Browsing by Subject "Challenges"

Now showing 1 - 7 of 7
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    The Challenges for Primary Caregivers of Adolescents With Disruptive Behavior Disorders
    (SAGE, 2014-12-10) Oruche, Ukamaka M.; Burke Draucker, Claire; Al-Khattab, Halima; Cravens, Hillary A.; Lowry, Brittany; Lindsey, Laura M.
    Adolescents with disruptive behavior disorders (DBD), including oppositional defiant disorder and conduct disorder, present unique challenges for their families. Although, most empirically supported treatments for DBD are family-based, the emphasis is typically on the behavior of the child rather than on the life challenges and resultant distress experienced by the family members. Fifteen families of adolescents with DBD were recruited from a large publicly funded Community Mental Health Center. For this report, data from in-depth interviews with the adolescents’ primary caregivers were analyzed by standard content analytic procedures to describe the challenges they experienced living with and caring for the adolescents. The primary caregivers reported that the challenges were overwhelming, demanding, and unrelenting. The two most salient challenges were (a) managing the adolescents’ aggressive, defiant, and deceitful behaviors, and (b) interacting frequently with a number of child-serving agencies. A number of clinical implications are drawn from these findings.
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    Challenges in institutional ethical review process and approval for international multicenter clinical studies in lower and middle-income countries: the case of PARITY study
    (Frontiers Media, 2024-11-05) Lopez-Baron, Eliana; Abbas, Qalab; Caporal, Paula; Agulnik, Asya; Attebery, Jonah E.; Holloway, Adrian; Kissoon, Niranjan Tex; Mulgado-Aguas, Celia Isabel; Amegan-Aho, Kokou; Majdalani, Marianne; Ocampo, Carmen; Pascal, Havugarurema; Miller, Erika; Kanyamuhunga, Aimable; Tekleab, Atnafu Mekonnen; Bacha, Tigist; González-Dambrauskas, Sebastian; Bhutta, Adnan T.; Kortz, Teresa B.; Murthy, Srinivas; Remy, Kenneth E.; Global Health Subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network; Pediatrics, School of Medicine
    Background: One of the greatest challenges to conducting multicenter research studies in low and middle-income countries (LMICs) is the heterogeneity in regulatory processes across sites. Previous studies have reported variations in requirements with a lack of standardization in the Institutional Review Board (IRB) processes between centers, imposing barriers for approval, participation, and development of multicenter research. Objectives: To describe the regulatory process, variability and challenges faced by pediatric researchers in LMICs during the IRB process of an international multicenter observational point prevalence study (Global PARITY). Design: A 16-question multiple-choice online survey was sent to site principal investigators (PIs) at PARITY study participating centers to explore characteristics of the IRB process, costs, and barriers to research approval. A shorter survey was employed for sites that expressed interest in participating in Global PARITY and started the approval process, but ultimately did not participate in data collection (non-participating sites) to assess IRB characteristics. Results: Of the 91 sites that sought IRB approval, 46 were successful in obtaining approval and finishing the data collection process. The survey was completed by 46 (100%) participating centers and 21 (47%) non-participating centers. There was a significant difference between participating and non-participating sites in IRB approval of a waiver consent and in the requirement for a legal review of the protocol. The greatest challenge to research identified by non-participating sites was a lack of research time and the lack of institutional support. Conclusions: Global collaborative research is crucial to increase our understanding of pediatric critical care conditions in hospitals of all resource-levels and IRBs are required to ensure that this research complies with ethical standards. Critical barriers restrict research activities in some resource limiting countries. Increasing the efficiency and accessibility of local IRB review could greatly impact participation of resource limited sites and enrollment of vulnerable populations.
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    Colorectal Cancer Screening Challenges in the Recent Afghan Refugee Population: A Comprehensive Review Article
    (Cureus, 2022-02-20) Waheed, Abdul; McCloskey, Audrey; Kennedy, Frank; Seraj, Siamak M.; Khan, Jaffar; Nama, Noor; Johnson, Omari; Lo, Peter; Magee, Harres; Akbar, Wazir; Ullah, Asad; Cason, Frederick D.; Pathology and Laboratory Medicine, School of Medicine
    Colorectal cancer (CRC) is more prevalent in south-central Asian countries, particularly the Afghan population. Screening for CRC in the Afghan population has always been challenging, primarily due to the tribal and social cultures, lack of facilities, and lack of education. The United States (US) will soon face a significantly massive influx of Afghan refugees. It becomes imperative to initiate and implement effective measures regarding CRC screening in these refugee populations. The current review article aims to identify the most likely challenges faced for CRC screening in this Afghan refugee population in the US and address the possible measures to overcome these challenges.
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    Peril and Possibility: Muslim Life in the United States
    (Bloomsbury Academic, 2004) Curtis, Edward E., IV
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    Recruitment and Retention Strategies for the Diabetes RElated to Acute Pancreatitis and Its Mechanisms Study: From the Type 1 Diabetes in Acute Pancreatitis Consortium
    (Wolters Kluwer, 2022) Yazici, Cemal; Dyer, Anne-Marie; Conwell, Darwin L.; Afghani, Elham; Andersen, Dana K.; Basina, Marina; Bellin, Melena D.; Boone, Leslie R.; Casu, Anna; Easler, Jeffrey J.; Greenbaum, Carla J.; Hart, Phil A.; Jeon, Christie Y.; Lee, Peter J.; Meier, Shelby; Papachristou, Georgios I.; Raja-Khan, Nazia T.; Saeed, Zeb I.; Serrano, Jose; Yadav, Dhiraj; Fogel, Evan L.; Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAP); Medicine, School of Medicine
    Recruitment and retention of patients with acute pancreatitis (AP) in clinical studies can be challenging. While some obstacles are similar to other clinical conditions, some are unique to AP. Identifying potential barriers early and developing targeted solutions can help optimize recruitment and retention in AP studies. Such preemptive and detailed planning can help prospective, longitudinal studies focusing on exocrine and endocrine complications of AP in accurately measuring outcomes. This manuscript highlights the challenges in recruitment and retention strategies in AP studies and reviews available resources to create opportunities to address them. We describe the multifaceted approach used by the Recruitment and Retention Committee of the Type 1 Diabetes in Acute Pancreatitis Consortium (T1DAPC), which builds upon earlier experiences to develop a recruitment and retention plan for the DREAM (Diabetes RElated to Acute pancreatitis and its Mechanisms) study.
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    Understanding metric-related pitfalls in image analysis validation
    (ArXiv, 2023-09-25) Reinke, Annika; Tizabi, Minu D.; Baumgartner, Michael; Eisenmann, Matthias; Heckmann-Nötzel, Doreen; Kavur, A. Emre; Rädsch, Tim; Sudre, Carole H.; Acion, Laura; Antonelli, Michela; Arbel, Tal; Bakas, Spyridon; Benis, Arriel; Blaschko, Matthew B.; Buettner, Florian; Cardoso, M. Jorge; Cheplygina, Veronika; Chen, Jianxu; Christodoulou, Evangelia; Cimini, Beth A.; Collins, Gary S.; Farahani, Keyvan; Ferrer, Luciana; Galdran, Adrian; Van Ginneken, Bram; Glocker, Ben; Godau, Patrick; Haase, Robert; Hashimoto, Daniel A.; Hoffman, Michael M.; Huisman, Merel; Isensee, Fabian; Jannin, Pierre; Kahn, Charles E.; Kainmueller, Dagmar; Kainz, Bernhard; Karargyris, Alexandros; Karthikesalingam, Alan; Kenngott, Hannes; Kleesiek, Jens; Kofler, Florian; Kooi, Thijs; Kopp-Schneider, Annette; Kozubek, Michal; Kreshuk, Anna; Kurc, Tahsin; Landman, Bennett A.; Litjens, Geert; Madani, Amin; Maier-Hein, Klaus; Martel, Anne L.; Mattson, Peter; Meijering, Erik; Menze, Bjoern; Moons, Karel G. M.; Müller, Henning; Nichyporuk, Brennan; Nickel, Felix; Petersen, Jens; Rafelski, Susanne M.; Rajpoot, Nasir; Reyes, Mauricio; Riegler, Michael A.; Rieke, Nicola; Saez-Rodriguez, Julio; Sánchez, Clara I.; Shetty, Shravya; Summers, Ronald M.; Taha, Abdel A.; Tiulpin, Aleksei; Tsaftaris, Sotirios A.; Van Calster, Ben; Varoquaux, Gaël; Yaniv, Ziv R.; Jäger, Paul F.; Maier-Hein, Lena; Pathology and Laboratory Medicine, School of Medicine
    Validation metrics are key for the reliable tracking of scientific progress and for bridging the current chasm between artificial intelligence (AI) research and its translation into practice. However, increasing evidence shows that particularly in image analysis, metrics are often chosen inadequately in relation to the underlying research problem. This could be attributed to a lack of accessibility of metric-related knowledge: While taking into account the individual strengths, weaknesses, and limitations of validation metrics is a critical prerequisite to making educated choices, the relevant knowledge is currently scattered and poorly accessible to individual researchers. Based on a multi-stage Delphi process conducted by a multidisciplinary expert consortium as well as extensive community feedback, the present work provides the first reliable and comprehensive common point of access to information on pitfalls related to validation metrics in image analysis. Focusing on biomedical image analysis but with the potential of transfer to other fields, the addressed pitfalls generalize across application domains and are categorized according to a newly created, domain-agnostic taxonomy. To facilitate comprehension, illustrations and specific examples accompany each pitfall. As a structured body of information accessible to researchers of all levels of expertise, this work enhances global comprehension of a key topic in image analysis validation.
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    The use of qualitative methods in venous thromboembolism research
    (Elsevier, 2021-09-12) Hernandez-Nino, Jackeline; Thomas, Mary; Alexander, Andreia B.; Ott, Mary A.; Kline, Jeffrey A.; Emergency Medicine, School of Medicine
    Introduction: Qualitative research has been increasingly used in health care research to allow in-depth insights and understanding of patients' lived experiences for poorly understood phenomena. The psychological stress mechanisms underlying fear, dyspnea, and pain after venous thromboembolism (VTE) remain poorly understood. However, novice VTE researchers may not be familiar with the process of undertaking qualitative research. Objective: The aim of this article is to describe the planning, methodology and execution of qualitative methods, using the example of patients' lived experiences during and after the diagnosis of VTE. We discuss challenges and solutions in implementing qualitative research methods in health care research. Methods: Patients were recruited from the emergency department and clinic using in-person and phone contact. We used both in-person and video format to interview 24 patients. Interviews were guided by a set of questions to be explored but conducted to elucidate unique thoughts and opinions from patients. Results: For recruitment, "cold-calling" was found to be largely unsuccessful. Many patients have preexisting diagnoses of anxiety and depression. Video interviews were found to be at least as effective as in-person interviews. Interviews revealed unique post-VTE experiences from all participants, with a wide range of impact on quality of life. Themes that were most common included perceptions of physician communication, fear of recurrence, and concerns of death. Conclusion: A qualitative research approach can reveal individual experiences and psychosocial impact in patients diagnosed with VTE, which allow the researchers to better comprehend the complexity of this phenomenon and its impact in health care.