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With limited control over their environment and resources, SMEs confront difficulties in initiating learning and carrying out the magnitude of change that is appropriate to meet accurately diagnosed problems.
In conclusion, we describe some of the major challenges and possible solutions to help a potential investigator through the myriad of difficulties in initiating an RCT in a complex environment.
Whereas primary insomnia is characterized by prominent subjective difficulties in initiating and maintaining sleep with only minor changes in objectively recorded sleep parameters [14], RLS is characterized by an impairment of sleep onset due to unpleasant feelings and an urge to move the limbs.
However, some limitations of the study create difficulties in initiating this protocol in our institution.
Fatigue is defined as difficulties in initiating or sustaining voluntary activities [ 3].
Difficulties in initiating contact, developing peer-mentor relationships and time constraints pose challenges to delivering lay-worker peer support.
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One of these, insomnia, is defined as the difficulty in initiating and/or maintaining sleep despite adequate opportunities.
They have difficulty in initiating movements, including walking, and they cannot put adequate force into fast movements.
On the one hand, they may have difficulty initiating a task or a behaviour, in extreme cases being virtually unable to move or speak, but more often they will simply have difficulty in initiating a task.
All types of parkinsonism are characterized by four main signs, including tremors of resting muscles, particularly of the hands; muscular rigidity of the arms, legs, and neck; difficulty in initiating movement (bradykinesia); and postural instability.
As dopamine levels fall, the disease's characteristic symptoms appear: tremors, rigidity, and difficulty in initiating motion.
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