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Persistent Problems (persistent + problem)

Distribution by Scientific Domains

Medical Sciences	31%
Humanities and Social Sciences	18%
Business, Economics, Finance and Accounting	18%

Selected Abstracts

The enduring contradictions of new software development approaches: a response to ,Persistent Problems and Practices in ISD'

INFORMATION SYSTEMS JOURNAL, Issue 3 2007
Richard Baskerville
First page of article [source]

Persistent problems and practices in information systems development

INFORMATION SYSTEMS JOURNAL, Issue 3 2007
Karlheinz Kautz
Abstract.,This paper identifies and discusses the persistent problems and development practices of information systems development (ISD). A critical examination and comparison of past times',traditional' and present-day ,web-based' development shows that contemporary ISD can be seen as an accentuated evolution , rather than a revolution , of well-known challenges and solutions. On this basis, (1) diversity; (2) knowledge; and (3) structure are identified as inherent and interrelated problems, while the practices for coping with these three challenges are (a) organization and specialization; (b) constant verbal communication and negotiation; and (c) pragmatic application of certain development methods and methodical concepts. We conclude that more research on the occurrence and interaction of problems and practices at, and between, different contextual levels (e.g. the business environment, company, project, team and individual levels) is needed to understand and assess (the gap between) ,observed practice' and ,good practice' across the many types of Web and non-Web ISD projects conducted today. We outline a possible research agenda to investigate these issues. [source]

RNA damage and surveillance under oxidative stress

IUBMB LIFE, Issue 10 2006
Zhongwei Li
Abstract RNA damage has been recently reported to increase under oxidative stress and in patients with many degenerative diseases, which has drawn attention to the consequences of RNA oxidation at the molecular and cellular levels. Under similar conditions the levels of oxidative damage in RNA are usually higher than those in DNA, which may impair protein synthesis or other RNA function. Therefore, accumulation of RNA damage must be prevented and cells have developed specific mechanisms to remove oxidatively-damaged RNA and to block incorporation of oxidized nucleotides during RNA synthesis. Removal of oxidized RNA may be mediated by specific proteins that recognize oxidative lesions and direct the RNA degradation machinery to eliminate the damaged RNAs. During RNA synthesis, oxidized ribonucleotides are hydrolyzed or discriminated from normal ribonucleotides during transcription, preventing their incorporation into RNA. Collective evidence suggests that RNA oxidative damage is a challenging and persistent problem normally controlled through RNA surveillance mechanisms, making them critical to maintaining cellular health and preventing disease. iubmb Life, 58: 581-588, 2006 [source]

Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients

JOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 6 2006
P. J. Barry MB
Summary Background:, In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) , 2003 version]. The Beers' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers' criteria CD contains 19 different categories containing possible drug,disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug,disease interactions. Objectives:, The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. Methods:, A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80·3 ± 6·1 years) and all patients had both Beers' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. Results:, The results of the study identified a high rate of inappropriate prescribing among this population of community-dwelling subjects. The total number of inappropriate prescriptions identified using the Beers' criteria (ID) was 148 affecting 121 patients. The Beers' criteria (CD) identified 69 inappropriate prescriptions in 60 patients and the IPET identified 112 inappropriate prescriptions in 78 patients. The Beers criteria (ID and CD combined) identified at least one inappropriate prescription in 34% of subjects and the IPET identified one in at least 22% of subjects. Conclusions:, This study identifies high rates of use of inappropriate medications in community-dwelling elderly presenting with acute illness to hospital. These are comparable with inappropriate prescribing rates identified in previous studies. The revised Beers' criteria (2003) identified more inappropriate prescriptions than the IPET in this population of elders. [source]

Chlamydial treatment failures: a persistent problem?

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2001
GI Byrne
[source]

Learning to Live with Our Children

PUBLIC HEALTH NURSING, Issue 6 2006
Henrietta Fleck
ABSTRACT As the title suggests, being perplexed by one's children is not unique to the 21st century. In her paper, published in the original Public Health Nursing, Henrietta Fleck (1949), chair of Home Economics at New York University, addressed this persistent problem by providing advice on parent education methods for public health nurses. The materials,films, newspapers, cartoons, posters,are all within the nurse's arsenal today, supplemented by television, and the Internet. More interesting was Fleck's philosophy about parenting and family life. The excerpt omits the dated description of resources, focusing instead on her point of view. It reflects post-World War II optimism about the meaning and power of democracy in shaping familial behavior. The United States was readjusting to civilian life following World War II, fathers were returning home from military fields of action overseas, women were gradually being displaced from the industrial workplace,the country was expanding into suburbia and baby boomers were making their first appearances in the world. Fleck's assumptions include belief in the value of individualism, the importance of sharing both privilege and obligation, and the nature of maturity evidenced in an ability to make reasoned and reasonable choices and to hold oneself accountable for them. The limitations of her view are left to us to ponder. [source]

Corporate Governance and Intellectual Capital: some conceptualisations

CORPORATE GOVERNANCE, Issue 4 2001
James Keenan
One of the persistent problems facing corporate governance is the increasing shift toward knowledge-intensive organisations. This article focuses on the fiduciary responsibility of corporate governance for creating, developing, and leveraging the intellectual capital existing and embedded in the people, structures, and processes of the firm. Research and practice, traditionally concerned with governance responsibility for financial and physical capitals, has not much focused on the relations between governance and intellectual capital. Here, the authors' intellectual capital paradigm is overlayered on a recent taxonomy of systems and features of corporate governance. The result is an explication of the role and characteristics of corporate governance in relation to the intellectual capital of the firm. [source]

Participation of experts and non-experts in a sustainability assessment of mobility

ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 4 2009
Lorraine Whitmarsh
Abstract The complexity, ambiguity and subjectivity that surround persistent problems of unsustainability, such as mobility, highlight the importance of stakeholder engagement in both knowledge production and policy development. This paper reports on research within the EU-funded MATISSE project to develop tools and methods for Integrated Sustainability Assessment (ISA), a novel interdisciplinary and participatory approach to sustainability strategy development. Two different methods , expert focus groups and citizen deliberative workshops , were employed to elicit knowledge and preferences of European stakeholders in respect of sustainable mobility. Findings from these exercises indicate areas of both convergence and divergence in the visions of sustainable mobility futures depicted by different stakeholder groups. Stakeholders agreed on the need to address problems of unsustainability in the transport sector, and identified broadly similar environmental, social and economic criteria for sustainable transport. Amenity of transport was more important for citizens, while experts focussed on pragmatic and technological issues. Both groups favoured modal shift and novel technologies, and citizens also supported demand reduction measures and choices; however, a range of barriers to achieving sustainable mobility was also identified by participants. Stakeholder feedback suggests the process was valuable and acted as a forum for social learning and the co-production of knowledge by citizens and experts, while at the same time empowering these groups to participate in an important social issue such as transport. The value and limitations of these methods for ISA are discussed and avenues for further research proposed. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment. [source]

THE SEARCH FOR A PROPORTIONATE CARE LAW BY FORMULA FUNDING IN THE ENGLISH NHS

FINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 4 2009
Gwyn Bevan
Although the National Health Service was created to achieve equity of access to health care in 1948, over twenty years later an ,inverse care law' was seen to operate. The 1976,Report of the Resource Allocation Working Party,laid the principles of formula funding to achieve an equitable distribution of resources, to move, over time, towards the operation of a proportionate care law. These principles have been applied ever since in England. This paper describes the context, governance and subsequent development of formulas and three persistent problems: accounting for populations, their needs and variations in the unavoidable costs of providers. The paper concludes by outlining continuing problems from the past and new challenges of formula funding in England to reduce ,avoidable' inequalities in health. [source]

A mixed logit model of health care provider choice: analysis of NSS data for rural India

HEALTH ECONOMICS, Issue 9 2006
Bijan J. Borah
Abstract In order to address the persistent problems of access to and delivery of health care in rural India, a better understanding of the individual provider choice decision is required. This paper is an attempt in this direction as it investigates the determinants of outpatient health care provider choice in rural India in the mixed multinomial logit (MMNL) framework. This is the first application of the mixed logit to the modeling of health care utilization. We also use the multiple imputation technique to impute the missing prices of providers that an individual did not visit when she was ill. Using data from National Sample Survey Organization of India, we find the following: price and distance to a health facility play significant roles in health care provider choice decision; when health status is poor, distance plays a less significant role in an adult's provider choice decision; price elasticity of demand for outpatient care varies with income, with low-income groups being more price-sensitive than high-income ones. Furthermore, outpatient care for children is more price-elastic than that for adults, which reflects the socio-economic structure of a typical household in rural India where an adult's health is more important than that of a child for the household's economic sustenance. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Persistent problems and practices in information systems development

The Role of Migrant Remittances in Development: Evidence from Mediterranean Countries

INTERNATIONAL MIGRATION, Issue 1 2002
Nicholas P. Glytsos
Given the persistent problems in the balance of trade in LDCs, the limited effect of foreign aid, and the difficulties of borrowing, the often huge amounts of migrant remittances can substitute for the inadequacies of these forms of foreign exchange. As market flows of foreign exchange, remittances have complex positive and negative effects on development. In this paper, I deal with this role of migrant remittances in the theoretical framework of development economics, as related to the importance of foreign exchange as an indispensable factor of growth and structural change in LDCs. Various channels transmitting the impact of remittances on development are investigated based on the experience of countries from both sides of the Mediterranean basin. [source]

A support group for patients who have recovered from thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS): The six-year experience of the Oklahoma TTP-HUS Study Group

JOURNAL OF CLINICAL APHERESIS, Issue 1 2003
Mark A. Howard
Abstract A support group for patients who have recovered from thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS), named The Oklahoma TTP-HUS Study Group, has been a successful program for 6 years. This group has met 3 times each year with an average attendance of 16 former patients; in addition, an average of 14 family members and friends have attended each meeting. Eighty-four percent of patients who attended a meeting were women as compared to 68% women among those who did not attend (P = 0.016). Twenty-three percent of patients who attended a meeting have relapsed as compared to 8% among those who did not attend (P = 0.006). There was also a difference in the rates of attendance among the different clinical categories of patients (P < 0.001). A survey of former patients, as well as their families and friends, documented that interest in learning more about TTP-HUS and talking with other people who have had TTP-HUS were principal motivations for attending the meetings. The meetings of The Oklahoma TTP-HUS Study Group have been successful not only for support of former patients but also for research. Long-term patient follow-up has been facilitated and the group discussions have revealed previously unreported persistent problems with cognitive ability and endurance. A survey of member centers of the American Association of Blood Banks and America's Blood Centers revealed no similar programs for patients who have recovered from TTP-HUS. The absence of a support group for TTP-HUS in the national survey contrasts to the 274 patient support groups and related wellness/education classes, including some for rare disorders, currently active in the Oklahoma City metropolitan area. The experience of The Oklahoma TTP-HUS Study Group suggests that it serves a previously unmet need. J. Clin. Apheresis 18:16,20, 2003. © 2003 Wiley-Liss, Inc. [source]

Pathways from Traumatic Child Victimization to Delinquency: Implications for Juvenile and Permanency Court Proceedings and Decisions

JUVENILE AND FAMILY COURT JOURNAL, Issue 1 2006
JULIAN D. FORD
ABSTRACT Research studies and observations by mental health and judicial professionals suggest that childhood traumatic victimization may contribute to the development of juvenile delinquency. Based on this evidence, we describe a chronological pathway that runs from: (a) early childhood victimization, to (b) escalating dysregulation of emotion and social information processing ("survival coping," which takes the form of depression, anxiety, social isolation, peer rejection, and conflicted relationships), to (c) severe and persistent problems with oppositional-defiance and overt or covert aggression compounded by post-traumatic reactivity and hypervigilance ("victim coping"). A case vignette is provided, and implications for judicial review and decisions are discussed. [source]

De Facto Disentitlement in an Information Economy: Enrollment Issues in Medicaid Managed Care

MEDICAL ANTHROPOLOGY QUARTERLY, Issue 1 2005
LESLIE LÓPEZ
This article discusses enrollment issues in New Mexico's Medicaid managed care (MMC) system and seeks to illuminate reasons for persistent problems reported by workers and clients. It argues that between 1997 and 2000, the MMC and welfare reforms raised enrollment barriers by complicating and dehumanizing the system, thus "technically disenfranchising" workers and clients. Specifically, the new system increased the need for professional, in-person enrollment assistance precisely when the state decreased its provision of it. Some aspects of the State Child Health Insurance Program (SCHIP) reforms indirectly aggravated those same problems, and though they also significantly lowered barriers in some areas, overall the new system was plagued with preexisting barriers as well as new, unmet needs that produced "de facto disentitlement" to health services. [source]

THE PATTERN AND EVOLUTION OF GEOGRAPHICAL WAGE DIFFERENTIALS IN THE PUBLIC AND PRIVATE SECTORS IN GREAT BRITAIN,

THE MANCHESTER SCHOOL, Issue 4 2007
DAVID BELL
Government policy on the nature of wage bargaining in the public sector can have important implications for the provision of public services. Using the New Earnings Survey, the Labour Force Survey and the British Household Panel Survey, we examine the size and evolution of public,private sector wage differentials across geographical areas within the UK and over time. Public sector bargaining structures have led to historically high wage premia, although these premia are declining over time. In high-cost low-amenity areas, such as the south-east of England, the public sector underpays relative to the private sector, therefore creating problems in recruitment to and provision of public services. Public sector labour markets are around 40 per cent as responsive to area differences in amenities and costs as are private sector labour markets. Differences in the degree of spatial variation between sectors are likely to remain, leading to persistent problems for the delivery of public services in some parts of the UK. Reform of public sector pay structures is likely to be costly, and so other non-pay policies need to be considered to increase the attractiveness of public sector jobs. [source]