Home About us Contact
|
Home About us Contact | ||
|
|
||
Overcoming Barriers (overcoming + barrier)
Selected AbstractsOVERCOMING BARRIERS TO PAIN RELIEF IN THE CARIBBEANDEVELOPING WORLD BIOETHICS, Issue 3 2009CHERYL MACPHERSON ABSTRACT This paper examines pain and pain relief in the Caribbean, where pain is widely perceived as an unavoidable part of life, and where unnecessary suffering results from untreated and under treated pain. Barriers to pain relief in the Caribbean include patient and family attitudes, inadequate knowledge among health professionals and unduly restrictive regulations on the medical use of opioids. Similar barriers exist all over the world. This paper urges medical, nursing and public health professionals, and educators to examine attitudes towards pain and pain relief and to work towards making effective pain relief and palliation more accessible. It recommends that i) health professionals and officials be better educated about pain, palliation and opioids, ii) regulatory restrictions be updated in light of clinical and scientific evidence, iii) opioid procurement policies be adjusted to facilitate increased medical use, iv) medical charts and records be modified to routinely elicit and document patients levels of pain, and v) educational campaigns be developed to inform the public that moderate and severe pain can be safely relieved at the end of life and other stages of life. The professional, respectful, and beneficent response to patients in pain is to provide rapid and aggressive pain relief or to urgently consult a pain or palliative specialist. When a health system hinders such efforts the ethical response is to identify, facilitate and advocate for overcoming barriers to improvement. [source] Introduction: Overcoming Barriers to the Extension of Social Protection: Lessons from the Asia RegionIDS BULLETIN, Issue 4 2010Naila Kabeer The contributions to this IDS Bulletin report on some of the findings from research undertaken under the Social Protection in Asia programme. This is a three-year policy-oriented research and network building programme, funded by the Ford Foundation and IDRC, with project partners in China, Vietnam, Indonesia, India, Pakistan and Bangladesh. The research focuses on examining interventions aimed at extending social protection to those sections of the population, the majority in many Asian countries, who are excluded from formal social security systems. It has sought to identify and address barriers to the establishment of more comprehensive social protection systems that could address such difficult-to-reach groups. This issue of the IDS Bulletin brings together some initial reflections on the findings from this research. These relate to advocacy efforts to draw attention to those groups that have been largely invisible in the social protection agenda; to the importance of civil society and grassroots mobilisation in creating access to state provision and to lessons from social protection efforts to go to scale. These reflections are intended to feed into current debates about the design of appropriate social protection schemes that effectively meet identified needs. [source] Stretch Goals and Backcasting: Approaches for Overcoming Barriers to Large-Scale Ecological RestorationRESTORATION ECOLOGY, Issue 4 2006Adrian D. Manning Abstract The destruction and transformation of ecosystems by humans threatens biodiversity, ecosystem function, and vital ecosystem services. Ecological repair of ecosystems will be a major challenge over the next century and beyond. Restoration efforts to date have frequently been ad hoc, and site or situation specific. Although such small-scale efforts are vitally important, without large-scale visions and coordination, it is unlikely that large functioning ecosystems will ever be constructed by chance through the cumulative effects of small-scale projects. Although the problems of human-induced environmental degradation and the need for a solution are widely recognized, these issues have rarely been addressed on a sufficiently large-scale basis. There are numerous barriers that prevent large-scale ecological restoration projects from being proposed, initiated, or carried through. Common barriers include the "shifting baseline syndrome," the scale and complexity of restoration, the long-term and open-ended nature of restoration, funding challenges, and preemptive constraint of vision. Two potentially useful approaches that could help overcome these barriers are stretch goals and backcasting. Stretch goals are ambitious long-term goals used to inspire creativity and innovation to achieve outcomes that currently seem impossible. Backcasting is a technique where a desired end point is visualized, and then a pathway to that end point is worked out retrospectively. A case study from the Scottish Highlands is used to illustrate how stretch goals and backcasting could facilitate large-scale restoration. The combination of these approaches offers ways to evaluate and shape options for the future of ecosystems, rather than accepting that future ecosystems are victims of past and present political realities. [source] Tropical Montane Forest Restoration in Costa Rica: Overcoming Barriers to Dispersal and EstablishmentRESTORATION ECOLOGY, Issue 4 2000Karen D. Holl Abstract Tropical forests are being cleared at an alarming rate although our understanding of their ecology is limited. It is therefore essential to design restoration experiments that both further our basic knowledge of tropical ecology and inform management strategies to facilitate recovery of these ecosystems. Here we synthesize the results of research on tropical montane forest recovery in abandoned pasture in Costa Rica to address the following questions: (1) What factors limit tropical forest recovery in abandoned pasture? and (2) How can we use this information to design strategies to facilitate ecosystem recovery? Our results indicate that a number of factors impede tropical forest recovery in abandoned pasture land. The most important barriers are lack of dispersal of forest seeds and seedling competition with pasture grasses. High seed predation, low seed germination, lack of nutrients, high light intensity, and rabbit herbivory also affect recovery. Successful strategies to facilitate recovery in abandoned pastures must simultaneously overcome numerous obstacles. Our research shows that establishment of woody species, either native tree seedlings or early-successional shrubs, can be successful in facilitating recovery, by enhancing seed dispersal and shading out pasture grasses. On the contrary, bird perching structures alone are not an effective strategy, because they only serve to enhance seed dispersal but do not reduce grass cover. Remnant pasture trees can serve as foci of natural recovery and may enhance growth of planted seedlings. Our results highlight the importance of: (1) understanding the basic biology of an ecosystem to design effective restoration strategies; (2) comparing results across a range of sites to determine which restoration strategies are most generally useful; and (3) considering where best to allocate efforts in large-scale restoration projects. [source] Public Health in the Emergency Department: Overcoming Barriers to Implementation and DisseminationACADEMIC EMERGENCY MEDICINE, Issue 11 2009Mary Pat McKay MD Abstract This article is the outcome of a consensus building workshop entitled, "Overcoming Barriers to Implementation and Dissemination" convened at the 2009 Academic Emergency Medicine Consensus Conference, ,,Public Health in the ED: Surveillance, Screening, and Intervention." The participants were asked to address potential methods for overcoming barriers to the dissemination and implementation in the emergency department (ED) of evidenced-based practices to improve public health. The panel discussed three broad areas of interest including methods for disseminating evidence-based practices, barriers encountered during the process of implementation, and the importance of involvement in activities outside the ED including engagement in policy development and improvement. Four recommendations were discussed in detail and consensus was reached. The recommendations included 1) researchers and advocates should disseminate findings through multiple forums beyond peer-reviewed publications when an ED-based public health intervention has enough evidence to support integration into the routine practice of emergency care; 2) local barriers to implementation of public health interventions should be recognized and well understood from multiple perspectives prior to implementation; 3) innovation must be put into place and adapted based on local institutional context and culture as barriers and the best methods for overcoming them will vary across institutions; and 4) use of legislation, regulation, and incentives outside of the ED should support and strengthen ED-based interventions. For each area of interest, research dimensions to extend the current understanding of methods for effectively and efficiently implementing evidence-based public health interventions in the ED were discussed and consensus was achieved. [source] Overcoming Barriers to Increase the Contribution of Clinical Psychologists to Work With Persons With Severe Mental IllnessCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2006David Roe Psychosocial treatments for persons with severe mental illness (SMI) have been developing rapidly over the past decade. Despite the fact that people with SMI are often in the greatest need of care, clinical psychologists are not currently playing a major role in their treatment and are underrepresented compared to other disciplines in this area such as nursing, social work, and psychiatry. In this article, we present possible reasons for clinical psychologists' underrepresentation and discuss motivators, potential opportunities, and ways for clinical psychologists to take a greater role in the provision of services for persons with SMI. Implications for the training of clinical psychologists are discussed. [source] Overcoming barriers to implementing environmentally benign manufacturing practices: Strategic tools for SMEsENVIRONMENTAL QUALITY MANAGEMENT, Issue 3 2009Manuel Seidel First page of article [source] Overcoming barriers to physical activity among culturally and linguistically diverse older adults: A randomised controlled trialAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2010Karen Borschmann Aim:, To investigate by randomised trial, health professional facilitated sessions aiming to overcome barriers to physical activity (PA), improve readiness to undertake PA, increase PA participation and improve fitness among older Australian adults from Macedonian and Polish backgrounds. Method:, One hundred and twenty-one participants (mean age 70 years, 63% female) were block randomised to the intervention group (three one-hour group education and goal setting sessions over 7 weeks) or control group (one-hour health promotion talk) following baseline assessment, with reassessment approximately 9 weeks later. Results:, No significant differences were found between experimental groups in primary (Stages of Change Questionnaire (SocQ), steps per day and Human Activity Profile) or secondary outcomes. Conclusion:, This study has highlighted methodological considerations for PA health promotion and research with older adults from culturally and linguistically diverse (CALD) backgrounds in a community setting. Investigation of older CALD adults' perceptions of what are ,adequate levels of PA' and methods of increasing PA is warranted. [source] Overcoming barriers to sustainability: an explanation of residential builders' reluctance to adopt clean technologiesBUSINESS STRATEGY AND THE ENVIRONMENT, Issue 8 2009Jonatan Pinkse Abstract The construction industry has great opportunities to significantly reduce CO2 emissions by improving the energy efficiency of residential buildings. However, in this industry, diffusion of cost-effective clean technologies has been notoriously slow and below potential. This paper sheds light on factors that explain why construction companies have been reluctant to adopt energy-efficient technologies. It questions why some companies have intensified their investments in clean technologies, while others are lagging behind. Based on a multiple case study of four Dutch building contractors, the paper shows that contractors that actively gather information and build internal technical capacity are keener on adopting energy-efficient technologies. Findings also reveal that it will be a major challenge for the construction industry to communicate the advantages of clean technologies to (potential) home buyers and create market demand. Copyright © 2008 John Wiley & Sons, Ltd and ERP Environment. [source] OVERCOMING BARRIERS TO PAIN RELIEF IN THE CARIBBEANDEVELOPING WORLD BIOETHICS, Issue 3 2009CHERYL MACPHERSON ABSTRACT This paper examines pain and pain relief in the Caribbean, where pain is widely perceived as an unavoidable part of life, and where unnecessary suffering results from untreated and under treated pain. Barriers to pain relief in the Caribbean include patient and family attitudes, inadequate knowledge among health professionals and unduly restrictive regulations on the medical use of opioids. Similar barriers exist all over the world. This paper urges medical, nursing and public health professionals, and educators to examine attitudes towards pain and pain relief and to work towards making effective pain relief and palliation more accessible. It recommends that i) health professionals and officials be better educated about pain, palliation and opioids, ii) regulatory restrictions be updated in light of clinical and scientific evidence, iii) opioid procurement policies be adjusted to facilitate increased medical use, iv) medical charts and records be modified to routinely elicit and document patients levels of pain, and v) educational campaigns be developed to inform the public that moderate and severe pain can be safely relieved at the end of life and other stages of life. The professional, respectful, and beneficent response to patients in pain is to provide rapid and aggressive pain relief or to urgently consult a pain or palliative specialist. When a health system hinders such efforts the ethical response is to identify, facilitate and advocate for overcoming barriers to improvement. [source] Critical issues in the treatment of hepatitis C virus infection in methadone maintenance patientsADDICTION, Issue 6 2008David M. Novick ABSTRACT Aims Hepatitis C virus (HCV) infection is a common chronic complication of injection drug use. Methadone maintenance programs contain large numbers of patients infected with HCV. This paper reviews HCV infection with emphasis on the medical care of HCV-infected, or HCV and human immunodeficiency virus co-infected, patients on methadone or buprenorphine maintenance. Methods Literature searches using PubMed, PsycINFO and SocINDEX were used to identify papers from 1990,present on antiviral therapy for HCV in methadone maintenance patients and on liver transplantation in methadone maintenance patients. Results Injection drug use is the most significant risk factor for HCV infection in most western countries. The prevalence of HCV antibody is high in injection drug users (53,96%) and in patients enrolled in methadone maintenance programs (67,96%). Studies of antiviral therapy for HCV in methadone maintenance patients show rates of sustained virological response (SVR), defined as negative HCV-RNA 24 weeks after the end of treatment, of 28,94%. In studies with contrast groups, no significant differences in SVR between methadone and contrast groups were found. Excellent completion rates of antiviral therapy (72,100%) were found in five of six studies. There are many barriers to methadone maintenance patients' receiving antiviral therapy, and research on overcoming barriers is discussed. Liver transplantation has been successful in methadone maintenance patients but has not been utilized widely. Conclusion High quality medical care for all aspects of HCV infection can be provided to methadone maintenance patients. The literature supports the effectiveness of such services, but the reality is that most patients do not receive them. [source] Promoting energy efficiency in small island states: overcoming barriers to the adoption of compact fluorescent lighting in Saint LuciaINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 5 2007Travis W. Reynolds Abstract The ,island factor' refers to a series of shared energy-related issues that many island nations face due to their isolation and limited population size. Under such conditions, one of the only ways to reduce energy costs for consumers is through energy efficiency , including the use of energy-saving compact fluorescent light bulbs. This study uses consumer survey data to investigate how awareness, past purchasing behaviour, and demographic characteristics influence Saint Lucian consumers' intentions to purchase energy-saving compact fluorescent bulbs. The findings indicate that a lack of awareness and understanding of energy efficiency, combined with high product costs and a lack of product availability currently inhibit the adoption of compact fluorescent technologies by Saint Lucian consumers. Awareness of energy efficiency, income and geographic location are identified as significant factors related to increased use of and willingness to pay for compact fluorescent bulbs. In the discussion, possibilities for public education and cost subsidy for compact fluorescent bulb promotion are proposed. [source] Tourism in Dubai: overcoming barriers to destination developmentINTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 2 2006Joan C. Henderson Abstract The Middle East as a whole attracts comparatively few visitors, and political events in the current century have generated new uncertainties and tensions which seem likely to further discourage tourists and investors. Additional barriers relate to poor accessibility, a perceived lack of conventional attractions and limited promotion. Despite these apparently unfavourable circumstances, international tourism has been adopted by the Dubai authorities as a core element in a programme of economic diversification. They have invested heavily in expensive facilities, as well as undertaken extensive marketing, and the outcome has been strong growth in tourism. There are great expectations of the future, reflected in the setting of very high arrival targets. However, there are also several constraints that might inhibit progress, with a need to review strategies. The experience of Dubai thus serves to illustrate factors that are critical to destination development, major impediments and approaches to overcoming these. Copyright © 2006 John Wiley &Sons, Ltd. [source] The Best of Public Health Nursing, Circa 1941PUBLIC HEALTH NURSING, Issue 3 2008Sarah E. Abrams ABSTRACT Public health nursing was the term Lillian Wald used to describe the work of nurses whose role it was to address both the immediate impact of sickness and the underlying relationship between poverty, social disadvantage, environmental hazards, and disease. The nature and content of American public health nursing of the 1930s are reflected in exemplars from Marguerite Wales's 1941 book, The Public Health Nurse in Action. Nurses' roles as educators, caregivers, and case managers overcoming barriers emerge from the tales. These vignettes illustrate the organic relationships that existed between nurses and communities. Nurses' understanding of the nature and influence of environmental, psychological and social factors on health behavior was essential to effective public health work. Their stories help us interpret the meaning of nursing at a moment in time. They also reflect the values of the founders of Henry Street Nursing Service and supervisors of public and voluntary agencies throughout the U.S. and Canada who selected and edited them for instructive purposes. Reading collections of such narratives also helps us to appreciate the difficulty of negotiating complex needs, and may provide greater appreciation for the work of our predecessors as well as our own. [source] Book Reviews: Spelling, Handwriting and Dyslexia: overcoming barriers to learning , By Diane MontgomeryBRITISH JOURNAL OF SPECIAL EDUCATION, Issue 4 2009Mary E. Chambers No abstract is available for this article. [source] | ||||||||||||||||