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Obstacles
Kinds of Obstacles Terms modified by Obstacles Selected AbstractsOBSTACLES TO IMPLEMENTATION OF NEW PUBLIC MANAGEMENT IN AN IRISH HOSPITALFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 1 2007Geraldine Robbins First page of article [source] Obstacles to Bottom-Up Implementation of Marine Ecosystem ManagementCONSERVATION BIOLOGY, Issue 5 2008KIRSTEN E. EVANS manejo de ecosistemas; manejo marino basado en ecosistemas; participación de partes interesadas; planificación de la conservación Abstract:,Ecosystem management (EM) offers a means to address multiple threats to marine resources. Despite recognition of the importance of stakeholder involvement, most efforts to implement EM in marine systems are the product of top-down regulatory control. We describe a rare, stakeholder-driven attempt to implement EM from the bottom up in San Juan County, Washington (U.S.A.). A citizens advisory group led a 2-year, highly participatory effort to develop an ecosystem-based management plan, guided by a preexisting conservation-planning framework. A key innovation was to incorporate social dimensions by designating both sociocultural and biodiversity targets in the planning process. Multiple obstacles hindered implementation of EM in this setting. Despite using a surrogate scheme, the information-related transaction costs of planning were substantial: information deficits prevented assessment of some biodiversity targets and insufficient resources combined with information deficits prevented scientific assessment of the sociocultural targets. Substantial uncertainty, practical constraints to stakeholder involvement, and the existence of multiple, potentially conflicting, objectives increased negotiation-related costs. Although information deficits and uncertainty, coupled with underinvestment in the transaction costs of planning, could reduce the long-term effectiveness of the plan itself, the social capital and momentum developed through the planning process could yield unforeseeable future gains in protection of marine resources. The obstacles we identified here will require early and sustained attention in efforts to implement ecosystem management in other grassroots settings. Resumen:,El manejo de ecosistemas es un medio para abordar múltiples amenazas a los recursos marinos. No obstante el reconocimiento de la importancia de la participación de las partes interesadas, la mayoría de los esfuerzos para implementar el manejo de ecosistemas en sistemas marinos son producto del control normativo de arriba hacia abajo. Describimos un intento raro, conducido por las partes interesadas, por implementar el manejo del ecosistema de abajo hacia arriba en el Condado San Juan, Washington (E.U.A.). Un grupo consultivo de ciudadanos dirigió un esfuerzo altamente participativo para desarrollar un plan de manejo basado en el ecosistema, guiados por un marco de planificación de la conservación preexistente. Una innovación clave fue la incorporación de dimensiones sociales al incluir objetivos tanto socioculturales como de biodiversidad en el proceso de planificación. Múltiples obstáculos dificultaron la implementación del manejo del ecosistema en este escenario. No obstante que se utilizó un plan sustituto, los costos de transacción de la planificación relacionados con la información fueron mayores de lo que el grupo pudo superar: los déficits de información impidieron la evaluación de algunos objetivos de biodiversidad y la insuficiencia de recursos combinada con los déficits de información impidieron la evaluación científica de los objetivos socioculturales. Los costos relacionados con la negociación incrementaron por la incertidumbre, por limitaciones prácticas en la participación de partes interesadas y la existencia de objetivos múltiples, potencialmente conflictivos. Aunque los déficits de información y la incertidumbre, aunados con la baja inversión en los costos de transacción de la planificación, pudieran reducir la efectividad a largo plazo del plan mismo, el capital social y el ímpetu desarrollados durante el proceso de planificación podrían producir ganancias futuras imprevisibles para la protección de recursos marinos. Los obstáculos que identificamos aquí requerirán de atención temprana y sostenida en los esfuerzos para implementar el manejo de ecosistemas en otros escenarios de base popular. [source] Corporate social responsibility in Asian supply chainsCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 3 2006Richard Welford Abstract This research provides an overview of CSR practices in Asia, evaluates the usefulness of codes of conduct, reviews the benefits of CSR in supply chains and reviews obstacles for companies wishing to adopt good CSR practices. In order to achieve this, interviews were undertaken with CSR managers, factory managers and other experts, conducted in confidence and anonymously. Codes of conduct and associated inspections and audits are common practice but in most cases flawed. Labour issues and the rights of workers are generally seen as the most important aspect of CSR in the region. Benefits of CSR include risk reduction, staff recruitment and retention, cost savings and building good relationships with stakeholders. Obstacles include a lack of resources and skills, a lack of awareness of stakeholders' demands and inefficient production techniques. It is noted that larger firms are more able to overcome such obstacles, with clear adverse implications for smaller companies. Copyright © 2006 John Wiley & Sons, Ltd and ERP Environment. [source] Optical remote mapping of rivers at sub-meter resolutions and watershed extentsEARTH SURFACE PROCESSES AND LANDFORMS, Issue 1 2008W. Andrew Marcus Abstract At watershed extents, our understanding of river form, process and function is largely based on locally intensive mapping of river reaches, or on spatially extensive but low density data scattered throughout a watershed (e.g. cross sections). The net effect has been to characterize streams as discontinuous systems. Recent advances in optical remote sensing of rivers indicate that it should now be possible to generate accurate and continuous maps of in-stream habitats, depths, algae, wood, stream power and other features at sub-meter resolutions across entire watersheds so long as the water is clear and the aerial view is unobstructed. Such maps would transform river science and management by providing improved data, better models and explanation, and enhanced applications. Obstacles to achieving this vision include variations in optics associated with shadows, water clarity, variable substrates and target,sun angle geometry. Logistical obstacles are primarily due to the reliance of existing ground validation procedures on time-of-flight field measurements, which are impossible to accomplish at watershed extents, particularly in large and difficult to access river basins. Philosophical issues must also be addressed that relate to the expectations around accuracy assessment, the need for and utility of physically based models to evaluate remote sensing results and the ethics of revealing information about river resources at fine spatial resolutions. Despite these obstacles and issues, catchment extent remote river mapping is now feasible, as is demonstrated by a proof-of-concept example for the Nueces River, Texas, and examples of how different image types (radar, lidar, thermal) could be merged with optical imagery. The greatest obstacle to development and implementation of more remote sensing, catchment scale ,river observatories' is the absence of broadly based funding initiatives to support collaborative research by multiple investigators in different river settings. Copyright © 2007 John Wiley & Sons, Ltd. [source] Trophic control of grassland production and biomass by pathogensECOLOGY LETTERS, Issue 2 2003Charles E. Mitchell Abstract Current theories of trophic regulation of ecosystem net primary production and plant biomass incorporate herbivores, but not plant pathogens. Obstacles to the incorporation of pathogens include a lack of data on pathogen effects on primary production, especially outside agricultural and forest ecosystems, and an apparent inability to quantify pathogen biomass. Here, I report the results of an experiment factorially excluding foliar fungal pathogens and insect herbivores from an intact grassland ecosystem. At peak in control plots, 8.9% of community leaf area was infected by pathogens. Disease reduction treatment dramatically increased root production and biomass by increasing leaf longevity and photosynthetic capacity. In contrast, herbivory reduction had no detectable effects at the ecosystem or leaf scale. Additionally, biomass of foliar fungal pathogens in the ecosystem was comparable with that of insect herbivores. These results identify pathogens as potential regulators of ecosystem processes and promote the incorporation of pathogens into trophic theory. [source] Obstacles to disinflation: what is the role of fiscal expectations?ECONOMIC POLICY, Issue 40 2004Oya Celasun SUMMARY Disinflation deficits Persistently high expected inflation often makes it difficult for policy-makers to recover from inflationary episodes without substantial output losses. Using survey data from eleven disinflation episodes, we can assess whether the more or less sluggish decline of inflation rates towards lower target levels is related to backward-looking pricing behavior or to imperfect credibility of the stabilization efforts. We find that expectations of future inflation play a much more important role than past inflation in shaping the inflation process. Second, we find that an improvement in various measures of fiscal balances significantly reduces inflation expectations. This evidence suggests that, when attempting to stabilize inflation, priority should be given to building fiscal credibility. , Oya Celasun, R. Gaston Gelos and Alessandro Prati [source] Quality assurance of specialised treatment of eating disorders using large-scale internet-based collection systems: Methods, results and lessons learned from designing the Stepwise databaseEUROPEAN EATING DISORDERS REVIEW, Issue 4 2010Andreas Birgegård Abstract Computer-based quality assurance of specialist eating disorder (ED) care is a possible way of meeting demands for evaluating the real-life effectiveness of treatment, in a large-scale, cost-effective and highly structured way. The Internet-based Stepwise system combines clinical utility for patients and practitioners, and provides research-quality naturalistic data. Stepwise was designed to capture relevant variables concerning EDs and general psychiatric status, and the database can be used for both clinical and research purposes. The system comprises semi-structured diagnostic interviews, clinical ratings and self-ratings, automated follow-up schedules, as well as administrative functions to facilitate registration compliance. As of June 2009, the system is in use at 20 treatment units and comprises 2776 patients. Diagnostic distribution (including subcategories of eating disorder not otherwise specified) and clinical characteristics are presented, as well as data on registration compliance. Obstacles and keys to successful implementation of the Stepwise system are discussed, including possible gains and on-going challenges inherent in large-scale, Internet-based quality assurance. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Empirical evidence of underutilization of referrals for epilepsy surgery evaluationEUROPEAN JOURNAL OF NEUROLOGY, Issue 4 2010P. De Flon Background:, Epilepsy surgery is a treatment that can cure patients with intractable epilepsy. This study investigates whether referrals for epilepsy surgery evaluation are underutilized. Methods:, Patients with epilepsy aged 18,60 years were identified in a computerized registry held by public health care providers in a Swedish county using ICD codes. Clinical data and data on referral status for epilepsy surgery were obtained from the patients' medical records. Potential candidates for epilepsy surgery evaluation were identified using pre-specified criteria. Obstacles for referral were analysed by comparing clinical data in patients who were considered for referral and those who were not. Appropriateness of non-referral was evaluated against recommendations from the Swedish Council on Technology in Health Care (SBU). Results:, Of 378 patients with epilepsy in the registry, 251 agreed to participate. Of 251, 40 were already referred patients and 48 patients were identified as potential candidates for epilepsy surgery evaluation by study criteria. Referral had been considered but not performed in 15 of the potential candidates. Potential candidates not considered for referral were less likely to have seen a neurologist, to have had an EEG, CT and MRI, and more likely to have cognitive disturbances. Following the recommendations by the SBU, 28 of 48 potential candidates were identified as inappropriately not referred patients. Conclusion:, The number of missed referrals for epilepsy surgery evaluation was estimated to be 60 per 100 000 inhabitants. Several important obstacles were found for not referring patients for epilepsy surgery evaluation. [source] Migration and Policies in the European Union: Highly Skilled Mobility, Free Movement of Labour and Recognition of DiplomasINTERNATIONAL MIGRATION, Issue 1 2001João Peixoto This article evaluates the relationship between highly skilled mobility (especially by individuals with university-level degrees) and migration policies. Data from the European Union (EU) and Portugal (in particular) provide the empirical basis of the research. EU policies regarding the free circulation of individuals which aim to build the "common market" for economic factors (including labour) are reviewed, as are the more specific recognition of diplomas policies for professional and academic purposes, and recent levels of international mobility in both the EU and Portugal. The article also enumerates the main obstacles that, from a political and legal or social and cultural perspective, explain the low mobility revealed by those figures. Obstacles include the broad denial of citizenship rights; the necessity of assuring a means of sustenance; linguistic and technical exigencies for diploma recognition; the social attributes of work (more explicit in the service sector); and the institutional nature of national skilled labour markets. The main exception to the low mobility rule , movements of cadres in the internal labour markets of transnational corporations , together with flows in other multinational organizations, are also reviewed. In these, migrations are relatively exempt from political constraints and, significantly, avoid the recognition procedures adopted by the EU. In other words, it seems that the entry of highly skilled individuals in a transnational corporation, and not their citizenship in a Europe without frontiers, is what enables them to achieve effective mobility. [source] Obstacles in large-scale epidemiological assessment of sensory impairments in a Dutch population with intellectual disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2004H. Evenhuis Abstract Background A population-based epidemiological study on visual and hearing impairment was planned in a random sample of 2100 clients, drawn from a base population of 9012 users of Dutch residential and day-care intellectual disability (ID) services with the whole range of IDs. Stratification was applied for age 50 years and over and Down syndrome. Visual and hearing functions were assessed according to a standardized protocol, in cooperation with regular ophthalmologists and regional audiological centres. Anticipated obstacles in sample collection, random inclusion, informed consent, expertise of investigators, time and costs were eliminated by a careful preparation. However, inclusion and participation were incomplete. Method In a descriptive retrospective design, we collected data from our study files on inclusion and participation as well as reasons for non-participation, to identify unanticipated obstacles for this kind of research. Results Consent was obtained for 1660 clients, and 1598 clients participated in the data collection (76% of intended sample of 2100). Inclusion and participation rates were especially lower in community-based care organizations, resulting in unintentional skewing of the sample towards more severe levels of ID. Complete and reliable data to diagnose visual impairment were obtained for 1358/1598 (85%) and to diagnose hearing impairment for 1237/1598 participants (77%). Unanticipated obstacles had to do with the quality of coordination within care organizations, with characteristics of screening methods, and with collaboration with the regular health care system. Assessments of visual function were more easy to organize than were those of hearing. Based on our current experience, practical recommendations are given for future multicentre research, especially in community-based settings. [source] Obstacles to desegregating public housing: Lessons learned from implementing eight consent decreesJOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 2 2003Susan J. Popkin Between 1992 and 1996 the U.S. Department of Housing and Urban Development (HUD) settled a number of legal cases involving housing authorities and agreed to take remedial action as part of court-enforced consent decrees entered into with plaintiffs. These housing authorities faced significant obstacles that impaired their ability to comply swiftly and fully with all of the elements in the desegregation consent decrees. The obstacles fell into two broad categories: contextual obstacles (racial composition of waiting lists and resident populations, lack of affordable rental housing, and inadequate public transportation), and capacity and coordination obstacles (conflict among implementing agencies and ineffective monitoring by HUD). Findings presented here highlight the sizable potential delay between the time a legal remedy is imposed and when plaintiffs in public housing segregation disputes realize any benefits. They also reinforce the argument that implementation problems will be legion when policies impose a significant scope of required changes on a large number of actors who must collaborate, yet are not uniformly capable or sympathetic to the goals being promoted. © 2003 by the Association for Public Policy Analysis and Management. [source] Obstacles to instructional innovation according to college science and mathematics facultyJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 1 2007Jeffrey J. Walczyk Numerous studies have documented the infrequent use of learner-centered instruction in college science and mathematics classrooms and its negative effects on undergraduate learning and motivation. The present research deepened understanding of why. Specifically, an Internet survey was constructed that explored obstacles, supports, and incentives for instructional innovation in the classroom and was sent out to college science and mathematics faculty of Louisiana. Results revealed that colleges generally were perceived to assign little or an indeterminate weight to instruction in personnel decision making. Faculty members generally have little training in pedagogy; but when they do, they are more likely to consult sources of instructional innovation and consider teaching an important part of their professional identities. Data concerning the most common sources of instructional innovation information are presented. Several suggestions are made for institutional reform that if enacted might contribute to systemic improvement in the quality of instruction undergraduates receive. © 2006 Wiley Periodicals, Inc. J Res Sci Teach [source] Unraveling the Ivory Fabric: Institutional Obstacles to the Handling of Sexual Harassment ComplaintsLAW & SOCIAL INQUIRY, Issue 1 2000Jennie Kihnley Title VII of the Civil Rights Act of 1964 and Title IX of the Educational Amendments of 1972 make universities liable for sexual harassment that occurs within both the employment and academic contexts. This article examines how universities implement and enforce the mandates of both Title VII and Title IX through exploratory research about sexual harassment complaint procedures at a public university system on the West Coast. In-depth interviews with personnel at each campus shed light on problems with inserting a complaint resolution process into an institution that simultaneously strives to eliminate sexual harassment, while wanting to protect itself from liability. This inherent conflict of goals is reflected in the differing roles of the Title IX office and the Women's Resource Center, in creation of a user friendly policy, and in the two branches of dispute resolution. [source] Transnational campuses: Obstacles and opportunities for institutional research in the global education marketNEW DIRECTIONS FOR INSTITUTIONAL RESEARCH, Issue 124 2004Jason E. Lane This chapter highlights some of the issues that need to be addressed when operating international campuses and provides a list of questions to help guide relevant institutional research. [source] Ports of Entry and Obstacles: Teenagers' Access to Volunteer ActivitiesNONPROFIT MANAGEMENT & LEADERSHIP, Issue 2 2000Richard A. Sundeen The recruitment of young people into volunteering activities is the primary focus of this article. We examine which teenagers volunteer, the ways that teenagers become involved in volunteer activities, and why teenagers do not volunteer. Teenagers who volunteer tend to have dominant status, that is, access to social power, high personal competency, and socialization into volunteer experiences through family, church, and school. Personal contact with family, friends, and teachers who are involved with service, prior participation in school- and church-based service, and personal initiative lead teenagers to learn about and engage in volunteering activities. Teenagers who do not volunteer often do not have sufficient time or interest. Differences exist among teenagers as to which factors prompt volunteering. For example, teenagers who are white, have parents who volunteer, and attend religious services are more likely than others to learn about volunteer activities through organizations, and teenagers with higher personal competency (grade point averages) are more likely than others to learn about volunteering activities at school. The article includes suggestions for recruitment policy and management of teenage volunteers. [source] The Presence of Love in Ethical CaringNURSING FORUM, Issue 1 2006Maria Arman RNM Caring as a virtue and an act of ethics is from both a natural and a professional point of view inseparably related to love as a universal/ontological value. Love is shown, like suffering and death, to be a concept of universal or metacharacter. From current nursing/caring science as well as from ethical and philosophical perspectives, this paper explores how love can be visible in caring through virtue and that the art of caring creates its evidence. The ethical and existential practicing of love, particularly unselfish love, allows a caregiver to come distinctly closer to the essence of his or her own personality and to live in a more authentic manner. Obstacles and alienation in caregivers that induce a holding back of one's own natural impulses to give the suffering patient tender, dignified care are examined. Economy, paradigm, and caring culture are cited, but ultimately it is a question concerning every caregiver's decision and responsibility to come forward to serve those the caregiver is actually there to represent, the suffering patient. This does not always require new knowledge, rather, liberation of the inner life and authenticity in caregivers. Love, if viewed only as a phenomenon without connection to a universal or ontological philosophy, risks being a problematic concept for caring science. If, on the other hand, it is viewed as the ontological basis for caring and ethical acts, then we can look for and practice phenomenological expressions for love that can enhance the patient's understanding of life as well as giving relief from suffering. [source] Obstacles to organ donation in ethnic minoritiesPEDIATRIC TRANSPLANTATION, Issue 6 2001C. O. Callender While the numbers of ethnic minority donors have increased over the last 20 yr, there is still a need for community outreach and education in order to dispel the myths and misperceptions within minority communities so that a greater number of persons will ultimately become donors. While lack of awareness, religious myths and misperceptions, medical distrust, fear of premature death, and racism continue to cause reluctance within ethnic minority communities, the National Minority Organ Tissue Transplant Education Program (National MOTTEP) applies a methodology which has proven successful within various ethnic minority populations. The methodology utilizes ethnically similar and culturally sensitive transplant recipients, candidates and donors or donor families, along with health care providers, as effective messengers who are recognized within the community. In addition, community volunteers are solicited to become involved in hands-on program planning and implementation of activities, which will impact the community regarding their knowledge, attitudes and behaviors. Data collected from 914 consenting adult participants indicated that there were significant increases (p < 0.000) in trust in doctors, future plans to become organ donors, and changes in the participants' spiritual/religious beliefs about organ/tissue donation. The conclusion is that culturally appropriate health education programs targeting ethnic minority populations can effect positive change in knowledge, attitudes, and behavior. [source] On the Status of Restoration Science: Obstacles and OpportunitiesRESTORATION ECOLOGY, Issue 2 2007Evan Weiher Abstract Terrestrial restoration ecology is not as well developed as aquatic and wetland restoration. There are several key obstacles to progress in restoration ecology, but these obstacles may also be viewed as opportunities to exploit. One obstacle is demonstration science, or an overreliance on simplistic experiments with few treatment factors and few levels of those factors. Complex, multivariate experiments yield greater insights, especially when teamed with sophisticated methods of data analysis. A second key obstacle is myopic scholarship that has led to little synthesis and weak conceptual theory. A greater awareness of and explicit references to ecological principles will help develop the conceptual basis of restoration science. Where should restoration ecology be headed? We should consider forming partnerships with developers, landscape artists, and industry to do complex, large-scale experiments and make restoration a more common part of everyday life. [source] Poor Christopher Colles: An Innovator's Obstacles in Early AmericaTHE JOURNAL OF AMERICAN CULTURE, Issue 2 2005Deborah Epstein Popper First page of article [source] Lentivirus vector-mediated gene transfer to the developing bronchiolar airway epithelium in the fetal lambTHE JOURNAL OF GENE MEDICINE, Issue 6 2007Ze-Yan Yu Abstract Background Development of effective and durable gene therapy for treatment of the respiratory manifestations of cystic fibrosis remains a formidable challenge. Obstacles include difficulty in achieving efficient gene transfer to mature airway epithelium and the need to stably transduce self-renewing epithelial progenitor cells in order to avoid loss of transgene expression through epithelial turnover. Targeting the developing airway epithelium during fetal life offers the prospect of circumventing these challenges. Methods In the current study we investigated vesicular stomatitis virus glycoprotein (VSVg)-pseudotyped HIV-1-derived lentivirus vector-mediated gene transfer to the airway epithelium of mid-gestation fetal lambs, both in vitro and in vivo. In the in vitro studies epithelial sheet explants and lung organ culture were used to examine transduction of the proximal and more distal airway epithelium, respectively. For the in vivo studies, vector was delivered directly into the proximal airway. Results We found that even during the early pseudoglandular and canalicular phases of lung development, occurring through mid-gestation, the proximal bronchial airway epithelium was relatively mature and highly resistant to lentivirus-mediated transduction. In contrast, the more distal bronchiolar airway epithelium was relatively permissive for transduction although the absolute levels achieved remained low. Conclusion This result is promising as the bronchiolar airway epithelium is a major site of pathology in the cystic fibrosis airway, and much higher levels of transduction are likely to be achieved by developing strategies that increase the amount of vector reaching the more distal airway after intratracheal delivery. Copyright © 2007 John Wiley & Sons, Ltd. [source] Christian-Muslim Dialogue: Goals and ObstaclesTHE MUSLIM WORLD, Issue 3 2004Mahmoud Ayoub First page of article [source] Donor Intervention and Organ Preservation: Where Is the Science and What Are the Obstacles?AMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2010S. Feng The organ shortage is widely acknowledged as the most critical factor hindering the full realization of success for solid organ transplantation. Innovation in the areas of donor management and organ preservation offers the most realistic hope to improve both the quality and size of the current organ supply. Although the basic science dissecting the complex processes of brain death and ischemia/reperfusion injury is replete with exciting discoveries, the clinical science investigating donor management and organ preservation is sparse in contrast. This review will survey the current landscape of trials to mitigate organ injury through interventions administered to donors in vivo or organs ex vivo. Consideration will then be given to the scientific, logistical and ethical obstacles that impede the transformation of laboratory breakthroughs into innovative treatments that simultaneously improve organ quality and supply. [source] Reaching a Global Agreement on Climate Change: What are the Obstacles?ASIAN ECONOMIC POLICY REVIEW, Issue 1 2010Gary Clyde HUFBAUER F13; F18; Q54; Q56 A successor accord to the Kyoto Protocol was supposed to be wrapped up in Copenhagen in December 2009, but negotiations are now expected to extend through the South African UNFCCC conference in 2011 since the Copenhagen talks failed to yield a binding agreement. To reach a comprehensive deal, major gaps between developing and developed countries must be narrowed. The gaps include the character of common but differentiated responsibilities, financial support, technology transfer, and trade subsidies and sanctions. The paper concludes with some options and recommendations. [source] Social Protection in Vietnam and Obstacles to ProgressivityASIAN SOCIAL WORK AND POLICY REVIEW, Issue 1 2008Martin Evans The present paper analyzes the incidence and progressivity of Vietnamese state income transfers using survey data from the Vietnamese Household Living Standards Survey 2004. Data quality and sample selection issues are highlighted, especially in the coverage of rural-urban migrants. Simple income-based profiles of incidence are matched to several influences that confound and complicate the measurement of progressivity. The issue of the informal economy is highlighted through analysis of both the extent of private inter-household transfers and remittances and their relationship with state transfers, and in the informal charges that accompany uptake of state services and other petty corruption. Second, the issue of user-charges for health and education services is considered, as a considerable portion of state transfers are related to the take up of schooling and health care. Third, the issue of behavioral effects is also considered, concentrating on private inter-household transfers. The paper concludes by drawing together the evidence and the obstacles to measurement and progressivity to argue a range of data collection, methodological and policy recommendations. [source] Physical activity advice in the primary care setting: results of a population study in New ZealandAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2006Karen Croteau Objectives: To determine the prevalence of physical activity advice, including the Green Prescription (a physical activity scripting scheme), given in the primary care setting, and the characteristics of New Zealanders who receive such advice. Method: Questions from a 2003 national postal survey (n=8,291), ,Obstacles to Action', were examined. The survey was designed to identify population segments to target for physical activity interventions. Binary logistic regression was used to examine independent factors associated with receiving a physician or practice nurse recommendation to increase physical activity and receiving a Green Prescription. Results: Overall, 13.3% of the sample reported receiving physical activity advice while 3.0% reported receiving a Green Prescription from their general practitioner or practice nurse in the last year. Those more likely to receive physical activity advice were Maori or Pacific, overweight or obese, sedentary, or suffering chronic disease. Results were similar for Green Prescription advice. When controlling for these and other demographics, physical inactivity was not related to the odds of receiving a Green Prescription. Conclusions: One out of every eight New Zealanders reported being given general physical activity advice in the primary care setting. While the physically inactive but otherwise healthy were not specifically targeted, the Green Prescription was more likely to be given on the basis of existing chronic conditions related to physical inactivity and other high-risk populations. Implications: Primary care settings provide an important opportunity to promote physical activity for New Zealand adults. While those most at risk are more likely to receive such advice, there are many more that may benefit. [source] Benchmarks and control charts for surgical site infectionsBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2000T. L. Gustafson Background Although benchmarks and control charts are basic quality improvement tools, few surgeons use them to monitor surgical site infection (SSI). Obstacles to widespread acceptance include: (1) small denominators, (2) complexities of adjusting for patient risk and (3) scepticism about their true purpose (cost cutting, surgical privilege determination or improving outcomes). Methods The application of benchmark charts (using US national SSI rates as limits) and control charts (using facility rates as limits) was studied in 51 hospitals submitting data to the AICE National Database Initiative. SSI rates were risk adjusted by calculating a new statistic, the standardized infection ratio (SIR), based on the risk index suggested by the Centers for Disease Control National Nosocomial Infection Surveillance Study. Fourteen different types of control chart were examined and 115 suspiciously high or low monthly rates were flagged. Participating hospital epidemiologists investigated and classified each flag as ,a real problem' (potentially preventable) or ,not a problem' (beyond the control of personnel at this facility). Results None of the standard, widely recommended, control charts studied showed practical value for identifying either preventable rate increases or outbreaks (clusters due to a single organism). On the other hand, several types of risk-adjusted control chart based on the SIR correctly identified most true opportunities for improvement. Sensitivity, specificity and receiver,operator characteristic (ROC) analysis revealed that the XmR chart of monthly SIRs would be useful in hospitals with smaller surgical volumes (ROC area = 0·732, P = 0·001). For larger hospitals, the most sensitive and robust SIR chart for real-time monitoring of surgical infections was the mXmR chart (ROC area = 0·753, P = 0·0005). © 2000 British Journal of Surgery Society Ltd [source] Discovery of Chromone-Based Inhibitors of the Transcription Factor STAT5CHEMBIOCHEM, Issue 5 2008Judith Müller Obstacles overcome: Gene-specific transcription factors are emerging therapeutic targets, but their direct inhibition is considered to be difficult because of the absence of enzymatic activities. This manuscript describes the discovery of chromone-based inhibitors of the protein,protein interactions required for activity of the transcription factor STAT5, a therapeutic target for the treatment of human cancers. [source] Obstacles to involving children and young people in foster care researchCHILD & FAMILY SOCIAL WORK, Issue 4 2002Robyn Gilbertson ABSTRACT Despite increasing recognition of the importance of including the perspectives of children and young people in care in alternative care research, in practice this is not always a straightforward matter. This paper describes the recruitment of disruptive young people in care under the jurisdiction of the South Australian statutory authority to three studies on placement instability. Non-response rates of 72.5% and 82% are reported. A large number of subjects were excluded because agency social workers did not cooperate with the project, and more subjects were excluded for reasons which suggest high levels of distress in this population. The dilemma of providing a voice to distressed subjects when distressed subjects are excluded from research is discussed, and the appointment of an independent representative for children in care to review research proposals and to negotiate research access to children is proposed. [source] Modifications in Children's Goals When Encountering Obstacles to Conflict ResolutionCHILD DEVELOPMENT, Issue 3 2005Wendy Troop-Gordon Previous studies have demonstrated that children's goals are associated with their success in peer relationships. The current study extends earlier findings by examining changes in children's goals during hypothetical conflicts. Participants were 252 children ages 9 to 12 years old (133 boys, 119 girls). As predicted, children's goals changed significantly when they encountered obstacles to conflict resolution, and these changes were predictive of their subsequent strategy choices. Both aggressive- and submissive-rejected children were more likely to evidence antisocial changes in their goals, including an increased desire to retaliate. They also showed reluctance to forego instrumental objectives. Other findings highlighted the need to investigate the combinations of goals children pursue as predictors of their strategies and the quality of their peer relationships. [source] Methods for Disseminating Research Products and Increasing Evidence-Based Practice: Promises, Obstacles, and Future DirectionsCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2002Michael E. Addis Although several different rationales for psychotherapy dissemination research have been well articulated, the most effective means for bringing research products to clinical practice have yet to be determined. Two commonly proposed methods are the dissemination of empirically supported treatments and the dissemination of general evidence-based stances to clinical decision making. Obstacles to either approach include (a) practical constraints on practitioners' ability to use research products, (b) lack of research on process and outcome of both empirically supported treatments and existing services in different practice contexts, (c) lack of research on acceptability of research products to end users including practitioners, clients, and administrators, (d) lack of research on training in the integration of science and practice at the undergraduate, graduate, and postgraduate levels, (e) systemic economic contingencies that favor or punish evidence-based decision making, and (f) the tendency to construct dissemination as a hierarchical and unidirectional process of transmission from research to clinical practice. Each obstacle is considered in detail and followed by recommendations for ways to broaden the scope of dissemination efforts. [source] | ||||||||||||||||||||||||||||||||||||||||