognize, especially when these individuals lack gemological training and access to standard gem-testing methods and equipment. In such instances, testing by a professional gemological laboratory may be required. Accurate gem identification and complete information disclosure are essential in the jewelry trade to maintain both the commercial value of natural gemstones and the confidence among consumers who are considering gemstone purchases. The goal of most current gemological research is to provide practical means of gem identification for jewelers and gemologists to help insure integrity in the international gemstone trade. To support this goal, research on gem materials increasingly relies upon characterization with modern analytical tools such as chemical analysis, various spectroscopy methods, and other scientific techniques.

  4. Neuropsychology in Japan: history, current challenges, and future prospects.

    Science.gov (United States)

    Sakamoto, Maiko

    2016-11-01

    The purpose of this special issue was to describe the cross-cultural differences in neuropsychology throughout the world. The current state of neuropsychology in Japan is discussed in this manuscript. Information on six topics, including (1) the history of Japanese neuropsychology, (2) licensure system, (3) job opportunities, (4) neuropsychological clinical services, (5) neuropsychological tests, and (6) neuropsychological research, was gathered via literature searches, official organization websites, and personal communication with clinical psychologists and other professionals in Japan. Neuropsychology reached Japan from the west in the late 1800s, a period of rapid political and social modernization. Professional associations were founded in the 1960s and 1970s and continued to grow. The need for neuropsychological assessment in Japan is growing; however, credential requirements for neuropsychologists have not yet been established. To practice clinical psychology in Japan, one must obtain a Master's degree and pass a licensure examination that is administered by a private professional foundation. Clinical psychologists often conduct neuropsychological tests; however, they have little training in neuropsychological assessment. While many western neuropsychological tests have been translated into Japanese and are used in clinical settings, the majority of translated tests have not been standardized and their psychometric properties remain poorly understood. Standardization and development of normative data in Japan is warranted. Given that needs for neuropsychological services are increasing, it is essential for clinical psychologists in Japan to improve their skills in neuropsychological evaluations. Japanese graduate schools must work to establish neuropsychology programs to educate and train clinical neuropsychologists.

  5. Complications and challenges associated with polycystic ovary syndrome: current perspectives.

    Science.gov (United States)

    Palomba, Stefano; Santagni, Susanna; Falbo, Angela; La Sala, Giovanni Battista

    2015-01-01

    Polycystic ovary syndrome (PCOS) represents the most common endocrine dysfunction in fertile women and it is considered a heterogeneous and multifaceted disorder, with multiple reproductive and metabolic phenotypes which differently affect the early- and long-term syndrome's risks. Women with PCOS present an adverse reproductive profile, including a high risk of pregnancy-induced hypertension, preeclampsia, and gestational diabetes mellitus. Patients with PCOS present not only a higher prevalence of classic cardiovascular risk factors, such as hypertension, dyslipidemia, and type-2 diabetes mellitus, but also of nonclassic cardiovascular risk factors, including mood disorders, such as depression and anxiety. Moreover, at the moment, clinical data on cardiovascular morbidity and mortality in women with PCOS are controversial. Finally, women with PCOS show an increased risk of endometrial cancer compared to non-PCOS healthy women, particularly during premenopausal period. Currently, we are unable to clarify if the increased PCOS early- and long-term risks are totally due to PCOS per se or mostly due to obesity, in particular visceral obesity, that characterized the majority of PCOS patients. In any case, the main endocrine and gynecological scientific societies agree to consider women with PCOS at increased risk of obstetric, cardiometabolic, oncology, and psychological complications throughout life, and it is recommended that these women be accurately assessed with periodic follow-up.

  6. People, personal projects and the challenging of social structures: a contribution to the reflection on the challenges of teaching development studies

    OpenAIRE

    Parra Heredia, J.D. (Juan David)

    2018-01-01

    textabstractThis article makes a critique of using Post-Development as a tool in teaching an introductory course in development studies. Such a debate was initiated by Harcourt in a previous issue of Third World Quarterly as she reflected on her teaching experience in a European Institution. Harcourt concludes that the lack of engagement of some of the students in the course reflects the unwillingness of privileged middle-class pupils to challenge western lifestyles. I draw on a critical real...

  7. Novel trends in affinity biosensors: current challenges and perspectives

    International Nuclear Information System (INIS)

    Arugula, Mary A; Simonian, Aleksandr

    2014-01-01

    Molecular biorecognition processes facilitate physical and biochemical interactions between molecules in all crucial metabolic pathways. Perhaps the target analyte and the biorecognition element interactions have the most impactful use in biosensing applications. Traditional analytical sensing systems offer excellent biorecognition elements with the ability to detect and determine the presence of analytes. High affinity antibodies and DNA play an important role in the development of affinity biosensors based on electrochemical, optical and mass sensitive approaches. Advancements in this area routinely employ labels, label free, nanoparticles, multifunctional matrices, carbon nanotubes and other methods to meet the requirements of its own application. However, despite increasing affinity ceilings for conventional biosensors, the field draws back in meeting specifically important demands, such as long-term stability, ultrasensitivity, rapid detection, extreme selectivity, strong biological base, calibration, in vivo measurements, regeneration, satisfactory performance and ease of production. Nevertheless, recent efforts through this line have produced novel high-tech nanosensing systems such as ‘aptamers’ and ‘phages’ which exhibit high-throughput sensing. Aptamers and phages are powerful tools that excel over antibodies in sensibility, stability, multi-detection, in vivo measurements and regeneration. Phages are superior in stability, screening for affinity-based target molecules ranging from small to proteins and even cells, and easy production. In this review, we focus mainly on recent developments in affinity-based biosensors such as immunosensors, DNA sensors, emphasizing aptasensors and phage-based biosensors basing on novel electrochemical, optical and mass sensitive detection techniques. We also address enzyme inhibition-based biosensors and the current problems associated with the above sensors and their future perspectives. (topical review)

  8. CHALLENGES OF INTERNAL AUDIT IN THE CURRENT CRISIS

    Directory of Open Access Journals (Sweden)

    Popa Adriana Florina

    2013-07-01

    Full Text Available Modern economic theories reject the generalization of theories concerning the economic and financial crises. Each financial crisis is unique, a historic accident, generated by specific factors in a certain socio-economic and political set-up. According to these theories, crises cannot be anticipated so as to minimize their negative effects. In spite of the fact that economic and financial crises are not identical and do not produce identical effects, history teaches us that they are strongly correlated with the cyclic nature of economic processes. The current economic recession, which shows in all fields of activity, is determining auditors to make evaluations which are a lot more precise, based on extensive procedures, as long as the presumption of activity continuity into the future is accurate. In this context, internal audit is individualized as an managerial assistance function, which allows a correct perception of the reality of the business as a whole and/or as predefined processes. The purpose of this paper is to create an overall picture of internal audit by collecting data and information from literature and showing the dimensions and the internal audit practices internationally. Therefore, we conducted a research based on the analysis of national and international publications, various articles and studies in the financial press, on the emergence and development of the internal audit function both internationally and nationally. Later we analyzed the position of internal audit in terms of global financial crisis, all these leading to the usage of a comparative study of twelve international companies in order to highlight the specific features of the internal audit function in each organization. Our intention is to emphasize aspects of internal audit departments, relations between them and the management, their role in companies based on studies provided by Protiviti, a global consulting and internal audit services company, having

  9. Neutron star matter equation of state: current status and challenges

    Science.gov (United States)

    Ohnishi, Akira

    2014-09-01

    Neutron star matter has a variety of constituents and structures depending on the density; neutron-rich nuclei surounded by electrons and drip neutrons in the crust, pasta nuclei at the bottom of inner crust, and uniform isospin-asymmetric nuclear matter in a superfluid state in the outer core. In the inner core, the neutron Fermi energy becomes so large that exotic constituents such as hyperons, mesons and quarks may emerge. Radioactive beam and hypernuclear experiments provide information on the symmetry energy and superfluidity in the crust and outer core and on the hyperon potentials in the inner core, respectively. Cold atom experiments are also helpful to understand pure neutron matter, which may be simulated by the unitary gas. An equation of state (EOS) constructed based on these laboratory experiments has to be verified by the astronomical observations such as the mass, radius, and oscillations of neutron stars. One of the key but missing ingredients is the three-baryon interactions such as the hyperon-hyperon-nucleon (YYN) interaction. YYN interaction is important in order to explain the recently discovered massive neutron stars consistently with laboratory experiments. We have recently found that the ΛΛ interaction extracted from the ΛΛ correlation at RHIC is somewhat stronger than that from double Λ hypernuclei. Since these two interactions corresponds to the vacuum and in-medium ΛΛ interactions, respectively, the difference may tell us a possible way to access the YYN interaction based on experimental data. In the presentation, after a review on the current status of neutron star matter EOS studies, we discuss the necessary tasks to pin down the EOS. We also present our recent study of ΛΛ interaction from correlation data at RHIC.

  10. Gambling in China: socio-historical evolution and current challenges.

    Science.gov (United States)

    Wu, Anise M S; Lau, Joseph T F

    2015-02-01

    This paper provides an overview of gambling issues in China, including historical development, governmental responses and social consequences. Based on materials written in Chinese or English available at academic databases and other online resources, historical, cultural and policy analyses were conducted. The focus is on mainland China, but reference is made to Hong Kong and Macao to illustrate differences. Throughout Chinese history, gambling was strictly prohibited by law. In contrast, small-stakes betting for entertainment instead of monetary gain, defined as 'gaming' in this paper, has been culturally acceptable and tolerated by governments. After banning gambling for three decades, the Chinese government attempts to meet public demand for 'gaming' and to confine gambling to 'gaming' by issuing national lotteries. In response to increased economic wealth, gambling opportunities were allowed to develop, but were restricted to Macao. Social problems such as illegal and youth gambling are, however, emerging. The 'gaming' perception may predispose Chinese individuals to wagering activities and increase the risk of gambling disorder, which has been widely seen as misconduct rather than a mental disorder. Currently, the country has a dearth of gambling research and limited prevention and rehabilitation services, almost none at national level. A distinction between small-stakes 'gaming' and large-stakes 'gambling', which has cultural roots, plays an important role in relevant governmental policies and social responses in mainland China. Gambling disorder prevention and treatment is not yet on the national agenda. The country's knowledge and services gaps on gambling problems need to be filled out. © 2014 Society for the Study of Addiction.

  11. Complications and challenges associated with polycystic ovary syndrome: current perspectives

    Directory of Open Access Journals (Sweden)

    Palomba S

    2015-07-01

    Full Text Available Stefano Palomba,1 Susanna Santagni,1 Angela Falbo,1 Giovanni Battista La Sala1,21Unit of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-Scientific Institute of Treatment and Care (IRCCS, Reggio Emilia, 2Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, ItalyAbstract: Polycystic ovary syndrome (PCOS represents the most common endocrine dysfunction in fertile women and it is considered a heterogeneous and multifaceted disorder, with multiple reproductive and metabolic phenotypes which differently affect the early- and long-term syndrome’s risks. Women with PCOS present an adverse reproductive profile, including a high risk of pregnancy-induced hypertension, preeclampsia, and gestational diabetes mellitus. Patients with PCOS present not only a higher prevalence of classic cardiovascular risk factors, such as hypertension, dyslipidemia, and type-2 diabetes mellitus, but also of nonclassic cardiovascular risk factors, including mood disorders, such as depression and anxiety. Moreover, at the moment, clinical data on cardiovascular morbidity and mortality in women with PCOS are controversial. Finally, women with PCOS show an increased risk of endometrial cancer compared to non-PCOS healthy women, particularly during premenopausal period. Currently, we are unable to clarify if the increased PCOS early- and long-term risks are totally due to PCOS per se or mostly due to obesity, in particular visceral obesity, that characterized the majority of PCOS patients. In any case, the main endocrine and gynecological scientific societies agree to consider women with PCOS at increased risk of obstetric, cardiometabolic, oncology, and psychological complications throughout life, and it is recommended that these women be accurately assessed with periodic follow-up.Keywords: cardiovascular disease, infertility, polycystic ovary syndrome, PCOS, pregnancy

  12. Design of a Shielded Reflection Type Pulsed Eddy Current Probe for the Evaluation of Thickness

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Young Kil; Choi, Dong Myung [Kunsan National University, Gunsan (Korea, Republic of)

    2007-10-15

    For better evaluation of material thickness by using the reflection type pulsed eddy current method, various probe models are designed and their response signals, characteristics, and sensitivities to thickness variation are investigated by a numerical analysis method. Since the sensor needs to detect magnetic fields from eddy currents induced in a test material, not from the exciter coil, two types of models that are shielded by the combination of copper and ferrite and only by ferrite are considered. By studying response signals from these shielded probe models, the peak value and the zero crossing time are selected as useful signal features for the evaluation of material thickness. Investigation of sensitivities of these two features shows that the sensitivity of peak value is more useful than that of zero crossing time and that the probe shielded only by ferrite gives much better sensitivity to thickness variation

  13. Current vector control challenges in the fight against malaria.

    Science.gov (United States)

    Benelli, Giovanni; Beier, John C

    2017-10-01

    The effective and eco-friendly control of Anopheles vectors plays a key role in any malaria management program. Integrated Vector Management (IVM) suggests making use of the full range of vector control tools available. The strategies for IVM require novel technologies to control outdoor transmission of malaria. Despite the wide number of promising control tools tested against mosquitoes, current strategies for malaria vector control used in most African countries are not sufficient to achieve successful malaria control. The majority of National Malaria Control Programs in Africa still rely on indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). These methods reduce malaria incidence but generally have little impact on malaria prevalence. In addition to outdoor transmission, growing levels of insecticide resistance in targeted vectors threaten the efficacy of LLINs and IRS. Larvicidal treatments can be useful, but are not recommended for rural areas. The research needed to improve the quality and delivery of mosquito vector control should focus on (i) optimization of processes and methods for vector control delivery; (ii) monitoring of vector populations and biting activity with reliable techniques; (iii) the development of effective and eco-friendly tools to reduce the burden or locally eliminate malaria and other mosquito-borne diseases; (iv) the careful evaluation of field suitability and efficacy of new mosquito control tools to prove their epidemiological impact; (v) the continuous monitoring of environmental changes which potentially affect malaria vector populations; (vi) the cooperation among different disciplines, with main emphasis on parasitology, tropical medicine, ecology, entomology, and ecotoxicology. A better understanding of behavioral ecology of malaria vectors is required. Key ecological obstacles that limit the effectiveness of vector control include the variation in mosquito behavior, development of insecticide resistance

  14. [Current situation and reflection on the prevention and treatment of burns in the elderly].

    Science.gov (United States)

    Zhang, J P; Huang, Y S

    2017-09-20

    With ageing of the population, it is estimated that the percentage of old people aged above 65 years old will be approached to 30% in China by 2035. This presents a considerable challenge to geriatric burn treatment, as elderly burn patients have more serious injuries, longer hospital lengths of stay, and higher rates of complications and mortality. In this article, we analyze the current status of burns in the elderly in China and the factors contributing to the outcome of the elderly, and put forward therapeutic strategies so as to improve the level of prevention and treatment of burns in the elderly.

  15. COIN Goes GLOCAL: Traditional COIN With a Global Perspective: Does the Current US Strategy Reflect COIN Theory, Doctrine and Principles

    Science.gov (United States)

    2007-05-17

    COIN goes “ GLOCAL ”: Traditional COIN with a Global Perspective: Does the Current US Strategy Reflect COIN Theory, Doctrine and Principles? A...TITLE AND SUBTITLE COIN goes “ GLOCAL ”: Traditional COIN with a Global P ti D th C t US St t R fl t COIN 5a. CONTRACT NUMBER Perspective: Does...Monograph: COIN goes “ GLOCAL ”: Traditional COIN with a Global Perspective: Does the Current US Strategy Reflect COIN Theory, Doctrine and Principles

  16. Teacher Educators' Reflections on Moments in a Secondary Teacher Education Course: Thinking Forward by Challenging Our Teaching Practices

    Science.gov (United States)

    Freedman, Debra M.; Bullock, Patricia L.; Duque, Genevieve S.

    2005-01-01

    In this paper the authors explore two pedagogical moments that occurred within a diversity-focused secondary teacher education course, giving specific attention to Genevieve's and Debra's reflections as course instructors. We explore the ways in which instructors find themselves challenged, engaged and provoked to rethink taken for granted ideas…

  17. An exploratory study on the building information modeling adoption in United Arab Emirates municipal projects- current status and challenges

    Directory of Open Access Journals (Sweden)

    Venkatachalam Senthilkumar

    2017-01-01

    Full Text Available Many modern complex building projects in the public and private sectors are characterized by its poor information management which is manifested by time and cost overruns around the world. Building Information Modelling (BIM is currently being adopted around the world with various countries mandated its implementation. In specific, the implementation of BIM is rapidly growing in developed countries such as USA, UK, Singapore and Australia, with government mandate through devising strategies and initiatives to increase the adoption. The implementation of BIM in United Arab Emirates (UAE and other developing countries lags behind due to the existence of numerous implementation barriers. This study explores the current status of BIM implementation in the UAE municipalities, further explores the people, process and technology readiness towards BIM adoption in the UAE building projects. Further the study also explores the current challenges against the BIM adoption. The study adopts a positivists approach by collecting data through questionnaires, a sample of sixty participants across the UAE municipalities from different states were selected randomly to acquire the data. The collected data is statistically analyzed to obtain the findings. The analysis results showed that there are inadequate people and process related readiness towards BIM adoption whereas the technology readiness does exist. The same also was reflected in further analysis on BIM adoption barriers as the challenges. Further the paper also discusses the possible strategies adopted around the world through literature to address the explored challenges in the study

  18. Water Recycling via Aquifers for Sustainable Urban Water Quality Management: Current Status, Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Elise Bekele

    2018-04-01

    Full Text Available Managed aquifer recharge (MAR is used worldwide in urban environments to replenish groundwater to provide a secure and sustainable supply of potable and non-potable water. It relies on natural treatment processes within aquifers (i.e., filtration, sorption, and degradation, and in some cases involves infiltration through the unsaturated zone to polish the given source water, e.g., treated wastewater, stormwater, or rainwater, to the desired quality prior to reuse. Whilst MAR in its early forms has occurred for millennia, large-scale schemes to replenish groundwater with advanced treated reclaimed water have come to the fore in cities such as Perth, Western Australia, Monterey, California, and Changwon, South Korea, as water managers consider provision for projected population growth in a drying climate. An additional bonus for implementing MAR in coastal aquifers is assisting in the prevention of seawater intrusion. This review begins with the rationale for large-scale MAR schemes in an Australian urban context, reflecting on the current status; describes the unique benefits of several common MAR types; and provides examples from around the world. It then explores several scientific challenges, ranging from quantifying aquifer removal for various groundwater contaminants to assessing risks to human health and the environment, and avoiding adverse outcomes from biogeochemical changes induced by aquifer storage. Scientific developments in the areas of water quality assessments, which include molecular detection methods for microbial pathogens and high resolution analytical chemistry methods for detecting trace chemicals, give unprecedented insight into the “polishing” offered by natural treatment. This provides opportunities for setting of compliance targets for mitigating risks to human health and maintaining high performance MAR schemes.

  19. Simulation of GNSS reflected signals and estimation of position accuracy in GNSS-challenged environment

    DEFF Research Database (Denmark)

    Jakobsen, Jakob; Jensen, Anna B. O.; Nielsen, Allan Aasbjerg

    2015-01-01

    non-line-of-sight satellites. The signal reflections are implemented using the extended geometric path length of the signal path caused by reflections from the surrounding buildings. Based on real GPS satellite positions, simulated Galileo satellite positions, models of atmospheric effect...... on the satellite signals, designs of representative environments e.g. urban and rural scenarios, and a method to simulate reflection of satellite signals within the environment we are able to estimate the position accuracy given several prerequisites as described in the paper. The result is a modelling...... of the signal path from satellite to receiver, the satellite availability, the extended pseudoranges caused by signal reflection, and an estimate of the position accuracy based on a least squares adjustment of the extended pseudoranges. The paper describes the models and algorithms used and a verification test...

  20. Audiovisual quality assessment in communications applications: Current status, trends and challenges

    DEFF Research Database (Denmark)

    Korhonen, Jari

    2010-01-01

    Audiovisual quality assessment is one of the major challenges in multimedia communications. Traditionally, algorithm-based (objective) assessment methods have focused primarily on the compression artifacts. However, compression is only one of the numerous factors influencing the perception...... addressed in practical quality metrics is the co-impact of audio and video qualities. This paper provides an overview of the current trends and challenges in objective audiovisual quality assessment, with emphasis on communication applications...

  1. Higher Education Quality in Kenya: A Critical Reflection of Key Challenges

    Science.gov (United States)

    Odhiambo, George O.

    2011-01-01

    This article examines the unique challenges facing Kenya's public higher education institutions. It explores the struggle to develop quality and quality assurance mechanisms against a background of rapidly diminishing income, brain drain, political interference and the negative aspects of globalisation. The challenges have consequently led to a…

  2. Didactic friction – challenges and reflections n interlinking PBL and discipline-specific tuition practices

    DEFF Research Database (Denmark)

    Bejder, Anne Kirkegaard; Larsen, Gunvor Riber; Wind, Simon

    2017-01-01

    This is a discussion paper that is based on the didactics reflections of three junior academics at the Architecture and Urban Design (A&UD) programme at Aalborg University. The discussion is moored in two narratives representing two typical student tuition situations. Unfolding two touch points...... didactic friction. This friction necessitates teachers and supervisors to critically reflect upon their teaching and supervision styles, and upon how ‘the problem’ is put into play in their tuition of students. The paper argues that teachers and supervisors have a heightened obligation and responsibility...

  3. The Practice of School Psychology in Quebec English Schools: Current Challenges and Opportunities

    Science.gov (United States)

    Finn, Cindy A.

    2016-01-01

    In Quebec, school psychology is alive and well. This article outlines current challenges and opportunities related to the practice of psychology in Quebec English schools. Changes to the practice of psychology in Quebec over the last decade have had an impact on the delivery of psychological services in schools. Modifications of the admission…

  4. Current status, future opportunities, and remaining challenges in landscape genetics [Chapter 14

    Science.gov (United States)

    Niko Balkenhol; Samuel A. Cushman; Lisette P. Waits; Andrew Storfer

    2016-01-01

    Landscape genetics has advanced the field of evolutionary ecology by providing a direct focus on relationships between landscape patterns and population processes, such as gene flow, selection, and genetic drift. This chapter discusses the current and emerging challenges and opportunities, which focus and facilitate future progress in the field. It presents ten...

  5. Solidarity in family medicine in Brazil and in Italy: reflecting on ethical issues and contemporary challenges

    OpenAIRE

    Rita de Cássia Gabrielli Souza Lima; Marta Inez Machado Verdi

    2010-01-01

    This study reflects on solidarity in the practice of family medicine in two realities. The objective is to search for solidarity as an ethical principle in the relationship between family doctor and subject. It is a descriptive exploratory research carried out in Florianópolis, state of Santa Catarina, Brazil, and in the Province of Rome, Lazio Region, Italy. It included fourteen Brazilian family doctors and fifteen Italian family doctors. The theoretical framework consisted of Pierre Bourdie...

  6. Modelling binaural processes involved in simultaneous reflection masking: limitations of current models

    DEFF Research Database (Denmark)

    Buchholz, Jörg

    2007-01-01

    Masked thresholds were measured for a single test reflection, masked by the direct sound, as a function of the reflection delay. This was done for diotic as well as for dichotic stimulus presentations and all stimuli were presented via headphones. The input signal was a 200-ms long broadband noise......, such as normalized cross-correlation models (e.g., Bernstein et al., 1999, JASA, pp. 870-876), the power-addition model (Zurek, 1979, JASA, pp. 1750-1757), or Equalization-Cancellation-based models (e.g., Breebaart et al., 2001, JASA, pp. 1074-1088), cannot account for the psychoacoustical data. The present talk...

  7. Reflections on the History of South African Student Counseling Services: Achievements, Challenges, and a Way Forward

    Science.gov (United States)

    Naidoo, Paulette; Cartwright, Duncan James

    2018-01-01

    Student counseling services are a recognizable feature of higher education institutions locally and abroad. This article reviews the sociohistorical development and evolution of student counseling services in South African institutions of higher learning, with an emphasis on systemic influences, achievements, and contemporary challenges. This…

  8. From products to services : reflections on the challenges in designing for services

    NARCIS (Netherlands)

    Bhomer, ten M.; De Lille, C. S. H.; Tomico, O.; Kleinsmann, M.S.

    2013-01-01

    In this paper we will point to implications for designers who support organizations in the transition process from products to services based business models. These implications are based on four important challenges when designing for services: the designerly mindset, collaboration, empathy with

  9. Reflections on Teaching App Inventor for Non-Beginner Programmers: Issues, Challenges and Opportunities

    Science.gov (United States)

    Soares, Andrey

    2014-01-01

    App Inventor has been used successfully to teach introduction to programming course for CS/IS/IT and Non-CS majors. Now, researchers are looking on how to include the tool in the curriculum of more advanced computing courses. This paper presents some Issues, Challenges and Opportunities observed while teaching courses on Mobile Application…

  10. Internationalization of traditional Chinese medicine: current international market, internationalization challenges and prospective suggestions.

    Science.gov (United States)

    Lin, Annie Xianghong; Chan, Ging; Hu, Yuanjia; Ouyang, Defang; Ung, Carolina Oi Lam; Shi, Luwen; Hu, Hao

    2018-01-01

    Through reviewing the current international market for traditional Chinese medicine (TCM), this paper identified the internationalization challenges for TCM, including unclear therapeutic material basis and mechanism, difficulty of quality control, low preparation level, registration/policy barriers, and shortage of intellectual property. To deal with these challenges, suggestions were given including: (1) product innovation of TCM (study the TCM by using the methods and means of western medicine; innovate the basic theory of TCM; develop TCM health product); (2) standard innovation of TCM; (3) building big data platform of Chinese medicine (big data platform of TCM preparation; big data platform on the quality of TCM).

  11. Analysis of Current Visualization Techniques and Main Challenges for the Future

    Directory of Open Access Journals (Sweden)

    Manuel Pérez Cota

    2017-08-01

    Full Text Available The big amount of data generated nowadays are being used by Big Data tools to generate knowledge and to facilitate the decision-making. However, this situation creates a new challenge: how to visualize all these data without losing mid/long term crucial information. The purpose of this article is to analyze the state of the art on massive data visualization, main problems and challenges of information representation current techniques as well as the evolution of the tools and the future of them, in other words, new functionalities to offer.

  12. Key technologies for the current and future challenges of the nuclear industry

    International Nuclear Information System (INIS)

    Martinez-Sancho, Lou; Roulleaux Dugage, Martin

    2017-01-01

    The current challenges of the nuclear industry are the result of too many uncertainties: low GDP growth of OECD countries, booming state debts, deregulated electricity markets, growing safety regulation and diminishing public support. As a result, nuclear technology companies tend to entrench in their current installed base, while attempting to develop global partnerships to market their products to new nuclear countries, along with viable financing schemes. But new opportunities are lying ahead. In a future context of effective and global climate policies, nuclear energy will have to play a key role in a new energy ecosystem aside the two other clean air energy production technologies: renewable energies and electricity storage. And still, the perspective of long-term sustainability of nuclear energy is still high. This paper explores the opportunity for key innovative technologies to shift the way we think about nuclear in the future energy system while addressing these major challenges. (author)

  13. Recent trends for practical rehabilitation robotics, current challenges and the future.

    Science.gov (United States)

    Yakub, Fitri; Md Khudzari, Ahmad Zahran; Mori, Yasuchika

    2014-03-01

    This paper presents and studies various selected literature primarily from conference proceedings, journals and clinical tests of the robotic, mechatronics, neurology and biomedical engineering of rehabilitation robotic systems. The present paper focuses of three main categories: types of rehabilitation robots, key technologies with current issues and future challenges. Literature on fundamental research with some examples from commercialized robots and new robot development projects related to rehabilitation are introduced. Most of the commercialized robots presented in this paper are well known especially to robotics engineers and scholars in the robotic field, but are less known to humanities scholars. The field of rehabilitation robot research is expanding; in light of this, some of the current issues and future challenges in rehabilitation robot engineering are recalled, examined and clarified with future directions. This paper is concluded with some recommendations with respect to rehabilitation robots.

  14. A Systematic Review of Wearable Patient Monitoring Systems - Current Challenges and Opportunities for Clinical Adoption.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Moqeem, Aasia A; Mirza, Farhaan; Lindén, Maria

    2017-07-01

    The aim of this review is to investigate barriers and challenges of wearable patient monitoring (WPM) solutions adopted by clinicians in acute, as well as in community, care settings. Currently, healthcare providers are coping with ever-growing healthcare challenges including an ageing population, chronic diseases, the cost of hospitalization, and the risk of medical errors. WPM systems are a potential solution for addressing some of these challenges by enabling advanced sensors, wearable technology, and secure and effective communication platforms between the clinicians and patients. A total of 791 articles were screened and 20 were selected for this review. The most common publication venue was conference proceedings (13, 54%). This review only considered recent studies published between 2015 and 2017. The identified studies involved chronic conditions (6, 30%), rehabilitation (7, 35%), cardiovascular diseases (4, 20%), falls (2, 10%) and mental health (1, 5%). Most studies focussed on the system aspects of WPM solutions including advanced sensors, wireless data collection, communication platform and clinical usability based on a specific area or disease. The current studies are progressing with localized sensor-software integration to solve a specific use-case/health area using non-scalable and 'silo' solutions. There is further work required regarding interoperability and clinical acceptance challenges. The advancement of wearable technology and possibilities of using machine learning and artificial intelligence in healthcare is a concept that has been investigated by many studies. We believe future patient monitoring and medical treatments will build upon efficient and affordable solutions of wearable technology.

  15. RESPONSIVENESS, LANGUAGE, AND ALIGNMENT: REFLECTIONS ON SOME CHALLENGES FOR HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Dillon, Andrew

    2015-01-01

    Health systems around the world cope with the challenge of difficult economic times, and the value of health technology assessment (HTA) is increasing. Making the right choices, with limited resources, in the face of increasingly complex technologies requires decisions informed by data and analyses that help us to manage the risks involved. Those who undertake and use HTA can play a greater role in helping decision makers meet these challenges; they need to think how to define innovation and respond to it, how to communicate their analyses, and, critically, how to align their work with the ambitions of their health systems. HTA can become a key health system enabler without compromising its objectivity or independence. It can say that it is too early to determine the value of a new technology when the data simply will not support a safe decision. However, it can also be bold and recommend the managed introduction of new technologies, even when the when the data is immature, provided that the health system understands the risks and there is a plausible case for believing that further research will support the value proposition. The goal for HTA is to be able confidently to do both.

  16. Stochastic nanopore sensors for the detection of terrorist agents: Current status and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Liu Aihua; Zhao Qitao [Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington, TX 76019-0065 (United States); Guan Xiyun, E-mail: xguan@uta.edu [Department of Chemistry and Biochemistry, University of Texas at Arlington, Arlington, TX 76019-0065 (United States)

    2010-08-24

    Nanopore stochastic sensor works by monitoring the ionic current modulations induced by the passage of analytes of interest through a single pore, which can be obtained from a biological ion channel by self-assembly or artificially fabricated in a solid-state membrane. In this minireview, we overview the use of biological nanopores and artificial nanopores for the detection of terrorist agents including explosives, organophosphorus nerve agents, nitrogen mustards, organoarsenic compounds, toxins, and viruses. We also discuss the current challenge in the development of deployable nanopore sensors for real-world applications.

  17. Internet of Things: Current Challenges in the Quality Assurance and Testing Methods

    OpenAIRE

    Bures, Miroslav; Cerny, Tomas; Ahmed, Bestoun S.

    2018-01-01

    Contemporary development of the Internet of Things (IoT) technology brings a number of challenges in the Quality Assurance area. Current issues related to security, user's privacy, the reliability of the service, interoperability, and integration are discussed. All these create a demand for specific Quality Assurance methodology for the IoT solutions. In the paper, we present the state of the art of this domain and we discuss particular areas of system testing discipline, which is not covered...

  18. Additive Manufacturing (AM) in Expeditionary Operations: Current Needs, Technical Challenges, and Opportunities

    Science.gov (United States)

    2016-06-01

    REPORT TYPE AND DATES COVERED Master’s Thesis 06-30-2014 to 06-17-2016 4. TITLE AND SUBTITLE ADDITIVE MANUFACTURING (AM) IN EXPEDITIONARY OPERATIONS: CUR...CODE 13. ABSTRACT (maximum 200 words) Additive manufacturing (AM), or 3D printing, is poised to change the world of military expeditionary operations...unlimited ADDITIVE MANUFACTURING (AM) IN EXPEDITIONARY OPERATIONS: CURRENT NEEDS, TECHNICAL CHALLENGES, AND OPPORTUNITIES Matthew Daniel Friedell Captain

  19. The qualitative interview and challenges for clinicians undertaking research: a personal reflection.

    Science.gov (United States)

    Fisher, Karin

    2011-01-01

    Drawing on my doctoral experience the aim of this article is to present my transition from practitioner to novice researcher and the challenges I encountered when undertaking qualitative in-depth interviews. The contents of my research diary were coded for words, sentences and paragraphs and were then grouped into themes and subsequently organised into concepts and categories. The analysis identified one core category: 'changing states: learning to become a researcher'. The related categories included 'guessing responses', 'confusing boundaries' and 'revealing hidden concepts'. These concepts provide a description of how I learnt to become a researcher and became a changed state. The paper provides practitioners with practical examples of my transition from practitioner to novice researcher. I offer some tips for practitioners who wish to undertake research in their clinical role.

  20. Access to health care as a human right in international policy: critical reflections and contemporary challenges.

    Science.gov (United States)

    Castillo, Camilo Hernán Manchola; Garrafa, Volnei; Cunha, Thiago; Hellmann, Fernando

    2017-07-01

    Using the United Nations (UN) and its subordinate body, the World Health Organization (WHO), as a frame of reference, this article explores access to healthcare as a human right in international intergovernmental policies. First, we look at how the theme of health is treated within the UN, focusing on the concept of global health. We then discuss the concept of global health from a human rights perspective and go on to outline the debate surrounding universal coverage versus universal access as a human right, addressing some important ethical questions. Thereafter, we discuss universal coverage versus universal access using the critical and constructivist theories of international relations as a frame of reference. Finally, it is concluded that, faced with the persistence of huge global health inequalities, the WHO began to reshape itself, leaving behind the notion of health as a human right and imposing the challenge of reducing the wide gap that separates international intergovernmental laws from reality.

  1. Nasal Lipopolysaccharide Challenge and Cytokine Measurement Reflects Innate Mucosal Immune Responsiveness.

    Directory of Open Access Journals (Sweden)

    Jaideep Dhariwal

    Full Text Available Practical methods of monitoring innate immune mucosal responsiveness are lacking. Lipopolysaccharide (LPS is a component of the cell wall of Gram negative bacteria and a potent activator of Toll-like receptor (TLR-4. To measure LPS responsiveness of the nasal mucosa, we administered LPS as a nasal spray and quantified chemokine and cytokine levels in mucosal lining fluid (MLF.We performed a 5-way cross-over, single blind, placebo-controlled study in 15 healthy non-atopic subjects (n = 14 per protocol. Doses of ultrapure LPS (1, 10, 30 or 100μg/100μl or placebo were administered by a single nasal spray to each nostril. Using the recently developed method of nasosorption with synthetic adsorptive matrices (SAM, a series of samples were taken. A panel of seven cytokines/chemokines were measured by multiplex immunoassay in MLF. mRNA for intercellular cell adhesion molecule-1 (ICAM-1 was quantified from nasal epithelial curettage samples taken before and after challenge.Topical nasal LPS was well tolerated, causing no symptoms and no visible changes to the nasal mucosa. LPS induced dose-related increases in MLF levels of IL-1β, IL-6, CXCL8 (IL-8 and CCL3 (MIP-1α (AUC at 0.5 to 10h, compared to placebo, p<0.05 at 30 and 100μg LPS. At 100μg LPS, IL-10, IFN-α and TNF-α were also increased (p<0.05. Dose-related changes in mucosal ICAM-1 mRNA were also seen after challenge, and neutrophils appeared to peak in MLF at 8h. However, 2 subjects with high baseline cytokine levels showed prominent cytokine and chemokine responses to relatively low LPS doses (10μg and 30μg LPS.Topical nasal LPS causes dose-dependent increases in cytokines, chemokines, mRNA and cells. However, responsiveness can show unpredictable variations, possibly because baseline innate tone is affected by environmental factors. We believe that this new technique will have wide application in the study of the innate immune responses of the respiratory mucosa.Ultrapure LPS was used

  2. Social Inclusion Through Para sport: A Critical Reflection on the Current State of Play.

    Science.gov (United States)

    Bantjes, Jason; Swartz, Leslie

    2018-05-01

    Medicine has played an integral role in both the inception and development of the Paralympic Games. Sports physicians are well positioned to continue to influence the development of the paralympic movement and to help focus the movement on its agenda to promote social inclusion. This article looks critically at some of the key challenges that the paralympic movement faces in its quest to promote social inclusion, and considers the role of sports medicine in this process. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Reflecting on the challenges of choosing and using a grounded theory approach.

    Science.gov (United States)

    Markey, Kathleen; Tilki, Mary; Taylor, Georgina

    2014-11-01

    To explore three different approaches to grounded theory and consider some of the possible philosophical assumptions underpinning them. Grounded theory is a comprehensive yet complex methodology that offers a procedural structure that guides the researcher. However, divergent approaches to grounded theory present dilemmas for novice researchers seeking to choose a suitable research method. This is a methodology paper. This is a reflexive paper that explores some of the challenges experienced by a PhD student when choosing and operationalising a grounded theory approach. Before embarking on a study, novice grounded theory researchers should examine their research beliefs to assist them in selecting the most suitable approach. This requires an insight into the approaches' philosophical assumptions, such as those pertaining to ontology and epistemology. Researchers need to be clear about the philosophical assumptions underpinning their studies and the effects that different approaches will have on the research results. This paper presents a personal account of the journey of a novice grounded theory researcher who chose a grounded theory approach and worked within its theoretical parameters. Novice grounded theory researchers need to understand the different philosophical assumptions that influence the various grounded theory approaches, before choosing one particular approach.

  4. A Systematic Underpinning and Framing of the Servicescape: Reflections on Future Challenges in Healthcare Services

    Science.gov (United States)

    Kwon, Gyu Hyun

    2018-01-01

    Ever since Bitner defined the term “servicescape” as the physical environment in which the service is assembled, several scholars have attempted to better understand the impact of the built environment in the context of different service settings. While servicescape is a topic of increasing academic interest among scholars and practitioners, most studies in the area are dedicated to understanding the built environment of hedonic service. More studies are needed to examine utilitarian servicescape and in this paper, we have focused on the healthcare environment. This study aims to identify the gap in servicescape and healthscape studies by providing a theoretical structure of the current servicescape literature and comprehend the academic differences between hedonic servicescape and utilitarian healthscape studies. After reviewing 44 selected papers based on rigorous criteria, we: (1) framed the servicescape factors; (2) analyzed the servicescape literature from the perspectives of terminologies, research fields, methodologies, and frameworks; and (3) identified the current paths of healthscape research. Through this work, we highlight the significance of adopting different dimensions and factors to evaluate the distinguished service environment by the servicescape type and propose several research agendas for future studies on healthscapes. The research findings can contribute to a deep understanding of healthscapes and can introduce a new viewpoint for interpreting the servicescape in diversified service settings. PMID:29534035

  5. EPA Leadership on Science, Innovation, and Decision Support Tools for Addressing Current and Future Challenges.

    Science.gov (United States)

    Hecht, Alan D; Ferster, Aaron; Summers, Kevin

    2017-10-16

    When the U.S. Environmental Protection Agency (EPA) was established nearly 50 years ago, the nation faced serious threats to its air, land, and water, which in turn impacted human health. These threats were effectively addressed by the creation of EPA (in 1970) and many subsequent landmark environmental legislations which in turn significantly reduced threats to the Nation's environment and public health. A key element of historic legislation is research aimed at dealing with current and future problems. Today we face national and global challenges that go beyond classic media-specific (air, land, water) environmental legislation and require an integrated paradigm of action and engagement based on (1) innovation based on science and technology, (2) stakeholder engagement and collaboration, and (3) public education and support. This three-pronged approach recognizes that current environmental problems, include social as well as physical and environmental factors, are best addressed through collaborative problem solving, the application of innovation in science and technology, and multiple stakeholder engagement. To achieve that goal, EPA's Office of Research and Development (ORD) is working directly with states and local communities to develop and apply a suite of accessible decision support tools (DST) that aim to improve environmental conditions, protect human health, enhance economic opportunity, and advance a resilient and sustainability society. This paper showcases joint EPA and state actions to develop tools and approaches that not only meet current environmental and public health challenges, but do so in a way that advances sustainable, healthy, and resilient communities well into the future. EPA's future plans should build on current work but aim to effectively respond to growing external pressures. Growing pressures from megatrends are a major challenge for the new Administration and for cities and states across the country. The recent hurricanes hitting

  6. EDGE EFFECT INFLUENCE TO REFLECTED IMPEDANCE OF EDDY-CURRENT PROBE

    Directory of Open Access Journals (Sweden)

    О. Закревський

    2012-04-01

    Full Text Available This work is dedicated to solve analytically the edge effect Eddy-Current Probe (ECP problem which helpto carry out mathematical research the edge effect influence to ECP precision and sensitivity ultrasonictransducer mechanical amplitude oscillation measurement mathematical research, pointed to cylindricalconductive objects radius control possibility with superimposed ECP.

  7. Dominant male song performance reflects current immune state in a cooperatively breeding songbird

    NARCIS (Netherlands)

    York, Jenny E.; Radford, Andrew N.; Groothuis, Ton G.; Young, Andrew J.

    Conspicuous displays are thought to have evolved as signals of individual quality, though precisely what they encode remains a focus of debate. While high quality signals may be produced by high quality individuals due to good genes or favourable early-life conditions, whether current immune state

  8. Current challenges and emerging drug delivery strategies for the treatment of psoriasis.

    Science.gov (United States)

    Hoffman, Melissa B; Hill, Dane; Feldman, Steven R

    2016-10-01

    Psoriasis is a common skin disorder associated with physical, social, psychological and financial burden. Over the past two decades, advances in our understanding of pathogenesis and increased appreciation for the multifaceted burden of psoriasis has led to new treatment development and better patient outcomes. Yet, surveys demonstrate that many psoriasis patients are either undertreated or are dissatisfied with treatment. There are many barriers that need be overcome to optimize patient outcomes and satisfaction. This review covers the current challenges associated with each major psoriasis treatment strategy (topical, phototherapy, oral medications and biologics). It also reviews the challenges associated with the psychosocial aspects of the disease and how they affect treatment outcomes. Patient adherence, inconvenience, high costs, and drug toxicities are all discussed. Then, we review the emerging drug delivery strategies in topical, oral, and biologic therapy. By outlining current treatment challenges and emerging drug delivery strategies, we hope to highlight the deficits in psoriasis treatment and strategies for how to overcome them. Regardless of disease severity, clinicians should use a patient-centered approach. In all cases, we need to balance patients' psychosocial needs, treatment costs, convenience, and effectiveness with patients' preferences in order to optimize treatment outcomes.

  9. ICT security curriculum or how to respond to current global challenges

    Directory of Open Access Journals (Sweden)

    Marian Silviu Poboroniuc

    2017-01-01

    Full Text Available The paper presents some results obtained through the implementation of the Erasmus LLP “SALEIE” (Strategic Alignment of Electrical and Information Engineering in European Higher Education Institutions. The aim of the project was to bring together experts from European universities to enhance the competitiveness of Electrical and Information Engineering (EIE education within Europe, especially in relation to modern global technical challenges and to provide higher education models in a few EIE fields in accordance with these challenges. One of the outcomes of the project was a new ICT (Information and Computer Technology Security curriculum for bachelor and master levels. The research methodology comprised such stages as: identifying the most important current global challenges, conducting a survey related to existing EIE programs in order to establish the top-level criteria for an EIE curriculum, analyzing the results of the survey, obtaining the industry feedback related to technical and non-technical skills required for the specific field, and proposing a new curriculum for ICT Security programmes to respond to the modern technical challenges and to meet the needs of the industry, students, academics and graduates. As future work we will focus on stakeholder assessment in the EIE field and, based on the resulting feedback, on improving the ICT Security curriculum.

  10. An Overview of Science Challenges Pertaining to our Understanding of Extreme Geomagnetically Induced Currents. Chapter 8

    Science.gov (United States)

    Ngwira, Chigomezyo M.; Pulkkinen, Antti A.

    2018-01-01

    Vulnerability of man-made infrastructure to Earth-directed space weather events is a serious concern for today's technology-dependent society. Space weather-driven geomagnetically induced currents (GICs) can disrupt operation of extended electrically conducting technological systems. The threat of adverse impacts on critical technological infrastructure, like power grids, oil and gas pipelines, and communication networks, has sparked renewed interest in extreme space weather. Because extreme space weather events have low occurrence rate but potentially high impact, this presents a major challenge for our understanding of extreme GIC activity. In this chapter, we discuss some of the key science challenges pertaining to our understanding of extreme events. In addition, we present an overview of GICs including highlights of severe impacts over the last 80 years and recent U.S. Federal actions relevant to this community.

  11. Capital Finance Decisions for project managers - A reflection on current methods

    Directory of Open Access Journals (Sweden)

    C. Scheepers

    2003-12-01

    Full Text Available This paper evaluates some of current financial investment selection methodologies for capital projects. The proc ess (and criteria of capital investment decisions is reviewed. The capital budget for most organisations is prepared annually by a committee of senior managers who then present it for approval by the board of directors. Investment proposals are usually subjected to two financial tests, "payback" and "internal rate of return (IRR". The management committee usually decides on the tests and acceptance criteria vary according to the type of project. Some shortcomings of these most frequently used current tests (Payback & IRR are identified and it is recommended that the Net Present Value (NPV should be used as the primary method for analysing, comparing and selecting capital projects.

  12. The reflection of evolving bearing faults in the stator current's extended park vector approach for induction machines

    Science.gov (United States)

    Corne, Bram; Vervisch, Bram; Derammelaere, Stijn; Knockaert, Jos; Desmet, Jan

    2018-07-01

    Stator current analysis has the potential of becoming the most cost-effective condition monitoring technology regarding electric rotating machinery. Since both electrical and mechanical faults are detected by inexpensive and robust current-sensors, measuring current is advantageous on other techniques such as vibration, acoustic or temperature analysis. However, this technology is struggling to breach into the market of condition monitoring as the electrical interpretation of mechanical machine-problems is highly complicated. Recently, the authors built a test-rig which facilitates the emulation of several representative mechanical faults on an 11 kW induction machine with high accuracy and reproducibility. Operating this test-rig, the stator current of the induction machine under test can be analyzed while mechanical faults are emulated. Furthermore, while emulating, the fault-severity can be manipulated adaptively under controllable environmental conditions. This creates the opportunity of examining the relation between the magnitude of the well-known current fault components and the corresponding fault-severity. This paper presents the emulation of evolving bearing faults and their reflection in the Extended Park Vector Approach for the 11 kW induction machine under test. The results confirm the strong relation between the bearing faults and the stator current fault components in both identification and fault-severity. Conclusively, stator current analysis increases reliability in the application as a complete, robust, on-line condition monitoring technology.

  13. Women in physics in El Salvador: Historical perspectives and current challenges

    Science.gov (United States)

    Jiménez, Telma; Jiménez, Diana; Larios, Gloria

    2015-12-01

    Physics as a discipline in El Salvador's higher education system has struggled historically; however, since 1991, it has enjoyed a growth-friendly environment. While there are few female physicists in El Salvador, they are employed in various organizations and educational institutions, demonstrating that physics is a viable career path. El Salvador currently offers a range of opportunities for women in physics. With the support of the 5th IUPAP International Conference on Women in Physics, we will both meet the challenges and take advantage of the opportunities that face female physicists in El Salvador.

  14. English as a foreign language teacher education current perspectives and challenges

    CERN Document Server

    de Dios Martínez Agudo,Juan

    2014-01-01

    The field of Second Language Teacher Education (SLTE) is mainly concerned with the professional preparation of L2 teachers. In order to improve teaching in the multilingual and multicultural classroom of the 21st century, both pre- and in-service L2 teachers as well as L2 teacher educators must be prepared to meet the new challenges of education under the current circumstances, expanding their roles and responsibilities so as to face the new complex realities of language instruction. This volume explores a number of key dimensions of EFL teacher education. The sixteen chapters discuss a wide

  15. Reflecting on the mirror neuron system in autism: a systematic review of current theories.

    Science.gov (United States)

    Hamilton, Antonia F de C

    2013-01-01

    There is much interest in the claim that dysfunction of the mirror neuron system in individuals with autism spectrum condition causes difficulties in social interaction and communication. This paper systematically reviews all published studies using neuroscience methods (EEG/MEG/TMS/eyetracking/EMG/fMRI) to examine the integrity of the mirror system in autism. 25 suitable papers are reviewed. The review shows that current data are very mixed and that studies using weakly localised measures of the integrity of the mirror system are hard to interpret. The only well localised measure of mirror system function is fMRI. In fMRI studies, those using emotional stimuli have reported group differences, but studies using non-emotional hand action stimuli do not. Overall, there is little evidence for a global dysfunction of the mirror system in autism. Current data can be better understood under an alternative model in which social top-down response modulation is abnormal in autism. The implications of this model and future research directions are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. THE TEACHER AND THE DIGITAL CULTURE: A THEORETICAL REFLECTION ABOUT THE NEW CHALLENGES IN EDUCATION PRACTICE FOR OUR

    Directory of Open Access Journals (Sweden)

    Nuria Pons Vilardell Camas

    2013-12-01

    Full Text Available This article has its origin in the discussions promoted by the members of the Interinstitutional Study Group of Digital Culture and Education (Federal University of Paraná, University of Ceará and Catholic University of São Paulo (Núcleo de Estudos Interinstitucional da Cultura Digital e Educação (NEICDE – UFPR/ UNICE - Universidade Ceará e a PUC-SP.The goal of this work is to understand, analyze and examine the theoretical basis and the reflections necessary regarding the complexity and the challenges of education for the use of technologies in our century; in the rupture of the fragmentation paradigms that the use of information and communication technologies demand of education.

  17. eHealth in Saudi Arabia: Current Trends, Challenges and Recommendations.

    Science.gov (United States)

    Alsulame, Khaled; Khalifa, Mohamed; Househ, Mowafa

    2015-01-01

    The purpose of this study is to explore the current status of eHealth in Saudi Arabia from the perspective of health informatics professionals. We used a case study approach and analyzed participant data using thematic analysis. The study took place between July and August 2013. Data collection included interviews with nine senior health information professionals in Saudi Arabia. The findings describe participant views on current eHealth trends in Saudi Arabia and show differences among Saudi healthcare organizations in terms of eHealth adoption. Participants also describe the challenges relating to organizational and cultural issues, end user attitudes towards eHealth projects, and the lack of specialized human resources to implement eHealth systems. Two main recommendations made by the participants were to form a new national body for eHealth and to develop a unified plan for the implementation of Saudi eHealth initiatives.

  18. Regulatory assessment of safety culture in nuclear organisations - current trends and challenges

    International Nuclear Information System (INIS)

    Tronea, M.

    2010-01-01

    The paper gives an overview of the current practices in the area of regulatory assessment of safety culture in nuclear organisations and of the associated challenges. While the assessment and inspection procedures currently in use by regulatory authorities worldwide are directed primarily at verifying compliance with the licensing basis, there is a recognised need for a more systematic approach to the identification, collection and review of data relevant to the safety culture in licensees' organisations. The paper presents a proposal for using the existing regulatory inspection practices for gathering information relevant to safety culture and for assessing it in an integrated manner. The proposal is based on the latest requirements and guidance issued by the International Atomic Energy Agency (IAEA) on management systems for nuclear facilities and activities, particularly as regards the attributes needed for a strong nuclear safety culture. (author)

  19. THE CHALLENGE OF KEEPING-UP: CURRENT METHODOLOGIES IN ANALYZING THE STUDENTS RECRUITING AREA BY UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    MĂLĂESCU SIMONA

    2013-11-01

    Full Text Available The challenge of keeping-up: current methodologies in analyzing the students recruiting area by universities. Despite all progress made in the field and in some collateral areas extremely useful methodologically (e.g. the use of GIS, for some countries emerging from communist space methodologically upgrading to the latest advances in modelling and forecast of students recruitment by universities remains a difficult challenge. The analysis and modelling of the geographical area of recruiting students for a particular university represents even for the foreign literature a niche, not necessarily consciously neglected but only reached sidely due, most likely, to ignoring the benefits which the focus of concerns on this aspect would bring into focus and directing more efficiently university marketing efforts. This paper aims precisely to seek, through a meta-analysis of existing literature, disparate developments that led in some form or will allow improved modeling spatial areas of recruitment of students by universities and the challenges and limitations that apply methodological advances the area where universities belonging to the ex-communist involved. Beyond the theoretical benefit from a practical perspective, the meta-analysis aimed at synthesizing elements of good practice that can be applied to the local university system.

  20. Current Challenges in Prostate Cancer Management and the Rationale behind Targeted Focal Therapy

    Directory of Open Access Journals (Sweden)

    Al B. Barqawi

    2012-01-01

    Full Text Available Among men, prostate cancer has a high prevalence, with relatively lower cancer-specific mortality risk compared to lung and colon cancer. Prostate-specific antigen (PSA screening has increased prostate cancer awareness since its implementation as a screening tool almost 25 years ago, but, due to the largely indolent course of this disease and the unspecific nature of the PSA test, increased incidence has largely been associated with cancers that would not go on to cause death (clinically insignificant, leading to an overdiagnosis challenge and an ensuing overtreatment consequences. The overtreatment problem is exacerbated by the high risk of side effects that current treatment techniques have, putting patients’ quality of life at risk with little or no survival benefit. The goals of this paper are to evaluate the rise, prevalence, and impact of the overdiagnosis and ensuing overtreatment problems, as well as highlight potential solutions. In this effort, a review of major epidemiological and screening studies, cancer statistics from the advent of prostate-specific antigen screening to the present, and reports on patient concerns and treatment outcomes was conducted to present the dominant factors that underlie current challenges in prostate cancer treatment and illuminate potential solutions.

  1. Clinical decision support systems in hospital care using ubiquitous devices: Current issues and challenges.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Moqeem, Aasia A; Mirza, Farhaan; Lindén, Maria

    2017-11-01

    Supporting clinicians in decision making using advanced technologies has been an active research area in biomedical engineering during the past years. Among a wide range of ubiquitous systems, smartphone applications have been increasingly developed in healthcare settings to help clinicians as well as patients. Today, many smartphone applications, from basic data analysis to advanced patient monitoring, are available to clinicians and patients. Such applications are now increasingly integrating into healthcare for clinical decision support, and therefore, concerns around accuracy, stability, and dependency of these applications are rising. In addition, lack of attention to the clinicians' acceptability, as well as the low impact on the medical professionals' decision making, are posing more serious issues on the acceptability of smartphone applications. This article reviews smartphone-based decision support applications, focusing on hospital care settings and their overall impact of these applications on the wider clinical workflow. Additionally, key challenges and barriers of the current ubiquitous device-based healthcare applications are identified. Finally, this article addresses current challenges, future directions, and the adoption of mobile healthcare applications.

  2. Current and future challenges in therapy for antibody-mediated rejection.

    Science.gov (United States)

    Nair, Nandini; Ball, Timothy; Uber, Patricia A; Mehra, Mandeep R

    2011-06-01

    Antibody-mediated rejection (AMR) continues to present a challenge for the survival of the cardiac allograft. AMR appears to be on the rise, likely secondary to changing trends in clinical practice, including selection of patients for transplantation on mechanical circulatory support and development of more effective combinations of immunosuppressive drugs against acute cellular rejection. Most current strategies are aimed at treating acute AMR, but the treatment of chronic AMR is still not well defined. Clinically, AMR can often be more severe than cellular rejection and more difficult to treat, often not responding to typical protocols of increased immunosuppression. Complex steps involved in the antibody response allows for several potential targets for therapeutic intervention, including suppression of T and B cells, elimination of circulating antibodies, and inhibition of residual antibodies. Existing evidence suggests a multiregimen approach is the best option. Sustenance of accommodation and induction of tolerance could be viewed as viable options if adequate immune surveillance can be achieved in this setting. This review discusses the challenges in treating AMR and provides a critical analysis of current and possible future therapies. Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Water Utility Management Strategies in Turkey: The current situation and the challenges

    Science.gov (United States)

    Alp, E.; Aksoy, M. N.; Koçer, B.

    2013-12-01

    As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement

  4. Clinical Research with Transcranial Direct Current Stimulation (tDCS): Challenges and Future Directions

    Science.gov (United States)

    Brunoni, Andre Russowsky; Nitsche, Michael A.; Bolognini, Nadia; Bikson, Marom; Wagner, Tim; Merabet, Lotfi; Edwards, Dylan J.; Valero-Cabre, Antoni; Rotenberg, Alexander; Pascual-Leone, Alvaro; Ferrucci, Roberta; Priori, Alberto; Boggio, Paulo; Fregni, Felipe

    2011-01-01

    Background Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past ten years, tDCS physiological mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodological, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them. Methods We convened a workgroup of researchers in the field to review, discuss and provide updates and key challenges of neuromodulation use for clinical research. Main Findings/Discussion We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (i) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (ii) methodological aspects related to the clinical research of tDCS as divided according to study phase (i.e., preclinical, phase I, phase II and phase III studies); (iii) ethical and regulatory concerns; (iv) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS. PMID:22037126

  5. A Systematic Review of Wearable Systems for Cancer Detection: Current State and Challenges.

    Science.gov (United States)

    Ray, Partha Pratim; Dash, Dinesh; De, Debashis

    2017-10-02

    Rapid growth of sensor and computing platforms have introduced the wearable systems. In recent years, wearable systems have led to new applications across all medical fields. The aim of this review is to present current state-of-the-art approach in the field of wearable system based cancer detection and identify key challenges that resist it from clinical adoption. A total of 472 records were screened and 11 were finally included in this study. Two types of records were studied in this context that includes 45% research articles and 55% manufactured products. The review was performed per PRISMA guidelines where considerations was given to records that were published or reported between 2009 and 2017. The identified records included 4 cancer detecting wearable systems such as breast cancer (36.3%), skin cancer (36.3%), prostate cancer (18.1%), and multi-type cancer (9%). Most works involved sensor based smart systems comprising of microcontroller, Bluetooth module, and smart phone. Few demonstrated Ultra-Wide Band (i.e. UWB) antenna based wearable systems. Skin cancer detecting wearable systems were most comprehensible ones. The current works are gradually progressing with seamless integration of sensory units along with smart networking. However, they lack in cloud computing and long-range communication paradigms. Artificial intelligence and machine learning are key ports that need to be attached with current wearable systems. Further, clinical inertia, lack of awareness, and high cost are altogether pulling back the actual growth of such system. It is well comprehended that upon sincere orientation of all identified challenges, wearable systems would emerge as vital alternative to futuristic cancer detection.

  6. Current activities and challenges of the European network for inspection and qualification (ENIQ)

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Oliver [European Commission, Joint Research Centre (JRC), Petten (Netherlands). Institute for Energy and Transport (IET); Martin, Etienne [EDF, St Denis (France). Direction Production Ingenierie; Booler, Russ [AMEC Clean Energy Europe, Warrington (United Kingdom); Zetterwall, Tommy [Swedish Qualification Centre, Taeby (Sweden); Walker, Tony [Rolls-Royce Submarines, Derby (United Kingdom)

    2014-10-15

    This article describes the development of the European Network for Inspection and Qualification (ENIQ) since the previous presentation of the network in the 2011 April/May edition of this journal, covering mainly the new technical challenges facing the network and resulting projects as well as the establishment of the new Task Group for Inspection Qualification Bodies. ENIQ is a utility-driven network dealing with the reliability and effectiveness of non-destructive testing (NDT) for nuclear power plants (NPP). ENIQ is recognised as one of the main contributors to today's global qualification codes and guidelines for in-service inspection (ISI) and has published nearly 50 documents. Among them are the 'European Methodology for Qualification of Non-Destructive Testing', the first qualification methodology based on technical justifications, the 'European Framework Document for Risk-Informed In-Service Inspection (RI-ISI)', and various recommend practices. In addition ENIQ has carried out two pilot studies and a number of surveys. In 2012, ENIQ joined the European based R and D association on Gen II and III reactors, NUGENIA, making ENIQ its 8{sup th} technical area. Following the entry into NUGENIA, ENIQ members have updated the ENIQ roadmap and included a number of new technical challenges facing its members in the near future. Also ENIQ established a third task group in 2013, the Task Group for Inspection Qualification Bodies (TGIQB), which should serve as an exchange forum for inspection qualification bodies. ENIQ is currently preparing or performing new projects and studies to tackle these challenges and new recommended practices and reports are likely to evolve from these projects, which will enable ENIQ to maintain its role as one of the main contributors to today's global qualification codes and guidelines for ISI.

  7. Current activities and challenges of the European network for inspection and qualification (ENIQ)

    International Nuclear Information System (INIS)

    Martin, Oliver; Martin, Etienne; Zetterwall, Tommy; Walker, Tony

    2014-01-01

    This article describes the development of the European Network for Inspection and Qualification (ENIQ) since the previous presentation of the network in the 2011 April/May edition of this journal, covering mainly the new technical challenges facing the network and resulting projects as well as the establishment of the new Task Group for Inspection Qualification Bodies. ENIQ is a utility-driven network dealing with the reliability and effectiveness of non-destructive testing (NDT) for nuclear power plants (NPP). ENIQ is recognised as one of the main contributors to today's global qualification codes and guidelines for in-service inspection (ISI) and has published nearly 50 documents. Among them are the 'European Methodology for Qualification of Non-Destructive Testing', the first qualification methodology based on technical justifications, the 'European Framework Document for Risk-Informed In-Service Inspection (RI-ISI)', and various recommend practices. In addition ENIQ has carried out two pilot studies and a number of surveys. In 2012, ENIQ joined the European based R and D association on Gen II and III reactors, NUGENIA, making ENIQ its 8 th technical area. Following the entry into NUGENIA, ENIQ members have updated the ENIQ roadmap and included a number of new technical challenges facing its members in the near future. Also ENIQ established a third task group in 2013, the Task Group for Inspection Qualification Bodies (TGIQB), which should serve as an exchange forum for inspection qualification bodies. ENIQ is currently preparing or performing new projects and studies to tackle these challenges and new recommended practices and reports are likely to evolve from these projects, which will enable ENIQ to maintain its role as one of the main contributors to today's global qualification codes and guidelines for ISI.

  8. Malaria in Brazil, Colombia, Peru and Venezuela: current challenges in malaria control and elimination.

    Science.gov (United States)

    Recht, Judith; Siqueira, André M; Monteiro, Wuelton M; Herrera, Sonia M; Herrera, Sócrates; Lacerda, Marcus V G

    2017-07-04

    In spite of significant progress towards malaria control and elimination achieved in South America in the 2000s, this mosquito-transmitted tropical disease remains an important public health concern in the region. Most malaria cases in South America come from Amazon rain forest areas in northern countries, where more than half of malaria is caused by Plasmodium vivax, while Plasmodium falciparum malaria incidence has decreased in recent years. This review discusses current malaria data, policies and challenges in four South American Amazon countries: Brazil, Colombia, Peru and the Bolivarian Republic of Venezuela. Challenges to continuing efforts to further decrease malaria incidence in this region include: a significant increase in malaria cases in recent years in Venezuela, evidence of submicroscopic and asymptomatic infections, peri-urban malaria, gold mining-related malaria, malaria in pregnancy, glucose-6-phosphate dehydrogenase (G6PD) deficiency and primaquine use, and possible under-detection of Plasmodium malariae. Some of these challenges underscore the need to implement appropriate tools and procedures in specific regions, such as a field-compatible molecular malaria test, a P. malariae-specific test, malaria diagnosis and appropriate treatment as part of regular antenatal care visits, G6PD test before primaquine administration for P. vivax cases (with weekly primaquine regimen for G6PD deficient individuals), single low dose of primaquine for P. falciparum malaria in Colombia, and national and regional efforts to contain malaria spread in Venezuela urgently needed especially in mining areas. Joint efforts and commitment towards malaria control and elimination should be strategized based on examples of successful regional malaria fighting initiatives, such as PAMAFRO and RAVREDA/AMI.

  9. Heat supply from municipal solid waste incineration plants in Japan: Current situation and future challenges.

    Science.gov (United States)

    Tabata, Tomohiro; Tsai, Peii

    2016-02-01

    The use of waste-to-energy technology as part of a municipal solid waste management strategy could reduce the use of fossil fuels and contribute to prevention of global warming. In this study, we examined current heat and electricity production by incineration plants in Japan for external use. Herein, we discuss specific challenges to the promotion of heat utilisation and future municipal solid waste management strategies. We conducted a questionnaire survey to determine the actual conditions of heat production by incineration plants. From the survey results, information of about 498 incineration plants was extracted. When we investigated the relationship between heat production for external use and population density where incineration plants were located, we found that regions with a population density situation. © The Author(s) 2015.

  10. Possibility and Challenges of Conversion of Current Virus Species Names to Linnaean Binomials

    Energy Technology Data Exchange (ETDEWEB)

    Postler, Thomas S.; Clawson, Anna N.; Amarasinghe, Gaya K.; Basler, Christopher F.; Bavari, Sbina; Benkő, Mária; Blasdell, Kim R.; Briese, Thomas; Buchmeier, Michael J.; Bukreyev, Alexander; Calisher, Charles H.; Chandran, Kartik; Charrel, Rémi; Clegg, Christopher S.; Collins, Peter L.; Juan Carlos, De La Torre; Derisi, Joseph L.; Dietzgen, Ralf G.; Dolnik, Olga; Dürrwald, Ralf; Dye, John M.; Easton, Andrew J.; Emonet, Sébastian; Formenty, Pierre; Fouchier, Ron A. M.; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balázs; Hewson, Roger; Horie, Masayuki; Jiāng, Dàohóng; Kobinger, Gary; Kondo, Hideki; Kropinski, Andrew M.; Krupovic, Mart; Kurath, Gael; Lamb, Robert A.; Leroy, Eric M.; Lukashevich, Igor S.; Maisner, Andrea; Mushegian, Arcady R.; Netesov, Sergey V.; Nowotny, Norbert; Patterson, Jean L.; Payne, Susan L.; PaWeska, Janusz T.; Peters, Clarence J.; Radoshitzky, Sheli R.; Rima, Bertus K.; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfaçon, Hélène; Salvato, Maria S.; Schwemmle, Martin; Smither, Sophie J.; Stenglein, Mark D.; Stone, David M.; Takada, Ayato; Tesh, Robert B.; Tomonaga, Keizo; Tordo, Noël; Towner, Jonathan S.; Vasilakis, Nikos; Volchkov, Viktor E.; Wahl-Jensen, Victoria; Walker, Peter J.; Wang, Lin-Fa; Varsani, Arvind; Whitfield, Anna E.; Zerbini, F. Murilo; Kuhn, Jens H.

    2016-10-22

    Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment. [Arenaviridae; binomials; ICTV; International Committee on Taxonomy of Viruses; Mononegavirales; virus nomenclature; virus taxonomy.

  11. Stem Cells as New Agents for the Treatment of Infertility: Current and Future Perspectives and Challenges

    Directory of Open Access Journals (Sweden)

    Vladislav Volarevic

    2014-01-01

    Full Text Available Stem cells are undifferentiated cells that are present in the embryonic, fetal, and adult stages of life and give rise to differentiated cells that make up the building blocks of tissue and organs. Due to their unlimited source and high differentiation potential, stem cells are considered as potentially new therapeutic agents for the treatment of infertility. Stem cells could be stimulated in vitro to develop various numbers of specialized cells including male and female gametes suggesting their potential use in reproductive medicine. During past few years a considerable progress in the derivation of male germ cells from pluripotent stem cells has been made. In addition, stem cell-based strategies for ovarian regeneration and oocyte production have been proposed as future clinical therapies for treating infertility in women. In this review, we summarized current knowledge and present future perspectives and challenges regarding the use of stem cells in reproductive medicine.

  12. Pretreatment of agricultural biomass for anaerobic digestion: Current state and challenges.

    Science.gov (United States)

    Paudel, Shukra Raj; Banjara, Sushant Prasad; Choi, Oh Kyung; Park, Ki Young; Kim, Young Mo; Lee, Jae Woo

    2017-12-01

    The anaerobic digestion (AD) of agricultural biomass is an attractive second generation biofuel with potential environmental and economic benefits. Most agricultural biomass contains lignocellulose which requires pretreatment prior to AD. For optimization, the pretreatment methods need to be specific to the characteristics of the biomass feedstock. In this review, cereal residue, fruit and vegetable wastes, grasses and animal manure were selected as the agricultural biomass candidates, and the fundamentals and current state of various pretreatment methods used for AD of these feedstocks were investigated. Several nonconventional methods (electrical, ionic liquid-based chemicals, ruminant biological pretreatment) offer potential as targeted pretreatments of lignocellulosic biomass, but each comes with its own challenges. Pursuing an energy-intensive route, a combined bioethanol-biogas production could be a promising a second biofuel refinery option, further emphasizing the importance of pretreatment when lignocellulosic feedstock is used. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Candidiasis: a fungal infection--current challenges and progress in prevention and treatment.

    Science.gov (United States)

    Hani, Umme; Shivakumar, Hosakote G; Vaghela, Rudra; Osmani, Riyaz Ali M; Shrivastava, Atul

    2015-01-01

    Despite therapeutic advances candidiasis remains a common fungal infection most frequently caused by C. albicans and may occur as vulvovaginal candidiasis or thrush, a mucocutaneous candidiasis. Candidiasis frequently occurs in newborns, in immune-deficient people like AIDS patients, and in people being treated with broad spectrum antibiotics. It is mainly due to C. albicans while other species such as C. tropicalis, C. glabrata, C. parapsilosis and C. krusei are increasingly isolated. OTC antifungal dosage forms such as creams and gels can be used for effective treatment of local candidiasis. Whereas, for preventing spread of the disease to deeper vital organs, candidiasis antifungal chemotherapy is preferred. Use of probiotics and development of novel vaccines is an advanced approach for the prevention of candidiasis. Present review summarizes the diagnosis, current status and challenges in the treatment and prevention of candidiasis with prime focus on host defense against candidiasis, advancements in diagnosis, probiotics role and recent progress in the development of vaccines against candidiasis.

  14. Current developments and future challenges in physics analyses of the NRU heavy water research reactor

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, S.; Wilkin, B.; Leung, T., E-mail: nguyens@aecl.ca, E-mail: leungt@aecl.ca [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)

    2011-07-01

    The National Research Universal (NRU) reactor is heavy water cooled and moderated, with on-power fueling capability. TRIAD, a 3D two-group diffusion code, is currently used for support of day-to-day NRU operations. Recently, an MCNP full reactor model of NRU has been developed for benchmarking TRIAD. While reactivity changes and flux and power distributions from both methods are in reasonably good agreement, MCNP appears to eliminate a k-eff bias in TRIAD. Beyond TRIAD's capability, MCNP enables the assessment of radiation in the NRU outer structure. Challenges include improving TRIAD accuracy and MCNP performance, as well as performing NRU core-following using MCNP. (author)

  15. [Current Status and Challenges of CAR-T Immunotherapy in Hematologic Malignancies -Review].

    Science.gov (United States)

    Cheng, Xin; Wang, Ya-Jie; Feng, Shuai; Wu, Ya-Yun; Yang, Tong-Hua; Lai, Xun

    2018-04-01

    The chimeric antigen receptor (CAR) T cell therapy has gradually became a new trend in the treatment of refractory and relapsed hematologic malignancies by developing for 30 years. With the exciting development of genetic engineering, CAR-T technology has subjected to 4 generations of innovation. Structure of CAR-T started from a single signal molecule to 2 or more than 2 co-stimulatory molecules, and then coding the CAR gene or promoter. CAR-T can specifically recognize tumor antigens, and does not be restricted by major histocompatibility complex (MHC), thus making a breakthrough in clinical treatment. In this review, the history, structure and mechanism of action of CAR-T, as well as the current status and challenges of CAR-T immunotherapy in acute lymphoblastic leukemia, acute myeloid leukemia, chronic myeloid leukemia and multiple myeloma are summarized.

  16. Sonic Interactions in Virtual Reality: State of the Art, Current Challenges, and Future Directions.

    Science.gov (United States)

    Serafin, Stefania; Geronazzo, Michele; Erkut, Cumhur; Nilsson, Niels C; Nordahl, Rolf

    2018-03-01

    A high-fidelity but efficient sound simulation is an essential element of any VR experience. Many of the techniques used in virtual acoustics are graphical rendering techniques suitably modified to account for sound generation and propagation. In recent years, several advances in hardware and software technologies have been facilitating the development of immersive interactive sound-rendering experiences. In this article, we present a review of the state of the art of such simulations, with a focus on the different elements that, combined, provide a complete interactive sonic experience. This includes physics-based simulation of sound effects and their propagation in space together with binaural rendering to simulate the position of sound sources. We present how these different elements of the sound design pipeline have been addressed in the literature, trying to find the trade-off between accuracy and plausibility. Recent applications and current challenges are also presented.

  17. Road safety in a globalised and more sustainable world: current issues and future challenges.

    Science.gov (United States)

    Daniels, Stijn; Risser, Ralf

    2014-01-01

    Although many countries have had considerable success in reducing traffic injuries over recent decades, there are still some fundamental problems in this area. At the same time, there is increasing focus on road safety research and policy development in the context of globalisation, sustainability, liveability and health. This special section presents a selection of papers that were presented at the annual ICTCT workshop held on the 8th and 9th of November 2012 in Hasselt, Belgium, and accepted for publication in Accident Analysis and Prevention following the journal's reviewing procedure. The aim of the ICTCT workshop was to analyse road safety facts, data and visions for the future in the wider context of current issues and future challenges in road safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Industrial-Strength Model-Based Testing - State of the Art and Current Challenges

    Directory of Open Access Journals (Sweden)

    Jan Peleska

    2013-03-01

    Full Text Available As of today, model-based testing (MBT is considered as leading-edge technology in industry. We sketch the different MBT variants that - according to our experience - are currently applied in practice, with special emphasis on the avionic, railway and automotive domains. The key factors for successful industrial-scale application of MBT are described, both from a scientific and a managerial point of view. With respect to the former view, we describe the techniques for automated test case, test data and test procedure generation for concurrent reactive real-time systems which are considered as the most important enablers for MBT in practice. With respect to the latter view, our experience with introducing MBT approaches in testing teams are sketched. Finally, the most challenging open scientific problems whose solutions are bound to improve the acceptance and effectiveness of MBT in industry are discussed.

  19. Engineering Ethics Education : Its Necessity, Objectives, Methods, Current State, and Challenges

    Science.gov (United States)

    Fudano, Jun

    The importance of engineering ethics education has become widely recognized in the industrialized countries including Japan. This paper examines the background against which engineering ethics education is required, and reviews its objectives, methods, and challenges, as well as its current state. In pointing out important issues associated with the apparent acceptance and quantitative development of ethics education, especially after the establishment of the Japan Accreditation Board for Engineering Education in 1999, the author stresses that the most serious problem is the lack of common understanding on the objectives of engineering ethics education. As a strategy to improve the situation, the so-called “Ethics-across-the-Curriculum” approach is introduced. The author also claims that business/organization ethics which is consistent with engineering ethics should be promoted in Japan.

  20. Delivery of Therapeutic Proteins Using Electrospun Fibers-Recent Developments and Current Challenges.

    Science.gov (United States)

    Seif, Salem; Planz, Viktoria; Windbergs, Maike

    2017-10-01

    Proteins play a vital role within the human body by regulating various functions and even serving as structural constituent of many body parts. In this context, protein-based therapeutics have attracted a lot of attention in the last few decades as potential treatment of different diseases. Due to the steadily increasing interest in protein-based therapeutics, different dosage forms were investigated for delivering such complex macromolecules to the human body. Here, electrospun fibers hold a great potential for embedding proteins without structural damage and for controlled release of the protein for therapeutic applications. This review provides a comprehensive overview of the current state of protein-based carrier systems using electrospun fibers, with special emphasis on discussing their potential and key challenges in developing such therapeutic strategies, along with a prospective view of anticipated future directions. © 2017 Deutsche Pharmazeutische Gesellschaft.

  1. Possibility and challenges of conversion of current virus species names to Linnaean binomials

    Science.gov (United States)

    Thomas, Postler; Clawson, Anna N.; Amarasinghe, Gaya K.; Basler, Christopher F.; Bavari, Sina; Benko, Maria; Blasdell, Kim R.; Briese, Thomas; Buchmeier, Michael J.; Bukreyev, Alexander; Calisher, Charles H.; Chandran, Kartik; Charrel, Remi; Clegg, Christopher S.; Collins, Peter L.; De la Torre, Juan Carlos; DeRisi, Joseph L.; Dietzgen, Ralf G.; Dolnik, Olga; Durrwald, Ralf; Dye, John M.; Easton, Andrew J.; Emonet, Sebastian; Formenty, Pierre; Fouchier, Ron A. M.; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balazs; Hewson, Roger; Horie, Masayuki; Jiang, Daohong; Kobinger, Gary P.; Kondo, Hideki; Kropinski, Andrew; Krupovic, Mart; Kurath, Gael; Lamb, Robert A.; Leroy, Eric M.; Lukashevich, Igor S.; Maisner, Andrea; Mushegian, Arcady; Netesov, Sergey V.; Nowotny, Norbert; Patterson, Jean L.; Payne, Susan L.; Paweska, Janusz T.; Peters, C.J.; Radoshitzky, Sheli; Rima, Bertus K.; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfacon, Helene; Salvato , Maria; Schwemmle, Martin; Smither, Sophie J.; Stenglein, Mark; Stone, D.M.; Takada , Ayato; Tesh, Robert B.; Tomonaga, Keizo; Tordo, N.; Towner, Jonathan S.; Vasilakis, Nikos; Volchkov, Victor E.; Jensen, Victoria; Walker, Peter J.; Wang, Lin-Fa; Varsani, Arvind; Whitfield , Anna E.; Zerbini, Francisco Murilo; Kuhn, Jens H.

    2017-01-01

    Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment.

  2. Seafood traceability: current needs, available tools, and biotechnological challenges for origin certification.

    Science.gov (United States)

    Leal, Miguel Costa; Pimentel, Tânia; Ricardo, Fernando; Rosa, Rui; Calado, Ricardo

    2015-06-01

    Market globalization and recurring food safety alerts have resulted in a growing consumer awareness of the need for food traceability. This is particularly relevant for seafood due to its perishable nature and importance as a key protein source for the population of the world. Here, we provide an overview of the current needs for seafood origin traceability, along with the limitations and challenges for its implementation. We focus on geochemical, biochemical, and molecular tools and how they should be optimized to be implemented globally and to address our societal needs. We suggest that seafood traceability is key to enforcing food safety regulations and fisheries control, combat fraud, and fulfill present and future expectations of conscientious producers, consumers, and authorities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Current challenges and future directions for bacterial self-healing concrete.

    Science.gov (United States)

    Lee, Yun Suk; Park, Woojun

    2018-04-01

    Microbially induced calcium carbonate precipitation (MICP) has been widely explored and applied in the field of environmental engineering over the last decade. Calcium carbonate is naturally precipitated as a byproduct of various microbial metabolic activities. This biological process was brought into practical use to restore construction materials, strengthen and remediate soil, and sequester carbon. MICP has also been extensively examined for applications in self-healing concrete. Biogenic crack repair helps mitigate the high maintenance costs of concrete in an eco-friendly manner. In this process, calcium carbonate precipitation (CCP)-capable bacteria and nutrients are embedded inside the concrete. These bacteria are expected to increase the durability of the concrete by precipitating calcium carbonate in situ to heal cracks that develop in the concrete. However, several challenges exist with respect to embedding such bacteria; harsh conditions in concrete matrices are unsuitable for bacterial life, including high alkalinity (pH up to 13), high temperatures during manufacturing processes, and limited oxygen supply. Additionally, many biological factors, including the optimum conditions for MICP, the molecular mechanisms involved in MICP, the specific microorganisms suitable for application in concrete, the survival characteristics of the microorganisms embedded in concrete, and the amount of MICP in concrete, remain unclear. In this paper, metabolic pathways that result in conditions favorable for calcium carbonate precipitation, current and potential applications in concrete, and the remaining biological challenges are reviewed.

  4. pH-Responsive carriers for oral drug delivery: challenges and opportunities of current platforms.

    Science.gov (United States)

    Liu, Lin; Yao, WenDong; Rao, YueFeng; Lu, XiaoYang; Gao, JianQing

    2017-11-01

    Oral administration is a desirable alternative of parenteral administration due to the convenience and increased compliance to patients, especially for chronic diseases that require frequent administration. The oral drug delivery is a dynamic research field despite the numerous challenges limiting their effective delivery, such as enzyme degradation, hydrolysis and low permeability of intestinal epithelium in the gastrointestinal (GI) tract. pH-Responsive carriers offer excellent potential as oral therapeutic systems due to enhancing the stability of drug delivery in stomach and achieving controlled release in intestines. This review provides a wide perspective on current status of pH-responsive oral drug delivery systems prepared mainly with organic polymers or inorganic materials, including the strategies used to overcome GI barriers, the challenges in their development and future prospects, with focus on technology trends to improve the bioavailability of orally delivered drugs, the mechanisms of drug release from pH-responsive oral formulations, and their application for drug delivery, such as protein and peptide therapeutics, vaccination, inflammatory bowel disease (IBD) and bacterial infections.

  5. The Canadian general surgery resident: defining current challenges for surgical leadership.

    Science.gov (United States)

    Tomlinson, Corey; Labossière, Joseph; Rommens, Kenton; Birch, Daniel W

    2012-08-01

    Surgery training programs in Canada and the United States have recognized the need to modify current models of training and education. The shifting demographic of surgery trainees, lifestyle issues and an increased trend toward subspecialization are the major influences. To guide these important educational initiatives, a contemporary profile of Canadian general surgery residents and their impressions of training in Canada is required. We developed and distributed a questionnaire to residents in each Canadian general surgery training program, and residents responded during dedicated teaching time. In all, 186 surveys were returned for analysis (62% response rate). The average age of Canadian general surgery residents is 30 years, 38% are women, 41% are married, 18% have dependants younger than 18 years and 41% plan to add to or start a family during residency. Most (87%) residents plan to pursue postgraduate education. On completion of training, 74% of residents plan to stay in Canada and 49% want to practice in an academic setting. Almost half (42%) of residents identify a poor balance between work and personal life during residency. Forty-seven percent of respondents have appropriate access to mentorship, whereas 37% describe suitable access to career guidance and 40% identify the availability of appropriate social supports. Just over half (54%) believe the stress level during residency is manageable. This survey provides a profile of contemporary Canadian general surgery residents. Important challenges within the residency system are identified. Program directors and chairs of surgery are encouraged to recognize these challenges and intervene where appropriate.

  6. Physics-based distributed snow models in the operational arena: Current and future challenges

    Science.gov (United States)

    Winstral, A. H.; Jonas, T.; Schirmer, M.; Helbig, N.

    2017-12-01

    The demand for modeling tools robust to climate change and weather extremes along with coincident increases in computational capabilities have led to an increase in the use of physics-based snow models in operational applications. Current operational applications include the WSL-SLF's across Switzerland, ASO's in California, and USDA-ARS's in Idaho. While the physics-based approaches offer many advantages there remain limitations and modeling challenges. The most evident limitation remains computation times that often limit forecasters to a single, deterministic model run. Other limitations however remain less conspicuous amidst the assumptions that these models require little to no calibration based on their foundation on physical principles. Yet all energy balance snow models seemingly contain parameterizations or simplifications of processes where validation data are scarce or present understanding is limited. At the research-basin scale where many of these models were developed these modeling elements may prove adequate. However when applied over large areas, spatially invariable parameterizations of snow albedo, roughness lengths and atmospheric exchange coefficients - all vital to determining the snowcover energy balance - become problematic. Moreover as we apply models over larger grid cells, the representation of sub-grid variability such as the snow-covered fraction adds to the challenges. Here, we will demonstrate some of the major sensitivities of distributed energy balance snow models to particular model constructs, the need for advanced and spatially flexible methods and parameterizations, and prompt the community for open dialogue and future collaborations to further modeling capabilities.

  7. Preclinical magnetic resonance imaging and systems biology in cancer research: current applications and challenges.

    Science.gov (United States)

    Albanese, Chris; Rodriguez, Olga C; VanMeter, John; Fricke, Stanley T; Rood, Brian R; Lee, YiChien; Wang, Sean S; Madhavan, Subha; Gusev, Yuriy; Petricoin, Emanuel F; Wang, Yue

    2013-02-01

    Biologically accurate mouse models of human cancer have become important tools for the study of human disease. The anatomical location of various target organs, such as brain, pancreas, and prostate, makes determination of disease status difficult. Imaging modalities, such as magnetic resonance imaging, can greatly enhance diagnosis, and longitudinal imaging of tumor progression is an important source of experimental data. Even in models where the tumors arise in areas that permit visual determination of tumorigenesis, longitudinal anatomical and functional imaging can enhance the scope of studies by facilitating the assessment of biological alterations, (such as changes in angiogenesis, metabolism, cellular invasion) as well as tissue perfusion and diffusion. One of the challenges in preclinical imaging is the development of infrastructural platforms required for integrating in vivo imaging and therapeutic response data with ex vivo pathological and molecular data using a more systems-based multiscale modeling approach. Further challenges exist in integrating these data for computational modeling to better understand the pathobiology of cancer and to better affect its cure. We review the current applications of preclinical imaging and discuss the implications of applying functional imaging to visualize cancer progression and treatment. Finally, we provide new data from an ongoing preclinical drug study demonstrating how multiscale modeling can lead to a more comprehensive understanding of cancer biology and therapy. Copyright © 2013 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  8. Informatics in clinical research in oncology: current state, challenges, and a future perspective.

    Science.gov (United States)

    Chahal, Amar P S

    2011-01-01

    The informatics landscape of clinical trials in oncology has changed significantly in the last 10 years. The current state of the infrastructure for clinical trial management, execution, and data management is reviewed. The systems, their functionality, the users, and the standards available to researchers are discussed from the perspective of the oncologist-researcher. Challenges in complexity and in the processing of information are outlined. These challenges include the lack of communication and information-interchange between systems, the lack of simplified standards, and the lack of implementation and adherence to the standards that are available. The clinical toxicology criteria from the National Cancer Institute (CTCAE) are cited as a successful standard in oncology, and HTTP on the Internet is referenced for its simplicity. Differences in the management of information standards between industries are discussed. Possible future advances in oncology clinical research informatics are addressed. These advances include strategic policy review of standards and the implementation of actions to make standards free, ubiquitous, simple, and easily interpretable; the need to change from a local data-capture- or transaction-driven model to a large-scale data-interpretation model that provides higher value to the oncologist and the patient; and the need for information technology investment in a readily available digital educational model for clinical research in oncology that is customizable for individual studies. These new approaches, with changes in information delivery to mobile platforms, will set the stage for the next decade in clinical research informatics.

  9. Public health engineering education in India: current scenario, opportunities and challenges.

    Science.gov (United States)

    Hussain, Mohammad Akhtar; Sharma, Kavya; Zodpey, Sanjay

    2011-01-01

    Public health engineering can play an important and significant role in solving environmental health issues. In order to confront public health challenges emerging out of environmental problems we need adequately trained public health engineers / environmental engineers. Considering the current burden of disease attributable to environmental factors and expansion in scope of applications of public health / environmental engineering science, it is essential to understand the present scenario of teaching, training and capacity building programs in these areas. Against this background the present research was carried out to know the current teaching and training programs in public health engineering and related disciplines in India and to understand the potential opportunities and challenges available. A systematic, predefined approach was used to collect and assemble the data related to various teaching and training programs in public health engineering / environmental engineering in India. Public health engineering / environmental engineering education and training in the country is mainly offered through engineering institutions, as pre-service and in-service training. Pre-service programs include diploma, degree (graduate) and post-graduate courses affiliated to various state technical boards, institutes and universities, whereas in-service training is mainly provided by Government of India recognized engineering and public health training institutes. Though trainees of these programs acquire skills related to engineering sciences, they significantly lack in public health skills. The teaching and training of public health engineering / environmental engineering is limited as a part of public health programs (MD Community Medicine, MPH, DPH) in India. There is need for developing teaching and training of public health engineering or environmental engineering as an interdisciplinary subject. Public health institutes can play an important and significant role in this

  10. Current status, questions and challenges of transcatheter uterine artery embolization for the treatment of uterine fibroids

    International Nuclear Information System (INIS)

    Chen Xiaoming; Luo Pengfei

    2006-01-01

    Current status, questions and challenges of transcatheter uterine artery embolization (UAE) in the treatment of uterine fibroids were summarized and analysed. It has been proved that UAE presents a good effectiveness in controlling the symptoms and shrinkage of fibroid and uterine volumes during follow-up of 4 to 6.9 years domestically and abroad, but relapse of the fibroid may however occur in 2 years or longer after UAE. Generally speaking, UAE is safe in the treatment of uterine fibroids but has a possibility of serious complications. UAE has no damage on normal uterine tissues but may affect pregnancy and delivery of patients significantly later on the cause of hypoxia and inertia of uterus. UAE may cause amenorrhea in the minority of women with ovarian failure and endometrium atrophy. The current questions are how to improve long-term efficiency to reduce relapse of tumor and to insure the safety of UAE. It is our further task to exploit more new effective and safe embolic agents by using animal and clinical study on the basic knowledge of pathology, pharmacology, biochemistry, endocrinology and molecular biology. (authors)

  11. Hematopoietic cell transplantation in Fanconi anemia: current evidence, challenges and recommendations.

    Science.gov (United States)

    Ebens, Christen L; MacMillan, Margaret L; Wagner, John E

    2017-01-01

    Hematopoietic cell transplantation for Fanconi Anemia (FA) has improved dramatically over the past 40 years. With an enhanced understanding of the intrinsic DNA-repair defect and pathophysiology of hematopoietic failure and leukemogenesis, sequential changes to conditioning and graft engineering have significantly improved the expectation of survival after allogeneic hematopoietic cell transplantation (alloHCT) with incidence of graft failure decreased from 35% to 40% to <10%. Today, five-year overall survival exceeds 90% in younger FA patients with bone marrow failure but remains about 50% in those with hematologic malignancy. Areas covered: We review the evolution of alloHCT contributing to decreased rates of transplant related complications; highlight current challenges including poorer outcomes in cases of clonal hematologic disorders, alloHCT impact on endocrine function and intrinsic FA risk of epithelial malignancies; and describe investigational therapies for prevention and treatment of the hematologic manifestations of FA. Expert commentary: Current methods allow for excellent survival following alloHCT for FA associated BMF irrespective of donor hematopoietic cell source. Alternative curative approaches, such as gene therapy, are being explored to eliminate the risks of GVHD and minimize therapy-related adverse effects.

  12. Current Technical Approaches for the Early Detection of Foodborne Pathogens: Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Il-Hoon Cho

    2017-09-01

    Full Text Available The development of novel and high-tech solutions for rapid, accurate, and non-laborious microbial detection methods is imperative to improve the global food supply. Such solutions have begun to address the need for microbial detection that is faster and more sensitive than existing methodologies (e.g., classic culture enrichment methods. Multiple reviews report the technical functions and structures of conventional microbial detection tools. These tools, used to detect pathogens in food and food homogenates, were designed via qualitative analysis methods. The inherent disadvantage of these analytical methods is the necessity for specimen preparation, which is a time-consuming process. While some literature describes the challenges and opportunities to overcome the technical issues related to food industry legal guidelines, there is a lack of reviews of the current trials to overcome technological limitations related to sample preparation and microbial detection via nano and micro technologies. In this review, we primarily explore current analytical technologies, including metallic and magnetic nanomaterials, optics, electrochemistry, and spectroscopy. These techniques rely on the early detection of pathogens via enhanced analytical sensitivity and specificity. In order to introduce the potential combination and comparative analysis of various advanced methods, we also reference a novel sample preparation protocol that uses microbial concentration and recovery technologies. This technology has the potential to expedite the pre-enrichment step that precedes the detection process.

  13. HIPAA, HIPAA, Hooray?: Current Challenges and Initiatives in Health Informatics in the United States.

    Science.gov (United States)

    Joshi, Sanjaya

    2008-01-01

    A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented. A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: HIPAA compliance is complex; data interoperability and integration remains difficult.Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule.Integration of e-prescribing and NPI data is an area where health informatics can make a real difference.Medical errors remain high.There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs.Health Information Technology (Health IT) projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability. A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.

  14. Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review.

    Science.gov (United States)

    Schlussel, Andrew T; Cherng, Nicole B; Alavi, Karim

    2017-11-01

    Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016. Twenty-six prospective articles provided directed guidelines for recommendations and these were graded based on the level of evidence. The postoperative management of Crohn's disease faces multiple challenges. Current indicated medications in this setting include: antibiotics, aminosalicylates, immunomodulators, and biologics. Each drug has inherent risks and benefits, and the optimal regimen is still unknown. Initiating therapy in a prophylactic fashion compared to endoscopic findings, or escalating therapy versus treating with the most potent drug first is debated. Although a definitive consensus on postoperative treatment is necessary, aggressive and early endoluminal surveillance is paramount in the treatment of these complicated patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Management options for pediatric patients who stutter: current challenges and future directions

    Directory of Open Access Journals (Sweden)

    Donaghy MA

    2016-07-01

    Full Text Available Michelle A Donaghy,1 Kylie A Smith,2,3 1Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, 2Murdoch Childrens Research Institute, Royal Childrens Hospital, 3Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia Abstract: Stuttering is a speech disorder, with onset often occurring in the preschool years. The prevalence of stuttering in young children is much higher than that in the general population, suggesting a high rate of recovery. However, we are unable to predict which children will recover without treatment, and it is widely acknowledged that stuttering therapy during childhood provides the best safeguard against chronic stuttering. This review reports on current evidence-based stuttering treatment options for preschoolers through to adolescents. We discuss the clinical challenges associated with treating pediatric clients who stutter at different stages of development and explore potential areas of treatment research that might serve to advance current clinical practice in the future. Keywords: stuttering, stammering, pediatric, therapy, evidence based

  16. Health Information System Role-Based Access Control Current Security Trends and Challenges.

    Science.gov (United States)

    de Carvalho Junior, Marcelo Antonio; Bandiera-Paiva, Paulo

    2018-01-01

    This article objective is to highlight implementation characteristics, concerns, or limitations over role-based access control (RBAC) use on health information system (HIS) using industry-focused literature review of current publishing for that purpose. Based on the findings, assessment for indication of RBAC is obsolete considering HIS authorization control needs. We have selected articles related to our investigation theme "RBAC trends and limitations" in 4 different sources related to health informatics or to the engineering technical field. To do so, we have applied the following search query string: "Role-Based Access Control" OR "RBAC" AND "Health information System" OR "EHR" AND "Trends" OR "Challenges" OR "Security" OR "Authorization" OR "Attacks" OR "Permission Assignment" OR "Permission Relation" OR "Permission Mapping" OR "Constraint". We followed PRISMA applicable flow and general methodology used on software engineering for systematic review. 20 articles were selected after applying inclusion and exclusion criteria resulting contributions from 10 different countries. 17 articles advocate RBAC adaptations. The main security trends and limitations mapped were related to emergency access, grant delegation, and interdomain access control. Several publishing proposed RBAC adaptations and enhancements in order to cope current HIS use characteristics. Most of the existent RBAC studies are not related to health informatics industry though. There is no clear indication of RBAC obsolescence for HIS use.

  17. HIPAA, HIPAA, Hooray? Current Challenges and Initiatives in Health Informatics in the United States

    Directory of Open Access Journals (Sweden)

    Sanjaya Joshi

    2008-01-01

    Full Text Available A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented.A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: * HIPAA compliance is complex; data interoperability and integration remains difficult. * Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule. * Integration of e-prescribing and NPI data is an area where health informatics can make a real difference. * Medical errors remain high. * There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs. * Health Information Technology (Health IT projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability.A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.

  18. Current Technical Approaches for the Early Detection of Foodborne Pathogens: Challenges and Opportunities.

    Science.gov (United States)

    Cho, Il-Hoon; Ku, Seockmo

    2017-09-30

    The development of novel and high-tech solutions for rapid, accurate, and non-laborious microbial detection methods is imperative to improve the global food supply. Such solutions have begun to address the need for microbial detection that is faster and more sensitive than existing methodologies (e.g., classic culture enrichment methods). Multiple reviews report the technical functions and structures of conventional microbial detection tools. These tools, used to detect pathogens in food and food homogenates, were designed via qualitative analysis methods. The inherent disadvantage of these analytical methods is the necessity for specimen preparation, which is a time-consuming process. While some literature describes the challenges and opportunities to overcome the technical issues related to food industry legal guidelines, there is a lack of reviews of the current trials to overcome technological limitations related to sample preparation and microbial detection via nano and micro technologies. In this review, we primarily explore current analytical technologies, including metallic and magnetic nanomaterials, optics, electrochemistry, and spectroscopy. These techniques rely on the early detection of pathogens via enhanced analytical sensitivity and specificity. In order to introduce the potential combination and comparative analysis of various advanced methods, we also reference a novel sample preparation protocol that uses microbial concentration and recovery technologies. This technology has the potential to expedite the pre-enrichment step that precedes the detection process.

  19. Current challenges in health economic modeling of cancer therapies: a research inquiry.

    Science.gov (United States)

    Miller, Jeffrey D; Foley, Kathleen A; Russell, Mason W

    2014-05-01

    The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology. We sought to explore some of the contentious issues associated with the development and use of oncology economic models as informative tools in current healthcare decision-making. Our objective was to draw attention to these complex pharmacoeconomic concerns and to promote discussion within the oncology and health economics research communities. Using our combined expertise in health economics research and economic modeling, we structured our inquiry around the following 4 questions: (1) Are economic models adequately addressing questions relevant to oncology decision makers; (2) What are the methodologic limitations of oncology economic models; (3) What guidelines are followed for developing oncology economic models; and (4) Is the evolution of oncology economic modeling keeping pace with treatment innovation? Within the context of each of these questions, we discuss issues related to the technical limitations of oncology modeling, the availability of adequate data for developing models, and the problems with how modeling analyses and results are presented and interpreted. There is general acceptance that economic models are good, essential tools for decision-making, but the practice of oncology and its rapidly evolving technologies present unique challenges that make assessing and demonstrating value especially complex. There is wide latitude for improvement in oncology modeling methodologies and how model results are presented and interpreted. Complex technical and

  20. Engineered skeletal muscle tissue for soft robotics: fabrication strategies, current applications, and future challenges.

    Science.gov (United States)

    Duffy, Rebecca M; Feinberg, Adam W

    2014-01-01

    Skeletal muscle is a scalable actuator system used throughout nature from the millimeter to meter length scales and over a wide range of frequencies and force regimes. This adaptability has spurred interest in using engineered skeletal muscle to power soft robotics devices and in biotechnology and medical applications. However, the challenges to doing this are similar to those facing the tissue engineering and regenerative medicine fields; specifically, how do we translate our understanding of myogenesis in vivo to the engineering of muscle constructs in vitro to achieve functional integration with devices. To do this researchers are developing a number of ways to engineer the cellular microenvironment to guide skeletal muscle tissue formation. This includes understanding the role of substrate stiffness and the mechanical environment, engineering the spatial organization of biochemical and physical cues to guide muscle alignment, and developing bioreactors for mechanical and electrical conditioning. Examples of engineered skeletal muscle that can potentially be used in soft robotics include 2D cantilever-based skeletal muscle actuators and 3D skeletal muscle tissues engineered using scaffolds or directed self-organization. Integration into devices has led to basic muscle-powered devices such as grippers and pumps as well as more sophisticated muscle-powered soft robots that walk and swim. Looking forward, current, and future challenges include identifying the best source of muscle precursor cells to expand and differentiate into myotubes, replacing cardiomyocytes with skeletal muscle tissue as the bio-actuator of choice for soft robots, and vascularization and innervation to enable control and nourishment of larger muscle tissue constructs. © 2013 Wiley Periodicals, Inc.

  1. Challenges associated with the current processes for ultrasonic inspection of CANDU reactor feeder piping

    Energy Technology Data Exchange (ETDEWEB)

    Machowski, C. [Babcock & Wilcox Canada Ltd., Cambridge, Ontario (Canada)

    2012-07-01

    CANDU® PHT Feeder Piping is generally constructed from SA106 Grade B carbon steel, which is known to be susceptible to flow accelerated corrosion when exposed to certain environmental conditions. The configuration of the CANDU reactor promotes thinning of the inside surface of the pipe walls, predominantly at the outlet feeders. Inspection of this piping is currently conducted using ultrasonic techniques and is governed by the requirements established by the CANDU Owners Group (COG). There are many challenges associated with these inspections as a result of the complexity of the reactor piping configuration. Geometrical anomalies on the surface of the pipe and non-circular geometries at the tight radius bends hinder the performance of conventional ultrasonic techniques. This can cause lost signals in areas of interest, which in turn often results in rework in order to satisfy the inspection requirements and justify fitness for service of these components. There are also many inspection sites which have limited access due to physical restrictions on the reactor face; therefore in order to maximize the performance of an inspection campaign, it is paramount that the inspection personnel and the inspection technology be well integrated through training simulations prior to execution. These inspection challenges increase the complexity of the analysis process as ultrasonic signals get distorted and lost as a result of non-circular pipe geometries. In order to ensure a high level of integrity in the analysis results, a conservative process is utilized in which two analysts independently examine the data, and a third analyst reviews their results and submits the final call. A Data Management Software application (DMS) is used to input and store the three analysis results. Another important function of the DMS is to provide a communication link between the different work-groups associated with the inspection activities. The focus of this presentation discusses:

  2. Current Status and Challenges in Identifying Disease Resistance Genes in Brassica napus

    Science.gov (United States)

    Neik, Ting Xiang; Barbetti, Martin J.; Batley, Jacqueline

    2017-01-01

    Brassica napus is an economically important crop across different continents including temperate and subtropical regions in Europe, Canada, South Asia, China and Australia. Its widespread cultivation also brings setbacks as it plays host to fungal, oomycete and chytrid pathogens that can lead to serious yield loss. For sustainable crop production, identification of resistance (R) genes in B. napus has become of critical importance. In this review, we discuss four key pathogens affecting Brassica crops: Clubroot (Plasmodiophora brassicae), Blackleg (Leptosphaeria maculans and L. biglobosa), Sclerotinia Stem Rot (Sclerotinia sclerotiorum), and Downy Mildew (Hyaloperonospora parasitica). We first review current studies covering prevalence of these pathogens on Brassica crops and highlight the R genes and QTL that have been identified from Brassica species against these pathogens. Insights into the relationships between the pathogen and its Brassica host, the unique host resistance mechanisms and how these affect resistance outcomes is also presented. We discuss challenges in identification and deployment of R genes in B. napus in relation to highly specific genetic interactions between host subpopulations and pathogen pathotypes and emphasize the need for common or shared techniques and research materials or tighter collaboration between researchers to reconcile the inconsistencies in the research outcomes. Using current genomics tools, we provide examples of how characterization and cloning of R genes in B. napus can be carried out more effectively. Lastly, we put forward strategies to breed resistant cultivars through introgressions supported by genomic approaches and suggest prospects that can be implemented in the future for a better, pathogen-resistant B. napus. PMID:29163558

  3. Tooth Matrix Analysis for Biomonitoring of Organic Chemical Exposure: Current Status, Challenges, and Opportunities

    Science.gov (United States)

    Andra, Syam S.; Austin, Christine; Arora, Manish

    2015-01-01

    Epidemiological evidence supports associations between prenatal exposure to environmental organic chemicals and childhood health impairments. Unlike the common choice of biological matrices such as urine and blood that can be limited by short half-lives for some chemicals, teeth provide a stable repository for chemicals with half-life in the order of decades. Given the potential of the tooth bio-matrix to study long-term exposures to environmental organic chemicals in human biomonitoring programs, it is important to be aware of possible pitfalls and potential opportunities to improve on the current analytical method for tooth organics analysis. We critically review previous results of studies of this topic. The major drawbacks and challenges in currently practiced concepts and analytical methods in utilizing tooth bio-matrix are (i) no consideration of external (from outer surface) or internal contamination (from micro odontoblast processes), (ii) the misleading assumption that whole ground teeth represent prenatal exposures (latest formed dentine is lipid rich and therefore would absorb and accumulate more organic chemicals), (iii) reverse causality in exposure assessment due to whole ground teeth, and (iv) teeth are a precious bio-matrix and grinding them raises ethical concerns about appropriate use of a very limited resource in exposure biology and epidemiology studies. These can be overcome by addressing the important limitations and possible improvements with the analytical approach associated at each of the following steps (i) tooth sample preparation to retain exposure timing, (ii) organics extraction and pre-concentration to detect ultra-trace levels of analytes, (iii) chromatography separation, (iv) mass spectrometric detection to detect multi-class organics simultaneously, and (v) method validation, especially to exclude chance findings. To highlight the proposed improvements we present findings from a pilot study that utilizes tooth matrix biomarkers to

  4. Current Status and Challenges in Identifying Disease Resistance Genes in Brassica napus

    Directory of Open Access Journals (Sweden)

    Ting Xiang Neik

    2017-11-01

    Full Text Available Brassica napus is an economically important crop across different continents including temperate and subtropical regions in Europe, Canada, South Asia, China and Australia. Its widespread cultivation also brings setbacks as it plays host to fungal, oomycete and chytrid pathogens that can lead to serious yield loss. For sustainable crop production, identification of resistance (R genes in B. napus has become of critical importance. In this review, we discuss four key pathogens affecting Brassica crops: Clubroot (Plasmodiophora brassicae, Blackleg (Leptosphaeria maculans and L. biglobosa, Sclerotinia Stem Rot (Sclerotinia sclerotiorum, and Downy Mildew (Hyaloperonospora parasitica. We first review current studies covering prevalence of these pathogens on Brassica crops and highlight the R genes and QTL that have been identified from Brassica species against these pathogens. Insights into the relationships between the pathogen and its Brassica host, the unique host resistance mechanisms and how these affect resistance outcomes is also presented. We discuss challenges in identification and deployment of R genes in B. napus in relation to highly specific genetic interactions between host subpopulations and pathogen pathotypes and emphasize the need for common or shared techniques and research materials or tighter collaboration between researchers to reconcile the inconsistencies in the research outcomes. Using current genomics tools, we provide examples of how characterization and cloning of R genes in B. napus can be carried out more effectively. Lastly, we put forward strategies to breed resistant cultivars through introgressions supported by genomic approaches and suggest prospects that can be implemented in the future for a better, pathogen-resistant B. napus.

  5. Addressing current and future challenges for the NHS: the role of good leadership.

    Science.gov (United States)

    Elton, Lotte

    2016-10-03

    Purpose This paper aims to describe and analyse some of the ways in which good leadership can enable those working within the National Health Service (NHS) to weather the changes and difficulties likely to arise in the coming years, and takes the format of an essay written by the prize-winner of the Faculty of Medical Leadership and Management's Student Prize. The Faculty of Medical Leadership and Management ran its inaugural Student Prize in 2015-2016, which aimed at medical students with an interest in medical leadership. In running the Prize, the Faculty hoped to foster an enthusiasm for and understanding of the importance of leadership in medicine. Design/methodology/approach The Faculty asked entrants to discuss the role of good leadership in addressing the current and future challenges faced by the NHS, making reference to the Leadership and Management Standards for Medical Professionals published by the Faculty in 2015. These standards were intended to help guide current and future leaders and were grouped into three categories, namely, self, team and corporate responsibility. Findings This paper highlights the political nature of health care in the UK and the increasing impetus on medical professionals to navigate debates on austerity measures and health-care costs, particularly given the projected deficit in NHS funding. It stresses the importance of building organisational cultures prizing transparency to prevent future breaches in standards of care and the value of patient-centred approaches in improving satisfaction for both patients and staff. Identification of opportunities for collaboration and partnership is emphasised as crucial to assuage the burden that lack of appropriate social care places on clinical services. Originality/value This paper offers a novel perspective - that of a medical student - on the complex issues faced by the NHS over the coming years and utilises a well-regarded set of standards in conceptualising the role that health

  6. Computational intelligence in gait research: a perspective on current applications and future challenges.

    Science.gov (United States)

    Lai, Daniel T H; Begg, Rezaul K; Palaniswami, Marimuthu

    2009-09-01

    Our mobility is an important daily requirement so much so that any disruption to it severely degrades our perceived quality of life. Studies in gait and human movement sciences, therefore, play a significant role in maintaining the well-being of our mobility. Current gait analysis involves numerous interdependent gait parameters that are difficult to adequately interpret due to the large volume of recorded data and lengthy assessment times in gait laboratories. A proposed solution to these problems is computational intelligence (CI), which is an emerging paradigm in biomedical engineering most notably in pathology detection and prosthesis design. The integration of CI technology in gait systems facilitates studies in disorders caused by lower limb defects, cerebral disorders, and aging effects by learning data relationships through a combination of signal processing and machine learning techniques. Learning paradigms, such as supervised learning, unsupervised learning, and fuzzy and evolutionary algorithms, provide advanced modeling capabilities for biomechanical systems that in the past have relied heavily on statistical analysis. CI offers the ability to investigate nonlinear data relationships, enhance data interpretation, design more efficient diagnostic methods, and extrapolate model functionality. These are envisioned to result in more cost-effective, efficient, and easy-to-use systems, which would address global shortages in medical personnel and rising medical costs. This paper surveys current signal processing and CI methodologies followed by gait applications ranging from normal gait studies and disorder detection to artificial gait simulation. We review recent systems focusing on the existing challenges and issues involved in making them successful. We also examine new research in sensor technologies for gait that could be combined with these intelligent systems to develop more effective healthcare solutions.

  7. Upper extremity transplantation: current concepts and challenges in an emerging field.

    Science.gov (United States)

    Elliott, River M; Tintle, Scott M; Levin, L Scott

    2014-03-01

    Loss of an isolated upper limb is an emotionally and physically devastating event that results in significant impairment. Patients who lose both upper extremities experience profound disability that affects nearly every aspect of their lives. While prosthetics and surgery can eventually provide the single limb amputee with a suitable assisting hand, limited utility, minimal haptic feedback, weight, and discomfort are persistent problems with these techniques that contribute to high rates of prosthetic rejection. Moreover, despite ongoing advances in prosthetic technology, bilateral amputees continue to experience high levels of dependency, disability, and distress. Hand and upper extremity transplantation holds several advantages over prosthetic rehabilitation. The missing limb is replaced with one of similar skin color and size. Sensibility, voluntary motor control, and proprioception are restored to a greater degree, and afford better dexterity and function than prosthetics. The main shortcomings of transplantation include the hazards of immunosuppression, the complications of rejection and its treatment, and high cost. Hand and upper limb transplantation represents the most commonly performed surgery in the growing field of Vascularized Composite Allotransplantation (VCA). As upper limb transplantation and VCA have become more widespread, several important challenges and controversies have emerged. These include: refining indications for transplantation, optimizing immunosuppression, establishing reliable criteria for monitoring, diagnosing, and treating rejection, and standardizing outcome measures. This article will summarize the historical background of hand transplantation and review the current literature and concepts surrounding it.

  8. Support time-dependent transformations for surveying and GIS : current status and upcoming challenges

    Science.gov (United States)

    Mahmoudabadi, H.; Lercier, D.; Vielliard, S.; Mein, N.; Briggs, G.

    2016-12-01

    The support of time-dependent transformations for surveying and GIS is becoming a critical issue. We need to convert positions from the realizations of the International Terrestrial Reference Frame to any national reference frame. This problem is easy to solve when all of the required information is available. But it becomes really complicated in a worldwide context. We propose an overview of the current ITRF-aligned reference frames and we describe a global solution to support time-dependent transformations between them and the International Terrestrial Reference Frame. We focus on the uncertainties of station velocities used. In a first approximation, we use a global tectonic plate model to calculate point velocities. We show the impact of the velocity model on the coordinate accuracies. Several countries, particularly in active regions, are developing semi-dynamic reference frames. These frames include local displacement models updated regularly and/or after major events (such as earthquakes). Their integration into surveying or GIS applications is an upcoming challenge. We want to encourage the geodetic community to develop and use standard formats.

  9. Radiation in pediatric health care: current situation and challenges in the Philippines

    International Nuclear Information System (INIS)

    Cabrera, Maria Gladys R.

    2009-01-01

    Radiation exposure to human health has been the topic of much research to date, focusing particularly on children as they are especially vulnerable and have longer life span to develop log term health effects. Taking into account the higher vulnerability of children, prevention of unnecessary radiation exposure is critical in pediatric patients. Issues such as pediatric patient receive a higher dose than necessary has been identified because adult computed tomography (CT) settings are used for children. Assessment of population exposures resulting from medical use of radiation is mainly available in industrialized countries, while in developing countries such as the Philippines, data are scarce. This information is very much scarce in the field of pediatric medical exposures and appropriate national surveys including frequency of pediatric procedures and children doses are still lacking. A broader and more effective participation of the regulatory authorities in such surveys could contribute to children risk assessment. The presentation explains the current situation, approach and challenges in the Philippines in dealing with radiation in pediatric health care. (author)

  10. Microalgae as multi-functional options in modern agriculture: current trends, prospects and challenges.

    Science.gov (United States)

    Renuka, Nirmal; Guldhe, Abhishek; Prasanna, Radha; Singh, Poonam; Bux, Faizal

    Algae are a group of ubiquitous photosynthetic organisms comprising eukaryotic green algae and Gram-negative prokaryotic cyanobacteria, which have immense potential as a bioresource for various industries related to biofuels, pharmaceuticals, nutraceuticals and feed. This fascinating group of organisms also has applications in modern agriculture through facilitating increased nutrient availability, maintaining the organic carbon and fertility of soil, and enhancing plant growth and crop yields, as a result of stimulation of soil microbial activity. Several cyanobacteria provide nitrogen fertilization through biological nitrogen fixation and through enzymatic activities related to interconversions and mobilization of different forms of nitrogen. Both green algae and cyanobacteria are involved in the production of metabolites such as growth hormones, polysaccharides, antimicrobial compounds, etc., which play an important role in the colonization of plants and proliferation of microbial and eukaryotic communities in soil. Currently, the development of consortia of cyanobacteria with bacteria or fungi or microalgae or their biofilms has widened their scope of utilization. Development of integrated wastewater treatment and biomass production systems is an emerging technology, which exploits the nutrient sequestering potential of microalgae and its valorisation. This review focuses on prospects and challenges of application of microalgae in various areas of agriculture, including crop production, protection and natural resource management. An overview of the recent advances, novel technologies developed, their commercialization status and future directions are also included. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Label-free SERS in biological and biomedical applications: Recent progress, current challenges and opportunities

    Science.gov (United States)

    Zheng, Xiao-Shan; Jahn, Izabella Jolan; Weber, Karina; Cialla-May, Dana; Popp, Jürgen

    2018-05-01

    To achieve an insightful look within biomolecular processes on the cellular level, the development of diseases as well as the reliable detection of metabolites and pathogens, a modern analytical tool is needed that is highly sensitive, molecular-specific and exhibits fast detection. Surface-enhanced Raman spectroscopy (SERS) is known to meet these requirements and, within this review article, the recent progress of label-free SERS in biological and biomedical applications is summarized and discussed. This includes the detection of biomolecules such as metabolites, nucleic acids and proteins. Further, the characterization and identification of microorganisms has been achieved by label-free SERS-based approaches. Eukaryotic cells can be characterized by SERS in order to gain information about the outer cell wall or to detect intracellular molecules and metabolites. The potential of SERS for medically relevant detection schemes is emphasized by the label-free detection of tissue, the investigation of body fluids as well as applications for therapeutic and illicit drug monitoring. The review article is concluded with an evaluation of the recent progress and current challenges in order to highlight the direction of label-free SERS in the future.

  12. Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

    Science.gov (United States)

    Fung, Foon Yin; Linn, Yeh Ching

    2015-01-01

    Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM. PMID:25949261

  13. Contrast media for fluoroscopic examinations of the GI and GU tracts: current challenges and recommendations.

    Science.gov (United States)

    Federle, Michael P; Jaffe, Tracy A; Davis, Peter L; Al-Hawary, Mahmoud M; Levine, Marc S

    2017-01-01

    One of the significant challenges facing radiologists who perform and interpret studies of the gastrointestinal and genitourinary systems have been periodic interruptions in the availability of barium and iodinated contrast media specially formulated for gastrointestinal (GI) and genitourinary (GU) studies. These interruptions are due to the US Food and Drug Administration's recent requirement for more stringent documentation of the safety and efficacy of contrast media and the consolidation among contrast manufacturers. Therefore, radiologists may be required to recommend an alternative means of evaluation, such as computed tomography, magnetic resonance, or endoscopy, or they may need to substitute a different formulation of a contrast agent not specifically developed for GI or GU use, for example the utilization of an agent designed and marketed for vascular use. This article reviews the current status of fluoroscopic contrast media, and provides suggestions and recommendations for the optimal and alternative use of contrast media formulations.

  14. Modelling marine sediment biogeochemistry: Current knowledge gaps, challenges, and some methodological advice for advancement

    DEFF Research Database (Denmark)

    Lessin, Gennadi; Artioli, Yuri; Almroth-Rosell, Elin

    2018-01-01

    The benthic environment is a crucial component of marine systems in the provision of ecosystem services, sustaining biodiversity and in climate regulation, and therefore important to human society. With the contemporary increase in computational power, model resolution and technological improveme......The benthic environment is a crucial component of marine systems in the provision of ecosystem services, sustaining biodiversity and in climate regulation, and therefore important to human society. With the contemporary increase in computational power, model resolution and technological...... improvements in quality and quantity of benthic data, it is necessary to ensure that benthic systems are appropriately represented in coupled benthic-pelagic biogeochemical and ecological modelling studies. In this paper we focus on five topical challenges related to various aspects of modelling benthic...... environments: organic matter reactivity, dynamics of benthic-pelagic boundary layer, microphytobenthos, biological transport and small-scale heterogeneity, and impacts of episodic events. We discuss current gaps in their understanding and indicate plausible ways ahead. Further, we propose a three...

  15. Development of oral food-grade delivery systems: current knowledge and future challenges.

    Science.gov (United States)

    Benshitrit, Revital Cohen; Levi, Carmit Shani; Tal, Sharon Levi; Shimoni, Eyal; Lesmes, Uri

    2012-01-01

    In recent years there has been an increasing interest in the development of new and efficient oral food delivery systems as tools to prevent disease and promote human health and well-being. Such vehicles are sought to protect bioactive ingredients added to food while controlling and targeting their release as they pass through the human gastrointestinal tract (GIT). This review aims to summarize the key concepts of food delivery systems, their characterization and evaluation. Particularly, evaluation of their performance within the human GIT is discussed. To this end an overview of several in vivo and in vitro methods currently applied for the study of such systems is given. Although considered to be still in its infancy, this promising field of research is likely to infiltrate into real products through rational design. In order for such efforts to materialize into real products some challenges still need to be met and are discussed herein. Overall, it seems that adopting a comprehensive pharmacological approach and relevant cutting edge tools are likely to facilitate innovations and help elucidate and perhaps tailor delivery systems' behavior in the human GIT.

  16. Classical Ecological Restoration and its Current Challenges: Assisted Migration as an Adaptation Strategy to Climate Change

    Directory of Open Access Journals (Sweden)

    Pilar A. Gómez-Ruiz

    2017-06-01

    Full Text Available Ecological restoration is a very active area in ecology and of great importance for ecosystems management. Despite of being a relatively young discipline, the classical concepts of restoration seem, at present, impractical considering the great challenges generated by modification and destruction of ecosystems. This is due to anthropic activities (deforestation, change of land use, pollution and global climate change. In the classic definition of restoration, the objective is to recover the degraded ecosystem to the same conditions of a historical reference state. However, nowadays the ecosystems return to a state prior to the disturbances seems unviable, because the thresholds of resilience have already been overcome. Additionally, climate change is causing environmental changes at an unprecedented rate. For this reason, ecological restoration needs to unite efforts of diverse actors to recover ecosystems that can be sustainable and functional in the future, where the species could be able to tolerate the environmental conditions that will exist in the long term. Assisted migration has been proposed as a conservation strategy; it is defined as the translocation of species to new locations outside their known range of distribution. In the current context of loss of diversity and ecosystems, this strategy could be fundamental for the formation of new communities that can later become novel ecosystems where species that are fundamental to the dynamics of ecosystems can persist and, at the same time, recover function, structure and resilience.

  17. The Rare Disease Bank of Japan: establishment, current status and future challenges.

    Science.gov (United States)

    Tada, Mayako; Hirata, Makoto; Sasaki, Mitsuho; Sakate, Ryuichi; Kohara, Arihiro; Takahashi, Ichiro; Kameoka, Yosuke; Masui, Toru; Matsuyama, Akifumi

    2018-04-02

    Research on rare diseases cannot be performed without appropriate samples from patients with such diseases. Due to the limited number of such patients, securing biosamples of sufficient quality for extensive research is a challenge and represents an important barrier to the advancement of research on rare diseases. To tackle this problem, the Rare Disease Bank (RDB) was established in 2009 at the National Institute of Biomedical Innovation (NIBIO; currently, the National Institutes of Biomedical Innovation, Health and Nutrition in Japan). Since then, the RDB has focused on three objectives: (1) emphasizing the importance of collecting biosamples from patients with rare diseases, together with appropriate clinical information, from various medical facilities nationwide; (2) maintaining strict high-quality sample management standards; and (3) sharing biosamples with research scientists across Japan for the advancement of research on rare diseases. As of August 2017, the bank has collected 4147 biosamples from patients with rare diseases, including DNA, serum, plasma, and cell samples from various university hospitals and other medical institutions across the country, and provided various research institutions with 13,686 biosample aliquots from 2850 cases. In addition, the management committee has successfully established a bank system that provides high-quality biosamples together with the results of human leukocyte antigen analysis. It is anticipated that the RDB, through the collection and sharing of biosamples with the medical research community, will enhance the understanding, prevention, and treatment of rare diseases in Japan and the world at large.

  18. Modelling Marine Sediment Biogeochemistry: Current Knowledge Gaps, Challenges, and Some Methodological Advice for Advancement

    Directory of Open Access Journals (Sweden)

    Gennadi Lessin

    2018-02-01

    Full Text Available The benthic environment is a crucial component of marine systems in the provision of ecosystem services, sustaining biodiversity and in climate regulation, and therefore important to human society. With the contemporary increase in computational power, model resolution and technological improvements in quality and quantity of benthic data, it is necessary to ensure that benthic systems are appropriately represented in coupled benthic-pelagic biogeochemical and ecological modelling studies. In this paper we focus on five topical challenges related to various aspects of modelling benthic environments: organic matter reactivity, dynamics of benthic-pelagic boundary layer, microphytobenthos, biological transport and small-scale heterogeneity, and impacts of episodic events. We discuss current gaps in their understanding and indicate plausible ways ahead. Further, we propose a three-pronged approach for the advancement of benthic and benthic-pelagic modelling, essential for improved understanding, management and prediction of the marine environment. This includes: (A development of a traceable and hierarchical framework for benthic-pelagic models, which will facilitate integration among models, reduce risk of bias, and clarify model limitations; (B extended cross-disciplinary approach to promote effective collaboration between modelling and empirical scientists of various backgrounds and better involvement of stakeholders and end-users; (C a common vocabulary for terminology used in benthic modelling, to promote model development and integration, and also to enhance mutual understanding.

  19. Academic plastic surgery: a study of current issues and future challenges.

    Science.gov (United States)

    Zetrenne, Eleonore; Kosins, Aaron M; Wirth, Garrett A; Bui, Albert; Evans, Gregory R D; Wells, James H

    2008-06-01

    The objectives of this study were (1) to evaluate the role of a full-time academic plastic surgeon, (2) to define the indicators predictive of a successful career in academic plastic surgery, and (3) to understand the current issues that will affect future trends in the practice of academic plastic surgery. A questionnaire was developed to evaluate the role of current full-time academic plastic surgeons and to understand the current issues and future challenges facing academic plastic surgery. Each plastic surgery program director in the United States was sent the survey for distribution among all full-time academic plastic surgeons. Over a 6-week period, responses from 143 full-time academic plastic surgeons (approximately 31%) were returned. Fifty-three percent of respondents had been academic plastic surgeons for longer than 10 years. Seventy-three percent of respondents defined academic plastic surgeons as clinicians who are teachers and researchers. However, 53% of respondents believed that academic plastic surgeons were not required to teach or practice within university hospitals/academic centers. The 3 factors reported most frequently as indicative of a successful career in academic plastic surgery were peer recognition, personal satisfaction, and program reputation. Dedication and motivation were the personal characteristics rated most likely to contribute to academic success. Forty-four percent of respondents were unable to identify future academic plastic surgeons from plastic surgery residency applicants, and 27% were not sure. Most (93%) of the respondents believed that academic surgery as practiced today will change. The overall job description of a full-time academic plastic surgeon remains unchanged (teacher and researcher). Whereas peer recognition, personal satisfaction, and program reputation were most frequently cited as indicative of a successful plastic surgery career, financial success was rated the least indicative. Similarly, whereas the

  20. Trends and EIE higher education response to the current global technical challenges

    DEFF Research Database (Denmark)

    Poboroniuc, Marian; Livint, Gheorghe; Friesel, Anna

    2014-01-01

    Education Institutions (SALEIE), an EU supported project, gathers together a global team aiming to provide higher education models in the EIE disciplines that can respond to the key global technical challenges. This paper deals with findings within the SALEIE project's work package WP3 (Global Challenges......), namely: state-of-the-art in implementation of the Bologna recommendation for Bachelor and Master, technical challenges that the EIE higher education faces nowadays, and existing models in EIE higher education and their degree of response to key global technical challenges....

  1. Organ Transplantation in Iran; Current State and Challenges with a View on Ethical Consideration

    Directory of Open Access Journals (Sweden)

    Mehrzad Kiani

    2018-03-01

    Full Text Available Organ transplantation is a new issue in medical science. It is an important achievement and a sign of the progression and ability of medical centers around the world. Governments, populations, the medical community and people involved in culture, art, and media all have a decisive role in the culture of organ donation, which is the only way to guarantee that the healthy organs of a brain-dead person can continue to work and save the lives of people in need of organ transplantation. The brain death phenomenon and its possible application in organ transplantation, while offering new hope for the salvation of a number of patients, has led to many ethical, cultural, and legal issues. Ethical issues in organ transplantation are very complicated due to many social factors such as religion, culture, and traditions of the affected communities. The ethical and legal points of removing organs from the body of a living or cadaveric source, the definition of brain death, the moral and legal conditions of the donor and the recipient, and the financial relationship between them and many others, are all critical issues in organ transplantation. While there may be no available explicit solution to these issues, they should be rigorously considered by the experts. Efforts to systematically eliminate barriers and solve problems in organ transplantation, can not only reduce the costs of maintaining brain-dead patients and encourage patients that need organ transplantation but can also prevent immoral and illegal activities. In this paper, we have reviewed the most important and current challenges in organ transplantation with a view to the ethical considerations, and we have suggested some strategies to extend it in Iran.

  2. Global occupational health: current challenges and the need for urgent action.

    Science.gov (United States)

    Lucchini, Roberto G; London, Leslie

    2014-01-01

    Global occupational health and safety (OHS) is strictly linked to the dynamics of economic globalization. As the global market is increasing, the gap between developed and underdeveloped countries, occupational diseases, and injuries affect a vast number of workers worldwide. Global OHS issues also become local in developed countries due to many factors, including untrained migrant workers in the informal sector, construction, and agriculture. To identify the current status and challenges of global occupational health and safety and the needs for preventive action. Absence of OHS infrastructure amplifies the devastating consequences of infectious outbreaks like the Ebola pandemic and tuberculosis. Interventions in global OHS are urgently needed at various levels: 1. Increased governmental funding is needed for international organizations like the World Health Organization and the International Labor Organization to face the increasing demand for policies, guidance, and training. 2. Regulations to ban and control dangerous products are needed to avoid the transfer of hazardous production to developing countries. 3. The OHS community must address global OHS issues through advocacy, position papers, public statements, technical and ethical guidelines, and by encouraging access of OHS professionals from the developing countries to leadership positions in professional and academic societies. 4. Research, education, and training of OHS professionals, workers, unions and employers are needed to address global OHS issues and their local impact. 5. Consumers also can influence significantly the adoption of OHS practices by demanding the protection of workers who are producing he goods that are sold in the global market. Following the equation of maximized profits prompted by the inhibition of OHS is an old practice that has proven to cause significant costs to societies in the developed world. It is now an urgent priority to stop this process and promote a harmonized global

  3. Analysis of metabolomic data: tools, current strategies and future challenges for omics data integration.

    Science.gov (United States)

    Cambiaghi, Alice; Ferrario, Manuela; Masseroli, Marco

    2017-05-01

    Metabolomics is a rapidly growing field consisting of the analysis of a large number of metabolites at a system scale. The two major goals of metabolomics are the identification of the metabolites characterizing each organism state and the measurement of their dynamics under different situations (e.g. pathological conditions, environmental factors). Knowledge about metabolites is crucial for the understanding of most cellular phenomena, but this information alone is not sufficient to gain a comprehensive view of all the biological processes involved. Integrated approaches combining metabolomics with transcriptomics and proteomics are thus required to obtain much deeper insights than any of these techniques alone. Although this information is available, multilevel integration of different 'omics' data is still a challenge. The handling, processing, analysis and integration of these data require specialized mathematical, statistical and bioinformatics tools, and several technical problems hampering a rapid progress in the field exist. Here, we review four main tools for number of users or provided features (MetaCoreTM, MetaboAnalyst, InCroMAP and 3Omics) out of the several available for metabolomic data analysis and integration with other 'omics' data, highlighting their strong and weak aspects; a number of related issues affecting data analysis and integration are also identified and discussed. Overall, we provide an objective description of how some of the main currently available software packages work, which may help the experimental practitioner in the choice of a robust pipeline for metabolomic data analysis and integration. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Current fundamental science challenges in low temperature plasma science that impact energy security and international competitiveness

    Science.gov (United States)

    Hebner, Greg

    2010-11-01

    Products and consumer goods that utilize low temperature plasmas at some point in their creation touch and enrich our lives on almost a continuous basis. Examples are many but include the tremendous advances in microelectronics and the pervasive nature of the internet, advanced material coatings that increase the strength and reliability of products from turbine engines to potato chip bags, and the recent national emphasis on energy efficient lighting and compact fluorescent bulbs. Each of these products owes their contributions to energy security and international competiveness to fundamental research investments. However, it would be a mistake to believe that the great commercial success of these products implies a robust understanding of the complicated interactions inherent in plasma systems. Rather, current development of the next generation of low temperature plasma enabled products and processes is clearly exposing a new set of exciting scientific challenges that require leaps in fundamental understanding and interdisciplinary research teams. Emerging applications such as liquid-plasma systems to improve water quality and remediate hazardous chemicals, plasma-assisted combustion to increase energy efficiency and reduce emissions, and medical applications promise to improve our lives and the environment only if difficult science questions are solved. This talk will take a brief look back at the role of low temperature plasma science in enabling entirely new markets and then survey the next generation of emerging plasma applications. The emphasis will be on describing the key science questions and the opportunities for scientific cross cutting collaborations that underscore the need for increased outreach on the part of the plasma science community to improve visibility at the federal program level. This work is supported by the DOE, Office of Science for Fusion Energy Sciences, and Sandia National Laboratories, a multi-program laboratory managed and operated

  5. Industrial hazardous waste management in Turkey: Current state of the field and primary challenges

    International Nuclear Information System (INIS)

    Salihoglu, Gueray

    2010-01-01

    A holistic evaluation of a country's hazardous waste management (HWM) practices is useful in identifying the necessary actions to focus on. Based on an analysis of industrial hazardous waste (HW) generation in Turkey, this paper attempts to critically evaluate and report current Turkish HWM practices and discuss the primary challenges to be addressed. The generation of industrial HW for Turkey reported in 2004 was 1.195 million tons, which accounted for 7% of the total industrial solid waste (ISW) generated by the manufacturing industry, and for nearly 4.9% of the total solid waste generated in the country. The HW generated by the top five manufacturing product categories - basic metals, chemicals and chemical products, food and beverages, coke and refined petroleum, motor vehicles and trailers - accounted for 89.0% of total industrial HW. 21% of the HW generated in 2004 was recycled or reused, and 6% was sold or donated, whereas 73% was sent to ultimate disposal. 67% of the HW sent to ultimate disposal was disposed of at municipal landfills. The total capacity of the existing regional HW facilities is 212,500 tons/year, which accounts for about 24% of the HW to be disposed. Turkey has identified the HW problem in the country and enacted legislation, designated a lead agency, and promulgated rules and regulations. Several new initiatives are planned for improving HW management nationally; however, some HWM problems will be persistent due to previous and existing industrial development plans. These development policies led to the concentration of industry in regions marked by precious agricultural fields and high population density. This occurred because the government previously exhibited a default prioritization towards industrial development, leading to insufficient implementation of regulations on HW generators. Some of the problems may also be rooted in other countries that allow illegal transboundary HW movements despite international regulations.

  6. Domestic UK retrofit challenge: Barriers, incentives and current performance leading into the Green Deal

    International Nuclear Information System (INIS)

    Dowson, Mark; Poole, Adam; Harrison, David; Susman, Gideon

    2012-01-01

    This paper reviews the thermal performance of the existing UK housing stock, the main fabric efficiency incentive schemes and the barriers to obtaining deep energy and CO 2 savings throughout the stock. The UK faces a major challenge to improve the thermal performance of its existing housing stock. Millions of dwellings possess ‘hard-to-treat’ solid walls and have glazing which is not cost effective to improve. A range of fabric efficiency incentive schemes exist, but many do not target the full range of private and social housing. From now on, the Green Deal will be the UK's key energy efficiency policy. However, the scheme is forecasted to have low consumer appeal and low incentives for investors. Moreover, calculated Green Deal loan repayments will be reliant upon estimated energy savings, yet it is claimed that retrofit measures may only be half as effective as anticipated due to a lack of monitoring, poor quality installation and the increased use of heating following refurbishment. Looking to Germany, there has been success through the Passivhaus standard, but the UK currently lacks appropriate skills and cost effective components to replicate this approach. In addition, the embodied energy in retrofit products and materials threatens to counter operational savings. - Highlights: ► CERT, CESP, Decent homes and Warm Front have not targeted the full extent of private and social homes. ► There is a risk that Green Deal will fail due to low consumer appeal and low incentives for investors. ► Up to half of the predicted energy savings from whole house retrofits may not be achieved in practice. ► Passivhaus is identified as best practice for retrofit, yet there is a lack of skills and components. ► Embodied energy in materials and components must be better understood to achieve life cycle savings.

  7. Drug-resistant tuberculosis--current dilemmas, unanswered questions, challenges, and priority needs.

    Science.gov (United States)

    Zumla, Alimuddin; Abubakar, Ibrahim; Raviglione, Mario; Hoelscher, Michael; Ditiu, Lucica; McHugh, Timothy D; Squire, S Bertel; Cox, Helen; Ford, Nathan; McNerney, Ruth; Marais, Ben; Grobusch, Martin; Lawn, Stephen D; Migliori, Giovanni-Battista; Mwaba, Peter; O'Grady, Justin; Pletschette, Michel; Ramsay, Andrew; Chakaya, Jeremiah; Schito, Marco; Swaminathan, Soumya; Memish, Ziad; Maeurer, Markus; Atun, Rifat

    2012-05-15

    Tuberculosis was declared a global emergency by the World Health Organization (WHO) in 1993. Following the declaration and the promotion in 1995 of directly observed treatment short course (DOTS), a cost-effective strategy to contain the tuberculosis epidemic, nearly 7 million lives have been saved compared with the pre-DOTS era, high cure rates have been achieved in most countries worldwide, and the global incidence of tuberculosis has been in a slow decline since the early 2000s. However, the emergence and spread of multidrug-resistant (MDR) tuberculosis, extensively drug-resistant (XDR) tuberculosis, and more recently, totally drug-resistant tuberculosis pose a threat to global tuberculosis control. Multidrug-resistant tuberculosis is a man-made problem. Laboratory facilities for drug susceptibility testing are inadequate in most tuberculosis-endemic countries, especially in Africa; thus diagnosis is missed, routine surveillance is not implemented, and the actual numbers of global drug-resistant tuberculosis cases have yet to be estimated. This exposes an ominous situation and reveals an urgent need for commitment by national programs to health system improvement because the response to MDR tuberculosis requires strong health services in general. Multidrug-resistant tuberculosis and XDR tuberculosis greatly complicate patient management within resource-poor national tuberculosis programs, reducing treatment efficacy and increasing the cost of treatment to the extent that it could bankrupt healthcare financing in tuberculosis-endemic areas. Why, despite nearly 20 years of WHO-promoted activity and >12 years of MDR tuberculosis-specific activity, has the country response to the drug-resistant tuberculosis epidemic been so ineffectual? The current dilemmas, unanswered questions, operational issues, challenges, and priority needs for global drug resistance screening and surveillance, improved treatment regimens, and management of outcomes and prevention of DR

  8. Traumatic brain injury and vestibulo-ocular function: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Wallace B

    2016-09-01

    Full Text Available Bridgett Wallace,1–4 Jonathan Lifshitz4–8 1360 Balance and Hearing, Department of Physical Therapy, Austin, TX, 2Concussion Health, Department of Clinical Education, Austin, TX, 3Conquering Concussions, Scottsdale, AZ, 4Barrow Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ, 5Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, 6The CACTIS Foundation, Scottsdale, 7Phoenix VA Healthcare System, Phoenix, AZ, 8Department of Psychology, Arizona State University, Tempe, AZ, USA Abstract: Normal function of the vestibulo-ocular reflex (VOR coordinates eye movement with head movement, in order to provide clear vision during motion and maintain balance. VOR is generated within the semicircular canals of the inner ear to elicit compensatory eye movements, which maintain stability of images on the fovea during brief, rapid head motion, otherwise known as gaze stability. Normal VOR function is necessary in carrying out activities of daily living (eg, walking and riding in a car and is of particular importance in higher demand activities (eg, sports-related activities. Disruption or damage in the VOR can result in symptoms such as movement-related dizziness, blurry vision, difficulty maintaining balance with head movements, and even nausea. Dizziness is one of the most common symptoms following traumatic brain injury (TBI and is considered a risk factor for a prolonged recovery. Assessment of the vestibular system is of particular importance following TBI, in conjunction with oculomotor control, due to the intrinsic neural circuitry that exists between the ocular and vestibular systems. The purpose of this article is to review the physiology of the VOR and the visual-vestibular symptoms associated with TBI and to discuss assessment and treatment guidelines for TBI. Current challenges and future prospects will also be addressed. Keywords: traumatic brain injury, concussion, vestibular, ocular

  9. Colombian ancillary services and international connections: Current weaknesses and policy challenges

    International Nuclear Information System (INIS)

    Carvajal, S.X.; Serrano, J.; Arango, S.

    2013-01-01

    Ancillary services are required to maintain the unity, stability, and quality of power systems. In Colombia these services are required to operate the national power system and the international connections with the neighboring countries. The system is influenced by factors ranging from system's topology to social and political aspects, such as the large number of terrorist attacks. In light of these particularities, we consider Colombia as a learning lab for ancillary services in the region. Colombia's power system relies on three ancillary services for its operation, namely frequency regulation, voltage control, and blackstart service. From 2010 Special Protection Systems were also added. In this paper we first analyze the technical aspects, operational restrictions, financial management, and the most relevant regulatory conditions of these ancillary services of the SIN. We also take into consideration the main regulatory characteristics and statistical data related to energy exchanges that have taken place between Colombia and Venezuela and Ecuador. Thereafter, we depict the main weaknesses and policy challenges that Colombia must address in order to increase the effectiveness and coverage of ancillary services in both the SIN and in the international interconnections. Finally, we propose new market oriented regulations to encourage investments and new tools for international connections. - Highlights: ► Blackout of 2007 forces Colombian regulator to improve security of power system. ► Four ancillary services are currently used for secure operation of Colombian system. ► Special Protection Systems service added in 2010. ► Frequency control is the only remunerated service in Colombia. ► Legislation should exist for remuneration of voltage control and black start services.

  10. Potentials and Challenges of Video-Based Self-Reflection for the Professionalisation of Early Childhood Education and Care Professionals

    Science.gov (United States)

    Durand, Judith; Hopf, Michaela; Nunnenmacher, Sabine

    2016-01-01

    In debate on professionalisation of early childhood education and care professionals (ECEC professionals), the focus is increasingly turning to the ability of ECEC professionals to reflect on and evaluate their own pedagogical practice. Self-reflection is considered a core competence of professional pedagogical practice. So far, little research…

  11. Challenging Thoughts, Changing Minds: Preservice Teachers' Reflections on Their Experience Working in an Alternative School Setting

    Science.gov (United States)

    Blevins, Brooke; Moore, Brandon; Dexter Torti, Cameron

    2017-01-01

    This study was designed to use critical reflective journaling practices to explore the experiences of preservice teachers working in a juvenile justice education program called the Reach Academy. Using a qualitative case study design, the researchers explored how 48 preservice teachers utilized critical reflective journaling to examine their own…

  12. An Investigation of Taiwanese Piano Teachers' Reflection on Teaching Challenges and Pupils' Learning Difficulties

    Science.gov (United States)

    Yeh, Yi-Lien

    2018-01-01

    The importance of music teachers reflecting on their teaching practise has been discussed for a long time [(Gaunt 2008. "One-to-one Tuition in a Conservatoire: The Perceptions of Instrumental and Vocal Teachers." "Psychology of Music" 36 (2): 215-245; Schön 1987. "Educating the Reflective Practitioner." San…

  13. Courses for tutors in problem-based learning. Current challenges at four Swedish universities

    Directory of Open Access Journals (Sweden)

    Helen Susan Setterud

    2015-06-01

    Full Text Available The key role of the tutor in problem-based learning (PBL is to help students become selfregulated learners. Tutors need training to acquire the necessary facilitating skills for this task. The aim of this article is to describe and discuss how PBL tutor training is currently arranged at four universities in Sweden: Linköping University, Lund Medical Faculty, Uppsala Medical School and Örebro School of Medicine. Moreover, we seek to analyse how the content and format of the tutor training courses correspond to the desired skills and competencies for PBL tutors described in the literature. We draw especially on work coming out of three pioneering universities for PBL: McMaster University, Canada; Maastricht University, The Netherlands; and Linköping University, Sweden. One aim has been to construct a framework for analysis that uses categories specifying the knowledge base, capabilities and skills to support students’ learning processes which characterise the full-fledged PBL tutor. For this framework, we have used the following categories: Knowledge of PBL and pedagogical theories, Personal traits, Student-centeredness, Ability to handle group processes, and Subject knowledge. We collected descriptions of the course design and content from the four universities, and assessed to what extent these categories were represented within the courses. Our results show that all categories inform the course content at all four universities, though the design varies between courses. In summary, we show that the four PBL tutor training courses are all designed to enable participants to experience PBL first-hand both as members of a tutorial group and as tutors. They all also include a theoretical base and offer opportunities for discussion and reflection with peers; however, there are some differences in design between the courses. According to participants, all four courses provide good preparation for the tutor role. Yet, we see a need for the

  14. Reflections on nuclear challenges today. 6 December 2005, London, UK, International Institute for Strategic Studies, Allistair Buchan Lecture

    International Nuclear Information System (INIS)

    ElBaradei, M.

    2005-01-01

    Emerging nuclear challenges are proliferation of nuclear weapons and sensitive nuclear technologies, emergence of nuclear clandestine procurement networks in nuclear materials and equipment and the sluggishment in nuclear disarmament. Practical steps to address them are 1) better control of access to nuclear fuel cycle technology; 2) supporting effective nuclear verification; 3) strengthening the credibility of enforcement mechanisms; 4) protecting nuclear material and 5) developing an alternative approach to collective security. For better control of access to nuclear fuel cycle technology a group of international experts proposes to a) provide assurance of supply of reactor technology and nuclear fuel; b) accept a time-limited moratorium (of perhaps 5-10 years) on new uranium enrichment and plutonium separation facilities - at the very least for countries that do not currently have such technologies; c) establish a framework for multilateral management and control of the 'back end' of the fuel cycle (i.e. spent fuel reprocessing and waste disposal); and d) create a similar framework for multilateral management and control of the 'front end' of the fuel cycle (i.e. enrichment and fuel production). The effectiveness of nuclear verification depends on the extend of access to information and locations in a given country and inspections can only verify what countries declare. The expanded access provided by the Additional Protocol to safeguards agreements enables the Agency to verify possible undeclared activities however both safeguards agreements are focused on nuclear material and therefore the Agency's authority to investigate possible parallel weaponization activity is limited. In addition only 70 countries have the additional protocol on force. A dditional transparency measures' may be required as well as additional funding to support R and D on new technologies for detecting clandestine nuclear facilities and activity. An important step to address the nuclear

  15. Climate policies in China, India and Brazil: current issues and future challenges

    International Nuclear Information System (INIS)

    Bellevrat, Elie

    2012-07-01

    Emerging countries will have to tackle different social and economic development challenges in the future, which translate nationally into the concepts of 'harmonious society' in China and 'inclusive growth' in India, and into the Brazilian slogan 'a wealthy country is a country without poverty'. Per capita (current US$), Brazil is more than two times richer than China, which in turn is three times richer than India. This graduation explains the variety of priorities of those countries: reducing inequalities and achieving the development processes in China and Brazil, alleviating poverty and enhancing energy access in India. Furthermore, these countries are increasingly linked internationally, along with the globalization process. Energy security is a key issue for China and India, while Brazil aims at playing a key role on future international energy markets. Emerging economies are progressively laying the foundations for low-carbon development strategies that will depend on their national contexts and priorities. Investments in building and transport infrastructures are increasingly important in all those countries, creating the conditions today for tomorrow's low-carbon economic development. China recently made important resolutions in the framework of its 12. Five-Year Plan, decoupling economic growth from GHG emissions. India has developed eight 'National Missions' on climate change and is now exploring future low-carbon strategies. And Brazil is affirming its position internationally, pushing for innovative 'green growth' concepts, within the framework of the Rio+20 Conference. All countries have already implemented several energy and climate policies and plan to develop them further, through innovative policy institutions and instruments. They are switching progressively from command- and-control to economic instruments. In particular, market-based mechanisms are increasingly used in all countries: mandatory pilot Emission Trading Systems (ETS) in China

  16. Clinical data management: Current status, challenges, and future directions from industry perspectives

    Directory of Open Access Journals (Sweden)

    Zhengwu Lu

    2010-06-01

    Full Text Available Zhengwu Lu1, Jing Su21Smith Hanley Consulting, Houston, Texas; 2Department of Chemical Engineering, University of Massachusetts, Amherst, MA, USAAbstract: To maintain a competitive position, the biopharmaceutical industry has been facing the challenge of increasing productivity both internally and externally. As the product of the clinical development process, clinical data are recognized to be the key corporate asset and provide critical evidence of a medicine’s efficacy and safety and of its potential economic value to the market. It is also well recognized that using effective technology-enabled methods to manage clinical data can enhance the speed with which the drug is developed and commercialized, hence enhancing the competitive advantage. The effective use of data-capture tools may ensure that high-quality data are available for early review and rapid decision-making. A well-designed, protocol-driven, standardized, site workflow-oriented and documented database, populated via efficient data feed mechanisms, will ensure regulatory and commercial questions receive rapid responses. When information from a sponsor’s clinical database or data warehouse develops into corporate knowledge, the value of the medicine can be realized. Moreover, regulators, payer groups, patients, activist groups, patient advocacy groups, and employers are becoming more educated consumers of medicine, requiring monetary value and quality, and seeking out up-todate medical information supplied by biopharmaceutical companies. All these developments in the current biopharmaceutical arena demand that clinical data management (CDM is at the forefront, leading change, influencing direction, and providing objective evidence. Sustaining an integrated database or data repository for initial product registration and subsequent postmarketing uses is a long-term process to maximize return on investment for organizations. CDM should be the owner of driving clinical data

  17. People, personal projects and the challenging of social structures: a contribution to the reflection on the challenges of teaching development studies

    NARCIS (Netherlands)

    Parra Heredia, J.D. (Juan David)

    2018-01-01

    textabstractThis article makes a critique of using Post-Development as a tool in teaching an introductory course in development studies. Such a debate was initiated by Harcourt in a previous issue of Third World Quarterly as she reflected on her teaching experience in a European Institution.

  18. Injection current minimization of InAs/InGaAs quantum dot laser by optimization of its active region and reflectivity of laser cavity edges

    International Nuclear Information System (INIS)

    Korenev, V V; Savelyev, A V; Zhukov, A E; Maximov, M V

    2015-01-01

    The ways to optimize key parameters of active region and edge reflectivity of edge- emitting semiconductor quantum dot laser are provided. It is shown that in the case of optimal cavity length and sufficiently large dispersion lasing spectrum of a given width can be obtained at injection current up to an order of magnitude lower in comparison to non-optimized sample. The influence of internal loss and edge reflection is also studied in details. (paper)

  19. Injection current minimization of InAs/InGaAs quantum dot laser by optimization of its active region and reflectivity of laser cavity edges

    Science.gov (United States)

    Korenev, V. V.; Savelyev, A. V.; Zhukov, A. E.; Maximov, M. V.

    2015-11-01

    The ways to optimize key parameters of active region and edge reflectivity of edge- emitting semiconductor quantum dot laser are provided. It is shown that in the case of optimal cavity length and sufficiently large dispersion lasing spectrum of a given width can be obtained at injection current up to an order of magnitude lower in comparison to non-optimized sample. The influence of internal loss and edge reflection is also studied in details.

  20. Further improvement in the light output power of InGaN-based light emitting diodes by reflective current blocking design

    International Nuclear Information System (INIS)

    Tsai, Chun-Fu; Su, Yan-Kuin; Lin, Chun-Liang

    2011-01-01

    In this study, the fabrication and characterization of InGaN/GaN multiple-quantum-well light-emitting diodes (LEDs) with further improvement by the design of a reflective current blocking layer (CBL) were described, and these are demonstrated to be an inexpensive and feasible way for improving the performance of LEDs. With the reflective CBL, not only was the injected current forced to spread outside instead of flowing directly downward under a p-pad, but the light generated from the active region could also be extracted outside of the LED by reflection under the p-pad. At 20 mA, as compared to the conventional LED, the light output power of the LEDs with the normal and reflective CBL can be increased by 15.7% and 25.8%, respectively. We found that the forward voltages of the LEDs with CBL structure were both about 3.7 V at 20 mA, which was slightly higher than that of the conventional LED (3.6 V). In our experiment, the further increase in the light output power of the reflective CBL LED could be attributed to more current injection into the light-emitting active region outside of the p-pad by the CBL and a reduction in optical absorption at the p-pad with more extraction by the reflective design

  1. Challenge

    International Nuclear Information System (INIS)

    Schwitters, R.F.

    1996-01-01

    The design of new and upgrades of existing high energy particle accelerators is reviewed in light of the current knowledge of the standard model determined from existing and past machines and funding factors. Current financing of science will delay determining unknowns, such as CP violation, proton decay, neutrino properties, and dark matter. Three options are given: (1) obtain more funding, (2) downsize scientific personnel as are private enterprises or (3) develop new technology which will reduce the high cost of building current designs of high energy accelerators. (AIP) copyright 1996 American Institute of Physics

  2. Learning psychology as a challenging process towards development as well as "studies as usual": a thematic analysis of medical students' reflective writing.

    Science.gov (United States)

    Semb, Olof; Kaiser, Niclas; Andersson, Sven-Olof; Sundbom, Elisabet

    2014-01-01

    Reflective writing in medical training has been shown to be most effective when combined with some form of personal meeting or dialog. During a course in medical psychology for medical students, reflective texts were followed up by an individual personal talk with a teacher from the course. Thematic analysis of the texts revealed four separate sub-themes: 1) the course has enabled me and the class to develop, which is good albeit arduous; 2) understanding myself is a resource in understanding people as well as knowing psychology; 3) the course provided me with new, purely intellectual skills as well as eye-openers; and 4) the receiving teacher is an integral part of my reflective writing. The main theme, capturing the students' writing process, concluded that students perceive the course as "Learning psychology as a challenging process towards development" as well as "studies as usual". Ethical, psychological, and pedagogical aspects are discussed in the paper.

  3. Learning psychology as a challenging process towards development as well as “studies as usual”: a thematic analysis of medical students’ reflective writing

    Science.gov (United States)

    Semb, Olof; Kaiser, Niclas; Andersson, Sven-Olof; Sundbom, Elisabet

    2014-01-01

    Reflective writing in medical training has been shown to be most effective when combined with some form of personal meeting or dialog. During a course in medical psychology for medical students, reflective texts were followed up by an individual personal talk with a teacher from the course. Thematic analysis of the texts revealed four separate sub-themes: 1) the course has enabled me and the class to develop, which is good albeit arduous; 2) understanding myself is a resource in understanding people as well as knowing psychology; 3) the course provided me with new, purely intellectual skills as well as eye-openers; and 4) the receiving teacher is an integral part of my reflective writing. The main theme, capturing the students’ writing process, concluded that students perceive the course as “Learning psychology as a challenging process towards development” as well as “studies as usual”. Ethical, psychological, and pedagogical aspects are discussed in the paper. PMID:25540601

  4. Palliative care for patients in the USA with amyotrophic lateral sclerosis: current challenges

    Directory of Open Access Journals (Sweden)

    Houseman G

    2015-11-01

    Full Text Available Gail Houseman,1 Mary Kelley2 1The ALS Association Greater Philadelphia Chapter, Ambler, PA, USA; 2Department of Neurology, ALS Center at Penn Medicine, Philadelphia, PA, USA Abstract: Amyotrophic lateral sclerosis (ALS is a motor neuron disease that results in eventual paralysis of all voluntary muscles. Cognitive impairment may be a co-occurring condition with the ALS patient. Palliative care, which involves symptom management, is the most utilized treatment of choice. Managing the symptoms of ALS can be challenging. This paper provides experience-based facts on daily care provision in the USA and some practical guidelines. Keywords: amyotrophic lateral sclerosis, ALS, palliative care, challenges, symptom management

  5. Patient Centred Systems: Techno-Anthropological reflections on the challenges of 'meaningfully engaging' patients within health informatics research.

    Science.gov (United States)

    Wong, Ming-Chao; Almond, Helen; Cummings, Elizabeth; Roehrer, Erin; Showell, Chris; Turner, Paul

    2015-01-01

    This chapter explores how Techno-Anthropology can contribute to more explicitly professional and ethically responsible reflections on the socio-technical practices involved in meaningfully engaging patients in health informatics research. The chapter draws on insights from health informatics research projects focused on chronic disease and self-management conducted in Tasmania during the last 10 years. Through these projects the paper explores three topics of relevance to 'meaningful engagement' with patients: (i) Patient Self-Management and Chronic Disease (ii) Patients as Users in Health Informatics research, and, (iii) Evaluations of outcomes in Health and Health Informatics Interventions. Techno-Anthropological reflections are then discussed through the concepts of liminality, polyphony and power. This chapter argues that beyond its contribution to methodology, an important role for Techno-Anthropology in patient centred health informatics research may be its capacity to support new ways of conceptualising and critically reflecting on the construction and mediation of patients' needs, values and perspectives.

  6. Current Pedagogical Challenges in Iranian EFL Teachers' Views: A Qualitative Study

    Science.gov (United States)

    Noughabi, Mostafa Azari

    2017-01-01

    Searching for the real voices in regard to pedagogical challenges Iranian EFL teachers may struggle against seems to be an unexplored issue, which is the purpose of this qualitative grounded study. To achieve generalizable findings, based on the tenets of grounded theory, data were collected using an open-ended questionnaire with 187 Iranian EFL…

  7. Ensuring energy security in ASEAN countries: Current trends and major challenges

    Science.gov (United States)

    Senderov, Sergey; Vorobev, Sergey

    2018-01-01

    The paper discusses the issues of formation of future challenges to energy security of the ASEAN countries in the period up to 2035. The article gives examples of strategic threats to the energy security of Russia. The opportunities to meet future demand for primary energy for individual countries of ASEAN and the whole region are discussed.

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

    Science.gov (United States)

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

    2002-01-01

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

  9. Type 1 diabetes: Awareness, management and challenges: Current scenario in India

    Directory of Open Access Journals (Sweden)

    K M Prasanna Kumar

    2015-01-01

    Full Text Available Type 1 diabetes mellitus (T1DM has a wide presence in children and has a high mortality rates. The disease, if left unmanaged, poses various challenges to the patient and healthcare providers, including development of diabetic complications and thus decreasing the life expectancy of the affected child. The challenges of T1DM include awareness of the disease that is very poor among the general public and also in parents of T1DM children along with the health care professionals. The challenge of lack of awareness of T1DM can be met by increasing public awareness programs, conducting workshops for diabetes educators regarding T1DM in children, newsletters, CMEs, online courses, and by structured teaching modules for diabetes educators. Diagnosis of T1DM was a challenge a few decades ago but the situation has improved today with diagnostic tests and facilities, made available even in villages. Investigation facilities and infrastructure, however, are very poor at the primary care level, especially in rural areas. Insulin availability, acceptability, and affordability are also major problems, compounded by the various types of insulin that are available in the market with a varied price range. But effective use of insulin remains a matter of utmost importance.

  10. Type 1 diabetes: Awareness, management and challenges: Current scenario in India

    Science.gov (United States)

    Kumar, K.M. Prasanna; Saboo, Banshi; Rao, P.V.; Sarda, Archana; Viswanathan, Vijay; Kalra, Sanjay; Sethi, Bipin; Shah, Nalini; Srikanta, S.S.; Jain, Sunil M; Raghupathy, P.; Shukla, Rishi; Jhingan, Ashok; Chowdhury, Subhankar; Jabbar, P.K.; Kanungo, Alok; Joshi, Rajesh; Kumar, Surendra; Tandon, Nikhil; Khadilkar, Vaman; Chadha, Manoj

    2015-01-01

    Type 1 diabetes mellitus (T1DM) has a wide presence in children and has a high mortality rates. The disease, if left unmanaged, poses various challenges to the patient and healthcare providers, including development of diabetic complications and thus decreasing the life expectancy of the affected child. The challenges of T1DM include awareness of the disease that is very poor among the general public and also in parents of T1DM children along with the health care professionals. The challenge of lack of awareness of T1DM can be met by increasing public awareness programs, conducting workshops for diabetes educators regarding T1DM in children, newsletters, CMEs, online courses, and by structured teaching modules for diabetes educators. Diagnosis of T1DM was a challenge a few decades ago but the situation has improved today with diagnostic tests and facilities, made available even in villages. Investigation facilities and infrastructure, however, are very poor at the primary care level, especially in rural areas. Insulin availability, acceptability, and affordability are also major problems, compounded by the various types of insulin that are available in the market with a varied price range. But effective use of insulin remains a matter of utmost importance. PMID:25941655

  11. Is fair value currently in compliance with the principle of true and real reflection in the Czech accounting?

    Directory of Open Access Journals (Sweden)

    Jana Gláserová

    2012-01-01

    Full Text Available Information value of data provided by the accounting is in significant extent dependent on the method of valuation used in accounting of individual economic operations especially on the method of valuation of individual items in the financial statements. Financial expression of the individual value of assets and liabilities of the company (including the balance sheet of the company, as well as the amount of equity, depend just on specific method of valuation of assets and liabilities that each entity used in the accounting system. This fact has also a crucial influence on the overall level of financial analysis since mostly aggregated data in the appropriate valuation gained from various parts of the financial statements are the input data for financial analysis.Certain items of assets and liabilities are valued at fair value at the balance sheet day in the Czech accounting in compliance with the global developments. The concept of fair value in Czech accounting is regulated by Czech Accounting Act in § 27 paragraph 4 and 5. The Czech regulation of the concept of the fair value is based on its detailed definition of the IAS / IFRS, including cases of practical use.The aim of this paper is to answer the question whether currently the fair value in the Czech accounting reflects the reality, based on definition of its content in accordance with applicable legal regulation. Partial aim is to identify specific cases of its application in the accounting of various types of business entities in the Czech Republic in existing practice. The paper also identifies methodological procedure of recording changes resulting from the valuation or revaluation of various types of assets at fair value, including their impacts on the financial statements. An integral part of the paper is the perspective of IAS / IFRS on fair value in accounting, so the definition of the fair value and also there is historical development of valuation of assets according to IAS

  12. Influence of Al{sub 2}O{sub 3} reflective layer under phosphor layer on luminance and luminous efficiency characteristics in alternating-current plasma display panel

    Energy Technology Data Exchange (ETDEWEB)

    Park, Choon-Sang [School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu (Korea, Republic of); Tae, Heung-Sik, E-mail: hstae@ee.knu.ac.kr [School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu (Korea, Republic of); Jung, Eun Young [Core Technology Lab., Corporate R and D Center, Samsung SDI Company Ltd., Cheonan (Korea, Republic of)

    2013-11-29

    This paper examines the optical and discharge characteristics of alternating-current plasma display panel when adopting the Al{sub 2}O{sub 3} reflective layer. The Al{sub 2}O{sub 3} reflective layer is deposited under the phosphor layer by using the screen-printing method. The resulting changes in the optical and discharge characteristics, including the power consumption, color temperature, luminance, luminous efficiency, scanning electron microscopy image, and reflectance, are then compared for both cases with and without Al{sub 2}O{sub 3} reflective layer. As a result of optimizing the thicknesses between the Al{sub 2}O{sub 3} and phosphor layers, the luminance and luminous efficiency are improved by about 17% and 7%, respectively. - Highlights: • We examine characteristics of plasma display panel when adopting reflective layer. • Al{sub 2}O{sub 3} reflective layer was deposited under the phosphor layer. • Al{sub 2}O{sub 3} reflective layer with flaky shape is very effective in enhancing luminance.

  13. Building Evidence for Health: Green Buildings, Current Science, and Future Challenges.

    Science.gov (United States)

    Cedeño-Laurent, J G; Williams, A; MacNaughton, P; Cao, X; Eitland, E; Spengler, J; Allen, J

    2018-04-01

    Civilizational challenges have questioned the status quo of energy and material consumption by humans. From the built environment perspective, a response to these challenges was the creation of green buildings. Although the revolutionary capacity of the green building movement has elevated the expectations of new commercial construction, its rate of implementation has secluded the majority of the population from its benefits. Beyond reductions in energy usage and increases in market value, the main strength of green buildings may be the procurement of healthier building environments. Further pursuing the right to healthy indoor environments could help the green building movement to attain its full potential as a transformational public health tool. On the basis of 40 years of research on indoor environmental quality, we present a summary of nine environment elements that are foundational to human health. We posit the role of green buildings as a critical research platform within a novel sustainability framework based on social-environmental capital assets.

  14. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems

    Science.gov (United States)

    Vaquero, Juan José; Kinahan, Paul

    2017-01-01

    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges. PMID:26643024

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

    Science.gov (United States)

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

    2017-11-01

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

  16. 3D and 4D Bioprinting of the Myocardium: Current Approaches, Challenges, and Future Prospects

    Directory of Open Access Journals (Sweden)

    Chin Siang Ong

    2018-01-01

    Full Text Available 3D and 4D bioprinting of the heart are exciting notions in the modern era. However, myocardial bioprinting has proven to be challenging. This review outlines the methods, materials, cell types, issues, challenges, and future prospects in myocardial bioprinting. Advances in 3D bioprinting technology have significantly improved the manufacturing process. While scaffolds have traditionally been utilized, 3D bioprinters, which do not require scaffolds, are increasingly being employed. Improved understanding of the cardiac cellular composition and multiple strategies to tackle the issues of vascularization and viability had led to progress in this field. In vivo studies utilizing small animal models have been promising. 4D bioprinting is a new concept that has potential to advance the field of 3D bioprinting further by incorporating the fourth dimension of time. Clinical translation will require multidisciplinary collaboration to tackle the pertinent issues facing this field.

  17. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems.

    Science.gov (United States)

    Vaquero, Juan José; Kinahan, Paul

    2015-01-01

    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges.

  18. Projecting Personnel Security Investigations (PSI) Requirements: Current Issues, Challenges and a Viable Approach

    Science.gov (United States)

    2008-09-01

    the DoD components to project annual investigations within 5% of annual submissions in order to properly staff the OPM investigations programa ...Level97E N/ANavigator Trainee92T1 N/APilot Trainee92T0 N/AWing Commander91W N/AGeneral Officer90G N/AAide- De -Camp88A N/ACommand and Control86P N/AUnited...the Navy and Marine Corps can simply reflect inclusion of clearances from individuals who have transitioned from the Selected Reserves to the

  19. Challenges of current hydraulic modeling with three examples; Herausforderungen des heutigen wasserbaulichen Versuchswesens mit drei Beispielen

    Energy Technology Data Exchange (ETDEWEB)

    De Cesare, Giovanni; Pfister, Michael; Daneshvari, Milad; Bieri, Martin [Ecole Polytechnique Federale de Lausanne (Switzerland). Lab. de Constructions Hydrauliques (EPFL-LCH)

    2012-07-01

    Most technical universities offering courses in civil engineering operate for meanwhile 100 years hydraulic laboratories. They investigate and optimize hydraulic structures related to dams, power plants and flood protection measures using physical modelling. These laboratories are usually fully booked today although this classical engineering approach was often predicted to disappear. The authors describe their experience and the new challenges in physical modelling, illustrated with three examples. (orig.)

  20. Integrated nutrient management, soil fertility, and sustainable agriculture: Current issues and future challenges

    OpenAIRE

    Goletti, F.; Gruhn, P.; Yudelman, M.

    2000-01-01

    Metadata only record The challenge for agriculture over the coming decades will be to meet the world's increasing demand for food in a sustainable way. Declining soil fertility and mismanagement of plant nutrients have made this task more difficult. In their 2020 Vision discussion paper, Peter Gruhn, Francesco Goletti, and Montague Yudelman point out that as long as agriculture remains a soil-based industry, major increases in productivity are unlikely to be attained without ensuring that ...

  1. Cancer Supportive and Survivorship Care in Singapore: Current Challenges and Future Outlook

    Directory of Open Access Journals (Sweden)

    Kiley Wei-Jen Loh

    2018-02-01

    Full Text Available Despite being a relatively young nation, Singapore has established itself as a leading multifaceted medical hub, both regionally and globally. Although Singapore continues to pursue excellence in oncology care, cancer supportive care and survivorship care remain in the infancy stage. In an effort to advance this important aspect of oncology care in Singapore, the first cancer supportive and survivorship care forum was held in December 2016, involving 74 oncology practitioners. The primary goals of this forum were to raise awareness of the importance of cancer supportive and survivorship care and to provide a platform for oncology practitioners of diverse backgrounds to converge and address the challenges associated with the delivery of cancer supportive and survivorship care in Singapore. Key challenges identified during this forum included, but were not limited to, care fragmentation in an oncologist-centric model of care, poor integration of allied health and rehabilitation services, passive engagement of community partners, lack of specialized skill sets and knowledge in supportive and survivorship care, and patient-related barriers such as poor health literacy. The survivorship care model commonly used in Singapore places an imbalanced emphasis on surveillance for cancer recurrence and second primary cancers, with little attention given to the supportive and survivorship needs of the survivors. In summary, these challenges set the stage for the development and use of a more survivor-centric model, one that focuses not only on cancer surveillance, but also on the broad and unique physical and psychosocial needs of survivors of cancer in Singapore.

  2. [Regulatory Program for Medical Devices in Cuba: experiences and current challenges].

    Science.gov (United States)

    Pereira, Dulce María Martínez; Rodríguez, Yadira Álvarez; Valdés, Yamila Cedeño; Ribas, Silvia Delgado

    2016-05-01

    Regulatory control of medical devices in Cuba is conducted through a system based on the Regulatory Program for Medical Devices as a way to ensure the safety, efficacy, and effectiveness of these technologies, which are in use by the National Health System. This program was launched in 1992, when the Regulations for State Evaluation and Registration of Medical Devices were approved. Its successive stages and the merging of regulatory activities for drugs and medical equipment have meant progress toward stronger, more transparent strategies and greater control of industry and the National Health System. Throughout its course the Cuban program has met with challenges and difficulties that it has addressed by drawing on its own experiences. During the new period, the greatest challenges revolve around ensuring that regulatory systems incorporate scientific evaluation, risk levels, maximum rigor through the use of technical standards, and the implementation of international recommendations, together with the application of the ISO 13485 certification scheme, enhanced market monitoring, and classification of medical devices in accordance with their relevance to the country's national health policies. From the regional standpoint, the greatest challenge lies in working toward regulatory convergence. The Collaborating Centre for the Regulation of Health Technologies will support the proposed regulatory strategy and established regional priorities, in particular in connection with the implementation of actions involving medical devices.

  3. Current Challenges in Bioequivalence, Quality, and Novel Assessment Technologies for Topical Products

    DEFF Research Database (Denmark)

    Yacobi, Avraham; Shah, Vinod P; Bashaw, Edward D

    2014-01-01

    This paper summarises the proceedings of a recent workshop which brought together pharmaceutical scientists and dermatologists from academia, industry and regulatory agencies to discuss current regulatory issues and industry practices for establishing therapeutic bioequivalence (BE) of dermatologic...

  4. Indonesia municiple solid waste life cycle and environmental monitoring: current situation, before and future challenges

    Science.gov (United States)

    Susmono

    2017-03-01

    Indonesia is a big country with circa 250 million population, with more than 500 Local Governments and they are going to improve their municiple solid waste dumping method from Open Dumping to Sanitary Landfill (SLF) and to promote Reduce-Reuse-Recycling (3R) since many years ago, and it is strengthened by issuing of Solid Waste Management Act No.18/2008, MSW Government Regulation No.12/2012 and other regulations which are issued by Central Government and Local Governments. During “Water and Sanitation Decade 1980-1990” through “Integrated Urban Infrastructures Development Program” some pilot project such as 30 units of 3R station were developed in the urban areas, and modified or simplification of SLF call Controlled Landfill (CLF) were implemented. In the year of 2002 about 45 units of composting pilot projects were developed under “Western Java Environmental Management Project”, and the result was notified that some of them are not sustain because many aspects. At the beginning of 2007 until now, some pilot projects of 3R were continued in some cities and since 2011 some Waste Banks are growing fast. In the year of 2014 was recorded that of 70 % of 3Rs in Java Island well developed (2014, Directorate of Environment Sanitation Report), and in the year of 2012 was recorded that development of Communal Waste Banks were growing fast during two months from 400 units to 800 units (2012, Ministry of Environment report), now more Communal Waste Banks all ready exist. After the last overview monitoring activity by Ministry of Environment and JICA (2008), because of lack of data is very difficult to give current accurate information of Municiple Solid Waste Handling in Indonesia. Nevertheless some innovation are developed because of impact of many pilot projects, Adipura City Cleanest Competition among Local Governments and growing of the spirit of autonomous policy of Local Governments, but some Local Governments still dependence on Central Government support

  5. LeaderBeing: Critical Reflections on Context, Character and Challenge in the Culture of Research and Its Administration

    Science.gov (United States)

    Gabriele, Edward F.; Caines, Vaughan V.

    2014-01-01

    Servant leadership is a critical concept for understanding the ongoing importance of research administration as a central profession of service within the culture of research itself. The leadership of research administrators is both a unique gift and a challenge to the research culture. To ensure the continued productivity of the research…

  6. Current progress and challenges in engineering viable artificial leaf for solar water splitting

    Directory of Open Access Journals (Sweden)

    Phuc D. Nguyen

    2017-12-01

    Full Text Available Large scale production of H2, a clean fuel, can be realized with just water and solar light energy by employing a viable energy conversion device called artificial leaf. In this tutorial review, we discuss on advances achieved recently and technical challenges remained toward the creation of such a leaf. Development of key components like catalysts for water electrolysis process and light harvester for harvesting solar energy as well as strategies being developed for assembling these components to create a complete artificial leaf will be highlighted.

  7. The Energy Charter Treaty and settlement of disputes – current challenges

    Directory of Open Access Journals (Sweden)

    Iuliana-Gabriela Iacob

    2016-06-01

    Full Text Available The Energy Charter Treaty (the “ECT” is a multilateral agreement aiming to promote energy cooperation and security. This paper focuses on the provisions of the ECT governing the protection of foreign investments and the settlement of disputes between investors and host states. In particular, this paper analyses the recent developments and challenges in the field of dispute settlement under the ECT, such as the increase in arbitrations, the withdrawal of Italy from the ECT, as well as the interplay between EU law and the ECT.

  8. Changing epidemiology of methicillin-resistant Staphylococcus aureus in Iceland from 2000 to 2008: a challenge to current guidelines

    DEFF Research Database (Denmark)

    Holzknecht, B.J.; Hardardottir, H.; Haraldsson, Gustav Helgi

    2010-01-01

    and microbiological data of all MRSA patients from the years 2000 to 2008 were collected prospectively. Isolates were characterized by pulsed-field gel electrophoresis (PFGE), sequencing of the repeat region of the Staphylococcus protein A gene (spa typing), staphylococcal cassette chromosome mec (SCCmec) typing...... setting. However, MRSA in Iceland is now shifting into the community, challenging the current Icelandic guidelines, which are tailored to the health care system....

  9. Controlling the HIV/AIDS epidemic: current status and global challenges

    Directory of Open Access Journals (Sweden)

    Thorsten eDemberg

    2012-08-01

    Full Text Available This review provides an overview of the current status of the global HIV pandemic and strategies to bring it under control. It updates numerous preventive approaches including behavioral interventions, male circumcision, pre- and post-exposure prophylaxis, vaccines, and microbicides. The manuscript summarizes current anti-retroviral treatment options, their impact in the western world, and difficulties faced by emerging and resource-limited nations in providing and maintaining appropriate treatment regimens. Current clinical and pre-clinical approaches towards a cure for HIV are described, including new drug compounds that target viral reservoirs and gene therapy approaches aimed at altering susceptibility to HIV infection. Recent progress in vaccine development is summarized, including novel approaches and new discoveries.

  10. Transcranial direct current stimulation in patients with Alzheimer’s disease: Challenges and responses

    Directory of Open Access Journals (Sweden)

    Hong Yuan

    2015-09-01

    Full Text Available The use of transcranial direct current stimulation (tDCS as a noninvasive therapeutic approach for Alzheimer’s disease (AD has gained increasing attention. Research regarding the utility of tDCS in AD is inconsistent. In this study, we reviewed the importance of individual diversity among AD patients, starting from the uninformative mean results. We also demonstrated variation among AD patients. Highly educated patients seem to benefit more; education also seems to modulate baseline measurements and the results. Individual cortical morphology also affects the current distribution, which influences the effectiveness of stimulation. We suggest the use of structural MRI to distinguish inter-individual variability; high-resolution modeling can also be used to predict current distributions and should be combined with cognitive training (CT along with tDCS.

  11. Current status, new frontiers and challenges in radiation biodosimetry using cytogenetic, transcriptomic and proteomic technologies

    Energy Technology Data Exchange (ETDEWEB)

    Fenech, Michael, E-mail: michael.fenech@csiro.au [Commonwealth Scientific and Industrial Research Organisation, Gate 13 Kintore Avenue, Adelaide, SA 5000 (Australia)

    2011-09-15

    Biodosimetric methods for determining exposure dose in individuals following a radiation accident are important for the health management of the exposed cohort and prioritisation of high dose exposure cases to receive emergency medical treatment. This brief review provides a succinct outline of (i) the current status of standard cytogenetic methods used in radiation biodosimetry; (ii) development of high-throughput systems for current standard cytogenetic methods; (iii) emerging minimally invasive methods; (iv) the impact of nutrition and genotype on observed dose-response relationships and (v) new frontiers in biodosimetry using molecular biology techniques such as transcriptomics and proteomics.

  12. Diagnosis of tuberculosis in camelids: old problems, current solutions and future challenges.

    Science.gov (United States)

    Alvarez, J; Bezos, J; Juan, L de; Vordermeier, M; Rodriguez, S; Fernandez-de-Mera, I G; Mateos, A; Domínguez, L

    2012-02-01

    In spite of great efforts for its control and eradication, tuberculosis remains one of the most important zoonosis worldwide. Its causative agents, the members of the Mycobacterium tuberculosis complex, have a wide host range that complicates the epidemiology of this disease. Among susceptible species to these pathogens, camelids from the New World (llama, alpaca and vicuña) and Old World (Bactrian camel and dromedary) are acquiring an increasing importance in several European countries because of its growing number and could act as reservoirs of the disease for livestock and humans in their natural habitat. In addition, tuberculosis caused by a number of M. tuberculosis complex members is a life-threatening disease in these animal species. Although tuberculosis has been known to affect camelids for a long time, ante-mortem diagnosis is still challenging because of the lack of standardized diagnostic techniques and the limited sensitivity and specificity of the most widely applied tests. However, in recent years, several techniques that can at least partially overcome these limitations have been developed. This paper reviews the results and advances achieved in tuberculosis diagnosis in camelids in the last decade as well as the progresses on ongoing investigations, with special attention to the remaining challenges that still have to be faced to assure the availability of reliable tools for the detection of tuberculosis-infected animals and herds. © 2011 Blackwell Verlag GmbH.

  13. Emotion regulation and mental health: recent findings, current challenges, and future directions.

    Science.gov (United States)

    Berking, Matthias; Wupperman, Peggilee

    2012-03-01

    In recent years, deficits in emotion regulation have been studied as a putative maintaining factor and promising treatment target in a broad range of mental disorders. This article aims to provide an integrative review of the latest theoretical and empirical developments in this rapidly growing field of research. Deficits in emotion regulation appear to be relevant to the development, maintenance, and treatment of various forms of psychopathology. Increasing evidence demonstrates that deficits in the ability to adaptively cope with challenging emotions are related to depression, borderline personality disorder, substance-use disorders, eating disorders, somatoform disorders, and a variety of other psychopathological symptoms. Unfortunately, studies differ with regard to the conceptualization and assessment of emotion regulation, thus limiting the ability to compare findings across studies. Future research should systematically work to use comparable methods in order to clarify the following: which individuals have; what kinds of emotion regulation difficulties with; which types of emotions; and what interventions are most effective in alleviating these difficulties. Despite some yet to be resolved challenges, the concept of emotion regulation has a broad and significant heuristic value for research in mental health.

  14. Addressing current challenges in cancer immunotherapy with mathematical and computational modelling.

    Science.gov (United States)

    Konstorum, Anna; Vella, Anthony T; Adler, Adam J; Laubenbacher, Reinhard C

    2017-06-01

    The goal of cancer immunotherapy is to boost a patient's immune response to a tumour. Yet, the design of an effective immunotherapy is complicated by various factors, including a potentially immunosuppressive tumour microenvironment, immune-modulating effects of conventional treatments and therapy-related toxicities. These complexities can be incorporated into mathematical and computational models of cancer immunotherapy that can then be used to aid in rational therapy design. In this review, we survey modelling approaches under the umbrella of the major challenges facing immunotherapy development, which encompass tumour classification, optimal treatment scheduling and combination therapy design. Although overlapping, each challenge has presented unique opportunities for modellers to make contributions using analytical and numerical analysis of model outcomes, as well as optimization algorithms. We discuss several examples of models that have grown in complexity as more biological information has become available, showcasing how model development is a dynamic process interlinked with the rapid advances in tumour-immune biology. We conclude the review with recommendations for modellers both with respect to methodology and biological direction that might help keep modellers at the forefront of cancer immunotherapy development. © 2017 The Author(s).

  15. Gelatin controversies in food, pharmaceuticals, and personal care products: Authentication methods, current status, and future challenges.

    Science.gov (United States)

    Ali, Eaqub; Sultana, Sharmin; Hamid, Sharifah Bee Abd; Hossain, Motalib; Yehya, Wageeh A; Kader, Abdul; Bhargava, Suresh K

    2018-06-13

    Gelatin is a highly purified animal protein of pig, cow, and fish origins and is extensively used in food, pharmaceuticals, and personal care products. However, the acceptability of gelatin products greatly depends on the animal sources of the gelatin. Porcine and bovine gelatins have attractive features but limited acceptance because of religious prohibitions and potential zoonotic threats, whereas fish gelatin is welcomed in all religions and cultures. Thus, source authentication is a must for gelatin products but it is greatly challenging due to the breakdown of both protein and DNA biomarkers in processed gelatins. Therefore, several methods have been proposed for gelatin identification, but a comprehensive and systematic document that includes all of the techniques does not exist. This up-to-date review addresses this research gap and presents, in an accessible format, the major gelatin source authentication techniques, which are primarily nucleic acid and protein based. Instead of presenting these methods in paragraph form which needs much attention in reading, the major methods are schematically depicted, and their comparative features are tabulated. Future technologies are forecasted, and challenges are outlined. Overall, this review paper has the merit to serve as a reference guide for the production and application of gelatin in academia and industry and will act as a platform for the development of improved methods for gelatin authentication.

  16. The health and health system of South Africa: historical roots of current public health challenges.

    Science.gov (United States)

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-05

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  17. Semantic Web research anno 2006 : Main streams, popular fallacies, current status and future challenges

    NARCIS (Netherlands)

    Van Harmelen, Frank

    2006-01-01

    In this topical paper we try to give an analysis and overview of the current state of Semantic Web research. We point to different interpretations of the Semantic Web as the reason underlying many controversies, we list (and debunk) four false objections which are often raised against the Semantic

  18. Inorganic and Hazardous Solid Waste Management: Current Status and Challenges for Indonesia

    NARCIS (Netherlands)

    Aprilia, A.; Tezuka, T.; Spaargaren, G.

    2013-01-01

    This article focuses on household waste management in Indonesia, with particular emphasis on inorganic and hazardous waste. It seeks to identify the current situation and also aims to provide a review of the existing policies that are particularly related to inorganic and hazardous waste management.

  19. Increasing Inter-Parliamentary Cooperation in the European Union : Current Trends and Challenges

    NARCIS (Netherlands)

    Fromage, D.B.|info:eu-repo/dai/nl/370195086

    2016-01-01

    This article analyses the blossoming of the initiatives for inter-parliamentary cooperation currently observable in the European Union from a democratic legitimacy perspective. It shows that there exists numerous forms and settings for the cooperation among national parliaments (NPs) and with the

  20. Use of hypotheses for analysis of variance Models: Challenging the current practice

    NARCIS (Netherlands)

    van Wesel, F.; Boeije, H.R.; Hoijtink, H

    2013-01-01

    In social science research, hypotheses about group means are commonly tested using analysis of variance. While deemed to be formulated as specifically as possible to test social science theory, they are often defined in general terms. In this article we use two studies to explore the current

  1. A DEMOCRACIA E O TERCEIRO SETOR NA ATUALIDADE: HISTÓRICO E REFLEXOS ATUAIS / DEMOCRACY AND THE CURRENT THIRD SECTOR: HISTORICAL AND CURRENT REFLECTIONS

    Directory of Open Access Journals (Sweden)

    José Eduardo Sabo Paes

    2017-04-01

    Full Text Available This article aims at analyzing the current role of civil society organized in improving the democratic setup of the Brazilian State. To this end, it has been shown through a literature review and application of the hypothetical deductive method, the evolution and the current application of the concepts of Democracy and Third Sector. As a specific objective it was conceptually demonstrated what democracy stand for, its function today, collating classic and current authors. The theoretical construction of the classic constitutional paradigms and the need for realization of the democratic rule of law now has been shown. The concepts of the Third Sector and its function of acting as an effective instrument of social change were also analyzed. Finally, it is concluded that the third sector is an instrument that seeks the realization of current Brazilian democracy, besides having a role of service provider that would imminently be a responsibility from the State.

  2. The Current Observation and Challenges of Tourism Development in Batur Global Geopark Area, Bali Province, Indonesia

    Science.gov (United States)

    Rosyidie, A.; Sagala, S.; Syahbid, M. M.; Sasongko, M. A.

    2018-05-01

    Geopark is a designated physical landscape with a geological heritage value. It is one of the approaches to combine both conservation and sustainable economic development. Geopark aims to attract tourists that ultimately bring impacts to the development, especially to the local governments and communities. The first global geopark in Indonesia, which is recognized by UNESCO, is Batur Geopark. Batur Geopark is in Kintamani, Bangli District, Bali Province. The main purpose of Batur Global Geopark development is to balance between the geology, environment, social-culture, economic, and conservation. Creating geoparks as tourism destination would achieve not only scientific and natural resource preservation, but also the development of tourism. Since Geopark is considered as a new concept in Indonesia, the main question is: does geopark indeed boost tourism? If so, how significant is it compared to other tourism in a particular area, such as Bali? What are the challenges faced in the development of geopark? Having the above questions, this study selects Batur Geopark as a case study and assesses to what extent Batur Geopark contributes to the tourism development in Bangli District and Bali Province. A framework to do this assessment is set up using geopark criteria developed by UNESCO as well as trend analysis since the establishment of Batur Geopark in 2012. To get a comprehensive picture, we conducted a field survey in Batur Geopark and asked questions to the local community, local champions, businessmen, tourism actors, local government agencies and scholars in tourism development, and we also explored the potential and the challenges of the tourism development of Batur Global Geopark. The findings indicate that developing Geopark as ecotourism is a complicated issue. Geopark is seen in various and different perspectives by different actors. While the aim of geopark is to trigger tourism development, some contra-geopark and tourism activities exist, such as sand

  3. Coaching for health and lifestyle change: Theory and guidelines for interacting and reflecting with women about their challenges and aspirations

    DEFF Research Database (Denmark)

    Stelter, Reinhard; Andersen, Vinnie

    2018-01-01

    was to support women in their attempts to remain physically active and to develop and maintain a healthy lifestyle. The main objective of this article is to take a close look at the best way to achieve this – not by telling the women what to do or by pushing them towards specific goals, but by inviting them...... into a space of common reflection and joint action. In that sense, the interaction (not intervention) will take its point of departure in a broad, collaboratively inspired approach that is broader in focus than widespread interventions, which are often exclusively based on motivational interviewing. The goal...

  4. Learning psychology as a challenging process towards development as well as “studies as usual”: a thematic analysis of medical students’ reflective writing

    Directory of Open Access Journals (Sweden)

    Semb O

    2014-12-01

    Full Text Available Olof Semb,1 Niclas Kaiser,2 Sven-Olof Andersson,1 Elisabet Sundbom3 1Department of Clinical Sciences, Division for Professional Development, Umeå University, Umeå, Sweden; 2Department of Psychology, Umeå University, Umeå, Sweden; 3Department of Clinical Sciences, Division for Psychiatry and Medical Psychology, Umeå University, Umeå, Sweden Abstract: Reflective writing in medical training has been shown to be most effective when combined with some form of personal meeting or dialog. During a course in medical psychology for medical students, reflective texts were followed up by an individual personal talk with a teacher from the course. Thematic analysis of the texts revealed four separate sub-themes: 1 the course has enabled me and the class to develop, which is good albeit arduous; 2 understanding myself is a resource in understanding people as well as knowing psychology; 3 the course provided me with new, purely intellectual skills as well as eye-openers; and 4 the receiving teacher is an integral part of my reflective writing. The main theme, capturing the students’ writing process, concluded that students perceive the course as “Learning psychology as a challenging process towards development” as well as “studies as usual”. Ethical, psychological, and pedagogical aspects are discussed in the paper. Keywords: reflective writing, self-knowledge, individual personal talks, thematic analysis, medical education

  5. Factors governing dissolution process of lignocellulosic biomass in ionic liquid: current status, overview and challenges.

    Science.gov (United States)

    Badgujar, Kirtikumar C; Bhanage, Bhalchandra M

    2015-02-01

    The utilisation of non-feed lignocellulosic biomass as a source of renewable bio-energy and synthesis of fine chemical products is necessary for the sustainable development. The methods for the dissolution of lignocellulosic biomass in conventional solvents are complex and tedious due to the complex chemical ultra-structure of biomass. In view of this, recent developments for the use of ionic liquid solvent (IL) has received great attention, as ILs can solubilise such complex biomass and thus provides industrial scale-up potential. In this review, we have discussed the state-of-art for the dissolution of lignocellulosic material in representative ILs. Furthermore, various process parameters and their influence for biomass dissolution were reviewed. In addition to this, overview of challenges and opportunities related to this interesting area is presented. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2018-05-05

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

  7. Current Challenges in Understanding and Forecasting Stable Boundary Layers over Land and Ice

    Directory of Open Access Journals (Sweden)

    Gert-Jan eSteeneveld

    2014-10-01

    Full Text Available Understanding and prediction of the stable atmospheric boundary layer is challenging. Many physical processes come into play in the stable boundary layer, i.e. turbulence, radiation, land surface coupling and heterogeneity, orographic turbulent and gravity wave drag. The development of robust stable boundary-layer parameterizations for weather and climate models is difficult because of the multiplicity of processes and their complex interactions. As a result, these models suffer from biases in key variables, such as the 2-m temperature, boundary-layer depth and wind speed. This short paper briefly summarizes the state-of-the-art of stable boundary layer research, and highlights physical processes that received only limited attention so far, in particular orographically-induced gravity wave drag, longwave radiation divergence, and the land-atmosphere coupling over a snow-covered surface. Finally, a conceptual framework with relevant processes and particularly their interactions is proposed.

  8. Unmanned Aerial Aircraft Systems for transportation engineering: Current practice and future challenges

    Directory of Open Access Journals (Sweden)

    Emmanouil N. Barmpounakis

    2016-10-01

    Full Text Available Acquiring and processing video streams from static cameras has been proposed as one of the most efficient tools for visualizing and gathering traffic information. With the latest advances in technology and visual media, combined with the increased needs in dealing with congestion more effectively and directly, the use of Unmanned Aerial Aircraft Systems (UAS has emerged in the field of traffic engineering. In this paper, we review studies and applications that incorporate UAS in transportation research and practice with the aim to set the grounds from the proper understanding and implementation of UAS related surveillance systems in transportation and traffic engineering. The studies reviewed are categorized in different transportation engineering areas. Additional significant applications from other research fields are also referenced to identify other promising applications. Finally, issues and emerging challenges in both a conceptual and methodological level are revealed and discussed.

  9. Electricity sector in Tunisia: Current status and challenges - An example for a developing country

    International Nuclear Information System (INIS)

    Ahmed, Souissi

    2011-01-01

    During the last decade, Tunisia evolved in an extremely difficult energy context characterized by the stabilization of the resources in hydrocarbons, the increase of the energy consumption and the increase of the price of oil ($147 the barrel in July, 2008), imposing on it to mobilize more to meet several challenges in terms of outside energetic dependence for the generation of electricity and the reduction of greenhouse gases. This policy allowed the reduction in the rate of growth of energy intensity of the country. This article presents a review about renewable and conventional energy resources, electricity consumption and production and the policy adopted by the country for energy conservation and the promotion of renewable energy. (author)

  10. Mind the Gap: Current Challenges and Future State of Heart Failure Care.

    Science.gov (United States)

    McDonald, Michael A; Ashley, Euan A; Fedak, Paul W M; Hawkins, Nathaniel; Januzzi, James L; McMurray, John J V; Parikh, Victoria N; Rao, Vivek; Svystonyuk, Daniyil; Teerlink, John R; Virani, Sean

    2017-11-01

    The past decade has seen many advances in the management of heart failure (HF) that have improved survival and quality of life for patients living with this condition. A number of gaps remain in our understanding of the pathophysiology of HF, and the application of emerging treatment strategies is an exciting but daunting challenge. It is possible that advances in genetic evaluation of cardiomyopathy will provide a more refined approach to characterizing HF syndromes, whereas large-scale clinical trials on the horizon should further clarify the role of novel pharmacologic agents and invasive therapies. Cardiac repair and regeneration hold great promise, but a number of pragmatic issues will limit clinical application in the near term. Replacing cardiac function with ventricular assist devices represents significant progress in the management of advanced disease; however, unacceptable rates of complications and costs need to be addressed before broader use in the general HF population is feasible. The ability to personalize care is limited, and the optimal model of disease management in the Canadian context remains uncertain. The emergence of biomarker-guided management and remote monitoring technologies might facilitate a more personalized approach to care in an effort to maintain health and stability and to prevent worsening HF. Ultimately, a greater understanding of how and when to intervene in the setting of acute HF should translate into improved outcomes for the highest-risk subgroup of patients. This review highlights key challenges in the management of HF and highlights the progress toward an ideal future state. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  11. Thermal hydraulic issues and challenges for current and new generation FBRs

    Energy Technology Data Exchange (ETDEWEB)

    Chellapandi, P.; Velusamy, K., E-mail: kvelu@igcar.gov.in

    2015-12-01

    Highlights: • We present challenges in thermal hydraulic design of sodium cooled fast reactors. • We present roadmap of Indian fast reactor program and innovative design concepts. • Analysis methodology for thermal striping and thermal stratification are highlighted. • Design solutions for gas entrainment are presented. • Experimental approaches for normal and post accident decay heat removal are highlighted. - Abstract: Pool type sodium cooled fast reactors pose several design challenges and among them, certain thermal hydraulics and structural mechanics issues are special. High frequency temperature fluctuations due to thermal striping, thermal stratifications and sodium free level fluctuations at the liquid–cover gas interfaces are to be investigated carefully to eliminate high cycle thermal fatigue of structures. Solutions to address the core thermal hydraulics call for high power computing. Innovative concepts and methods are developed to carry out plant dynamics and safety studies. Particularly, extensive numerical and experimental simulation techniques are needed for understanding and solving the gas entrainment mechanisms and its effects on core safety. Though decay heat removal through natural convection is achievable in a pool type SFR, demonstration of design solutions conceived in the reactor and performance of diverse systems under all operating conditions, especially over prolonged station blackout situations needs advanced CFD computations and should be validated by relatively large scale simulated experiments. These issues are addressed in this paper under five broad topics: special thermal hydraulic issues to be addressed in SFR, thermal hydraulic design and analysis, plant dynamics studies, safety studies and evolving thermal hydraulic studies for the future FBRs. The 500 MWe Prototype Fast Breeder Reactor (PFBR) is taken as the reference design for addressing the issues. Indian fast reactor programme is highlighted in the introduction

  12. Monitoring techniques for the impact assessment during nuclear and radiological emergencies: current status and the challenges

    International Nuclear Information System (INIS)

    Pradeepkumar, K.S.; Sharma, D.N.

    2003-01-01

    Preparedness and response capability for Nuclear and Radiological emergencies, existing world over, are mainly based on the requirement of responding to radiation emergency caused by nuclear or radiological accidents. Cosmos satellite accident, plutonium contamination at Polaris, nuclear accidents like Kystium, Windscale, TMI and Chernobyl, radiological accidents at Goiania etc have demonstrated the requirement of improved radiation monitoring techniques. For quick decision making, state of the art monitoring methodology which can support quantitative and qualitative impact assessment is essential. Evaluation of radiological mapping of the area suspected to be contaminated needs ground based as well as aerial based monitoring systems to predict the level of radioactive contamination on ground. This will help in delineating the area and deciding the required countermeasures, based on the quantity and type of radionuclides responsible for it. The response can be successful with the effective use of i) Early Warning System ii) Mobile Monitoring System and iii) Aerial Gamma Spectrometric System. Selection of the monitoring methodology and survey parameters and assessment of situation using available resources etc. are to be optimized depending on the accident scenario. Recently, many countries and agencies like IAEA have expressed the requirement for responding to other types of nuclear/radiological emergencies i.e, man made radiation emergency situations aimed at harming public at large that can also lead to environmental contamination and significant exposure to public. Reports of lost / misplaced / stolen radioactive sources from many countries are alarming as safety and security of these radioactive sources are under challenge. The monitoring methodology has to take into account of the increase in such demands and more periodic monitoring in suspected locations is to be carried out. Detection of orphan sources possible amidst large heap of metallic scraps may pose

  13. Transgenesis and paratransgenesis to control insect-borne diseases: Current status and future challenges

    Science.gov (United States)

    Coutinho-Abreu, Iliano V.; Zhu, Kun Yan; Ramalho-Ortigao, Marcelo

    2009-01-01

    Insect-borne diseases cause significant human morbidity and mortality. Current control and preventive methods against vector-borne diseases rely mainly on insecticides. The emergence of insecticide resistance in many disease vectors highlights the necessity to develop new strategies to control these insects. Vector transgenesis and paratransgenesis are novel strategies that aim at reducing insect vectorial capacity, or seek to eliminate transmission of pathogens such as Plasmodium sp., Trypanosoma sp., and Dengue virus currently being developed. Vector transgenesis relies on direct genetic manipulation of disease vectors making them incapable of functioning as vectors of a given pathogen. Paratransgenesis focuses on utilizing genetically modified insect symbionts to express molecules within the vector that are deleterious to pathogens they transmit. Despite the many successes achieved in developing such techniques in the last several years, many significant barriers remain and need to be overcome prior to any of these approaches become a reality. Here, we highlight the current status of these strategies, pointing out advantages and constraints, and also explore issues that need to be resolved before the establishment of transgenesis and paratransgenesis as tools to prevent vector-borne diseases. PMID:19819346

  14. Navigating Grounded Theory:A critical and reflective response to the challenges of using grounded theory in an education PhD

    OpenAIRE

    Nelson, James

    2015-01-01

    This paper offers a critical reflection upon the use of a grounded theory approach within a doctoral study. As well as providing an outline of grounded theory, it begins by noting the existence of some powerful critiques of a grounded theory approach, in particular around the key concepts of ‘theory’, ‘discovery’ and ‘ground’. It is argued that, in some cases, grounded theory struggles to counter these challenges, especially in its ‘purist’ forms. However, with reference to research carried o...

  15. Retos actuales de la investigación educativa / Current challenges of the educational research

    Directory of Open Access Journals (Sweden)

    Delgado de Colmenares, Flor

    2008-12-01

    Full Text Available Resumen: El presente artículo constituye parte de los resultados de una investigación ya concluida, donde se realizó un estudio crítico del estado de la investigación educativa en general y su práctica tradicional en la escuela latinoamericana; se trató de una investigación de tipo analítica e interpretativa - crítica de la obra de autores seleccionados y de experiencias practicas llevadas a cabo. El artículo en cuestión tiene como propósito contribuir a la discusión y reflexión sobre este importante tema, en el marco de la crisis de paradigmas de las ciencias sociales y frente a la asunción de nuevas perspectivas teóricas que tienen entre sus premisas la reivindicación de lo humano y cualitativo en la búsqueda del conocimiento de lo social y educativo..Abstract: The present article is part of the results of a research, a critical study of the state of the educational research and the traditional practice of the same one in the Latin American. The article in question has as purpose to contribute to the discussion and reflection on this important topic, in the mark of the crisis of paradigms of the social sciences and in front of the assumption of theoretical new perspectives that you/they have among its premises the recovery of the human and qualitative in the search of the knowledge of the social and educational.

  16. The Challenge in Diagnosis and Current Treatment of Chronic Thromboembolic Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Anggoro Budi Hartopo

    2017-04-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is currently underdiagnosis and consequently undertreatment in the clinical practice. A deficient in diagnostic modality and treatment availability especially in developing countries makes the CTEPH diagnosis unlikely to confirm. However, high index of clinical suspicion of CTEPH will lead to proper diagnosis and correct treatment  with significant reduction in morbidity and mortality. Left untreated, the mean survival time is 6.8 years and the three year mortality rate may be as high as 90 %. The pathophysiology, diagnosis and treatment of CTEPH are necessary to be shared among internists and primary care physicians, in order to improve the overall outcome of the patients.

  17. The European mountain cryosphere: a review of its current state, trends, and future challenges

    Science.gov (United States)

    Beniston, Martin; Farinotti, Daniel; Stoffel, Markus; Andreassen, Liss M.; Coppola, Erika; Eckert, Nicolas; Fantini, Adriano; Giacona, Florie; Hauck, Christian; Huss, Matthias; Huwald, Hendrik; Lehning, Michael; López-Moreno, Juan-Ignacio; Magnusson, Jan; Marty, Christoph; Morán-Tejéda, Enrique; Morin, Samuel; Naaim, Mohamed; Provenzale, Antonello; Rabatel, Antoine; Six, Delphine; Stötter, Johann; Strasser, Ulrich; Terzago, Silvia; Vincent, Christian

    2018-03-01

    The mountain cryosphere of mainland Europe is recognized to have important impacts on a range of environmental processes. In this paper, we provide an overview on the current knowledge on snow, glacier, and permafrost processes, as well as their past, current, and future evolution. We additionally provide an assessment of current cryosphere research in Europe and point to the different domains requiring further research. Emphasis is given to our understanding of climate-cryosphere interactions, cryosphere controls on physical and biological mountain systems, and related impacts. By the end of the century, Europe's mountain cryosphere will have changed to an extent that will impact the landscape, the hydrological regimes, the water resources, and the infrastructure. The impacts will not remain confined to the mountain area but also affect the downstream lowlands, entailing a wide range of socioeconomical consequences. European mountains will have a completely different visual appearance, in which low- and mid-range-altitude glaciers will have disappeared and even large valley glaciers will have experienced significant retreat and mass loss. Due to increased air temperatures and related shifts from solid to liquid precipitation, seasonal snow lines will be found at much higher altitudes, and the snow season will be much shorter than today. These changes in snow and ice melt will cause a shift in the timing of discharge maxima, as well as a transition of runoff regimes from glacial to nival and from nival to pluvial. This will entail significant impacts on the seasonality of high-altitude water availability, with consequences for water storage and management in reservoirs for drinking water, irrigation, and hydropower production. Whereas an upward shift of the tree line and expansion of vegetation can be expected into current periglacial areas, the disappearance of permafrost at lower altitudes and its warming at higher elevations will likely result in mass movements

  18. Current challenges facing the assessment of the allergenic capacity of food allergens in animal models

    DEFF Research Database (Denmark)

    Bøgh, Katrine Lindholm; van Bilsen, Jolanda; Głogowski, Robert

    2016-01-01

    of novel food proteins. There is no doubt that robust and reliable animal models for the identification and characterization of food allergens would be valuable tools for safety assessment. However, although various animal models have been proposed for this purpose, to date, none have been formally...... validated as predictive and none are currently suitable to test the allergenic potential of new foods. Here, the design of various animal models are reviewed, including among others considerations of species and strain, diet, route of administration, dose and formulation of the test protein, relevant...

  19. E-waste management challenges in Iran: presenting some strategies for improvement of current conditions.

    Science.gov (United States)

    Taghipour, Hassan; Nowrouz, Parviz; Jafarabadi, Mohamad Asghari; Nazari, Jalil; Hashemi, Ahmad Asl; Mosaferi, Mohammad; Dehghanzadeh, Reza

    2012-11-01

    E-waste is one of the fastest-growing waste streams in Iran, owing to an increase in consumption of electrical and electronic equipment. Nevertheless, as is the case in some other countries, E-waste management has not received sufficient attention. For the successful implementation of any waste management plan (including an E-waste management plan), the availability of sufficient and accurate information on the quantities and composition of the waste generated and on current management conditions is a fundamental prerequisite. At present, in Iran, there is no available and accurate information that describes the characteristics and generation rate of E-waste or the actual practice of management and handling of the waste. For this initial study, eight electronic products were selected for the determination of their E-waste generation rate in the country, and two cities, Tehran and Tabriz, were selected for assessment of the current condition of E-waste management. The study found that the amount of E-waste generation in the country for the eight selected electronic items alone was 115,286, 112,914 and 115,151 metric tons in 2008, 2009 and 2010, respectively. Of the types of electronic items included in the study, televisions, with an average of 42.42%, and PCs, with an average of 32.66% accounted for the greatest proportions of the total mass of E-waste generated during 2008-2010. Currently, despite the fact that primary legislation for E-waste management (as part of general waste legislation) exists in Iran, this primary legislation has not yet been implemented. In practical terms, there is no definite policy or plan for the allocation of funds to prepare suitable equipment and facilities for the management and recycling of E-waste at the end of the products' useful life. Proposed improvements in current conditions are identified, first by considering other countries' experiences and then suggesting specific practical policies, rules, and regulations that should be

  20. Content knowledge development in a chemistry teacher preparation program: A current potentials and challenges

    Science.gov (United States)

    Widhiyanti, Tuszie; Treagust, David F.; Mocerino, Mauro; Vishnumolakala, Venkat

    2017-08-01

    One of the essential facets in teacher education program is the development of the teachers' content knowledge and it has been suggested by many scholars that the study to analyse the process of content knowledge development in teacher education program is necessary. Regarding this, the aim of this research is to evaluate the existing program of developing pre-service chemistry teachers' content knowledge, especially in the topic about the particulate nature of matter. The curriculum of content knowledge development was analysed using the forms of the curriculum evaluation (Akker, 1998; Goodlad, Klein, and Tye (1979); Treagust, 1987). Within this framework, the curriculum was evaluated in several aspects including the vision and intention of the curriculum as mentioned in the curriculum documents (intended curriculum), the users' interpretation and perception about the curriculum (perceived curriculum), the actual process of curriculum implementation (implemented curriculum), and the outcomes of the curriculum (achieved curriculum). According to the framework used for this study, the research combined qualitative and quantitative methods of data collection and the interpretation including document analysis, classroom observation, interviews, and two-tier diagnostic test. Through this research we examined the coherence among those aspects. The results reveal that although the content knowledge development is explicitly intended in a curriculum, its implementation and lecturers' perceptions give influence in the results as appear in pre-service teachers' achievements. In general, this research provides basic information about the effectiveness of the program including the challenges and the potentials for a reconsideration of the program in the future.

  1. MicroRNAs as biomarkers for liver injury: Current knowledge, challenges and future prospects.

    Science.gov (United States)

    Lin, Haixia; Ewing, Laura E; Koturbash, Igor; Gurley, Bill J; Miousse, Isabelle R

    2017-12-01

    MicroRNAs (miRNAs) are short regulatory RNAs that are involved in various biological processes that regulate gene expression posttranscriptionally. Changes in miRNA expression can be detected in many physiological and pathological events, such as liver injury. Drug induced liver injury is a life threatening condition that frequently requires organ transplantation. Hepatotoxicity is also one of the major causes of drug failure in clinical trials and of drug withdrawal from the market. The profiling of miRNA expression shows great promise in monitoring liver injury, in the prediction of outcome in patients, and in the identification of liver-reactive compounds in toxicological assessment. Recent studies have demonstrated organ-specificity of some miRNAs (i.e., miR-122), which are released into biological fluids as a result of hepatocyte damage. This attests to the potential of miRNAs as noninvasive biomarkers to detect liver toxicity. This review presents information on miRNA signatures of hepatotoxicity and on the application of promising miRNA biomarkers in preclinical safety assessment. We further discuss the technical challenges associated with these emerging biomarkers for early diagnosis and detection of hepatotoxicity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Safeguards and non-proliferation: current challenges and the implications for Australia

    International Nuclear Information System (INIS)

    Leask, A.; Carlson, J.

    2006-01-01

    Full text: The expansion of nuclear programs raises the issue of how to ensure this does not increase the risk of nuclear weapons proliferation. The non-proliferation regime - based on the NPT and its verification mechanism, the IAEA safeguards system - has been developed to provide assurance that nuclear programs are exclusively peaceful. Although to date the non-proliferation regime has been remarkably successful, in recent years it has come under serious challenge. Nuclear proliferation is emerging as one of the major issues facing the international community. Addressing technical and institutional aspects of the non-proliferation regime - especially safeguards, but also complementary measures such as export controls, proliferation-resistant technology, and an international framework on sensitive technology - is important. But proliferation is a political problem, and ultimately the success of the non-proliferation regime depends on political resolve to uphold compliance, using incentives and if necessary sanctions. These issues are vitally important to Australia's future. Being a major uranium supplier has strengthened Australia's influence in non-proliferation and safeguards developments

  3. Current scenario of the wind energy in Pakistan challenges and future perspectives: A case study

    Directory of Open Access Journals (Sweden)

    Mazhar H. Baloch

    2016-11-01

    Full Text Available Electricity plays an important role in the socioeconomic growth and social prosperity of any country. It is to be considered as the basic need for human development. Nowadays, low production of electricity is a serious problem in Pakistan, which directly restricts the development of the state. One-third of Pakistan’s population does not have any electricity in the rural areas and about 10–12 hours load shedding in urban areas and is quite common. Although, the state of Pakistan always shows a deficit in the conventional resources, but no progress was also being made in the renewable resources such as the wind and solar energy. Therefore, it is better to utilize these natural assets in order to fulfill the electricity supply the country. In this manuscript, our main objective is to study and outlooks the country energy profile situation vis-à-vis wind energy potential characteristics of the most important wind corridor in the southern part of the country. Pakistan has around 1100 kilometers (km coastal line for the wind energy potential, but in this manuscript, we have chosen one of the most suitable wind corridors of the southern part of the country. We also tried to prove theoretically that this wind zone is more favorable for country consumer demand. Moreover, future perspective and the major challenges during windmill implementation is also being discussed herein.

  4. Towards Comparison of Ultrasound Dose Measurements - Current Capabilities and Open Challenges

    Science.gov (United States)

    Durando, G.; Guglielmone, C.; Haller, J.; Georg, O.; Shaw, A.; Martin, E.; Karaböce, B.

    The aim of this work is to evaluate measurement methods for dosimetry and exposimetry quantities that were developed in the EMRP project "Dosimetry for Ultrasound Therapy -DUTy" by comparing the measurement results for three common quantities from three national laboratories. It further aims to investigate the general feasibility of possible future (key) comparisons for dosimetry and exposimetry quantities and to identify possible open challenges towards this goal. The general format is similar to a metrological comparison, with which the National Metrological Institutes, NMIs, are already familiar. The first step involved the agreement of the protocol that was to specify the set of transducers to be circulated and the measurement conditions. Two transducers were circulated and different drive voltage levels and pulsing regimes were defined and tissue mimicking materials (TMMs) characteristics were specified. Each lab was asked to prepare the TMMs for their own measurements with the inclusion of formulations and preparation instructions specified in the protocol. Uncertainties of the input data were to be declared by the participating laboratories.

  5. The impact of climate change on food security in South Africa: Current realities and challenges ahead

    Directory of Open Access Journals (Sweden)

    Tshepo S. Masipa

    2017-08-01

    Full Text Available This article aims to examine the impact of climate change on food security in South Africa. For this purpose, the article adopted a desktop study approach. Previous studies, reports, surveys and policies on climate change and food (insecurity. From this paper’s analysis, climate change presents a high risk to food security in sub-Saharan countries from crop production to food distribution and consumption. In light of this, it is found that climate change, particularly global warming, affects food security through food availability, accessibility, utilisation and affordability. To mitigate these risks, there is a need for an integrated policy approach to protect the arable land against global warming. The argument advanced in this article is that South Africa’s ability to adapt and protect its food items depends on the understanding of risks and the vulnerability of various food items to climate change. However, this poses a challenge in developing countries, including South Africa, because such countries have weak institutions and limited access to technology. Another concern is a wide gap between the cost of adapting and the necessary financial support from the government. There is also a need to invest in technologies that will resist risks on food systems.

  6. Airborne biological hazards and urban transport infrastructure: current challenges and future directions.

    Science.gov (United States)

    Nasir, Zaheer Ahmad; Campos, Luiza Cintra; Christie, Nicola; Colbeck, Ian

    2016-08-01

    Exposure to airborne biological hazards in an ever expanding urban transport infrastructure and highly diverse mobile population is of growing concern, in terms of both public health and biosecurity. The existing policies and practices on design, construction and operation of these infrastructures may have severe implications for airborne disease transmission, particularly, in the event of a pandemic or intentional release of biological of agents. This paper reviews existing knowledge on airborne disease transmission in different modes of transport, highlights the factors enhancing the vulnerability of transport infrastructures to airborne disease transmission, discusses the potential protection measures and identifies the research gaps in order to build a bioresilient transport infrastructure. The unification of security and public health research, inclusion of public health security concepts at the design and planning phase, and a holistic system approach involving all the stakeholders over the life cycle of transport infrastructure hold the key to mitigate the challenges posed by biological hazards in the twenty-first century transport infrastructure.

  7. Important hemoprotozoan diseases of livestock: Challenges in current diagnostics and therapeutics: An update

    Directory of Open Access Journals (Sweden)

    Biswa Ranjan Maharana

    2016-05-01

    Full Text Available Hemoprotozoan parasites pose a serious threat to the livestock population in terms of mortality, reduced milk yield and lowered draft power. Diagnosis of these diseases often poses a challenging task. Needless to say that impact of disease in health and productivity is huge though a fair economic assessment on the quantum of economic loss associated is yet to be worked out from India. The diagnosis of hemoprotozoan infections largely depends on various laboratory-based diagnostic methods as the clinical manifestations are often inconspicuous and non-specific. Traditional diagnostic methods rely on microscopical demonstration of infective stages in blood or tissue fluids. However, it is laborious, lesser sensitive, and cannot differentiate between morphologically similar organisms. Recent development in the technologies has opened new avenues for improvement in the accurate diagnosis of parasitic infections. Serological tests are simple, fast but lack specificity. With advent of molecular techniques, as DNA hybridization assays, polymerase chain reaction and its modifications ensure the detection of infection in the latent phase of the disease. Nucleic acid-based assays are highly sensitive, free from immunocompetence and can differentiate between morphologically similar parasites. With the advent of newer diagnostics complemented with traditional ones will be of huge help for targeted selective treatment with better chemotherapeutic agents.

  8. Interactions between biomass-burning aerosols and clouds over Southeast Asia: current status, challenges, and perspectives.

    Science.gov (United States)

    Lin, Neng-Huei; Sayer, Andrew M; Wang, Sheng-Hsiang; Loftus, Adrian M; Hsiao, Ta-Chih; Sheu, Guey-Rong; Hsu, N Christina; Tsay, Si-Chee; Chantara, Somporn

    2014-12-01

    The interactions between aerosols, clouds, and precipitation remain among the largest sources of uncertainty in the Earth's energy budget. Biomass-burning aerosols are a key feature of the global aerosol system, with significant annually-repeating fires in several parts of the world, including Southeast Asia (SEA). SEA in particular provides a "natural laboratory" for these studies, as smoke travels from source regions downwind in which it is coupled to persistent stratocumulus decks. However, SEA has been under-exploited for these studies. This review summarizes previous related field campaigns in SEA, with a focus on the ongoing Seven South East Asian Studies (7-SEAS) and results from the most recent BASELInE deployment. Progress from remote sensing and modeling studies, along with the challenges faced for these studies, are also discussed. We suggest that improvements to our knowledge of these aerosol/cloud effects require the synergistic use of field measurements with remote sensing and modeling tools. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Molecular Biosensors for Electrochemical Detection of Infectious Pathogens in Liquid Biopsies: Current Trends and Challenges.

    Science.gov (United States)

    Campuzano, Susana; Yáñez-Sedeño, Paloma; Pingarrón, José Manuel

    2017-11-03

    Rapid and reliable diagnosis of infectious diseases caused by pathogens, and timely initiation of appropriate treatment are critical determinants to promote optimal clinical outcomes and general public health. Conventional in vitro diagnostics for infectious diseases are time-consuming and require centralized laboratories, experienced personnel and bulky equipment. Recent advances in electrochemical affinity biosensors have demonstrated to surpass conventional standards in regards to time, simplicity, accuracy and cost in this field. The tremendous potential offered by electrochemical affinity biosensors to detect on-site infectious pathogens at clinically relevant levels in scarcely treated body fluids is clearly stated in this review. The development and application of selected examples using different specific receptors, assay formats and electrochemical approaches focusing on the determination of specific circulating biomarkers of different molecular (genetic, regulatory and functional) levels associated with bacterial and viral pathogens are critically discussed. Existing challenges still to be addressed and future directions in this rapidly advancing and highly interesting field are also briefly pointed out.

  10. Leisure travel. Current and future challenges and chances; Freizeitverkehr. Aktuelle und kuenftige Herausforderungen und Chancen

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    Leisure travel increases more and more which is proved by forcasts. Nevertheless unlimited growth can not be left to its own in an environment of limited resources. Before society is ruled by restrictions and limitations of political inventions, all creation possibilities should be exhausted to ensure individual mobility for a long time. Experts from policy, science and economy discussed in this meeting on the present situation, challenges in future and also possible strategies. This book gives a comprehensive overview on essential contributions, results and conclusions. [German] Der Freizeitverkehr weist seit laengerem unvermindert steigende Zuwachsraten auf. Alle Prognosen deuten darauf hin, dass dies auch in Zukunft so bleiben wird. Allerdings kann unbegrenztes Wachstum in einem Umfeld begrenzter Ressourcen nicht sich selbst ueberlassen werden. Bevor aber der Gesellschaft Einschraenkungen und Begrenzungen in Form ordnungspolitischer Interventionen auferlegt werden, sollten alle Gestaltungsmoeglichkeiten zur langfristigen Sicherung der individuellen Mobilitaet ausgeschoepft sein. Im Rahmen einer Konferenz mit Experten aus Politik, Wissenschaft und Wirtschaft wurden diesbezueglich sowohl die gegenwaertige Situation als auch kuenftige Herausforderungen und moegliche Strategien diskutiert. Dieses Buch gibt einen umfassenden Ueberblick ueber die wesentlichen Beitraege, Ergebnisse und Schlussfolgerungen. (orig.)

  11. Phytoextraction of Cd-Contaminated Soils: Current Status and Future Challenges.

    Science.gov (United States)

    Li, Jin-Tian; Baker, Alan J M; Ye, Zhi-Hong; Wang, Hong-Bin; Shu, Wen-Sheng

    2012-10-01

    Cadmium (Cd) is one of the most toxic and widely distributed pollutants in the environment. Cadmium contamination of soils has posed a serious threat to safe food production in many parts of the world. The authors present a comprehensive review of present status of phytoextraction technology for cleaning up Cd-contaminated soils, based primarily on the data resulting from both laboratory and field-scale studies that have been conducted to assess or improve the Cd phytoextraction potential of various plant species in the past decade. The encouraging results of field-scale studies have provided a fundamental basis to usher phytoextraction technology into practical use to remediate slightly to moderately Cd-contaminated soils in Europe and Asia, although this technology is not yet ready for widespread application. Chelators and microorganisms tested so far seem not to contribute to the applicability of Cd phytoextraction. The major challenges for the large-scale application of Cd phytoextraction are (a) how to further improve the efficiency of Cd phytoextraction, (b) how to cut the overall costs of Cd phytoextraction, and (c) how to get greater stakeholders' acceptance of Cd phytoextraction as a reliable option.

  12. Management of severe sepsis: advances, challenges, and current status

    Directory of Open Access Journals (Sweden)

    Martin-Loeches I

    2015-04-01

    Full Text Available Ignacio Martin-Loeches,1 Mitchell M Levy,2 Antonio Artigas31Multidisciplinary Intensive Care Research Organization (MICRO, St James’s University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland; 2Brown University, Providence, RI, USA; 3Critical Care Center, CIBER Enfermedades Respiratorias, Sabadell Hospital, Corporació Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Barcelona, SpainAbstract: The complexity of treating severe sepsis and septic shock has been elucidated in myriad studies, particularly in the past 10 years. The development of clinical guidelines, insight into the effect of bundle elements, and results of clinical trials have brought to light further opportunities and questions in the approach to pharmaceutical interventions for the global challenge to save lives and reduce healthcare costs. Therapeutic interventions including fluid resuscitation, hemodynamic monitoring, glycemic control, corticosteroids, and antimicrobial therapy and stewardship inform outcomes. Research on biomarkers, use of mesenchymal stem cells, blood purification, immunoglobulins, and antioxidative treatments apropos the immune response may soon yield viable therapies.Keywords: sepsis, septic shock, guidelines, critical care, biomarkers, surviving sepsis campaign

  13. [Anesthesia in obstetrics: Tried and trusted methods, current standards and new challenges].

    Science.gov (United States)

    Kranke, P; Annecke, T; Bremerich, D H; Hanß, R; Kaufner, L; Klapp, C; Ohnesorge, H; Schwemmer, U; Standl, T; Weber, S; Volk, T

    2016-01-01

    Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology. The topics are in particular, special features and pitfalls of informed consent in the delivery room, challenges in education and training in obstetric anesthesia, expedient inclusion of simulation-assisted training and further education on risk minimization, knowledge and recommendations on fasting for the delivery room and cesarean sections, monitoring in obstetric anesthesia by neuraxial and alternative procedures, the possibilities and limitations of using ultrasound for lumbal epidural catheter positioning in the delivery room, recommended approaches in preparing peridural catheters for cesarean section, basic principles of cardiotocography, postoperative analgesia after cesarean section, the practice of early bonding in the delivery room during cesarean section births and the management of postpartum hemorrhage.

  14. Current challenges for radiographers and following changes in the education and the qualification requirements

    International Nuclear Information System (INIS)

    Taneva, E.; Gagova, E.

    2006-01-01

    Full text: The communication is intended to present the new requisites for the activity of the X-ray laboratory assistant, laying changes in the educational background and the qualification of the respective medical specialists. The need of new knowledge and skills lead to changes in the competence of the X-ray laboratory assistants and call for urgent measures for updating the curriculum, programmes and exercises. The implementation of new technologies in the profession requires an education of new quality that complies with the needs of the health care in the country and harmonizing it with the requirements of the European Union. Having made an analysis of the education so far and comparing its condition with that of the leading European countries we came to the conclusion that not only the contents of the education should be changed, but also the teaching hours and the qualification of the X-ray laboratory assistants. Knowing the new realities and challenges in the health care system, the professors of the medical colleges and the health specialists are aware of the need to introduce changes in the medical practice and work together for its implementation

  15. THE ECONOMIC AND SOCIAL COORDINATES OF DEVELOPING A SPORT ENTREPRENEURSHIP INDEX – CURRENT CHALLENGES AND PREREQUISITES

    Directory of Open Access Journals (Sweden)

    MUNTEANU SEBASTIAN MADALIN

    2015-07-01

    Full Text Available Focussing on the consideration of the multivariate relationship between sport and economics, the present study is based on the sport potential of supporting economic growth through the enhancement of the relatively new domain of “sport entrepreneurship”. The brief revision of the specialized literature regarding the development of sport entrepreneurship in general terms is followed by a series of fundamental factors for the innovative proposal of a sport entrepreneurship index (SEI in the European Union member countries. The methodological issues concerning the structure of the index represent the main novelty aspect of this research, which aims to be a prerequisite of a future thorough analysis regarding the micro- and macro-economic implications of developing a sport entrepreneurship index (SEI in EU countries. The main identified challenge is a scientific one and it resides in the summative assessment of the elements representing entrepreneurship, sport and culture in the SEI, whereas the necessity of determining such an index appears because of economic and social reasons.

  16. Meeting report: Ocean ‘omics science, technology and cyberinfrastructure: current challenges and future requirements (August 20-23, 2013)

    Science.gov (United States)

    Gilbert, Jack A; Dick, Gregory J.; Jenkins, Bethany; Heidelberg, John; Allen, Eric; Mackey, Katherine R. M.

    2014-01-01

    The National Science Foundation’s EarthCube End User Workshop was held at USC Wrigley Marine Science Center on Catalina Island, California in August 2013. The workshop was designed to explore and characterize the needs and tools available to the community that is focusing on microbial and physical oceanography research with a particular emphasis on ‘omic research. The assembled researchers outlined the existing concerns regarding the vast data resources that are being generated, and how we will deal with these resources as their volume and diversity increases. Particular attention was focused on the tools for handling and analyzing the existing data, on the need for the construction and curation of diverse federated databases, as well as development of shared, interoperable, “big-data capable” analytical tools. The key outputs from this workshop include (i) critical scientific challenges and cyber infrastructure constraints, (ii) the current and future ocean ‘omics science grand challenges and questions, and (iii) data management, analytical and associated and cyber-infrastructure capabilities required to meet critical current and future scientific challenges. The main thrust of the meeting and the outcome of this report is a definition of the ‘omics tools, technologies and infrastructures that facilitate continued advance in ocean science biology, marine biogeochemistry, and biological oceanography. PMID:25197495

  17. Meeting report: Ocean 'omics science, technology and cyberinfrastructure: current challenges and future requirements (August 20-23, 2013).

    Science.gov (United States)

    Gilbert, Jack A; Dick, Gregory J; Jenkins, Bethany; Heidelberg, John; Allen, Eric; Mackey, Katherine R M; DeLong, Edward F

    2014-06-15

    The National Science Foundation's EarthCube End User Workshop was held at USC Wrigley Marine Science Center on Catalina Island, California in August 2013. The workshop was designed to explore and characterize the needs and tools available to the community that is focusing on microbial and physical oceanography research with a particular emphasis on 'omic research. The assembled researchers outlined the existing concerns regarding the vast data resources that are being generated, and how we will deal with these resources as their volume and diversity increases. Particular attention was focused on the tools for handling and analyzing the existing data, on the need for the construction and curation of diverse federated databases, as well as development of shared, interoperable, "big-data capable" analytical tools. The key outputs from this workshop include (i) critical scientific challenges and cyber infrastructure constraints, (ii) the current and future ocean 'omics science grand challenges and questions, and (iii) data management, analytical and associated and cyber-infrastructure capabilities required to meet critical current and future scientific challenges. The main thrust of the meeting and the outcome of this report is a definition of the 'omics tools, technologies and infrastructures that facilitate continued advance in ocean science biology, marine biogeochemistry, and biological oceanography.

  18. Electroplated reticulated vitreous carbon current collectors for lead-acid batteries: opportunities and challenges

    Science.gov (United States)

    Gyenge, Elod; Jung, Joey; Mahato, Basanta

    Reticulated, open-cell structures based on vitreous carbon substrates electroplated with a Pb-Sn (1 wt.%) alloy were investigated as current collectors for lead-acid batteries. Scanning and backscattered electron microscopy, cyclic voltammetry, anodic polarization and flooded 2 V single-cell battery testing was employed to characterize the performance of the proposed collectors. A battery equipped with pasted electroplated reticulated vitreous carbon (RVC) electrodes of 137 cm 2 geometric area, at the time of manuscript submission, completed 500 cycles and over 1500 h of continuous operation. The cycling involved discharges at 63 A kg PAM-1 corresponding to a nominal 0.75 h rate and a positive active mass (PAM) utilization efficiency of 21%. The charging protocol was composed of two voltage limited (i.e. 2.6 V/cell), constant current steps of 35 and 9.5 A kg PAM-1, respectively, with a total duration of about 2 h. The charge factor was 1.05-1.15. The observed cycling behavior in conjunction with the versatility of electrodeposition to produce application-dependent optimized lead alloy coating thickness and composition shows promise for the development of lead-acid batteries using electroplated reticulated vitreous carbon collectors.

  19. Challenging the current strategy of radiological protection of the environment: arguments for an ecosystem approach

    International Nuclear Information System (INIS)

    Brechignac, F.; Doi, Masahiro

    2009-01-01

    The system of radiological protection of the environment that is currently under development is one contribution to the general need to adequately protect the environment against stress. Dominated by operational goals, it emphasizes conceptual and methodological approaches that are readily accessible today: reference organisms supported by individual-based traditional ecotoxicological data. Whilst there are immediate advantages to this approach (pragmatism, consistency with other approaches in use for man and biota), there are also clear limitations, especially in a longer run perspective, that need to be acknowledged and further considered. One can mention a few: uncertainties generated by the need for various extrapolations (from lower to higher levels of biological organisation, ...), various features missed such as potential ecological impact through impairment of ecosystem processes, trans-generational impacts as mediated through genomic instability, indirect effects mediated through trophic interactions or disruption of ecological balances, ... Such limitations have already been faced in other fields of environmental protection against other stressors, pushing a number of environment professionals to assign stronger emphasis on more systemic approaches. This review discusses the advantages and limitations of the current approach designed for the radiological protection of non-human biota in the broader context of environment protection as a whole, with especial reference to upcoming trends and evolutions. This leads in particular to advocating the need to boost scientific and methodological approaches featuring the ecosystem concept as a mean to access a unified goal of protection: preserving life sustainability through protection of ecosystem structure and functioning.

  20. Challenging the current strategy of radiological protection of the environment: arguments for an ecosystem approach

    Energy Technology Data Exchange (ETDEWEB)

    Brechignac, F., E-mail: francois.brechignac@irsn. [Institute for Radioprotection and Nuclear Safety (IRSN), Centre d' Etudes de Cadarache, Blg 229, 13115 Saint-Paul-lez-Durance (France); Doi, Masahiro [National Institute of Radiological Sciences, NIRS, Center for Radiation Protection, Regulatory Sciences Research Group, 4-9-1, Anagawa, Inage, Chiba, 263-8555 (Japan)

    2009-12-15

    The system of radiological protection of the environment that is currently under development is one contribution to the general need to adequately protect the environment against stress. Dominated by operational goals, it emphasizes conceptual and methodological approaches that are readily accessible today: reference organisms supported by individual-based traditional ecotoxicological data. Whilst there are immediate advantages to this approach (pragmatism, consistency with other approaches in use for man and biota), there are also clear limitations, especially in a longer run perspective, that need to be acknowledged and further considered. One can mention a few: uncertainties generated by the need for various extrapolations (from lower to higher levels of biological organisation, ...), various features missed such as potential ecological impact through impairment of ecosystem processes, trans-generational impacts as mediated through genomic instability, indirect effects mediated through trophic interactions or disruption of ecological balances, ... Such limitations have already been faced in other fields of environmental protection against other stressors, pushing a number of environment professionals to assign stronger emphasis on more systemic approaches. This review discusses the advantages and limitations of the current approach designed for the radiological protection of non-human biota in the broader context of environment protection as a whole, with especial reference to upcoming trends and evolutions. This leads in particular to advocating the need to boost scientific and methodological approaches featuring the ecosystem concept as a mean to access a unified goal of protection: preserving life sustainability through protection of ecosystem structure and functioning.

  1. Mathematical models of blast induced TBI: current status, challenges and prospects

    Directory of Open Access Journals (Sweden)

    Raj K Gupta

    2013-05-01

    Full Text Available Blast induced traumatic brain injury (TBI has become a signature wound of recent military activities and is the leading cause of death and long-term disability among U.S. soldiers. The current limited understanding of brain injury mechanisms impedes the development of protection, diagnostic and treatment strategies. We believe mathematical models of blast wave brain injury biomechanics and neurobiology, complemented with in vitro and in vivo experimental studies, will enable a better understanding of injury mechanisms and accelerate the development of both protective and treatment strategies. The goal of this paper is to review the current state of the art in mathematical and computational modeling of blast induced TBI, identify research gaps and recommend future developments. A brief overview of blast wave physics, injury biomechanics and the neurobiology of brain injury is used as a foundation for a more detailed discussion of multiscale mathematical models of primary biomechanics and secondary injury and repair mechanisms. The paper also presents a discussion of model development strategies, experimental approaches to generate benchmark data for model validation and potential applications of the model for prevention and protection against blast wave TBI.

  2. Old Disease and New Challenges: Major Obstacles of Current Strategies in the Prevention of Pertussis

    Science.gov (United States)

    Sedighi, Iraj; Karimi, Abdollah; Amanati, Ali

    2016-01-01

    Context Universal immunization against Bordetella pertussis has partially controlled the burden of the disease and its transmission. However, according to recent data, the epidemiology of this vaccine-preventable disease has changed. Now, younger infants, adolescents, and adults are at greater risk of infection. This article has studied the interaction between the various factors involved in the changing epidemiology of pertussis and the major obstacles faced by the current strategies in its prevention. Evidence Acquisition In this narrative review, the most recently published sources of information on pertussis control measures, consisting of textbooks and articles, have been reviewed. We focused on the more recent data about the changing epidemiology or pertussis in Scopus through the use of the MeSH-term words [pertussis] or [whooping cough] and [epidemiology] or [outbreak] or [resurgence], but our search was not restricted to this particular strategy; we also tried to find all of the most recent available data in the general field through other means. Results Primary and booster doses of the pertussis vaccine seem to partially control transmission of the disease, but despite the different preventive strategies available, pertussis continues to cause mortality and morbidity among high-risk groups. Conclusions Adding booster doses of acellular pertussis vaccine to the current national immunization practices with whole-cell vaccines for young adults and pregnant women seems to be a good option for controlling mortality and morbidity among high-risk groups such as very young infants. PMID:27729960

  3. The challenge and countermeasure for radioactivity monitor in ocean--the reflection derived from Fukushima nuclear power plant accident

    International Nuclear Information System (INIS)

    Liu Guangshan

    2014-01-01

    Environmental radioactivity monitor (ERM) follows with interest raising level, sink and transportation of radioactive materials in the environment. There are two kinds of challenges for marine radioactivity monitor (MRM), for which one concerned with facilities and methods that lead the very difficult measurement of MRM. Up to now, the bulk of sample must collected and prepared for most MRM by radiometry (counting method) and long acquisition period is needed. The long time from sampling to derived results postponed the time of the scientists and government officials learning contamination distribution information. Developing accelerator mass spectrometry (AMS) can overcome above difficulty because AMS method need one tenth of sample and one tenth measuring time needed by radiometric method. The second challenge is lack of the behavior research of radionuclide in the ocean. In the ocean, radionuclide behavior is constrained by physical and biogeochemical process, following that the radionuclides are transported from released sea area to where far from source area, from upper water to deep and bottom waters, and buried to sediment. There are some reports about radionuclide transportation with physical oceanographical process, but few paper about radionuclide biogeochemistry has been found. Lesser theory knowledge and lesser investigation data make scientists worked on MRM puzzling. The radionuclide behavior in the ocean can be studied by the method used in marine biogeochemistry. (author)

  4. Re-thinking reflection in supervision

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    The paper presents a socio-cultural perspective on supervision in professional education, which challenges the current reflective paradigm and move the debate on reflection in supervision in professional education and learning towards a recognition of context, power dynamics and ideological...... of reflective practice has been formalized by regulatory bodies as a way to develop the professionalism of both individual professional practitioners as students through continuing professional developmental processes. Consequently, reflection is often used as a `tool´ for personal and professional development...... al., 2010). This conceptual paper presents a critical, socio-cultural perspective on the current paradigm or dogma of reflective practice within supervision in professional education and learning. The purpose I to challenge the dogma and critically to analyze and move the debate on reflection...

  5. The Current Landscape of Genetic Testing in Cardiovascular Malformations: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Benjamin John Landis

    2016-07-01

    Full Text Available Human cardiovascular malformations (CVMs frequently have a genetic contribution. Through the application of novel technologies such as next generation sequencing, DNA sequence variants associated with CVMs are being identified at a rapid pace. While clinicians are now able to offer testing with next generation sequencing gene panels or whole exome sequencing to any patient with a CVM, the interpretation of genetic variation remains problematic. Variable phenotypic expression, reduced penetrance, inconsistent phenotyping methods, and the lack of high throughput functional testing of variants, contribute to these challenges. This article elaborates critical issues that impact the decision to broadly implement clinical molecular genetic testing in CVMs. Major benefits of testing include establishing a genetic diagnosis, facilitating cost-effective screening of family members who may have subclinical disease, predicting recurrence risk in offspring, enabling early diagnosis and anticipatory management of CV and non-CV disease phenotypes, predicting long term outcomes, and facilitating the development of novel therapies aimed at disease improvement or prevention. Limitations include financial cost, psychosocial cost, and ambiguity of interpretation of results. Multiplex families and patients with syndromic features are two groups where disease causation could potentially be firmly established. However, these account for the minority of the overall CVM population, and there is increasing recognition that genotypes previously associated with syndromes also exist in patients who lack non-CV findings. In all circumstances, ongoing dialogue between cardiologists and clinical geneticists will be needed to accurately interpret genetic testing and improve these patients’ health. This may be most effectively implemented by the creation and support of CV genetics services at centers committed to pursuing testing for patients.

  6. Distributed generation in European electricity markets. Current challenges and future opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Ropenus, S. (Technical Univ. of Denmark, Risoe National Lab. for Sustainable Energy. Systems Analysis Div., Roskilde (Denmark))

    2010-07-01

    This Ph.D. thesis studies the role of distributed generation in European electricity markets. It focuses primarily on the interactions of economics and policy with the aim of contributing to the understanding of how distributed generation is embedded in the present regulatory and market framework, which barriers exist, and which role it may possibly play in the future. To capture the interdisciplinarity of the topic, a combination of qualitative and quantitative methods is applied. Subsequent to the identification of barriers, this thesis turns to the microeconomic perspective on the interplay of vertical structure, regulation and distributed generation. This is done through the application of quantitative methods in the form of partial equilibrium models focusing on the effects induced by the vertical structure of the network operator, either a combined operator or a distribution system operator, in a market with small distributed producers. In areas where the promotion of renewable energy sources and combined heat and power has induced a substantial increase in distributed generation, new challenges in system integration arise. In particular, high levels of generation from intermittent energy sources, such as wind, add to the complexity of network operation and control, which can hardly be tackled with the present 'fit and forget' approach. The conclusion is that distributed generation has great potential to enhance competitiveness, sustainability and security of supply in European electricity markets. A prerequisite is the removal of market and regulatory barriers, taking the interdependencies of vertical structure, support mechanisms and network access into account. In the future, higher penetration levels of distributed generation necessitate changes in the power system and the adoption of new technologies, where hydrogen production by grid connected electrolysis constitutes one example. (LN)

  7. [Tracheal Intubation by Paramedics in a Local Community: Current Situation and Future Challenges].

    Science.gov (United States)

    Takinami, Yoshikazu

    2016-03-01

    As of April 2013, 164 paramedics are certified to perform tracheal intubation in Fukui Prefecture. This study investigated the current situation surrounding tracheal intubation performed by paramedics in prehospital care. Subjects were 58 paramedics who completed practical training at our hospital. Post-training duration, number of tracheal intubation cases, number of attempts before successful tracheal intubation, disease involved, rate of return of spontaneous circulation, and prognosis were examined. Tracheal intubation was successful on the first attempt in 92% of cases. Rate of return of spontaneous circulation was high in paramedics whose post-training duration was short. No return of spontaneous circulation occurred after a second attempt. Four patients survived asphyxia or aspiration. It is important to perform successful tracheal intubation on the first attempt, to recognize the probability of successful resuscitation in patients with exogenous disease, and to strengthen the medical control system.

  8. Combining Upper Limb Robotic Rehabilitation with Other Therapeutic Approaches after Stroke: Current Status, Rationale, and Challenges

    Directory of Open Access Journals (Sweden)

    Stefano Mazzoleni

    2017-01-01

    Full Text Available A better understanding of the neural substrates that underlie motor recovery after stroke has led to the development of innovative rehabilitation strategies and tools that incorporate key elements of motor skill relearning, that is, intensive motor training involving goal-oriented repeated movements. Robotic devices for the upper limb are increasingly used in rehabilitation. Studies have demonstrated the effectiveness of these devices in reducing motor impairments, but less so for the improvement of upper limb function. Other studies have begun to investigate the benefits of combined approaches that target muscle function (functional electrical stimulation and botulinum toxin injections, modulate neural activity (noninvasive brain stimulation, and enhance motivation (virtual reality in an attempt to potentialize the benefits of robot-mediated training. The aim of this paper is to overview the current status of such combined treatments and to analyze the rationale behind them.

  9. A mother cell-to-forespore channel: current understanding and future challenges.

    Science.gov (United States)

    Crawshaw, Adam D; Serrano, Mónica; Stanley, Will A; Henriques, Adriano O; Salgado, Paula S

    2014-09-01

    Formation of endospores allows some bacteria to survive extreme nutrient limitation. The resulting dormant cell, the spore, persists in the environment and is highly resistant to physical and chemical stresses. During spore formation, cells divide asymmetrically and the mother cell engulfs the developing spore, encasing it within a double membrane and isolating it from the medium. Communication between mother cell and isolated forespore involves a specialised connection system that allows nurturing of the forespore and continued macromolecular synthesis, required to finalise spore maturation. Here, we review current understanding of this feeding channel formed by a forespore protein, SpoIIQ, and a mother cell protein, SpoIIIAH, in the model organism Bacillus subtilis and the important human pathogen Clostridium difficile. We also analyse the presence of this channel across endospore-forming bacteria and highlight the main questions still remaining. © 2014 The Authors FEMS Microbiology Letters published by John Wiley & Sons Ltd on behalf of Federation of European Microbiological Societies.

  10. Internet use, misuse, and addiction in adolescents: current issues and challenges.

    Science.gov (United States)

    Greydanus, Donald E; Greydanus, Megan M

    2012-01-01

    The Internet has revolutionized education and social communication in the 21st century. This article reviews the growing literature identifying a number of adolescents and young adults with a pathologically excessive Internet use leading to many potential consequences. Current research dilemmas in this area include that Internet addiction is a broad topic with no standard definition and no standard measurement tools. Management of youth with identified problematic Internet use or misuse centers on behavioral therapy and treatment of comorbidities. Pharmacologic approaches are limited at this time but are undergoing research, such as use of opioid antagonists and antidepressants in adults with pathological gambling. Efforts should be expanded on not only the education of all adolescents regarding the benefits but also the potential negative consequences of Internet use. It is vital that we do this for Generation Z, whereas Generation ALPHA will soon benefit or suffer from our efforts in this regard today.

  11. Education for sustainability: A new challenge for the current university model

    Directory of Open Access Journals (Sweden)

    Ana Fernández Pérez

    2018-01-01

    Full Text Available Education for Sustainable Development aims to disseminate and promote a set of principles and values within the university model through management, teaching, research and university extension. It does not focus on a specific area but covers many areas such as equality, peace, health, sustainable urbanization, the environment. The objective of this study is to make an appeal in all these areas so that universities incorporate the dimension of sustainability in their curricula, through teaching, research and university management. For this, the different international and regional initiatives that have emphasized the need for Universities to be committed to the culture of sustainability and their inclusion in the current university model have been analyzed. The work will conclude with the idea that a sustainable development is perhaps one of the key pieces in the conception of the University of the 21st century.

  12. Current knowledge and pending challenges in zoonosis caused by Mycobacterium bovis: a review.

    Science.gov (United States)

    Pérez-Lago, Laura; Navarro, Yurena; García-de-Viedma, Darío

    2014-10-01

    Mycobacterium bovis is both the causative agent of bovine tuberculosis (TB) and a zoonotic pathogen. In humans, considerably fewer cases of TB are caused by M. bovis than M. tuberculosis; nevertheless, diagnostic limitations mean that currently available data on prevalence grossly underestimate the true dimension of the problem. The routes of transmission from animals to humans are well known and include direct exposure to infected animals or consumption of contaminated animal products. Application of fingerprinting tools facilitates analysis of the molecular epidemiology of M. bovis in animal-to-human and human-to-human transmission. Apart from cattle and M. bovis, other animal species and members within the M. tuberculosis complex can contribute to the zoonosis. Improvements in diagnostic techniques, application of more advanced discriminatory genotyping tools, and collaboration between veterinary and human health care researchers are key to our understanding of this zoonosis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Detectors for X-ray diffraction and scattering: current technology and future challenges

    International Nuclear Information System (INIS)

    Bahr, D.; Brugemann, L.; Gerndt, E.

    2003-01-01

    Full text: Detectors are crucial devices determining the quality, the reliability and the throughput of x-ray diffraction (XRD) and scattering investigations. This is of utmost importance in an industrial environment where in many cases untrained personnel or even without human intervention the experiments and data evaluations are running. The currently used technology of 0-dimensional to 2-dim XRD detectors is presented using selected examples. The application specific requirements on e.g. energy range and resolution, count rate limit, background and dynamic range, and size versus price are discussed. Due to the fact that x-ray diffraction investigations are becoming increasingly attractive in science, research and industry the advance in detector technology is pushed beyond existing limits. The discussion of the resultant market opportunities versus the cost of ownership and market entrance barrier is the final section of the presentation

  14. Chemical and molecular factors in irritable bowel syndrome: current knowledge, challenges, and unanswered questions.

    Science.gov (United States)

    Camilleri, Michael; Oduyebo, Ibironke; Halawi, Houssam

    2016-11-01

    Several chemical and molecular factors in the intestine are reported to be altered and to have a potentially significant role in irritable bowel syndrome (IBS), particularly in IBS with diarrhea. These include bile acids; short-chain fatty acids; mucosal barrier proteins; mast cell products such as histamine, proteases, and tryptase; enteroendocrine cell products; and mucosal mRNAs, proteins, and microRNAs. This article reviews the current knowledge and unanswered questions in the pathobiology of the chemical and molecular factors in IBS. Evidence continues to point to significant roles in pathogenesis of these chemical and molecular mechanisms, which may therefore constitute potential targets for future research and therapy. However, it is still necessary to address the interaction between these factors in the gut and to appraise how they may influence hypervigilance in the central nervous system in patients with IBS. Copyright © 2016 the American Physiological Society.

  15. Endpoints and cutpoints in head and neck oncology trials: methodical background, challenges, current practice and perspectives.

    Science.gov (United States)

    Hezel, Marcus; von Usslar, Kathrin; Kurzweg, Thiemo; Lörincz, Balazs B; Knecht, Rainald

    2016-04-01

    This article reviews the methodical and statistical basics of designing a trial, with a special focus on the process of defining and choosing endpoints and cutpoints as the foundations of clinical research, and ultimately that of evidence-based medicine. There has been a significant progress in the treatment of head and neck cancer in the past few decades. Currently available treatment options can have a variety of different goals, depending e.g. on tumor stage, among other factors. The outcome of a specific treatment in clinical trials is measured using endpoints. Besides classical endpoints, such as overall survival or organ preservation, other endpoints like quality of life are becoming increasingly important in designing and conducting a trial. The present work is based on electronic research and focuses on the solid methodical and statistical basics of a clinical trial, on the structure of study designs and on the presentation of various endpoints.

  16. Brucellosis in Sub-Saharan Africa: Current challenges for management, diagnosis and control.

    Science.gov (United States)

    Ducrotoy, M; Bertu, W J; Matope, G; Cadmus, S; Conde-Álvarez, R; Gusi, A M; Welburn, S; Ocholi, R; Blasco, J M; Moriyón, I

    2017-01-01

    Brucellosis is a highly contagious zoonosis caused by bacteria of the genus Brucella and affecting domestic and wild mammals. In this paper, the bacteriological and serological evidence of brucellosis in Sub-Saharan Africa (SSA) and its epidemiological characteristics are discussed. The tools available for the diagnosis and treatment of human brucellosis and for the diagnosis and control of animal brucellosis and their applicability in the context of SSA are presented and gaps identified. These gaps concern mostly the need for simpler and more affordable antimicrobial treatments against human brucellosis, the development of a B. melitensis vaccine that could circumvent the drawbacks of the currently available Rev 1 vaccine, and the investigation of serological diagnostic tests for camel brucellosis and wildlife. Strategies for the implementation of animal vaccination are also discussed. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  17. HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities.

    Science.gov (United States)

    Kharsany, Ayesha B M; Karim, Quarraisha A

    2016-01-01

    Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included.

  18. Protein Analysis in Human Cerebrospinal Fluid: Physiological Aspects, Current Progress and Future Challenges

    Directory of Open Access Journals (Sweden)

    Andreas F. Hühmer

    2006-01-01

    Full Text Available The introduction of lumbar puncture into clinical medicine over 100 years ago marks the beginning of the study of central nervous system diseases using the human cerebrospinal fluid (CSF. Ever since, CSF has been analyzed extensively to elucidate the physiological and biochemical bases of neurological disease. The proximity of CSF to the brain makes it a good target for studying the pathophysiology of brain functions, but the barrier function of the CSF also impedes its diagnostic value. Today, measurements to determine alterations in the composition of CSF are central in the differential diagnosis of specific diseases of the central nervous system (CNS. In particular, the analysis of the CSF protein composition provides crucial information in the diagnosis of CNS diseases. This enables the assessment of the physiology of the blood-CSF barrier and of the immunology of intrathecial responses. Besides those routine measurements, protein compositional studies of CSF have been extended recently to many other proteins in the expectation that comprehensive analysis of lower abundance CSF proteins will lead to the discovery of new disease markers. Disease marker discovery by molecular profiling of the CSF tissue has the enormous potential of providing many new disease relevant molecules. New developments in protein profiling techniques hold promise for the discovery and validation of relevant disease markers. In this review, we summarize the current efforts and progress in CSF protein profiling measurements using conventional and current protein analysis tools. We also discuss necessary development in methodology in order to have the highest impact on the study of the molecular composition of CSF proteins.

  19. Past challenges faced: An overview of current educational activities of IUTOX

    International Nuclear Information System (INIS)

    Dybing, Erik; MacGregor, Judith; Malmfors, Torbjoern; Chipman, J. Kevin; Wright, Paul

    2005-01-01

    Over the past decade, educational programmes have been the main focus of the activities of the International Union of Toxicology (IUTOX). The IUTOX educational programmes are dynamic and have been growing in scope and frequency each year. It is envisaged that this growth will continue with guidance from our member societies and the continuing support of our sponsors. Presently, IUTOX is engaged in the following educational programmes: (1) International congresses that provide the opportunity for direct communication of current toxicological information. Fellowships are sponsored to facilitate attendance at these congresses for toxicologists in need. (2) Workshops that permit interaction on a more localised level of topics of more regional interest. Workshops have served to help stimulate formation of toxicology societies by bringing together sufficient scientists to facilitate these discussions. (3) Continuing educational (CE) programmes at member society meetings. Topics are prioritised based on input received from the local societies. Programmes often are those from CE courses given at meetings, such as conferences of the US Society of Toxicology (US SOT) and EUROTOX from the previous year. (4) Biennial Risk Assessment Summer School (RASS), an intensive week-long interaction between senior toxicologists who serve as faculty with attendees providing individual training. (5) Dissemination of donated printed toxicological books from publishers and syllabi from continuing education courses to regional locations. (6) Web-based interactive training programmes in regions where formal toxicological educational programmes are limited or lacking. (7) Preparation and distribution of monographs on selected topics of very current interest. Monographs on environmental oestrogens and genetically-modified foods have been published. The recent activities in each of these programmes are reviewed in this paper

  20. HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities

    Science.gov (United States)

    Kharsany, Ayesha B.M.; Karim, Quarraisha A.

    2016-01-01

    Global trends in HIV infection demonstrate an overall increase in HIV prevalence and substantial declines in AIDS related deaths largely attributable to the survival benefits of antiretroviral treatment. Sub-Saharan Africa carries a disproportionate burden of HIV, accounting for more than 70% of the global burden of infection. Success in HIV prevention in sub-Saharan Africa has the potential to impact on the global burden of HIV. Notwithstanding substantial progress in scaling up antiretroviral therapy (ART), sub-Saharan Africa accounted for 74% of the 1.5 million AIDS related deaths in 2013. Of the estimated 6000 new infections that occur globally each day, two out of three are in sub-Saharan Africa with young women continuing to bear a disproportionate burden. Adolescent girls and young women aged 15-24 years have up to eight fold higher rates of HIV infection compared to their male peers. There remains a gap in women initiated HIV prevention technologies especially for women who are unable to negotiate the current HIV prevention options of abstinence, behavior change, condoms and medical male circumcision or early treatment initiation in their relationships. The possibility of an AIDS free generation cannot be realized unless we are able to prevent HIV infection in young women. This review will focus on the epidemiology of HIV infection in sub-Saharan Africa, key drivers of the continued high incidence, mortality rates and priorities for altering current epidemic trajectory in the region. Strategies for optimizing the use of existing and increasingly limited resources are included. PMID:27347270

  1. HIV/AIDS in sub-Saharan Africa: Current status, challenges and prospects

    Directory of Open Access Journals (Sweden)

    Nweze Justus Amuche

    2017-04-01

    Full Text Available The problem of HIV/AIDS was sort of a fairy tale and mere information till the immunological disorder was scientifically confirmed. Today, HIV/AIDS has continued to be a serious international health concern, and sub-Saharan Africa remains the most affected region. Over 25.6 million persons are currently living with HIV in sub-Saharan Africa. This accounts for two-thirds of the recent overall world HIV infections and more than 70 percent of all AIDSrelated deaths. In 2015, Eastern and Southern Africa had about 7.1% adult HIV prevalence rate (about 19 million HIV patients, while Western and Central Africa accounted for about 2.2% (about 6.5 million HIV patients. Few countries now boast of numerous signs of gradual to moderate declines in HIV occurrence. However, HIV prevalence rate has continued to increase in countries like Lesotho (22.7%, Botswana (22.2% and South Africa (19.2%. The nature, procedure and result of the scourge in this region have been fashioned by a mind-boggling interaction of traditional, behavioural, social and material factors. Even if there are notably strong prevention, treatment and care programmes, too many sexual partners are engaging in risky sexual practices. The aim of this article is to discuss the current trends of HIV/AIDS in sub-Saharan Africa, the factors that might have contributed to high prevalence of the virus in the region, the effect of the HIV/AIDS scourge, the prevention programmes and the way forward.

  2. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction

    Science.gov (United States)

    Tintoré, Mar; Alexander, Maggie; Costello, Kathleen; Duddy, Martin; Jones, David E; Law, Nancy; O’Neill, Gilmore; Uccelli, Antonio; Weissert, Robert; Wray, Sibyl

    2017-01-01

    Background Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. Methods A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice. Results A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT); satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment. Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so. Conclusion Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment. PMID:28053511

  3. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction.

    Science.gov (United States)

    Tintoré, Mar; Alexander, Maggie; Costello, Kathleen; Duddy, Martin; Jones, David E; Law, Nancy; O'Neill, Gilmore; Uccelli, Antonio; Weissert, Robert; Wray, Sibyl

    2017-01-01

    Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice. A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT); satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment. Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so. Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment.

  4. Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

    Science.gov (United States)

    Bilal, Arebu Issa; Tilahun, Zelalem; Gebretekle, Gebremedhin Beedemariam; Ayalneh, Belete; Hailemeskel, Bisrat; Engidawork, Ephrem

    2017-05-19

    Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to

  5. Food security, wheat production and policy in South Africa: Reflections on food sustainability and challenges for a market economy

    Directory of Open Access Journals (Sweden)

    Francois de Wet

    2018-01-01

    Full Text Available The traditional concept of security has broadened over the past decades. Food security in South Africa is an imperative for human and non-human survival. In the contemporary political economy, there is a real nexus between globalisation, exploitation, the state, scarcity of resources, the market, peoples’ need to feel secure, notions of state responsibility and food production. Political economy and human security in theoretical debates and face-to-face politics are intrinsically linked. The notion of a ‘secure community’ changed. Food security and the right to quality living became a social imperative. Understanding current agricultural economics requires the ability to link security and access to food for all. In this case study, wheat production in South Africa is addressed against the interface of the global and the local including South Africa’s transition to a democratic and constitutional state with a Bill of Rights. The current security approach represents a more comprehensive understanding of what security is meant to be and include, amongst others, housing security, medical security, service delivery and food security, as set out in the Millennium Development Goals and the subsequent Sustainable Development Goals. The issue of food security is addressed here with particular reference to wheat production, related current government policies and the market economy. The authors chose to limit their socio-economic focus to a specific sector of the agricultural market, namely wheat, rather than discuss food security in South Africa in general. Wheat was chosen as a unit of analysis because as a crop, wheat used in bread is one of the staples for the majority of South Africans and given the current negative economic developments, wheat as a staple is likely to remain integral, if not increasing its status of dependability

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

    Science.gov (United States)

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

    2018-03-14

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

  7. Current Challenges in Development of a Database of Three-Dimensional Chemical Structures

    Science.gov (United States)

    Maeda, Miki H.

    2015-01-01

    We are developing a database named 3DMET, a three-dimensional structure database of natural metabolites. There are two major impediments to the creation of 3D chemical structures from a set of planar structure drawings: the limited accuracy of computer programs and insufficient human resources for manual curation. We have tested some 2D–3D converters to convert 2D structure files from external databases. These automatic conversion processes yielded an excessive number of improper conversions. To ascertain the quality of the conversions, we compared IUPAC Chemical Identifier and canonical SMILES notations before and after conversion. Structures whose notations correspond to each other were regarded as a correct conversion in our present work. We found that chiral inversion is the most serious factor during the improper conversion. In the current stage of our database construction, published books or articles have been resources for additions to our database. Chemicals are usually drawn as pictures on the paper. To save human resources, an optical structure reader was introduced. The program was quite useful but some particular errors were observed during our operation. We hope our trials for producing correct 3D structures will help other developers of chemical programs and curators of chemical databases. PMID:26075200

  8. Current Challenge in Consumer Health Informatics: Bridging the Gap between Access to Information and Information Understanding

    Directory of Open Access Journals (Sweden)

    Laurence Alpay

    2009-01-01

    Full Text Available The number of health-related websites has proliferated over the past few years. Health information consumers confront a myriad of health related resources on the internet that have varying levels of quality and are not always easy to comprehend. There is thus a need to help health information consumers to bridge the gap between access to information and information understanding—i.e. to help consumers understand health related web-based resources so that they can act upon it. At the same time health information consumers are becoming not only more involved in their own health care but also more information technology minded. One way to address this issue is to provide consumers with tailored information that is contextualized and personalized e.g. directly relevant and easily comprehensible to the person’s own health situation. This paper presents a current trend in Consumer Health Informatics which focuses on theory-based design and development of contextualized and personalized tools to allow the evolving consumer with varying backgrounds and interests to use online health information efficiently. The proposed approach uses a theoretical framework of communication in order to support the consumer’s capacity to understand health-related web-based resources.

  9. Ensemble forecasting for renewable energy applications - status and current challenges for their generation and verification

    Science.gov (United States)

    Pinson, Pierre

    2016-04-01

    The operational management of renewable energy generation in power systems and electricity markets requires forecasts in various forms, e.g., deterministic or probabilistic, continuous or categorical, depending upon the decision process at hand. Besides, such forecasts may also be necessary at various spatial and temporal scales, from high temporal resolutions (in the order of minutes) and very localized for an offshore wind farm, to coarser temporal resolutions (hours) and covering a whole country for day-ahead power scheduling problems. As of today, weather predictions are a common input to forecasting methodologies for renewable energy generation. Since for most decision processes, optimal decisions can only be made if accounting for forecast uncertainties, ensemble predictions and density forecasts are increasingly seen as the product of choice. After discussing some of the basic approaches to obtaining ensemble forecasts of renewable power generation, it will be argued that space-time trajectories of renewable power production may or may not be necessitate post-processing ensemble forecasts for relevant weather variables. Example approaches and test case applications will be covered, e.g., looking at the Horns Rev offshore wind farm in Denmark, or gridded forecasts for the whole continental Europe. Eventually, we will illustrate some of the limitations of current frameworks to forecast verification, which actually make it difficult to fully assess the quality of post-processing approaches to obtain renewable energy predictions.

  10. Current challenges in adherence to clinical guidelines for antibiotic prophylaxis in surgery.

    Science.gov (United States)

    Khan, Sohail Ahmad; Rodrigues, Gabrial; Kumar, Pramod; Rao, Padma G M

    2006-06-01

    To study the impact of guidelines on surgical antibiotic prophylaxis in clinical practice, barriers involved in adherence to guidelines and how to overcome the same. Literature pertaining to prophylactic antibiotic usage was searched. Medscape, Medline, Cochrane, Surgical Infection Prevention (SIP) project databases were reviewed. Recent articles from relevant journals, texts, and standard guidelines were also studied. Local guidelines seem more likely to be accepted and followed than those developed nationally. Major barriers involved in adherence to guidelines include lack of awareness about the guidelines, general perception of guideline as a bureaucratic rather than educational tool. Some practitioners perceive guidelines as "cookbook medicine" that does not permit them to make their own medical decisions. Other barriers are complex, multi-step systems that create confusion, decrease accountability. Methods for guideline adherence include surveillance and data analysis, new systems to facilitate documentation and improving workflow, education regarding current evidence-based guidelines and promoting the development of local guidelines or protocol, development and implementation of reminders to facilitate adherence to the local guidelines. A multidisciplinary steering team of surgeons, infectious disease specialists, pharmacists, anesthesiologists, microbiologists and nurses should develop local guidelines suitable to their institution and methods for adherence to prevent the surgical site infections. The gap between evidence-based guidelines and practice must be addressed in order to achieve optimal practice in this domain.

  11. Genetics and sport performance: current challenges and directions to the future

    Directory of Open Access Journals (Sweden)

    João Paulo Limongi França GUILHERME

    2014-03-01

    Full Text Available In recent years there has been a great progress in molecular biology techniques, which has facilitated the researches on influence of genetics on human performance. There are specific regions of DNA that can vary between individuals. Such variations (i.e., polymorphisms may, in part, explain why some individuals have differentiated responses to certain stimuli, including the responses to sports training. In a particular sport, the presence of specific polymorphisms may contribute to high levels of performance. Since 1998, several polymorphisms have been associated with athletic phenotypes; however the accumulation of information generated over these 15 years shows that the influence of genetics to sport is extremely complex. In this review, we will summarise the current status of the field, discussing the implications of available knowledge for the practice of professionals involved with the sport and suggesting future directions for research. We also discuss topics related to the importance of polygenic profile characterization of athletes, methods for the identification of new polymorphisms associated with physical performance, the use of genetic testing for predicting competitive success, and how crucial is the genetic profile for the success athletes in competition.

  12. Current International Crisis and Social Challenges for the Romanian Orthodox Church

    Directory of Open Access Journals (Sweden)

    Vasile Nistor

    2008-06-01

    Full Text Available Current economic and financial crisis appears to be unprecedented in the last half century.A massive loss of confidence, both in the business sector and the consumers, both responding byrestricting spending, is in full progress. The world's financial and economic crisis is largely the resultof greed, of unjust gain, of financial speculation, of tax evasion worldwide. We live in a world wherepeople are seeking more temporary material wealth than spiritual wealth of the Faith and eternal life,and in addition to more severe material poverty, we see spiritual poverty and weakening of faith, acooling brotherly love and a decrease in good deeds and philanthropy. In this situation of economicpolicy without ethics, when everything is uncertain and unpredictable, changeable, and deceitful, weneed to close to God, the steadfast and insurmountable, just and merciful, but also an increase inalertness, attention and financial prudence. Romanian Orthodox Church is in a enough favorableposition into the Romanian society to take a proactive process of anticipating social problems thattrouble present Romanian society (poverty, social exclusion, unemployment, migration, domesticviolence, school dropout, alcoholism, drug abuse, aging, social system and poor health, lack ofmotivation and educational perspectives, youth work and family, etc., which will ultimately lead todeveloping a comprehensive plan for promotion and social involvement that will play a decisive rolein solving social and spiritual needs of Romanians, present and future.

  13. Current challenges facing the assessment of the allergenic capacity of food allergens in animal models.

    Science.gov (United States)

    Bøgh, Katrine Lindholm; van Bilsen, Jolanda; Głogowski, Robert; López-Expósito, Iván; Bouchaud, Grégory; Blanchard, Carine; Bodinier, Marie; Smit, Joost; Pieters, Raymond; Bastiaan-Net, Shanna; de Wit, Nicole; Untersmayr, Eva; Adel-Patient, Karine; Knippels, Leon; Epstein, Michelle M; Noti, Mario; Nygaard, Unni Cecilie; Kimber, Ian; Verhoeckx, Kitty; O'Mahony, Liam

    2016-01-01

    Food allergy is a major health problem of increasing concern. The insufficiency of protein sources for human nutrition in a world with a growing population is also a significant problem. The introduction of new protein sources into the diet, such as newly developed innovative foods or foods produced using new technologies and production processes, insects, algae, duckweed, or agricultural products from third countries, creates the opportunity for development of new food allergies, and this in turn has driven the need to develop test methods capable of characterizing the allergenic potential of novel food proteins. There is no doubt that robust and reliable animal models for the identification and characterization of food allergens would be valuable tools for safety assessment. However, although various animal models have been proposed for this purpose, to date, none have been formally validated as predictive and none are currently suitable to test the allergenic potential of new foods. Here, the design of various animal models are reviewed, including among others considerations of species and strain, diet, route of administration, dose and formulation of the test protein, relevant controls and endpoints measured.

  14. Solid state dye-sensitized solar cells. Current state of the art. Challenges and opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Lenzmann, F.O.; Olson, C.L.; Goris, M.J.A.A.; Kroon, J.M. [ECN Solar Energy, Petten (Netherlands)

    2008-09-15

    The first generation of dye-sensitized solar cell technology is based on a liquid electrolyte component. Today, this technology is on the verge of commercialization. The step towards the market and real applications is supported by the prospect of low manufacturing costs, good efficiency as well as the expectation that the current stability level of this technology is at least sufficient for applications in mobile electronics. These favorable developments may be reinforced and accelerated even further, if the corrosive liquid electrolyte could be replaced by a non-corrosive solid, since this would ease a number of stringent requirements in the production process. A successful exchange of the liquid electrolyte by a solid-state holeconductor requires to at least maintain, preferably improve, the most relevant technical parameters of the solar cell (efficiency, stability, cost). First pioneering work with solid-state hole conductors was carried out 10 years ago with an initial efficiency level below 1%. Until 2007, the record efficiency could be improved to 5%. This paper gives an overview of the solid-state concept as an early stage approach with good perspectives for the mid-term future (5-10 years)

  15. Advance Care Planning Documentation in Electronic Health Records: Current Challenges and Recommendations for Change.

    Science.gov (United States)

    Lamas, Daniela; Panariello, Natalie; Henrich, Natalie; Hammes, Bernard; Hanson, Laura C; Meier, Diane E; Guinn, Nancy; Corrigan, Janet; Hubber, Sean; Luetke-Stahlman, Hannah; Block, Susan

    2018-04-01

    To develop a set of clinically relevant recommendations to improve the state of advance care planning (ACP) documentation in the electronic health record (EHR). Advance care planning (ACP) is a key process that supports goal-concordant care. For preferences to be honored, clinicians must be able to reliably record, find, and use ACP documentation. However, there are no standards to guide ACP documentation in the electronic health record (EHR). We interviewed 21 key informants to understand the strengths and weaknesses of EHR documentation systems for ACP and identify best practices. We analyzed these interviews using a qualitative content analysis approach and subsequently developed a preliminary set of recommendations. These recommendations were vetted and refined in a second round of input from a national panel of content experts. Informants identified six themes regarding current inadequacies in documentation and accessibility of ACP information and opportunities for improvement. We offer a set of concise, clinically relevant recommendations, informed by expert opinion, to improve the state of ACP documentation in the EHR.

  16. Current Understanding and Remaining Challenges in Modeling Long-Term Degradation of Borosilicate Nuclear Waste Glasses

    International Nuclear Information System (INIS)

    Vienna, John D.; Ryan, Joseph V.; Gin, Stephane; Inagaki, Yaohiro

    2013-01-01

    Chemical durability is not a single material property that can be uniquely measured. Instead it is the response to a host of coupled material and environmental processes whose rates are estimated by a combination of theory, experiment, and modeling. High-level nuclear waste (HLW) glass is perhaps the most studied of any material yet there remain significant technical gaps regarding their chemical durability. The phenomena affecting the long-term performance of HLW glasses in their disposal environment include surface reactions, transport properties to and from the reacting glass surface, and ion exchange between the solid glass and the surrounding solution and alteration products. The rates of these processes are strongly influenced and are coupled through the solution chemistry, which is in turn influenced by the reacting glass and also by reaction with the near-field materials and precipitation of alteration products. Therefore, those processes must be understood sufficiently well to estimate or bound the performance of HLW glass in its disposal environment over geologic time-scales. This article summarizes the current state of understanding of surface reactions, transport properties, and ion exchange along with the near-field materials and alteration products influences on solution chemistry and glass reaction rates. Also summarized are the remaining technical gaps along with recommended approaches to fill those technical gaps

  17. Biodesulfurization of Petroleum Distillates—Current Status, Opportunities and Future Challenges

    Directory of Open Access Journals (Sweden)

    Olawumi O. Sadare

    2017-11-01

    Full Text Available Sulfur oxide (SO2 and hydrogen sulfide (H2S are considered as one of the major air pollutants in the world today. In addition, high sulfur levels in petroleum distillates can promote the deactivation of catalysts through poisoning in fluidized catalytic cracking (FCC during hydrocracking of the heavy distillates to lighter ones. The presence of high sulfur-containing compounds in the process streams could cause corrosion of piping and fittings and equipment, thereby damaging the pipelines and leading to air emissions of sulfur-containing compounds, which are undesirable for mankind and his environment. In many cases, a large quantity of SOx is released into the atmosphere when petroleum distillates that contain substantial amount of sulphur-containing compounds are used as fuel and combust. In this article, a short overview of different desulfurization methods that are employed to remove sulfur from petroleum distillates is provided. In particular, the review concentrates on biodesulfurization technique. In addition, this article intends to provide its readers current status of biodesulfurization (BDS. It critically analyses the trend in the development of the technology to showcase its strength and weakness that could pave a way for future opportunities. Approaches that are suitable to remediate sulfur-contaminated environment are discussed as well. Lastly, speculations on future directions or opportunities that require exploration are provided as a way of provoking the thoughts of researchers in this field.

  18. Management of menopause-associated vasomotor symptoms: Current treatment options, challenges and future directions

    Directory of Open Access Journals (Sweden)

    Deirdre R Pachman

    2010-05-01

    Full Text Available Deirdre R Pachman1, Jason M Jones1, Charles L Loprinzi21Internal Medicine, Mayo Clinic, Rochester, MN, USA; 2Medical Oncology, Mayo Clinic, Rochester, MN, USAAbstract: Hot flashes are one of the most common and distressing symptoms associated with menopause, occurring in more than 75% of postmenopausal women. They are especially problematic in breast cancer patients since some breast cancer therapies can induce hot flashes. For mild hot flashes, it is proposed that behavioral modifications are the first step in management. Hormonal therapies, including estrogens and progestogens, are the most well known effective agents in relieving hot flashes; however, the safety of these agents is controversial. There is an increasing amount of literature on nonhormonal agents for the treatment of hot flashes. The most promising data regard newer antidepressant agents such as venlafaxine, which reduces hot flashes by about 60%. Gabapentin is another nonhormonal agent that is effective in reducing hot flashes. While many complimentary therapies, including phytoestrogens, black cohosh, and dehydroepiandrosterone, have been explored for the treatment of hot flashes; none can be recommended at this time. Furthermore, there is a lack of strong evidence to support exercise, yoga, or relaxation for the treatment of hot flashes. Paced respirations and hypnosis appear to be promising enough to warrant further investigation. Another promising nonpharmacological therapy, currently under investigation, involves a stellate ganglion block.Keywords: vasomotor symptoms, hot flashes, menopause, therapy

  19. Pharmacogenetics and pharmacogenomics in psoriasis treatment: current challenges and future prospects.

    Science.gov (United States)

    Sutherland, Alison; Power, Rebecca J; Rahman, Proton; O'Rielly, Darren D

    2016-08-01

    Topical, systemic, oral disease modifying, and biologic agents are part of the armamentarium to manage psoriatic disease. The choice of therapy depends upon disease severity, relevant co-morbidities and patient preference. There is great variability in patient response with these agents, and there is still no clear method of selecting the preferred therapeutic agent for efficacy or lack of adverse events. This article will review the pharmacogenetic and pharmacogenomic targets that are currently known with respect to psoriasis vulgaris, and the most frequent co-morbidity of psoriasis, psoriatic arthritis. Presently, no clinically actionable biomarker exists for any therapeutic agent used to treat psoriasis or psoriatic arthritis. The lack of validated outcome measures and conflicting results of open-label studies conducted may be attributed to a multitude of issues that confound discovery. Consequently, studies have been underpowered to identify genes or genetic variants worth translating to clinical practice. In order to achieve a pharmacogenetic/pharmacogenomic signature, improvements in study design of future investigations are required, including carefully designed prospective studies. It is imperative to combine known clinical, serological, and molecular markers with consistent outcomes and an adequate health economic evaluation before they can be adopted widely in clinical practice.

  20. Mechanisms of exercise-induced bronchoconstriction in athletes: Current perspectives and future challenges.

    Science.gov (United States)

    Couto, M; Kurowski, M; Moreira, A; Bullens, D M A; Carlsen, K-H; Delgado, L; Kowalski, M L; Seys, S F

    2018-01-01

    The evidence of exercise-induced bronchoconstriction (EIB) without asthma (EIBw A ) occurring in athletes led to speculate about different endotypes inducing respiratory symptoms within athletes. Classical postulated mechanisms for bronchial obstruction in this population include the osmotic and the thermal hypotheses. More recently, the presence of epithelial injury and inflammation in the airways of athletes was demonstrated. In addition, neuronal activation has been suggested as a potential modulator of bronchoconstriction. Investigation of these emerging mechanisms is of major importance as EIB is a significant problem for both recreational and competitive athletes and is the most common chronic condition among Olympic athletes, with obvious implications for their competing performance, health and quality of life. Hereby, we summarize the latest achievements in this area and identify the current gaps of knowledge so that future research heads toward better defining the etiologic factors and mechanisms involved in development of EIB in elite athletes as well as essential aspects to ultimately propose preventive and therapeutic measures. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  1. Breast Cancer Challenges and Screening in China: Lessons From Current Registry Data and Population Screening Studies.

    Science.gov (United States)

    Song, Qing-Kun; Wang, Xiao-Li; Zhou, Xin-Na; Yang, Hua-Bing; Li, Yu-Chen; Wu, Jiang-Ping; Ren, Jun; Lyerly, Herbert Kim

    2015-07-01

    As one of its responses to the increasing global burden of breast cancer (BC), China has deployed a national registration and BC screening campaign. The present report describes these programs and the initial results of these national BC control strategies, highlighting the challenges to be considered. The primary BC incidence and prevalence data were obtained from the Chinese National Central Cancer Registry. MapInfo software was used to map the geographic distribution and variation. The time trends were estimated by the annual percentage of change from 2003 to 2009. The description of the screening plans and preliminary results were provided by the Ministry of Health. Chinese cancer registries were primarily developed and activated in the East and Coastal regions of China, with only 12.5% of the registries located in West China. Geographic variation was noted, with the incidence of BC higher in North China than in South China and in urban areas compared with rural areas. Of great interest, these registries reported that the overall BC incidence has been increasing in China, with an earlier age of onset compared with Western countries and a peak incidence rate at age 50. In response to this increasing incidence and early age of onset, BC screening programs assessed 1.46 million women aged 35-59 years, using clinical breast examinations and ultrasound as primary screening tools between 2009 and 2011. The diagnostic rate for this screening program was only 48.0/10(5) with 440 cases of early stage BC. Early stage BC was detected in nearly 70% of screened patients. Subsequently, a second-generation screening program was conducted that included older women aged 35-64 years and an additional 6 million women were screened. The cancer registration system in China has been uneven, with a greater focus on East rather than West China. The data from these registries demonstrate regional variation, an increasing BC incidence, and an early age of onset. The 2009 to 2011 BC

  2. Computer-aided diagnosis in radiological imaging: current status and future challenges

    Science.gov (United States)

    Doi, Kunio

    2009-10-01

    Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. Many different types of CAD schemes are being developed for detection and/or characterization of various lesions in medical imaging, including conventional projection radiography, CT, MRI, and ultrasound imaging. Commercial systems for detection of breast lesions on mammograms have been developed and have received FDA approval for clinical use. CAD may be defined as a diagnosis made by a physician who takes into account the computer output as a "second opinion". The purpose of CAD is to improve the quality and productivity of physicians in their interpretation of radiologic images. The quality of their work can be improved in terms of the accuracy and consistency of their radiologic diagnoses. In addition, the productivity of radiologists is expected to be improved by a reduction in the time required for their image readings. The computer output is derived from quantitative analysis of radiologic images by use of various methods and techniques in computer vision, artificial intelligence, and artificial neural networks (ANNs). The computer output may indicate a number of important parameters, for example, the locations of potential lesions such as lung cancer and breast cancer, the likelihood of malignancy of detected lesions, and the likelihood of various diseases based on differential diagnosis in a given image and clinical parameters. In this review article, the basic concept of CAD is first defined, and the current status of CAD research is then described. In addition, the potential of CAD in the future is discussed and predicted.

  3. MIGRATION, A CURRENT ISSUE: THE CRISIS OF TODAY, THE CHALLENGE OF TOMORROW

    Directory of Open Access Journals (Sweden)

    Radu PĂTRAŞCU

    2015-12-01

    Full Text Available The present paper aims to portray a clear perspective of the problem of immigrants, who are arriving in Europe from the Middle East conflict zones (particularly Syria and Iraq and from North Africa (mainly Libya. The causes that conducted to the development of such a phenomenon represent the motivation for choosing this theme, as well as its effects on the functionality of the EU at an institutional level and finally yet importantly the “trenchant” visions of the European public opinion, amplified by the mass media: the pros and cons of accepting the wave of refugees. The author's approach aims to put in balance both the positive effects of the phenomenon on the European continent, as well as the negative ones. Positive effects might consist in obtaining additional work force, as Europe is currently facing a demographic aging phenomenon. Furthermore, from the perspective of EU citizens, who believe in the cohesion of the European institutions, the acceptance of refugees represents a basic value for unity and further on stands for the formation of a homogenous European Union, therefore emphasising the importance of each individual. On the other hand, analysing the matter in the most realistic possible way, the risk of potential terrorist penetration in Europe is quite high and unmanageable. As a research method, we will use document analysis, referring to media articles and official documents. This phenomenon is particularly complex and the crisis result will depend on the effectiveness of the manner in which each national authority as well as the European ones will handle the issue.

  4. Epidemiology in Latin America and the Caribbean: current situation and challenges.

    Science.gov (United States)

    Barreto, Sandhi M; Miranda, Jaime J; Figueroa, J Peter; Schmidt, Maria Inês; Munoz, Sergio; Kuri-Morales, P Pablo; Silva, Jarbas B

    2012-04-01

    require establishing research partnerships within and outside the region, between rich and poor countries, promoting collaborations between LAC research institutions and universities to boost postgraduate programmes and aligning research investments and outputs with the current burden of disease.

  5. Current status of alcohol marketing policy--an urgent challenge for global governance.

    Science.gov (United States)

    Casswell, Sally

    2012-03-01

    To review research literature and available information on the extent and impacts of marketing, current policy response and the interests engaged in the policy debate in order to inform recommendations for policy change on alcohol marketing. Relevant literature, including systematic reviews and publicly available information (websites and participant observation) is reviewed and synthesized. Alcohol marketing has expanded markedly in the past 50 years and, while there remains uncertainty about the impact across the population, there is now clear evidence of its impact on the consumption of young people. Few countries have effective policy in place restricting alcohol marketing, and there is a lack of an international response to alcohol marketing which crosses national boundaries. The protection of alcohol marketing has been a major focus for vested interest groups and this has affected governmental response at national and international levels. There has been a lack of non-governmental organization engagement. The policy response to tobacco marketing provides a clear contrast to that of alcohol marketing policy and provides a model for alcohol marketing policy. The global exposure of young people to alcohol marketing requires an urgent policy response. The Framework Convention on Tobacco Control provides an appropriate model for global governance to control alcohol marketing. There are extant examples of national level legislation achieving comprehensive bans with France's Loi Evin providing a feasible model. Resources from philanthropic organizations to allow non-governmental organization engagement are urgently required, as is engagement by the governmental sector independent of commercial influence. © 2012 The Author, Addiction © 2012 Society for the Study of Addiction.

  6. Arctic hydroclimate variability during the last 2000 years: current understanding and research challenges

    Science.gov (United States)

    Linderholm, Hans W.; Nicolle, Marie; Francus, Pierre; Gajewski, Konrad; Helama, Samuli; Korhola, Atte; Solomina, Olga; Yu, Zicheng; Zhang, Peng; D'Andrea, William J.; Debret, Maxime; Divine, Dmitry V.; Gunnarson, Björn E.; Loader, Neil J.; Massei, Nicolas; Seftigen, Kristina; Thomas, Elizabeth K.; Werner, Johannes; Andersson, Sofia; Berntsson, Annika; Luoto, Tomi P.; Nevalainen, Liisa; Saarni, Saija; Väliranta, Minna

    2018-04-01

    Reanalysis data show an increasing trend in Arctic precipitation over the 20th century, but changes are not homogenous across seasons or space. The observed hydroclimate changes are expected to continue and possibly accelerate in the coming century, not only affecting pan-Arctic natural ecosystems and human activities, but also lower latitudes through the atmospheric and ocean circulations. However, a lack of spatiotemporal observational data makes reliable quantification of Arctic hydroclimate change difficult, especially in a long-term context. To understand Arctic hydroclimate and its variability prior to the instrumental record, climate proxy records are needed. The purpose of this review is to summarise the current understanding of Arctic hydroclimate during the past 2000 years. First, the paper reviews the main natural archives and proxies used to infer past hydroclimate variations in this remote region and outlines the difficulty of disentangling the moisture from the temperature signal in these records. Second, a comparison of two sets of hydroclimate records covering the Common Era from two data-rich regions, North America and Fennoscandia, reveals inter- and intra-regional differences. Third, building on earlier work, this paper shows the potential for providing a high-resolution hydroclimate reconstruction for the Arctic and a comparison with last-millennium simulations from fully coupled climate models. In general, hydroclimate proxies and simulations indicate that the Medieval Climate Anomaly tends to have been wetter than the Little Ice Age (LIA), but there are large regional differences. However, the regional coverage of the proxy data is inadequate, with distinct data gaps in most of Eurasia and parts of North America, making robust assessments for the whole Arctic impossible at present. To fully assess pan-Arctic hydroclimate variability for the last 2 millennia, additional proxy records are required.

  7. Control of cervical cancer in Peru: Current barriers and challenges for the future.

    Science.gov (United States)

    Aguilar, Alfredo; Pinto, Joseph A; Araujo, Jhajaira; Fajardo, Williams; Bravo, Leny; Pinillos, Luis; Vallejos, Carlos

    2016-08-01

    Cervical cancer is the leading malignant neoplasm in Peruvian women. This malignancy is a public health problem and several efforts were previously performed to develop cancer control plans. Geographical, cultural, structural, infrastructural and procedural barriers can limit the implementation of such strategies. Several previous studies have characterized human papilloma virus (HPV) epidemiology, where prevalence of high-risk HPV in adult females is ~12% and the prevalence in cervical cancer is 90-95%. The predominant barriers for the control of cervical cancer are lack of specialists in remote villages, education/cultural issues, loss of patients in follow-up, lack of access to HPV testing and lack of compliance for HPV vaccination. A good strategy for the prevention and early detection of high-risk HPV, pre-malignant neoplasms and cervical cancer, identified by interventional studies, is the self-sampling test, which assists with overcoming the cultural and geographic barriers. The current cancer control plan, termed 'Plan Esperanza', is performed with massive training of health professionals and social sensitization campaigns leading to filling the gaps regarding education and, in addition, it provides cancer care coverage for poorer individuals. In our experience at Oncosalud-AUNA, with a cohort of ~750,000 affiliates using a pre-paid system with annual screenings for cervical cancer for women, offered free-of-charge, a lower incidence of this malignancy (5.8/100,000) is now observed compared with the national incidence (32.7/100,000). As in other countries, the HPV vaccination can be a cost-utility strategy to reduce the high burdens of cervical cancer in Peru, a rapid and cheap HPV molecular sub-typification is rapidly required.

  8. An alternative explanation for the occurrence of short circuit current increases in the small intestine following challenge by bacterial enterotoxins.

    Science.gov (United States)

    Lucas, M L

    2013-10-01

    Secretory diarrhoeal disease due to enterotoxins is thought to arise from the enhancement to pathologically high rates of normally occurring chloride ion and therefore fluid secretion from enterocytes. In support of this concept, many enterotoxins increase intestinal short-circuit current, regarded now as faithfully reflecting the increased chloride ion secretion. Contradicting this assumption, STa reduces absorption but does not cause secretion in vivo although short-circuit current is increased in vitro. There is therefore a mismatch between an assumed enterocyte mediated secretory event that should but does not cause net fluid secretion and an undoubtedly increased short-circuit current. It is proposed here that short-circuit current increases are not themselves secretory events but result from interrupted fluid absorption. A noteworthy feature of compounds that inhibit the increase in short-circuit current is that the majority are vasoactive, neuroactive or both. In general, vasodilator substances increase current. An alternative hypothesis for the origin of short-circuit current increases is that these result from reflex induction of electrogenic fluid absorption. This reflex enhances a compensatory response that is also present at a cellular level. An intestinal reflex is therefore proposed by which decreases in interstitial and intravascular volume or pressure within the intestine initiate an electrogenic fluid absorption mechanism that compensates for the loss of electrically neutral fluid absorption. This hypothesis would explain the apparently complex pharmacology of short-circuit current increases since many depressor substances have receptors in common with enterocytes and enteric nerves. The proposed alternative view of the origin of short-circuit current increases assumes that these do not represent chloride secretion from the enterocytes. This view may therefore aid the successful development of anti-diarrhoeal drugs to overcome a major cause of

  9. [Challenges of the medical entomology for the surveillance in public health in Colombia: reflections on the state of malaria].

    Science.gov (United States)

    Brochero, Helena; Quiñones, Martha L

    2008-03-01

    The relevance of the medical entomology was considered with respect to current framework of malaria control programs in Colombia. A responsibility is indicated for balancing control efforts along with providing information on the malaria vectors. This knowledge must be acquired in order to focus the related activities that are required. The malaria control program must be based on results of local entomological surveillance, and the data must be in a form to give practical answers to questions regarding the control program. Difficulties in undertaking the required studies are described, particularly regarding the taxonomic identification of Colombian Anopheles in Colombia and which of these can be incriminated as malaria vectors.

  10. Os movimentos populares no Brasil: elementos sócio-históricos e desafios atuais * The popular movements in Brazil: elements historic social and current challenges

    Directory of Open Access Journals (Sweden)

    MICHELLY FERREIRA MONTEIRO ELIAS

    2014-12-01

    Full Text Available Resumo: Este artigo reflete sobre alguns desafios dos movimentos sociais de caráter popular no contexto atual da luta de classes no país. Consideram-se os movimentos populares como manifestações das lutas sociais que possuem determinações específicas de acordo com o movimento histórico. Diante das lutas que se configuraram da década de 1980 até os anos 2000, atualmente os desafios colocados para os movimentos populares estão permeados pela fragilidade do movimento operário; pela permanência da reestruturação produtiva e predominância do capital financeiro no contexto imperialista; pela continuidade de uma correlação de forças desfavoráveis para as lutas da classe trabalhadora e por uma conjuntura política caracterizada pelo Partido dos Trabalhadores (PT no comando do Governo Federal.Palavras-chave: lutas sociais; movimentos populares; realidade brasileira.Abstract: This article reflects about some challenges of social movements of popular character in the current context of class struggles in the country. Consider the popular movements as expressions of social struggles which have specific determinations in accordance with the historical movement. Faced of the struggles that have taken shape of the decade from 1980 until the year 2000, currently the challenges posed to the popular movements are permeated by the weakness of the labor movement; the permanence of productive restructuring and the predominance of financial capital in the context imperialist; by continuity of a correlation of forces unfavourable for the struggles of the working class and by a political situation characterized by the Partido dos Trabalhadores (PT in command of the Federal Government.Keywords: social struggles; populars movements; Brazilian reality.

  11. Current status of deepwater oil spill modelling in the Faroe-Shetland Channel, Northeast Atlantic, and future challenges.

    Science.gov (United States)

    Gallego, Alejandro; O'Hara Murray, Rory; Berx, Barbara; Turrell, William R; Beegle-Krause, C J; Inall, Mark; Sherwin, Toby; Siddorn, John; Wakelin, Sarah; Vlasenko, Vasyl; Hole, Lars R; Dagestad, Knut Frode; Rees, John; Short, Lucy; Rønningen, Petter; Main, Charlotte E; Legrand, Sebastien; Gutierrez, Tony; Witte, Ursula; Mulanaphy, Nicole

    2018-02-01

    As oil reserves in established basins become depleted, exploration and production moves towards relatively unexploited areas, such as deep waters off the continental shelf. The Faroe-Shetland Channel (FSC, NE Atlantic) and adjacent areas have been subject to increased focus by the oil industry. In addition to extreme depths, metocean conditions in this region characterise an environment with high waves and strong winds, strong currents, complex circulation patterns, sharp density gradients, and large small- and mesoscale variability. These conditions pose operational challenges to oil spill response and question the suitability of current oil spill modelling frameworks (oil spill models and their forcing data) to adequately simulate the behaviour of a potential oil spill in the area. This article reviews the state of knowledge relevant to deepwater oil spill modelling for the FSC area and identifies knowledge gaps and research priorities. Our analysis should be relevant to other areas of complex oceanography. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  12. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    International Nuclear Information System (INIS)

    Skandamis, Panagiotis N.; Andritsos, Nikolaos; Psomas, Antonios; Paramythiotis, Spyridon

    2015-01-01

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) the Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total ‘failure’ that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user

  13. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    Energy Technology Data Exchange (ETDEWEB)

    Skandamis, Panagiotis N., E-mail: pskan@aua.gr; Andritsos, Nikolaos, E-mail: pskan@aua.gr; Psomas, Antonios, E-mail: pskan@aua.gr; Paramythiotis, Spyridon, E-mail: pskan@aua.gr [Laboratory of Food Quality Control and Hygiene, Department of Food Science and Technology, Agricultural University of Athens, Iera Odos 75, 118 55, Athens (Greece)

    2015-01-22

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) the Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total ‘failure’ that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user

  14. New risk metrics and mathematical tools for risk analysis: Current and future challenges

    Science.gov (United States)

    Skandamis, Panagiotis N.; Andritsos, Nikolaos; Psomas, Antonios; Paramythiotis, Spyridon

    2015-01-01

    The current status of the food safety supply world wide, has led Food and Agriculture Organization (FAO) and World Health Organization (WHO) to establishing Risk Analysis as the single framework for building food safety control programs. A series of guidelines and reports that detail out the various steps in Risk Analysis, namely Risk Management, Risk Assessment and Risk Communication is available. The Risk Analysis approach enables integration between operational food management systems, such as Hazard Analysis Critical Control Points, public health and governmental decisions. To do that, a series of new Risk Metrics has been established as follows: i) the Appropriate Level of Protection (ALOP), which indicates the maximum numbers of illnesses in a population per annum, defined by quantitative risk assessments, and used to establish; ii) Food Safety Objective (FSO), which sets the maximum frequency and/or concentration of a hazard in a food at the time of consumption that provides or contributes to the ALOP. Given that ALOP is rather a metric of the public health tolerable burden (it addresses the total `failure' that may be handled at a national level), it is difficult to be interpreted into control measures applied at the manufacturing level. Thus, a series of specific objectives and criteria for performance of individual processes and products have been established, all of them assisting in the achievement of FSO and hence, ALOP. In order to achieve FSO, tools quantifying the effect of processes and intrinsic properties of foods on survival and growth of pathogens are essential. In this context, predictive microbiology and risk assessment have offered an important assistance to Food Safety Management. Predictive modelling is the basis of exposure assessment and the development of stochastic and kinetic models, which are also available in the form of Web-based applications, e.g., COMBASE and Microbial Responses Viewer), or introduced into user-friendly softwares

  15. Growth curves and the international standard: How children's growth reflects challenging conditions in rural Timor-Leste.

    Science.gov (United States)

    Spencer, Phoebe R; Sanders, Katherine A; Judge, Debra S

    2018-02-01

    Population-specific growth references are important in understanding local growth variation, especially in developing countries where child growth is poor and the need for effective health interventions is high. In this article, we use mixed longitudinal data to calculate the first growth curves for rural East Timorese children to identify where, during development, deviation from the international standards occurs. Over an eight-year period, 1,245 children from two ecologically distinct rural areas of Timor-Leste were measured a total of 4,904 times. We compared growth to the World Health Organization (WHO) standards using z-scores, and modeled height and weight velocity using the SuperImposition by Translation And Rotation (SITAR) method. Using the Generalized Additive Model for Location, Scale and Shape (GAMLSS) method, we created the first growth curves for rural Timorese children for height, weight and body mass index (BMI). Relative to the WHO standards, children show early-life growth faltering, and stunting throughout childhood and adolescence. The median height and weight for this population tracks below the WHO fifth centile. Males have poorer growth than females in both z-BMI (p = .001) and z-height-for-age (p = .018) and, unlike females, continue to grow into adulthood. This is the most comprehensive investigation to date of rural Timorese children's growth, and the growth curves created may potentially be used to identify future secular trends in growth as the country develops. We show significant deviation from the international standard that becomes most pronounced at adolescence, similar to the growth of other Asian populations. Males and females show different growth responses to challenging conditions in this population. © 2017 Wiley Periodicals, Inc.

  16. Current status of quality evaluation of nursing care through director review and reflection from the Nursing Quality Control Centers

    OpenAIRE

    Duan, Xia; Shi, Yan

    2014-01-01

    Background: The quality evaluation of nursing care is a key link in medical quality management. It is important and worth studying for the nursing supervisors to know the disadvantages during the process of quality evaluation of nursing care and then to improve the whole nursing quality. This study was to provide director insight on the current status of quality evaluation of nursing care from Nursing Quality Control Centers (NQCCs). Material and Methods: This qualitative study used a sample ...

  17. [Organisational challenges of community information offices for the elderly in Switzerland : A qualitative study with ethical reflections].

    Science.gov (United States)

    Abraham, Andrea; Huber, Hildegard; Baumann-Hölzle, Ruth

    2016-08-01

    Current Swiss politics concerning age and ageing are orientated towards the principle "out-patient before in-patient". As part of new regulations, in 2011 all communities were required to set up information offices to answer questions about out-patient and in-patient care. The aim of this qualitative study was to analyse in which form and under which conditions such information offices are run. A qualitative study was conducted which consisted of semistructured interviews with managers of information offices. They were analysed using qualitative content analysis. The analysis shows that on the one hand the information offices have the potential to serve an important role in the communities and that they have a highly complex, demanding and responsible function. On the other hand the results illustrate that in organisational respects the situation is highly heterogeneous and unregulated. For the running of the information offices, there is need for action such as the definition of general framework, quality standards, qualifications and values profiles, objectives, mission, responsibility and legitimation, instruments for networking and cooperations.

  18. Current challenges of Germany’s energy transition project and competing strategies of challengers and incumbents: The case of direct marketing of electricity from renewable energy sources

    International Nuclear Information System (INIS)

    Wassermann, Sandra; Reeg, Matthias; Nienhaus, Kristina

    2015-01-01

    Electricity generated by renewable energies (RES-E) already accounts for 25% of Germany’s electricity supply. This has led to recent discussions for a better market integration of RES-E. The paper examines how competing actors and their ideas on market integration developed new services for direct marketing according to their respective origins and tried to shape the regulatory framework. The paper analyses this process and explains the current shape of the field of direct marketing. Medium-sized structured actors, who favoured RES-E integration via the conventional wholesale power markets, and who formed early close coalitions with RES-E power producers at the same time, have been most successful in terms of market shares. Moreover, they have been very successful for different reasons in building-up coalitions with governance units and influencing the field rules and routines. Based on those findings, the paper will conclude with some policy advices for the future adjustment of the current regulative frameworks. As long as there is no evidence of how RES-E can be integrated most effectively and efficiently, policies should maintain a competition between different direct marketing strategies to find out which strategies serve the best in terms of achieving a successful energy transition. - Highlights: • Innovation sociological analysis of the market integration of electricity from renewables in the German electricity markets. • Direct marketing of RES-E seen as a new strategic action field in the German “Energiewende”. • Strategies of incumbent and challenger actors to shape the rules of the field. • Suggestions for the future design of policy instruments for direct marketing of RES-E

  19. Current status of quality evaluation of nursing care through director review and reflection from the Nursing Quality Control Centers

    Science.gov (United States)

    Duan, Xia; Shi, Yan

    2014-01-01

    Background: The quality evaluation of nursing care is a key link in medical quality management. It is important and worth studying for the nursing supervisors to know the disadvantages during the process of quality evaluation of nursing care and then to improve the whole nursing quality. This study was to provide director insight on the current status of quality evaluation of nursing care from Nursing Quality Control Centers (NQCCs). Material and Methods: This qualitative study used a sample of 12 directors from NQCCs who were recruited from 12 provinces in China to evaluate the current status of quality evaluation of nursing care. Data were collected by in-depth interviews. Content analysis method was used to analyze the data. Results: Four themes emerged from the data: 1) lag of evaluation index; 2) limitations of evaluation content; 3) simplicity of evaluation method; 4) excessive emphasis on terminal quality. Conclusion: It is of great realistic significance to ameliorate nursing quality evaluation criteria, modify the evaluation content based on patient needs-oriented idea, adopt scientific evaluation method to evaluate nursing quality, and scientifically and reasonably draw horizontal comparisons of nursing quality between hospitals, as well as longitudinal comparisons of a hospital’s nursing quality. These methods mentioned above can all enhance a hospital’s core competitiveness and benefit more patients. PMID:25419427

  20. Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

    Science.gov (United States)

    Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

    2015-01-01

    Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

  1. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction

    Directory of Open Access Journals (Sweden)

    Tintoré M

    2016-12-01

    Full Text Available Mar Tintoré,1 Maggie Alexander,2 Kathleen Costello,3 Martin Duddy,4 David E Jones,5 Nancy Law,6 Gilmore O’Neill,7 Antonio Uccelli,8 Robert Weissert,9 Sibyl Wray10 1Multiple Sclerosis Centre of Catalonia, Hospital Vall d’Hebron, Barcelona, Spain; 2European Multiple Sclerosis Platform, Brussels, Belgium; 3National Multiple Sclerosis Society, Denver, CO, USA; 4Royal Victoria Infirmary, Newcastle-upon-Tyne, UK; 5Department of Neurology, University of Virginia, Charlottesville, VA, USA; 6Nancy Law Consulting LLC, Parker, CO, USA; 7Biogen, Cambridge, MA, USA; 8Centre of Excellence for Biomedical Research, University of Genoa, Genoa, Italy; 9Department of Neurology, University of Regensburg, Regensburg, Germany; 10Hope Neurology Multiple Sclerosis Center, Knoxville, TN, USA Background: Managing multiple sclerosis (MS treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. Methods: A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice. Results: A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT; satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment

  2. Pedagogical Education: Current Challenges

    Science.gov (United States)

    Sokolova, I. I.

    2011-01-01

    Research on the teaching profession in Russia shows that its prestige and effectiveness are becoming weaker. The research on the influence of the teaching and upbringing process on the state of students' health has shown that negative deviations in respiratory and cardiovascular systems, ability to work, and fatigue are not connected with…

  3. Current Issues and Challenges

    International Nuclear Information System (INIS)

    Agnihotri, Newal K.

    2004-01-01

    Mr. Makoto Satake, Director of the Board and Deputy Executive General Manager, Nuclear Power Division, Tokyo Electric Power Company (TEPCO), was interviewed regarding his views on a series of questions related to the future of nuclear power plant construction and operation in Japan. Regarding nuclear power plant economics, he discusses what improvements should be made in the construction cost reduction area and in operation and maintenance costs to make costs more viable. Regarding public relations, he stated that regaining public trust is the most important today. Information disclosure to the public and two-way communication activities (direct discussions, public hearings, etc.) are being expanded. To improve economic competitiveness, two points are important: electric power generating cost reduction through stable operation and a legal framework that eliminates uncertainty by collecting funds to promote plutonium recycling and back-end costs. In the construction of a new plant, the coexistence of quality assurance and a shortened construction period are essential. It is necessary to decide on the design and on the construction process as early as possible. In Japan, 3D-computer aided design is used as the key technology for efficient construction. Moreover, in order to improve project management abilities, computer software aimed at process control and design information management has been developed using past construction experiences. The software will be applied to the next construction project. He cited the reasons why government support is essential for new plant construction, and in what ways existing nuclear power plants in Japan have improved in the last five years. As far as the best available technology for constructing plants, he recommended the large-block construction method and the all-weather construction method as effective construction technologies. The advanced boiling water reactor is best suited for plant construction in the future. Regarding human resources for the future, he noted the use of digital databases with several components, a Systematic Approach to Training method for reactor operators and other plant personnel, and the use of retired professionals to enhance technical skills and troubleshoot problems in advance

  4. The regional species richness and genetic diversity of Arctic vegetation reflect both past glaciations and current climate

    DEFF Research Database (Denmark)

    Stewart, L.; Alsos, Inger G.; Bay, Christian

    2016-01-01

    Aim The Arctic has experienced marked climatic differences between glacial and interglacial periods and is now subject to a rapidly warming climate. Knowledge of the effects of historical processes on current patterns of diversity may aid predictions of the responses of vegetation to future climate...... species richness of the vascular plant flora of 21 floristic provinces and examined local species richness in 6215 vegetation plots distributed across the Arctic. We assessed levels of genetic diversity inferred from amplified fragment length polymorphism variation across populations of 23 common Arctic...... size compared to the models of bryophyte and lichen richness. Main conclusion Our study suggests that imprints of past glaciations in Arctic vegetation diversity patterns at the regional scale are still detectable today. Since Arctic vegetation is still limited by post-glacial migration lag...

  5. To retain or remove user fees?: reflections on the current debate in low- and middle-income countries.

    Science.gov (United States)

    James, Chris D; Hanson, Kara; McPake, Barbara; Balabanova, Dina; Gwatkin, Davidson; Hopwood, Ian; Kirunga, Christina; Knippenberg, Rudolph; Meessen, Bruno; Morris, Saul S; Preker, Alexander; Souteyrand, Yves; Tibouti, Abdelmajid; Villeneuve, Pascal; Xu, Ke

    2006-01-01

    Many low- and middle-income countries continue to search for better ways of financing their health systems. Common to many of these systems are problems of inadequate resource mobilisation, as well as inefficient and inequitable use of existing resources. The poor and other vulnerable groups who need healthcare the most are also the most affected by these shortcomings. In particular, these groups have a high reliance on user fees and other out-of-pocket expenditures on health which are both impoverishing and provide a financial barrier to care. It is within this context, and in light of recent policy initiatives on user fee removal, that a debate on the role of user fees in health financing systems has recently returned. This paper provides some reflections on the recent user fees debate, drawing from the evidence presented and subsequent discussions at a recent UNICEF consultation on user fees in the health sector, and relates the debate to the wider issue of access to adequate healthcare. It is argued that, from the wealth of evidence on user fees and other health system reforms, a broad consensus is emerging. First, user fees are an important barrier to accessing health services, especially for poor people. They also negatively impact on adherence to long-term expensive treatments. However, this is offset to some extent by potentially positive impacts on quality. Secondly, user fees are not the only barrier that the poor face. As well as other cost barriers, a number of quality, information and cultural barriers must also be overcome before the poor can access adequate health services. Thirdly, initial evidence on fee abolition in Uganda suggests that this policy has improved access to outpatient services for the poor. For this to be sustainable and effective in reaching the poor, fee removal needs to be part of a broader package of reforms that includes increased budgets to offset lost fee revenue (as was the case in Uganda). Fourthly, implementation matters

  6. Current status and bioanalytical challenges in the detection of unknown anabolic androgenic steroids in doping control analysis.

    Science.gov (United States)

    Pozo, Oscar J; De Brabanter, Nik; Fabregat, Andreu; Segura, Jordi; Ventura, Rosa; Van Eenoo, Peter; Deventer, Koen

    2013-11-01

    Androgenic anabolic steroids (AAS) are prohibited in sports due to their anabolic effects. Doping control laboratories usually face the screening of AAS misuse by target methods based on MS detection. Although these methods allow for the sensitive and specific detection of targeted compounds and metabolites, the rest remain undetectable. This fact opens a door for cheaters, since different AAS can be synthesized in order to evade doping control tests. This situation was evidenced in 2003 with the discovery of the designer steroid tetrahydrogestrinone. One decade after this discovery, the detection of unknown AAS still remains one of the main analytical challenges in the doping control field. In this manuscript, the current situation in the detection of unknown AAS is reviewed. Although important steps have been made in order to minimize this analytical problem and different analytical strategies have been proposed, there are still some drawbacks related to each approach.

  7. Challenges of influenza A viruses in humans and animals and current animal vaccines as an effective control measure

    Science.gov (United States)

    2018-01-01

    Influenza A viruses (IAVs) are genetically diverse and variable pathogens that share various hosts including human, swine, and domestic poultry. Interspecies and intercontinental viral spreads make the ecology of IAV more complex. Beside endemic IAV infections, human has been exposed to pandemic and zoonotic threats from avian and swine influenza viruses. Animal health also has been threatened by high pathogenic avian influenza viruses (in domestic poultry) and reverse zoonosis (in swine). Considering its dynamic interplay between species, prevention and control against IAV should be conducted effectively in both humans and animal sectors. Vaccination is one of the most efficient tools against IAV. Numerous vaccines against animal IAVs have been developed by a variety of vaccine technologies and some of them are currently commercially available. We summarize several challenges in control of IAVs faced by human and animals and discuss IAV vaccines for animal use with those application in susceptible populations. PMID:29399575

  8. Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

    Directory of Open Access Journals (Sweden)

    Whitehead JC

    2015-06-01

    Full Text Available Jocelyne C Whitehead,1 Sara A Gambino,1 Jeffrey D Richter,2 Jennifer D Ryan1,3,41Rotman Research Institute, Baycrest, 2Independent Human Factors Consultant, Toronto, ON, Canada; 3Department of Psychology, 4Department of Psychiatry, University of Toronto, Toronto, ON, CanadaObjective: This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current tools.Methods: Two focus group sessions were conducted with nurses and physicians who routinely administer neurocognitive assessments to geriatric populations. Video recordings of the focus group sessions were transcribed and a thematic analysis was performed.Results: Participants reported the need for assessment and diagnostic tools that are accessible and efficient, and that are capable of accommodating the rapid growth in the aging population. The prevalence of more complex ailments experienced by older adults has had repercussions in the quality of care that the clients receive, and has contributed to lengthy wait times and resource shortages. Health-care professionals stated that they are hampered by the disjointed structure of the health-care system and that they would benefit from a more efficient allocation of responsibilities made possible through tools that did not require extensive training or certification. Eyetracking-based cognitive assessments were thought to strongly complement this system, yet it was thought that difficulty would be faced in gaining the support and increased uptake by health-care professionals due to the nonintuitive relationship between eyetracking and cognition.Conclusion: The findings suggest that health-care professionals are receptive to the use of eyetracking technology to assess for cognitive health as it would conserve resources by allowing frontline staff to administer assessments with minimal training

  9. Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project

    Science.gov (United States)

    Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

    2017-01-01

    Background There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. Objective The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. Methodology An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Results Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. Conclusion The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies

  10. Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project.

    Science.gov (United States)

    Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

    2017-01-01

    There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Three categories emerged from the analysis: "Balancing complex situations" clarified the complexity regarding senior employees; "Working with a proactive approach" indicated the need for working with a new proactive approach supporting sustainable health; and "Collaborate internally and externally" showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close

  11. Leadership in Force XXI: Is the Army's Current Leadership Model and Leader Development Doctrine Properly Addressing the Challenges Brought About by the Transition to Force XXI

    National Research Council Canada - National Science Library

    Johnson, Carl

    1999-01-01

    .... The purpose of this research paper is to answer the question, Is the Army's current leadership model and leader development doctrine properly addressing the challenges brought about by the transition to Force XXI...

  12. Regulatory aspects of oncology drug safety evaluation: Past practice, current issues, and the challenge of new drugs

    International Nuclear Information System (INIS)

    Rosenfeldt, Hans; Kropp, Timothy; Benson, Kimberly; Ricci, M. Stacey; McGuinn, W. David; Verbois, S. Leigh

    2010-01-01

    The drug development of new anti-cancer agents is streamlined in response to the urgency of bringing effective drugs to market for patients with limited life expectancy. FDA's regulation of oncology drugs has evolved from the practices set forth in Arnold Lehman's seminal work published in the 1950s through the current drafting of a new International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) safety guidance for anti-cancer drug nonclinical evaluations. The ICH combines the efforts of the regulatory authorities of Europe, Japan, and the United States and the pharmaceutical industry from these three regions to streamline the scientific and technical aspects of drug development. The recent development of new oncology drug classes with novel mechanisms of action has improved survival rates for some cancers but also brings new challenges for safety evaluation. Here we present the legacy of Lehman and colleagues in the context of past and present oncology drug development practices and focus on some of the current issues at the center of an evolving harmonization process that will generate a new safety guidance for oncology drugs, ICH S9. The purpose of this new guidance will be to facilitate oncology drug development on a global scale by standardizing regional safety requirements.

  13. Industrial stakes and scientific challenges associated to current fleet and new generation of reactors for a utility

    International Nuclear Information System (INIS)

    Jean-Michel, Delbecq

    2004-01-01

    Energy supply sustainability and nuclear energy are major issues for the 21st century. EDF strategy is to keep the nuclear option open in the energy mix of the future. To achieve this, in a context of electricity market liberalization, nuclear energy must remain safe, clean and competitive. The main axes of EDF strategy are to operate durably its current fleet, to improve nuclear fuel efficiency, to pursue the development of efficient solutions for a good management of high level waste, to prepare the near future with new LWR design to be ready in time for nuclear power replacement of current PWRs and to prepare the long term future by taking an active part in the Generation IV program. This strategy implies a strong R and D effort in many fields. A special focus is made on thermal hydraulics developments by EDF in cooperation with its national and international partners. For an optimum use of nuclear fuel as well as for plant lifetime management and for preparing future nuclear systems, high performance numerical simulation is an indispensable and strategic tool. The necessary evolutions in EDF tools are to-day well engaged: more basic physics, 3D simulations, multi-physics and multi-scale coupling for a more realistic representation of ''reality'' and for enhanced accuracy. EDF R and D Division has structured its R and D in this field around six scientific challenges. This 5 to 10 years long effort, shared with its partners, will lead to an advanced numerical toolbox in 2010. (author)

  14. Current Issues and Challenges in the Use of Aerosolized Surfactant for Respiratory Distress Syndrome in the Newborns

    Directory of Open Access Journals (Sweden)

    Dion Darius Samsudin

    2013-08-01

    Full Text Available BACKGROUND: Surfactant replacement therapy is a recognized treatment for respiratory distress syndrome (RDS in the newborns. Over the past 30 years, human and animal trials have been performed regarding administration of aerosolized surfactant to the injured lung, however the result has been unsatisfactory when compared with instilled surfactant delivery via endotracheal tube (ETT. This review aims to investigate the current issues, challenges and future recommendation of aerosolized surfactant therapy. CONTENT: Five randomized clinical trials in humans and 13 animal trials met the inclusion criteria and were reviewed. Most animal trials agree that this method of treatment is feasible. However, human trials presented conflicting results, and generally showed it to be ineffective. When compared with surfactant delivery via ETT, aerosolized surfactant is less effective in improving respiratory function. SUMMARY: The current data from human trials does not support the implementation of aerosolized surfactant therapy to treat newborns with RDS. Further research is necessary to improve nebulization, delivery, distribution and deposition in the lung, to investigate aerosolized surfactant delivery via ETT and to determine the appropriate dose. KEYWORDS: surfactant, aerosol, prematurity, respiratory distress syndrome.

  15. An integrative view of cisplatin-induced renal and cardiac toxicities: molecular mechanisms, current treatment challenges and potential protective measures

    Science.gov (United States)

    Dugbartey, George J.; Peppone, Luke J.; de Graaf, Inge A.M.

    2017-01-01

    Cisplatin is currently one of the most widely-used chemotherapeutic agents against various malignancies. Its clinical application is limited, however, by inherent renal and cardiac toxicities and other side effects, of which the underlying mechanisms are only partly understood. Experimental studies show cisplatin generates reactive oxygen species, which impair the cell’s antioxidant defense system, causing oxidative stress and potentiating injury, thereby culminating in kidney and heart failure. Understanding the molecular mechanisms of cisplatin-induced renal and cardiac toxicities may allow clinicians to prevent or treat this problem better and may also provide a model for investigating drug-induced organ toxicity in general. This review discusses some of the major molecular mechanisms of cisplatin-induced renal and cardiac toxicities including disruption of ionic homeostasis and energy status of the cell leading to cell injury and cell death. We highlight clinical manifestations of both toxicities as well as (novel)biomarkers such as kidney injury molecule-1 (KIM-1), tissue inhibitor of metalloproteinase-1 (TIMP-1) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). We also present some current treatment challenges and propose potential protective strategies with novel pharmacological compounds that might mitigate or prevent these toxicities, which include the use of hydrogen sulfide. PMID:27717837

  16. How current Clinical Practice Guidelines for low back pain reflect Traditional Medicine in East Asian Countries: a systematic review of Clinical Practice Guidelines and systematic reviews.

    Directory of Open Access Journals (Sweden)

    Hyun-Woo Cho

    Full Text Available OBJECTIVES: The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs and evidence from current systematic reviews and meta-analyses (SR-MAs and to analyze the impact of this gap on present CPGs. METHODS: We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. RESULTS: Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54% mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure. However, the CPGs did not recommend acupuncture (or acupressure. Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (subacute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (subacute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. CONCLUSIONS: The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.

  17. The Determination of Current Challenges and Potentials in Each of the Main Elements of Social Harms in Tehran

    Directory of Open Access Journals (Sweden)

    H. A. Gafari

    2016-10-01

    Full Text Available This study is an attempt to monitor and investigate the main elements of social harms from political, economic, sociocultural, technological, environmental and legal perspectives in accordance with the factors of PESTEL. One of the findings of the present study indicates that Iran has taken several measures in order to fight narcotics.  In poverty and unemployment, it must be admitted that casting shadow of global economic situation on Iran's economy along with failure to implement Article 44 on the Constitution have led to the fact that a considerable section of the country’s economy has remained under direct government control. It seems that broadcasting performance has been weak from cultural perspective; this issue has caused satellite networks intrusion on the culture of people. No organization instructs young generation in life skills and how to prevent from divorce. This problem together with lack of life facilities has caused many marriages to end in divorce within the first year. Considering limited financial resources, the municipality and its affiliated organizations have had a quite good performance in organizing homeless people, but it is not sufficient. Donations contributing to susceptible classes of society are assessed absolutely positive and worthwhile. Street children are considered as an increasing harm in the world and Iran. If we do not reflect on some strategies in order to address this issue, it will be converted to a social crisis. Beggary has a significant manifestation in megacities as a social harm and challenge; it is mostly assumed to be a social dilemma rather than an individual problem. It can be really influential to educate people how to behave with beggars.

  18. Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project

    Directory of Open Access Journals (Sweden)

    Lydell M

    2017-05-01

    Full Text Available Marie Lydell,1 Cathrine Hildingh,1 Arne Söderbom,2 Kristina Ziegert1 1Center of Research on Welfare, Health and Sport (CVHI, School of Social and Health Sciences, 2Center for Innovation, Entrepreneurship and Learning Research (CIEL, School of Economics, Technology and Science, Halmstad University, Halmstad, Sweden Background: There is clearly a need for research in the field of occupational health service (OHS for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. Objective: The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. Methodology: An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12. A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116. In phase III, a scoping review was undertaken. Results: Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. Conclusion: The results outlined that it is necessary to

  19. MO-B-201-01: Overcoming the Challenges of Motion Management in Current Lung SBRT Practice

    Energy Technology Data Exchange (ETDEWEB)

    Shang, C. [Boca Raton Regional Hospital (United States)

    2016-06-15

    The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanics of the application and the related physiology especially related to respiration. The image-guided radiation beam control, or tumor tracking, further realized the endeavor for precision-targeting. During tumor tracking, the respiratory motion is often constantly monitored by non-ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X-ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly-developed MR guided RT. Learning Objectives: Through this presentation, the audience will understand basic roles of commonly used imaging modalities for lung cancer studies; familiarize the major advantages and limitations of each discussed motion control methods; familiarize the major advantages and

  20. MO-B-201-01: Overcoming the Challenges of Motion Management in Current Lung SBRT Practice

    International Nuclear Information System (INIS)

    Shang, C.

    2016-01-01

    The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanics of the application and the related physiology especially related to respiration. The image-guided radiation beam control, or tumor tracking, further realized the endeavor for precision-targeting. During tumor tracking, the respiratory motion is often constantly monitored by non-ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X-ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly-developed MR guided RT. Learning Objectives: Through this presentation, the audience will understand basic roles of commonly used imaging modalities for lung cancer studies; familiarize the major advantages and limitations of each discussed motion control methods; familiarize the major advantages and