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Sample records for access echocardiography service

  1. Evaluation of an open access echocardiography service in the Netherlands: a mixed methods study of indications, outcomes, patient management and trends

    Streppel Marjolijn

    2010-02-01

    Full Text Available Abstract Background In our region (Eastern South Limburg, The Netherlands an open access echocardiography service started in 2002. It was the first service of this kind in The Netherlands. Our study aims were: (1 to evaluate demand for the service, participation, indications, echocardiography outcomes, and management by the general practitioner (GP; (2 to analyse changes in indications and outcomes over the years. Methods (1 Data from GP request forms, echocardiography reports and a retrospective GP questionnaire on management (response rate 83% of 625 consecutive patients (Dec. 2002 - March 2007 were analysed cross-sectionally. (2 For the analysis of changes over the years, data from GP request forms and echocardiography reports of the first and last 250 patients that visited the service between Dec. 2002 and Feb. 2008 (n = 1001 were compared. Results The echocardiography service was used by 81% of the regional GPs. On average, a GP referred one patient per year to the service. Intended indications for the service were dyspnoea (32%, cardiac murmur (59%, and peripheral oedema (17%. Of the other indications (22%, one-third was for evaluation of suspected left ventricular hypertrophy (LVH. Expected outcomes were left ventricular dysfunction (LVD (43%, predominantly diastolic and valve disease (25%. We also found a high proportion of LVH (50%. Only 24% of all echocardiograms showed no relevant disease. The GP followed the cardiologist's advice to refer the patient for further evaluation in 71%. In recent patients, more echocardiography requests were done for 'cardiac murmur' and 'other' indications, but less for 'dyspnoea'. The proportions of patients with LVD, LVH and valve disease decreased and the proportion of patients with no relevant disease increased. The number of advices by the cardiologists increased. Conclusion Overall, GPs used the open access echocardiography service efficiently (i.e. with a high chance of finding relevant pathology

  2. Disruption - Access cards service

    2014-01-01

    We would like to inform you that between 10 November and 15 December 2014, the access cards service in Building 55 will be disrupted, as the GS Department has decided to improve the facilities for users of this building. During the work, you will find the registration, biometric registration and dosimeter exchange services on the second floor of Building 55 and the vehicle sticker service on the ground floor along with the access cards service. We thank you for your understanding and apologise for any inconvenience caused.

  3. Access to physiotherapy services

    Partridge, C. J.

    1982-01-01

    A survey of community physiotherapy services operating within the National Health Service throughout England and Wales in 1980 showed a considerable increase in the availability of physiotherapy outside hospital, with 159 health districts (75 per cent) having some form of community physiotherapy. Additional information obtained about access by general practitioners to hospital physiotherapy departments showed that in 140 districts (66 per cent), some direct access was available.

  4. Determination of the acceptable MPEG-4 quality for clinical real-time tele-echocardiography services

    Andrea Giordano; Fabio Comazzi; Francesco Scapellato; Ermanno Eleuteri; Pantaleo Giannuzzi; Giuseppe Minuco

    2009-01-01

    The characteristics of Moving Picture experts Group (MPEG-4) video compression, in particular its adaptability to narrowband channels and the elevated degree of compression obtainable, make it of interest for services of telemedicine that require instantaneous video transmission and interpretation. In this study we faced the problem of the minimum quality of service (QoS) in specific applications of tele-echocardiography (T-E). In the specifics we evaluated the clinical adequacy of MpEG-4 com...

  5. Accessibility to dental services

    Evenden, Craig Andrew

    2007-01-01

    Background: Access to dental care has become a key focus for Government officials in Scotland. Newton et al. (2004) note that the White Paper ‘Towards a healthier Scotland’ (The Scottish Office Department of Health, 1999), identifies dental health as a key area for action, with large numbers of the population unable to gain access to dental care. Various methodologies have been developed in an attempt to explore the inequalities in dental health care access; however a number of studies have ...

  6. Accessibility of adolescent health services

    S Richter

    2000-09-01

    Full Text Available Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community’s efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.

  7. Open Access Resources and Services

    Waller, Andrew

    2008-01-01

    This presentation covers some of the basic elements of Open Access as well as some Open Access-related resources and services that are available to library users at the University of Calgary. Presented at a Libraries and Cultural Resources (LCR) training session, University of Calgary, Information Commons classroom B, October 20, 2008.

  8. Determination of the acceptable MPEG-4 quality for clinical real-time tele-echocardiography services

    Andrea Giordano

    2009-12-01

    Full Text Available The characteristics of Moving Picture experts Group (MPEG-4 video compression, in particular its adaptability to narrowband channels and the elevated degree of compression obtainable, make it of interest for services of telemedicine that require instantaneous video transmission and interpretation. In this study we faced the problem of the minimum quality of service (QoS in specific applications of tele-echocardiography (T-E. In the specifics we evaluated the clinical adequacy of MpEG-4 compression in the real time transmission of echocardiographic studies. Forty echocardiographic examinations consisting of standard projections of patients affected by ischemic heart disease were submitted to two observers expert in echocardiography, who made 4 separate evaluations as follows: 2 on the same equipment on which the original studies were performed; 1 after online MpEG-4 codification of the studies at 256 kb/s; 1 after online MpEG-4 codification of the studies at 128 kb/s. For each evaluation, the following data were collected: subjective opinion on the overall visual quality of the images; estimate of ejection fraction and level of impairment; wall Motion Score Index and percentage of asynergy; mitral failure. The results: 1 the subjective quality of the echocardiographic images was the same as that perceived in the video at Mpeg4/256 kb/s compression level while it was lower, as expected, in the video Mpeg4/128 kb/s; 2 the quality degradation did not produce a statistically significant difference in the evaluation of left ventricular function and regional wall motion impairments. these results confirm the feasibility of MpEG-4 compression for the transmission of echocardiographic studies for use in telemedicine and suggest that it is not necessary to seek transmission speeds higher than 256 kb/s for the semiquantitative reading of left venticular kinetics.

  9. Targeted neonatal echocardiography services: need for standardized training and quality assurance.

    Finan, Emer

    2014-10-01

    Targeted neonatal echocardiography refers to a focused assessment of myocardial performance and hemodynamics directed by a specific clinical question. It has become the standard of care in many parts of the world, but practice is variable, and there has been a lack of standardized training and evaluation to date. Targeted neonatal echocardiography was first introduced to Canada in 2006. The purpose of this study was to examine the characteristics of targeted neonatal echocardiography practice and training methods in Canadian neonatal intensive care units (NICUs).

  10. Access control and service-oriented architectures

    Leune, C.J.

    2007-01-01

    Access Control and Service-Oriented Architectures" investigates in which way logical access control can be achieved effectively, in particular in highly dynamic environments such as service-oriented architectures (SOA's). The author combines state-of-the-art best-practice and projects these onto the

  11. Open Access Resources, Services, and More

    Waller, Andrew

    2009-01-01

    This presentation briefly discusses the basics and benefits of Open Access as well as some Open Access-related resources and services that are available to library users at the University of Calgary. It also covers the upcoming Open Access Week activities. Presented at a Libraries and Cultural Resources (LCR) training session, University of Calgary, Information Commons classroom B, October 15, 2009.

  12. A nationwide access management service - Athens

    Johnson, Mike; Zedlewski, Edward J.

    2001-01-01

    The Athens service enables secure access to online services for universities and colleges throughout the UK and overseas. The key features include "single password sign-on" to multiple resources and fully distributed management of user accounts. The service is used by all UK higher education institutions and many users in allied sectors. Use of Athens has now reached "critical mass", with over 800,000 accounts at more than 300 institutions, 100 National Health Service Trusts and most Scandi...

  13. CGE Modeling of Market Access in Services

    Elisabeth M. Christen; Francois, Joseph; Hoekman, Bernard

    2012-01-01

    This paper examines how the applied multi-sector computable general equilibrium (CGE) literature has moved into quantication of the impacts of greater market access for services. This includes discussion of multi-sector linkages to the service sector, as well both measuring barriers to trade and investment (generally with a mix of firm surveys, price comparisons, and econometrics), and how...

  14. EARS: Electronic Access to Reference Service.

    Weise, F O; Borgendale, M

    1986-01-01

    Electronic Access to Reference Service (EARS) is a front end to the Health Sciences Library's electronic mail system, with links to the online public catalog. EARS, which became operational in September 1984, is accessed by users at remote sites with either a terminal or microcomputer. It is menu-driven, allowing users to request: a computerized literature search, reference information, a photocopy of a journal article, or a book. This paper traces the history of EARS and discusses its use, i...

  15. Fetal echocardiography

    USG performed with a high-end machine, using a good cine-loop facility is extremely helpful in the diagnosis of fetal cardiac anomalies. In fetal echocardiography, the four-chamber view and the outflow-tract view are used to diagnose cardiac anomalies. The most important objective during a targeted anomaly scan is to identify those cases that need a dedicated fetal echocardiogram. Associated truncal and chromosomal anomalies need to be identified. This review shows how fetal echocardiography, apart from identifying structural defects in the fetal heart, can be used to look at rhythm abnormalities and other functional aspects of the fetal heart

  16. Web services interface to EPICS channel access

    Web services is used in Experimental Physics and Industrial Control System (EPICS). Combined with EPICS Channel Access protocol, Web services high usability, platform independence and language independence can be used to design a fully transparent and uniform software interface layer, which helps us complete channel data acquisition, modification and monitoring functions. This software interface layer, a cross-platform of cross-language, has good interoperability and reusability. (authors)

  17. Moving beyond the Amalgam: Restructuring Access Services

    Austin, Brice

    2010-01-01

    At least since the early 1990s, academic libraries have been merging Circulation and various other related functions into a single department typically labeled "Access Services." In many cases, however, that merger has proven to be administrative rather than functional, with minimal integration of common workflows. This article describes a…

  18. Assessment and Evaluation Methods for Access Services

    Long, Dallas

    2014-01-01

    This article serves as a primer for assessment and evaluation design by describing the range of methods commonly employed in library settings. Quantitative methods, such as counting and benchmarking measures, are useful for investigating the internal operations of an access services department in order to identify workflow inefficiencies or…

  19. STRESS ECHOCARDIOGRAPHY

    Salustri, Alessandro

    1994-01-01

    textabstractIn the studies reported in this thesis, stress echocardiography (either with exercise or with pharmacological agents) and myocardial perfusion scintigraphy have been performed in different groups of patients and in different clinical conditions. Some practical aspects on the protocols of echocardiographic tests are briefly reported

  20. Unifying access to services: ESO's user portal

    Chavan, A. M.; Tacconi-Garman, L. E.; Peron, M.; Sogni, F.; Canavan, T.; Nass, P.

    2006-06-01

    The European Southern Observatory (ESO) is in the process of creating a central access point for all services offered to its user community via the Web. That gateway, called the User Portal, will provide registered users with a personalized set of service access points, the actual set depending on each user's privileges. Correspondence between users and ESO will take place by way of "profiles", that is, contact information. Each user may have several active profiles, so that an investigator may choose, for instance, whether their data should be delivered to their own address or to a collaborator. To application developers, the portal will offer authentication and authorization services, either via database queries or an LDAP server. The User Portal is being developed as a Web application using Java-based technology, including servlets and JSPs.

  1. Improving service accessibility in service-oriented HIS.

    Babamir, Seyed Morteza; Arabfard, Masoud

    2012-12-01

    Nowadays, new trend in design and implementation of Hospital Information System (HIS) is towards using Web-based Service-Oriented Architecture (SOA). However, the standard SOA includes an insensitive service store through which the accessibility of some hospital services becomes difficult when their specification or network address are changed or missed. This paper discusses problems of insensitive service store and then presents a model where a sensitive service store is used to mitigate the problems. To show the efficiency of the proposed model, HIS of the Shahid Beheshti Hospital of Kashan including information systems of Admission, Outpatient, Ward, Pharmacy, Medical Document, Discharge and Insurance was designed and implemented with sensitive service store and its performance was considered. PMID:22898904

  2. Access database that calls ServCat REST Services

    US Fish and Wildlife Service, Department of the Interior — Microsoft Access database that calls the U.S. Fish and Wildlife Service Catalog ServCat Representational State Transfer REST Services to display the title and...

  3. Authentication Issues in Multi-Service Residential Access Networks

    Rossebo, Judith; Ronan, John; Walsh, Kristian

    2003-01-01

    Multi-service residential access networks allow residential customers to choose amongst a variety of service offerings, over a range of Core Networks and subject to user requirements such as QoS, mobility, cost and availability. These issues place requirements on authentication for network access, with a need for mutual authentication of the residential gateway (RG) to the local access point (LAP). The EU-IST project TORRENT is building a testbed providing for multi-service residential access...

  4. NASA Alternate Access to Station Service Concept

    Bailey, M. D.; Crumbly, C.

    2002-01-01

    The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply

  5. 47 CFR 69.3 - Filing of access service tariffs.

    2010-10-01

    ....3, see the List of CFR Sections Affected, which appears in the Finding Aids section of the printed... 47 Telecommunication 3 2010-10-01 2010-10-01 false Filing of access service tariffs. 69.3 Section... (CONTINUED) ACCESS CHARGES General § 69.3 Filing of access service tariffs. (a) Except as provided...

  6. 47 CFR 36.213 - Network access services revenues.

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User...

  7. Mediating Semantic Web Service Access using the Semantic Firewall

    Jacyno, M.; Payne, T. R.; Watkins, E R; Taylor, S. J.; Surridge, M.

    2007-01-01

    As the technical infrastructure to support Grid environments matures, attention should focus on providing dynamic access to services, whilst ensuring such access is appropriately monitored and secured. Access policies may be dynamic, whereby intra-organisational workflows define local knowledge that could be used to establish appropriate credentials necessary to access the desired service. We describe a typical Grid-based scenario that requires local semantic workflows that establish the appr...

  8. American Society of Echocardiography

    American Society of Echocardiography Join Ase Member Portal Log In Membership Member Portal Log In Join ASE Renew Benefits Rates FASE – Fellow of the American Society of Echocardiography Member Referral Program FAQs Initiatives Advocacy ...

  9. [Echocardiography in infirmary].

    Heredia Guerrero, Ericka Nancy

    2007-01-01

    Cardiovascular diseases are the 1st death cause worldwide in the beginning of the third millennium. Due to its high incidence and fatal complications the study of ischaemic cardiopathy had great importance. Echocardiography is an image diagnostic technique, based on the use of ultrasound, applied in the evaluation and recognition of cardiovascular diseases. It is non invasive, harmless, accessible, easy to made and quick to interpret, safe and cheaper than others imaging techniques, its continuous development has allow its use in all cardiology fields. An area where the nursing staff begin their participation in the National Institute of Cardiology "Ignacio Chavez" is the Echocardiography Department where the nurse professional profile must embrace knowledge in different areas, with an active participation in the echocardiographic studies and protocols, optimizing the patient's quality of attention with the use of Nursing Attention Process based in the theory of Dorothea Orem with the aim of standardize and improve the patient's quality of attention along with the interdisciplinary team. PMID:18938734

  10. Planning toward equal accessibility to services: a quadratic programming approach

    Fahui Wang; Quan Tang

    2013-01-01

    In the literature various accessibility indices have been developed to assess the relative ease by which the locations of services (supply) can be reached from a residential (demand) location. In this paper we address the planning problem: how the resources can be redistributed to achieve the highest equality of accessibility to the service providers. In particular, a quadratic programming approach is used to minimize the variance of accessibility scores across demand locations by readjusting...

  11. Library Service-Oriented Architecture to Enhance Access to Science

    Akerman, Richard

    2007-01-01

    In the digital world, library services need to be transformed to recognize that automation and machine-to-machine communication of information enables many advanced features. NRC CISTI, Canada's National Science Library, has addressed this challenge using Service-Oriented Architecture (SOA). Using SOA based on Enterprise Architecture, we have modeled services provided by the catalogue, services related to document delivery, and advanced services to provide more open data access. We will prese...

  12. SIDECACHE: Information access, management and dissemination framework for web services

    Robbins Kay A; Burkhardt Cory; Doderer Mark S

    2011-01-01

    Abstract Background Many bioinformatics algorithms and data sets are deployed using web services so that the results can be explored via the Internet and easily integrated into other tools and services. These services often include data from other sites that is accessed either dynamically or through file downloads. Developers of these services face several problems because of the dynamic nature of the information from the upstream services. Many publicly available repositories of bioinformati...

  13. Service Accessibility for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth

    Acevedo-Polakovich, Ignacio David; Bell, Bailey; Gamache, Peter; Christian, Allison S.

    2013-01-01

    Although Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning (LGBTQ) youth experience alarming rates of behavioral and social problems, service use among these youth is disproportionately low. It is likely that decreased service accessibility plays a causal role in service underutilization among LGBTQ youth. To expand the existing…

  14. Health services accessibility among Spanish elderly.

    Fernández-Mayoralas, G; Rodríguez, V; Rojo, F

    2000-01-01

    The paper aims to identify the variables that best explain the use of health services by people aged 65 and over in Spain. The data comes from the 1993 Spanish National Health Survey (ENSE 93). The conceptual framework is the model proposed by Andersen, who suggests that utilisation is a function of predisposition to use the services, the ability to use them and of need. A bivariate and multivariate analysis (SPSS-X Discriminant Procedure) is conducted to define the predictors that best discriminate users and non-users. The use of each health service is explained by a different set of variables. The need variables play a more important role in predicting the use of non-discretionary services that are more closely related to healing processes (medical consultations, emergencies and hospitalisation). The predisposing and enabling variables are more relevant in explaining the use of dental services, indicating a certain degree of inequity of these discretionary services. PMID:10622691

  15. Providing Access to Justice through Service Learning

    Kubichek, Mary

    2010-01-01

    In the Casper College Legal Service (CCLS) program, Casper College paralegal students, under supervision of pro bono attorneys, use paralegal skills to provide legal services and work product. CCLS is different from other legal clinics; it is not law school based, bar based, or court based. CCLS is paralegal based.

  16. Loss of Medicaid and access to health services

    Brown, E. Richard; Cousineau, Michael R.

    1991-01-01

    In this article, the authors assessed the effects of the loss of Medicaid eligibility on access to health services by the medically indigent population in two California counties. An historically derived baseline of health services received by each county's medically indigent adults under Medicaid was compared with the volume of services provided by the county to the same population after they lost Medicaid eligibility. The baseline figures were used as an “expected” volume of services which ...

  17. Enhancing Access to Scientific Models through Standard Web Services Project

    National Aeronautics and Space Administration — We propose to investigate the feasibility and value of the "Software as a Service" paradigm in facilitating access to Earth Science numerical models. We...

  18. SIDECACHE: Information access, management and dissemination framework for web services

    Robbins Kay A

    2011-06-01

    Full Text Available Abstract Background Many bioinformatics algorithms and data sets are deployed using web services so that the results can be explored via the Internet and easily integrated into other tools and services. These services often include data from other sites that is accessed either dynamically or through file downloads. Developers of these services face several problems because of the dynamic nature of the information from the upstream services. Many publicly available repositories of bioinformatics data frequently update their information. When such an update occurs, the developers of the downstream service may also need to update. For file downloads, this process is typically performed manually followed by web service restart. Requests for information obtained by dynamic access of upstream sources is sometimes subject to rate restrictions. Findings SideCache provides a framework for deploying web services that integrate information extracted from other databases and from web sources that are periodically updated. This situation occurs frequently in biotechnology where new information is being continuously generated and the latest information is important. SideCache provides several types of services including proxy access and rate control, local caching, and automatic web service updating. Conclusions We have used the SideCache framework to automate the deployment and updating of a number of bioinformatics web services and tools that extract information from remote primary sources such as NCBI, NCIBI, and Ensembl. The SideCache framework also has been used to share research results through the use of a SideCache derived web service.

  19. A Directory Service for Perspective Access Networks

    Goodell, Geoffrey Lewis; Roussopoulos, Mema; Bradner, Scott O.

    2006-01-01

    Network fragmentation occurs when the accessibility of a network-based resource to an observer is a function of how the observer is connected to the network. In the context of the Internet, network fragmentation is well-known and occurs in many situations, including an increasing preponderance of network address translation, firewalls, and virtual private networks. Recently, however, new threats to Internet consistency have received media attention. Alternative namespaces have emerged as the ...

  20. Making Spatial Statistics Service Accessible On Cloud Platform

    Mu, X.; Wu, J.; Li, T.; Zhong, Y.; Gao, X.

    2014-04-01

    Web service can bring together applications running on diverse platforms, users can access and share various data, information and models more effectively and conveniently from certain web service platform. Cloud computing emerges as a paradigm of Internet computing in which dynamical, scalable and often virtualized resources are provided as services. With the rampant growth of massive data and restriction of net, traditional web services platforms have some prominent problems existing in development such as calculation efficiency, maintenance cost and data security. In this paper, we offer a spatial statistics service based on Microsoft cloud. An experiment was carried out to evaluate the availability and efficiency of this service. The results show that this spatial statistics service is accessible for the public conveniently with high processing efficiency.

  1. Unifying Access to National Hydrologic Data Repositories via Web Services

    Valentine, D. W.; Jennings, B.; Zaslavsky, I.; Maidment, D. R.

    2006-12-01

    The CUAHSI hydrologic information system (HIS) is designed to be a live, multiscale web portal system for accessing, querying, visualizing, and publishing distributed hydrologic observation data and models for any location or region in the United States. The HIS design follows the principles of open service oriented architecture, i.e. system components are represented as web services with well defined standard service APIs. WaterOneFlow web services are the main component of the design. The currently available services have been completely re-written compared to the previous version, and provide programmatic access to USGS NWIS. (steam flow, groundwater and water quality repositories), DAYMET daily observations, NASA MODIS, and Unidata NAM streams, with several additional web service wrappers being added (EPA STORET, NCDC and others.). Different repositories of hydrologic data use different vocabularies, and support different types of query access. Resolving semantic and structural heterogeneities across different hydrologic observation archives and distilling a generic set of service signatures is one of the main scalability challenges in this project, and a requirement in our web service design. To accomplish the uniformity of the web services API, data repositories are modeled following the CUAHSI Observation Data Model. The web service responses are document-based, and use an XML schema to express the semantics in a standard format. Access to station metadata is provided via web service methods, GetSites, GetSiteInfo and GetVariableInfo. The methdods form the foundation of CUAHSI HIS discovery interface and may execute over locally-stored metadata or request the information from remote repositories directly. Observation values are retrieved via a generic GetValues method which is executed against national data repositories. The service is implemented in ASP.Net, and other providers are implementing WaterOneFlow services in java. Reference implementation of

  2. 3PAC: Enforcing Access Policies for Web Services

    Bemmel, van J.; Wegdam, M.; Lagerberg, K.

    2005-01-01

    Web services fail to deliver on the promise of ubiquitous deployment and seamless interoperability due to the lack of a uniform, standards-based approach to all aspects of security. In particular, the enforcement of access policies in a service oriented architecture is not addressed adequately. We p

  3. Secure Access to Private Services in Intranet for Mobile Clients

    Li Kuang

    2013-02-01

    Full Text Available With wide adoption of Service Computing and Mobile Computing, people tend to invoke services with mobile devices, requiring accurate and real-time feedback from services at any time and any place. Among these services, some are private to limited users and require identity authorization before use; hence secure access control in wireless network should be provided. To address the challenge, in this study, we propose the architecture and protocols of a system of access to private services for mobile clients, which combines the technologies of trusted computing, Diffie-Hellman key agreement protocol, digital certificate, DES data encryption algorithm and twice verification. We further show the implementation of the proposed system, in which we have realized the authentication and authorization of mobile clients and then secure data transfer between mobile clients in the unsafe Internet and private services in the Intranet.

  4. The Critical Role of Institutional Services in Open Access Advocacy

    Tomasz Neugebauer

    2013-06-01

    Full Text Available This paper examines the development of the Open Access movement in scholarly communication, with particular attention to some of the rhetorical strategies and policy mechanisms used to promote it to scholars and scientists. Despite the majority of journal publishers’ acceptance of author self-archiving practices, and the minimal time commitment required by authors to successfully self-archive their work in disciplinary or institutional repositories, the majority of authors still by and large avoid participation. The paper reviews the strategies and arguments used for increasing author participation in open access, including the role of open access mandates. We recommend a service-oriented approach towards increasing participation in open access, rather than rhetoric that speculates on the benefits that open access will have on text/data mining innovation. In advocating for open access participation, we recommend focusing on its most universal and tangible purpose: increasing public open (gratis access to the published results of publicly funded research. Researchers require strong institutional support to understand the copyright climate of open access self-archiving, user-friendly interfaces and useful metrics, such as repository usage statistics. We recommend that mandates and well-crafted and responsive author support services at universities will ultimately be required to ensure the growth of open access. We describe the mediated deposit service that was developed to support author self-archiving in Spectrum: Concordia University Research Repository. By comparing the number of deposits of non-thesis materials (e.g. articles and conference presentations that were accomplished through the staff-mediated deposit service to the number of deposits that were author-initiated, we demonstrate the relative significance of this service to the growth of the repository.

  5. An entity access control model for network services management

    Dias, Bruno

    2005-01-01

    The Network Services Management Framework tries to overcome the most important limitations of present network management frameworks, namely the most widely supported framework – the Internet Network Management Framework – by defining a management framework using a network services management distributed architecture that provides services management functions with any desired level of functionality. This document introduces one of the most important parts of this framework, the Entity Access ...

  6. NASA's Eos ClearingHOuse: Integrating Access to Data Services

    Burnett, M. T.; Pfister, R.; Wichman, K.

    2002-12-01

    ECHO (The Earth Observing System (EOS) ClearingHOuse) is being developed to provide flexibility to NASA's EOS to better meet the needs of the science community. ECHO is a clearinghouse of metadata, representing the data offerings of participating data providers. ECHO is being built with the goal of being an enabling system: Enabling a variety of Data Providers to participate. Enabling access to an ever-changing variety of Earth Science Data. Enabling access to an ever-growing suite of services, provided by the Science Community, which improves the usefulness of this data, including the binding of those services to the data represented in the clearinghouse. The purpose of this enabling philosophy is to support current Science efforts, but also to give the opportunity for creative organizations and individuals to break the traditional paradigm for discovering and leveraging Earth Science Data and Services in completely new ways. This presentation will focus on ECHO's approach to integrating Data Services from varied Service Providers, and facilitating access to those services by the user community. ECHO can be viewed as a typical Service oriented architecture. The fundamental interactions that it supports are (abstractly) Publish, Find and Bind. ECHO provides interfaces and mechanisms that allow organizations to publish their services. Using these interfaces, Service Providers can effectively "plug-in" their capabilities. There are mechanisms that allow the correlation of their service to the data types in the clearinghouse. ECHO's user community can find, or discover, services through a separate set of interfaces. Bindings are the mechanisms that support the invocation of services by ECHO's user community. ECHO supports binding either directly between the user and the service provider, or indirectly by using ECHO as a Service Broker. ECHO is supporting all of these Service capabilities by leveraging the contemporary (and evolving) "standards" of Web Services. Web

  7. Controlled trial of an open-access physiotherapy service

    Gentle, P. H.; Herlihy, P. J.; Roxburgh, I. O.

    1984-01-01

    A randomized controlled trial of outpatient open-access physiotherapy was carried out at West Cornwall Hospital during 1979/80. The referral rate to consultant outpatient clinics for those patients offered open-access physiotherapy was considerably lower than for the control group (17 per cent and 56 per cent respectively). Patients using the service received physiotherapy promptly although this did not result in shorter treatments. Those of the control group who eventually received physiothe...

  8. A Service Access Security Control Model in Cyberspace

    Qianmu, Li; Jie, Yin; Jun, Hou; Jian, Xu; Hong, Zhang; Yong, Qi

    A service access control model in cyberspace is proposed, which provides a generalized and effective mechanism of security management with some items constraint specifications. These constraint specifications are organized to form a construction, and an enact process is proposed to make it scalable and flexible to meet the need of diversified service application systems in cyberspace. The model of this paper erases the downward information flow by extended rules of read/write, which is the breakthrough of the limitations when applying the standard role-based access control in cyberspace.

  9. Accessing Geospatial Services in Limited Bandwidth Service-Oriented Architecture (SOA) Environments

    Boggs, James D.

    2013-01-01

    First responders are continuously moving at an incident site and this movement requires them to access Service-Oriented Architecture services, such as a Web Map Service, via mobile wireless networks. First responders from inside a building often have problems in communicating to devices outside that building due to propagation obstacles. Dynamic…

  10. VODance: VO Data Access Layer Service Creation Made Easy

    Smareglia, R.; Laurino, O.; Knapic, C.

    2011-07-01

    We present a tool for rapid deployment of Virtual Observatory compliant services. Users who want to publish their datasets to the Virtual Observatory can achieve this goal without having to deal with the technical details of standard services development and without having to move their data. With VODance users just have to provide a database connection to our center that points to their available data and fill out a metadata description form without having to export their data. Data Access Layer services are created on the fly and published, through the Italian Astronomical Archive Center (IA2), to the Virtual Observatory. VODance has been successfully used to publish Cone Search and Simple Image Access Protocol services out of MySQL and Oracle database management systems.

  11. Gender Differences in Access to Extension Services and Agricultural Productivity

    Ragasa, Catherine; Berhane, Guush; Tadesse, Fanaye; Taffesse, Alemayehu Seyoum

    2013-01-01

    Purpose: This article contributes new empirical evidence and nuanced analysis on the gender difference in access to extension services and how this translates to observed differences in technology adoption and agricultural productivity. Approach: It looks at the case of Ethiopia, where substantial investments in the extension system have been…

  12. Richmond Wellbeing Service Access Strategy for Older Adults

    Gowling, Sarah; Persson, Jennie; Holt, Genevieve; Ashbourne, Sue; Bloomfield, James; Shortland, Hannah; Bate, Clare

    2016-01-01

    IAPT (Improving Access to Psychological Therapies) is a national programme aimed at increasing availability of evidence based psychological therapies in the NHS. IAPT is primarily for people who have mild to moderate, common mental health difficulties such as depression, anxiety, phobias and post traumatic stress disorder (PTSD). The programme seeks to use the least intrusive method of care possible to treat people at the time when it will be of most help to them. Individuals are able to self-refer into most IAPT services or alternatively can request to be referred by their GP or other services in the community. Richmond Wellbeing Service (RWS) is one such IAPT Service and this research is based on our work to promote accessibility of the service to one of the harder to reach population groups - older adults. We know that IAPT services could have a positive impact on older adults as it is believed on average, 25% of over 65 year olds face common mental health problems. However, only a third of these people discuss this with their GP and so are less likely to be referred to an IAPT Service. In relation to the above, this project was designed to look at increasing access for older adults into Richmond Wellbeing Service (RWS) specifically to improve access to the RWS by older adults by 100. The overall goal was to increase older adult (65+) referral rates by 20% over a year, in raw number this would translate to an increase of 100 over a year period, and in percentage terms an average of 8% of total referrals. Results yielded an increase of 39 referrals between baseline and test period. The majority of this increase had occurred in the final five months of the projects duration(31). Interestingly the number of older adults in the older age band (85+) almost doubled within this period (from 12 to 21). In total, in percentage terms this translates to an an increase of OA referrals from 6% up to 6.7%, as above we are aiming for 8% or an additional increase of 61 patients

  13. Richmond Wellbeing Service Access Strategy for Older Adults.

    Gowling, Sarah; Persson, Jennie; Holt, Genevieve; Ashbourne, Sue; Bloomfield, James; Shortland, Hannah; Bate, Clare

    2016-01-01

    IAPT (Improving Access to Psychological Therapies) is a national programme aimed at increasing availability of evidence based psychological therapies in the NHS. IAPT is primarily for people who have mild to moderate, common mental health difficulties such as depression, anxiety, phobias and post traumatic stress disorder (PTSD). The programme seeks to use the least intrusive method of care possible to treat people at the time when it will be of most help to them. Individuals are able to self-refer into most IAPT services or alternatively can request to be referred by their GP or other services in the community. Richmond Wellbeing Service (RWS) is one such IAPT Service and this research is based on our work to promote accessibility of the service to one of the harder to reach population groups - older adults. We know that IAPT services could have a positive impact on older adults as it is believed on average, 25% of over 65 year olds face common mental health problems. However, only a third of these people discuss this with their GP and so are less likely to be referred to an IAPT Service. In relation to the above, this project was designed to look at increasing access for older adults into Richmond Wellbeing Service (RWS) specifically to improve access to the RWS by older adults by 100. The overall goal was to increase older adult (65+) referral rates by 20% over a year, in raw number this would translate to an increase of 100 over a year period, and in percentage terms an average of 8% of total referrals. Results yielded an increase of 39 referrals between baseline and test period. The majority of this increase had occurred in the final five months of the projects duration(31). Interestingly the number of older adults in the older age band (85+) almost doubled within this period (from 12 to 21). In total, in percentage terms this translates to an an increase of OA referrals from 6% up to 6.7%, as above we are aiming for 8% or an additional increase of 61 patients

  14. Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers

    Riggs Elisha; Davis Elise; Gibbs Lisa; Block Karen; Szwarc Jo; Casey Sue; Duell-Piening Philippa; Waters Elizabeth

    2012-01-01

    Abstract Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refug...

  15. Pediatric transesophageal echocardiography

    O.F.W. Stümper (Oliver)

    1991-01-01

    textabstractIn face of several limitations of precordial ultrasound investigations in children with congenital heart disease, it was attempted to defme the additional value of pediatric transesophageal echocardiography. Its comparative value, firstly, in the preoperative diagnosis of congenital hear

  16. Echocardiography in Mice

    Gao, Shumin; Ho, David; Vatner, Dorothy E.; Vatner, Stephen F.

    2011-01-01

    Murine models have been utilized with increasing frequency mainly due to availability of genetically engineered models. With advancement in high spatial and temporal resolution, echocardiography is used extensively for the evaluation of cardiovascular function in murine models of cardiovascular disease. This review summarizes the general applications and methods involved in echocardiography used to study mouse models for cardiovascular research, based on 20 years of experience in our laborato...

  17. Expanding Access to Pro-Poor Energy Services in Nigeria

    Eleri, Ewah Otu; Ugwu, Okechukwu; Onuvae, Precious

    2012-10-15

    Nigeria experiences a remarkable paradox -- the abundance of energy resources and widespread energy poverty. Only about 40% of the population has access to the country’s grid electricity. About 72% of the population depends on traditional fuelwood for cooking. Despite this, government financing of energy services that benefits majority of Nigeria’s population has been grossly inadequate. Private sector investments and donor support have not fared better. This paper examines the current level of energy poverty in Nigeria. It analyses the level of government, private sector and donor funding for energy services that benefit the poor. It further reviews international best practices in expanding access for pro poor energy services. The paper finds a significant decline in political interest for expanding electricity services to rural areas. Even though ambitious policy reforms have commenced, agreed programmes are not implemented effectively. Not only are investments in rural electrification in decline, there is no history of annual budgeting for cooking energy programmes. The paper recommends a number of action points for expanding access to energy services that benefit the poor. These include the development and launching of a new national rural electrification strategy; establishment of a national cooking energy programme; and the development of clear policy incentives to support private sector investment in energy services for the poor. It calls on the Nigerian Central Bank of Nigeria to set aside 10% of the existing power intervention fund for pro poor energy financing; and the Nigerian Electricity Regulatory Commission to establish a clear framework for the utilization of the Consumer Assistance Fund. Other recommendations include the use of a proportion of the Ecological Fund to finance cooking energy; establishment of a donor’s platform on pro poor energy; and the mobilization of civil society in providing community-level energy services.

  18. Quantitative analysis of access strategies to remoteinformation in network services

    Olsen, Rasmus Løvenstein; Schwefel, Hans-Peter; Hansen, Martin Bøgsted

    2006-01-01

    Remote access to dynamically changing information elements is a required functionality for various network services, including routing and instances of context-sensitive networking. Three fundamentally different strategies for such access are investigated in this paper: (1) a reactive approach...... analytic models to compute different performance metrics for these approaches, with special focus on the so-called mismatch probability. The results of the analytic models allow for design decisions on which strategy to implement for specific input parameters (change rate of the information element...

  19. Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers

    Riggs Elisha

    2012-05-01

    Full Text Available Abstract Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years. Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making

  20. Liberalization and Universal Access to Basic Services : Telecommunications, Water and Sanitation, Financial Services, and Electricity

    Organisation for Economic Co-operation and Development; World Bank

    2006-01-01

    Access to basic services plays an important role in both individual well-being and a country's economic development. For this reason, general availability of these services to citizens, regardless of income level and geographical location, has generally been viewed as an important public policy goal. However, the precise definition of this goal and the means of attaining it have provoked c...

  1. Three-dimensional echocardiography

    Buck, Thomas [University Hospital Essen (Germany). West German Heart Center; Franke, Andreas [Klinikum Region Hannover - Klinikum Siloah, Hannover (Germany). Dept. of Cardiology, Angiology and Intensive Care Medicine; Monaghan, Mark J. (eds.) [King' s College Hospital, London (United Kingdom)

    2011-07-01

    Presents tips and tricks for beginners and experts Provides educational material for 3D training courses Features comprehensively illustrated cases Includes an accompanying DVD with video clips of all sample cases Three-dimensional echocardiography is the most recent fundamental advancement in echocardiography. Since real-time 3D echocardiography became commercially available in 2002, it has rapidly been accepted in echo labs worldwide. This book covers all clinically relevant aspects of this fascinating new technology, including a comprehensive explanation of its basic principles, practical aspects of clinical application, and detailed descriptions of specific uses in the broad spectrum of clinically important heart disease. The book was written by a group of well-recognized international experts in the field, who have not only been involved in the scientific and clinical evolution of 3D echocardiography since its inception but are also intensively involved in expert training courses. As a result, the clear focus of this book is on the practical application of 3D echocardiography in daily clinical routine with tips and tricks for both beginners and experts, accompanied by more than 150 case examples comprehensively illustrated in more than 800 images and more than 500 videos provided on a DVD. In addition to an in-depth review of the most recent literature on real-time 3D echocardiography, this book represents an invaluable reference work for beginners and expert users of 3D echocardiography. - Tips and tricks for beginners and experts - Educational material for 3D training courses - Comprehensively illustrated cases - DVD with video clips of all sample cases.

  2. Three-dimensional echocardiography

    Presents tips and tricks for beginners and experts Provides educational material for 3D training courses Features comprehensively illustrated cases Includes an accompanying DVD with video clips of all sample cases Three-dimensional echocardiography is the most recent fundamental advancement in echocardiography. Since real-time 3D echocardiography became commercially available in 2002, it has rapidly been accepted in echo labs worldwide. This book covers all clinically relevant aspects of this fascinating new technology, including a comprehensive explanation of its basic principles, practical aspects of clinical application, and detailed descriptions of specific uses in the broad spectrum of clinically important heart disease. The book was written by a group of well-recognized international experts in the field, who have not only been involved in the scientific and clinical evolution of 3D echocardiography since its inception but are also intensively involved in expert training courses. As a result, the clear focus of this book is on the practical application of 3D echocardiography in daily clinical routine with tips and tricks for both beginners and experts, accompanied by more than 150 case examples comprehensively illustrated in more than 800 images and more than 500 videos provided on a DVD. In addition to an in-depth review of the most recent literature on real-time 3D echocardiography, this book represents an invaluable reference work for beginners and expert users of 3D echocardiography. - Tips and tricks for beginners and experts - Educational material for 3D training courses - Comprehensively illustrated cases - DVD with video clips of all sample cases.

  3. SERVICE AVAILABILITY AND ACCESSIBILITY OF REQUIREMENTS USINGCLUSTERING IN CLOUD ENVIRONMENT

    Thamilvaani Arvaree Alvar

    2012-01-01

    Full Text Available Cloud computing is one contemporary technology in which the research community has recently embarked. Cloud computing faces many of the challenges and difficulties. Meeting the user needs is the important issue in any business environment. The need for quality services that satisfies both customers and service providers is very essential. Lacking of guarantees for the customer to fully satisfy with the retrieved services from the service provider for the requested requirements has been identified as the major problem statement of this study. Clustering is one of the methods that widely used in data mining especially for information retrieval. Information retrieval is a process of group similar content or files together. There are different algorithms available to do the clustering such as partitioned clustering (K-means Clustering and Hierarchical Clustering (Agglomerative Hierarchical Clustering (AHC. Due to large amount of data efficient access and exploration of information retrieval is always critical. Most of the time, user will get a long list of documents which is partially match their requirements. While searching for services or access the service, there are many irrelevant documents returned with the relevant document which meets the requirements. Therefore, clustering will be used to overcome the above problem. This technique will implemented in an application to efficiently assess the correctness (fitness of requirements measurement for the required services in cloud computing. The results or findings from the application will be the evidence to ensure meeting customer requirements more adequately while providing services. Reducing the inadequacy of meeting requirements will be the major contribution of this research with the support of the application.

  4. A SOAP Web Service for accessing MODIS land product subsets

    SanthanaVannan, Suresh K [ORNL; Cook, Robert B [ORNL; Pan, Jerry Yun [ORNL; Wilson, Bruce E [ORNL

    2011-01-01

    Remote sensing data from satellites have provided valuable information on the state of the earth for several decades. Since March 2000, the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor on board NASA s Terra and Aqua satellites have been providing estimates of several land parameters useful in understanding earth system processes at global, continental, and regional scales. However, the HDF-EOS file format, specialized software needed to process the HDF-EOS files, data volume, and the high spatial and temporal resolution of MODIS data make it difficult for users wanting to extract small but valuable amounts of information from the MODIS record. To overcome this usability issue, the NASA-funded Distributed Active Archive Center (DAAC) for Biogeochemical Dynamics at Oak Ridge National Laboratory (ORNL) developed a Web service that provides subsets of MODIS land products using Simple Object Access Protocol (SOAP). The ORNL DAAC MODIS subsetting Web service is a unique way of serving satellite data that exploits a fairly established and popular Internet protocol to allow users access to massive amounts of remote sensing data. The Web service provides MODIS land product subsets up to 201 x 201 km in a non-proprietary comma delimited text file format. Users can programmatically query the Web service to extract MODIS land parameters for real time data integration into models, decision support tools or connect to workflow software. Information regarding the MODIS SOAP subsetting Web service is available on the World Wide Web (WWW) at http://daac.ornl.gov/modiswebservice.

  5. Access pricing, bypass and universal service in post

    Armstrong, Mark

    2006-01-01

    A postal regulator typically faces two issues which make the design of efficient access pricing especially difficult and which complicate the process of liberalizing the industry. First, universal service obligations, together with the presence of fixed costs, require retail prices to depart from the underlying marginal costs of the incumbent provider. Second, competing firms may be able to bypass the incumbent’s delivery network. Within a simple and stylized framework, this note ...

  6. Health Seeking Behavior and Family Planning Services Accessibility in Indonesia

    Niniek Lely Pratiwi; Hari Basuki

    2014-01-01

    Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in...

  7. Access to dental public services by disabled persons

    Leal Rocha, Lyana; Vieira de Lima Saintrain, Maria; Pimentel Gomes Fernandes Vieira-Meyer, Anya

    2015-01-01

    Background According to the World Health Organization, one in every 10 people has a disability, and more than two-thirds of them do not receive any type of oral dental care. The Brazilian Constitution of 1988 guarantees all civilians including disabled people the right to healthcare, shaping the guidelines of the Brazilian National Health Care System (Sistema Único de Saúde – SUS). However, there is limited information about the true accessibility of dental services. This study evaluated the ...

  8. An evaluation of a direct access flexible fibreoptic sigmoidoscopy service.

    Vellacott, K D; Roe, A M; Mortensen, N J

    1987-01-01

    During a 3 year period 146 general practitioners referred 630 patients to a direct access flexible sigmoidoscopy clinic. The yield was 53.3% with significant colonic or rectal pathology in 30%. Twenty six cancers, 4 Dukes' A, and 38 patients with symptomatic adenomatous polyps were detected. Five further cancers were detected by subsequent barium enemas. The service reduced delay in diagnosing colorectal pathology but did not reduce the number of barium enemas requested by general practitione...

  9. Transparent Adaptable Network Access and Service Content Differentiation

    Senneset, Thomas

    2006-01-01

    Today s most advanced mobile devices support communication through a variety of network technologies; GSM (including GPRS and EDGE), UMTS, WLAN, Bluetooth, and IR. This master thesis characterizes different network technologies and protocols available to mobile devices, phones in particular. In addition, service provisioning capabilities over different types of networks are identified. Internet access till now has been provided over GSM or UMTS, often via a WAP Gateway. With a WAP Gateway, ...

  10. Access of rural AFDC Medicaid beneficiaries to mental health services.

    Lambert, D; Agger, M S

    1995-01-01

    This article examines geographic differences in the use of mental health services among Aid to Families with Dependent Children (AFDC)-eligible Medicaid beneficiaries in Maine. Findings indicate that rural AFDC beneficiaries have significantly lower utilization of mental health services than urban beneficiaries. Specialty mental health providers account for the majority of ambulatory visits for both rural and urban beneficiaries. However, rural beneficiaries rely more on primary-care providers than do urban beneficiaries. Differences in use are largely explained by variations in the supply of specialty mental health providers. This finding supports the long-held assumption that lower supply is a barrier to access to mental health services in rural areas. PMID:10153467

  11. Towards Emulation-as-a-Service: Cloud Services for Versatile Digital Object Access

    Dirk von Suchodoletz

    2013-06-01

    Full Text Available The changing world of IT services opens the chance to more tightly integrate digital long-term preservation into systems, both for commercial and end users. The emergence of cloud offerings re-centralizes services, and end users interact with them remotely through standardized (web-client applications on their various devices. This offers the chance to use partially the same concepts and methods to access obsolete computer environments and allows for more sustainable business processes. In order to provide a large variety of user-friendly remote emulation services, especially in combination with authentic performance and user experience, a distributed system model and architecture is required, suitable to run as a cloud service, allowing for the specialization both of memory institutions and third party service providers.The shift of the usually non-trivial task of the emulation of obsolete software environments from the end user to specialized providers can help to simplify digital preservation and access strategies. Besides offering their users better access to their holdings, libraries and archives may gain new business opportunities to offer services to a third party, such as businesses requiring authentic reproduction of digital objects and processes for legal reasons. This paper discusses cloud concepts as the next logical step for accessing original digital material. Emulation-as-a-Service (EaaS fills the gap between the successful demonstration of emulation strategies as a long term access strategy and it’s perceived availability and usability. EaaS can build upon the ground of research and prototypical implementations of previous projects, and reuse well established remote access technology.In this article we develop requirements and a system model, suitable for a distributed environment. We will discuss the building blocks of the core services as well as requirements regarding access management. Finally, we will try to present a

  12. Health Seeking Behavior and Family Planning Services Accessibility in Indonesia

    Niniek Lely Pratiwi

    2014-11-01

    Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.

  13. A JEE RESTful service to access Conditions Data in ATLAS

    Formica, Andrea; Gallas, E. J.

    2015-12-01

    Usage of condition data in ATLAS is extensive for offline reconstruction and analysis (e.g. alignment, calibration, data quality). The system is based on the LCG Conditions Database infrastructure, with read and write access via an ad hoc C++ API (COOL), a system which was developed before Run 1 data taking began. The infrastructure dictates that the data is organized into separate schemas (assigned to subsystems/groups storing distinct and independent sets of conditions), making it difficult to access information from several schemas at the same time. We have thus created PL/SQL functions containing queries to provide content extraction at multi-schema level. The PL/SQL API has been exposed to external clients by means of a Java application providing DB access via REST services, deployed inside an application server (JBoss WildFly). The services allow navigation over multiple schemas via simple URLs. The data can be retrieved either in XML or JSON formats, via simple clients (like curl or Web browsers).

  14. A JEE RESTful service to access Conditions Data in ATLAS

    Formica, Andrea; The ATLAS collaboration

    2015-01-01

    Usage of Conditions Data in ATLAS is extensive for offline reconstruction and analysis (e.g.: alignment, calibration, data quality). The system is based on the LCG Conditions Database infrastructure, with read and write access via an ad hoc C++ API (COOL), a system which was developed before Run 1 data taking began. The infrastructure dictates that the data is organized into separate schemata (assigned to subsystems/groups storing distinct and independent sets of conditions), making it difficult to access information from several schemata at the same time. We have thus created PL/SQL functions containing queries to provide content extraction at multi-schema level. The PL/SQL API has been exposed to external clients by means of a Java application providing DB access via RESTful services, deployed inside an application server (JBoss WildFly). The services allow navigation over multiple schemata via simple URLs. The data can be retrieved either in XML or JSON formats, via simple clients (like curl or Web browser...

  15. A JEE RESTful service to access Conditions Data in ATLAS

    Formica, Andrea; The ATLAS collaboration

    2015-01-01

    Usage of Conditions Data in ATLAS is extensive for offline reconstruction and analysis (for example: alignment, calibration, data quality). The system is based on the LCG Conditions Database infrastructure, with read and write access via an ad hoc C++ API (COOL), a system which was developed before Run 1 data taking began. The infrastructure dictates that the data is organized into separate schemas (assigned to subsystems/groups storing distinct and independent sets of conditions), making it difficult to access information from several schemas at the same time. We have thus created PL/SQL functions containing queries to provide content extraction at multi-schema level. The PL/SQL API has been exposed to external clients by means of an intermediate java application server (JBoss), where an application delivering access to the DB via RESTful services has been deployed. The services allow navigation over multiple schema content, via simple URLs. The queried data can be retrieved either in XML or JSON formats, vi...

  16. A JEE RESTful service to access Conditions Data in ATLAS

    Formica, Andrea

    2015-01-01

    Usage of condition data in ATLAS is extensive for offline reconstruction and analysis (e.g. alignment, calibration, data quality). The system is based on the LCG Conditions Database infrastructure, with read and write access via an ad hoc C++ API (COOL), a system which was developed before Run 1 data taking began. The infrastructure dictates that the data is organized into separate schemas (assigned to subsystems/groups storing distinct and independent sets of conditions), making it difficult to access information from several schemas at the same time. We have thus created PL/SQL functions containing queries to provide content extraction at multi-schema level. The PL/SQL API has been exposed to external clients by means of a Java application providing DB access via REST services, deployed inside an application server (JBoss WildFly). The services allow navigation over multiple schemas via simple URLs. The data can be retrieved either in XML or JSON formats, via simple clients (like curl or Web browsers).

  17. Web Services Provide Access to SCEC Scientific Research Application Software

    Gupta, N.; Gupta, V.; Okaya, D.; Kamb, L.; Maechling, P.

    2003-12-01

    Web services offer scientific communities a new paradigm for sharing research codes and communicating results. While there are formal technical definitions of what constitutes a web service, for a user community such as the Southern California Earthquake Center (SCEC), we may conceptually consider a web service to be functionality provided on-demand by an application which is run on a remote computer located elsewhere on the Internet. The value of a web service is that it can (1) run a scientific code without the user needing to install and learn the intricacies of running the code; (2) provide the technical framework which allows a user's computer to talk to the remote computer which performs the service; (3) provide the computational resources to run the code; and (4) bundle several analysis steps and provide the end results in digital or (post-processed) graphical form. Within an NSF-sponsored ITR project coordinated by SCEC, we are constructing web services using architectural protocols and programming languages (e.g., Java). However, because the SCEC community has a rich pool of scientific research software (written in traditional languages such as C and FORTRAN), we also emphasize making existing scientific codes available by constructing web service frameworks which wrap around and directly run these codes. In doing so we attempt to broaden community usage of these codes. Web service wrapping of a scientific code can be done using a "web servlet" construction or by using a SOAP/WSDL-based framework. This latter approach is widely adopted in IT circles although it is subject to rapid evolution. Our wrapping framework attempts to "honor" the original codes with as little modification as is possible. For versatility we identify three methods of user access: (A) a web-based GUI (written in HTML and/or Java applets); (B) a Linux/OSX/UNIX command line "initiator" utility (shell-scriptable); and (C) direct access from within any Java application (and with the

  18. Training in critical care echocardiography

    Mayo, Paul H

    2011-01-01

    Echocardiography is useful for the diagnosis and management of hemodynamic failure in the intensive care unit so that competence in some elements of echocardiography is a core skill of the critical care specialist. An important issue is how to provide training to intensivists so that they are competent in the field. This article will review issues related to training in critical care echocardiography.

  19. 3D Harmonic Echocardiography:

    M.M. Voormolen

    2007-01-01

    textabstractThree dimensional (3D) echocardiography has recently developed from an experimental technique in the ’90 towards an imaging modality for the daily clinical practice. This dissertation describes the considerations, implementation, validation and clinical application of a unique

  20. Estimating the Impact of Access Conditions on Service Quality in Post

    Swinand, Gregory; O'Toole, Conor; Lyons, Seán

    2010-01-01

    Third party access to postal networks can be made subject to a range of access conditions. While the pricing of postal network access has received much research attention, the effects of access on quality of service have received less. Using data on international postal services in a large panel of European countries, we estimate an econometric model of average time-to-delivery for letter post, including a range of access conditions. We find that several access conditions have a significant a...

  1. Ontology management in a service-oriented architecture: Architecture of an knowledge base access service

    Moßgraber, Jürgen; Rospocher, M.

    2012-01-01

    An increasing number of information systems integrate semantic data stores for managing ontologies. To access these knowledge bases most of the available implementations provide application programming interfaces (APIs). The implementations of these APIs normally do not support any kind of network protocol or service interface. This works fine as long as a monolithic system is developed. If the need arises to integrate such a knowledge base into a service-oriented architecture a different app...

  2. Discussing the Issues: A Report on the 2013 Ivies + Access Services Symposium

    Wilson, Andrew M.

    2014-01-01

    As access services emerges as a discrete discipline within the field of librarianship, opportunities for access services librarians to meet and discuss the issues facing today's libraries continue to grow. One annual meeting that has attracted less attention over the years is the Ivies + Access Services Symposium. Held at various member…

  3. Secure external access to CERN's services to replace VPN

    2005-01-01

    CERN has recently experienced several computer security incidents caused by people opening VPN connections and (unknown to them) allowing malicious software to enter CERN. VPN should be used to connect to CERN only in extreme and exceptional circumstances and it is formally discouraged as a general solution. If incidents continue, the availability of the service will need to be reviewed. Recommended methods of connecting to CERN from the Internet for common functionalities such as e-mail, access to CERN web or file servers and interactive sessions on CERN systems are described at http://cern.ch/security/vpn

  4. The Role of Postal Networks in Expanding Access to Financial Services : Kazakhstan's Postal Finance Services

    World Bank

    2004-01-01

    This paper discusses the role of the postal network in expanding access to financial services in Kazakhstan. It reviews the public postal operator within the postal sector and within the broader context of the communications sector. The roles of the postal network and state and privately-owned banks are also reviewed from the perspective of the financial sector development, with particular...

  5. Pilot evaluation of a web-based intervention targeting sexual health service access.

    Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I

    2016-04-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. PMID:26928566

  6. A Semantic Context-Based Model for MobileWeb Services Access Control

    Haibo Shen; Yu Cheng

    2011-01-01

    As mobile web services becomes more pervasive, applications based on mobile web services will need flexible access control mechanisms. Unlike traditional approaches based on the identity or role for access control, access decisions for these applications will depend on the combination of the required attributes of users and the contextual information. This paper proposes a semantic context-based access control model (called SCBAC) to be applied in mobile web services environment by combining ...

  7. Pacing stress echocardiography

    Agrusta Marco; Gligorova Suzana

    2005-01-01

    Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates ...

  8. Pediatric transesophageal echocardiography

    Stümper, Oliver

    1991-01-01

    textabstractIn face of several limitations of precordial ultrasound investigations in children with congenital heart disease, it was attempted to defme the additional value of pediatric transesophageal echocardiography. Its comparative value, firstly, in the preoperative diagnosis of congenital heart disease had to be determined (Chapters 4-8), secondly, its place as an intraoperative monitoring technique in the surgery of congenital heart disease had to be assessed (Chapter 9), and thirdly, ...

  9. Transthoracic Echocardiography in Mice

    Respress, Jonathan L.; Wehrens, Xander H. T.

    2010-01-01

    In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene expression. Transgenic and gene targeting methods can be used to generate mice with altered cardiac size and function,1-3 and as a result, in vivo techniques are needed to evaluate their cardiac phenotype. Transthoracic echocardiography, pulse wave Doppler (PWD), and tissue Doppler imaging (TDI) can be used to provide dimensional measurement...

  10. The relation between gender and access to dental services and goods

    Maria Vieira de Lima Saintrain; Paulo Leonardo Ponte Marques; Lúcio Hélio Pereira de Almeida; Caroline Barbosa Lourenço; Raimunda Magalhães da Silva; Anya Pimentel Gomes Fernandes Vieira

    2014-01-01

    ABSTRACT The Brazilian National Health System guarantees universal access to health services. However, this universal access is not always achieved, making relevant studies that evaluate access to health care and the way gender influence this access. Objective: Identify the influence of gender in the access to dental services and goods such as consultation, toothbrush, toothpaste and dental prostheses use in Brazil’s Northeast region. Methods: Cross-sectional, quantitative and population ...

  11. A Collaborative Wireless Access to On-Demand Services

    Zohar Naor

    2008-02-01

    Full Text Available A collaborative access scheme that exploits the broadcast nature of the wireless communication in order to achieve multicast content delivery is presented in this paper. The key idea is that individual clients requesting for the same content can collaborate and share the same data channel. As opposed to broadcasting, this method enables the clients to determine online the delivered content, and thus supports on-demand services. On the other hand, a multicast content delivery is much more efficient than a unicast content distribution, which must use a dedicated data channel per each and every client. This method is particularly suitable for sessions having a long-time duration, for applications in which clients can subscribe to ahead of time, and for applications in which the clients receive the same information simultaneously. A multicast content distribution increases the network service throughput in terms of the expected number of clients served simultaneously, and therefore it offers a reduced waiting time for content delivery at highly loaded time periods. It is shown that the problem of maximizing the efficiency of distributing a content in a wireless network is NP-hard. An approximation algorithm is therefore used, that for any 0<ε<1 finds an approximation solution with a relative accuracy ε. The proposed method does not require any hardware modification on the network equipment. Thus, it can be easily implemented.

  12. Resolving mobility constraints impeding rural seniors' access to regionalized services.

    Ryser, Laura; Halseth, Greg

    2012-01-01

    Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors. PMID:22720890

  13. Reaching the Unreachable: Barriers of the Poorest to Accessing NGO Healthcare Services in Bangladesh

    Ahmed, Nizam U.; Alam, Mohammed M.; Sultana, Fadia; Sayeed, Shahana N.; Pressman, Aliza M.; Powers, Mary Beth

    2006-01-01

    The NGO Service Delivery Program (NSDP), a USAID-funded programme, is the largest NGO programme in Bangladesh. Its strategic flagship activity is the essential services package through which healthcare services are administered by NGOs in Bangladesh. The overall goal of the NSDP is to increase access to essential healthcare services by communities, especially the poor. Recognizing that the poorest in the community often have no access to essential healthcare services due to various barriers, ...

  14. Open Access to Knowledge Resources in Science and Technology : The Role of Digital Reference Service to Facilitate Accessing Scholarly Information

    Chandra, Harish

    2005-01-01

    The present paper discusses the importance, objectives and major developments in open access initiatives. It further examines the specific use of digital information services including the digital reference service. The paper also highlights the various steps taken in this direction at the Central Library of IIT Madras.

  15. Access to fertility services by transgender persons: an Ethics Committee opinion.

    2015-11-01

    This statement explores the ethical considerations surrounding the provision of fertility services to transgender individuals and concludes that denial of access to fertility services is not justified. PMID:26363388

  16. Access Control Mechanisms for Semantic Web services-A Discussion on Requirements & Future Directions

    Gondara, Mandeep Kaur

    2011-01-01

    Semantic Web is an open, distributed, and dynamic environment where access to resources cannot be controlled in a safe manner unless the access decision takes into account during discovery of web services. Security becomes the crucial factor for the adoption of the semantic based web services. An access control means that the users must fulfill certain conditions in order to gain access over web services. Access control is important in both perspectives i.e. legal and security point of view. This paper discusses important requirements for effective access control in semantic web services which have been extracted from the literature surveyed. I have also discussed open research issues in this context, focusing on access control policies and models in this paper.

  17. Spatial analysis of elderly access to primary care services

    Lozano-Gracia Nancy

    2006-05-01

    Full Text Available Abstract Background Admissions for Ambulatory Care Sensitive Conditions (ACSCs are considered preventable admissions, because they are unlikely to occur when good preventive health care is received. Thus, high rates of admissions for ACSCs among the elderly (persons aged 65 or above who qualify for Medicare health insurance are signals of poor preventive care utilization. The relevant geographic market to use in studying these admission rates is the primary care physician market. Our conceptual model assumes that local market conditions serving as interventions along the pathways to preventive care services utilization can impact ACSC admission rates. Results We examine the relationships between market-level supply and demand factors on market-level rates of ACSC admissions among the elderly residing in the U.S. in the late 1990s. Using 6,475 natural markets in the mainland U.S. defined by The Health Resources and Services Administration's Primary Care Service Area Project, spatial regression is used to estimate the model, controlling for disease severity using detailed information from Medicare claims files. Our evidence suggests that elderly living in impoverished rural areas or in sprawling suburban places are about equally more likely to be admitted for ACSCs. Greater availability of physicians does not seem to matter, but greater prevalence of non-physician clinicians and international medical graduates, relative to U.S. medical graduates, does seem to reduce ACSC admissions, especially in poor rural areas. Conclusion The relative importance of non-physician clinicians and international medical graduates in providing primary care to the elderly in geographic areas of greatest need can inform the ongoing debate regarding whether there is an impending shortage of physicians in the United States. These findings support other authors who claim that the existing supply of physicians is perhaps adequate, however the distribution of them across

  18. Self-harm in trafficked adults accessing secondary mental health services in England

    Borschmann, Rohan; Oram, Sian; Howard, Louise Michele; Kinner, Stuart; Dutta, Rina; Zimmerman, Cathy

    2016-01-01

    Objective: This study estimated the prevalence, correlates and mental health service responses to self-harm among trafficked adults accessing secondary mental health services in England. Methods: A clinical records database was searched to identify trafficked adults who accessed secondary mental health services in South London from 2006-2012. A matched cohort of non-trafficked patients was selected. Data were extracted on self-harm, socio-demographic, clinical and service use characteristics....

  19. 47 CFR 54.621 - Access to advanced telecommunications and information services.

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Access to advanced telecommunications and information services. 54.621 Section 54.621 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... § 54.621 Access to advanced telecommunications and information services. (a) Twenty-five percent of...

  20. Mass Media and Public Services : The Effects of Radio Access on Public Education in Benin

    Keefer, Philip; Khemani, Stuti

    2011-01-01

    Does radio access improve public service provision? And if so, does it do so by increasing government accountability to citizens, or by persuading households to take advantage of publicly-provided services? Prior research has argued that citizens with greater access to mass media receive greater benefits from targeted government welfare programs, but has not addressed these questions for public ...

  1. Real-time transmission of full-motion echocardiography over a high-speed data network: impact of data rate and network quality of service

    Main, M. L.; Foltz, D.; Firstenberg, M. S.; Bobinsky, E.; Bailey, D.; Frantz, B.; Pleva, D.; Baldizzi, M.; Meyers, D. P.; Jones, K.; Spence, M. C.; Freeman, K.; Morehead, A.; Thomas, J. D.

    2000-01-01

    With high-resolution network transmission required for telemedicine, education, and guided-image acquisition, the impact of errors and transmission rates on image quality needs evaluation. METHODS: We transmitted clinical echocardiograms from 2 National Aeronautics and Space Administration (NASA) research centers with the use of Motion Picture Expert Group-2 (MPEG-2) encoding and asynchronous transmission mode (ATM) network protocol over the NASA Research and Education Network. Data rates and network quality (cell losses [CLR], errors [CER], and delay variability [CVD]) were altered and image quality was judged. RESULTS: At speeds of 3 to 5 megabits per second (Mbps), digital images were superior to those on videotape; at 2 Mbps, images were equivalent. Increasing CLR caused occasional, brief pauses. Extreme CER and CDV increases still yielded high-quality images. CONCLUSIONS: Real-time echocardiographic acquisition, guidance, and transmission is feasible with the use of MPEG-2 and ATM with broadcast quality seen above 3 Mbps, even with severe network quality degradation. These techniques can be applied to telemedicine and used for planned echocardiography aboard the International Space Station.

  2. Access to Maternal Health Care Services in the Cape Coast Metropolitan Area, Ghana

    D. Adei; Y.B. Fiscian; L. Ephraim; S.K. Diko

    2012-01-01

    Maternal mortality can be prevented if mothers had routine obstetric care and access to emergency obstetric services. However, in accessing healthcare most expecting mothers will have to struggle with distance and financial problems. The study sought to; assess the barriers that discourage women from accessing antenatal, delivery and postnatal services in the Cape coast Metropolis and give recommendations to inform policy. Questionnaire was administered to 150 pregnant women and nursing mothe...

  3. Accessibility and Utilization of Internet Service by Graduate Students in University of Lagos, Nigeria

    Oyeronke Olufunmilola Ogunlade; Olaniyi Oladimeji Bola

    2012-01-01

    The major objective of the study was to examine the accessibility and utilization of Internet service by graduate students in university of Lagos, Nigeria. Specifically, the study made effort to determine the extent to which Internet service was accessible to staff and students of the university, how point of Internet access influenced its usage, factors motivating the use of Internet and what Internet was used for by graduate students in University of Lagos. The study adopted a descriptive s...

  4. Two service units with interference in the access to servers

    Rosa E. Lillo

    1999-01-01

    Full Text Available We examine the service mechanism of two queueing models with two units in tandem. In the first model, customers who complete service in Unit 1 must wait in an intermediate buffer until the ongoing service in Unit II ends. In the second model, jobs can be pre-positioned in an intermediate buffer to await service in Unit II. Under the assumption of phase-type service times, the steady-state regime of the service system is studied in detail.

  5. Advertising and competitive access pricing to internet services or pay-TV

    Jean, JASKOLD-GABSZEWICZ; Didier, LAUSSEL; Nathalie, SONNAC

    2006-01-01

    We study access pricing by platforms providing internet services or pay-TV to users while they allow advertisers to have access to these users against payment via ads or banners. Users are assumed to be ad-haters. It is shown that equilibrium access prices in the users’ market are increasing in the dimension of the advertising market : the larger the number of advertisers, the higher the access prices for both platforms.

  6. Pacing stress echocardiography

    Agrusta Marco

    2005-12-01

    Full Text Available Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates to assess global left ventricular contractility. Methods The pathophysiologic rationale of pacing stress for noninvasive detection of coronary artery disease is obvious, with the stress determined by a controlled increase in heart rate, which is a major determinant of myocardial oxygen demand, and thereby tachycardia may exceed a fixed coronary flow reserve in the presence of hemodynamically significant coronary artery disease. The use of pacing stress echo to assess left ventricular contractile reserve is less established, but promising. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon. To build the force-frequency relationship, the force is determined at different heart rate steps as the ratio of the systolic pressure (cuff sphygmomanometer/end-systolic volume index (biplane Simpson rule. The heart rate is determined from ECG. Conclusion Two-dimensional echocardiography during pacing is a useful tool in the detection of coronary artery disease. Because of its safety and ease of repeatability noninvasive pacing stress echo can be the first-line stress test in patients with permanent pacemaker. The force-frequency can be defined as up- sloping (normal when the peak stress pacing systolic pressure/end-systolic volume index is higher than baseline and intermediate stress

  7. Access to eye health services among indigenous Australians: an area level analysis

    Kelaher Margaret; Ferdinand Angeline; Taylor Hugh

    2012-01-01

    Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, ...

  8. Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review

    Alencar Albuquerque, Grayce; de Lima Garcia, Cintia; da Silva Quirino, Glauberto; Alves, Maria Juscinaide Henrique; Belém, Jameson Moreira; dos Santos Figueiredo, Francisco Winter; da Silva Paiva, Laércio; do Nascimento, Vânia Barbosa; da Silva Maciel, Érika; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos; Adami, Fernando

    2016-01-01

    Background The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. Method A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 200...

  9. Access to Core Course Materials Project: DigiCOMS: report of the pilot service

    Secker, J

    2001-01-01

    One of the objectives of the Access to Core Course Materials Project was to set up, run and evaluate a pilot electronic study pack service. The needs analysis demonstrated that the service needed to encompass a range of materials and so the service was broadened to include a variety of electronic course materials. The service included the production of electronic study packs, but also offered a digitisation service for other types of course materials; in particular a facility to make availabl...

  10. Important Advances In Technology: Echocardiography

    Nagueh, Sherif F; Quiñones, Miguel A.

    2014-01-01

    Echocardiography has evolved over the past 45 years from a simple M-mode tracing to an array of technologies that include two-dimensional imaging, pulsed and continuous wave spectral Doppler, color flow and tissue Doppler, and transesophageal echocardiography. Together, these modalities provide a comprehensive anatomic and functional evaluation of cardiac chambers and valves, pericardium, and ascending and descending aorta. The switch from analog to digital signal processing revolutionized th...

  11. Socioeconomic inequalities in the access to and quality of health care services

    Bruno Pereira Nunes

    2014-12-01

    Full Text Available OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days for assistance, and waiting time (in hours in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

  12. Access control for on-demand provisioned cloud infrastructure services

    Ngo, C.T.

    2016-01-01

    The evolution of Cloud Computing brings advantages to both customers and service providers to utilize and manage computing and network resources more efficiently with virtualization, service-oriented architecture technologies, and automated on-demand resource provisioning. However, these advantages come with challenges on how to securely and efficiently protect customer resources in cloud environments. Service providers need to provide elastic and flexible cloud resources to their large numbe...

  13. An Access Control Metamodel for Web Service-Oriented Architecture

    Emig, Christian; Brandt, Frank; Abeck, Sebastian; Biermann, Jürgen; Klarl, Heiko

    2008-01-01

    With the mutual consent to use WSDL (Web Service Description Language) to describe web service interfaces and SOAP as the basic communication protocol, the cornerstone for web service-oriented architecture (WSOA) has been established. Considering the momentum observable by the growing number of specifications in the web service domain for the indispensable cross-cutting concern of identity management (IdM) it is still an open issue how a WSOA-aware IdM architecture is built and how it is link...

  14. Semantic Data Access Services at NASA's Atmospheric Science Data Center

    Huffer, E.; Hertz, J.; Kusterer, J.

    2012-12-01

    The corpus of Earth Science data products at the Atmospheric Science Data Center at NASA's Langley Research Center comprises a widely heterogeneous set of products, even among those whose subject matter is very similar. Two distinct data products may both contain data on the same parameter, for instance, solar irradiance; but the instruments used, and the circumstances under which the data were collected and processed, may differ significantly. Understanding the differences is critical to using the data effectively. Data distribution services must be able to provide prospective users with enough information to allow them to meaningfully compare and evaluate the data products offered. Semantic technologies - ontologies, triple stores, reasoners, linked data - offer functionality for addressing this issue. Ontologies can provide robust, high-fidelity domain models that serve as common schema for discovering, evaluating, comparing and integrating data from disparate products. Reasoning engines and triple stores can leverage ontologies to support intelligent search applications that allow users to discover, query, retrieve, and easily reformat data from a broad spectrum of sources. We argue that because of the extremely complex nature of scientific data, data distribution systems should wholeheartedly embrace semantic technologies in order to make their data accessible to a broad array of prospective end users, and to ensure that the data they provide will be clearly understood and used appropriately by consumers. Toward this end, we propose a distribution system in which formal ontological models that accurately and comprehensively represent the ASDC's data domain, and fully leverage the expressivity and inferential capabilities of first order logic, are used to generate graph-based representations of the relevant relationships among data sets, observational systems, metadata files, and geospatial, temporal and scientific parameters to help prospective data consumers

  15. A Service Oriented Architecture for Personalized Universal Media Access

    Ingo Brunkhorst

    2011-04-01

    Full Text Available Multimedia streaming means delivering continuous data to a plethora of client devices. Besides the actual data transport, this also needs a high degree of content adaptation respecting the end users’ needs given by content preferences, transcoding constraints, and device capabilities. Such adaptations can be performed in many ways, usually on the media server. However, when it comes to content editing, like mixing in subtitles or picture-in-picture composition, relying on third party service providers may be necessary. For economic reasons this should be done in a service-oriented way, because a lot of adaptation modules can be reused within different adaptation workflows. Although service-oriented architectures have become widely accepted in the Web community, the multimedia environment is still dominated by monolithic systems. The main reason is the insufficient support for working with continuous data: generally the suitability of Web services for handling complex data types and state-full applications is still limited. In this paper we discuss extensions of Web service frameworks, and present a first implementation of a service-oriented framework for media streaming and digital item adaptation. The focus lies on the technical realization of the services. Our experimental results show the practicality of the actual deployment of service-oriented multimedia frameworks.

  16. 42 CFR 422.112 - Access to services.

    2010-10-01

    ... limited English proficiency or reading skills, and diverse cultural and ethnic backgrounds. (9) Ambulance... with community and social services generally available through contracting or noncontracting providers... may specify the networks of providers from whom enrollees may obtain services if the MA...

  17. Contrast echocardiography in Canada: Canadian Cardiovascular Society/Canadian Society of Echocardiography position paper

    Honos, George; Amyot, Robert; Choy, Jonathan; Leong-Poi, Howard; Schnell, Greg; Yu, Eric

    2007-01-01

    As an adjunct to transthoracic, transesophageal and stress echocardiography, contrast echocardiography (CE) improves the diagnostic accuracy of technically suboptimal studies when used in conjunction with harmonic imaging.

  18. IVOA Recommendation: SimpleDALRegExt: Describing Simple Data Access Services

    Plante, Raymond; Harrison, Paul; Tody, Doug

    2014-01-01

    An application that queries or consumes descriptions of VO resources must be able to recognize a resource's support for standard IVOA protocols. This specification describes how to describe a service that supports any of the four fundamental data access protocols -- Simple Cone Search (SCS), Simple Image Access (SIA), Simple Spectral Access (SSA), Simple Line Access (SLA) -- using the VOResource XML encoding standard. A key part of this specification is the set of VOResource XML extension schemas that define new metadata that are specific to those protocols. This document describes in particular rules for describing such services within the context of IVOA Registries and data discovery as well as the VO Standard Interface (VOSI) and service self-description. In particular, this document spells out the essential markup needed to identify support for a standard protocol and the base URL required to access the interface that supports that protocol.

  19. Accessibility to primary health care services in the state of Goiás

    Juliana Pires Ribeiro

    2015-09-01

    Full Text Available The objective of this study was to evaluate accessibility to primary health care services in the state of Goiás. A descriptive cross-sectional study was conducted based on secondary data from the National Program to Improve Access to and Quality of Primary Health Care. The study sample was composed of health professionals from 1,216 primary health care units. Results showed that 68.5% of the health units miss a screening room, thus considerably damaging prompt decision-making by professionals. The lack of medical offices in 2% of the sites hinders the primary health care services accessibility in Goiás. As regards opening hours and work shifts, 86% of the units are open five days a week in eight-hour shifts, which does not favor accessibility for users. This study confirms the lack of accessibility to health services and the need for additional investments to strengthen primary health care.

  20. Areas with access to municipal sewer service in the United States Pacific Northwest for 2002

    U.S. Geological Survey, Department of the Interior — This spatial data set was created by the U.S. Geological Survey (USGS) to represent areas that had access to municipal sewer service in the Pacific Northwest region...

  1. KBWS: an EMBOSS associated package for accessing bioinformatics web services

    Tomita Masaru

    2011-04-01

    Full Text Available Abstract The availability of bioinformatics web-based services is rapidly proliferating, for their interoperability and ease of use. The next challenge is in the integration of these services in the form of workflows, and several projects are already underway, standardizing the syntax, semantics, and user interfaces. In order to deploy the advantages of web services with locally installed tools, here we describe a collection of proxy client tools for 42 major bioinformatics web services in the form of European Molecular Biology Open Software Suite (EMBOSS UNIX command-line tools. EMBOSS provides sophisticated means for discoverability and interoperability for hundreds of tools, and our package, named the Keio Bioinformatics Web Service (KBWS, adds functionalities of local and multiple alignment of sequences, phylogenetic analyses, and prediction of cellular localization of proteins and RNA secondary structures. This software implemented in C is available under GPL from http://www.g-language.org/kbws/ and GitHub repository http://github.com/cory-ko/KBWS. Users can utilize the SOAP services implemented in Perl directly via WSDL file at http://soap.g-language.org/kbws.wsdl (RPC Encoded and http://soap.g-language.org/kbws_dl.wsdl (Document/literal.

  2. Implementation of levels of services on broadband networks with cable modem access

    Campos, Luis A.; Yu, Che-Fn

    1997-10-01

    Residential broadband access networks using technologies such as ADSL and cable modems have enabled the provisioning of emerging Internet applications such as Internet telephony, video conferencing and interactive games. These applications have specific end-to-end performance requirements from the network in order to have an acceptable performance. Currently the Internet is a best effort network which doesn't provide levels of service. There are many elements of an end-to-end network which are currently suitable to provide quality-of- service guaranties such as ATM links. Nevertheless, only with recent deployments of broadband access technologies and the introduction of Internet protocols such as RSVP, providing levels of service becomes feasible without the use expensive links to the customer site. This paper examines several network implementation options for introducing levels of service using cable modem access. Limitations imposed by the applications on the network as well as the contribution of the different network elements to level of service parameters such as end-to-end delay, throughput and jitter are examined. Concentration network architectures as well as proposed backbone configuration options for end-to-end level of service provisioning are presented. At the access network, provisioning of level of service using bandwidth control through packet throttling and through access network design providing excess bandwidth to customers are presented. HFC protocol dependent means to provide level of services including reservation and ATM based protocols are examined as well.

  3. The Value of Contrast Echocardiography

    Shannon C. Treiber

    2016-01-01

    Full Text Available Purpose: There is much evidence-based research proving the effectiveness of contrast echocardiography, but there are still questions and concerns about its specific uses. This study tested the effectiveness of contrast echocardiography in defining the left ventricular endocardial border. Methods: From 30 patients, a total of 60 echocardiograms –– 30 with and 30 without use of contrast –– were retrospectively reviewed by four blinded cardiologists with advanced training in echocardiography. No single cardiologist reviewed contrast and noncontrast images of the same patient. Each set of 30 echocardiograms was then studied for wall-motion scoring. Visualization of left ventricular wall segments and a global visualization confidence level of interpretation were recorded. Results: Of all wall segments (N = 510, 91% were visualized in echocardiograms with use of contrast, whereas 75% of the walls were visualized in echocardiograms without contrast (P < 0.001. Of 30 examinations, 17 contrast echocardiograms were read with high confidence compared to 6 without contrast use (P = 0.004. The number of walls visualized with contrast was increased in 18 patients (60%, whereas noncontrast echocardiograms yielded more visualized walls in 6 patients (20%, P = 0.002. Conclusions: This study demonstrates that contrast is valuable to echocardiographic imaging. Its use should be supported throughout echocardiography clinics and encouraged in certain patients for whom resting and stress echocardiography results without contrast often prove uninterpretable.

  4. Household choices, circumstances and equity of access to basic health and education services in the Philippines

    Joseph J. Capuno; Kraft, Aleli D.

    2010-01-01

    In developing countries like the Philippines, a major policy concern is the inequity in access to health and education services. In this paper, we investigate the effects of factors over which households have control ("choices") or none ("circumstances") on their access to basic services. Our logit regression analyses of two nationwide household surveys reveal that household income and composition, mother's age and education status, and the child's age and gender are critical. The circumstanc...

  5. Patients' online access to their electronic health records and linked online services: a systematic interpretative review

    de Lusignan, S.; Mold, F.; Sheikh, A; Majeed, A; Wyatt, J C; Quinn, T.; Cavill, M.; Gronlund, T. A.; Franco, C.; Chauhan, U.; Blakey, H.; N. Kataria; Barker, F; Ellis, B; Koczan, P

    2014-01-01

    Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 ...

  6. AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

    Ebener Steeve

    2008-12-01

    Full Text Available Abstract Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1 modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2 modeling geographic coverage according to the availability of services; (3 projecting the coverage of a scaling-up of an existing network; (4 providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on

  7. Impact of open access endoscopy on early diagnosis, treatment and gastrointestinal radiology service

    Tiwari Indrajit; Uddin Wasim; Mazhar Zia

    1997-01-01

    The objective is to compare the endoscopic findings before and after initiation of open access and its effect on gastrointestinal radiology services. The data of endoscopic findings before open access endoscopy (July, 1989-June, 1992) and after open access endoscopy (July, 1992-June, 1995) was collected from the records of the endoscopy unit. Similarly, data of barium meals for the same periods was collected from the radiology department. An X 2 test was used to compare the endoscopic findi...

  8. Access to and Use of Eye Care Services in Rural Arkansas

    Kilmer, Greta; Bynum, LaTonya; Balamurugan, Appathurai

    2010-01-01

    Context: Rural residents are more likely to be uninsured and have low income. Purpose: To determine if rural residents in Arkansas have decreased access to eye care services and use them less frequently than urban residents. Methods: Data from the 2006 Visual Impairment and Access to Eye Care Module from the Arkansas Behavioral Risk Factor…

  9. Ensuring Rights: Improving Access to Sexual and Reproductive Health Services for Female International Students in Australia

    Poljski, Carolyn; Quiazon, Regina; Tran, Chau

    2014-01-01

    Drawing on the research and advocacy work being conducted by the Multicultural Centre for Women's Health (MCWH), a national community-based organization in Victoria, Australia, the paper analyzes female international students' experiences with accessing sexual and reproductive health information and services. Accessibility of sexual and…

  10. The Critical Role of Institutional Services in Open Access Advocacy

    Tomasz Neugebauer; Annie Murray

    2013-01-01

    This paper examines the development of the Open Access movement in scholarly communication, with particular attention to some of the rhetorical strategies and policy mechanisms used to promote it to scholars and scientists. Despite the majority of journal publishers’ acceptance of author self-archiving practices, and the minimal time commitment required by authors to successfully self-archive their work in disciplinary or institutional repositories, the majority of authors still by and large ...

  11. Web service activities at the IRIS DMC to support federated and multidisciplinary access

    Trabant, Chad; Ahern, Timothy K.

    2013-04-01

    At the IRIS Data Management Center (DMC) we have developed a suite of web service interfaces to access our large archive of, primarily seismological, time series data and related metadata. The goals of these web services include providing: a) next-generation and easily used access interfaces for our current users, b) access to data holdings in a form usable for non-seismologists, c) programmatic access to facilitate integration into data processing workflows and d) a foundation for participation in federated data discovery and access systems. To support our current users, our services provide access to the raw time series data and metadata or conversions of the raw data to commonly used formats. Our services also support simple, on-the-fly signal processing options that are common first steps in many workflows. Additionally, high-level data products derived from raw data are available via service interfaces. To support data access by researchers unfamiliar with seismic data we offer conversion of the data to broadly usable formats (e.g. ASCII text) and data processing to convert the data to Earth units. By their very nature, web services are programmatic interfaces. Combined with ubiquitous support for web technologies in programming & scripting languages and support in many computing environments, web services are very well suited for integrating data access into data processing workflows. As programmatic interfaces that can return data in both discipline-specific and broadly usable formats, our services are also well suited for participation in federated and brokered systems either specific to seismology or multidisciplinary. Working within the International Federation of Digital Seismograph Networks, the DMC collaborated on the specification of standardized web service interfaces for use at any seismological data center. These data access interfaces, when supported by multiple data centers, will form a foundation on which to build discovery and access mechanisms

  12. Accessing the SEED Genome Databases via Web Services API: Tools for Programmers

    Vonstein Veronika

    2010-06-01

    Full Text Available Abstract Background The SEED integrates many publicly available genome sequences into a single resource. The database contains accurate and up-to-date annotations based on the subsystems concept that leverages clustering between genomes and other clues to accurately and efficiently annotate microbial genomes. The backend is used as the foundation for many genome annotation tools, such as the Rapid Annotation using Subsystems Technology (RAST server for whole genome annotation, the metagenomics RAST server for random community genome annotations, and the annotation clearinghouse for exchanging annotations from different resources. In addition to a web user interface, the SEED also provides Web services based API for programmatic access to the data in the SEED, allowing the development of third-party tools and mash-ups. Results The currently exposed Web services encompass over forty different methods for accessing data related to microbial genome annotations. The Web services provide comprehensive access to the database back end, allowing any programmer access to the most consistent and accurate genome annotations available. The Web services are deployed using a platform independent service-oriented approach that allows the user to choose the most suitable programming platform for their application. Example code demonstrate that Web services can be used to access the SEED using common bioinformatics programming languages such as Perl, Python, and Java. Conclusions We present a novel approach to access the SEED database. Using Web services, a robust API for access to genomics data is provided, without requiring large volume downloads all at once. The API ensures timely access to the most current datasets available, including the new genomes as soon as they come online.

  13. Access to Cancer Services for Rural Colorectal Cancer Patients

    Baldwin, Laura-Mae; Cai, Yong; Larson, Eric H.; Dobie, Sharon A.; Wright, George E.; Goodman, David C.; Matthews, Barbara; Hart, L. Gary

    2008-01-01

    Context: Cancer care requires specialty surgical and medical resources that are less likely to be found in rural areas. Purpose: To examine the travel patterns and distances of rural and urban colorectal cancer (CRC) patients to 3 types of specialty cancer care services--surgery, medical oncology consultation, and radiation oncology consultation.…

  14. Echocardiography in Pregnancy: Part 2.

    Narayanan, Meena; Elkayam, Uri; Naqvi, Tasneem Z

    2016-09-01

    The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves. PMID:27457084

  15. Investigation of Priority Needs in Terms of Museum Service Accessibility for Visually Impaired Visitors

    Handa, Kozue; Dairoku, Hitoshi; Toriyama, Yoshiko

    2010-01-01

    This study investigates the priority needs of museum service accessibility for visually impaired visitors. For this purpose, conjoint analysis was utilized. Four conjoint attributes of museum services were selected: A--facilities for wayfinding; B--exhibitions and collections including objects for touching, hearing, smelling, etc.; C--information…

  16. Options to Increase Access to Telecommunications Services in Rural and Low-Income Areas

    Muente-Kunigami, Arturo; Navas-Sabater, Juan

    2010-01-01

    Recent evidence suggests that increasing overall service coverage and promoting access to telecommunications services have a high economic benefit. Overall, it is estimated that a ten percent increase in mobile telephony penetration could increase economic growth by 0.81 percent in developing countries, whereas a ten percent increase in broadband penetration could increase economic growth ...

  17. Community Consultation and Intervention: Supporting Students Who Do Not Access Counseling Services

    Mier, Sharon; Boone, Matthew; Shropshire, Sonya

    2009-01-01

    Although the severity of psychological problems among college students and the demand for campus counseling services has increased, many students who could benefit from mental health services still do not access them. This article describes Community Consultation and Intervention, a program designed to support students who are unlikely to access…

  18. 28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exemption of the Immigration and....99 Exemption of the Immigration and Naturalization Service Systems-limited access. (a) The following systems of records of the Immigration and Naturalization Service are exempt from 5 U.S.C. 552a (c) (3)...

  19. Public vs. Private Insurance: Cost, Use, Accessibility, and Outcomes of Services for Children with Autism Spectrum Disorders

    Young, April; Ruble, Lisa; McGrew, John

    2009-01-01

    Very little research has been conducted on insurance type (private vs. public funded) and costs, accessibility, and use of services of children with autism. Analysis of five parent reported outcomes: (a) out-of-pocket expenditures, (b) variety of services used, (c) access to services, (d) child and family service outcomes, and (e) satisfaction…

  20. Multiple access protocol for supporting multimedia services in wireless ATM networks

    Liu, Hong; Dittmann, Lars; Gliese, Ulrik Bo;

    1999-01-01

    . In this paper, we propose a multiple access protocol using centralized and distributed channel access control techniques to provide QoS guarantees for multimedia services by taking advantage of the characteristics of different kinds of ATM traffics. Multimedia traffic, including constant bit rate......The furture broadband wireless asynchronous transfer mode (ATM) networks must provide seamless extension of multimedia services from the wireline ATM networks. This requires an effecient wireless access protocol to fulfill varying Quality-og-Service (QoS) requirements for multimedia applications...... (CBR), variable bit rate (VBR) and available bit rate (ABR) with different kinds of applications, such as voice, video-conferening, MPEG video and Web-browising, is considered to evaluate the proposed protocol. Simulation results show that the proposed multiple access protocol can support a wide range...

  1. A domotic system with remote access based on web services

    Pardo, Mauricio Esteban; Strack, Guillermo; Martínez, Diego C.

    2008-01-01

    Domotics systems are intelligent systems for houses and apartments to control several issues as security and light or climate devices. In this work we present the development of an economic domotic system to control different electrical devices in a private house. This is achieved either from inside the building or by remote control using a regular Internet connection. In order to provide this functionality, the system includes a server that provides web services to the controlling applicatio...

  2. RASSC (Retention and Access Services in Supply Chains)

    Addis, Matthew

    2012-01-01

    This report describes a cost model and associated tools for estimating the long-term costs of operating a trusted digital repository service for aerospace data. The report reviews work already done by the digital preservation community on techniques for cost modelling, analyses the requirements for cost modelling for long-term retention and re-use of aerospace data (design, manufacturing and IVHM), and then describes both a simple empirical cost model and more sophisticated cost simulation to...

  3. Holistic vision for creating accessible services based on MOOCs

    Rodrigo, Covadonga; Iniesto, Francisco

    2015-01-01

    MOOCs are examples of the evolution of eLearning environments towards more a revolutionary computer and mobile-based scenario along with social technologies that will lead to the emergence of new kinds of learning applications that enhance communication and collaboration processes. The flexibility of the learning service students to learn at their own time, place and pace, enhancing continuous communication and interaction between all participants in knowledge and community building, especial...

  4. The Study of Access Control for Service-Oriented Computing in Internet of Things

    Guoping Zhang

    2012-06-01

    Full Text Available In Internet of Things, computing and processing of information is the core supporting. In this paper, we introduce “Service-Oriented Computing” to solve the computing and processing of information in IoT. However, a key challenge in service-oriented environment is the design of effective access control schemas.We put forward a model of Workflow -oriented Attributed Based Access Control (WABAC, and an access control framework based on WABAC model. WABAC model grants and adapts permissions to subjects according to subject atttribute, resource attribute, environment attribute and current task, meeting access control request of SOC. Using the approach presented can effectively enhance the access control security for SOC applications, and prevent the abuse of subject permissions.

  5. Assessment of intracardiac masses by transesophageal echocardiography.

    DeVille, J B; Corley, D; Jin, B S; de Castro, C M; Hall, R J; Wilansky, S

    1995-01-01

    Transesophageal echocardiography and 2-dimensional transthoracic echocardiography have proved to be extremely valuable in the diagnosis of cardiac masses. In this report, we review the echocardiographic findings, clinical history, and histopathologic findings in 21 patients with intracardiac masses who underwent transthoracic echocardiography, transesophageal echocardiography, or both, at our institution. Of these patients, 14 had benign masses and 7 had malignant tumors. The potential role o...

  6. The relation between gender and access to dental services and goods

    Maria Vieira de Lima Saintrain

    2014-09-01

    Full Text Available ABSTRACT The Brazilian National Health System guarantees universal access to health services. However, this universal access is not always achieved, making relevant studies that evaluate access to health care and the way gender influence this access. Objective: Identify the influence of gender in the access to dental services and goods such as consultation, toothbrush, toothpaste and dental prostheses use in Brazil’s Northeast region. Methods: Cross-sectional, quantitative and population coverage study, with the population of Guaiuba municipality. Data were collected by Community Health Agents from July 2007 to February 2008. We used the Community Oral Health Indicator to verify the access to oral health services, oral hygiene, dental visit, use and need of dental prosthesis. Data were analyzed using SPSS 15.0 software, using the chi-square test and significance level of 5%. Results: 2581 people participated, with a mean age of 24.42 years (SD± 19, 365, with 1628 female (63.1%. Among the interviewees, 2,341 (90.7% had access to a toothbrush, 2272 (88.0% to toothpaste, and 1175 (45.5% to a dental appointment. The need for dental prosthesis was higher in women, 581 (35.7% versus 221 (23.2% men and their access [354 (60.9%] versus [96 (43.4%] with p<0.05. Conclusion: The access to health services and dental treatment presents gender as an influence factor. Women have most of the needs and benefits. The edentulism affects mostly the population with a poor access to dental prosthesis.

  7. Library publishing services: An investigation into open access publishing in academic libraries

    Lawson, Stuart

    2013-01-01

    The aim of this research is to investigate whether it is feasible for a UK university to publish its research output itself through an open access library publishing service. It achieves this by undertaking a qualitative study at one institution, Anglia Ruskin University. It identifies the scholarly communication needs of the institution and its academics, and evaluates whether a library publishing service meets these needs. It also assesses the potential level of support for such a service w...

  8. Demographics, referral patterns and management of patients accessing the Welsh Eye Care Service

    McAlinden, Colm; Corson, Helen; Sheen, Nik; Garwood, Peter

    2016-01-01

    Background The Primary Eyecare Acute Referral Service (PEARS) and the Wales Eye Health Examination (WEHE) operate as enhanced optometry services for patients residing in Wales, enabling the examination of a patient presenting with an acute eye problem (PEARS) or the examination of patients at higher risk of eye disease (WEHE). The purpose of the study is to assess the demographics of patients accessing these services, referral patterns and clinical management in one Health Board in Wales (Ane...

  9. An interaction-based access control model (IBAC) for collaborative services

    Altunay, Mine; /Fermilab; Byrd, Gregory T.; Brown, Doug E.; Dean, Ralph A.; /North Carolina State U.

    2008-04-01

    A collaboration is a collection of services that work together to achieve a common goal. Although collaborations help when tackling difficult problems, they lead to security issues. First, a collaboration is often performed by services that are drawn from different security domains. Second, a service interacts with multiple peer services during the collaboration. These interactions are not isolated from one another--e.g., data may flow through a sequence of different services. As a result, a service is exposed to multiple peer services in varying degrees, leading to different security threats. We identify the types of interactions that can be present in collaborations, and discuss the security threats due to each type. We propose a model for representing the collaboration context so that a service can be made aware of the existing interactions. We provide an access control model for a service participating in a collaboration. We couple our access control model with a policy model, so that the access requirements from collaborations can be expressed and evaluated.

  10. Factors that help injecting drug users to access and benefit from services: A qualitative study

    sheard Laura

    2007-10-01

    Full Text Available Abstract Background International research shows that injecting drug users (IDUs can encounter many barriers when they try to access drug treatment and other services. However, the existing literature is mostly quantitative and does not consider the kinds of factors that injectors themselves identify as enabling them to access and benefit from services. Responding to this gap in knowledge, our paper explores IDUs' own suggestions for improving service engagement and their reports of other factors enabling them to seek help. Methods Semi-structured qualitative interviews were conducted with 75 current illicit drug injectors in three geographically diverse areas of West Yorkshire, England. Recruitment was through needle exchange programmes, with additional snowball sampling to ensure inclusivity of gender, ethnicity and primary drug injected. Transcribed data were analysed thematically using Framework. Results Although participants were often satisfied with current access to services, they made three broad suggestions for improving engagement. These were: providing more services (more providers and more forms of support; better operation of existing services (including better communication systems and more flexibility around individual needs; and staffing-related improvements (particularly, less judgemental and more understanding staff attitudes. Other factors identified as important enablers of help seeking were: having supporting relationships (particularly with family members; personal circumstances/life events (especially becoming a parent; and an injector's state of mind (such as feeling motivated and positive. Conclusion A range of practical suggestions for improving IDUs' access to drug treatment and other services are identified.

  11. Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China

    Shijun Lu

    2015-06-01

    Full Text Available This study assessed the association between accessibility of catering service venues and adolescents’ alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR and 95% confidence intervals (CI of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57 and 1.47 (1.06, 2.02, respectively (p < 0.001 for trend test. This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.

  12. Vietnam - The Role of Postal Networks in Expanding Access to Financial Services Country case : Vietnam's postal finance services

    World Bank

    2004-01-01

    This paper discusses the role of the postal network in expanding access to financial services in Vietnam. It reviews the public postal operator within the postal sector and within the broader context of the communications sector. The roles of the Vietnam postal network and post bank are also reviewed from the perspective of the financial sector development, with particular focus on payment...

  13. A Semantic Context-Based Model for MobileWeb Services Access Control

    Haibo Shen

    2011-02-01

    Full Text Available As mobile web services becomes more pervasive, applications based on mobile web services will need flexible access control mechanisms. Unlike traditional approaches based on the identity or role for access control, access decisions for these applications will depend on the combination of the required attributes of users and the contextual information. This paper proposes a semantic context-based access control model (called SCBAC to be applied in mobile web services environment by combining semantic web technologies with context-based access control mechanism. The proposed model is a context-centric access control solutions, context is the first-class principle that explicitly guides both policy specification and enforcement process. In order to handle context information in the model, this paper proposes a context ontology to represent contextual information and employ it in the inference engine. As well as, this paper specifies access control policies as rules over ontologies representing the concepts introduced in the SCBAC model, and uses semantic web rule language (SWRL to form policy rule and infer those rules by JESS inference engine. The proposed model can also be applied to context-aware applications.

  14. Government policy and access to natural gas service in Canada

    As part of the Canadian energy policy between the mid-1970's to the mid-1980's, consumers were encouraged to use fuels alternative to oil. The first set of policy issues involved measures to provide consumers with incentives to switch to non-oil-burning equipment, whereas the second set of. policy papers emphasized the expansion of the natural gas distribution system. More than $1 billion have been spent on the gas pipeline expansion project. Consequences of program expenditures in each province were examined. With the exception of Manitoba, it was found that annual net pipeline additions were higher during the program period, indicating that the program policies induced these activities to occur sooner than if the policies were not in place. Kilometres of gas pipeline per individual constructed was highest in Quebec, where construction proceeded mainly between the more densely populated centres. In contrast, in Saskatchewan and Alberta, the program encouraged natural gas pipeline construction in rural areas with lower populations. Without the program, these areas may not have had access to natural gas for a very long time. It was concluded that, in this, and some other instances, public investment had the effect of accelerating developments, or encouraging the completion of projects that otherwise would not have been undertaken. It was suggested that in the future decision-makers consider the costs of changes in activity patterns prior to designing such programs. 2 figs., 1 table

  15. Data Access Services interoperability in the Geosciences by means of the GI-axe Brokering Framework

    Boldrini, Enrico; Santoro, Mattia; Papeschi, Fabrizio; Nativi, Stefano

    2013-04-01

    Many software tools are in use in the different Geosciences domains to the aim of publishing, accessing, evaluating and using available datasets in a service based environment. These tools/services are often domain-specific and usually support a small and disciplinary set of protocols and data models. On the other hand, multidisciplinary applications need to access many of these tools/services belonging to different domains in order to retrieve heterogeneous datasets (e.g. satellite acquired gridded coverages and in-situ sensor time series), then "uniformly process them" and achieve a deeper insight. Moreover datasets, to be easily processed, should be available according to a given Common Grid Environment (CGE): i.e. a geospatial environment characterized by a common spatio-temporal CRS (Coordinate Reference System), resolution, extension and by a common format encoding. Now, the interoperability effort needed by multidisciplinary applications is ordinarily in charge of data providers servers or user clients: in both cases, this represents a high entry barrier. The GI-axe Access Broker addresses this interoperability issue by taking charge of the needed implementation effort. It acts as an intermediation service between the User Clients and the Data Provider Services, placing itself in a third party (Broker) Layer. Indeed the Access Broker can access datasets available through well known access services in use by the Geosciences communities (e.g. OGC WCS, WMS, WFS, OPeNDAP, FTP, REST APIs, …) and republish them according to the application client interfaces. Moreover, GI-axe transforms datasets according to the a CGE specified by Users. In doing so it may resort to external processing services already in use by the community, supplementing the functionalities already supported by the data provider services. The external processing services list can be configured by Users. GI-axe is also a flexible framework, composed of extensible components. This architecture

  16. Accessibility, affordability and use of health services in an urban area in South Africa

    Ethelwynn L. Stellenberg

    2015-02-01

    Full Text Available Background: Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right.Objectives: The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured population in the Western Cape, South Africa.Method: A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6% was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data.Results: The hypothesis was accepted. The statistical association between affordability (p = < 0.01, accessibility (p = < 0.01 and the use of health services was found to be significant using the Chi-square (χ² test.Conclusion: The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

  17. Programmatic access to data and information at the IRIS DMC via web services

    Weertman, B. R.; Trabant, C.; Karstens, R.; Suleiman, Y. Y.; Ahern, T. K.; Casey, R.; Benson, R. B.

    2011-12-01

    The IRIS Data Management Center (DMC) has developed a suite of web services that provide access to the DMC's time series holdings, their related metadata and earthquake catalogs. In addition, services are available to perform simple, on-demand time series processing at the DMC prior to being shipped to the user. The primary goal is to provide programmatic access to data and processing services in a manner usable by and useful to the research community. The web services are relatively simple to understand and use and will form the foundation on which future DMC access tools will be built. Based on standard Web technologies they can be accessed programmatically with a wide range of programming languages (e.g. Perl, Python, Java), command line utilities such as wget and curl or with any web browser. We anticipate these services being used for everything from simple command line access, used in shell scripts and higher programming languages to being integrated within complex data processing software. In addition to improving access to our data by the seismological community the web services will also make our data more accessible to other disciplines. The web services available from the DMC include ws-bulkdataselect for the retrieval of large volumes of miniSEED data, ws-timeseries for the retrieval of individual segments of time series data in a variety of formats (miniSEED, SAC, ASCII, audio WAVE, and PNG plots) with optional signal processing, ws-station for station metadata in StationXML format, ws-resp for the retrieval of instrument response in RESP format, ws-sacpz for the retrieval of sensor response in the SAC poles and zeros convention and ws-event for the retrieval of earthquake catalogs. To make the services even easier to use, the DMC is developing a library that allows Java programmers to seamlessly retrieve and integrate DMC information into their own programs. The library will handle all aspects of dealing with the services and will parse the returned

  18. Access to general practitioner services amongst underserved Australians: a microsimulation study

    Schofield Deborah J

    2012-01-01

    Full Text Available Abstract Background One group often identified as having low socioeconomic status, those living in remote or rural areas, are often recognised as bearing an unequal burden of illness in society. This paper aims to examine equity of utilisation of general practitioner services in Australia. Methods Using the 2005 National Health Survey undertaken by the Australian Bureau of Statistics, a microsimulation model was developed to determine the distribution of GP services that would occur if all Australians had equal utilisation of health services relative to need. Results It was estimated that those who are unemployed would experience a 19% increase in GP services. Persons residing in regional areas would receive about 5.7 million additional GP visits per year if they had the same access to care as Australians residing in major cities. This would be a 18% increase. There would be a 20% increase for inner regional residents and a 14% increase for residents of more remote regional areas. Overall there would be a 5% increase in GP visits nationally if those in regional areas had the same access to care as those in major cities. Conclusion Parity is an insufficient goal and disadvantaged persons and underserved areas require greater access to health services than the well served metropolitan areas due to their greater poverty and poorer health status. Currently underserved Australians suffer a double disadvantage: poorer health and poorer access to health services.

  19. Remote information service access system based on a client-server-service model

    Konrad, Allan M.

    1996-01-01

    A local host computing system, a remote host computing system as connected by a network, and service functionalities: a human interface service functionality, a starter service functionality, and a desired utility service functionality, and a Client-Server-Service (CSS) model is imposed on each service functionality. In one embodiment, this results in nine logical components and three physical components (a local host, a remote host, and an intervening network), where two of the logical components are integrated into one Remote Object Client component, and that Remote Object Client component and the other seven logical components are deployed among the local host and remote host in a manner which eases compatibility and upgrade problems, and provides an illusion to a user that a desired utility service supported on a remote host resides locally on the user's local host, thereby providing ease of use and minimal software maintenance for users of that remote service.

  20. Access to Rural Mental Health Services: Service Use and Out-of-Pocket Costs

    Ziller, Erika C.; Anderson, Nathaniel J.; Coburn, Andrew F.

    2010-01-01

    Purpose: To examine rural-urban differences in the use of mental health services (mental health and substance abuse office visits, and mental health prescriptions) and in the out-of-pocket costs paid for these services. Methods: The pooled 2003 and 2004 Medical Expenditure Panel Surveys were used to assess differences in mental health service use…

  1. Applying Fourth Generation Management to Access Services: Reinventing Customer Service and Process Management

    Hasty, Douglas F.

    2004-01-01

    Are librarians doing all they can to ensure that customer services are delivered with the customer in mind? Librarians are great at helping, but we sometimes need help with identifying customers, defining their needs, developing services, and reviewing the processes behind the services. Fourth Generation Management provides new insight for…

  2. Addressing Service Access Barriers for Homeless Youth: A Call for Collaboration

    Jeffrey L. PERRON

    2014-06-01

    Full Text Available Homeless youth are among the most vulnerable individuals in North American society. The day-to-day stressors they face while living on the streets pose a great threat to their mental and physical health. A number of barriers that youth face in accessing care have been identified in the literature. This discussion article highlights work that has been done to apply geographic theory to issues of service access among homeless youth. To date, most such work has been theoretical in nature, with collaborations between geographers and homeless youth researchers to make applied recommendations for the location of services. Urban geographers and homeless youth researchers are implored to collaborate in order to make recommendations that will increase the access to service, particularly for rural homeless youth.

  3. Satisfaction with Access to Health Services: The Perspective of Estonian Patients with Rheumatoid Arthritis

    Kaja Põlluste

    2012-01-01

    Full Text Available In this cross-sectional study we explained the possible determinants of satisfaction with access to health services in patients with rheumatoid arthritis (RA. Of the 2000 randomly selected Estonian adult patients with RA, a total 1259 completed the survey. Regression analysis was used to analyse the predictors of patients' satisfaction with access to health services. Half of the respondents were satisfied with their access to health services. Factors that had a negative impact on satisfaction included pain intensity, longer waiting times to see the doctors, as well as low satisfaction with the doctors. Transportation costs to visit a rheumatologist and higher rehabilitation expenses also affected the degree of satisfaction. Patients who could choose the date and time at which they could visit the rheumatologist or who could visit their “own” doctor were more likely to be satisfied than patients whose appointment times were appointed by a healthcare provider.

  4. Advancing Migrant Access to Health Services in Europe (AMASE): Protocol for a Cross-sectional Study

    Fakoya, I; Álvarez-Del Arco, D.; Monge, S; Copas, A J; Gennotte, A. F.; Volny-Anne, A.; Göpel, S.; Touloumi, G.; Prins, M; Barros, H; Staehelin, C.; del Amo, J.; Burns, F. M.

    2016-01-01

    BACKGROUND: Migrants form a substantial proportion of the population affected by the human immunodeficiency virus (HIV) epidemic in Europe, yet HIV prevention for this population is hindered by poor understanding of access to care and of postmigration transmission dynamics. OBJECTIVE: We present the design and methods of the advancing Migrant Access to health Services in Europe (aMASE) study, the first European cross-cultural study focused on multiple migrant populations. It aims to identify ...

  5. ResearchScope - A Federated Search Service for Irish Open Access Research

    Kane, David

    2009-01-01

    ResearchScope To mark open access week 2009, (See: http://www.openaccessweek.org/ ),WIT Libraries have launched a federated harvesting and discovery service called ResearchScope. ResearchScope is a national portal designed to raise the profile of Open Access research in Ireland - by making it more visible. It works by harvesting information from research repositories, which present their records in an agreed standard called OAI-DC. By pulling this information together in to one index...

  6. Quantitative analysis of access strategies to remote information in network services

    Olsen, Rasmus Løvenstein; Schwefel, Hans-Peter; Hansen, Martin Bøgsted

    2006-01-01

    Remote access to dynamically changing information elements is a required functionality for various network services, including routing and instances of context-sensitive networking. Three fundamentally different strategies for such access are investigated in this paper: (1) a reactive approach initiated by the requesting entity, and two versions of proactive approaches in which the entity that contains the information element actively propagates its changes to potential requesters, either (2)...

  7. Access to and use of infertility services in the United States: framing the challenges.

    Adashi, Eli Y; Dean, Laura A

    2016-05-01

    An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the U.S. must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men. PMID:26826275

  8. Living large: the experiences of large-bodied women when accessing general practice services

    Russell N

    2013-09-01

    Full Text Available INTRODUCTION: Numerous studies report high levels of stigma and discrimination experienced by obese/overweight women within the health care system and society at large. Despite general practice being the most utilised point of access for health care services, there is very little international or national exploration of the experiences of large-bodied women (LBW accessing these services. The aim of this study was to explore LBW's experiences of accessing general practice services in New Zealand. METHODS: This is a qualitative, descriptive, feminist study. Local advertising for participants resulted in eight self-identified, large-bodied women being interviewed. A post-structural feminist lens was applied to the data during thematic analysis. FINDINGS: The women in this study provided examples of verbal insults, inappropriate humour, negative body language, unmet health care needs and breaches of dignity from health care providers in general practice. Seven themes were identified: early experiences of body perception, confronting social stereotypes, contending with feminine beauty ideals, perceptions of health, pursuing health, respecting the whole person, and feeling safe to access care. CONCLUSION: Pressure for body size vigilance has, in effect, excluded the women in this study from the very locations of health that they are 'encouraged' to attend-including socialising and exercising in public, screening opportunities that require bodily exposure, and accessing first point of care health services.

  9. Performance Issues Related to Web Service Usage for Remote Data Access

    Web services are starting to be widely used in applications for remotely accessing data. This is of special interest for research based on small and medium scale fusion devices, since scientists participating remotely to experiments are accessing large amounts of data over the Internet. Recent tests were conducted to see how the new network traffic, generated by the use of web services, can be integrated in the existing infrastructure and what would be the impact over existing applications, especially those used in a remote participation scenario

  10. Wireless and wireline service convergence in next generation optical access networks - the FP7 WISCON project

    Vegas Olmos, Juan José; Pang, Xiaodan; Lebedev, Alexander;

    2014-01-01

    The next generation of information technology demands both high capacity and mobility for applications such as high speed wireless access capable of supporting broadband services. The transport of wireless and wireline signals is converging into a common telecommunication infrastructure. In this...... paper, we will present the Marie Curie Framework Program 7 project “Wireless and wireline service convergence in next generation optical access networks” (WISCON), which focuses on the conception and study of novel architectures for wavelength-division-multiplexing (WDM) optical multi-modulation format...

  11. Location- and Time-Dependent VPD for Privacy-Preserving Wireless Accesses to Cloud Services

    Yoon, Jong P

    2011-01-01

    The advent of smartphones in recent years has changed the wireless landscape. Smartphones have become a platform for online user interface to cloud databases. Cloud databases may provide a large set of user-private and sensitive data (i.e., objects), while smartphone users (i.e., subjects) provide location-sensitive information. Secure and private services in wireless accessing to cloud databases have been discussed actively for the past recent years. However, the previous techniques are unsatisfactory for dynamism of moving subjects' wireless accesses. In this paper, we propose a novel technique to dynamically generate virtual private databases (VPD) for each access by taking subjects' location and time information into account. The contribution of this paper includes a privacy-preserving access control mechanism for dynamism of wireless access.

  12. Access to eye health services among indigenous Australians: an area level analysis

    Kelaher Margaret

    2012-09-01

    Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.

  13. Echocardiography in the flight program

    Charles, John B.; Bungo, Michael W.; Mulvagh, Sharon L.

    1991-01-01

    Observations on American and Soviet astronauts have documented the association of changes in cardiovascular function during orthostasis with space flight. A basic understanding of the cardiovascular changes occurring in astronauts requires the determination of cardiac output and total peripheral vascular resistance as a minimum. In 1982, we selected ultrasound echocardiography as our means of acquiring this information. Ultrasound offers a quick, non-invasive and accurate means of determining stroke volume which, when combined with the blood pressure and heart rate measurements of the stand test, allows calculation of changes in peripheral vascular resistance, the body's major response to orthostatic stress. The history of echocardiography in the Space Shuttle Program is discussed and the results are briefly presented.

  14. Echocardiography in military oxygen divers.

    Boussuges, Alain; Riera, Florence; Rossi, Pascal; Castagna, Olivier; Galland, François; Blatteau, Jean-Eric

    2007-01-01

    BACKGROUND: Oxygen divers undergo environmental stressors such as immersion, ventilation with scuba, cold exposure, and increased ambient pressure. All of these stressors may be responsible for acute hemodynamic modifications. We hypothesized that repeated hyperbaric hyperoxia exposure induces long-term cardiovascular modifications. METHODS: A Doppler echocardiography was conducted on 20 military oxygen divers (average 12 yr diving experience) and compared with 22 controls. Parameters known t...

  15. Risk and Regulation of Access to Personal Data on Online Social Networking Services in the UK

    Haynes, J. D.

    2015-01-01

    This research investigates the relative effectiveness of different modes of regulation of access to personal data on social networking services in the UK. A review of the literature demonstrated that there was a gap in research comparing different regulatory modes applied to online social networking services (SNSs). A model of regulation was developed based on Lessig’s four modes of regulating the internet. Risk to individual users was selected as a way of testing different regulatory approac...

  16. The Political Economy of Health Services Provision and Access in Brazil

    Mushfiq Mobarak, Ahmed; Rajkumar, Andrew Sunil; Cropper, Maureen

    2005-01-01

    The authors examine the impact of local politics and government structure on the allocation of publicly subsidized (SUS) health services across municipios (counties) in Brazil, and on the probability that uninsured individuals who require medical attention actually receive access to those health services. Using data from the 1998 PNAD survey they demonstrate that higher per capita levels of SUS doctors, nurses, and clinic rooms increase the probability that an uninsured individual gains acces...

  17. Disparities in Access to Easy-to-Use Services for Children with Special Health Care Needs.

    Rosen-Reynoso, Myra; Porche, Michelle V; Kwan, Ngai; Bethell, Christina; Thomas, Veronica; Robertson, Julie; Hawes, Eva; Foley, Susan; Palfrey, Judith

    2016-05-01

    Objectives Families, clinicians and policymakers desire improved delivery of health and related services for children with special health care needs (CSHCN). We analyzed factors associated with ease of use in obtaining such services. We also explored what were specific difficulties or delays in receiving services. By examining data from the National Survey of Children with Special Health Care Needs (NS-CSHCN 2009-2010) and using the revised criteria for "ease of use," we were able to assess the percentage of parents who reported that their experiences seeking services for their children met those criteria. Methods We performed Chi square tests to examine associations between the independent variables and their relationship to the difficulties or delays assessed in the survey; including: eligibility, availability of services, waiting lists, cost, and access to information. We used logistic regression to determine the association of meeting the "ease of use" criteria with socio-demographic, complexity of need, and access variables. Results Overall, a third of families of CSHCN (35.3 %) encounter difficulties, delays, or frustrations in obtaining health and related services. The lack of access to health and community services in this study fell most heavily on children from racial/ethnic minority backgrounds, those in poverty, and those with complex emotional/behavioral or developmental needs and functional limitations. Conclusions for Practice CSHCN require services from a broad array of providers across multiple systems. Unfortunately, there are certain difficulties that hamper the accessibility of these systems. These findings underscore the need for both practice-level response and systems-level reform to ensure equitable distribution of health and community resources. PMID:26728898

  18. Are social franchises contributing to universal access to reproductive health services in low-income countries?

    Sundari Ravindran, T K; Fonn, Sharon

    2011-11-01

    A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming. PMID:22118144

  19. Virtual queueing techniques for UBR+ service in ATM with fair access and minimum bandwidth guarantee

    Siu, K.Y.; Wu, Y.; Ren, W.

    1998-11-01

    The ATM Forum is currently discussing the need for a new best-effort service called UBR+, which is an enhancement to the existing UBR service, to support data traffic. The objective of the UBR+ service is to provide each user with a minimum service rate guarantee and a fair access to any excess available bandwidth. In this paper, the authors present a new efficient scheme for supporting this service. The key advantage of the scheme is that it employs only FIFO queueing (instead of per-VC queueing) and admits simple implementation in ATM switches. The ideas involve a simple scheduling mechanism that is based on per-VC queueing and incorporate the virtual queueing technique that can efficiently emulate per-VC queueing on a shared FIFO queue. Simulation results are presented to show that the schemes can deliver almost ideal performance for supporting the new service requirements of UBR+.

  20. Essays on the Impacts of Geography and Institutions on Access to Energy and Public Infrastructure Services

    Archibong, Belinda

    While previous literature has emphasized the importance of energy and public infrastructure services for economic development, questions surrounding the implications of unequal spatial distribution in access to these resources remain, particularly in the developing country context. This dissertation provides evidence on the nature, origins and implications of this distribution uniting three strands of research from the development and political economy, regional science and energy economics fields. The dissertation unites three papers on the nature of spatial inequality of access to energy and infrastructure with further implications for conflict risk , the historical institutional and biogeographical determinants of current distribution of access to energy and public infrastructure services and the response of households to fuel price changes over time. Chapter 2 uses a novel survey dataset to provide evidence for spatial clustering of public infrastructure non-functionality at schools by geopolitical zone in Nigeria with further implications for armed conflict risk in the region. Chapter 3 investigates the drivers of the results in chapter 2, exploiting variation in the spatial distribution of precolonial institutions and geography in the region, to provide evidence for the long-term impacts of these factors on current heterogeneity of access to public services. Chapter 4 addresses the policy implications of energy access, providing the first multi-year evidence on firewood demand elasticities in India, using the spatial variation in prices for estimation.

  1. Domestic Violence Survivors' Access of Career Counseling Services: A Qualitative Investigation

    Chronister, Krista M.; Linville, Deanna; Kaag, Kristi Palmer

    2008-01-01

    The present study was a qualitative investigation of the impact of domestic violence on women's career development and the contextual barriers and supports that affect women's ability to access career counseling services. Our sample included 11 women who completed various stages of a community-based career counseling intervention program. The…

  2. Religious institutions and the politics of access to basic services in displacement contexts

    Lauterbach, Karen

    categories of services provided by churches and the categorization of people gaining access to these resources. The furthermore paper discusses what forms of recognition engaging in these more material relations of exchange entail, as well as the forms of authority that are established....

  3. Provider Perspectives on School-Based Mental Health for Urban Minority Youth: Access and Services

    Gamble, Brandon E.; Lambros, Katina M.

    2014-01-01

    This article provides results from a qualitative study on the efforts of school-based mental health providers (SBMHPs) who serve students in urban, suburban, and ethnically diverse settings to help families access quality mental health services. School-based mental health plays a key role in the provision of direct and indirect intervention…

  4. Towards automated processing of the right of access in inter-organizational Web Service compositions

    Herkenhöner, Ralph; De Meer, Hermann; Jensen, Meiko;

    2010-01-01

    with trade secret protection. In this paper, we present an automated architecture to enable exercising the right of access in the domain of inter-organizational business processes based on Web Services technology. Deriving its requirements from the legal, economical, and technical obligations, we show...

  5. Data Archiving and Networked Services (DANS) promotes sustained access to digital research data

    van Berchum, M.; Kraaikamp, Emilie

    2015-01-01

    Data Archiving and Networked Services (DANS) promotes sustained access to digital research data. For this purpose, DANS encourages researchers to archive and reuse data in a sustained form. In the online archiving system EASY research data is stored in a permanent and sustainable manner, according t

  6. Enhancing Health Literacy through Accessing Health Information, Products, and Services: An Exercise for Children and Adolescents

    Brey, Rebecca A.; Clark, Susan E.; Wantz, Molly S.

    2007-01-01

    The second National Health Education Standard states the importance of student demonstration of the ability to access valid health information and services. The teaching technique presented in this article provides an opportunity for children and adolescents to develop their health literacy and advocacy skills by contributing to a class resource…

  7. Niger - Rural Financial Services : Expanding Financial Access to the Rural Poor

    World Bank

    2011-01-01

    The main objective of this study is to identify the major impediments to access to financial services in rural areas, and provide practical recommendations to address the identified problems. The study aims to inform on rural finance policies and innovative instruments by examining both supply and demand sides including an identification of non-financial issues that restrict development of...

  8. Restructuring to Promote Collaboration and Exceed User Needs: The Blackwell Library Access Services Experience

    Chakraborty, Mou; English, Michael; Payne, Sharon

    2013-01-01

    Through vision, leadership, and creativity, Salisbury University's Blackwell Library transformed its access services department structurally and philosophically to better position itself to meet, and strive to exceed, today's user needs and expectations. Restructuring and the introduction of new leadership and new ideas provided the foundation for…

  9. 76 FR 9012 - Access to Confidential Business Information by Electronic Consulting Services, Inc.

    2011-02-16

    ...EPA has authorized its contractor, Electronic Consulting Services, Inc. (ECS) of Fairfax, VA, to access information which has been submitted to EPA under all sections of the Toxic Substances Control Act (TSCA). Some of the information may be claimed or determined to be Confidential Business Information...

  10. Social Capital, Acculturation, Mental Health, and Perceived Access to Services among Mexican American Women

    Valencia-Garcia, Dellanira; Simoni, Jane M.; Alegria, Margarita; Takeuchi, David T.

    2012-01-01

    Objective: We examined whether individual-level social capital--the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community--was associated with acculturation, depression and anxiety symptoms, and perceived access to services among women of Mexican…

  11. Efficient Information Access for Location-Based Services in Mobile Environments

    Lee, Chi Keung

    2009-01-01

    The demand for pervasive access of location-related information (e.g., local traffic, restaurant locations, navigation maps, weather conditions, pollution index, etc.) fosters a tremendous application base of "Location Based Services (LBSs)". Without loss of generality, we model location-related information as "spatial objects" and the accesses…

  12. Matrix Management in Practice in Access Services at the NCSU Libraries

    Harris, Colleen S.

    2010-01-01

    The former Associate Head of Access and Delivery Services of the North Carolina State University Libraries reports on successful use of matrix management techniques for the Circulation and Reserves unit of the department. Despite their having fallen out of favor in much of the management literature, matrix management principles are useful for…

  13. Accessibility to tuberculosis control services and tuberculosis programme performance in southern Ethiopia

    Mesay Hailu Dangisso

    2015-11-01

    Full Text Available Background: Despite the expansion of health services and community-based interventions in Ethiopia, limited evidence exists about the distribution of and access to health facilities and their relationship with the performance of tuberculosis (TB control programmes. We aim to assess the geographical distribution of and physical accessibility to TB control services and their relationship with TB case notification rates (CNRs and treatment outcome in the Sidama Zone, southern Ethiopia. Design: We carried out an ecological study to assess physical accessibility to TB control facilities and the association of physical accessibility with TB CNRs and treatment outcome. We collected smear-positive pulmonary TB (PTB cases treated during 2003–2012 from unit TB registers and TB service data such as availability of basic supplies for TB control and geographic locations of health services. We used ArcGIS 10.2 to measure the distance from each enumeration location to the nearest TB control facilities. A linear regression analysis was employed to assess factors associated with TB CNRs and treatment outcome. Results: Over a decade the health service coverage (the health facility–to-population ratio increased by 36% and the accessibility to TB control facilities also improved. Thus, the mean distance from TB control services was 7.6 km in 2003 (ranging from 1.8 to 25.5 km between kebeles (the smallest administrative units and had decreased to 3.2 km in 2012 (ranging from 1.5 to 12.4 km. In multivariate linear regression, as distance from TB diagnostic facilities (b-estimate=−0.25, p<0.001 and altitude (b-estimate=−0.31, p<0.001 increased, the CNRs of TB decreased, whereas a higher population density was associated with increased TB CNRs. Similarly, distance to TB control facilities (b-estimate=−0.27, p<0.001 and altitude (b-estimate=−0.30, p<0.001 were inversely associated with treatment success (proportion of treatment completed or cured cases

  14. Constraints and Benefits of Child Welfare Contracts with Behavioral Health Providers: Conditions that Shape Service Access.

    Bunger, Alicia C; Cao, Yiwen; Girth, Amanda M; Hoffman, Jill; Robertson, Hillary A

    2016-09-01

    This qualitative study examines worker perceptions of how public child welfare agencies' purchase of service contracts with private behavioral health organizations can both facilitate and constrain referral making and children's access to services. Five, 90-min focus groups were conducted with workers (n = 50) from an urban public child welfare agency in the Midwest. Using a modified grounded theory approach, findings suggest that contracts may expedite service linkages, but contract benefits are conditioned upon design and implementation. Results also suggest the critical role of front line workers in carrying out contractual relationships. Implications for research and interventions for enhancing contracting are discussed. PMID:26427998

  15. From the voices of women: facilitating survivor access to IPV services.

    Simmons, Catherine A; Farrar, Melissa; Frazer, Kitty; Thompson, Mary Jane

    2011-10-01

    This mixed-method study investigated perceptions women domestic violence survivors/victims have about why women do not seek help from formal support structures and actions domestic helping agencies can take to facilitate survivor access to services. Congruent with previous research, quantitative analysis identified 17 reasons women do not seek help from formal support structures. Expanding current knowledge, concept mapping revealed six ways family violence programs can better reach women in abusive relationships, including (1) remove barriers to services, (2) improve comfort with services, (3) "talk about it," (4) improve community awareness, (5) victim-targeted marketing, and (6) "I honestly don't know." PMID:22071094

  16. SCIE Research briefing 35:Black and minority ethnic people with dementia and their access to support and services

    Moriarty, Joanna; Sharif, Nadira; Robinson, Julie

    2011-01-01

    This briefing discusses the barriers currently faced by BME people in accessing dementia care services and some of the ways in which services can become better at responding to the needs of BME people in their locality.

  17. Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-01-01

    Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of

  18. Assessment of universal access to comprehensive sexual and reproductive health services in Egypt

    Doaa Oraby

    2015-09-01

    Full Text Available In 2005, a World Health Organization resolution called for health systems to move towards universal coverage, such that everyone would have access to promotive, preventive, curative and rehabilitative health interventions at an affordable cost. Responding to this call, a new target for achieving universal access to reproductive health was integrated within the revised millennium development goals framework. Forty-eight African countries adopted the Maputo Plan of Action committing to the goal of universal access to comprehensive sexual and reproductive health services in Africa by 2015. The aim of this study was to assess Egypt’s commitment to implementing the Maputo Plan of Action. This was achieved through soliciting information relating to the extent of Egypt’s progress towards the achievement of universal access to sexual and reproductive health and rights information and services. In late 2009, a qualitative study was conducted. It included in-depth interviews with 20 physicians and 10 key informants in addition to 8 focus group discussions with sub-segments of 65 beneficiaries, including married women of reproductive age, married men and youth of both sexes. The study revealed that public sector, non-governmental organisations and private sector organisations delivering sexual and reproductive health services functioned in isolation from each other. Delivered services focused mainly on family planning and maternity care and targeted married women of reproductive age. Scaling up universal access to sexual and reproductive health services requires programmes to expand beyond the maternal and child health delivery model targeted solely at married women with children.

  19. Access to general health care services by a New Zealand population with serious mental illness.

    Wheeler A

    2014-03-01

    Full Text Available INTRODUCTION: Literature suggests that good quality health care access can have a positive impact on the health of people with serious mental illness (SMI, but literature relating to patterns of access by this group is equivocal. AIM: This study was designed to explore health care access patterns in a group of people with SMI and to compare them with a general New Zealand population group, in order for health providers to understand how they might contribute to positive health outcomes for this group. METHODS: The study surveyed 404 mental health consumers aged 18-65 years receiving care from one district health board in Auckland about their patterns of health care access. Results were compared with those from the New Zealand Health Survey of the general population. RESULTS: Findings suggest that the SMI consumer respondents had poorer physical health than the general population respondents, accessed health care services in more complex ways and were more particular about who they accessed for their care than the general population respondents. There was some concern from SMI consumers around discrimination from health care providers. The study also suggested that some proactive management with SMI consumers for conditions such as metabolic syndrome was occurring within the health care community. DISCUSSION: The first point of access for SMI consumers with general health problems is not always the family general practitioner and so other health professionals may sometimes need to consider the mental and physical health of such consumers in a wider context than their own specialism.

  20. Access to diagnostics in primary care and the impact on a primary care led health service.

    O'Riordan, M

    2015-02-01

    We undertook a postal survey of GPs to establish their current access to radiological and endoscopic tests. More than one fifth of GPs do not have direct access to abdominal (n = 42, 21.4%) or pelvic (n = 49, 24.6%) ultrasound in the public system. Where access is available public patients have an average 14 week waiting period. In stark contrast in the private system virtually all GPs have direct access (n = 159, 99.2% and n = 156, 98.8% respectively for abdominal and pelvic ultrasound) with an average wait of just over four days. Direct access to CT scan in the public system is available to the minority of GPs, e.g. n = 31, 18.4% for chest scan, in the public system; even where available, there is an average 12 week wait for this. In comparison 151 (88.6%) GPs have access to CT chest scanning in the private sector with an average waiting time of 5.4 working days. Such limited access to diagnostics impacts on the delivery of a quality service.

  1. EarthScope: Cyberinfrastructure to Access USArray Data Products and Services

    Ahern, T. K.; Trabant, C. M.; Bahavar, M.; Hutko, A. R.; Karstens, R.; Reyes, C. G.; Suleiman, Y. Y.; Weertman, B.

    2013-12-01

    Motivated by the need to improve efficiency in the way earth scientists access information, IRIS has developed significant new cyberinfrastructure to allow access to all time series data at the IRIS DMC including the wealth of new observations generated as a part of EarthScope. Driven specifically by the USArray component of EarthScope, IRIS Data Services has also actively developed a wealth of new higher level products that serve as stepping stones to further research. These products are available either through the SPUD product management system or directly through web services. This presentation will highlight ways that web services simplify access to the time series information at the IRIS DMC, allow simple incorporation of data into scientist's workflows, provide limited preprocessing of data, as well as providing access to higher level products that can bridge the gap between disciplines as well as assisting seismologists in data selection. IRIS is actively promoting these web services techniques in other high profile projects sponsored by the National Science Foundation including both Cooperation between Europe and the United States (COOPEUS) project as well as within the NSF promoted EarthCube project. In both of these activities it is IRIS' goal to assist in the integration of data between earth science disciplines by leveraging the experience we have gained in our web service activities. Additionally IRIS will leverage web services to better provide research ready data sets. Such data sets will enable researchers to request data that are suitable for use in their specific research studies by comparing data quality attributes of the data to those that the researcher specifies are required in their work.

  2. A Flexible Component based Access Control Architecture for OPeNDAP Services

    Kershaw, Philip; Ananthakrishnan, Rachana; Cinquini, Luca; Lawrence, Bryan; Pascoe, Stephen; Siebenlist, Frank

    2010-05-01

    Network data access services such as OPeNDAP enable widespread access to data across user communities. However, without ready means to restrict access to data for such services, data providers and data owners are constrained from making their data more widely available. Even with such capability, the range of different security technologies available can make interoperability between services and user client tools a challenge. OPeNDAP is a key data access service in the infrastructure under development to support the CMIP5 (Couple Model Intercomparison Project Phase 5). The work is being carried out as part of an international collaboration including the US Earth System Grid and Curator projects and the EU funded IS-ENES and Metafor projects. This infrastructure will bring together Petabytes of climate model data and associated metadata from over twenty modelling centres around the world in a federation with a core archive mirrored at three data centres. A security system is needed to meet the requirements of organisations responsible for model data including the ability to restrict data access to registered users, keep them up to date with changes to data and services, audit access and protect finite computing resources. Individual organisations have existing tools and services such as OPeNDAP with which users in the climate research community are already familiar. The security system should overlay access control in a way which maintains the usability and ease of access to these services. The BADC (British Atmospheric Data Centre) has been working in collaboration with the Earth System Grid development team and partner organisations to develop the security architecture. OpenID and MyProxy were selected at an early stage in the ESG project to provide single sign-on capability across the federation of participating organisations. Building on the existing OPeNDAP specification an architecture based on pluggable server side components has been developed at the BADC

  3. Exploring inequalities in access to and use of maternal health services in South Africa

    Silal Sheetal P

    2012-05-01

    Full Text Available Abstract Background South Africa’s maternal mortality rate (625 deaths/100,000 live births is high for a middle-income country, although over 90% of pregnant women utilize maternal health services. Alongside HIV/AIDS, barriers to Comprehensive Emergency Obstetric Care currently impede the country’s Millenium Development Goals (MDGs of reducing child mortality and improving maternal health. While health system barriers to obstetric care have been well documented, “patient-oriented” barriers have been neglected. This article explores affordability, availability and acceptability barriers to obstetric care in South Africa from the perspectives of women who had recently used, or attempted to use, these services. Methods A mixed-method study design combined 1,231 quantitative exit interviews with sixteen qualitative in-depth interviews with women (over 18 in two urban and two rural health sub-districts in South Africa. Between June 2008 and September 2009, information was collected on use of, and access to, obstetric services, and socioeconomic and demographic details. Regression analysis was used to test associations between descriptors of the affordability, availability and acceptability of services, and demographic and socioeconomic predictor variables. Qualitative interviews were coded deductively and inductively using ATLAS ti.6. Quantitative and qualitative data were integrated into an analysis of access to obstetric services and related barriers. Results Access to obstetric services was impeded by affordability, availability and acceptability barriers. These were unequally distributed, with differences between socioeconomic groups and geographic areas being most important. Rural women faced the greatest barriers, including longest travel times, highest costs associated with delivery, and lowest levels of service acceptability, relative to urban residents. Negative provider-patient interactions, including staff inattentiveness, turning

  4. Perceived Barriers for Accessing Health Services among Individuals with Disability in Four African Countries.

    Arne H Eide

    Full Text Available There is an increasing awareness among researchers and others that marginalized and vulnerable groups face problems in accessing health care. Access problems in particular in low-income countries may jeopardize the targets set by the United Nations through the Millennium Development Goals. Thus, identifying barriers for individuals with disability in accessing health services is a research priority. The current study aimed at identifying the magnitude of specific barriers, and to estimate the impact of disability on barriers for accessing health care in general. A population based household survey was carried out in Sudan, Namibia, Malawi, and South Africa, including a total of 9307 individuals. The sampling strategy was a two-stage cluster sampling within selected geographical areas in each country. A listing procedure to identify households with disabled members using the Washington Group six screening question was followed by administering household questionnaires in households with and without disabled members, and questionnaires for individuals with and without disability. The study shows that lack of transport, availability of services, inadequate drugs or equipment, and costs, are the four major barriers for access. The study also showed substantial variation in perceived barriers, reflecting largely socio-economic differences between the participating countries. Urbanity, socio-economic status, and severity of activity limitations are important predictors for barriers, while there is no gender difference. It is suggested that education reduces barriers to health services only to the extent that it reduces poverty. Persons with disability face additional and particular barriers to health services. Addressing these barriers requires an approach to health that stresses equity over equality.

  5. Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

    Freda Mold

    2015-12-01

    Full Text Available Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1 Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2 Whether online access to records improves patient safety and health outcomes; (3 Whether record access increases disparities across social classes and between genders; and (4 Improving efficiency. The challenges for practice are: (1 How to incorporate online access into clinical workflow; (2 The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

  6. GROWTH OF SME SECTOR AND WAYS OF IMPROVING ACCESS TO FINANCIAL SERVICES IN UZBEKISTAN

    Turaboy Koraliev

    2014-04-01

    Full Text Available Private sector is recognized as the driving force and the engine for economic growth in many countries. It delivers important goods and services, provides jobs, generates revenue for public sector, and creates and maintains infrastructure. SMEs in particular create jobs and lead to more equitable distribution of incomes. In Uzbekistan the share of SMEs in GDP steadily increased from 30% in 2000 to 54% in 2012. The sector accounts for 75% of total employment in the country and it is forecasted that SMEs will add around half a million of new jobs in 2013.Despite these improvements, SMEs’ productivity and competitiveness potential have been affected by regulatory and institutional constraints. Access to adequate financial services is a key component for sustainable growth of the private sector, economic diversification and creation of more and better jobs. Adequate access to finance includes not only bank loans, but also a host of financing instruments that are geared to meet the diverse needs of enterprises and entrepreneurs with different characteristics and profiles. In addition, access to a broader range of efficient and reliable financial services, including electronic payment services, enables enterprises to manage the financial resources available to them more effectively.  

  7. Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

    Newman, Roger D., E-mail: Roger.Newman@lthtr.nhs.uk [Dept. of Speech and Language Therapy, Lancashire Teaching Hospitals, Sharoe Green lane, Fulwood, Preston PR2 9HT (United Kingdom); University of Salford (United Kingdom); Nightingale, Julie [University of Salford (United Kingdom)

    2011-11-15

    Quality Issue: Although costly and time consuming, videofluoroscopic swallowing (VFS) examinations are the gold standard for imaging of oro-pharyngeal dysphagia, and demand is likely to increase with an ageing population. Traditional radiologist-led VFS services in the UK are gradually being replaced by practitioner-led clinics undertaken jointly by speech and language therapists and radiographers. This article explores the impact on patient access of a practitioner-led VFS clinic at a large teaching hospital. Initial Assessment: Specific information pertaining to VFS patient waiting times and service quality was collected for a twelve month period both pre- and post-clinic formation. Choice of Solution: Additional capacity was achieved with the introduction of the practitioner-led clinic, with overall patient access improving by 111%. Mean waiting times for in-patients reduced by 75%, many of whom had the procedure on the same day as referral, with out-patients waiting times reducing by 62.5%. Evaluation: The data demonstrates that patient access and report turnaround times are significantly improved, with no adverse effects as measured by inadequate studies, incorrect reports, complaints and documented radiation dose levels. Lessons Learnt: Practitioner-led VFS services can be recommended as a safe and efficient method of improving service provision.

  8. Access to health services in six Colombian cities: limitations and consequences

    Julián Vargas J

    2009-08-01

    Full Text Available Objective: To understand the characteristics of access to the General System of Social Security in health (SGSS, from the perspective of doctors, nurses, administrators and users. Methodology: based on the grounded theory we present a study in six cities in Colombia: Barranquilla, Bucaramanga, Bogota, Leticia, Medellín and Pasto, for which interviews were conducted in-depth with health professionals involved in service delivery and focus groups with service users. Results: The findings indicate that insurance has become an end in itself, and being affiliated to SGSSS does not guarantee effective access to services. The dominance of the market, the financial profitability of insurers, imposed cost-containment mechanisms over the right to health. There are limitations from the rules, benefit plans that create geographical, economic and cultural barriers from the various actors involved in the chain of decisions. Additionally, display individual and institutional ethical shortcomings, clientelism and corruption in the management of resources, coupled with poverty and geographical dispersion of communities, mean that further limiting access to health services.

  9. Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

    Quality Issue: Although costly and time consuming, videofluoroscopic swallowing (VFS) examinations are the gold standard for imaging of oro-pharyngeal dysphagia, and demand is likely to increase with an ageing population. Traditional radiologist-led VFS services in the UK are gradually being replaced by practitioner-led clinics undertaken jointly by speech and language therapists and radiographers. This article explores the impact on patient access of a practitioner-led VFS clinic at a large teaching hospital. Initial Assessment: Specific information pertaining to VFS patient waiting times and service quality was collected for a twelve month period both pre- and post-clinic formation. Choice of Solution: Additional capacity was achieved with the introduction of the practitioner-led clinic, with overall patient access improving by 111%. Mean waiting times for in-patients reduced by 75%, many of whom had the procedure on the same day as referral, with out-patients waiting times reducing by 62.5%. Evaluation: The data demonstrates that patient access and report turnaround times are significantly improved, with no adverse effects as measured by inadequate studies, incorrect reports, complaints and documented radiation dose levels. Lessons Learnt: Practitioner-led VFS services can be recommended as a safe and efficient method of improving service provision.

  10. Addressing Service Access Barriers for Homeless Youth: A Call for Collaboration

    Jeffrey L. PERRON

    2014-01-01

    Homeless youth are among the most vulnerable individuals in North American society. The day-to-day stressors they face while living on the streets pose a great threat to their mental and physical health. A number of barriers that youth face in accessing care have been identified in the literature. This discussion article highlights work that has been done to apply geographic theory to issues of service access among homeless youth. To date, most such work has been theoretical in nature, with c...

  11. Quantitative analysis of access strategies to remote information in network services

    Olsen, Rasmus Løvenstein; Schwefel, Hans-Peter; Hansen, Martin Bøgsted

    2006-01-01

    Remote access to dynamically changing information elements is a required functionality for various network services, including routing and instances of context-sensitive networking. Three fundamentally different strategies for such access are investigated in this paper: (1) a reactive approach...... analytic models to compute different performance metrics for these approaches, with special focus on the so-called mismatch probability. The results of the analytic models allow for design decisions on which strategy to implement for specific input parameters (change rate of the information element...

  12. Research on Rural Residence and Access to Drug Abuse Services: Where Are We and where Do We Go?

    Borders, Tyrone F.; Booth, Brenda M.

    2007-01-01

    Context: Illicit drug use is common in rural areas, but very little research has investigated rural populations' access to drug abuse services. Purpose: To describe the current state of the scientific literature on access to drug abuse services in rural areas and suggest directions for future research. Methods: We performed a literature review of…

  13. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

    Dastjerdi Mahdieh

    2012-09-01

    Full Text Available Abstract Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men who were adults (at least 18 years old and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP, becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains

  14. Service Class Resource Management For Green Wireless-Optical Broadband Access NetworksWOBAN

    SRUTHY.S

    2015-08-01

    Full Text Available Abstract-Broadband access networks have become an essential part of worldwide communication systems because of the exponential growth of broadband services such as video on demand high definition TV internet protocol TV and video conferencing. Exponential growth in the volume of wireless data boosted by the growing popularity of mobile devices such as smartphone and tablets has forced the telecommunication industries to rethink the way networks are currently designed and to focus on the development of high-capacity mobile broadband networks. In response to this challenge researchers have been working toward the development of an integrated wireless optical broadband access network. Two major candidate technologies which are currently known for their high capacity as well as quality of service QoS for multimedia traffic are passive optical networks PON and fourth generation 4G wireless networks. PON is a wired access technology well known for its cost efficiency and high capacity whereas 4G is a wireless broadband access technology which has achieved broad market acceptance because of its ease of deployment ability to offer mobility and its cost efficiency. Integration of PON and 4G technologies in the form of wireless-optical broadband access networks offers advantages such as extension of networks in rural areas support for mobile broadband services and quick deployment of broadband networks. These two technologies however have different design architectures for handling broadband services that require quality of service. For example 4G networks use traffic classification for supporting different QoS demands whereas the PON architecture has no such mechanism to differentiate between types of traffic. These two technologies also differ in their power saving mechanisms. Propose a service class mapping for the integrated PON-4G network which is based on the MG1 queuing model and class-based power saving mechanism which significantly improves the

  15. A study of patients with a primary malignant brain tumour and their carers: symptoms and access to services.

    Arber, A; Faithfull, S; Plaskota, M; Lucas, C.; De Vries, K.

    2010-01-01

    The aim of this study is to investigate the symptom experience, access to supportive care services and rehabilitation of patients with a primary malignant brain tumour (PMBT) and their carers. Methods A case review of 70 patients with a diagnosis of PMBT who received palliative care in five specialist palliative care units between July 2005 and June 2006. The review examined patient’s symptom experience, care issues, access to rehabilitation and access to supportive care services....

  16. [Real time 3D echocardiography

    Bauer, F.; Shiota, T.; Thomas, J. D.

    2001-01-01

    Three-dimensional representation of the heart is an old concern. Usually, 3D reconstruction of the cardiac mass is made by successive acquisition of 2D sections, the spatial localisation and orientation of which require complex guiding systems. More recently, the concept of volumetric acquisition has been introduced. A matricial emitter-receiver probe complex with parallel data processing provides instantaneous of a pyramidal 64 degrees x 64 degrees volume. The image is restituted in real time and is composed of 3 planes (planes B and C) which can be displaced in all spatial directions at any time during acquisition. The flexibility of this system of acquisition allows volume and mass measurement with greater accuracy and reproducibility, limiting inter-observer variability. Free navigation of the planes of investigation allows reconstruction for qualitative and quantitative analysis of valvular heart disease and other pathologies. Although real time 3D echocardiography is ready for clinical usage, some improvements are still necessary to improve its conviviality. Then real time 3D echocardiography could be the essential tool for understanding, diagnosis and management of patients.

  17. [Doppler echocardiography in endomyocardial fibrosis].

    Tello, R; Cuan, V; Abundes, A; Navarro, J; García Lara, J; Astudillo, R; Ariza, H; Cuan, M

    1994-01-01

    Twelve patients with endomyocardial fibrosis with angiographic and/or histologic corroboration were studied with Doppler echocardiography with the purpose of describing the echocardiographic features and identify the affected sites. The average age was 41 years (range 16 to 59 years), 2 men and 10 women. Three patients (25%) had isolated right ventricular involvement, one patient (8%) left ventricular, 8 patients (66%) both ventricular. Our Doppler echocardiographic findings were: right atrium enlargement (91%), right ventricle outflow dilatation (83%), paradoxical septal motion (83%), left atrial enlargement (33%), mitral and tricuspid valve prolapse (50%), pericardial effusion (41%), mitral regurgitation (75%), tricuspid regurgitation (100%), apex obliteration (50%) and a restrictive type flow pattern (50%). Doppler echocardiography is a useful method for the diagnosis of endomyocardial fibrosis, the finding of normal or small ventricles associated with apex obliteration and enlarged atria, mitral or tricuspid regurgitation and a restrictive type flow pattern are characteristics of this disease. In our population, the isolated or predominantely right ventricular involvement is the most common finding as it represented 83% of the cases. PMID:7979815

  18. Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities

    MacDonnell Judith A

    2011-09-01

    Full Text Available Abstract Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1 to identify dominant and counter discourses in health services access and equity literature; and 2 to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1 multicultural discourse, and 2 diversity discourse; and three counter discourses: 3 social determinants of health (SDOH discourse; 4 anti-oppression (AOP discourse; and 5 citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress

  19. Access to CERN from the Internet: termination of the VPN service - Reminder

    IT Department

    2008-01-01

    Due to the continued incidents and growing security risks associated with the service, access to CERN using the VPN (Virtual Private Network) service will be discontinued as of Tuesday, 29 January 2008. In addition, new registrations are no longer accepted. For further information see: http://cern.ch/security/vpn. Users are requested to stop using VPN immediately and to start to use the recommended alternative methods for connecting to CERN from the Internet. An outline of these methods and a set of FAQs are available at: http://cern.ch/security/Internet IT Department

  20. Access to CERN from the Internet: termination of the VPN service

    2007-01-01

    Due to the continued incidents and growing security risks from the service, access to CERN using the VPN (Virtual Private Network) service will be discontinued on Tuesday 29th January 2008. In addition, new registrations will no longer be accepted. Further information is linked from: http://cern.ch/security/vpn Users are requested to stop using VPN immediately and start using the recommended alternative methods for connecting to CERN from the Internet. These are outlined together with a set of FAQs at: http://cern.ch/security/Internet IT Department

  1. An Alternative Solution to Https for Secure Access to Web Services

    Cristina Livia Iancu

    2012-06-01

    Full Text Available This paper presents a solution for accessing web services in a light-secure way. Because the payload of the messages is not so sensitive, it is taken care only about protecting the user name and the password used for authentication and authorization into the web services system. The advantage of this solution compared to the common used SSL is avoiding the overhead related to the handshake and encryption, providing a faster response to the clients. The solution is intended for Windows machines and is developed using the latest stable Microsoft technologies.

  2. SOCIO-ECONOMIC AND CULTURAL FACTORS INFLUENCING ROMA PEOPLE’S ACCESSIBILITY TO HEALTH SERVICES

    Camelia Soponaru

    2015-11-01

    Full Text Available Roma people’s life expectancy is at least ten years below that of the majority population the main incriminating factor for this state of affairs being the poor access to education and health services. Adding to that, other factors are deeply influencing the accessibility of roma people to health services: the level of the integration in the community, the health related believes due to cultural aspects, migration, the image of the person who cures (could be the doctor and the complicated explanation of disease and death in terms of religious and metaphorical approach and the lack of education for health. Roma people remain a vulnerable population regarding diagnostic, treatment and recovering.

  3. Research on the accessibility to health and educational services in the rural areas in Extremadura

    Nieto Masot Ana

    2015-03-01

    Full Text Available As the competent laws on Health and Education of the Extremaduran Government read, all the Extremaduran people have the right to their benefits, irrespective of their social, economic and cultural characteristics. Nevertheless, in the Region of Extremadura there are still differences between the rural and urban areas, so, studying how the Extremaduran people can access, with the same conditions, to those services considered basic, such as health and education, is very significant. Using techniques as Network Analyst and the interpolation method IDW, we can note that in Extremadura there are still zones with a very-far- from- laws reality, rural areas with a difficult access to the named services and equipment due to the location on low developed in population and economy areas, and very far from the main communication roads

  4. Characteristics of collaborative care in increasing access to mental health service in the Asian community.

    Sung, Jeehee; Mayo, Nicolle; Ko, Mei-Ju; Lasley, Chandra

    2013-09-01

    This study examined the use of thematic analysis to determine how characteristics of collaborative care facilitate accessibility to mental health services among the Asian community in the United States. This investigation explored characteristics of collaborative care in patient treatment, barriers that prevent the Asian community from utilizing care, and how collaborative settings can facilitate mental health care access in the Asian community. Mental health providers with relevant experiences in collaborative care were recruited through snowball sampling to participate in a telephone interview with the researchers. The results suggested a collectivistic culture, valuing authority, acculturation, language, and stigma as themes of Asian patients as well as key providers (mental and medical health providers), colocation, the physician's leading role, the provider's language, and collaboration among providers as themes for collaborative care. The study suggests that collaborative care's foundational characteristics can promote easier access to mental health care for the Asian community. PMID:23937434

  5. Conceptual Design and Access Assessment for In-Service Inspection and Repair of KALIMER-600

    The conceptual design of in-service inspection (ISI) and repair for KALIMER-600 reactor system and components has been performed. The basic concept and strategy of ISI and repair has been described for considering the design characteristics of KALIMER-600 and the intents of the ASME XI Division 3. The postulated failure defects for main components and structures are estimated and evaluated for KALIMER-600 safety and reliability. The assessment of the ISI performance, accessibility and maintainability has been analyzed and reviewed

  6. SOARAN: A Service-oriented Architecture for Radio Access Network Sharing in Evolving Mobile Networks

    He, Jun; Song, Wei

    2015-01-01

    Mobile networks are undergoing fast evolution to software-defined networking (SDN) infrastructure in order to accommodate the ever-growing mobile traffic and overcome the network management nightmares caused by unremitting acceleration in technology innovations and evolution of the service market.Enabled by virtualized network functionalities, evolving carrier wireless networks tend to share radio access network (RAN) among multiple (virtual) network operators so as to increase network capaci...

  7. Conceptual Design and Access Assessment for In-Service Inspection and Repair of KALIMER-600

    Joo, Young-Sang; Park, Chang-Gyu; Kim, Seok-Hun; Lee, Jae-Han

    2007-02-15

    The conceptual design of in-service inspection (ISI) and repair for KALIMER-600 reactor system and components has been performed. The basic concept and strategy of ISI and repair has been described for considering the design characteristics of KALIMER-600 and the intents of the ASME XI Division 3. The postulated failure defects for main components and structures are estimated and evaluated for KALIMER-600 safety and reliability. The assessment of the ISI performance, accessibility and maintainability has been analyzed and reviewed.

  8. Location- and Time-Dependent VPD for Privacy-Preserving Wireless Accesses to Cloud Services

    Yoon, Jong P.

    2011-01-01

    The advent of smartphones in recent years has changed the wireless landscape. Smartphones have become a platform for online user interface to cloud databases. Cloud databases may provide a large set of user-private and sensitive data (i.e., objects), while smartphone users (i.e., subjects) provide location-sensitive information. Secure and private services in wireless accessing to cloud databases have been discussed actively for the past recent years. However, the previous techniques are unsa...

  9. A Model for Remote Access and Protection of Smartphones using Short Message Service

    Kuppusamy, K. S.; R, Senthilraja.; G. Aghila

    2012-01-01

    The smartphone usage among people is increasing rapidly. With the phenomenal growth of smartphone use, smartphone theft is also increasing. This paper proposes a model to secure smartphones from theft as well as provides options to access a smartphone through other smartphone or a normal mobile via Short Message Service. This model provides option to track and secure the mobile by locking it. It also provides facilities to receive the incoming call and sms information to the remotely connecte...

  10. Arab Republic of Egypt - Inequality of Opportunity in Access to Basic Services among Egyptian Children

    World Bank

    2012-01-01

    Egypt's children and youth, representing more than one-third of the country´s population and its future, face several significant challenges, as shown by higher child poverty rates and unequal access to basic services. The objective of this report is three-fold: (i) to analyze the extent of inequality of opportunity among Egyptian children; (ii) to inform government policy on how success ...

  11. Service Class Resource Management For Green Wireless-Optical Broadband Access NetworksWOBAN

    Sruthy, S.; SUMI CHITRA K.A

    2015-01-01

    Abstract-Broadband access networks have become an essential part of worldwide communication systems because of the exponential growth of broadband services such as video on demand high definition TV internet protocol TV and video conferencing. Exponential growth in the volume of wireless data boosted by the growing popularity of mobile devices such as smartphone and tablets has forced the telecommunication industries to rethink the way networks are currently designed and to focus on the devel...

  12. Fair queueing with service envelopes (FQSE): A cousin-fair hierarchical scheduler for subscriber access networks

    Kramer, Glen; A. Banerjee; Singhal, N K; Mukherjee, B.; Dixit, S.; Ye, Y H

    2004-01-01

    In this paper, we propose and investigate the characteristics of a fair queueing with service envelopes (FQSE) algorithm-a hierarchical fair-share scheduling algorithm for access networks based on a remote scheduling system such as Ethernet passive optical networks (EPON) or cable TV network. FQSE is designed to overcome the limiting factors of a typical remote scheduling system such as large control-plane delay, limited control-plane bandwidth, and significant queue switch-over overhead. The...

  13. Based on asynchronous communication protocol of geographic space information service access mechanism research

    G. Chen; Zhao, J.; Gu, M; Li, D.

    2014-01-01

    At present, the traditional way of accessing to classified network in geographic spatial information services is using network gatekeeper and firewall etc. to ensure public and classified network communications links. However, the physical isolation between classified network and public network is crossed, which is bound to cause classified network potential security hazard. In Yunnan province space Land dynamic monitoring integration project, it proposed the point to point text m...

  14. Data Archiving and Networked Services (DANS) promotes sustained access to digital research data

    van Berchum, M.; Kraaikamp, Emilie

    2015-01-01

    Data Archiving and Networked Services (DANS) promotes sustained access to digital research data. For this purpose, DANS encourages researchers to archive and reuse data in a sustained form. In the online archiving system EASY research data is stored in a permanent and sustainable manner, according to the guidelines of the international Data Seal of Approval. Each datasets receives a Digital Object Identifier (DOI), facilitating the citation of research data. The metadata of all datasets in EA...

  15. Improving territorial accessibility of mental health services: The case of Spain

    Enrique López-Lara

    2012-12-01

    Full Text Available Background and Objectives: Citizens choose their health care services not only depending on their needs, but also on where they are located. The location of the services is especially important in the case of mental health due to the specific features of mental disorders. This article provides an analysis of temporal access by road to outpatient mental health centres in Andalusia (Spain with a view to improving accessibility for the greatest volume of population possible. Methods: Firstly, accessibility by road to the outpatient mental health centres was calculated in terms of time by establishing journey times using the ArcGIS Geographical Information System´s (GIS Network Analyst module. These journey times by road enabled travel times to be established for these sections, temporal accessibility areas to be plotted from each of the outpatient mental health centres and the number of people included in each accessibility area to be calculated. Results: The accessibility analysis enabled the sitting of the centres to be evaluated for 2006, a comparison to be made with 2011 (with six new facilities having been set up since 2006 and new locations for the siting of these six new facilities to be proposed. Conclusions: This study has enabled the optimum territorial locations to be proposed for the six mental health centres created between 2006 and 2011 that would allow travel times to be reduced for the greatest numbers of people possible. It can be stated on the basis of this study that, if territorial criteria had been taken into account, 97,720 inhabitants would have seen their travel times to their nearest mental health centres reduced using the same resources.

  16. Transesophageal echocardiography in NeoChord procedure

    Pittarello Demetrio

    2015-01-01

    Full Text Available Background: Transapical off-pump mitral valve intervention with neochord implantation for degenerative mitral valve disease have been recently introduced in the surgical practice. The procedure is performed under 2D-3D transesophageal echocardiography guidance. Methods: The use of 3D real-time transesophageal echocardiography provides more accurate information than 2D echocardiography only in all the steps of the procedure. In particular 3D echocardiography is mandatory for preoperative assessment of the morphology of the valve, for correct positioning of the neochord on the diseased segment , for the final tensioning of the chordae and for the final evaluation of the surgical result. Result and Conclusion: This article is to outline the technical aspects of the transesophageal echocardiography guidance of the NeoChord procedure showing that the procedure can be performed only with a close and continuous interaction between the anesthesiologist and the cardiac surgeon.

  17. Towards equity and sustainability of rural and remote health services access: supporting social capital and integrated organisational and professional development

    Schoo, Adrian; Lawn, Sharon; Carson, Dean

    2016-01-01

    Background Access to rural health services is compromised in many countries including Australia due to workforce shortages. The issues that consequently impact on equity of access and sustainability of rural and remote health services are complex. Discussion The purpose of this paper is to describe a number of approaches from the literature that could form the basis of a more integrated approach to health workforce and rural health service enhancement that can be supported by policy. A case s...

  18. Qualitative investigation of barriers to accessing care by people who inject drugs in Saskatoon, Canada: perspectives of service providers

    Lang, Katherine; Neil, Jaycie; Wright, Judith; Dell, Colleen Anne; Berenbaum, Shawna; El-Aneed, Anas

    2013-01-01

    Background People who inject drugs (PWID) often encounter barriers when attempting to access health care and social services. In our previous study conducted to identify barriers to accessing care from the perspective of PWIDs in Saskatoon, Canada: poverty, lack of personal support, discrimination, and poor knowledge and coordination of service providers among other key barriers were identified. The purpose of the present investigation was to explore what service providers perceive to be the ...

  19. Evaluation of Public E-Services and Information Technology Accessibility in Different Social Groups

    Ramutė Naujikienė

    2012-12-01

    Full Text Available The purpose of this study is to develop an approach based on the social quality evaluation square model for evaluation of information technology usage in different social groups. Componential view to the accessibility of e-services including IT means providing the possibility to research the influences of different life conditions to usage of the public e-services. The task of this empirical study is directed towards revealing the differences of e-inclusion and e-services accessibility for social groups of citizens of Lithuania, and to compare this accessibility data with other EU countries.Design/methodology/approach—the approach is based on the square model of social quality evaluation of information technology usage in different social groups. The social division square model includes an assessment of quality according to the evaluation of socioeconomic security, social inclusion, social cohesion, and empowerment. Empowerment can be defined as consisting of individual or collective decisions to act on one’s own life.Findings—the results are demonstrated by the accessibility of public e-services data, which are evaluated by the quality of social group development according to IT applications. The hypothesis was confirmed that the e-government activities can be realized by properly selecting and installing technologies, and using technology facilities. E-services influence the capabilities of state officials to apply modern technology and increase the availability of e-services for social groups. Results consist of individual or collective decisions to act on one’s own life, to implementation of effective information technologies in the e-government activities and using of e-services. An important indicator is the implementation of e-services in the activity of citizens. It is submitted as the index of e-participation in dealing with the activities of citizens and the possibilities of authorities directly related with providing services

  20. Evaluation of Public E-Services and Information Technology Accessibility in Different Social Groups

    Ramutė Naujikienė

    2013-02-01

    Full Text Available The purpose of this study is to develop an approach based on the social quality evaluation square model for evaluation of information technology usage in different social groups. Componential view to the accessibility of e-services including IT means providing the possibility to research the influences of different life conditions to usage of the public e-services. The task of this empirical study is directed towards revealing the differences of e-inclusion and e-services accessibility for social groups of citizens of Lithuania, and to compare this accessibility data with other EU countries. Design/methodology/approach—the approach is based on the square model of social quality evaluation of information technology usage in different social groups. The social division square model includes an assessment of quality according to the evaluation of socioeconomic security, social inclusion, social cohesion, and empowerment. Empowerment can be defined as consisting of individual or collective decisions to act on one’s own life. Findings—the results are demonstrated by the accessibility of public e-services data, which are evaluated by the quality of social group development according to IT applications. The hypothesis was confirmed that the e-government activities can be realized by properly selecting and installing technologies, and using technology facilities. E-services influence the capabilities of state officials to apply modern technology and increase the availability of e-services for social groups. Results consist of individual or collective decisions to act on one’s own life, to implementation of effective information technologies in the e-government activities and using of e-services. An important indicator is the implementation of e-services in the activity of citizens. It is submitted as the index of e-participation in dealing with the activities of citizens and the possibilities of authorities directly related with providing

  1. An evaluation of access to health care services along the rural-urban continuum in Canada

    Sibley Lyn M

    2011-01-01

    Full Text Available Abstract Background Studies comparing the access to health care of rural and urban populations have been contradictory and inconclusive. These studies are complicated by the influence of other factor which have been shown to be related to access and utilization. This study assesses the equity of access to health care services across the rural-urban continuum in Canada before and after taking other determinants of access into account. Methods This is a cross-sectional study of the population of the 10 provinces of Canada using data from the Canadian Community Health Survey (CCHS 2.1. Five different measures of access and utilization are compared across the continuum of rural-urban. Known determinants of utilization are taken into account according to Andersen's Health Behaviour Model (HBM; location of residence at the levels of province, health region, and community is also controlled for. Results This study found that residents of small cities not adjacent to major centres, had the highest reported utilisation rates of influenza vaccines and family physician services, were most likely to have a regular medical doctor, and were most likely to report unmet need. Among the rural categories there was a gradient with the most rural being least likely to have had a flu shot, use specialist physicians services, or have a regular medical doctor. Residents of the most urban centres were more likely to report using specialist physician services. Many of these differences are diminished or eliminated once other factors are accounted for. After adjusting for other factors those living in the most urban areas were more likely to have seen a specialist physician. Those in rural communities had a lower odds of receiving a flu shot and having a regular medical doctor. People residing in the most urban and most rural communities were less likely to have a regular medical doctor. Those in any of the rural categories were less likely to report unmet need

  2. Remote access to information sources in National and university library: development of service

    Gorazd Vodeb

    2006-01-01

    Full Text Available National and University Library established remote access to information sources in september 2004. The article describes implementation and development of the service. Library wanted to offer information sources to users wherever and whenever they would need them. First main evaluation criteria for software selection were integration with existing authentication system and second no need for intervention user side. The EZproxy software from Useful Utilities was chosen. Key step to implementation was establishing communication between software applications EZproxy and COBISS library automation system. Library needed to obtain licence agreements from publishers. Promotion campaign aimed to notify large number of users. Only users of National & University Library were able to use the service. Other users and libraries of Ljubljana University requested to authenticate by credentials of their library. Remote access service was developed further in order to enable authentication for other libraries. We needed to establish authentication and authorisation system and also upgrade and install the communication command procedure on different servers. The data about service usage are presented.

  3. Privacy-Aware Relevant Data Access with Semantically Enriched Search Queries for Untrusted Cloud Storage Services.

    Pervez, Zeeshan; Ahmad, Mahmood; Khattak, Asad Masood; Lee, Sungyoung; Chung, Tae Choong

    2016-01-01

    Privacy-aware search of outsourced data ensures relevant data access in the untrusted domain of a public cloud service provider. Subscriber of a public cloud storage service can determine the presence or absence of a particular keyword by submitting search query in the form of a trapdoor. However, these trapdoor-based search queries are limited in functionality and cannot be used to identify secure outsourced data which contains semantically equivalent information. In addition, trapdoor-based methodologies are confined to pre-defined trapdoors and prevent subscribers from searching outsourced data with arbitrarily defined search criteria. To solve the problem of relevant data access, we have proposed an index-based privacy-aware search methodology that ensures semantic retrieval of data from an untrusted domain. This method ensures oblivious execution of a search query and leverages authorized subscribers to model conjunctive search queries without relying on predefined trapdoors. A security analysis of our proposed methodology shows that, in a conspired attack, unauthorized subscribers and untrusted cloud service providers cannot deduce any information that can lead to the potential loss of data privacy. A computational time analysis on commodity hardware demonstrates that our proposed methodology requires moderate computational resources to model a privacy-aware search query and for its oblivious evaluation on a cloud service provider. PMID:27571421

  4. A Data Capsule Framework For Web Services: Providing Flexible Data Access Control To Users

    Kannan, Jayanthkumar; Chun, Byung-Gon

    2010-01-01

    This paper introduces the notion of a secure data capsule, which refers to an encapsulation of sensitive user information (such as a credit card number) along with code that implements an interface suitable for the use of such information (such as charging for purchases) by a service (such as an online merchant). In our capsule framework, users provide their data in the form of such capsules to web services rather than raw data. Capsules can be deployed in a variety of ways, either on a trusted third party or the user's own computer or at the service itself, through the use of a variety of hardware or software modules, such as a virtual machine monitor or trusted platform module: the only requirement is that the deployment mechanism must ensure that the user's data is only accessed via the interface sanctioned by the user. The framework further allows an user to specify policies regarding which services or machines may host her capsule, what parties are allowed to access the interface, and with what parameter...

  5. Some Programs Should Not Run on Laptops - Providing Programmatic Access to Applications Via Web Services

    Gupta, V.; Gupta, N.; Gupta, S.; Field, E.; Maechling, P.

    2003-12-01

    hosted these Web Services as a part of the SCEC Community Modeling Environment (SCEC/CME) ITR Project (http://www.scec.org/cme). We have implemented Web Services for several of the reasons sited previously. For example, we implemented a FORTRAN-based Earthquake Rupture Forecast (ERF) as a Web Service for use by client computers that don't support a FORTRAN runtime environment. We implemented a Generic Mapping Tool (GMT) Web Service for use by systems that don't have local access to GMT. We implemented a Hazard Map Calculator Web Service to execute Hazard calculations that are too computationally intensive to run on a local system. We implemented a Coordinate Conversion Web Service to enforce a standard and consistent method for converting between UTM and Lat/Lon. Our experience developing these services indicates both strengths and weakness in current Web Service technology. Client programs that utilize Web Services typically need network access, a significant disadvantage at times. Programs with simple input and output parameters were the easiest to implement as Web Services, while programs with complex parameter-types required a significant amount of additional development. We also noted that Web services are very data-oriented, and adapting object-oriented software into the Web Service model proved problematic. Also, the Web Service approach of converting data types into XML format for network transmission has significant inefficiencies for some data sets.

  6. Distance, rurality and the need for care: access to health services in South West England

    Martin David

    2004-09-01

    Full Text Available Abstract Background This paper explores the geographical accessibility of health services in urban and rural areas of the South West of England, comparing two measures of geographical access and characterising the areas most remote from hospitals. Straight-line distance and drive-time to the nearest general practice (GP and acute hospital (DGH were calculated for postcodes and aggregated to 1991 Census wards. The correlation between the two measures was used to identify wards where straight-line distance was not an accurate predictor of drive-time. Wards over 25 km from a DGH were classified as 'remote', and characterised in terms of rurality, deprivation, age structure and health status of the population. Results The access measures were highly correlated (r2>0.93. The greatest differences were found in coastal and rural wards of the far South West. Median straight-line distance to GPs was 1 km (IQR = 0.6–2 km and to DGHs, 12 km (IQR = 5–19 km. Deprivation and rates of premature limiting long term illness were raised in areas most distant from hospitals, but there was no evidence of higher premature mortality rates. Half of the wards remote from a DGH were not classed as rural by the Office for National Statistics. Almost a quarter of households in the wards furthest from hospitals had no car, and the proportion of households with access to two or more cars fell in the most remote areas. Conclusion Drive-time is a more accurate measure of access for peripheral and rural areas. Geographical access to health services, especially GPs, is good, but remoteness affects both rural and urban areas: studies concentrating purely on rural areas may underestimate geographical barriers to accessing health care. A sizeable minority of households still had no car in 1991, and few had more than one car, particularly in areas very close to and very distant from hospitals. Better measures of geographical access, which integrate public and private transport

  7. Essential Public Health Services' Accessibility and its Determinants among Adults with Chronic Diseases in China.

    Miaomiao Tian

    Full Text Available Along with three years implementation of health reform in China, this study aimed at providing the up-to-date evidence about the accessibility of essential public health services (EPHS among adults with chronic diseases (CDs in both urban and rural areas, as well as determinants in access to EPHS.The data were collected from a cross-sectional survey conducted in 2013, which used a multistage stratified random sampling method to select 54 urban communities and 54 rural villages. Hypertension patients and diabetes patients were the target population who are the main beneficiaries of EPHS. Single factor analysis of influencing factors on difference access to EPHS was performed by Chi-Square analysis. Logistic regression analysis was used to determine the predictors of effective management and effective control.Patients with hypertension or diabetes were predominantly middle-aged or older persons and had a mean age of 65.26 year. People with CDs in China have a higher basic accessibility rate in EPHS with more than 90% of them having experience in receiving EPHS. And those who are willing to receive services from doctors have the most positive influence on effective management and control in blood pressure or blood glucose. But unsatisfied quality and equity of EPHS still exist in primary health system. 90% of participants could receive EPHS, but just 44% of them could control their diseases effectively. And participants from cities had the higher rates in effective management (urban: rural = 57%: 50.6% and effective control (urban: rural = 39.5%: 27.8%.People with CDs have a high level in geography and economic accessibility to EPHS, but the effectiveness of health management also needs to be improved, especially for those living in rural areas. Our study highlights the continuing need for improving ability to provide EPHS and the equality among regions. Meanwhile, strengthen health education and promotion for patients with CDs to improve their

  8. Enhanced Access to Earth Science Data through Standards-based Web Services and Applications

    Hiatt, S. H.; Hashimoto, H.; Melton, F. S.; Michaelis, A.; Milesi, C.; Nemani, R. R.; Votava, P.; Wang, W.

    2009-12-01

    The Terrestrial Observation and Prediction System (TOPS) at NASA Ames Research Center's Ecological Forecasting Lab generates a suite of gridded data products in near real-time that are designed to enhance management decisions related to floods, droughts, forest fires, human health, as well as crop, range, and forest production. Derived from the synthesis of satellite imagery, ground observations, and specialized ecosystem models, our data products hold great potential for supporting research and practical applications across a wide range of disciplines. In order to provide enhanced access to our data and to promote multidisciplinary collaboration we implement standards-based web services. We serve TOPS data conforming to the Open-source Project for a Network Data Access Protocol (OPeNDAP) which allows subsetting and distribution of large HDF or NetCDF datasets, complete with standards-based metadata. Additionally, we implement a standard Web Map Service (WMS) for visualization of geospatial data. To further extend the use of our data to a wider audience we build upon these web services to develop browser-based visualization and analysis tools. We use Asynchronous Javascript and XML (AJAX) techniques to build interactive web applications leveraging our web services. For example, our WMS provides the map image tiles used in our mapping client. Users can click on the map to query TOPS datasets and regional summaries via OPeNDAP, producing time-series charts allowing temporal analysis of environmental trends and associated phenomena. We present the TOPS Data Gateway and its components, highlighting how the use of open protocols and standards provides improved data access for our clients and research partners, encouraging data interoperability and multidisciplinary collaboration.

  9. Applying the Earth System Grid Security System in a Heterogeneous Environment of Data Access Services

    Kershaw, Philip; Lawrence, Bryan; Lowe, Dominic; Norton, Peter; Pascoe, Stephen

    2010-05-01

    CEDA (Centre for Environmental Data Archival) based at STFC Rutherford Appleton Laboratory is host to the BADC (British Atmospheric Data Centre) and NEODC (NERC Earth Observation Data Centre) with data holdings of over half a Petabyte. In the coming months this figure is set to increase by over one Petabyte through the BADC's role as one of three data centres to host the CMIP5 (Coupled Model Intercomparison Project Phase 5) core archive of climate model data. Quite apart from the problem of managing the storage of such large volumes there is the challenge of collating the data together from the modelling centres around the world and enabling access to these data for the user community. An infrastructure to support this is being developed under the US Earth System Grid (ESG) and related projects bringing together participating organisations together in a federation. The ESG architecture defines Gateways, the web interfaces that enable users to access data and data serving applications organised into Data Nodes. The BADC has been working in collaboration with US Earth System Grid team and other partners to develop a security system to restrict access to data. This provides single sign-on via both OpenID and PKI based means and uses role based authorisation facilitated by SAML and OpenID based interfaces for attribute retrieval. This presentation will provide an overview of the access control architecture and look at how this has been implemented for CEDA. CEDA has developed an expertise in data access and information services over several years through a number of projects to develop and enhance these capabilities. Participation in CMIP5 comes at a time when a number of other software development activities are coming to fruition. New services are in the process of being deployed alongside services making up the system for ESG. The security system must apply access control across this heterogeneous environment of different data services and technologies. One strand

  10. The Copernicus Climate Change Service (C3S): Open Access to a Climate Data Store

    Thepaut, Jean-Noel; Dee, Dick

    2016-04-01

    In November 2014, The European Centre for Medium-range Weather Forecasts (ECMWF) signed an agreement with the European Commission to deliver two of the Copernicus Earth Observation Programme Services on the Commission's behalf. The ECMWF delivered services - the Copernicus Climate Change Service (C3S) and Atmosphere Monitoring Service (CAMS) - will bring a consistent standard to how we monitor and predict atmospheric conditions and climate change. They will maximise the potential of past, current and future earth observations - ground, ocean, airborne, satellite - and analyse these to monitor and predict atmospheric conditions and in the future, climate change. With the wealth of free and open data that the services provide, they will help business users to assess the impact of their business decisions and make informed choices, delivering a more energy efficient and climate aware economy. These sound investment decisions now will not only stimulate growth in the short term, but reduce the impact of climate change on the economy and society in the future. C3S is in its proof of concept phase and through its Climate Data Store will provide • global and regional climate data reanalyses; • multi-model seasonal forecasts; • customisable visual data to enable examination of wide range of scenarios and model the impact of changes; • access to all the underlying data, including climate data records from various satellite and in-situ observations. In addition, C3S will provide key indicators on climate change drivers (such as carbon dioxide) and impacts (such as reducing glaciers). The aim of these indicators will be to support European adaptation and mitigation policies in a number of economic sectors. At the heart of the Service is the provision of open access to a one stop shop (the Climate Data Store) of climate data and modelling, analysing more than 20 Essential Climate Variables to build a global picture of our past, present and future climate and developing

  11. The post-2015 delivery of universal and sustainable access to infrastructure services. Working Paper

    Doczi, Julian, Dorr, Tobias; Mason, Nathaniel; Scott, Andrew

    2013-06-15

    In this new working paper, the authors focus specifically on what would be necessary to achieve High Level Panel-style goals and targets for water, energy and transport, if these were to be eventually adopted by world leaders. In all three cases, much of the advocacy - and the proposed High Level Panel goals - have emphasized the need to strive for universal and sustainable access to at least basic levels of services from these sectors. Many of the proposals for post-2015 goals and targets appear ambitious, but what would it take to achieve them? This paper assesses what is needed to achieve goals for universal and sustainable access to infrastructure, specifically water, energy and transport. Using illustrative goals and targets, the paper reviews the development challenges in each sector, and what will be necessary to overcome the barriers to universal and sustainable access to water, energy and transport infrastructure services, in the areas of governance, finance, capacity development and environmental protection. The paper ends with general conclusions about infrastructure in the post-2015 development agenda.

  12. Access denied”? Managing access to the World Wide Web within the National Health Service (NHS) in England: technology, risk, culture, policy and practice

    Ebenezer, Catherine; Bath, Peter A.; Pinfield, Stephen

    2015-01-01

    1. Introduction The research project as a whole examines the factors that bear on the accessibility of online published professional information within the National Health Service (NHS) in England. The poster focuses on one aspect of this, control of access to the World Wide Web within NHS organisations. The overall aim of this study is to investigate the apparent disjunction between stated policy regarding evidence-based practice and professional learning, and actual IT (information te...

  13. Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar

    Thin Zaw Phyu Phyu

    2012-12-01

    Full Text Available Abstract Background Inequity of accessibility to and utilization of reproductive health (RH services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar. Methods A community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression. Results Although geographical accessibility was high (79.3%, financial accessibility was low (19.1% resulting in a low overall accessibility (34.5% to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge

  14. Digital Watermarks Enabling E-Commerce Strategies: Conditional and User Specific Access to Services and Resources

    Jana Dittmann

    2002-02-01

    Full Text Available Digital watermarking is well known as enabling technology to prove ownership on copyrighted material, detect originators of illegally made copies, monitor the usage of the copyrighted multimedia data and analyze the spread spectrum of the data over networks and servers. Research has shown that data hiding techniques can be applied successfully to other application areas like manipulations recognition. In this paper, we show our innovative approach for integrating watermark and cryptography based methods within a framework of new application scenarios spanning a wide range from dedicated and user specific services, “Try&Buy” mechanisms to general means for long-term customer relationships. The tremendous recent efforts to develop and deploy ubiquitous mobile communication possibilities are changing the demands but also possibilities for establishing new business and commerce relationships. Especially we motivate annotation watermarks and aspects of M-Commerce to show important scenarios for access control. Based on a description of the challenges of the application domain and our latest work we discuss, which methods can be used for establishing services in a fast convenient and secure way for conditional access services based on digital watermarking combined with cryptographic techniques. We introduce an example scenario for digital audio and an overview of steps in order to establish these concepts practically.

  15. Digital Watermarks Enabling E-Commerce Strategies: Conditional and User Specific Access to Services and Resources

    Dittmann, Jana; Steinebach, Martin; Wohlmacher, Petra; Ackermann, Ralf

    2002-12-01

    Digital watermarking is well known as enabling technology to prove ownership on copyrighted material, detect originators of illegally made copies, monitor the usage of the copyrighted multimedia data and analyze the spread spectrum of the data over networks and servers. Research has shown that data hiding techniques can be applied successfully to other application areas like manipulations recognition. In this paper, we show our innovative approach for integrating watermark and cryptography based methods within a framework of new application scenarios spanning a wide range from dedicated and user specific services, "Try&Buy" mechanisms to general means for long-term customer relationships. The tremendous recent efforts to develop and deploy ubiquitous mobile communication possibilities are changing the demands but also possibilities for establishing new business and commerce relationships. Especially we motivate annotation watermarks and aspects of M-Commerce to show important scenarios for access control. Based on a description of the challenges of the application domain and our latest work we discuss, which methods can be used for establishing services in a fast convenient and secure way for conditional access services based on digital watermarking combined with cryptographic techniques. We introduce an example scenario for digital audio and an overview of steps in order to establish these concepts practically.

  16. PKI-based secure mobile access to electronic health services and data.

    Kambourakis, G; Maglogiannis, I; Rouskas, A

    2005-01-01

    Recent research works examine the potential employment of public-key cryptography schemes in e-health environments. In such systems, where a Public Key Infrastructure (PKI) is established beforehand, Attribute Certificates (ACs) and public key enabled protocols like TLS, can provide the appropriate mechanisms to effectively support authentication, authorization and confidentiality services. In other words, mutual trust and secure communications between all the stakeholders, namely physicians, patients and e-health service providers, can be successfully established and maintained. Furthermore, as the recently introduced mobile devices with access to computer-based patient record systems are expanding, the need of physicians and nurses to interact increasingly with such systems arises. Considering public key infrastructure requirements for mobile online health networks, this paper discusses the potential use of Attribute Certificates (ACs) in an anticipated trust model. Typical trust interactions among doctors, patients and e-health providers are presented, indicating that resourceful security mechanisms and trust control can be obtained and implemented. The application of attribute certificates to support medical mobile service provision along with the utilization of the de-facto TLS protocol to offer competent confidentiality and authorization services is also presented and evaluated through experimentation, using both the 802.11 WLAN and General Packet Radio Service (GPRS) networks. PMID:16340094

  17. Concurrent access to a virtual microscope using a web service oriented architecture

    Corredor, Germán.; Iregui, Marcela; Arias, Viviana; Romero, Eduardo

    2013-11-01

    Virtual microscopy (VM) facilitates visualization and deployment of histopathological virtual slides (VS), a useful tool for education, research and diagnosis. In recent years, it has become popular, yet its use is still limited basically because of the very large sizes of VS, typically of the order of gigabytes. Such volume of data requires efficacious and efficient strategies to access the VS content. In an educative or research scenario, several users may require to access and interact with VS at the same time, so, due to large data size, a very expensive and powerful infrastructure is usually required. This article introduces a novel JPEG2000-based service oriented architecture for streaming and visualizing very large images under scalable strategies, which in addition need not require very specialized infrastructure. Results suggest that the proposed architecture enables transmission and simultaneous visualization of large images, while it is efficient using resources and offering users proper response times.

  18. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    Kangolle Alfred CT; Hanna Timothy P

    2010-01-01

    Abstract Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly availab...

  19. Promoting equality of opportunity and improving access to social services. Notes for a course of action from the Peruvian state.

    Cortázar V., Juan

    2014-01-01

    This article proposes a strategy of government action to promote an equal access to basic social services and lo social insertion opportunities.   In the case of social services, it proposes the need to point out the responsibility of the government in relation to the financing and provision of such services. Although the poverty of the country implies that the government should finance directly the greater part of social services, this does not mean that the provision should be exclusively i...

  20. Access to health services in Western Newfoundland, Canada: Issues, barriers and recommendations emerging from a community-engaged research project

    Janelle Hippe

    2014-06-01

    Full Text Available Research indicates that people living in rural and remote areas of Canada face challenges to accessing health services. This article reports on a community-engaged research project conducted by investigators at Memorial University of Newfoundland in collaboration with the Rural Secretariat Regional Councils and Regional Partnership Planners for the Corner Brook–Rocky Harbour and Stephenville–Port aux Basques Rural Secretariat Regions of Newfoundland and Labrador. The aim of this research was to gather information on barriers to accessing health services, to identify solutions to health services’ access issues and to inform policy advice to government on enhancing access to health services. Data was collected through: (1 targeted distribution of a survey to communities throughout the region, and (2 informal ‘kitchen table’ discussions to discuss health services’ access issues. A total of 1049 surveys were collected and 10 kitchen table discussions were held. Overall, the main barriers to care listed in the survey included long wait times, services not available in the area and services not available at time required. Other barriers noted by survey respondents included transportation problems, financial concerns, no medical insurance coverage, distance to travel and weather conditions. Some respondents reported poorer access to maternal/child health and breast and cervical screening services and a lack of access to general practitioners, pharmacy services, dentists and nurse practitioners. Recommendations that emerged from this research included improving the recruitment of rural physicians, exploring the use of nurse practitioners, assisting individuals with travel costs,  developing specialist outreach services, increasing use of telehealth services and initiating additional rural and remote health research. Keywords: rural, remote, healthcare, health services, social determinants of health

  1. Apollo: Giving application developers a single point of access to public health models using structured vocabularies and Web services

    Wagner, Michael M.; Levander, John D.; Brown, Shawn; Hogan, William R.; Millett, Nicholas; Hanna, Josh

    2013-01-01

    This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem—which we define as a configuration and a query of results—exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services. PMID:24551417

  2. Data Access and Web Services at the EarthScope Plate Boundary Observatory

    Matykiewicz, J.; Anderson, G.; Henderson, D.; Hodgkinson, K.; Hoyt, B.; Lee, E.; Persson, E.; Torrez, D.; Smith, J.; Wright, J.; Jackson, M.

    2007-12-01

    The EarthScope Plate Boundary Observatory (PBO) at UNAVCO, Inc., part of the NSF-funded EarthScope project, is designed to study the three-dimensional strain field resulting from deformation across the active boundary zone between the Pacific and North American plates in the western United States. To meet these goals, PBO will install 880 continuous GPS stations, 103 borehole strainmeter stations, and five laser strainmeters, as well as manage data for 209 previously existing continuous GPS stations and one previously existing laser strainmeter. UNAVCO provides access to data products from these stations, as well as general information about the PBO project, via the PBO web site (http://pboweb.unavco.org). GPS and strainmeter data products can be found using a variety of access methods, incuding map searches, text searches, and station specific data retrieval. In addition, the PBO construction status is available via multiple mapping interfaces, including custom web based map widgets and Google Earth. Additional construction details can be accessed from PBO operational pages and station specific home pages. The current state of health for the PBO network is available with the statistical snap-shot, full map interfaces, tabular web based reports, and automatic data mining and alerts. UNAVCO is currently working to enhance the community access to this information by developing a web service framework for the discovery of data products, interfacing with operational engineers, and exposing data services to third party participants. In addition, UNAVCO, through the PBO project, provides advanced data management and monitoring systems for use by the community in operating geodetic networks in the United States and beyond. We will demonstrate these systems during the AGU meeting, and we welcome inquiries from the community at any time.

  3. Support networks and people with physical disabilities: social inclusion and access to health services

    Cristina Marques de Almeida Holanda; Fabienne Louise Juvêncio Paes de Andrade; Maria Aparecida Bezerra; João Paulo da Silva Nascimento; Robson da Fonseca Neves; Simone Bezerra Alves; Kátia Suely Queiroz Silva Ribeiro

    2015-01-01

    This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these indiv...

  4. Service time analysis of secondary packet transmission with opportunistic channel access

    Usman, Muneer

    2014-09-01

    Cognitive radio transceiver can opportunistically access the underutilized channels of primary systems for new wireless services. The secondary transmission may be interrupted by the primary user\\'s transmission. To facilitate the delay analysis of such secondary packet transmission, we study the resulting extended delivery time for a fixed-size secondary packet that includes both transmission time and waiting time. In particular we derive the exact distribution functions of extended delivery time of secondary transmission for both continuous sensing and periodic sensing cases. Selected numerical results are presented for illustrating the mathematical formulation.

  5. Study of conditions of use of E-services accessible to visually disabled persons

    Bobiller-Chaumon, Marc-Eric; Sandoz-Guermond, Françoise

    2007-01-01

    The aim of this paper is to determine the expectations that French-speaking disabled persons have for electronic administrative sites (utility). At the same time, it is a matter of identifying the difficulties of use that the manipulation of these E-services poses concretely for blind people (usability) and of evaluating the psychosocial impacts on the way of life of these people with specific needs. We show that the lack of numerical accessibility is likely to accentuate the social exclusion of which these people are victim by establishing a numerical glass ceiling.

  6. Access to HIV prevention services among gender based violence survivors in Tanzania

    Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

    2012-01-01

    Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Sa...

  7. Spatial-Temporal dynamics of surface water flooding and consequences for emergency services accessibility

    Pattison, Ian; Green, Daniel; Yu, Dapeng; Bosher, Lee; Wilby, Rob; Yang, Lili; Ryley, Tim

    2016-04-01

    Urban areas are increasingly susceptible to surface water flooding, with more intense precipitation and intensification of land development. Flooding has both direct impacts i.e. locations inundated with water, and indirect impacts i.e. transport networks, utility e.g. electricity/water services etc. The direct areas flooded evolve in space through the event, and are predicted by standard inundation models. However, the wider indirect impacts and the spatial-temporal patterns are less constrained and it is these that are needed to manage the impacts in real-time. This paper focusses on the Category One responders of the Fire and Rescue and Ambulance Services in the City of Leicester, East Midlands, UK. Leicester is ranked 16th out of 4215 settlements at risk of surface water flooding in the UK based upon the population at risk (15,200 people) (DEFRA, 2009). The analysis undertaken involved overlaying the flood extent with the Integrated Transport Network (ITN) data within a GIS framework. Then a simple transport routing algorithm was used to predict the travel time from specific nodes representing ambulance or fire stations to different parts of the city. Flood magnitudes with 1:20, 1:100 and 1:1000 return periods have been investigated. Under a scenario of no flooding, 100% of the city is accessible by the six fire stations in the city. However, in the 1 in 20 year surface water flood event the peak inundation results in 66.5% being accessible in the 10 minute permitted time and 6% is totally inaccessible. This falls to 40% and 13% respectively for the 1 in 100 year event. Maps show the area of the city that are accessible by two or more stations within the permitted response time, which shows these areas are the most resilient to surface water flooding. However, it isn't just the peak water depths at every location which impacts accessibility within the city but the spatial-temporal patterns of the inundation. The areas within the 10 minute response time expand

  8. Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana

    Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Ahmed N. Zakariah; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Thomas B. Campbell

    2015-01-01

    Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana’s national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. Methods: A survey instrument was developed using Pechansky and Thomas’s model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability....

  9. Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil

    Cássio Silveira; Nivaldo Carneiro Junior; Manoel Carlos Sampaio de Almeida Ribeiro; Rita de Cássia Barradas Barata

    2013-01-01

    Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging p...

  10. Impact of Access to Online Databases on Document Delivery Services within Iranian Academic Libraries

    Zohreh Zahedi

    2007-04-01

    Full Text Available The present study investigates the impact of access to online databases on the document delivery services in Iranian Academic Libraries, within the framework of factors such as number of orders lodged over the years studied and their trends, expenditures made by each university, especially those universities and groups that had the highest number of orders. This investigation was carried out through a survey and by calling on the library document supply unit in universities as well as in-person interview with librarians in charge. The study sample was confined to the universities of Shiraz, Tehran and Tarbiyat Modaress along with their faculties. Findings indicate that the rate of document requests in various universities depends on the target audience, capabilities, students’ familiarity as well as mode of document delivery services..

  11. Dobutamine Stress Echocardiography and Tissue Synchronization Imaging

    Tas, Hakan; Gundogdu, Fuat; Gurlertop, Yekta; Karakelleoglu, Sule

    2008-01-01

    Dobutamine stress echocardiography has emerged as a reliable method for the diagnosis of coronary artery disease and the management of its treatment. Several studies have shown that that this technique works with 80–85% accuracy in comparison with other imaging methods. There are few studies aimed at developing the clinical utility of dobutamine stress echocardiography for the evaluation of normal and abnormal segments that result from dobutamine stress with Tissue Synchronization Imaging.

  12. A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

    Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

    2013-01-01

    There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics. PMID:23903937

  13. Public service or commodity goods? Electricity reforms, access, and the politics of development in Tanzania

    Ghanadan, Rebecca Hansing

    Since the 1990s, power sector reforms have become paramount in energy policy, catalyzing a debate in Africa about market-based service provision and the effects of reforms on access. My research seeks to move beyond the conceptual divide by grounding attention not in abstract 'market forces' but rather in how development institutions shape energy services and actually practice policy on the ground. Using the case of Tanzania, a country known for having instituted some of the most extensive reforms and a 'success story' in Africa, I find that reforms are creating large burdens and barriers for access and use of services, including: increasing costs, enforcement pressures, and measures to impose 'market' discipline. However, I also find that many of the most significant outcomes are not found in direct 'market' changes, but rather how reforms are selective, partial, and shaped by the wider needs and claims of the institutions driving reforms, so that questions of how reforms are implemented, how they are measured, and who tells the story become as important as the policies themselves. Using a multiple-arenas framework, including (i) a household and community level study of urban energy conditions, (ii) a study of service and management conditions at the national electric utility, (iii) an examination of the international policy process, and (iv) a study of the history of electricity services across colonial, post-independence, and reform periods, I show that African energy reforms are a technical and political project connecting energy to international investments, donor aid programs, and elite interests within national governments. Energy reforms also involve fundamental service changes that are reorganizing how the costs and benefits of energy systems are distributed, allocated, and managed. The effects of reform extend beyond formal services to have wide-reaching repercussions within natural resources, and uneven social dynamics on the ground. These features point

  14. Anemia management: development of a rapid-access anemia and intravenous iron service

    Radia D

    2013-08-01

    Full Text Available Deepti Radia,1 Ibrahim Momoh,2 Richard Dillon,1 Yvonne Francis,1 Laura Cameron,1 Toni-Lee Fagg,1 Hannah Overland,1 Susan Robinson,1 Claire N Harrison11Haematology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK; 2Bupa Home Healthcare, Harlow, UKAbstract: This article describes the initiation and evolution of the Rapid-Access Anemia Clinic (RAAC at Guy's and St Thomas' Hospitals, London, UK. This clinic was set up to provide diagnosis and treatment, and to coordinate investigative procedures, where necessary, into the underlying causes of anemia. Initially piloted with anemic preoperative orthopedic patients, the clinic now treats a wide range of conditions, deriving from both internal and external referrals. Treatment includes dietary advice, supplementation with iron, vitamin B12 and folate, and blood transfusion. Most patients at the RAAC need iron replacement, the majority of which require intravenous (IV iron. Therefore the first-line IV iron-administration protocol is carefully considered to ensure viability of the service and patient satisfaction. Four IV irons available in the UK are discussed, with explanation of the benefits and drawbacks of each product and the reasoning behind the IV iron choice at different stages of the RAAC's development. Costs to the service, affected by IV iron price and administration regimen, are considered, as well as the product's contraindications. Finally, the authors reflect on the success of the RAAC and how it has improved patients' quality-of-treatment experience, in addition to benefiting the hospital and National Health Service in achieving specific health-care mandates and directives. Drawing from the authors' experiences, recommendations are given to assist others in setting up and providing a successful rapid-access anemia service or similar facility.Keywords: hemoglobin, iron deficiency, ferric carboxymaltose, iron sucrose, iron dextran, iron isomaltoside

  15. Support networks and people with physical disabilities: social inclusion and access to health services.

    Holanda, Cristina Marques de Almeida; De Andrade, Fabienne Louise Juvêncio Paes; Bezerra, Maria Aparecida; Nascimento, João Paulo da Silva; Neves, Robson da Fonseca; Alves, Simone Bezerra; Ribeiro, Kátia Suely Queiroz Silva

    2015-01-01

    This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these individuals predominantly consist of family members (parents, siblings, children, spouses) and people outside the family (friends and neighbors). However, 50% of the interviewees declared that they could not count on any support from outside the family. It was observed that the support network contributes to access to the services and participation in social groups. However, reduced social inclusion was detected, due to locomotion difficulties, this being the main barrier to social interaction. Among those individuals who began to interact in society, the part played by social support was fundamental. PMID:25650611

  16. Support networks and people with physical disabilities: social inclusion and access to health services

    Cristina Marques de Almeida Holanda

    2015-01-01

    Full Text Available This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these individuals predominantly consist of family members (parents, siblings, children, spouses and people outside the family (friends and neighbors. However, 50% of the interviewees declared that they could not count on any support from outside the family. It was observed that the support network contributes to access to the services and participation in social groups. However, reduced social inclusion was detected, due to locomotion difficulties, this being the main barrier to social interaction. Among those individuals who began to interact in society, the part played by social support was fundamental.

  17. [The social value of teeth and access to dental health services].

    Fonseca, Luciara Leão Viana; Nehmy, Rosa Maria Quadros; Mota, Joaquim Antônio César

    2015-10-01

    Oral healthcare provided by the Unified Health System (SUS) faces the challenge of attending the epidemiological profile of Brazil's adult population. Qualitative research using semi-structured interviews was conducted to understand the experiences, expectations and perception of SUS users to services in Diamantina, State of Minas Gerais, and content analysis was used to assess the data. Discussion of the results was based on dialogue between the symbolic interactionism of Goffman and Bourdieu's concept of habitus. The results show that the users did not give importance to dental care during childhood and adolescence because care was unknown to them. There was no offer of treatment besides dental extraction. Today, they value teeth and suffer the embarrassment caused by rotten teeth. However, access to dental restoration via SUS is not possible. For their children, they perceive better access to information and care, but for specialized procedures there are barriers. They express resignation both in relation to the poor state of the teeth and the difficulties of access to dental care, which can be understood by the constant exclusion experienced by them in the past, shaping their actions in the present. It was concluded that oral health in SUS should incorporate the social value and the aesthetic dimension of teeth as a social right. PMID:26465855

  18. Access and preservation of digital research content: Linked open data services - A research library perspective

    Kraft, Angelina; Sens, Irina; Löwe, Peter; Dreyer, Britta

    2016-04-01

    Globally resolvable, persistent digital identifiers have become an essential tool to enable unambiguous links between published research results and their underlying digital resources. In addition, this unambiguous identification allows citation. In an ideal research world, any scientific content should be citable and the coherent content, as well as the citation itself, should be persistent. However, today's scientists do not just produce traditional research papers - they produce comprehensive digital collections of objects which, alongside digital texts, include digital resources such as research data, audiovisual media, digital lab journals, images, statistics and software code. Researchers start to look for services which allow management of these digital resources with minimum time investment. In light of this, we show how the German National Library of Science and Technology (TIB) develops supportive frameworks to accompany the life cycle of scientific knowledge generation and transfer. This includes technical infrastructures for • indexing, cataloguing, digital preservation, DOI names and licencing for text and digital objects (the TIB DOI registration, active since 2004) and • a digital repository for the deposition and provision of accessible, traceable and citeable research data (RADAR). One particular problem for the management of data originating from (collaborating) research infrastructures is their dynamic nature in terms of growth, access rights and quality. On a global scale, systems for access and preservation are in place for the big data domains (e.g. environmental sciences, space, climate). However, the stewardship for disciplines without a tradition of data sharing, including the fields of the so-called long tail, remains uncertain. The RADAR - Research Data Repository - project establishes a generic end-point data repository, which can be used in a collaborative way. RADAR enables clients to upload, edit, structure and describe their

  19. Management of chronic heart failure in the community: role of a hospital based open access heart failure service

    Shah, S.; Davies, M K; Cartwright, D; Nightingale, P.

    2004-01-01

    Objective: To evaluate the role of an open access heart failure service based at a teaching hospital for the diagnosis and treatment optimisation of patients with heart failure in the community and to identify measures that may further enhance the effectiveness of such a service.

  20. Understanding the Voice of the Customer: Practical, Data-Driven Planning and Decision Making for Access Services

    Huff-Eibl, Robyn; Miller-Wells, John; Begay, Wendy

    2014-01-01

    This article describes the process and role frontline access and public service staff play in needs assessment and evaluation of user services, specifically in understanding the voice of the customer. Information includes how the University of Arizona Libraries have incorporated daily data collection into the strategic planning process, resources…

  1. Access to Grey Literature in the Netherlands : Grey Literature at Data Archiving and Networked Services – DANS

    Dijk, E.M.S.; Doorn, P.K.

    2015-01-01

    Data Archiving and Networked Services (DANS) is the national Dutch organization for permanent access to research data, with a focus on the humanities and social sciences. DANS offers three services to the scholarly community: DataverseNL, EASY, and NARCIS. DataverseNL is intended to support data man

  2. Improving Access to Mental Health Services for Racialized Immigrants, Refugees, and Non-Status People Living with HIV/AIDS.

    Chen, Y Y Brandon; Li, Alan Tai; Fung, Kenneth Po; Wong, Josephine Pui

    2015-05-01

    The demographic characteristics of people living with HIV/AIDS (PHAs) in Canada are increasingly diverse. Despite literature suggesting a potentially heightened mental health burden borne by racialized immigrant, refugee, and non-status PHAs (IRN-PHAs), researchers have hitherto paid insufficient attention to whether existing services adequately address this need and how services might be improved. Employing community-based research methodology involving PHAs from five ethnoracial groups in Toronto, Ontario, this study explored IRN-PHAs' mental health service-seeking behaviors, service utilization experiences, and suggestions for service improvements. Results showed that while most IRN-PHAs were proactive in improving their mental health, their attempts to obtain support were commonly undermined by service provider mistreatment, unavailability of appropriate services, and multiple access barriers. A three-pronged approach involving IRN-PHA empowerment, anti-stigma and cultural competence promotion, and greater service integration is proposed for improving IRN-PHAs' mental health service experience. PMID:25913347

  3. Improving access to essential health care services: the case of Israel.

    van de Ven, Wynand P M M

    2016-01-01

    In a recent article in this journal Simon-Tuval, Horev and Kaplan argue that in order to improve the protection of consumers there might be a need to impose a threshold on the medical loss ratio (MLR) for voluntary health insurance (VHI) in Israel [1]. Their argument is that VHI in Israel covers several essential services that are not covered by the mandatory benefits package due to budget constraints, while there are market failures in the VHI market that justify regulation to assure consumer protection such as high accessibility to high quality coverage. In this commentary it will be argued that in addition to market failures there are also government failures. It is doubtful whether imposing a threshold on MLR is effective because of government failures. It can be even counter-productive. Therefore, alternative regulatory measures are discussed to promote the protection of the beneficiaries. If essential services covered by VHI are unaffordable for some low-income people, government can extend the current mandatory basic health insurance so that it covers all essential services. If there is a budget restriction, the amount of government funds could be increased, or the health plans could be allowed to request an additional flat rate premium, set by them and to be paid by the consumer directly to their health plan. Also, effective out-of-pocket payments could be introduced. Subsidies could be given to low-income people to compensate for their additional expenses under the mandatory health insurance. If these changes are adopted, then the government would no longer be held responsible for access to benefits outside the mandatory health insurance. Accordingly, all VHI could be sold on the normal free insurance market, just as other types of indemnity insurance. In addition, the Israeli health insurance and healthcare markets could be made more competitive by introducing procompetitive regulation. This would increase the efficiency and affordability of healthcare

  4. Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal

    Nokulunga H. Cele

    2015-07-01

    Full Text Available Background: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the study: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC services in Umlazi in the province ofKwaZulu-Natal (KZN.Method: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.Results: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.Conclusion: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

  5. Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study

    Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

    2016-01-01

    Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and

  6. Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study.

    John Kuumuori Ganle

    Full Text Available While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana.A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling's thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers' insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability.Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for

  7. GSL: An Open Source Framework for the Rapid Development of Data Archive Access Services

    McWhirter, J.; Boler, F. M.; Bock, Y.; Squibb, M. B.; Ratzesberger, L.

    2011-12-01

    The Geodetic Seamless Archive Center (GSAC) project is a NASA ROSES ACCESS funded effort with the goal to define and implement a web service API for uniform querying across multiple geodetic data repositories. The project information technology partners include two International GNSS Service (IGS) Data Centers, CDDIS and SOPAC, and a third global NSF and NASA-funded Data Center, UNAVCO. A science partner, the University of Nevada, Reno Geodetic Laboratory is utilizing the services and contributing new quality assessment products. Each of the participant data centers has its own internal database schema and various web-based access mechanisms to suit the needs of their individual user communities. The software engineering challenge that we faced was to unify these access mechanisms into a common web service API. To facilitate the development of the GSAC interfaces within these disparate repositories we have developed a Java-based open source middleware framework called the GSAC Service Layer (GSL). It was recognized early on in the project that much of the required functionality within each repository could be provided by a common software layer, thus achieving a substantial reduction in the development effort required by each partner institution. The GSL provides a range of common services for repository configuration, initialization, database management, web interface generation, and data model and metadata creation. Each repository implementation then simply focuses on the core task of responding to query requests and delivering to the GSL layer the internal results. The GSL layer is then responsible for encoding the results in the desired format. A fundamental challenge in developing a framework such as the GSL is balancing the trade-off between the agnosticism needed within the GSL so that it is applicable to a wide range of problem domains and the specific needs required for a particular repository implementations. The GSL addresses this challenge through an

  8. Access to infertility services in Canada for HIV-positive individuals and couples: a cross-sectional study

    Loutfy Mona R; Shapiro Heather M; Yudin Mark H

    2010-01-01

    Abstract Background Family and pregnancy planning issues are important among human immunodeficiency virus (HIV)-positive individuals and couples. However, access to fertility services may be limited for this population. The objective of this study was to estimate the types of services available in fertility clinics in Canada for these individuals. Methods A survey was sent to all registered fertility clinics in Canada to assess the availability of services (investigations and treatment) for i...

  9. Advancing Migrant Access to Health Services in Europe (AMASE): Protocol for a Cross-sectional Study

    Álvarez-del Arco, Débora; Monge, Susana; Copas, Andrew J; Gennotte, Anne-Francoise; Volny-Anne, Alain; Göpel, Siri; Touloumi, Giota; Prins, Maria; Barros, Henrique; Staehelin, Cornelia; del Amo, Julia; Burns, Fiona M

    2016-01-01

    Background Migrants form a substantial proportion of the population affected by the human immunodeficiency virus (HIV) epidemic in Europe, yet HIV prevention for this population is hindered by poor understanding of access to care and of postmigration transmission dynamics. Objective We present the design and methods of the advancing Migrant Access to health Services in Europe (aMASE) study, the first European cross-cultural study focused on multiple migrant populations. It aims to identify the structural, cultural, and financial barriers to HIV prevention, diagnosis, and treatment and to determine the likely country of HIV acquisition in HIV-positive migrant populations. Methods We delivered 2 cross-sectional electronic surveys across 10 countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Switzerland, and United Kingdom). A clinic survey aimed to recruit up to 2000 HIV-positive patients from 57 HIV clinics in 9 countries. A unique study number linked anonymized questionnaire data to clinical records data (viral loads, CD4 cell counts, viral clades, etc). This questionnaire was developed by expert panel consensus and cognitively tested, and a pilot study was carried out in 2 countries. A Web-based community survey (n=1000) reached those living with HIV but not currently accessing HIV clinics, as well as HIV-negative migrants. It was developed in close collaboration with a community advisory group (CAG) made up of representatives from community organizations in 9 of the participating countries. The CAG played a key role in data collection by promoting the survey to higher-risk migrant groups (sub-Saharan Africans, Latin Americans, men who have sex with men, and people who inject drugs). The questionnaires have considerable content overlap, allowing for comparison. Questions cover ethnicity, migration, immigration status, HIV testing and treatment, health-seeking behavior, sexual risk, and drug use. The electronic questionnaires

  10. A GeoServices Infrastructure for Near-Real-Time Access to Suomi NPP Satellite Data

    Evans, J. D.; Valente, E. G.; Hao, W.; Chettri, S.

    2012-12-01

    The new Suomi National Polar-orbiting Partnership (NPP) satellite extends NASA's moderate-resolution, multispectral observations with a suite of powerful imagers and sounders to support a broad array of research and applications. However, NPP data products consist of a complex set of data and metadata files in highly specialized formats; which NPP's operational ground segment delivers to users only with several hours' delay. This severely limits their use in critical applications such as weather forecasting, emergency / disaster response, search and rescue, and other activities that require near-real-time access to satellite observations. Alternative approaches, based on distributed Direct Broadcast facilities, can reduce the delay in NPP data delivery from hours to minutes, and can make products more directly usable by practitioners in the field. To assess and fulfill this potential, we are developing a suite of software that couples Direct Broadcast data feeds with a streamlined, scalable processing chain and geospatial Web services, so as to permit many more time-sensitive applications to use NPP data. The resulting geoservices infrastructure links a variety of end-user tools and applications to NPP data from different sources, and to other rapidly-changing geospatial data. By using well-known, standard software interfaces (such as OGC Web Services or OPeNDAP), this infrastructure serves a variety of end-user analysis and visualization tools, giving them access into datasets of arbitrary size and resolution and allowing them to request and receive tailored products on demand. The standards-based approach may also streamline data sharing among independent satellite receiving facilities, thus helping them to interoperate in providing frequent, composite views of continent-scale or global regions. To enable others to build similar or derived systems, the service components we are developing (based in part on the Community Satellite Processing Package (CSPP) from

  11. Future Supply and Demand for Oncologists : Challenges to Assuring Access to Oncology Services

    Erikson, Clese; Salsberg, Edward; Forte, Gaetano; Bruinooge, Suanna; Goldstein, Michael

    2007-01-01

    include any alterations based on changes in practice patterns, service use, or cancer treatments. Various alternate scenarios were also developed to show how supply and demand might change under different assumptions. Conclusions ASCO, policy makers, and the public have major challenges ahead of them to forestall likely shortages in the capacity to meet future demand for oncology services. A multifaceted strategy will be needed to ensure that Americans have access to oncology services in 2020, as no single action will fill the likely gap between supply and demand. Among the options to consider are increasing the number of oncology fellowship positions, increasing use of nonphysician clinicians, increasing the role of primary care physicians in the care of patients in remission, and redesigning service delivery. PMID:20859376

  12. Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

    Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth

    2013-03-01

    In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. PMID:23009742

  13. Data Access Tools And Services At The Goddard Distributed Active Archive Center (GDAAC)

    Pham, L. B.; Eng, E.; Sweatman, P.

    2003-12-01

    As one of the largest providers of Earth Science data from the Earth Observing System, GDAAC provides the latest data from the Moderate Resolution Imaging Spectroradiometer (MODIS), Atmospheric Infrared Sounder (AIRS), Solar Radiation and Climate Experiment (SORCE) data products via GDAAC's data pool (50TB of disk cache). In order to make this huge volume of data more accessible to the public and science communities, the GDAAC offers multiple data access tools and services: Open Source Project for Network Data Access Protocol (OPeNDAP), Grid Analysis and Display System (GrADS/DODS) (GDS), Live Access Server (LAS), OpenGIS Web Map Server (WMS) and Near Archive Data Mining (NADM). The objective is to assist users in retrieving electronically a smaller, usable portion of data for further analysis. The OPeNDAP server, formerly known as the Distributed Oceanographic Data System (DODS), allows the user to retrieve data without worrying about the data format. OPeNDAP is capable of server-side subsetting of HDF, HDF-EOS, netCDF, JGOFS, ASCII, DSP, FITS and binary data formats. The GrADS/DODS server is capable of serving the same data formats as OPeNDAP. GDS has an additional feature of server-side analysis. Users can analyze the data on the server there by decreasing the computational load on their client's system. The LAS is a flexible server that allows user to graphically visualize data on the fly, to request different file formats and to compare variables from distributed locations. Users of LAS have options to use other available graphics viewers such as IDL, Matlab or GrADS. WMS is based on the OPeNDAP for serving geospatial information. WMS supports OpenGIS protocol to provide data in GIS-friendly formats for analysis and visualization. NADM is another access to the GDAAC's data pool. NADM gives users the capability to use a browser to upload their C, FORTRAN or IDL algorithms, test the algorithms, and mine data in the data pool. With NADM, the GDAAC provides an

  14. EarthScope: Cyberinfrastructure to access Plate Boundary Observatory data products and services

    Meertens, C. M.; Mattioli, G. S.; Miller, M.; Boler, F. M.; Crosby, C. J.; Mencin, D.; Phillips, D. A.; Snett, L.

    2013-12-01

    The wealth of data from geodetic observing systems, especially the Plate Boundary Observatory (PBO), presents major data management challenges. The challenges are driven by ingenious new uses of Global Positioning System (GPS) data, demands for higher-rate, lower latency data, the need for continued access and long term preservation of archival data, the expansion of data users into other science, engineering and commercial arenas, and the growth of enhanced products that expand the utility of the data. To meet these challenges, UNAVCO has established a comprehensive suite of data services encompassing sensor network data operations, data product generation (through the activities of partners at Massachusetts Institute of Technology, Central Washington University, New Mexico Institute of Mining and Technology, and the University of California, San Diego - UCSD), data management, access and archiving, and advanced cyberinfrastructure. PBO sensor systems include 1,100 continuously operating GPS stations, 79 borehole geophysical sites (with a combination of strainmeters, tiltmeters, seismometers, pore pressure gauges, and meteorological sensors), and 6 long baseline strainmeters. Imaging data acquired for EarthScope include large volumes of satellite synthetic aperture radar (SAR) and airborne LiDAR data. Core data products such as daily GPS position time series and derived crustal motion velocities have been augmented with real-time data streams and positions calculated every second from 367 PBO stations. Higher rate (5 Hz) data files are available for applications such as GPS seismology. Efforts are underway with UCSD to integrate GPS and accelerometers at a subset of PBO sites to increase the reliability and capability of the observations. These observations have utility for research and hazards mitigation. Ingenious methods of GPS data analysis, developed by the University of Colorado and the University Corporation for Atmospheric Research, measure snow depth

  15. A Model for Remote Access and Protection of Smartphones using Short Message Service

    Kuppusamy, K S; Aghila, G; 10.5121/ijcseit.2012.2109

    2012-01-01

    The smartphone usage among people is increasing rapidly. With the phenomenal growth of smartphone use, smartphone theft is also increasing. This paper proposes a model to secure smartphones from theft as well as provides options to access a smartphone through other smartphone or a normal mobile via Short Message Service. This model provides option to track and secure the mobile by locking it. It also provides facilities to receive the incoming call and sms information to the remotely connected device and enables the remote user to control the mobile through SMS. The proposed model is validated by the prototype implementation in Android platform. Various tests are conducted in the implementation and the results are discussed.

  16. Comparison of Traditional and Open-Access Appointment Scheduling for Exponentially Distributed Service Time.

    Yan, Chongjun; Tang, Jiafu; Jiang, Bowen; Fung, Richard Y K

    2015-01-01

    This paper compares the performance measures of traditional appointment scheduling (AS) with those of an open-access appointment scheduling (OA-AS) system with exponentially distributed service time. A queueing model is formulated for the traditional AS system with no-show probability. The OA-AS models assume that all patients who call before the session begins will show up for the appointment on time. Two types of OA-AS systems are considered: with a same-session policy and with a same-or-next-session policy. Numerical results indicate that the superiority of OA-AS systems is not as obvious as those under deterministic scenarios. The same-session system has a threshold of relative waiting cost, after which the traditional system always has higher total costs, and the same-or-next-session system is always preferable, except when the no-show probability or the weight of patients' waiting is low. It is concluded that open-access policies can be viewed as alternative approaches to mitigate the negative effects of no-show patients. PMID:26753439

  17. Digital echocardiography 2002: now is the time

    Thomas, James D.; Greenberg, Neil L.; Garcia, Mario J.

    2002-01-01

    The ability to acquire echocardiographic images digitally, store and transfer these data using the DICOM standard, and routinely analyze examinations exists today and allows the implementation of a digital echocardiography laboratory. The purpose of this review article is to outline the critical components of a digital echocardiography laboratory, discuss general strategies for implementation, and put forth some of the pitfalls that we have encountered in our own implementation. The major components of the digital laboratory include (1) digital echocardiography machines with network output, (2) a switched high-speed network, (3) a high throughput server with abundant local storage, (4) a reliable low-cost archive, (5) software to manage information, and (6) support mechanisms for software and hardware. Implementation strategies can vary from a complete vendor solution providing all components (hardware, software, support), to a strategy similar to our own where standard computer and networking hardware are used with specialized software for management of image and measurement information.

  18. Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study

    McCann Terence V

    2012-08-01

    Full Text Available Abstract Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from

  19. Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

    Briggs Andrew M

    2012-10-01

    Full Text Available Abstract Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP. However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1 poor access to information and services in rural settings; 2 inadequate knowledge and skills among local practitioners; 3 feelings of isolation and frustration; 4 psychological burden associated with CLBP; and 5 competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing

  20. Conception and Implementation of an OGC-Compliant Sensor Observation Service for a Standardized Access to Raster Data

    Juergen Sorg

    2015-07-01

    Full Text Available The target of the Open Geospatial Consortium (OGC is interoperability of geographic information, which means creating opportunities to access geodata in a consistent, standardized way. In the domain of sensor data, the target will be picked up within the OGC Sensor Web Enablement Initiative and especially reached through the Sensor Observation Service (SOS standard. This one defines a service for a standardized access to time series data and is usually used for in situ sensors (like discharge gauges and climate stations. Although the standard considers raster data, no implementation of the standard for raster data exists presently. In this paper an OGC-compliant Sensor Observation Service for a standardized access to raster data is described. A data model was developed that enables effective storage of the raster data with the corresponding metadata in a database, reading this data in an efficient way, and encoding it with result formats that the SOS-standard provides.

  1. Open access to information bridges science and development in Amazonia: lessons of the SIAMAZONIA service

    Access to and availability of accurate information has often been stated to play an important role in sustainable environmental management. There is a growing trend of setting up internet-based information services to support the availability of relevant information. The current initiatives that aim to facilitate such information sharing through the web are still, however, often premature and unable to ensure constant flow of data from producers to users. We examine these common challenges by using as an example a network-based facility of biodiversity and environmental information about the Peruvian Amazon region called SIAMAZONIA. Launched in 2001, the service includes data provided by 13 different nodes. The experiences of this initiative have been both encouraging and confusing. A good professional level has been reached, but participation by large information holders is impeded. Participation is obviously considered an additional task rather than an attractive option for enhanced performance at the individual or institutional levels. This dilemma reflects a genuine problem in the modern scientific community, which still lacks agreed ways to reward those who share their data and results through the web. If these problems are solved, internet-based information sharing may become a vital resource for environmental management in Amazonia and also elsewhere

  2. Q-SOS—A Sensor Observation Service for Accessing Quality Descriptions of Environmental Data

    Anusuriya Devaraju

    2015-08-01

    Full Text Available The worldwide Sensor Web comprises observation data from diverse sources. Each data provider may process and assess datasets differently before making them available online. This information is often invisible to end users. Therefore, publishing observation data with quality descriptions is vital as it helps users to assess the suitability of data for their applications. It is also important to capture contextual information concerning data quality such as provenance to trace back incorrect data to its origins. In the Open Geospatial Consortium (OGC’s Sensor Web Enablement (SWE framework, there is no sufficiently and practically applicable approach how these aspects can be systematically represented and made accessible. This paper presents Q-SOS—an extension of the OGC’s Sensor Observation Service (SOS that supports retrieval of observation data together with quality descriptions. These descriptions are represented in an observation data model covering various aspects of data quality assessment. The service and the data model have been developed based on open standards and open source tools, and are productively being used to share observation data from the TERENO observatory infrastructure. We discuss the advantages of deploying the presented solutions from data provider and consumer viewpoints. Enhancements applied to the related open-source developments are also introduced.

  3. A Spectrum Access Based on Quality of Service (QoS) in Cognitive Radio Networks.

    Zhai, Linbo; Wang, Hua; Gao, Chuangen

    2016-01-01

    The quality of service (QoS) is important issue for cognitive radio networks. In the cognitive radio system, the licensed users, also called primary users (PUs), are authorized to utilize the wireless spectrum, while unlicensed users, also called secondary users (SUs), are not authorized to use the wireless spectrum. SUs access the wireless spectrum opportunistically when the spectrum is idle. While SUs use an idle channel, the instance that PUs come back makes SUs terminate their communications and leave the current channel. Therefore, quality of service (QoS) is difficult to be ensured for SUs. In this paper, we first propose an analysis model to obtain QoS for cognitive radio networks such as blocking probability, completed traffic and termination probability of SUs. When the primary users use the channels frequently, QoS of SUs is difficult to be ensured, especially the termination probability. Then, we propose a channel reservation scheme to improve QoS of SUs. The scheme makes the terminated SUs move to the reserved channels and keep on communications. Simulation results show that our scheme can improve QoS of SUs especially the termination probability with a little cost of blocking probability in dynamic environment. PMID:27171196

  4. Availability of supplies and motivations for accessing voluntary HIV counseling and testing services in Blantyre, Malawi

    Muula Adamson S

    2008-01-01

    Full Text Available Abstract Background HIV counseling and testing is an important intervention in the prevention, control and management of the human immunodeficiency virus (HIV. Counseling and testing can be an entry point for prevention, care and support. Knowledge of the quality of services and motivations for testing by individuals is important for effective understanding of the testing environment. Methods A cross sectional explorative study of clients accessing HIV voluntary counseling and testing (VCT and counselors was conducted in 6 government health centers in Blantyre City, Malawi. We aimed to assess the availability of critical clinic supplies and identify the motivations of clients seeking counseling and testing services. We also aimed to identify the health professional cadres that were providing VCT in Blantyre city. Results 102 VCT clients and 26 VCT counselors were interviewed. Among the VCT clients, 74% were Conclusion HIV counseling and testing facilities were available in Blantyre city in all the six public health facilities assessed. The majority of counseling and testing clients were motivated by perceptions of being at risk of HIV infection. In a country with 12% of individuals 15 to 49 years infected, there is need to encourage testing among population groups that may not perceive themselves to be at risk of infection.

  5. A Time-constrained Network Voronoi Construction and Accessibility Analysis in Location-based Service Technology

    Yu, W.; Ai, T.

    2014-11-01

    Accessibility analysis usually requires special models of spatial location analysis based on some geometric constructions, such as Voronoi diagram (abbreviated to VD). There are many achievements in classic Voronoi model research, however suffering from the following limitations for location-based services (LBS) applications. (1) It is difficult to objectively reflect the actual service areas of facilities by using traditional planar VDs, because human activities in LBS are usually constrained only to the network portion of the planar space. (2) Although some researchers have adopted network distance to construct VDs, their approaches are used in a static environment, where unrealistic measures of shortest path distance based on assumptions about constant travel speeds through the network were often used. (3) Due to the computational complexity of the shortest-path distance calculating, previous researches tend to be very time consuming, especially for large datasets and if multiple runs are required. To solve the above problems, a novel algorithm is developed in this paper. We apply network-based quadrat system and 1-D sequential expansion to find the corresponding subnetwork for each focus. The idea is inspired by the natural phenomenon that water flow extends along certain linear channels until meets others or arrives at the end of route. In order to accommodate the changes in traffic conditions, the length of network-quadrat is set upon the traffic condition of the corresponding street. The method has the advantage over Dijkstra's algorithm in that the time cost is avoided, and replaced with a linear time operation.

  6. Open access to information bridges science and development in Amazonia: lessons of the SIAMAZONIA service

    Kalliola, Risto; Toivonen, Tuuli; Miyakawa, Victor; Mavila, Manuel

    2008-07-01

    Access to and availability of accurate information has often been stated to play an important role in sustainable environmental management. There is a growing trend of setting up internet-based information services to support the availability of relevant information. The current initiatives that aim to facilitate such information sharing through the web are still, however, often premature and unable to ensure constant flow of data from producers to users. We examine these common challenges by using as an example a network-based facility of biodiversity and environmental information about the Peruvian Amazon region called SIAMAZONIA. Launched in 2001, the service includes data provided by 13 different nodes. The experiences of this initiative have been both encouraging and confusing. A good professional level has been reached, but participation by large information holders is impeded. Participation is obviously considered an additional task rather than an attractive option for enhanced performance at the individual or institutional levels. This dilemma reflects a genuine problem in the modern scientific community, which still lacks agreed ways to reward those who share their data and results through the web. If these problems are solved, internet-based information sharing may become a vital resource for environmental management in Amazonia and also elsewhere.

  7. Self-reported health status and access to health services in a sample of prisoners in Italy

    Pileggi Claudia; Nicotera Gaetano; Flotta Domenico; Nobile Carmelo GA; Angelillo Italo F

    2011-01-01

    Abstract Background Self-reported health status in underserved population of prisoners has not been extensively explored. The purposes of this cross-sectional study were to assess self-reported health, quality of life, and access to health services in a sample of male prisoners of Italy. Methods A total of 908 prisoners received a self-administered anonymous questionnaire pertaining on demographic and detention characteristics, self-reported health status and quality of life, access to health...

  8. Health status and access to health services of female prisoners in Greece: a cross-sectional survey

    Geitona, Mary; Milioni, Stella-Olga

    2016-01-01

    Background Self-reported health status of prisoners’ population and access to health services during incarceration have not been adequately explored in Greece. The purpose of this study was to assess female prisoners’ health status and access to healthcare in the Attica detention center “Korydallos”. Methods A cross-sectional survey was carried out in 2014. A semi-structured questionnaire was developed, including questions on the prisoners’ socio-demographic characteristics, self-reported hea...

  9. Illness costs to households are a key barrier to access diagnostic and treatment services for tuberculosis in Tajikistan

    Abdualimova Hanifa

    2010-12-01

    Full Text Available Abstract Background Tuberculosis (TB control is based on early detection and complete treatment of infectious cases. Consequently, it is important that TB suspects and patients can readily access medical care. This qualitative study investigated determinants of access to DOTS services as identified by patients, health providers and community members in four districts in Tajikistan. Findings Focus group discussions were conducted in order to investigate access to TB services. A conceptual framework for access to care guided the analysis. Thirteen focus group discussions involving a total of 97 informants were conducted. Content analysis of discussions and a rating to quantify the relative importance of discussed factors were carried out. The conceptual framework identifies five main components of access to which factors can be assigned: availability, adequacy, acceptability, accessibility and affordability. Financial factors were considered the most important determinants of access to diagnosis and treatment of tuberculosis. Expenditure for drugs and consultations, for transport, and for special foods as well as lost income were identified as major barriers to treatment. Stigma, doubts about curability and low perceived quality of care were not seen to be significant determinants of access to care for tuberculosis. Community members were well aware of symptoms of tuberculosis and of medical services. These findings were consistent between different respondent groups (community members, patients and providers. They were also highly consistent between the open discussion and the confidential rating. Conclusions Illness-costs to households were identified as the main barrier to tuberculosis diagnosis and treatment. To improve access and ultimately adherence to tuberculosis treatment, effective mitigation strategies, e.g. changes in case management, food contributions or financial stimuli, need to be explored and implemented.

  10. Using Public-Private Partnerships to Mitigate Disparities in Access to Genetic Services: Lessons from Wisconsin

    Senier, Laura; Kearney, Matthew; Orne, Jason

    2016-01-01

    Purpose This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin. Methodology We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design. Findings Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models. Implications Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized. Contribution There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.

  11. Access to Interpreter Services at U.S. Dental School Clinics.

    Simon, Lisa; Hum, Lauren; Nalliah, Romesh

    2016-01-01

    The number of Americans with limited English proficiency (LEP) is growing, and legal protections mandate that LEP individuals have equal access to health care services. The aim of this study was to determine the availability of interpretation services in U.S. dental school clinics and the kinds of instruction dental students are given regarding treatment of LEP patients. A survey was distributed to the academic deans of all U.S. dental schools; 35 completed the survey for a response rate of 58%. Respondents were asked to report on the number of LEP patients treated in their student clinics, the resources available to students working with LEP patients, and the extent of instruction offered. Descriptive statistics were calculated. The results indicated that the proportion of LEP patients treated at U.S. dental schools was perceived to be higher than that of the general population. The availability of interpreter services and the extent of student education about LEP individuals varied widely. Among the responding schools, the most common language spoken by LEP patients was Spanish, followed by Chinese (Mandarin and Cantonese) and Russian. Most of the responding dental schools reported offering fewer than two hours of instruction to their predoctoral students on treating LEP patients. Although almost 90% of the respondents indicated believing LEP patients received care equal in quality to that of non-LEP patients in their clinics, only 61.9% indicated that their students were adequately prepared to manage LEP patients following graduation. These findings suggest that dental schools should consider curricular innovations that will prepare students to work with LEP populations and improve the ability of LEP patients to receive care in the teaching clinic setting. PMID:26729684

  12. Echocardiography in the Era of Multimodality Cardiovascular Imaging

    Benoy Nalin Shah

    2013-01-01

    Full Text Available Echocardiography remains the most frequently performed cardiac imaging investigation and is an invaluable tool for detailed and accurate evaluation of cardiac structure and function. Echocardiography, nuclear cardiology, cardiac magnetic resonance imaging, and cardiovascular-computed tomography comprise the subspeciality of cardiovascular imaging, and these techniques are often used together for a multimodality, comprehensive assessment of a number of cardiac diseases. This paper provides the general cardiologist and physician with an overview of state-of-the-art modern echocardiography, summarising established indications as well as highlighting advances in stress echocardiography, three-dimensional echocardiography, deformation imaging, and contrast echocardiography. Strengths and limitations of echocardiography are discussed as well as the growing role of real-time three-dimensional echocardiography in the guidance of structural heart interventions in the cardiac catheter laboratory.

  13. The Design of Passive Optical Networking+Ethernet over Coaxial Cable Access Networking and Video-on-Demand Services Carrying

    Ji, Wei

    2013-07-01

    Video on demand is a very attractive service used for entertainment, education, and other purposes. The design of passive optical networking+Ethernet over coaxial cable accessing and a home gateway system is proposed. The network integrates the passive optical networking and Ethernet over coaxial cable to provide high dedicated bandwidth for the metropolitan video-on-demand services. Using digital video broadcasting, IP television protocol, unicasting, and broadcasting mechanisms maximizes the system throughput. The home gateway finishes radio frequency signal receiving and provides three kinds of interfaces for high-definition video, voice, and data, which achieves triple-play and wire/wireless access synchronously.

  14. Access to mental health and psychosocial services in Cambodia by survivors of trafficking and exploitation: a qualitative study

    Aberdein, C; Zimmerman, C.

    2015-01-01

    Background Emerging evidence indicates the extreme forms of violence and acute and longer-term mental health consequences associated with trafficking and exploitation. However, there has been little research on post-trafficking mental health and psychosocial support services for survivors. This study explored the availability and accessibility of mental health and psychosocial support services in Cambodia for women, men and children trafficked and exploited for sex or labour purposes. Methods...

  15. Urban poverty, access to basic services and public policies: a case study of the marginal suburbs of guayaquil, Ecuador.

    Bastiaenen M; Solf, J. J; Vos R

    1983-01-01

    ILO pub. Working paper on urban area poverty and essential services in marginal suburbs (slums) of Guayaquil, Ecuador - describes social implications of rural migration, obstacles to adequate housing and health services, and development of illegal squatter human settlements with no access to water supply, electricity, waste disposal or primary health care; stresses need for state aid to improve living conditions. Bibliography, diagram, questionnaire, statistical tables.

  16. Automated analysis of 3D echocardiography

    Stralen, Marijn van

    2009-01-01

    In this thesis we aim at automating the analysis of 3D echocardiography, mainly targeting the functional analysis of the left ventricle. Manual analysis of these data is cumbersome, time-consuming and is associated with inter-observer and inter-institutional variability. Methods for reconstruction o

  17. Dynamic 3D echocardiography in virtual reality.

    A.E. van den Bosch (Annemien); A.H.J. Koning (Anton); F.J. Meijboom (Folkert); J.S. McGhie (Jackie); M.L. Simoons (Maarten); P.J. van der Spek (Peter); A.J.J.C. Bogers (Ad)

    2005-01-01

    textabstractBACKGROUND: This pilot study was performed to evaluate whether virtual reality is applicable for three-dimensional echocardiography and if three-dimensional echocardiographic 'holograms' have the potential to become a clinically useful tool. METHODS: Three-dimensional echocardiographic d

  18. Strain Echocardiography in Acute Cardiovascular Diseases.

    Favot, Mark; Courage, Cheryl; Ehrman, Robert; Khait, Lyudmila; Levy, Phillip

    2016-01-01

    Echocardiography has become a critical tool in the evaluation of patients presenting to the emergency department (ED) with acute cardiovascular diseases and undifferentiated cardiopulmonary symptoms. New technological advances allow clinicians to accurately measure left ventricular (LV) strain, a superior marker of LV systolic function compared to traditional measures such as ejection fraction, but most emergency physicians (EPs) are unfamiliar with this method of echocardiographic assessment. This article discusses the application of LV longitudinal strain in the ED and reviews how it has been used in various disease states including acute heart failure, acute coronary syndromes (ACS) and pulmonary embolism. It is important for EPs to understand the utility of technological and software advances in ultrasound and how new methods can build on traditional two-dimensional and Doppler techniques of standard echocardiography. The next step in competency development for EP-performed focused echocardiography is to adopt novel approaches such as strain using speckle-tracking software in the management of patients with acute cardiovascular disease. With the advent of speckle tracking, strain image acquisition and interpretation has become semi-automated making it something that could be routinely added to the sonographic evaluation of patients presenting to the ED with cardiovascular disease. Once strain imaging is adopted by skilled EPs, focused echocardiography can be expanded and more direct, phenotype-driven care may be achievable for ED patients with a variety of conditions including heart failure, ACS and shock. PMID:26823931

  19. Scaling-up of Energy Services Access in East Africa to achieve the Millennium Development Goals

    Arvidson, Anders; Nordstroem, Mattias; Forslund, Helena; Syngellakis, Katerina; Marcel, Jean-Christian; Woodsworth, Gregory; Songela, Francis; Sawe, Estomih; Ngigi, Ashington; Macharia, Daniel; Ngoye, Elizabeth

    2006-06-15

    From the 13th to the 15th March 2006, the ENABLE team together with UNDP facilitated a three day consultative workshop hosted by the East African Community. The principal objective of this workshop was to facilitate the design of a regional energy access workplan and accompanying investment programmes to support the achievement of the millennium development goals. The workshop brought together almost 50 stakeholders from the East African region, representing various sectors (health, education, water, agriculture, environment, finance, etc.), organisations (public, private and NGOs) and donors, with the objective to identify and recommend actions that need to be undertaken in East Africa at regional, national and local levels in order to achieve the EAC Regional Energy Access Scale-up targets endorsed by the Ministers of Energy of Kenya, Tanzania and Uganda in August 2005. In order to generate new and substantive information during the three days, a highly interactive and participatory approach was used, where participants worked intensively in small groups with a set of questions which examined the issues and actions needed to achieve the four EAC Regional Energy Access Scale-up targets, as listed below: Target 1: Enable the use of modern fuels for 50% of those who at present use traditional biomass for cooking. Support efforts to develop and adopt the use of improved cook stoves, means to reduce indoor air pollution, and measures to increase sustainable biomass production. Target 2: Access to reliable modern energy services for all urban and peri-urban poor. Target 3: Electricity for services such as lighting, refrigeration, information and communication technology, and water treatment and supply for schools, clinics, hospitals and community centres. Target 4: Access to mechanical power within the community for all communities for productive uses. The main output from the workshop was a set of interventions for each of the energy access scale-up targets

  20. Data Services and Transnational Access for European Geosciences Multi-Scale Laboratories

    Funiciello, Francesca; Rosenau, Matthias; Sagnotti, Leonardo; Scarlato, Piergiorgio; Tesei, Telemaco; Trippanera, Daniele; Spires, Chris; Drury, Martyn; Kan-Parker, Mirjam; Lange, Otto; Willingshofer, Ernst

    2016-04-01

    The EC policy for research in the new millennium supports the development of european-scale research infrastructures. In this perspective, the existing research infrastructures are going to be integrated with the objective to increase their accessibility and to enhance the usability of their multidisciplinary data. Building up integrating Earth Sciences infrastructures in Europe is the mission of the Implementation Phase (IP) of the European Plate Observing System (EPOS) project (2015-2019). The integration of european multiscale laboratories - analytical, experimental petrology and volcanology, magnetic and analogue laboratories - plays a key role in this context and represents a specific task of EPOS IP. In the frame of the WP16 of EPOS IP working package 16, European geosciences multiscale laboratories aims to be linked, merging local infrastructures into a coherent and collaborative network. In particular, the EPOS IP WP16-task 4 "Data services" aims at standardize data and data products, already existing and newly produced by the participating laboratories, and made them available through a new digital platform. The following data and repositories have been selected for the purpose: 1) analytical and properties data a) on volcanic ash from explosive eruptions, of interest to the aviation industry, meteorological and government institutes, b) on magmas in the context of eruption and lava flow hazard evaluation, and c) on rock systems of key importance in mineral exploration and mining operations; 2) experimental data describing: a) rock and fault properties of importance for modelling and forecasting natural and induced subsidence, seismicity and associated hazards, b) rock and fault properties relevant for modelling the containment capacity of rock systems for CO2, energy sources and wastes, c) crustal and upper mantle rheology as needed for modelling sedimentary basin formation and crustal stress distributions, d) the composition, porosity, permeability, and

  1. Dobutamine stress echocardiography: a review and update

    Gilstrap LG

    2014-04-01

    Full Text Available Lauren Gray Gilstrap,1 R Sacha Bhatia,2 Rory B Weiner,3 David M Dudzinski3 1Division of Cardiology, Brigham and Women's Hospital, Boston, MA, USA; 2Institute for Health Systems Solutions, Women's College Hospital, Toronto, ON, Canada; 3Cardiology Division, Massachusetts General Hospital, Boston, MA, USA Abstract: Stress echocardiography is a noninvasive cardiovascular diagnostic test that provides functional and hemodynamic information in the assessment of a number of cardiac diseases. Performing stress echocardiography with a pharmacologic agent such as dobutamine allows for simulation of increased heart rate and increased myocardial physiologic demands in patients who may be unable to exercise due to musculoskeletal or pulmonary comorbidities. Dobutamine stress echocardiography (DSE, like exercise echocardiography, has found its primary application in ischemic heart disease, with roles in identification of obstructive epicardial coronary artery disease, detection of viable myocardium, and assessment of the efficacy of anti-ischemic medical therapy in patients with known coronary artery disease. DSE features prominently in the evaluation and management of valvular heart disease by helping to assess the effects of mitral and aortic stenoses, as well as a specific use in differentiating true severe valvular aortic stenosis from pseudostenosis that may occur in the setting of left ventricular systolic dysfunction. DSE is generally well tolerated, and its side effects and contraindications generally relate to consequences of excess inotropic and/or chronotropic stimulation of the heart. The aim of this paper is to review the indications, contraindications, advantages, disadvantages, and risks of DSE. Keywords: stress echocardiography, dobutamine, coronary artery disease, myocardial ischemia

  2. HIV-TB co-infection in children: associated factors and access to HIV services in Lagos, Nigeria

    Daniel, O. J.; Adejumo, O. A.; Gidado, M.; Abdur-Razzaq, H. A.; Jaiyesimi, E. O.

    2015-01-01

    Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading causes of death from infectious disease worldwide. The World Health Organization estimates that the prevalence of HIV among children with TB in moderate to high prevalence countries ranges between 10% and 60%. This study aimed to determine the access to HIV services of HIV-TB co-infected children.

  3. Neighbourhood Deprivation, Health Inequalities and Service Access by Adults with Intellectual Disabilities: A Cross-Sectional Study

    Cooper, S. A.; McConnachie, A.; Allan, L. M.; Melville, C.; Smiley, E.; Morrison, J.

    2011-01-01

    Background: Adults with intellectual disabilities (IDs) experience health inequalities and are more likely to live in deprived areas. The aim of this study was to determine whether the extent of deprivation of the area a person lives in affects their access to services, hence contributing to health inequalities. Method: A cross-sectional study…

  4. Massive Access Control Aided by Knowledge-Extraction for Co-Existing Periodic and Random Services over Wireless Clinical Networks.

    Du, Qinghe; Zhao, Weidong; Li, Weimin; Zhang, Xuelin; Sun, Bo; Song, Houbing; Ren, Pinyi; Sun, Li; Wang, Yichen

    2016-07-01

    The prosperity of e-health is boosted by fast development of medical devices with wireless communications capability such as wearable devices, tiny sensors, monitoring equipments, etc., which are randomly distributed in clinic environments. The drastically-increasing population of such devices imposes new challenges on the limited wireless resources. To relieve this problem, key knowledge needs to be extracted from massive connection attempts dispersed in the air towards efficient access control. In this paper, a hybrid periodic-random massive access (HPRMA) scheme for wireless clinical networks employing ultra-narrow band (UNB) techniques is proposed. In particular, the proposed scheme towards accommodating a large population of devices include the following new features. On one hand, it can dynamically adjust the resource allocated for coexisting periodic and random services based on the traffic load learned from signal collision status. On the other hand, the resource allocation within periodic services is thoroughly designed to simultaneously align with the timing requests of differentiated services. Abundant simulation results are also presented to demonstrate the superiority of the proposed HPRMA scheme over baseline schemes including time-division multiple access (TDMA) and random access approach, in terms of channel utilization efficiency, packet drop ratio, etc., for the support of massive devices' services. PMID:27240842

  5. Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil

    Cássio Silveira

    2013-10-01

    Full Text Available Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious, and the supply of health services from the public primary care system.

  6. Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil.

    Silveira, Cássio; Carneiro Junior, Nivaldo; Ribeiro, Manoel Carlos Sampaio de Almeida; Barata, Rita de Cássia Barradas

    2013-10-01

    Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system. PMID:24127096

  7. Output-Based Aid in the Philippines : Improved Access to Water Services for Poor Households in Metro Manila

    Menzies, Iain; Suardi, Mario

    2009-01-01

    This project aims to provide access to water services through individual household connections to several low-income communities in Rizal province (Antipolo City, Baras, Rodriguez, and San Mateo) and Taguig city in the Manila Metropolitan region through collaboration with the concessionaire for Manila's east zone, the Manila Water Company (MWC). The GPOBA intervention supports Manila Water...

  8. Accessibility to health services in the prison population in Colombia: a public health challenge

    Luz Mery Mejía O

    2010-08-01

    Full Text Available This article is the result of a product of a study elaborated with the aim of systematizing the available information related to the accessibility to the health services of the prison population in the penitentiary centers. To this end, we reviewed the literature and systematic collection of the academic available material in the principal university libraries in the city of Medellin, scientific databases and the web pages of national and international organizations that have dealt with this topic. The information was systematized considering some historical references to prisons and health, the record of experiences in some countries and the current regulations for health care in the prison population in the Colombian case. We conclude that although significant progress has been made to ensure health care for the prison population, in the prison there are still obstacles and limitations that infringe the right to health of this population. Likewise, it is evidenced that it has not been considered a public health problem in the country, which it is considered a challenge to incorporate it as such.

  9. Enabling Access to Welfare Services - the Place of Social Solidarity and Dialogue

    2007-08-01

    Full Text Available The welfare state in the UK presents immigrant communities with a set of institutions, which are potentially new and unknown. What is the best way to ensure that the questions of access to the welfare institutions are best managed? Trusting, understanding and feeling solidarity with the welfare state will obviously help with this problem. In order to shed light on this phenomenon, this paper presents a qualitative exploratory study dealing with elements of solidarity as perceived by members of the South Asian Community in the UK. Six indepth interviews with South Asian first generation immigrants who had never experienced mental health problems were conducted. They were asked questions about who their support networks would be in the event of them experiencing mental health problems. The thematic analysis of the interviews suggests that the respondents believed that solidarity and support ties are found to be present in families, within the south Asian community and also with welfare institutions. It is concluded that there although things are far from perfect, assimilation and integration based on dialogue is an observable positive aspect of mental health service provision in the UK.

  10. The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

    Elsje Scheffler

    2015-02-01

    Full Text Available Background: Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups.Objectives: The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa.Methods: A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis.Results: Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the DistrictHealth System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services.Conclusion: Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services and demand (user needs and promote universal and equitable access.

  11. Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

    Agha, Sohail; Gage, Anastasia; Balal, Asma

    2007-05-01

    With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to

  12. Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes

    Nonhlanhla Nxumalo

    2013-01-01

    Full Text Available Introduction: In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO, a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods: The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results: The local satellite (of a national NGO, successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion: Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures.

  13. Ethnic minority, young onset, rare dementia type, depression: A case study of a Muslim male accessing UK dementia health and social care services.

    Regan, Jemma L

    2016-07-01

    A case study comprised of formal interviews, formal observations and informal discussions investigated the motivations and experiences accessing dementia care health and social care services for a Muslim, Pakistani male with dementia. Motivations derived from 'desperation' and an inability to access support from family or religious community. Experiences of accessing services were mostly negative. Dementia services were ill-informed about how to support persons with young onset dementia, with pre-existing mental health conditions, from an ethnic minority. Education and training to remove barriers to all dementia care services is required for persons with dementia, their families and within dementia services and religious communities. PMID:24858552

  14. Open Access Complements Interlibrary Loan Services, but Additional User Education is

    Richard Hayman

    2016-03-01

    Full Text Available Objective – To examine interlibrary loan (ILL request rates for open access (OA materials and determine how OA may affect resource sharing. This research updates the author’s previous study. Design – Quantitative analysis. Setting – A large, urban, public research university library system in the United States of America. Subjects – 1,557 open access ILL material requests among 23,531 total ILL requests submitted during the 2012 and 2013 fiscal years (July 2011-June 2013. Methods – The library has tracked and recorded OA requests that appear among ILL material requests since 2009. Using OCLC’s ILLiad software to manage ILL requests, they have implemented two custom routines. One routine is for open access searching on standard items, and uses software plugins to search across various open resources. All materials published prior to 1923 are treated as being in the public domain, so requests for these materials are automatically routed to this queue. The second custom routine is used for searching for OA electronic theses and dissertations, and is employed when the requested resource is not found in the library’s subscription resources. Other article requests are routed to the RapidILL service for open access availability. Main Results – The research presented reveals that ILL requests for OA materials exhibited a steady increase year over year, while overall ILL requests decreased slightly. This finding is true both for the fiscal years reported in this study and also the years since the author’s original study in 2011 (Baich, 2012. Of the 1,557 OA requests examined, 72% (n=1,135 were for journal articles, 8% (n=125 were for books or book chapters, 9% (n=140 were for theses or dissertations, 3% (n=54 were for conference papers, and 7% (n=105 were for reports. Library staff typically fill these article requests using gold OA or green OA sources. The researcher notes the difficulty in refining by source, though confirmed that

  15. Accessing community health services: challenges faced by poor people with disabilities in a rural community in South Africa

    Lisbet Grut

    2012-05-01

    Full Text Available Poor people with disabilities who live in poor rural societies experience unique problems in accessing health services. Their situation is influenced by multiple factors which unfold and interplay throughout the person’s life course. The difficulties do not only affect the person with a disability and his or her family, but also impact on the relevant care unit. The barriers are rooted in a life in poverty, upheld and maintained by poverty-reinforcing social forces of the past and the present, and reinforced by the lack of the person’s perspective of the health services. This article explores how difficulties may interact and influence access to and utilisation of health services, and how this may render health services out of reach even when they are available. The study reveals that non-compliance is not necessarily about neglect but could as well be a matter of lived poverty. The study was based on in-depth interviews with people with disabilities and family members, and semi-structured interviews with health personnel. The data analysis is contextual and interpretive. When offering health services to people with disabilities living in resource-poor settings, services should take into consideration the person’s history, the needs, and the resources and abilities of the family group. Rethinking access to health services should transcend a narrow medical institutionalization of health professional’s training, and include a patient’s perspective and a social vision in understanding and practice. Such rethinking requires health service models that integrate the skills of health professionals with the skills of disabled people and their family members. Such skills lie dormant at community level, and need to be recognized and utilized.

  16. Gender-Related Barriers and Delays in Accessing Tuberculosis Diagnostic and Treatment Services: A Systematic Review of Qualitative Studies

    Lakshmi Krishnan

    2014-01-01

    Full Text Available Background. Tuberculosis (TB remains a significant global public health problem with known gender-related (male versus female disparities. We reviewed the qualitative evidence (written/spoken narrative for gender-related differences limiting TB service access from symptom onset to treatment initiation. Methods. Following a systematic process, we searched 12 electronic databases, included qualitative studies that assessed gender differences in accessing TB diagnostic and treatment services, abstracted data, and assessed study validity. Using a modified “inductive coding” system, we synthesized emergent themes within defined barriers and delays limiting access at the individual and provider/system levels and examined gender-related differences. Results. Among 13,448 studies, 28 studies were included. All were conducted in developing countries and assessed individual-level barriers; 11 (39% assessed provider/system-level barriers, 18 (64% surveyed persons with suspected or diagnosed TB, and 7 (25% exclusively surveyed randomly sampled community members or health care workers. Each barrier affected both genders but had gender-variable nature and impact reflecting sociodemographic themes. Women experienced financial and physical dependence, lower general literacy, and household stigma, whereas men faced work-related financial and physical barriers and community-based stigma. Conclusions. In developing countries, barriers limiting access to TB care have context-specific gender-related differences that can inform integrated interventions to optimize TB services.

  17. eTriage--a novel, web-based triage and booking service: enabling timely access to sexual health clinics.

    Jones, R; Menon-Johansson, A; Waters, A M; Sullivan, A K

    2010-01-01

    In recent years, the sexual health of the nation has risen in profile. We face increasing demands and targets, in particular the 48-hour waiting time directive, and as a result clinic access has become a priority. eTriage is a novel, secure, web-based service designed specifically to increase access to our clinics. It has proved a popular booking method, providing access to 10% of all appointments across the Directorate within six months of introduction. KC60 analyses revealed that the majority of users (58%) underwent asymptomatic screening with the remainder having some degree of pathology. There was a greater percentage prevalence of human papilloma virus, chlamydia, non-specific urethritis, gonorrhoea, herpes and trichomonas in the eTriage population when compared with the general clinic population. A notes review illustrated a high degree of concordance between data entered on eTriage registration and clinical review (97%). A patient survey revealed high levels of patient satisfaction with the service. As an adjunct to our existing booking services, eTriage has served to increase patient choice and has proved itself to be a safe, efficient and effective means of improving patient access. PMID:19884355

  18. Three dimensional echocardiography in congenital heart defects

    Shirali Girish

    2008-01-01

    Full Text Available Three dimensional echocardiography (3DE is a new, rapidly evolving modality for cardiac imaging. Important technological advances have heralded an era where practical 3DE scanning is becoming a mainstream modality. We review the modes of 3DE that can be used. The literature has been reviewed for articles that examine the applicability of 3DE to congenital heart defects to visualize anatomy in a spectrum of defects ranging from atrioventricular septal defects to mitral valve abnormalities and Ebstein′s anomaly. The use of 3DE color flow to obtain echocardiographic angiograms is illustrated. The state of the science in quantitating right and left ventricular volumetrics is reviewed. Examples of novel applications including 3DE transesophageal echocardiography and image-guided interventions are provided. We also list the limitations of the technique, and discuss potential future developments in the field.

  19. Role of echocardiography in patients with stroke.

    Nakanishi, Koki; Homma, Shunichi

    2016-08-01

    Investigation of potential embolic source is an important diagnostic step in treating patients with ischemic stroke and transient ischemic attack. Cardiogenic embolism has been estimated to be the causative factor in 15-30% of all cases of ischemic stroke. Cardioembolic strokes are generally severe and recurrence and mortality rate high. Various cardiac disorders including atrial fibrillation, ventricular thrombus, valvular heart disease, cardiac tumors, and structural heart defects can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually considered under source of cardiac embolism (cardioaortic source) and is reviewed in this article. Echocardiography (both transthoracic and transesophageal) is a widely used and versatile technique that can provide comprehensive information of thromboembolic risk in patients with stroke. This article reviews potential cardiac sources of stroke and discusses the role of echocardiography in clinical practice. PMID:27256218

  20. Low-cost MCM-D fabrication and assembly from MIDAS: the multichip module interconnect designer's access service

    Peltier, Jennifer; Hansford, Wes

    1997-06-01

    The MCM Designers' Access Service (MIDAS) allows designers to obtain prototype and small quantities of MCMs. To date the service has processed designs from industry, government and major universities. The service currently accesses processes at the following MCM-D foundries: nChip/Flextronics in San Jose, CA; Micromodule Systems in Cupertino, CA; and IBM Microelectronics in Hopewell Junction, NY. MIDAS provides a low cost service achieved through a multiproject environment where the customers share tooling and substrate manufacturing costs. The service offers design support, distributes foundry design kits, groups the projects onto regularly scheduled runs, places orders and supplies fully assembled modules. As well, MIDAS offers a limited selection of open tooled, second-level packages, bare tested die, and test sockets to aid with the design process. Often when investigating implementation of MCMs into a working system designers need a prototype. In many cases a foundry prefers to handle only high volume orders or imposes minimum purchase quantities. These may likely exceed the entire project budget. MIDAS functions as a technology enabler by supplying the designers with an interface `transparent' to the fabricator and common to multiple vendors. Foundries prefer to work with a single source who coordinates the details of multiple orders to spare valuable overhead. By completing front-end foundry tasks such as data preparation and mask fabrication and by grouping multiple users together on a run, MIDAS serves this purpose. Certain design conditions such as footprint size and I/O ring, layer stacking and number of layers exist to establish uniformity amongst the unrelated customers. This paper discusses the history of the service, the operating guidelines and presents an overview of how to access the service for MCM fabrication.

  1. Unofficial policy: access to housing, housing information and social services among homeless drug users in Hartford, Connecticut

    Corbett A Michelle

    2007-03-01

    Full Text Available Abstract Background Much research has shown that the homeless have higher rates of substance abuse problems than housed populations and that substance abuse increases individuals' vulnerability to homelessness. However, the effects of housing policies on drug users' access to housing have been understudied to date. This paper will look at the "unofficial" housing policies that affect drug users' access to housing. Methods Qualitative interviews were conducted with 65 active users of heroin and cocaine at baseline, 3 and 6 months. Participants were purposively sampled to reflect a variety of housing statuses including homeless on the streets, in shelters, "doubled-up" with family or friends, or permanently housed in subsidized, unsubsidized or supportive housing. Key informant interviews and two focus group interviews were conducted with 15 housing caseworkers. Data were analyzed to explore the processes by which drug users receive information about different housing subsidies and welfare benefits, and their experiences in applying for these. Results A number of unofficial policy mechanisms limit drug users' access to housing, information and services, including limited outreach to non-shelter using homeless regarding housing programs, service provider priorities, and service provider discretion in processing applications and providing services. Conclusion Unofficial policy, i.e. the mechanisms used by caseworkers to ration scarce housing resources, is as important as official housing policies in limiting drug users' access to housing. Drug users' descriptions of their experiences working with caseworkers to obtain permanent, affordable housing, provide insights as to how access to supportive and subsidized housing can be improved for this population.

  2. Modern echocardiography in pediatric right heart assessment

    Kutty, S.

    2016-01-01

    Right heart function is a key determinant of clinical status, prognosis and outcome in a variety of heart diseases, particularly in patients with congenital heart disease. Various non-invasive imaging tools have been used to assess right heart function in the setting of adult heart disease; however there has been little exploration of those modalities in younger patients. Newer imaging techniques, including tissue Doppler imaging, three-dimensional echocardiography and deformation imaging hav...

  3. Echocardiography and genetic counselling in tuberous sclerosis.

    Webb, D W; Thomas, R D; Osborne, J P

    1992-01-01

    OBJECTIVE--To assess echocardiography as an investigation for the detection of occult gene carriers in tuberous sclerosis. PATIENTS--Sixty parents of children with tuberous sclerosis who had been extensively investigated for signs of the disease and 60 age and sex matched controls. PROCEDURE--Blind study by two experienced echocardiographers and blind interpretation of video recordings by an adult cardiologist. SETTING--Cardiology department of a district general hospital. RESULTS--Two parent...

  4. "It is an Issue of not Knowing Where to Go": Service Providers' Perspectives on Challenges in Accessing Social Support and Services by Immigrant Mothers of Children with Disabilities.

    Khanlou, Nazilla; Haque, Nasim; Sheehan, Sinead; Jones, Gail

    2015-12-01

    In Canada little is known about the challenges immigrant mothers of children with disabilities encounter in accessing formal and informal social support. This paper presents the perspectives of service providers on the mothers' challenges. Data was collected from 27 service providers in Toronto, Canada in 2012 through in-depth interviews. The interview guide was informed by published literature on families of children with special needs. Level one analyses entailed descriptive analyses; and level two consisted of applying House's 4 domains of social support to organize the themes. Following House's domains, challenges to (1) Structural support, (2) Instrumental support, (3) Emotional support, and (4) Perception of support were identified. Among providers who work with families of children with disabilities there is recognition of the mothers' particular challenges in light of their immigration status. Language and communication are significant barriers for immigrant mothers in accessing social support. PMID:25376126

  5. Rurality and Race: Inequities in Access to Five Types of Healthcare Services

    Caldwell, Julia

    2015-01-01

    Background. Rurality may influence racial/ethnic disparities in access to healthcare. This study sought to: (1) compare and contrast measures used to assess rurality and urbanicity; (2) determine if racial/ethnic disparities in access to healthcare differ for rural vs. urban areas; and, (3) determine if residential segregation and access to healthcare differ for rural vs. urban areas.Sample. The sample was adult respondents to the 2005-2010 Medical Expenditure Panel Survey (MEPS), a nationall...

  6. THE PRESENT AND THE IMPORTANCE OF SOCIAL ECONOMY IN ENSURING THE EQUITY OF THE ACCESS TO HEALTH SERVICES

    Adina Rebeleanu

    2013-02-01

    Full Text Available It is recognized and accepted that social economy has a significant contribution within the area of social inclusion policies. The intervention areas regarded are extremely diverse: professional education and training, employment policies, social and socio‐medical services, social insurances, the banking and cultural environment,leisure activities, proximity services designed for the population with social exclusion risk etc. This study focuses on some of the ways where social economy mechanisms could be introduced in the field of health protection from Romania.Accepting and recognizing the utility of the mutual insurance type structures is desirable for the increase of the preconditions of a real equity within the access tothe health care services, including the vulnerable groups, without endangering social solidarity, focusing on the service needs and guaranteeing the active participation to the formation and management of the funds thus created.

  7. Access to Basic HIV-Related Services and PrEP Acceptability among Men Who Have sex with Men Worldwide: Barriers, Facilitators, and Implications for Combination Prevention

    George Ayala

    2013-01-01

    Full Text Available Introduction. Men who have sex with men (MSM are disproportionately impacted by HIV globally. Easily accessible combination HIV prevention strategies, tailored to the needs of MSM, are needed to effectively address the AIDS pandemic. Methods and Materials. We conducted a cross-sectional study among MSM (n=3748 from 145 countries from April to August 2012. Using multivariable random effects models, we examined factors associated with acceptability of preexposure prophylaxis (PrEP and access to condoms, lubricants, HIV testing, and HIV treatment. Results. Condoms and lubricants were accessible to 35% and 22% of all respondents, respectively. HIV testing was accessible to 35% of HIV-negative respondents. Forty-three percent of all HIV-positive respondents reported that antiretroviral therapy was easily accessible. Homophobia, outness, and service provider stigma were significantly associated with reduced access to services. Conversely, community engagement, connection to gay community, and comfort with service providers were associated with increased access. PrEP acceptability was associated with lower PrEP-related stigma, less knowledge about PrEP, less outness, higher service provider stigma, and having experienced violence for being MSM. Conclusions. Ensuring HIV service access among MSM will be critical in maximizing the potential effectiveness of combination approaches, especially given the interdependence of both basic and newer interventions like PrEP. Barriers and facilitators of HIV service access for MSM should be better understood and addressed.

  8. Enhancing Access to Electricity for Clean and Efficient Energy Services in Africa

    Christensen, John M.; Mackenzie, Gordon A.; Nygaard, Ivan;

    This report examines key issues related to electricity access in Africa, through the lens of selected case studies of countries that have successfully managed to increase access significantly in a short period of time, backed up with more general regional analysis. On the basis of this overview a...

  9. Availability and Accessibility of Student-Specific Weight Loss Programs and Other Risk Prevention Health Services on College Campuses

    Hayes, Sharon; Napolitano, Melissa; Hufnagel, Katrina

    2016-01-01

    Background More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown. Objective The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment. Methods The 10 public universities with the largest student bodies with a mean (SD) undergraduate enrollment of 41,122 (7657) students were examined. The websites of the universities were assessed to determine the availability of weight loss programs. Services for high-risk health needs common to university campuses (ie, alcohol and other drugs, victim services, sexual health, and eating disorders) were searched. Results Of the universities searched, 3 (30%, 3/10) offered weight loss programming, however, none met the predetermined criteria. Comparatively, all schools (100%, 10/10) offered no-cost and continual enrollment programming for the other high-risk health needs. Conclusions There are limited weight loss services available to undergraduate students compared with other university services. Collaboration between existing college health service providers is suggested for the delivery of appropriate programming for overweight and obese undergraduates wanting to lose weight. PMID:27278261

  10. Multi-service small-cell cloud wired/wireless access network based on tunable optical frequency comb

    Xiang, Yu; Zhou, Kun; Yang, Liu; Pan, Lei; Liao, Zhen-wan; Zhang, Qiang

    2015-11-01

    In this paper, we demonstrate a novel multi-service wired/wireless integrated access architecture of cloud radio access network (C-RAN) based on radio-over-fiber passive optical network (RoF-PON) system, which utilizes scalable multiple- frequency millimeter-wave (MF-MMW) generation based on tunable optical frequency comb (TOFC). In the baseband unit (BBU) pool, the generated optical comb lines are modulated into wired, RoF and WiFi/WiMAX signals, respectively. The multi-frequency RoF signals are generated by beating the optical comb line pairs in the small cell. The WiFi/WiMAX signals are demodulated after passing through the band pass filter (BPF) and band stop filter (BSF), respectively, whereas the wired signal can be received directly. The feasibility and scalability of the proposed multi-service wired/wireless integrated C-RAN are confirmed by the simulations.

  11. Concepts, reflections and applications of social equity: approaches to accessibility to primary goods and services in the region of Flanders, Belgium

    Fransen, Koos; Deruyter, Greet; De Maeyer, Philippe

    2015-01-01

    Mobility presents a variety of opportunities as it allows users to access locations and services, and to meet people beyond their immediate surroundings. While the concept of mobility primarily focuses on the ease of moving, accessibility delineates the actual potential to participate in out-of-home activities. As a result, accessibility is a complex concept with a multitude of foci. This complexity is presented in the first section, which explains the general concept of accessibility, how it...

  12. The Charité Grid Portal: User-friendly and secure access to Grid-based resources and services

    Wu, J.; Siewert, R; Hoheisel, A.; Falkner, J.; Strauss, O.; Berberovic, D.; Krefting, D

    2012-01-01

    The Charit, Grid Portal combines portal components from different groups and projects to provide domain researchers a gateway to Grid-based biomedical applications. Trusted users can securely access and employ Grid resources and services. In this paper, five portal components are presented: (1) The credential management administrates the user-credentials and authenticates them to the Grid. (2) The brain imaging data analysis (FSL) submits workflows to the Grid as part of Medical Image process...

  13. Neighborhood Alcohol Outlet Density and Rates of Child Abuse and Neglect: Moderating Effects of Access to Substance Abuse Services

    Morton, Cory M.; Simmel, Cassandra; Peterson, N Andrew

    2014-01-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized...

  14. Stigma as experienced by women accessing prevention of parent to child transmission of HIV services in Karnataka, India

    Rahangdale, Lisa; Banandur, Pradeep; Sreenivas, Amita; Turan, Janet; Washington, Reynold; Cohen, Craig R.

    2010-01-01

    In Karnataka, India only one-third of HIV-infected pregnant women received antiretroviral prophylaxis at delivery in 2007 through the state government’s prevention of parent-to-child HIV transmission (PPTCT) program. The current qualitative study explored the role of HIV-associated stigma as a barrier to accessing PPTCT services in the rural northern Karnataka district of Bagalkot using in depth interviews and focus group discussions with HIV-infected women who had participated in the PPTCT p...

  15. Scaling Up Access to Electricity : Pay-as-You-Go Plans in Off-Grid Energy Services

    Moreno, Alejandro; Bareisaite, Asta

    2015-01-01

    Although the payment models offered by off-grid energy companies are less flexible than those implemented with great success by mobile telephone companies, they may still have an important role to play in scaling up off-grid energy services for billions of people who lack access to electricity. More research is needed to assess the importance of flexible payments in attracting reliable low...

  16. Demand for and Accessibility to Reproductive Health Service of Urban Floating Population

    2005-01-01

    The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.

  17. Health systems and access to antiretroviral drugs for HIV in Southern Africa: service delivery and human resources challenges.

    Schneider, Helen; Blaauw, Duane; Gilson, Lucy; Chabikuli, Nzapfurundi; Goudge, Jane

    2006-05-01

    Without strengthened health systems, significant access to antiretroviral (ARV) therapy in many developing countries is unlikely to be achieved. This paper reflects on systemic challenges to scaling up ARV access in countries with both massive epidemics and weak health systems. It draws on the authors' experience in southern Africa and the World Health Organization's framework on health system performance. Whilst acknowledging the still significant gap in financing, the paper focuses on the challenges of reorienting service delivery towards chronic disease care and the human resource crisis in health systems. Inadequate supply, poor distribution, low remuneration and accelerated migration of skilled health workers are increasingly regarded as key systems constraints to scaling up of HIV treatment. Problems, however, go beyond the issue of numbers to include productivity and cultures of service delivery. As more countries receive funds for antiretroviral access programmes, strong national stewardship of these programmes becomes increasingly necessary. The paper proposes a set of short- and long-term stewardship tasks, which include resisting the verticalisation of HIV treatment, the evaluation of community health workers and their potential role in HIV treatment access, international action on the brain drain, and greater investment in national human resource functions of planning, production, remuneration and management. PMID:16713875

  18. Chinese Doctors Connecting to the English Publishing World: Literature Access, Editorial Services, and Training in Publication Skills

    Yongyan Li

    2013-12-01

    Full Text Available In the literature on academic publishing, little attention has been paid to the needs and concerns of non-English-speaking researchers in professional contexts. This paper addresses the gap in that literature by providing insights into the situation with medical doctors in China. Following an overview of the broad picture, I will report a case study, which was conducted at a major hospital in East China and which aimed at exploring how a group of orthopedic surgeons access the English medical literature and to what extent they seek the support of editorial services and training in academic writing/publication skills. The results of the study show that the participant doctors tend to rely on their students or overseas personal connections for access to full-text medical literature, and they have generally had limited experience with language editorial services and academic writing/publication skills seminars. The paper ends by discussing some challenges while proposing recommendations for enhancing Chinese doctors’ access to the full-text medical literature, as well as their understanding of the kind of support that can be provided by editorial services and training in publication skills.

  19. Accessible Internet-of-Things and Internet-of-Content Services for All in the Home or on the Move

    Dimitris Tektonidis

    2012-10-01

    Full Text Available Public authorities and national healthcare service providers across the European Union and beyond are increasingly under pressure to deliver better services with diminishing resources. Users, quite rightly, demand a high standard of service and increasingly also convenience focused on the needs of the users rather than how the services are organised to deliver them. Users, on the whole, also prefer to be supported in their homes, and be free to move as much as possible. While users without impairments and generally well provided for, there are increasingly also users who have special needs, including the aged and those with a range of physical and mental disabilities who are unable to make effective use of such services from their homes due to the lack of proactive and accessible services. The idea we promote in the chapter is to provide better support to users with disabilities and impairments from the comfort of their home by means of providing them with a set of scalable services which can be either offered for free or purchased through some central form of a marketplace repository.

  20. Integrated databanks access and sequence/structure analysis services at the PBIL

    Perrière, Guy; Combet, Christophe; Penel, Simon; Blanchet, Christophe; Thioulouse, Jean; Geourjon, Christophe; Grassot, Julien; Charavay, Céline; Gouy, Manolo; Duret, Laurent; Deléage, Gilbert

    2003-01-01

    The World Wide Web server of the PBIL (Pôle Bioinformatique Lyonnais) provides on-line access to sequence databanks and to many tools of nucleic acid and protein sequence analyses. This server allows to query nucleotide sequence banks in the EMBL and GenBank formats and protein sequence banks in the SWISS-PROT and PIR formats. The query engine on which our data bank access is based is the ACNUC system. It allows the possibility to build complex queries to access functional zones of biological...

  1. Health system weaknesses constrain access to PMTCT and maternal HIV services in South Africa: a qualitative enquiry

    Chersich Matthew F

    2011-03-01

    Full Text Available Abstract Background HIV remains responsible for an estimated 40% of mortality in South African pregnant women and their children. To address these avoidable deaths, eligibility criteria for antiretroviral therapy (ART in pregnant women were revised in 2010 to enhance ART coverage. With greater availability of HIV services in public health settings and increasing government attention to poor maternal-child health outcomes, this study used the patient's journey through the continuum of maternal and child care as a framework to track and document women's experiences of accessing ART and prevention of mother-to-child HIV transmission (PMTCT programmes in the Eastern Cape (three peri-urban facilities and Gauteng provinces (one academic hospital. Results In-depth interviews identified considerable weaknesses within operational HIV service delivery. These manifested as missed opportunities for HIV testing in antenatal care due to shortages of test kits; insufficient staff assigned to HIV services; late payment of lay counsellors, with consequent absenteeism; and delayed transcription of CD4 cell count results into patient files (required for ART initiation. By contrast, individual factors undermining access encompassed psychosocial concerns, such as fear of a positive test result or a partner's reaction; and stigma. Data and information systems for monitoring in the three peri-urban facilities were markedly inadequate. Conclusions A single system- or individual-level delay reduced the likelihood of women accessing ART or PMTCT interventions. These delays, when concurrent, often signalled wholesale denial of prevention and treatment. There is great scope for health systems' reforms to address constraints and weaknesses within PMTCT and ART services in South Africa. Recommendations from this study include: ensuring autonomy over resources at lower levels; linking performance management to facility-wide human resources interventions; developing

  2. Sustainable access to data, products, services and software from the European seismological Research Infrastructures: the EPOS TCS Seismology

    Haslinger, Florian; Dupont, Aurelien; Michelini, Alberto; Rietbrock, Andreas; Sleeman, Reinoud; Wiemer, Stefan; Basili, Roberto; Bossu, Rémy; Cakti, Eser; Cotton, Fabrice; Crawford, Wayne; Diaz, Jordi; Garth, Tom; Locati, Mario; Luzi, Lucia; Pinho, Rui; Pitilakis, Kyriazis; Strollo, Angelo

    2016-04-01

    Easy, efficient and comprehensive access to data, data products, scientific services and scientific software is a key ingredient in enabling research at the frontiers of science. Organizing this access across the European Research Infrastructures in the field of seismology, so that it best serves user needs, takes advantage of state-of-the-art ICT solutions, provides cross-domain interoperability, and is organizationally and financially sustainable in the long term, is the core challenge of the implementation phase of the Thematic Core Service (TCS) Seismology within the EPOS-IP project. Building upon the existing European-level infrastructures ORFEUS for seismological waveforms, EMSC for seismological products, and EFEHR for seismological hazard and risk information, and implementing a pilot Computational Earth Science service starting from the results of the VERCE project, the work within the EPOS-IP project focuses on improving and extending the existing services, aligning them with global developments, to at the end produce a well coordinated framework that is technically, organizationally, and financially integrated with the EPOS architecture. This framework needs to respect the roles and responsibilities of the underlying national research infrastructures that are the data owners and main providers of data and products, and allow for active input and feedback from the (scientific) user community. At the same time, it needs to remain flexible enough to cope with unavoidable challenges in the availability of resources and dynamics of contributors. The technical work during the next years is organized in four areas: - constructing the next generation software architecture for the European Integrated (waveform) Data Archive EIDA, developing advanced metadata and station information services, fully integrate strong motion waveforms and derived parametric engineering-domain data, and advancing the integration of mobile (temporary) networks and OBS deployments in

  3. Systems and Services for Real-Time Web Access to NPP Data Project

    National Aeronautics and Space Administration — Global Science & Technology, Inc. (GST) proposes to investigate information processing and delivery technologies to provide near-real-time Web-based access to...

  4. INTEGRATIVE METHOD OF TEACHING INFORMATION MODELING IN PRACTICAL HEALTH SERVICE BASED ON MICROSOFT ACCESS QUERIES

    Svetlana A. Firsova; Elena A. Ryabukhina

    2016-01-01

    Introduction: this article explores the pedagogical technology employed to teach medical students foundations of work with MICROSOFT ACCESS databases. The above technology is based on integrative approach to the information modeling in public health practice, drawing upon basic didactic concepts that pertain to objects and tools databases created in MICROSOFT ACCESS. The article examines successive steps in teaching the topic “Queries in MICROSOFT ACCESS” – from simple queries to complex ones...

  5. Management of Data Access with Quality of Service in PL-Grid Environment

    Renata Słota; Darin Nikolow; Kornel Skałkowski; Jacek Kitowski

    2012-01-01

    e-Science applications increasingly require both computational power and storage resources, currently supported with a certain level of quality. Since in the grid and cloud environments, where we can execute the e-Science applications, heterogeneity of storage systems is higher than that of computational power resources, optimization of data access defines one of challenging tasks nowadays. In this paper we present our approach to management of data access in the grid environment. The main is...

  6. Open Access Electronic Publishing Services in Academic Libraries: The case study of University of Patras

    Gkogkou, Despoina; Georgiou, Panos; Tsakonas, Giannis

    2010-01-01

    Open Access to scientific information is a major revolution that challenges traditional publishing structures. The initiatives are mainly supported by advances in information technology; however, no major shift could be feasible without the support of information organizations, like libraries. In many contexts, mainly academic, libraries have undertaken the responsibility of disseminating the concept of Open Access and beyond the common promotional practices they have engaged into electronic ...

  7. 75 FR 4409 - Ryan White HIV/AIDS Program Part D-Coordinated HIV Services and Access to Research for Women...

    2010-01-27

    ... HUMAN SERVICES Health Resources and Services Administration Ryan White HIV/AIDS Program Part D--Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth AGENCY: Health... Department, Orlando, Florida, that will ensure continuity of Part D HIV/AIDS care and treatment...

  8. Enabling the maximum number of people to access essential services will not be possible without private sector involvement and appropriate pricing of the services concerned

    Luc Rigouzzo

    2012-06-01

    Full Text Available Private sector provision of basic services (water, energy, financial services and housing for people in developing countries is a necessity if we really want to try to curb poverty. However, ‘traditional’ private funding is not spontaneously directed towards these sectors, largely as a result of rejecting the idea that poor population groups should ‘pay’ for essential services; an issue that has often been the subject of opposition campaigns mounted by social stakeholders. Nevertheless, there are many, many examples to show that given the impact of these services on their quality of life, consumers in these countries - and especially those at the ‘bottom of the pyramid’ - are prepared to pay for them as long as they have access to a high-quality service. In these sectors, the nominal cost of the service concerned matters much less than its opportunity cost and the impact it will have on the lives of those who benefit from it. Very often, this service may even be paid for in advance as a way of enabling families to gain greater control over the expenditure they can devote to obtaining it.It is, however, important to distinguish between the supply of essential services and those of consumer goods, and - of course - to avoid abuses. In any event, the possibility of building financially-balanced models is what governs the process of securing sufficient funding from local and international financial institutions. In this area, as in others, the way forward is probably the happy medium: avoiding the excesses of overpricing, but accepting the need to maintain profitable economic models. These should enable investors to receive a level of profit that encourages them to continue and increase their investment, thereby increasing the number of recipients as quickly as possible. Aspiring to build social models that reject the ambition to achieve a reasonable profit and rule out any distribution of dividends to shareholders is to condemn the

  9. Assessment and analysis of territorial experiences in digital tele-echocardiography

    Enrico Frumento; Cesare Colombo; Gabriella Borghi; Cristina Masella; Paolo Zanaboni; Paolo Barbier; Dario Cavoretto

    2009-01-01

    Nowadays digital ultrasound-cardiovascular devices are able to send out directly digital images and films. Thanks to the large adoption of such devices, the echocardiographic world is facing new ways of exchanging images and collaborating. What we present in this paper is a review of the experimental projects carried in Lombardy, meant to support the work of specialists by means of second opinion and telemedicine services. On the medical point of view echocardiography is a widely used activit...

  10. Enhanced Class-of-Service Oriented Packet Scheduling Scheme for EPON Access Networks

    Han, Intark; Park, Hong-Shik; Han, Man-Soo

    A fast class-of-service oriented packet scheduling (FCOPS) has a service fairness problem since a credit pool for a service class is initialized at the beginning of a transmission cycle whose starting moment is fixed at a specific ONU. To remedy the service unfairness of FCOPS, we suggest an enhanced class-of-service oriented packet scheduling (ECOPS) that uses a new initialization cycle whose starting moment is fairly distributed to each ONU. Also, ECOPS generates a colorless grant to utilize the resource wastage, when traffic is light and the total sum of grants of an ONU is less than a minimum size. Using simulation, we validate ECOPS as superior to FCOPS in the mean delay and the service fairness.

  11. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC.

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

  12. Priorities and realities: addressing the rich-poor gaps in health status and service access in Indonesia

    Utomo Budi

    2011-11-01

    Full Text Available Abstract Introduction Over the past four decades, the Indonesian health care system has greatly expanded and the health of Indonesian people has improved although the rich-poor gap in health status and service access remains an issue. The government has been trying to address these gaps and intensify efforts to improve the health of the poor following the economic crisis in 1998. Methods This paper examines trends and levels in socio-economic inequity of health and identifies critical factors constraining efforts to improve the health of the poor. Quantitative data were taken from the Indonesian Demographic Health Surveys and the National Socio-Economic Surveys, and qualitative data were obtained from interviews with individuals and groups representing relevant stakeholders. Results The health of the population has improved as indicated by child mortality decline and the increase in community access to health services. However, the continuing prevalence of malnourished children and the persisting socio-economic inequity of health suggest that efforts to improve the health of the poor have not yet been effective. Factors identified at institution and policy levels that have constrained improvements in health care access and outcomes for the poor include: the high cost of electing formal governance leaders; confused leadership roles in the health sector; lack of health inequity indicators; the generally weak capacity in the health care system, especially in planning and budgeting; and the leakage and limited coverage of programs for the poor. Conclusions Despite the government's efforts to improve the health of the poor, the rich-poor gap in health status and service access continues. Factors at institutional and policy levels are critical in contributing to the lack of efficiency and effectiveness for health programs that address the poor.

  13. Access to Health Service related to Use of Antenatal Care Facilities at the Kawangu Health Centre, East Sumba

    Nara Adriana

    2015-04-01

    Full Text Available Background and purpose: The study aims to determine factors influencing the utilization of accredited government-run ANC facilities at the Kawangu Health Centre. Methods: Research was a cross-sectional study, with a total sample of 85 respondents taken by consecutive sampling from the Kawangu Health Centre. The dependent variable was the use government-run ANC facility at the Kawangu Health Centre. The independent variables were knowledge, awareness, attitudes, access to health services, frequency of receiving information and family support. The data were collected by interview using questionnaires. The data analysis includes univariate, bivariate (chi-square and multivariate analysis with logistic regression. Results: The results of the study indicates that there was a significant relationship between the use of accredited government-run ANC facilities with maternal knowledge/awareness (p=0.001, attitude (p<0.001, ability to access to health services (p<0.001, frequency of information (p=0.039, and family support (p<0.001. Multivariate analysis indicated that the only significant independent variable related to the use of adequate delivery was the ability to access health services with OR =11.68 (95%CI: 1.37 to 99.89. Conclusion: An inability to access either due to distance to travel, lack of vehicle and/or infrastructure concerns such as poor quality/lack of roads was the dominant variable in the utilization of accredited government-run ANC facility. Keywords: accredited government-run ANC facilities, influencing factors, East Sumba

  14. Accessible interaction solution based on confidence for the deployment of pervasive sensitive services in intelligent environments

    Vega Barbas, Mario

    2016-01-01

    Services based on the Information and Communications Technologies (ICT) are present more and more in the lives of people. The advancement of ICT in technical and social acceptance terms has led the creation of new models of service provision. These provision models involve further integration with people's activities so that are not only present in their professions or civic space but also in a more intimate areas related to their own identity. So it is now common to find services aware of us...

  15. Therapeutic implications of transesophageal echocardiography after transthoracic echocardiography on acute stroke patients

    Tiago Tribolet de Abreu

    2008-03-01

    Full Text Available Tiago Tribolet de Abreu, Sonia Mateus, Cecilia Carreteiro, Jose CorreiaLaboratorio de Ultrasonografia Cardiaca e Neurovascular, Hospital do Espirito Santo-Evora, E. P. E., PortugalBackground: The role of transesophageal echocardiography (TEE in the evaluation of acute stroke patients is still ill-defined. We conducted a prospective observational study to find the prevalence of TEE findings that indicate anticoagulation as beneficial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocardiography (TTE findings.Methods: We prospectively studied all patients referred to our laboratory for TTE and TEE. Patients were excluded if the diagnosis was not acute ischemic stroke or if they had an indication for anticoagulation based on clinical, electrocardiographic, or TTE data. Patients with TEE findings that might indicate anticoagulation as beneficial were identified.Results: A total of 84 patients with acute ischemic stroke and without indication for anticoagulation based on clinical and electrocardiographic or TTE data were included in the study. Findings indicating anticoagulation as beneficial were found in 32.1%: spontaneous echo contrast (1.2%, complex aortic atheroma (27.4%, thrombus (8.3%, and simultaneous patent foramen ovale and atrial septal aneurysm (2.4%.Conclusions: The results of our study show that TEE can have therapy implications in 32.1% of ischemic stroke patients in sinus rhythm and with TTE with no indication for anticoagulation.Keywords: acute ischemic stroke, transesophageal echocardiography, transthoracic echocardiography, therapy

  16. Predicting and measuring fluid responsiveness with echocardiography

    Ashley Miller

    2016-06-01

    Full Text Available Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart–lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid esuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately.

  17. Measurement of Thrombus Flux Using Transesophageal Echocardiography

    Yamaguchi, Tadashi; Hirai, Kazuki; Aoki, Masami; Miyagi, Jin; Suzuki, Masahiko; Moriya, Hideshige; Hachiya, Hiroyuki

    2006-05-01

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the FSET to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed.

  18. Measurement of thrombus flux using transesophageal Echocardiography

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the fiber structure extraction technique (FSET) to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed. (author)

  19. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    Kangolle Alfred CT

    2010-10-01

    Full Text Available Abstract Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1 Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2 Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3 Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1 Capacity building in oncology health services research, policy and planning relevant to developing countries. (2 Development of high-quality health data sources. (3 More oncology-related economic evaluations in developing countries. (4 Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and

  20. Service-Learning in the Financial Planning Curriculum: Expanding Access to the Community

    Annis, Paul M.; Palmer, Lance; Goetz, Joseph

    2010-01-01

    Service-learning projects are a cornerstone of student experiential learning. Such programs have proven to be mutually beneficial to communities and students within a variety of family and consumer sciences courses. However, there is a paucity of literature addressing service-learning efforts within the field of financial planning. There is an…

  1. Coherent detection passive optical access network enabling converged delivery of broadcast and dedicated broadband services

    Osadchiy, Alexey Vladimirovich; Prince, Kamau; Guerrero Gonzalez, Neil;

    2011-01-01

    We propose a passive optical network architecture based on coherent detection for converged delivery of broadcast services from a dedicated remote broadcast server and user-specific services from a local central office. We experimentally demonstrate this architecture with mixed traffic types...

  2. 7 CFR 1755.500 - RUS standard for service installations at customers access locations.

    2010-01-01

    ...-1999, NEC ® is incorporated by reference in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies... 7 Agriculture 11 2010-01-01 2010-01-01 false RUS standard for service installations at customers..., ACCEPTABLE MATERIALS, AND STANDARD CONTRACT FORMS § 1755.500 RUS standard for service installations...

  3. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    Prabhu, Neeta T

    2010-03-01

    The goal of this study was to elicit the views of patients or parents\\/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients\\/parents\\/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent\\/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.

  4. Hybrid Terrestrial-Satellite DVB/IP Infrastructure in Overlay Constellations for Triple-Play Services Access in Rural Areas

    A. Bourdena

    2010-01-01

    Full Text Available This paper discusses the convergence of digital broadcasting and Internet technologies, by elaborating on the design, implementation, and performance evaluation of a hybrid terrestrial/satellite networking infrastructure, enabling triple-play services access in rural areas. At local/district level, the paper proposes the exploitation of DVB-T platforms in regenerative configurations for creating terrestrial DVB/IP backhaul between the core backbone (in urban areas and a number of intermediate communication nodes distributed within the DVB-T broadcasting footprint (in rural areas. In this way, triple play services that are available at the core backbone, are transferred via the regenerative DVB-T/IP backhaul to the entire district and can be accessed by rural users via the corresponding intermediate node. On the other hand, at regional/national level, the paper proposes the exploitation of a satellite interactive digital video broadcasting platform (DVB S2/RCS as an overlay network that interconnects the regenerative DVB-T/IP platforms, as well as individual users, and services providers, to each other. Performance of the proposed hybrid terrestrial/satellite networking environment is validated through experimental tests that were conducted under real transmission/reception conditions (for the terrestrial segment and via simulation experiments (for the satellite segment at a prototype network infrastructure.

  5. Interactive access to LP DAAC satellite data archives through a combination of open-source and custom middleware web services

    Davis, Brian N.; Werpy, Jason; Friesz, Aaron M.; Impecoven, Kevin; Quenzer, Robert; Maiersperger, Tom; Meyer, David J.

    2015-01-01

    Current methods of searching for and retrieving data from satellite land remote sensing archives do not allow for interactive information extraction. Instead, Earth science data users are required to download files over low-bandwidth networks to local workstations and process data before science questions can be addressed. New methods of extracting information from data archives need to become more interactive to meet user demands for deriving increasingly complex information from rapidly expanding archives. Moving the tools required for processing data to computer systems of data providers, and away from systems of the data consumer, can improve turnaround times for data processing workflows. The implementation of middleware services was used to provide interactive access to archive data. The goal of this middleware services development is to enable Earth science data users to access remote sensing archives for immediate answers to science questions instead of links to large volumes of data to download and process. Exposing data and metadata to web-based services enables machine-driven queries and data interaction. Also, product quality information can be integrated to enable additional filtering and sub-setting. Only the reduced content required to complete an analysis is then transferred to the user.

  6. College Access and Success for Students Experiencing Homelessness: A Toolkit for Educators and Service Providers

    Dukes, Christina

    2013-01-01

    This toolkit serves as a comprehensive resource on the issue of higher education access and success for homeless students, including information on understanding homeless students, assisting homeless students in choosing a school, helping homeless students pay for application-related expenses, assisting homeless students in finding financial aid…

  7. 75 FR 43460 - Nondiscrimination on the Basis of Disability; Accessibility of Web Information and Services of...

    2010-07-26

    ... accommodation through other mediums, such as telephone or mail). But see Access Now, Inc. v. Southwest Airlines... 2004 ADA/ABA Guidelines. 69 FR 58768. On June 17, 2008, the Department issued a notice of proposed.... 73 FR 34466. The NPRM addressed the issues raised in the public's comments to the ANPRM and...

  8. NGO Provision of Basic Education: Alternative or Complementary Service Delivery to Support Access to the Excluded?

    Rose, Pauline

    2009-01-01

    This paper focuses on approaches by non-government organisations (NGOs) to reach primary school-aged children excluded from access to the conventional state education system. It highlights recent shifts in international literature and agency priorities from the portrayal of NGO provision as a (non-formal) "alternative" to (formal) state schooling,…

  9. Accessing the online archive for the Journal of the Royal Naval Medical Service.

    Angus, D

    2015-01-01

    Following work by the editorial team, notably Surg Lt Cdr M O'Shea, and with funding from the Wellcome Trust, every edition of this Journal dating back to the first edition in 1915 is available on our website. This article gives details of how to access it. PMID:26867403

  10. NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

    Aleman, Alicia; Olsen, Lola; Ritz, Scott; Morahan, Michael; Cepero, Laurel; Stevens, Tyler

    2011-01-01

    NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide. The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs. Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information. In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries. By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways. This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data. http://gcmd.nasa.gov/

  11. Augmentation of Virtual Space Physics Observatory Services to Expand Data Access Capabilities Project

    National Aeronautics and Space Administration — Aquilent, Inc. proposes to support the effort of Virtual Space Physics Observatory (VSPO) by developing services to expand the VSPO search capabilities, developing...

  12. 77 FR 69820 - Access to Confidential Business Information by Electronic Consulting Services, Inc., and Its...

    2012-11-21

    ... providers (e.g. VoIP, PBX, switches, routers, hubs, Wireless LANs, network wiring, mobile telephone services... endpoints; Assistive Technology Center Support; and Training and Conference Room Support. The SPs will...

  13. Extending Binary Large Object Support to Open Grid Services Architecture-Data Access and Integration Middleware Client Toolkit

    Kiran K. Patnaik

    2011-01-01

    Full Text Available Problem statement: OGSA-DAI middleware allows data resources to be federated and accessed via web services on the web or within grids or clouds. It provides a client API for writing programs that access the exposed databases. Migrating existing applications to the new technology and using a new API to access the data of DBMS with BLOB is difficult and discouraging. A JDBC Driver is a much convenient alternative to existing mechanism and provides an extension to OGSA-DAI middleware and allows applications to use databases exposed in a grid through the OGSA-DAI 3.0. However, the driver does not support Binary Large Objects (BLOB. Approach: The driver is enhanced to support BLOB using the OGSA-DAI Client API. It transforms the JDBC calls into an OGSA-DAI workflow request and sends it to the server using Web Services (WS. The client API of OGSA-DAI uses activities that are connected to form a workflow and executed using a pipeline. This workflow mechanism is embedded into the driver. The WS container dispatches the request to the OGSA-DAI middleware for processing and the result is then transformed back to an instance of ResultSet implementation using the OGSA-DAI Client API, before it is returned to the user. Results: Test on handling of BLOBs (images, flash files and videos ranging from size 1 KB to size 2 GB were carried out on Oracle, MySQL and PostgreSQL databases using our enhanced JDBC driver and it performed well. Conclusion: The enhanced JDBC driver now can offer users, with no experience in Grid computing specifically on OGSA-DAI, the possibility to give their applications the ability to access databases exposed on the grid with minimal effort.

  14. Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men

    Scheim, Ayden I; Santos, Glenn-Milo; Arreola, Sonya; Makofane, Keletso; Do, Tri D; Hebert, Patrick; Thomann, Matthew; Ayala, George

    2016-01-01

    Introduction Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM). In the global context of stigma and poor healthcare access, transgender (trans) MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender) MSM. Methods The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM) from any country and available in seven languages. Baseline data (n=3857) were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. Results About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%); lived in western Europe, North America, or Oceania (75.4%); and reported being HIV-negative (98.6%). HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR=0.57, 95% CI=0.33, 0.98) and condom-compatible lubricants (OR=0.54, 95% CI=0.30, 0.98). Conclusions This first look at access

  15. Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men

    Ayden I Scheim

    2016-07-01

    Full Text Available Introduction: Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM. In the global context of stigma and poor healthcare access, transgender (trans MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender MSM. Methods: The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM from any country and available in seven languages. Baseline data (n=3857 were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. Results: About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%; lived in western Europe, North America, or Oceania (75.4%; and reported being HIV-negative (98.6%. HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR=0.57, 95% CI=0.33, 0.98 and condom-compatible lubricants (OR=0.54, 95% CI=0.30, 0.98. Conclusions: This first

  16. Operational value and accessibility of services in SOA-based intelligence information systems

    Ackoski, Jugoslav; Serafimova, Nevena; Angelovski, Slavko; Dojcinovski, Metodija; Bogatinov, Dimitar

    2013-01-01

    Abstract – The concept of Service-Oriented Architecture (SOA) can be used as a foundation for establishing an integrated Intelligence System, which would be based on services as software components. It offers better coordination among institutions involved in intelligence, thus providing increase of intelligence effectiveness. In this article, the central focus is placed on determining measurement tools that allow evaluation of the service’s potential within an Inte...

  17. MRI and echocardiography in the diagnosis of cardiac amyloidosis

    Objective: To assess the values of MRI and echocardiography for the diagnosis of cardiac amyloidosis (CA). Methods: Eleven cases with CA proved pathologically performed MRI and echocardiography, the findings were analyzed retrospectively. Results: The characteristic features of cardiac amyloidosis on MRI and echocardiography were: diffuse slight myocardial thickening of the left ventricular wall and interventricular septum (11 cases), slight myocardial thickening of the interatrial septum (5 cases), increased left ventricular mass (7 cases), enlarged left atrium (7 cases), impaired ventricular systolic and diastolic function (10 cases), pleural and pericardial effusions (11 and 9 cases). Echocardiography showed that myocardium was hyperechoic and presented as ground glass with some spotty hyperechoes in 6 cases. MRI revealed a distinct diffuse delayed enhancement of subendocardial and entire myocardium in 8 cases. Conclusion: Doppler echocardiography is the first-choice imaging technique and cardiac magnetic resonance imaging can provide more information for the diagnosis of CA. (authors)

  18. Echocardiography as an indication of continuous-time cardiac quiescence

    Wick, C. A.; Auffermann, W. F.; Shah, A. J.; Inan, O. T.; Bhatti, P. T.; Tridandapani, S.

    2016-07-01

    Cardiac computed tomography (CT) angiography using prospective gating requires that data be acquired during intervals of minimal cardiac motion to obtain diagnostic images of the coronary vessels free of motion artifacts. This work is intended to assess B-mode echocardiography as a continuous-time indication of these quiescent periods to determine if echocardiography can be used as a cost-efficient, non-ionizing modality to develop new prospective gating techniques for cardiac CT. These new prospective gating approaches will not be based on echocardiography itself but on CT-compatible modalities derived from the mechanics of the heart (e.g. seismocardiography and impedance cardiography), unlike the current standard electrocardiogram. To this end, echocardiography and retrospectively-gated CT data were obtained from ten patients with varied cardiac conditions. CT reconstructions were made throughout the cardiac cycle. Motion of the interventricular septum (IVS) was calculated from both echocardiography and CT reconstructions using correlation-based, deviation techniques. The IVS was chosen because it (1) is visible in echocardiography images, whereas the coronary vessels generally are not, and (2) has been shown to be a suitable indicator of cardiac quiescence. Quiescent phases were calculated as the minima of IVS motion and CT volumes were reconstructed for these phases. The diagnostic quality of the CT reconstructions from phases calculated from echocardiography and CT data was graded on a four-point Likert scale by a board-certified radiologist fellowship-trained in cardiothoracic radiology. Using a Wilcoxon signed-rank test, no significant difference in the diagnostic quality of the coronary vessels was found between CT volumes reconstructed from echocardiography- and CT-selected phases. Additionally, there was a correlation of 0.956 between the echocardiography- and CT-selected phases. This initial work suggests that B-mode echocardiography can be used as a

  19. Access to Financial Services and the Financial Inclusion Agenda around the World : A Cross-Country Analysis with a New Data Set

    Ardic, Oya Pinar; Heimann, Maximilien; Mylenko, Nataliya

    2011-01-01

    Recent empirical evidence highlights that access to basic financial services can make a substantial positive difference in improving poor people's lives. Accordingly, financial sector reforms that promote financial inclusion are increasingly at the core of policymakers agendas. The Consultative Group to Assist the Poor and the World Bank Group, in response, launched the Financial Access p...

  20. Access and Equity Guide for Services Working with Young People: How To Develop and Implement Your Own A&E Policy. Second Edition.

    Napoli, Sandra; Wong, Debbie

    The aim of this guide is to help youth services workers in New South Wales (Australia) develop and implement their own access and equity policy for their organizations. The focus is on addressing the access barriers to young people from a non-English speaking background, but many of the issues, strategies, and processes discussed are applicable to…

  1. Influence of accessibility of services on Quality of Life of school children with Cerebral Palsy in Latvia

    Cibule L.

    2012-10-01

    Full Text Available The aim of the study was to investigate the influence of accessibility of services and health related factors on Quality of Life (QoL of school children with Cerebral Palsy (CP in Latvia. 80 children 47 boys and 33 girls with CP and their parents from all regions of Latvia took part in the study. Mean age of participants was 11,7 (SD± 3,5 years. 50 children without diagnosed chronic diseases formed the control group. Validated evaluation tools were used in the study (KIDSCREEN-52, GMFCS- E&R. The results show lower QoL in children with CP in comparison with their healthy peers and European children. QoL is influenced by the level of gross motor functions, lack of coordination of services, lack of rehabilitation infrastructure and presence of environmental barriers in Latvia.

  2. From Service Providers to Content Producers: New Opportunities For Libraries in Collaborative Open Access Book Publishing

    Adema, Janneke; Schmidt, Birgit

    2010-01-01

    Several libraries have become active partners in Open Access publishing of books in the Humanities and Social Sciences (HSS). Not only have libraries started up their own presses, they are also collaborating with existing presses or forming alliances with other institutions on campus such as scholarly communication offices, ICT departments, and academic research centers. By combining institutional strengths and enabling the sharing of resources across institutions, these col...

  3. Primary care satellite clinics and improved access to general and mental health services.

    Rosenheck, R

    2000-01-01

    OBJECTIVES: To evaluate the relationship between the implementation of community-based primary care clinics and improved access to general health care and/or mental health care, in both the general population and among people with disabling mental illness. STUDY SETTING: The 69 new community-based primary care clinics in underserved areas, established by the Department of Veterans Affairs (VA) between the last quarter of FY 1995 and the second quarter of FY 1998, including the 21 new clinics ...

  4. Assessing young unmarried men's access to reproductive health information and services in rural India

    Saavala Minna; Char Arundhati; Kulmala Teija

    2011-01-01

    Abstract Background We investigated the accessibility of reproductive health information and contraceptives in a relatively less developed area of rural central India and assessed the risks facing young unmarried men. Methods This cross-sectional study used both qualitative and quantitative methods. Participants included 38 unmarried rural men in four focus-group discussions and a representative sample of 316 similarly profiled men, aged 17-22 years, in a survey. Information was collected on ...

  5. Anemia management: development of a rapid-access anemia and intravenous iron service

    Radia D; Momoh I; Dillon R; Francis Y; Cameron L; Fagg TL; Overl; H; Robinson S.; Harrison CN

    2013-01-01

    Deepti Radia,1 Ibrahim Momoh,2 Richard Dillon,1 Yvonne Francis,1 Laura Cameron,1 Toni-Lee Fagg,1 Hannah Overland,1 Susan Robinson,1 Claire N Harrison11Haematology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK; 2Bupa Home Healthcare, Harlow, UKAbstract: This article describes the initiation and evolution of the Rapid-Access Anemia Clinic (RAAC) at Guy's and St Thomas' Hospitals, London, UK. This clinic was set up to provide diagnosis and treatment, and to co...

  6. Universalization of access to modern energy services in Indian households-Economic and policy analysis

    Provision of modern energy services for cooking (with gaseous fuels) and lighting (with electricity) is an essential component of any policy aiming to address health, education or welfare issues; yet it gets little attention from policy-makers. Secure, adequate, low-cost energy of quality and convenience is core to the delivery of these services. The present study analyses the energy consumption pattern of Indian domestic sector and examines the urban-rural divide and income energy linkage. A comprehensive analysis is done to estimate the cost for providing modern energy services to everyone by 2030. A public-private partnership-driven business model, with entrepreneurship at the core, is developed with institutional, financing and pricing mechanisms for diffusion of energy services. This approach, termed as EMPOWERS (entrepreneurship model for provision of wholesome energy-related basic services), if adopted, can facilitate large-scale dissemination of energy-efficient and renewable technologies like small-scale biogas/biofuel plants, and distributed power generation technologies to provide clean, safe, reliable and sustainable energy to rural households and urban poor. It is expected to integrate the processes of market transformation and entrepreneurship development involving government, NGOs, financial institutions and community groups as stakeholders.

  7. Universalization of access to modern energy services in Indian households-Economic and policy analysis

    Reddy, B. Sudhakara, E-mail: sreddy@igidr.ac.i [Indira Gandhi Institute of Development Research, Goregaon (E), Mumbai 400 065 (India); Balachandra, P. [Department of Management Studies, Indian Institute of Science, Bangalore 560 012 (India); Nathan, Hippu Salk Kristle [Indira Gandhi Institute of Development Research, Goregaon (E), Mumbai 400 065 (India)

    2009-11-15

    Provision of modern energy services for cooking (with gaseous fuels) and lighting (with electricity) is an essential component of any policy aiming to address health, education or welfare issues; yet it gets little attention from policy-makers. Secure, adequate, low-cost energy of quality and convenience is core to the delivery of these services. The present study analyses the energy consumption pattern of Indian domestic sector and examines the urban-rural divide and income energy linkage. A comprehensive analysis is done to estimate the cost for providing modern energy services to everyone by 2030. A public-private partnership-driven business model, with entrepreneurship at the core, is developed with institutional, financing and pricing mechanisms for diffusion of energy services. This approach, termed as EMPOWERS (entrepreneurship model for provision of wholesome energy-related basic services), if adopted, can facilitate large-scale dissemination of energy-efficient and renewable technologies like small-scale biogas/biofuel plants, and distributed power generation technologies to provide clean, safe, reliable and sustainable energy to rural households and urban poor. It is expected to integrate the processes of market transformation and entrepreneurship development involving government, NGOs, financial institutions and community groups as stakeholders.

  8. Universalization of access to modern energy services in Indian households. Economic and policy analysis

    Provision of modern energy services for cooking (with gaseous fuels) and lighting (with electricity) is an essential component of any policy aiming to address health, education or welfare issues; yet it gets little attention from policy-makers. Secure, adequate, low-cost energy of quality and convenience is core to the delivery of these services. The present study analyses the energy consumption pattern of Indian domestic sector and examines the urban-rural divide and income energy linkage. A comprehensive analysis is done to estimate the cost for providing modern energy services to everyone by 2030. A public-private partnership-driven business model, with entrepreneurship at the core, is developed with institutional, financing and pricing mechanisms for diffusion of energy services. This approach, termed as EMPOWERS (entrepreneurship model for provision of wholesome energy-related basic services), if adopted, can facilitate large-scale dissemination of energy-efficient and renewable technologies like small-scale biogas/biofuel plants, and distributed power generation technologies to provide clean, safe, reliable and sustainable energy to rural households and urban poor. It is expected to integrate the processes of market transformation and entrepreneurship development involving government, NGOs, financial institutions and community groups as stakeholders. (author)

  9. A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

    Kenicer David

    2012-09-01

    Full Text Available Abstract Background NICE recommends computerised cognitive behavioural therapy (cCBT for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks.

  10. Providing access to risk prediction tools via the HL7 XML-formatted risk web service.

    Chipman, Jonathan; Drohan, Brian; Blackford, Amanda; Parmigiani, Giovanni; Hughes, Kevin; Bosinoff, Phil

    2013-07-01

    Cancer risk prediction tools provide valuable information to clinicians but remain computationally challenging. Many clinics find that CaGene or HughesRiskApps fit their needs for easy- and ready-to-use software to obtain cancer risks; however, these resources may not fit all clinics' needs. The HughesRiskApps Group and BayesMendel Lab therefore developed a web service, called "Risk Service", which may be integrated into any client software to quickly obtain standardized and up-to-date risk predictions for BayesMendel tools (BRCAPRO, MMRpro, PancPRO, and MelaPRO), the Tyrer-Cuzick IBIS Breast Cancer Risk Evaluation Tool, and the Colorectal Cancer Risk Assessment Tool. Software clients that can convert their local structured data into the HL7 XML-formatted family and clinical patient history (Pedigree model) may integrate with the Risk Service. The Risk Service uses Apache Tomcat and Apache Axis2 technologies to provide an all Java web service. The software client sends HL7 XML information containing anonymized family and clinical history to a Dana-Farber Cancer Institute (DFCI) server, where it is parsed, interpreted, and processed by multiple risk tools. The Risk Service then formats the results into an HL7 style message and returns the risk predictions to the originating software client. Upon consent, users may allow DFCI to maintain the data for future research. The Risk Service implementation is exemplified through HughesRiskApps. The Risk Service broadens the availability of valuable, up-to-date cancer risk tools and allows clinics and researchers to integrate risk prediction tools into their own software interface designed for their needs. Each software package can collect risk data using its own interface, and display the results using its own interface, while using a central, up-to-date risk calculator. This allows users to choose from multiple interfaces while always getting the latest risk calculations. Consenting users contribute their data for future

  11. User Access Control and Authentication System for VoIP Service in Mobile Communication Environments

    Ho-Kyung Yang; Jeong-Kyung Moon; Cheol-Rim Choi; Hwang-Bin Ryou

    2014-01-01

    VoIP, which is used to transmit voice data on the Internet, is being welcomed as a replacement for the PSTN. In VoIP, voice data are converted to IP data and transmitted in an ordinary IP network. As a result, it is less expensive than the ordinary telephone network and has excellent scalability. With the increasing demand for VoIP services, problems are also occurring, namely, security vulnerabilities and degraded service quality. To address these issues, in this paper an AA (Attribute Autho...

  12. Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

    Ken Russell Coelho

    2011-01-01

    Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

  13. Diagnostic value of harmonic transthoracic echocardiography in native valve infective endocarditis: comparison with transesophageal echocardiography

    Embil John M

    2007-05-01

    Full Text Available Abstract Background Although echocardiography has been incorporated into the diagnostic algorithm of patients with suspected infective endocarditis (IE, systematic usage in clinical practice remains ill defined. To determine the diagnostic accuracy of detecting vegetations using harmonic transthoracic echocardiography (hTTE as compared to transesophageal echocardiography (TEE in patients with an intermediate likelihood of native valve IE. Methods Between 2004 and 2005, 36 consecutive inpatients with an intermediate likelihood of disease were prospectively evaluated by hTTE and TEE. Results Of 36 patients (21 males with a mean age of 57 ± 15 years, range 32 to 86 years, 19 patients had definite IE by TEE. The sensitivity for the detection of vegetations by hTTE was 84%, specificity of 88%, positive predictive value (PPV of 89% and negative predictive value (NPV of 82%. The association between hTTE and TTE interpretation for the presence and absence of vegetations were high (kappa = 0.90 and 0.85 respectively. Conclusion In patients with an intermediate likelihood of native valve IE, TTE with harmonic imaging provides diagnostic quality images in the majority of cases, has excellent concordance with TEE and should be recommended as the first line test.

  14. Ethnicity and Adolescent Depression: Prevalence, Access to Services, and Promising Interventions

    Wagstaff, Amanda E.; Polo, Antonio J.

    2012-01-01

    Depression is more common among adolescents of ethnic minority backgrounds, who also are less likely to receive professional help. This article presents information about prevalence of depression and service use across ethnic groups, and then outlines several promising intervention programs that are designed for adolescents suffering from…

  15. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

    Burra, Tara A.; Hwang, Stephen W.; Rourke, Sean B.; Stergiopoulos, Vicky

    2012-01-01

    This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender,…

  16. Study of knowledge, accessibility and utilization of the existing rehabilitation services by disabled in a rural Goan community

    Sagar Borker

    2012-01-01

    Full Text Available Objective: To study the knowledge, accessibility and utilization of the existing Medical rehabilitation services by the PWD (Persons with Disability in a rural Goan community and their reasons for inaccessibility. Methods and Materials: Semi structured questionnaire with the interview technique was used. Systematic random sampling of families was done. This cross sectional study lasted from June 05 - Oct 06. Sample sizes of four thousand eight hundred six subjects were chosen from the 5 subcentres of RHTC (Rural Health and Training Centre Mandur (Rural area in Goa. Results : One ninety PWD were found.77.9% of the disabled or the parent, guardian, family member of the disabled have knowledge, only 44.2% have accessibility, 24.2% utilize the rehabilitative services. In which 49.1% of disabilities are temporary in nature. Cataract is the commonest cause of temporary disability. Mental retardation is the commonest cause of permanent disability. Conclusion : There is a need to make people aware of the rehabilitative measures and distribute the rehabilitative appliances in the community set up at a subsidized rate. A CBR (Community based rehabilitation worker is a must. People should also be made aware of various social welfare measures.

  17. Design of a High Resolution Open Access Global Snow Cover Web Map Service Using Ground and Satellite Observations

    Kadlec, J.; Ames, D. P.

    2014-12-01

    The aim of the presented work is creating a freely accessible, dynamic and re-usable snow cover map of the world by combining snow extent and snow depth datasets from multiple sources. The examined data sources are: remote sensing datasets (MODIS, CryoLand), weather forecasting model outputs (OpenWeatherMap, forecast.io), ground observation networks (CUAHSI HIS, GSOD, GHCN, and selected national networks), and user-contributed snow reports on social networks (cross-country and backcountry skiing trip reports). For adding each type of dataset, an interface and an adapter is created. Each adapter supports queries by area, time range, or combination of area and time range. The combined dataset is published as an online snow cover mapping service. This web service lowers the learning curve that is required to view, access, and analyze snow depth maps and snow time-series. All data published by this service are licensed as open data; encouraging the re-use of the data in customized applications in climatology, hydrology, sports and other disciplines. The initial version of the interactive snow map is on the website snow.hydrodata.org. This website supports the view by time and view by site. In view by time, the spatial distribution of snow for a selected area and time period is shown. In view by site, the time-series charts of snow depth at a selected location is displayed. All snow extent and snow depth map layers and time series are accessible and discoverable through internationally approved protocols including WMS, WFS, WCS, WaterOneFlow and WaterML. Therefore they can also be easily added to GIS software or 3rd-party web map applications. The central hypothesis driving this research is that the integration of user contributed data and/or social-network derived snow data together with other open access data sources will result in more accurate and higher resolution - and hence more useful snow cover maps than satellite data or government agency produced data by

  18. “We don’t need services. We have no problems”: exploring the experiences of young people who inject drugs in accessing harm reduction services

    Anita Krug

    2015-02-01

    Full Text Available Introduction: Evidence suggests that people who inject drugs often begin their drug use and injecting practices in adolescence, yet there are limited data available on the HIV epidemic and the responses for this population. The comprehensive package of interventions for the prevention, treatment and care of HIV infection among people who inject drugs first laid out in 2009 (revised in 2012 by World Health Organization, United Nations Office of Drugs and Crime and Joint United Nations Programme on HIV/AIDS, does not consider the unique needs of adolescent and young people. In order to better understand the values and preferences of young people who inject drugs in accessing harm reduction services and support, we undertook a series of community consultations with young people with experience of injecting drugs during adolescence. Methods: Community consultations (4–14 persons were held in 14 countries. Participants were recruited using a combined criterion and maximum variation sampling strategy. Data were analyzed using collaborative qualitative data analysis. Frequency analysis of themes was conducted. Results: Nineteen community consultations were organized with a total of 132 participants. All participants had experienced injecting drugs before the age of 18. They had the following age distribution: 18–20 (37%, 21–25 (48% and 26–30 (15%. Of the participants, 73.5% were male while 25.7% were female, with one transgender participant. Barriers to accessing the comprehensive package included: lack of information and knowledge of services, age restrictions on services, belief that services were not needed, fear of law enforcement, fear of stigma, lack of concern, high cost, lack of outreach, lack of knowledge of HCV/TB and lack of youth friendly services. Conclusions: The consultations provide a rare insight into the lived experiences of adolescents who inject drugs and highlight the dissonance between their reality and current policy and

  19. SME Access to Finance and Enterprise Development Services (RG-K1148)

    Ignacio De Leon; Araceli Herlihy

    2010-01-01

    This study is an input to the Inter-American Development Bank's regional strategy to improve access to credit for Small and Medium Enterprises (SMEs) in the Latin America region. The core of this strategy is a reform of secure lending on the basis of movable collaterals that will allow SMEs to use a larger portion of their assets to obtain credit. The expectations are that once implementation is complete, the supply of bank credit to SMEs will expand and the terms will also improve in costs, ...

  20. The Unified Access Framework (UAF) guide to building an interoperable gridded data service in about 15 minutes

    O'Brien, K.; Austin, M.; Casey, K. S.; de la Beaujardiere, J.; Habermann, T.; Hankin, S. C.; Koyuk, H.; McCulloch, L.; Mendelssohn, R.; Rutledge, G. K.; Signell, R. P.

    2011-12-01

    Insufficiently integrated data management and access systems are a major problem that data managers, scientists and users encounter when trying to serve, locate or use climate data. A fragmented approach to data management has promoted individualized solutions, often resulting in the creation of non-interoperable data formats and protocols. The NOAA-led Unified Access Framework (UAF) project has endeavored to define a framework for data providers wishing to share their data in a more interoperable manner. Using standards and conventions that are already widely used and embraced by the community, such interoperable data solutions can be quickly and easily configured and made available to the public. Though gazing through this optimistic interoperability lens, we do realize that there are still limitations within the data community that must be faced. In fact, the solutions that we plan to demonstrate are only really mature for gridded datasets. As well, there are many outstanding issues dealing with immature metadata (including lack of detailed model configurations and data provenance information) which must be overcome for true interoperability. In this presentation, however, we will be demonstrating that, by embracing open standards and conventions and community supported resources, it is possible to have an interoperable data service for gridded data up and running in less than 15 minutes. Following the storyline of a modeler who has data s/he wants to share immediately, we'll demonstrate how to serve the data using OPeNDAP and THREDDS. We'll also exhibit how to easily improve the data in order to increase interoperability, without modification to the original dataset. These improvements will include techniques for data aggregation and also methods to ensure compliance with known conventions, such as the Climate and Forecast (CF) metadata conventions. The presentation will culminate with a discussion and demonstration of a few of the many available and widely

  1. Poverty, food security and universal access to sexual and reproductive health services: a call for cross-movement advocacy against neoliberal globalisation.

    Sundari Ravindran, T K

    2014-05-01

    Universal access to sexual and reproductive health services is one of the goals of the International Conference on Population and Development of 1994. The Millennium Development Goals were intended above all to end poverty. Universal access to health and health services are among the goals being considered for the post-2015 agenda, replacing or augmenting the MDGs. Yet we are not only far from reaching any of these goals but also appear to have lost our way somewhere along the line. Poverty and lack of food security have, through their multiple linkages to health and access to health care, deterred progress towards universal access to health services, including for sexual and reproductive health needs. A more insidious influence is neoliberal globalisation. This paper describes neoliberal globalisation and the economic policies it has engendered, the ways in which it influences poverty and food security, and the often unequal impact it has had on women as compared to men. It explores the effects of neoliberal economic policies on health, health systems, and universal access to health care services, and the implications for access to sexual and reproductive health. To be an advocate for universal access to health and health care is to become an advocate against neoliberal globalisation. PMID:24908453

  2. A Web Service for File-Level Access to Disk Images

    Sunitha Misra

    2014-07-01

    Full Text Available Digital forensics tools have many potential applications in the curation of digital materials in libraries, archives and museums (LAMs. Open source digital forensics tools can help LAM professionals to extract digital contents from born-digital media and make more informed preservation decisions. Many of these tools have ways to display the metadata of the digital media, but few provide file-level access without having to mount the device or use complex command-line utilities. This paper describes a project to develop software that supports access to the contents of digital media without having to mount or download the entire image. The work examines two approaches in creating this tool: First, a graphical user interface running on a local machine. Second, a web-based application running in web browser. The project incorporates existing open source forensics tools and libraries including The Sleuth Kit and libewf along with the Flask web application framework and custom Python scripts to generate web pages supporting disk image browsing.

  3. Access to serviced land for the urban poor: the regularization paradox in Mexico

    Alfonso Iracheta Cenecorta

    2000-01-01

    Full Text Available The insufficient supply of serviced land at affordable prices for the urban poor and the need for regularization of the consequent illegal occupations in urban areas are two of the most important issues on the Latin American land policy agenda. Taking a structural/integrated view on the functioning of the urban land market in Latin America, this paper discusses the nexus between the formal and the informal land markets. It thus exposes the perverse feedback effects that curative regularization policies may have on the process by which irregularity is produced in the first place. The paper suggests that a more effective approach to the provision of serviced land for the poor cannot be resolved within the prevailing (curative regularization programs. These programs should have the capacity to mobilize the resources that do exist into a comprehensive program that links regularization with fiscal policy, including the exploration of value capture mechanisms.

  4. Access to physician services: does supplemental insurance matter? evidence from France.

    Buchmueller, Thomas C; Couffinhal, Agnès; Grignon, Michel; Perronnin, Marc

    2004-07-01

    In France, public health insurance is universal but incomplete, with private payments accounting for roughly 25% of all spending. As a result, most people have supplemental private health insurance. We investigate the effects of such insurance on the utilization of physician services using data from the 1998 Enquête sur la santé et la protection sociale, a nationally representative survey of the non-institutionalized French population. Our results indicate that insurance has a strong and significant effect on the utilization of physician services. Individuals with supplemental coverage have substantially more physician visits than those without. While French patients have greater freedom than patients in other countries to choose to see a specialist rather than a general practitioner, we find no evidence that supplemental insurance affects this decision. PMID:15259046

  5. Consumer adoption of access-based consumption services - Case AirBnB

    Satama, Sampo

    2014-01-01

    Increasing internet and smart phone penetration has given rise to a new business model, in which the service companies act as intermediaries and allow consumers to exchange value between them. Usually this is done by facilitating resource exchange between the consumers - one party that needs a resource such as a car, a designer bag or a place to stay rents or shares this resource with another party that has no need for the resource at the moment. This phenomenon has been dubbed collaborati...

  6. Some issues on provision and access to dental services in Norway

    Abelsen, Birgit

    2009-01-01

    The organisation and financing of the Norwegian oral health care differ compared to general health care. The public responsibility for general health care includes the whole population, and the scope is universal coverage involving public finance, and historically public provision as well. Concerning oral health care, there seems to be less emphasis on providing the same level of service to all citizens. The limited public responsibility for providing oral health care leaves Norwegian dentist...

  7. The development of web service for the Ubiquiti mFi device data access

    Vuk, Zdenko

    2014-01-01

    The purpose of thesis is to present the development of a web service which eliminates the problems when using the mFi products of the company Ubiquiti Networks, inc. The problems are mainly the limited functionality offered by the software bundled with these devices. The webservice uses the communication protocol SOAP. Additionally and we encountered a relatively unknown database management system named MongoDB. Ubiquiti mFi is a family of gadgets to monitor events in buildings. The protoc...

  8. Social accountability mechanisms and access to public service delivery in rural Africa

    Friis-Hansen, Esbern; Cold-Ravnkilde, Signe Marie

    2013-01-01

    This study rationale is to fill a knowledge gap about the performance of social accountability initiatives in rural Africa South of Sahara supported by foreign aid in the context of decentralization. Based on a review of available literature the study focuses on the experience of social accountability initiatives, namely public expenditure tracking surveys (PETS), participatory budgeting, community-based monitoring, participatory planning and priority setting and demand drive service provisio...

  9. BROADBAND CABLE ACCESS NETWORKS FOR TRIPLE PLAY SERVICES: SOURCE-DESTENATION

    Nasser N. Khamiss

    2012-01-01

    Full Text Available This paper evaluates the performance of sending Triple play Services over hybrid networks. The network performance factors will be considered by observing the network`s availability, packet loss, delay and throughput. These evaluations will be tested over different network scenario, where the last mile media services suggested to be delivered over telephone twisted pair by means of using ADSL. The attention will be concerned for services over cable, where a proposal of using bandwidth efficient turbo trellis coded modulation (TTCM in ADSL DMT systems instead of the multidimensional 16-state Trellis Coded Modulation (MTCM that is given as an option in Asymmetric Digital Subscriber Lines (ADSL standard based on discrete multitone (DMT techniques. The results show that by using turbo codes, it can obtain 6 dB coding gain for a bit error rate (BER of 10-6 in AWGN channels and more than 6.8 dB coding gain for a BER of 10-7 using a concatenated coding scheme.

  10. A nutrition strategy to reduce the burden of diet related disease: access to dietician services must complement population health approaches.

    Segal, Leonie; Opie, Rachelle S

    2015-01-01

    Poor diet quality is implicated in almost every disease and health issue. And yet, in most advanced market economies diet quality is poor, with a minority meeting guidelines for healthy eating. Poor diet is thus responsible for substantial disease burden. Societies have at their disposal a range of strategies to influence diet behaviors. These can be classified into: (i) population level socio-educational approaches to enhance diet knowledge; (ii) pricing incentives (subsidies on healthy foods, punitive taxes on unhealthy foods); (iii) regulations to modify the food environment, and (iv) the provision of clinical dietetic services. There is little evidence that societies are active in implementing the available strategies. Advertising of "junk foods" is largely unchecked, contrasting with strict controls on advertising tobacco products, which also attract punitive taxes. Access to dieticians is restricted in most countries, even in the context of universal health care. In Australia in 2011 there were just 2,969 practicing dieticians/nutritionists or 1.3 clinicians per 10,000 persons, compared with 5.8 physiotherapists per 10,000 persons, 14.8 general practitioners (family physicians) per 10,000 persons or 75 nurses per 10,000 persons. It is time to implement comprehensive national nutrition strategies capable of effecting change. Such strategies need to be multi-component, incorporating both public health approaches and expanded publicly funded dietetic services. Access to individualized dietetic services is needed by those at risk, or with current chronic conditions, given the complexity of the diet message, the need for professional support for behavior change and to reflect individual circumstances. The adoption of a comprehensive nutrition strategy offers the promise of substantial improvement in diet quality, better health and wellbeing and lower health care costs. PMID:26321951

  11. Access to infertility services in Canada for HIV-positive individuals and couples: a cross-sectional study

    Loutfy Mona R

    2010-05-01

    Full Text Available Abstract Background Family and pregnancy planning issues are important among human immunodeficiency virus (HIV-positive individuals and couples. However, access to fertility services may be limited for this population. The objective of this study was to estimate the types of services available in fertility clinics in Canada for these individuals. Methods A survey was sent to all registered fertility clinics in Canada to assess the availability of services (investigations and treatment for infertility and/or viral transmission risk reduction in achieving pregnancy. The proportion and location of clinics willing to carry out investigations and treatments were determined. Logistic regression analysis was performed to assess differences in response rates, investigations, and treatments by province and by couple scenario. Results Completed surveys were received from 23/28 (82% of clinics across eight Canadian provinces. Seventy-eight per cent (18/23 were willing to accept HIV-positive individuals in consultation, and 52% had actually seen at least one HIV-positive man or woman in the previous year. Clinics in every province were willing to offer infertility investigations, but only clinics located in five provinces were willing to offer fertility treatments. The most commonly available treatment was intrauterine insemination for couples in which the female partner was HIV-positive (52%. Other techniques, such as sperm washing (26% or in vitro fertilization (17%, were less commonly offered. A smaller number of clinics were willing to offer risk reduction techniques in achieving pregnancy. Conclusions Access to infertility investigations and treatments in Canada is limited and regionally dependent. Trial Registration Registered with ClinicalTrials.gov at http://www.clinicaltrials.gov, registration number NCT00782132.

  12. Improving access to competitive employment for service users in forensic psychiatric units

    Beck, Charlotte; Wernham, Connie

    2014-01-01

    Employment has been proven to be an effective recovery tool and therapeutic intervention for those with severe and enduring mental health conditions. Aside from monetary reward, employment is a means of structuring time and provides a sense of worth and achievement, which enhances self-esteem and confidence. A social identity is developed through employment, encouraging social support and increasing social networks. Securing employment can bring about improved quality of life and positive change in one's social circumstances; therefore it can reduce symptoms associated with mental illness and potentially prevent re-offending, as the individual develops a sense of independence, self-efficacy, and value. Barriers to employment exist for forensic mental health service users and therefore it is imperative that employment needs are addressed at the earliest possible stage in recovery. An evaluation of employment activities across two forensic mental health units revealed a lack of appropriate employment opportunities for service users, and those roles available were not implemented in line with recommended best practice. In response to this issue several enterprises were established to offer opportunities for service users to engage in meaningful employment and develop skills that a future employer would value. Each enterprise responds to a business need within the units to ensure sustainability of services. The enterprises are essentially micro-businesses with social objectives whose surpluses are reinvested for the purpose of increasing opportunities for service users. The enterprises are underpinned by the philosophy of the Individual Placement and Support (IPS) model; empirical evidence suggests that the IPS model is the most effective intervention, based on the ‘place then train’ philosophy. The model recommends a focus upon rapid job search to achieve competitive employment for those who want to work; opportunities sourced should be consistent with individual

  13. Improving access to competitive employment for service users in forensic psychiatric units.

    Beck, Charlotte; Wernham, Connie

    2014-01-01

    Employment has been proven to be an effective recovery tool and therapeutic intervention for those with severe and enduring mental health conditions. Aside from monetary reward, employment is a means of structuring time and provides a sense of worth and achievement, which enhances self-esteem and confidence. A social identity is developed through employment, encouraging social support and increasing social networks. Securing employment can bring about improved quality of life and positive change in one's social circumstances; therefore it can reduce symptoms associated with mental illness and potentially prevent re-offending, as the individual develops a sense of independence, self-efficacy, and value. Barriers to employment exist for forensic mental health service users and therefore it is imperative that employment needs are addressed at the earliest possible stage in recovery. An evaluation of employment activities across two forensic mental health units revealed a lack of appropriate employment opportunities for service users, and those roles available were not implemented in line with recommended best practice. In response to this issue several enterprises were established to offer opportunities for service users to engage in meaningful employment and develop skills that a future employer would value. Each enterprise responds to a business need within the units to ensure sustainability of services. The enterprises are essentially micro-businesses with social objectives whose surpluses are reinvested for the purpose of increasing opportunities for service users. The enterprises are underpinned by the philosophy of the Individual Placement and Support (IPS) model; empirical evidence suggests that the IPS model is the most effective intervention, based on the 'place then train' philosophy. The model recommends a focus upon rapid job search to achieve competitive employment for those who want to work; opportunities sourced should be consistent with individual

  14. Web服务访问控制规范及其实现%Specification and realization of access control of Web services

    张赛男

    2011-01-01

    This paper proposes an access control model for Web services. The integration of the security model into Web services can realize dynamic right changes of security access control on Web services for improving static access control at present. The new model provides view policy language to describe access control policy of Web services. At the end of the paper we describe an infrastructure of integration of the security model into Web services to enforce access control polices of Web services.%提出了一种用于Web服务的访问控制模型,这种模型和Web服务相结合,能够实现Web服务下安全访问控制权限的动态改变,改善目前静态访问控制问题。新的模型提供的视图策略语言VPL用于描述Web服务的访问控制策略。给出了新的安全模型和Web服务集成的结构,用于执行Web服务访问控制策略。

  15. Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries

    Stepurko, Tetiana; Pavlova, Milena; Groot, Wim

    2016-01-01

    Background: The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with...

  16. Mapping socio-environmentally vulnerable populations access and exposure to ecosystem services at the U.S.-Mexico borderlands

    Norman, Laura M.; Villarreal, Miguel L.; Lara-Valencia, Francisco; Yuan, Yongping; Nie, Wenming; Wilson, Sylvia; Amaya, Gladys; Sleeter, Rachel

    2012-01-01

    Socio-environmental vulnerable populations are often unrepresented in land-use planning yet have great potential for loss when exposed to changes in ecosystem services. Administrative boundaries, cultural differences, and language barriers increase the disassociation between land-use management and marginalized populations living in the U.S.–Mexico borderlands. This paper describes the development of a Modified Socio-Environmental Vulnerability Index (M-SEVI), using determinants from binational census and neighborhood data that describe levels of education, access to resources, migratory status, housing, and number of dependents, to provide a simplified snapshot of the region's populace that can be used in binational planning efforts. We apply this index at the SCW, located on the border between Arizona, USA and Sonora, Mexico. For comparison, the Soil and Water Assessment Tool is concurrently applied to assess the provision of erosion- and flood control services over a 9-year period. We describe how this coupling of data can form the base for an ecosystem services assessment across political boundaries that can be used by land-use planners. Results reveal potential disparities in environmental risks and burdens throughout the binational watershed in residential districts surrounding and between urban centers. The M-SEVI can be used as an important first step in addressing environmental justice for binational decision-making.

  17. Does the company's economic performance affect access to occupational health services?

    Suhonen Aki

    2009-09-01

    Full Text Available Abstract Background In Finland like in many other countries, employers are legally obliged to organize occupational health services (OHS for their employees. Because employers bear the costs of OHS it could be that in spite of the legal requirement OHS expenditure is more determined by economic performance of the company than by law. Therefore, we explored whether economic performance was associated with the companies' expenditure on occupational health services. Methods We used a prospective design to predict expenditure on OHS in 2001 by a company's economic performance in 1999. Data were provided by Statistics Finland and expressed by key indicators for profitability, solidity and liquidity and by the Social Insurance Institution as employers' reimbursement applications for OHS costs. The data could be linked at the company level. Regression analysis was used to study associations adjusted for various confounders. Results Nineteen percent of the companies (N = 6 155 did not apply for reimbursement of OHS costs in 2001. The profitability of the company represented by operating margin in 1999 and adjusted for type of industry was not significantly related to the company's probability to apply for reimbursement of the costs in 2001 (OR = 1.00, 95%CI: 0.99 to 1.01. Profitability measured as operating profit in 1999 and adjusted for type of industry was not significantly related to costs for curative medical services (Beta -0.001, 95%CI: -0.00 to 0.11 nor to OHS cost of prevention in 2001 (Beta -0.001, 95%CI: -0.00 to 0.00. Conclusion We did not find a relation between the company's economic performance and expenditure on OHS in Finland. We suppose that this is due to legislation obliging employers to provide OHS and the reimbursement system both being strong incentives for employers.

  18. Influence of socio-demographic factors on distances travelled to access HIV services: enhanced surveillance of HIV patients in north west England

    Tocque Karen

    2009-03-01

    Full Text Available Abstract Background Patient choice and access to health care is compromised by many barriers including travel distance. Individuals with the human immunodeficiency virus (HIV can seek free specialist care in Britain, without a referral, providing flexible access to care services. Willingness to travel beyond local services for preferred care has funding and service implications. Data from an enhanced HIV surveillance system were used to explore geodemographic and clinical factors associated with accessing treatment services. Methods We extracted data on the location, type and frequency of care services utilized by HIV positive persons (n = 3983 accessing treatment in north west England between January 1st 2005 and June 30th 2006. Individuals were allocated a deprivation score and grouped by urban/rural residence, and distance to care services was calculated. Analysis identified independent predictors of distance travelled (general linear modelling and, for those bypassing their nearest clinic, the probability of accessing a specialist service (logistic regression, SPSS ver 14. Inter-relationships between variables and distance travelled were visualised using detrended correspondence analysis (PC-ORD ver 4.1. Results HIV infected persons travelled an average of 4.8 km (95% confidence intervals (CI 4.6–4.9 per trip and had on average 6 visits (95% CI 5.9–6.2 annually for care. Longer trips were made by males (4.8 km vs 4.5 km, white people (6.2 km, the young (>15 years, 6.8 km and elderly (60+ years, 6.3 km, those on multiple therapy (5.3 km vs 4.0 km, and the more affluent living in rural areas (16.1 km, P Conclusion Distance travelled, and type of HIV services used, were associated with socioeconomic status, even after accounting for ethnicity, route of infection and age. Thus despite offering an 'equitable' service, travel costs may advantage those with higher income.

  19. Intra-cardiac echocardiography in alcohol septal ablation

    Cooper, Robert M; Shahzad, Adeel; Newton, James;

    2015-01-01

    Alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy reduces left ventricular outflow tract gradients. A third of patients do not respond; inaccurate localisation of the iatrogenic infarct can be responsible. Transthoracic echocardiography (TTE) using myocardial contrast can be...

  20. Trans-esophageal echocardiography for tricuspid and pulmonary valves

    Prabhu Mahesh

    2009-01-01

    Full Text Available Transesophageal echocardiography has been shown to provide unique information about cardiac anatomy, function, hemodynamics and blood flow and is relatively easy to perform with a low risk of complications. Echocardiographic evaluation of the tricuspid and pulmonary valves can be achieved with two-dimensional and Doppler imaging. Transesophageal echocardiography of these valves is more challenging because of their complex structure and their relative distance from the esophagus. Two-dimensional echocardiography allows an accurate visualization of the cardiac chambers and valves and their motion during the cardiac cycle. Doppler echocardiography is the most commonly used diagnostic technique for detecting and evaluating valvular regurgitation. The lack of good quality evidence makes it difficult to recommend a validated quantitative approach but expert consensus recommends a clinically useful qualitative approach. This review ennumerates probe placement, recommended cross-sectional views, flow patterns, quantitative equations including the clinical approach to the noninvasive quantification of both stenotic and regurgitant lesions.

  1. Teaching focused echocardiography for rheumatic heart disease screening

    Daniel Engelman

    2015-01-01

    Full Text Available Screening for rheumatic heart disease (RHD requires workers skilled in echocardiography, which typically involves prolonged, specialized training. Task shifting echocardiographic screening to nonexpert health workers may be a solution in settings with limited human resources. An 8-week training program was designed to train health workers without any prior experience in focused echocardiography for RHD screening. Seven health workers participated. At the completion of training, the health workers performed unsupervised echocardiography on 16 volunteer children with known RHD status. A pediatric cardiologist assessed image quality. Participants provided qualitative feedback. The quality of echocardiograms were high at completion of training (55 of 56 were adequate for diagnosis and all cases of RHD were identified. Feedback was strongly positive. Training health workers to perform focused echocardiography for RHD screening is feasible. After systematic testing for accuracy, this training program could be adapted in other settings seeking to expand echocardiographic capabilities.

  2. Advanced quantitative echocardiography in arrhythmogenic right ventricular cardiomyopathy

    Kjaergaard, Jesper; Hastrup Svendsen, Jesper; Sogaard, Peter;

    2007-01-01

    BACKGROUND: Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a regional disease of the RV myocardium with variable degrees of left ventricular involvement. Three-dimensional echocardiography and Doppler tissue imaging (DTI) are new echocardiographic modalities for the evaluation of ...

  3. Teaching focused echocardiography for rheumatic heart disease screening

    Screening for rheumatic heart disease (RHD) requires workers skilled in echocardiography, which typically involves prolonged, specialized training. Task shifting echocardiographic screening to nonexpert health workers may be a solution in settings with limited human resources. An 8-week training program was designed to train health workers without any prior experience in focused echocardiography for RHD screening. Seven health workers participated. At the completion of training, the health workers performed unsupervised echocardiography on 16 volunteer children with known RHD status. A pediatric cardiologist assessed image quality. Participants provided qualitative feedback. The quality of echocardiograms were high at completion of training (55 of 56 were adequate for diagnosis) and all cases of RHD were identified. Feedback was strongly positive. Training health workers to perform focused echocardiography for RHD screening is feasible. After systematic testing for accuracy, this training program could be adapted in other settings seeking to expand echocardiographic capabilities

  4. Community, service, and policy strategies to improve health care access in the changing urban environment.

    Andrulis, D P

    2000-06-01

    Urban communities continue to face formidable historic challenges to improving public health. However, reinvestment initiatives, changing demographics, and growth in urban areas are creating changes that offer new opportunities for improving health while requiring that health systems be adapted to residents' health needs. This commentary suggests that health care improvement in metropolitan areas will require setting local, state, and national agendas around 3 priorities. First, health care must reorient around powerful population dynamics, in particular, cultural diversity, growing numbers of elderly, those in welfare-workplace transition, and those unable to negotiate an increasingly complex health system. Second, communities and governments must assess the consequences of health professional shortages, safety net provider closures and conversions, and new marketplace pressures in terms of their effects on access to care for vulnerable urban populations; they must also weigh the potential value of emerging models for improving those populations' care. Finally, governments at all levels should use their influence through accreditation, standards, tobacco settlements, and other financing streams to educate and guide urban providers in directions that respond to urban communities' health care needs. PMID:10846501

  5. Apparatus for servicing an eleongated suspended pump motor in an electric power plant with limited access

    Elongated coolant pump motors suspended under steam generators within containment in a power plant with limited access space, are removed and replaced by an upright elongated maintenance cart with an elongated opening along one side in which the motor is received. Rollers support the cart for conveying the elongated motor in an upright position out from under the steam generator and onto an elevator. The elevator is lowered to transfer support of the cart and motor through trunnions to saddles straddling the elevator for rotation of the cart to a generally horizontal position. The elevator then raises the horizontally disposed cart carrying the motor to a higher floor where it is rolled off the elevator on rollers and out through the auxiliary equipment hatch. The cart includes a top V-shaped collar for supporting the motor, and a further lower support cradle operative when the cart is horizontal. Jacks support the motor during unbolting from the pump casing and lower it onto the cart. (Author)

  6. Access to HIV/AIDS services for disabled persons in Uganda

    Andersen, Helle Elisabeth

    2006-01-01

    a complex external-internal dialectic, and created at the boundaries that a society creates between “normals” and “outsiders”. This project explores what it means to be infected with HIV/AIDS and/or disabled in Uganda and how this affects a person’s identity. The lower social value of disabled persons......Abstract This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person...... reported as important issues regarding attendance at these services for PWDs. Those obstacles are there, but according to my fieldwork the physical barriers in the “healthcare system” do not seem to be as important as barriers outside the “healthcare system”. These barriers are constituted through...

  7. Access to HIV/AIDS services for disabled persons in Uganda - problems of stigma and discrimination?

    Andersen, Helle Elisabeth

    2009-01-01

    -internal dialectic, and created at the boundaries that a society creates between “normals” and “outsiders”. This project explores what it means to be infected with HIV/AIDS and/or disabled in Uganda and how this affects a person’s identity. The lower social value of disabled persons prevents them from participating......This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person with disabilities...... as important issues regarding attendance at these services for PWDs. Those obstacles are there, but according to my fieldwork the physical barriers in the “healthcare system” do not seem to be as important as barriers outside the “healthcare system”. These barriers are constituted through a complex external...

  8. Access to special care dentistry, part 6. Special care dentistry services for young people.

    Dougall, A; Fiske, J

    2008-09-13

    This article brings together some of the 'hidden disabilities' common amongst adolescents and young adults. Many of these conditions carry a social stigma and some are associated with secretive behaviour and even denial. The article will describe the features, management and oral implications of five eating disorders (Prader-Willi syndrome, anorexia nervosa, bulimia nervosa, binge eating disorder and pica) and three types of mental health problems (schizophrenia, obsessive-compulsive disorder and bipolar disorder). Without the input of the dental profession, and in the main the primary dental care service, all these conditions can have a detrimental effect on the dentition at a relatively early stage in life. Mental health problems are more common in adolescents and young adults than most people realise and this article will also consider the impact on oral health and delivery of dental care to young people who have experienced childhood sexual abuse. PMID:18791579

  9. Barriers to accessing eye care services among visually impaired populations in rural Andhra Pradesh, South India

    Kovai Vilas

    2007-01-01

    Full Text Available Purpose: To understand the reasons why people in rural south India with visual impairment arising from various ocular diseases do not seek eye care. Materials and Methods: A total of 5,573 persons above the age of 15 were interviewed and examined in the South Indian state of Andhra Pradesh covering the districts of Adilabad, West Godavari and Mahaboobnagar. A pre-tested structured questionnaire on barriers to eye care was administered by trained field investigators. Results: Of the eligible subjects, 1234 (22.1%, N=5573 presented with distant visual acuity < 20/60 or equivalent visual field loss in the better eye. Of these, 898 (72.7%, N=1234 subjects had not sought treatment despite noticing a decrease in vision citing personal, economic and social reasons. The analysis also showed that the odds of seeking treatment was significantly higher for literates [odds ratio (OR 1.91, 95% confidence interval (CI 1.38 to 2.65], for those who would be defined as blind by visual acuity category (OR 1.35, 95% CI 0.96 to 1.90 and for those with cataract and other causes of visual impairment (OR 1.50, 95% CI 1.11 to 2.03. Barriers to seeking treatment among those who had not sought treatment despite noticing a decrease in vision over the past five years were personal in 52% of the respondents, economic in 37% and social in 21%. Conclusion: Routine planning for eye care services in rural areas of India must address the barriers to eye care perceived by communities to increase the utilization of services.

  10. Statistics for library and information services a primer for using open source R software for accessibility and visualization

    Friedman, Alon

    2016-01-01

    Statistics for Library and Information Services, written for non-statisticians, provides logical, user-friendly, and step-by-step instructions to make statistics more accessible for students and professionals in the field of Information Science. It emphasizes concepts of statistical theory and data collection methodologies, but also extends to the topics of visualization creation and display, so that the reader will be able to better conduct statistical analysis and communicate his/her findings. The book is tailored for information science students and professionals. It has specific examples of dataset sets, scripts, design modules, data repositories, homework assignments, and a glossary lexicon that matches the field of Information Science. The textbook provides a visual road map that is customized specifically for Information Science instructors, students, and professionals regarding statistics and visualization. Each chapter in the book includes full-color illustrations on how to use R for the statistical ...

  11. Trans-esophageal echocardiography for tricuspid and pulmonary valves

    Prabhu Mahesh

    2009-01-01

    Transesophageal echocardiography has been shown to provide unique information about cardiac anatomy, function, hemodynamics and blood flow and is relatively easy to perform with a low risk of complications. Echocardiographic evaluation of the tricuspid and pulmonary valves can be achieved with two-dimensional and Doppler imaging. Transesophageal echocardiography of these valves is more challenging because of their complex structure and their relative distance from the esophagus. Two-dimension...

  12. Prognostic value of dobutamine stress echocardiography in patients with diabetes

    Sozzi, Fabiola; Elhendy, Abdou; Schinkel, Arend; Vourvouri, Eleni; Bax, Jeroen; Sutter, J.; Borghetti, A.; Poldermans, Don; Roelandt, Jos; Domburg, Ron

    2003-01-01

    textabstractOBJECTIVE: The aim of this study was to assess the incremental value of dobutamine stress echocardiography (DSE) for the risk stratification of diabetic patients who are unable to perform an adequate exercise stress test. Exercise capacity is frequently impaired in patients with diabetes. The role of pharmacologic stress echocardiography in the risk stratification of diabetic patients has not been well defined. RESEARCH DESIGN AND METHODS: We studied 396 diabetic patients (mean ag...

  13. [Improved reproducibility of contrast echocardiography by SH U 454. Experimental studies using digital subtraction echocardiography].

    Grube, E; Fritzsch, T

    1986-06-01

    The right heart chambers of 10 animals were contrasted by conventional (NaCl, CO2, H2O2, indocyanine green (ICG), haemaccel) and a newly developed echo-contrast medium (SH U 454) and studied by 2-D echocardiography. By means of digital subtraction echocardiography (DSE) endocardial borders were defined automatically and the results were compared with the manual input of endocardial borders of original and contrast echocardiograms. The area enclosed by these borders served as basis for the calculation of reproducibility (in %) and correlations. The following correlation coefficients (r) and SEE were calculated between the areas defined by the different contrast media and DSE and manually derived borders: r = 0.85, 3.98 cm2 (ICG), and 0.89, 1.00 cm2 (haemaccel). The best calculations were found using SH U 454 in concentrations between 100 and 300 mg/ml. The correlation coefficients were in the range of r = 0.95 and 0.98 with an SEE of 0.21 to 0.56 cm2 between manually and automatically derived contours. Comparing the reproducibility of data between the different evaluation methods we found the following results: manual input of endocardial borders in original echocardiograms 12.3%-16.9%; manual definition of endocardial borders in contrast echocardiograms 2.0% (SH U 454) - 15.7% (CO2); automatic contour finding in original echocardiograms 8.6%-28.9% (mean 21.6%); automatic definition of endocardium by DSE in contrast echocardiograms 7.6% (ICG) - 0.9% (SH U 454, 300 mg/ml). Our results demonstrate that digital subtraction echocardiography is a simple an safe procedure to define endocardial contours if echo contrast media lead to a uniform and homogeneous opacification of the left and right cardiac cavities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3529670

  14. Avoiding transthoracic echocardiography and transesophageal echocardiography for patients with variable body mass indexes in infective endocarditis

    Robert Sogomonian

    2016-04-01

    Full Text Available Background: Echocardiography has been a popular modality used to aid in the diagnosis of infective endocarditis (IE with the modified Duke criteria. We evaluated the necessity between the uses of either a transthoracic echocardiography (TTE or transesophageal echocardiography (TEE in patients with a body mass index (BMI greater than or equal to 25 kg/m2 and less than 25 kg/m2. Methods: A single-centered, retrospective study of 198 patients between 2005 and 2012 diagnosed with IE based on modified Duke criteria. Patients, required to be above age 18, had undergone an echocardiogram study and had blood cultures to be included in the study. Results: Among 198 patients, two echocardiographic groups were evaluated as 158 patients obtained a TTE, 143 obtained a TEE, and 103 overlapped with TEE and TTE. Out of these patients, 167 patients were included in the study as 109 (65% were discovered to have native valve vegetations on TEE and 58 (35% with TTE. TTE findings were compared with TEE results for true negatives and positives to isolate valvular vegetations. Overall sensitivity of TTE was calculated to be 67% with a specificity of 93%. Patients were further divided into two groups with the first group having a BMI ≥25 kg/m2 and the subsequent group with a BMI <25 kg/m2. Patients with a BMI ≥25 kg/m2 who underwent a TTE study had a sensitivity and specificity of 54 and 92%, respectively. On the contrary, patients with a BMI < 25 kg/m2 had a TTE sensitivity and specificity of 78 and 95%, respectively. Conclusions: Patients with a BMI <25 kg/m2 and a negative TTE should refrain from further diagnostic studies, with TEE strong clinical judgment is warranted. Patients with a BMI ≥ 25 kg/m2 may proceed directly to TEE as the initial study, possibly avoiding an additional study with a TTE.

  15. Self-reported health status and access to health services in a sample of prisoners in Italy

    Pileggi Claudia

    2011-07-01

    Full Text Available Abstract Background Self-reported health status in underserved population of prisoners has not been extensively explored. The purposes of this cross-sectional study were to assess self-reported health, quality of life, and access to health services in a sample of male prisoners of Italy. Methods A total of 908 prisoners received a self-administered anonymous questionnaire pertaining on demographic and detention characteristics, self-reported health status and quality of life, access to health services, lifestyles, and participation to preventive, social, and rehabilitation programs. A total of 650 prisoners agreed to participate in the study and returned the questionnaire. Results Respectively, 31.6% and 43.5% of prisoners reported a poor perceived health status and a poor quality of life, and 60% admitted that their health was worsened or greatly worsened during the prison stay. Older age, lower education, psychiatric disorders, self-reported health problems on prison entry, and suicide attempts within prison were significantly associated with a perceived worse health status. At the time of the questionnaire delivery, 30% of the prisoners self-reported a health problem present on prison entry and 82% present at the time of the survey. Most frequently reported health problems included dental health problems, arthritis or joint pain, eye problems, gastrointestinal diseases, emotional problems, and high blood pressure. On average, prisoners encountered general practitioners six times during the previous year, and the frequency of medical encounters was significantly associated with older age, sentenced prisoners, psychiatric disorders, and self-reported health problems on prison entry. Conclusions The findings suggest that prisoners have a perceived poor health status, specific care needs and health promotion programs are seldom offered. Programs for correction of risk behaviour and prevention of long-term effects of incarceration on prisoners

  16. Transoesophageal echocardiography: What a neuroanaesthesiologist should know?

    Minati Choudhury

    2015-01-01

    Full Text Available Transoesophageal echocardiography (TEE is a semi invasive imaging modality rapidly gained credence and popularity in the cardiothoracic centers worldwide by mid 1990s. It has also been found to be useful in some noncardiac surgical procedures, in particular in the management of neurosurgical patients and haemodynamically unstable patients in intensive care units (ICUs. The principal goal of basic transoesophageal echocardiographic examination encompass a broad range of anatomic imaging including the diagnosis of air embolism, causes of haemodynamic instability, ventricular size and function, volume status, and complications from invasive procedures, as well as the clinical impact or etiology of pulmonary dysfunction in ICU. TEE is relatively cheap and semi-invasive, but it should not be used as a stand-alone device but as a tool which provides data in addition to the data acquired from other forms of monitoring. The establishment of TEE in perioperative neuro anaesthetic care though recent, may result in a significant change in the role of the anaesthetsiologist who, using TEE can provide new information which may change the course and the outcome of surgical procedures.

  17. Dynamic 3D echocardiography in virtual reality

    Simoons Maarten L

    2005-12-01

    Full Text Available Abstract Background This pilot study was performed to evaluate whether virtual reality is applicable for three-dimensional echocardiography and if three-dimensional echocardiographic 'holograms' have the potential to become a clinically useful tool. Methods Three-dimensional echocardiographic data sets from 2 normal subjects and from 4 patients with a mitral valve pathological condition were included in the study. The three-dimensional data sets were acquired with the Philips Sonos 7500 echo-system and transferred to the BARCO (Barco N.V., Kortrijk, Belgium I-space. Ten independent observers assessed the 6 three-dimensional data sets with and without mitral valve pathology. After 10 minutes' instruction in the I-Space, all of the observers could use the virtual pointer that is necessary to create cut planes in the hologram. Results The 10 independent observers correctly assessed the normal and pathological mitral valve in the holograms (analysis time approximately 10 minutes. Conclusion this report shows that dynamic holographic imaging of three-dimensional echocardiographic data is feasible. However, the applicability and use-fullness of this technology in clinical practice is still limited.

  18. Minimally invasive cardiac surgery and transesophageal echocardiography

    Ajay Kumar Jha

    2014-01-01

    Full Text Available Improved cosmetic appearance, reduced pain and duration of post-operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS; however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra-operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real-time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post-operative outcome of patients managed with MICS.

  19. Echocardiography and cardiac resynchronisation therapy, friends or foes?

    van Everdingen, W M; Schipper, J C; van 't Sant, J; Ramdat Misier, K; Meine, M; Cramer, M J

    2016-01-01

    Echocardiography is used in cardiac resynchronisation therapy (CRT) to assess cardiac function, and in particular left ventricular (LV) volumetric status, and prediction of response. Despite its widespread applicability, LV volumes determined by echocardiography have inherent measurement errors, interobserver and intraobserver variability, and discrepancies with the gold standard magnetic resonance imaging. Echocardiographic predictors of CRT response are based on mechanical dyssynchrony. However, parameters are mainly tested in single-centre studies or lack feasibility. Speckle tracking echocardiography can guide LV lead placement, improving volumetric response and clinical outcome by guiding lead positioning towards the latest contracting segment. Results on optimisation of CRT device settings using echocardiographic indices have so far been rather disappointing, as results suffer from noise. Defining response by echocardiography seems valid, although re-assessment after 6 months is advisable, as patients can show both continuous improvement as well as deterioration after the initial response. Three-dimensional echocardiography is interesting for future implications, as it can determine volume, dyssynchrony and viability in a single recording, although image quality needs to be adequate. Deformation patterns from the septum and the derived parameters are promising, although validation in a multicentre trial is required. We conclude that echocardiography has a pivotal role in CRT, although clinicians should know its shortcomings. PMID:26645707

  20. Usefulness and limitations of transthoracic echocardiography in heart transplantation recipients

    Galderisi Maurizio

    2008-01-01

    Full Text Available Abstract Transthoracic echocardiography is a primary non-invasive modality for investigation of heart transplant recipients. It is a versatile tool which provides comprehensive information about cardiac structure and function. Echocardiographic examinations can be easily performed at the bedside and serially repeated without any patient's discomfort. This review highlights the usefulness of Doppler echocardiography in the assessment of left ventricular and right ventricular systolic and diastolic function, of left ventricular mass, valvular heart disease, pulmonary arterial hypertension and pericardial effusion in heart transplant recipients. The main experiences performed by either standard Doppler echocardiography and new high-tech ultrasound technologies are summarised, pointing out advantages and limitations of the described techniques in diagnosing acute allograft rejection and cardiac graft vasculopathy. Despite the sustained efforts of echocardiographic technique in predicting the biopsy state, endocardial myocardial biopsies are still regarded as the gold standard for detection of acute allograft rejection. Conversely, stress echocardiography is able to identify accurately cardiac graft vasculopathy and has a recognised prognostic in this clinical setting. A normal stress-echo justifies postponement of invasive studies. Another use of transthoracic echocardiography is the monitorisation and the visualisation of the catheter during the performance of endomyocardial biopsy. Bedside stress echocardiography is even useful to select appropriately heart donors with brain death. The ultrasound monitoring is simple and effective for monitoring a safe performance of biopsy procedures.

  1. Access to abortion services: abortions performed by mid-level practitioners.

    Kowalczyk, E A

    1993-01-01

    Because the number of physicians available to perform abortions in the US is dwindling, certified nurse-midwives, nurse practitioners, and physician assistants should be trained and permitted to perform abortions. Roadblocks to this change are the fact that the Supreme Court would likely allow states to prevent mid-level practitioners from performing abortions in the name of protecting the health of the mother. Also, existing statutes would probably not be interpreted by courts to allow mid-level practitioners to perform abortions. However, physician assistants have been performing abortions in Vermont since 1975, and a 1981-82 comparative study affirmed that physician assistants are well-equipped to perform abortions (of 2458 procedures, the complication rate/1000 was 27.4 for physician assistants and 30.8 for physicians). However, controversy surrounds the provision of abortion by these physician assistants in Vermont, since the relevant statute suggests that abortion is illegal unless performed by a physician. However, the statute has not been changed since Roe vs. Wade and is likely unconstitutional. Court cases in Missouri and Tennessee suggest that courts may be willing to include abortion within the scope of progressive nursing practice acts, but a recent similar case in Massachusetts resulted in a narrow interpretation of nursing practice statutes. Because the definition of professional nursing varies with each state statute, it will be a formidable task to convince every jurisdiction to include abortion as a permissible mid-level practice. Even in Vermont, the nursing practice statute defines in an exclusive list what services the professional nurse may perform (whereas the physician assistant regulations limit their scope of practice only to that delegated by a supervising physician). States could, of course, pass statutes which include abortion as a permissible practice for the mid-level practitioner. However, specific legislation would provide a clear

  2. Assessment and analysis of territorial experiences in digital tele-echocardiography.

    Frumento, Enrico; Colombo, Cesare; Borghi, Gabriella; Masella, Cristina; Zanaboni, Paolo; Barbier, Paolo; Cavoretto, Dario

    2009-01-01

    Nowadays digital ultrasound-cardiovascular devices are able to send out directly digital images and films. Thanks to the large adoption of such devices, the echocardiographic world is facing new ways of exchanging images and collaborating. What we present in this paper is a review of the experimental projects carried in Lombardy, meant to support the work of specialists by means of second opinion and telemedicine services. On the medical point of view echocardiography is a widely used activity where operators are perfectly accustomed to do repetitive operations and steps. Tele-echocardiography (T-E) introduces new methods and technologies into stable and everyday medical practice, causing disruptions either on the side of the specialists' way of working or on the new opportunities and service. Introducing such a service means to properly model it in order to reduce the changes in the operators' way of working while maximizing the benefits. A proper method of modelling the operators' needs is then a key factor which must be correctly addressed. This paper will present some successful projects and the assessment procedure but it will also discuss a possible service modelling method, which has been adopted for the described experiences. PMID:20061656

  3. Assessment and analysis of territorial experiences in digital tele-echocardiography

    Enrico Frumento

    2009-12-01

    Full Text Available Nowadays digital ultrasound-cardiovascular devices are able to send out directly digital images and films. Thanks to the large adoption of such devices, the echocardiographic world is facing new ways of exchanging images and collaborating. What we present in this paper is a review of the experimental projects carried in Lombardy, meant to support the work of specialists by means of second opinion and telemedicine services. On the medical point of view echocardiography is a widely used activity where operators are perfectly accustomed to do repetitive operations and steps. Tele-echocardiography (T-E introduces new methods and technologies into stable and everyday medical practice, causing disruptions either on the side of the specialists' way of working or on the new opportunities and service. Introducing such a service means to properly model it in order to reduce the changes in the operators' way of working while maximizing the benefits. A proper method of modelling the operators' needs is then a key factor which must be correctly addressed. This paper will present some successful projects and the assessment procedure but it will also discuss a possible service modelling method, which has been adopted for the described experiences.

  4. The APIS service : a tool for accessing value-added HST planetary auroral observations over 1997-2015

    Lamy, L.; Henry, F.; Prangé, R.; Le Sidaner, P.

    2015-10-01

    The Auroral Planetary Imaging and Spectroscopy (APIS) service http://obspm.fr/apis/ provides an open and interactive access to processed auroral observations of the outer planets and their satellites. Such observations are of interest for a wide community at the interface between planetology, magnetospheric and heliospheric physics. APIS consists of (i) a high level database, built from planetary auroral observations acquired by the Hubble Space Telescope (HST) since 1997 with its mostly used Far-Ultraviolet spectro- imagers, (ii) a dedicated search interface aimed at browsing efficiently this database through relevant conditional search criteria (Figure 1) and (iii) the ability to interactively work with the data online through plotting tools developed by the Virtual Observatory (VO) community, such as Aladin and Specview. This service is VO compliant and can therefore also been queried by external search tools of the VO community. The diversity of available data and the capability to sort them out by relevant physical criteria shall in particular facilitate statistical studies, on long-term scales and/or multi-instrumental multispectral combined analysis [1,2]. We will present the updated capabilities of APIS with several examples. Several tutorials are available online.

  5. The Permanent Service for Mean Sea Level: Recent Improvements in Data Access and Storage

    Matthews, A. P.; Bradshaw, E.; Gordon, K.; Holgate, S. J.; Jevrejeva, S.; Rickards, L. J.; Tamisiea, M.; Woodworth, P. L.

    2010-05-01

    The Permanent Service for Mean Sea Level (PSMSL) is the internationally recognised global sea level databank for long term sea level change information from tide gauges. Established in 1933, the PSMSL continues to be responsible for the collection, publication, analysis and interpretation of sea level data. The PSMSL was formerly a member of the Federation of Astronomical and Geophysical Data Analysis (FAGS), and is currently being incorporated into the new World Data System (WDS) of the International Council for Science (ICSU). In addition, the PSMSL has close links with the Intergovernmental Oceanographic Commission's (IOC's) Global Sea Level Observing System (GLOSS). Currently the PSMSL databank holds over 58,000 station years of data from over 2,000 stations and in the region of 200 authorities worldwide. Data undergo careful quality control, including ensuring year to year continuity, before addition to the databank. Where possible, data is reduced to a common datum for time series analysis. In 2007 the PSMSL combined its monthly mean sea level activities with the higher frequency data collection from GLOSS station sites conducted by the British Oceanographic Data Centre (BODC). The PSMSL also attempts to stimulate the development of tide gauge networks at national, regional and global level. It provides training and technical advice to national sea level authorities, mainly through its work with GLOSS. It has also been closely involved in the installation and continued operation of twelve gauges in Africa and the Western Indian Ocean as part of the ODINAFRICA and Indian Ocean Tsunami Warning System programmes. The PSMSL data storage systems have recently been redesigned in order to increase data integrity and take advantage of recent developments in database technology. A suite of graphical user interfaces have been developed to facilitate maintenance and quality control of the database by PSMSL staff. In addition, a new interactive data portal has been

  6. Factors that influence the preventive care offered to adolescents accessing Public Oral Health Services, NSW, Australia

    Masoe AV

    2015-06-01

    Full Text Available Angela V Masoe,1 Anthony S Blinkhorn,2 Jane Taylor,1 Fiona A Blinkhorn1 1School of Health Sciences, Faculty of Health and Medicine, Oral Health, University of Newcastle, Ourimbah, NSW, Australia; 2Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia Background: Many adolescents are at risk of dental caries and periodontal disease, which may be controlled through health education and clinical preventive interventions provided by oral health and dental therapists (therapists. Senior clinicians (SCs can influence the focus of dental care in the New South Wales (NSW Public Oral Health Services as their role is to provide clinical support and advice to therapists, advocate for their communities, and inform Local Health District (LHD managers of areas for clinical quality improvement. The objective of this study was to record facilitating factors and strategies that are used by SCs to encourage therapists to provide preventive care and advice to adolescent patients. Methods: In-depth, semistructured interviews were undertaken with 16 SCs from all of the 15 NSW LHDs (nine rural and six metropolitan. A framework matrix was used to systematically code data and enable key themes to be identified for analysis. Results: All SCs from the 15 NSW Health LHDs participated in the study. Factors influencing SCs' ability to integrate preventive care into clinical practice were: 1 clinical leadership and administrative support, 2 professional support network, 3 clinical and educational resources, 4 the clinician's patient management aptitude, and 5 clinical governance processes. Clinical quality improvement and continuing professional development strategies equipped clinicians to manage and enhance adolescents' confidence toward self-care. Conclusion: This study shows that SCs have a clear understanding of strategies to enhance the therapist's offer of scientific-based preventive care to adolescents. The problem

  7. FETAL ECHOCARDIOGRAPHY: A STUDY OF CLINICAL OUTCOME

    Rajanish

    2014-01-01

    Full Text Available BACKGROUND : S tructural abnormalities of the heart and great vessels are fairly common congenital lab normalities with the incidenceof8 in 1000 live births. With the advent of real time scanners fetal cardia can atomy can be analyze d echocardiographically. The earlier diagnosis will make an impact on clinical management of fetus with congenital heart disease. It helps intimely triage and optimal management of specific congenital heart disease either structural , functional orarrhythmia . OBJECTIVES : This study was conducted to note the spectrum of congenital heart diseases detected on fetal echo in pregnant mothers referred with high risk for CHD sand to assess the outcome of prenatally detected congenital heart diseases. MATERIAL S AND METHODS : T he study is aprospective descriptive study conducted in a tertiary care pediatric hospital in Mumbai over period of one year . P regnant mothers were referred for fetal echo , where pregnancy was considered as high risk for CHDs due to maternal , fetalfactorsorabnormallevel 1 scan.Fetal echowas performed by a trained pediatric cardiologistat 18 to 20 week of gestation using HP sonos 2000 echocardiographicmachinewith3/3.5 Hz transducer. Cardiac lesionsandoutcome of pregnancy was noted by postnatal follow - up of patients. RESULTS : A total of 170 patients underwent fetal echo , 13 patients have not delivered and 48 were lost to follow - up. Fetal echo was normal in 130(76.4% and abnormalities were detected in 40(23.5%.Structural anomalies were seen in 24(14.1% , arrhythmia in 5(2.9% and functional abnormalities in 11(6.4%.On outcome analysis84 (77.1% arealive , IUD /terminationof pregnancyoccurred in 18(16.5% , neonatal death in 6 (5.5% , infant death in 1 (0.9%. CONCLUSIONS : All ranges of CHDs can be diagnosed by fetal echocardiography . O utcome of prenatally detected complex congenital heart disease is poor ; nonetheless earlier detection provides a n opportunity for early interventions and

  8. Digital tele-echocardiography: a look inside

    Daniele Giansanti

    2009-12-01

    Full Text Available Digital tele-echocardiography (T-E has the potentiality to allow relevant change in health care organization. The purpose of the paper is to analyze the scientific development around the digital T-E to explore the successful applications and individuate the limits which hamper the routine introduction in the National Health Care System (NHCS. A literature review was carried out by searching for studies from 1988 to 2008. The studies have been investigated according to four crucial issues: a the employment of the digital T-E versus the traditional videotape registrations; b the evolution of the telecommunication network and T-E; c the quality assessment of the images after transmission; d the economical legal and social impact of the T-E. The analysis showed a generalized increased diffusion of the digital T-E thanks to the wonderful development of the information technology. This diffusion was sometimes also accompanied by investigation studies on the diagnostic accuracy and on cost-benefit analysis with special care to the economical and social impact. The study examined some points which need to be improved to allow a better introduction of the T-E in the NHCS as a routine exam. Among these two were the most important. The first was the lacking of an easy and automatic methodology for the image quality assessment alternative to the currently used methods which are highly complex, expensive and needing a long time to be applied. The second was the lacking of a properly designed methodology for the health technology assessment in T-E, the latter, as it is well known is a very complex and heterogeneus system embedding parts from telematics, bioengineering, and medical physics.

  9. BioGRID REST Service, BiogridPlugin2 and BioGRID WebGraph: new tools for access to interaction data at BioGRID

    Winter, A. G.; Wildenhain, J; Tyers, M

    2011-01-01

    Summary: The Biological General Repository for Interaction Datasets (BioGRID) representational state transfer (REST) service allows full URL-based access to curated protein and genetic interaction data at the BioGRID database. Appending URL parameters allows filtering of data by various attributes including gene names and identifiers, PubMed ID and evidence type. We also describe two visualization tools that interface with the REST service, the BiogridPlugin2 for Cytoscape and the BioGRID Web...

  10. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative

    Hennessy, Thomas W; Bressler, Jonathan M.

    2016-01-01

    Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH) has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services an...

  11. Preferences of Hungarian consumers for quality, access and price attributes of health care services — result of a discrete choice experiment

    Baji, Petra; Pavlova, Milena; Gulácsi, László; Groot, Wim

    2012-01-01

    In 2010, a household survey was carried out in Hungary among 1037 respondents to study consumer preferences and willingness to pay for health care services. In this paper, we use the data from the discrete choice experiments included in the survey, to elicit the preferences of health care consumers about the choice of health care providers. Regression analysis is used to estimate the effect of the improvement of service attributes (quality, access, and price) on patients’ choice, as well as t...

  12. Federally Qualified Health Centers Minimize the Impact of Loss of Frequency and Independence of Movement in Older Adult Patients through Access to Transportation Services

    Krystal Elaine Knight

    2011-01-01

    Loss of mobility in older adults (65 and older) is associated with falling, loss of independence, and mortality. This paper, which to the author's knowledge is the first of its kind, summarizes findings of Federally Qualified Health Center (FQHC) case reports and how FQHCs minimize the impacts of mobility loss in older adult patients (who would not receive primary services without these transportation programs) by providing access to primary care services through transportation programs. This...

  13. POST GRADUATE PROGRAMME IN DIETETICS &FOOD SERVICE MANAGEMENT (MSCDFSM PROGRAMME of IGNOU: Access through the Lucknow Regional Centre

    J. S. DOROTHY

    2014-10-01

    Full Text Available Indira Gandhi National Open University (IGNOU which was established initially as a Single mode Distance Teaching Institution (DTI in the year 1985 opened its campus to face-to-face education in the year 2008 and thus now is a Dual mode Distance Teaching Institution (DTI. The Post Graduate Programme (Master of Science in Dietetics and Food Service Management (MScDFSM Programme of IGNOU offered through the Distance Learning Mode from the year 2005 has been the boon in developing human resources involved in Nutrition and Dietetics services and also serves as a mode for continuing education among the professionals on-the-job. Accessibility to the programme is independent of the qualification earned at the Bachelor’s level as at IGNOU flexibility of the qualification is ensured for fulfilling the eligibility criteria into the MScDFSM Programme so that the diverse needs of the aspirants are accommodated at entry level itself. The Programme is unique in that it has compulsory Dissertation and Internship besides the Theory and Practical Courses. The Self-Study is enriched by the Teacher inbuilt Self-instructional Study Materials coupled with compulsory submission of the Tutor Marked Assignments (TMA which phase learning and initiate the didactic communication between the Academic Counsellor (who facilitate the Academic Transactions at the field level functionary - the Learner Support Centre and the Learner. The MSc DFSM Programme of IGNOU, as the distance learning programme offered by the School of Continuing Education (SOCE of IGNOU in the Indian Sub-Continent only. This paper discusses how the MScDFSM Programme of IGNOU is contributing to the staff development of in-service Nutritionists and Dietitians through the distance education/learning mode in Lucknow (Uttar Pradesh, North India Regional Centre. This paper also highlights the Institutions, which served as the Learner Support Centres from the year 2005 (when the programme was launched till 2011

  14. Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana

    Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Zakariah, Ahmed N; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Campbell, Thomas B

    2015-01-01

    Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana’s national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. Methods: A survey instrument was developed using Pechansky and Thomas’s model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. Results: 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18–35 years were more likely than older respondents to prefer an ambulance (odds

  15. Extreme Tele-Echocardiography: Methodology for Remote Guidance of In-Flight Echocardiography Aboard the International Space Station

    Martin, David S.; Borowski, Allan; Bungo, Michael W.; Gladding, Patrick; Greenberg, Neil; Hamilton, Doug; Levine, Benjamin D.; Lee, Stuart M.; Norwood, Kelly; Platts, Steven H.; Matz, Timothy; Roper, Matthew; Sandoz, Gwenn; Thomas, James D.

    2012-01-01

    Methods: In the year before launch of an ISS mission, potential astronaut echocardiographic operators participate in 5 sessions to train for echo acquisitions that occur roughly monthly during the mission, including one exercise echocardiogram. The focus of training is familiarity with the study protocol and remote guidance procedures. On-orbit, real-time guidance of in-flight acquisitions is provided by a sonographer in the Telescience Center of Mission Control. Physician investigators with remote access are able to relay comments on image quality to the sonographer. Live video feed is relayed from the ISS to the ground via the Tracking and Data Relay Satellite System with a 2- second transmission delay. The expert sonographer uses these images, along with twoway audio, to provide instructions and feedback. Images are stored in non-compressed DICOM format for asynchronous relay to the ground for subsequent off-line analysis. Results: Since June, 2009, a total of 27 resting echocardiograms and 5 exercise studies have been performed during flight. Average acquisition time has been 45 minutes, reflecting 26,000 km of ISS travel per study. Image quality has been adequate in all studies, and remote guidance has proven imperative for fine-tuning imaging and prioritizing views when communication outages limit the study duration. Typical resting studies have included 27 video loops and 30 still-frame images requiring 750 MB of storage. Conclusions: Despite limited crew training, remote guidance allows research-quality echocardiography to be performed by non-experts aboard the ISS. Analysis is underway and additional subjects are being recruited to define the impact of microgravity on cardiac structure and systolic and diastolic function.

  16. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative

    Thomas W. Hennessy

    2016-04-01

    Full Text Available Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services and for health indicators associated with these services. In this review, we highlight relevant data and describe an initiative through the Arctic Council's Sustainable Development Working Group to characterize the extent of WASH services in Arctic nations, the related health indicators and climate-related vulnerabilities to WASH services. With this as a baseline, efforts to build collaborations across the Arctic will be undertaken to promote innovations that can extend the benefits of water and sanitation services to all residents.

  17. Improving health in the Arctic region through safe and affordable access to household running water and sewer services: an Arctic Council initiative.

    Hennessy, Thomas W; Bressler, Jonathan M

    2016-01-01

    Important health disparities have been documented among the peoples of the Arctic and subarctic, including those related to limited access to in-home improved drinking water and sanitation services. Although improving water, sanitation and hygiene (WASH) has been a focus of the United Nations for decades, the Arctic region has received little attention in this regard. A growing body of evidence highlights inequalities across the region for the availability of in-home drinking WASH services and for health indicators associated with these services. In this review, we highlight relevant data and describe an initiative through the Arctic Council's Sustainable Development Working Group to characterize the extent of WASH services in Arctic nations, the related health indicators and climate-related vulnerabilities to WASH services. With this as a baseline, efforts to build collaborations across the Arctic will be undertaken to promote innovations that can extend the benefits of water and sanitation services to all residents. PMID:27132632

  18. Lowering the Barrier to Cross-Disciplinary Scientific Data Access via a Brokering Service Built Around a Unified Data Model

    Lindholm, D. M.; Wilson, A.

    2012-12-01

    reference implementation of the data model and server framework (with a RESTful service interface) in the Scala programming language. Scala can be thought of as the next generation of Java. It runs on the Java Virtual Machine and can directly use Java code. Scala improves upon Java's object-oriented capabilities and adds support for functional programming paradigms which are particularly well suited for scientific data analysis. The Scala implementation of LaTiS can be thought of as a Domain Specific Language (DSL) which presents an API that better matches the semantics of the problems scientific data users are trying to solve. Instead of working with bytes, ints, or arrays, the data user can directly work with data as "time series" or "spectra". LaTiS provides many layers of abstraction with which users can interact to support a wide variety of data access and analysis needs.

  19. Speckle Tracking Echocardiography of the Right Atrium: The Neglected Chamber.

    Rai, Aitzaz Bin Sultan; Lima, Eduardo; Munir, Farrukh; Faisal Khan, Anum; Waqas, Ahmed; Bughio, Sara; ul Haq, Ehtesham; Attique, Hassan Bin; Rahman, Zia Ur

    2015-11-01

    The right atrium (RA) plays a pivotal role in electromechanical and endocrine regulation of the heart. Its peculiar anatomical features and phasic mechanical function make it distinct from ventricles. Various invasive and noninvasive techniques have been used to elucidate RA structure and function. Of these modalities, echocardiography has distinct advantages over others. Several conventional measures of RA function through echocardiography have been described in the literature, but they are load dependent. A relatively new technique is speckle tracking-derived strain, which is relatively less dependent on loading conditions. Speckle tracking echocardiography tracks acoustic scatters (speckles) of myocardium frame-by-frame to calculate strain or deformation of the myocardium. Speckle tracking echocardiography has been used extensively for strain assessment of the right and left ventricle to detect subtle disease pathology, to gain mechanistic insight, as a marker of ischemic metabolic memory, as an endpoint in clinical trials, and as a functional assessment tool. The RA is a relatively neglected chamber, as it is mostly studied for assessment of atrial mass lesions, for electrophysiological studies, and in animal models for physiological assessment. However, its role in the systolic and diastolic function of the right heart, pulmonary vascular pathology, congenital heart diseases, and combined electromechanical activation phenomena has been less explored or unexplored. Speckle tracking echocardiography is an ideal tool for the assessment of the RA because of its regional and global functional characterization, angle independence, and high temporal resolution. PMID:26418622

  20. What every radiologist should know about paediatric echocardiography

    Sorantin, Erich, E-mail: erich.sorantin@medunigraz.at [Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 34, A-8036 Graz (Austria); Heinzl, Bernd [Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Medical University Graz, Auenbruggerplatz 34, A-8036 Graz (Austria)

    2014-09-15

    Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images. In addition, typical echocardiographic findings in common CHD is presented. In older children, adolescents and grown-ups with CHD (GUCH) echocardiography suffers from limitations – partially due to skeletal deformations and lung emphysema. In particular right ventricular function assessment is not always possible by echocardiography. Therefore strengths and limitations of echocardiography will be discussed the role of cardiac magnetic resonance imaging (cMRI) and cardiac computed tomography (cCT) emphasized.

  1. What every radiologist should know about paediatric echocardiography

    Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images. In addition, typical echocardiographic findings in common CHD is presented. In older children, adolescents and grown-ups with CHD (GUCH) echocardiography suffers from limitations – partially due to skeletal deformations and lung emphysema. In particular right ventricular function assessment is not always possible by echocardiography. Therefore strengths and limitations of echocardiography will be discussed the role of cardiac magnetic resonance imaging (cMRI) and cardiac computed tomography (cCT) emphasized

  2. Detection of congenital heart disease by fetal echocardiography

    Objective: The objective of the study was to determine the sensitivity, specificity, accuracy and predictive value of fetal echocardiography in our set up using postnatal echocardiography as gold standard. Study Design: Validation study. Place and Duration of study: This is an ongoing study in the Radiology department of CMH Rawalpindi and Armed Forces Institute of Cardiology (AFIC) Rawalpindi and the data collected from January 2007 to Jan 2012 is presented. Patients and Methods: Two hundred eighty seven patients reported for fetal echocardiography. Two hundred twenty nine patients were subsequently included in the study. These included patients of all ages who reported to the Radiology department of CMH Rawalpindi for fetal echocardiography. Fetal echo was done on Toshiba Aplio with 3.5 MHz probe having Doppler facility. Post natal evaluation was done by a pediatric cardiologist. Results: There were 207 (90.4%) true negative cases, 15 (6.6%) true positive, 2 (0.9%) false positive and 6 (2.2%) false negative cases. The sensitivity, specificity, positive and negative predictive values were 75%, 99%, 88%, 97% respectively. Conclusion: Fetal echocardiography has high specificity, negative predictive values and accuracy and cases diagnosed as normal can reassure the parents about the normal cardiac status of the fetus. (author)

  3. Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

    Angela Dawson

    Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

  4. Strengthening Postabortion Family Planning Services in Ethiopia: Expanding Contraceptive Choice and Improving Access to Long-Acting Reversible Contraception.

    Samuel, Melaku; Fetters, Tamara; Desta, Demeke

    2016-08-11

    Where unmet need for the safest, most effective, and long-acting reversible contraceptives (LARCs) is very high, the health system and partners need to implement problem-solving, locally feasible, and comprehensive family planning delivery strategies. Because young and unmarried women are most at risk for unintended pregnancy and repeat abortion due to poor access to contraceptive services, postabortion family planning (PAFP) is a key component in such strategies. In Southern Nations, Nationalities, and People's Region, Ethiopia, Ipas implemented health system strengthening efforts from fiscal year (FY) 2010 (July 2009 to June 2010) to FY 2014 (July 2013 to June 2014) to improve the quality of PAFP services and expand method choice in 101 public facilities. The intervention significantly improved PAFP uptake at the project sites. Specifically, the proportion of abortion clients receiving LARCs progressively improved during the intervention period. The proportion of abortion clients who left the facilities with a contraceptive method increased from 58% in FY 2010 to 83% in FY 2014. The share of method mix for LARCs rose from 2% in FY 2010 to 55% in FY 2014, while the share for condoms, injectables, and oral contraceptives declined from 98% to 45%. Implant use rose from 2% in FY 2010 to 43% in FY 2014, while the use of intrauterine devices increased from 0.1% in FY 2010 to 12% in FY 2014. A larger proportion of PAFP users received LARCs at health centers, where midwives and nurses are the primary providers, than at hospitals (59% versus 37%, respectively). A broader method mix can satisfy clients with a variety of needs, a key factor for higher uptake of more effective methods and program success. Further evidence-based interventions need to be implemented to improve the quality of PAFP in a feasible and replicable strategy that addresses unmet need for modern contraceptive methods. PMID:27540126

  5. Access to Services, Quality of Care, and Family Impact for Children with Autism, Other Developmental Disabilities, and Other Mental Health Conditions

    Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire

    2014-01-01

    This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with…

  6. [Reflections on the conceptualization and measurement of access to health services in Argentina: The case of the National Survey of Risk Factors 2009].

    Ballesteros, Matías Salvador; Freidin, Betina

    2015-12-01

    In this article we reflect on the complexity surrounding the conceptualization and measurement of access to health services. We present the theoretical models habitually used to approach the issue and different ways of operationalizing these models, taking into account the implications for the analysis of the data and the information obtained. As an example of this complexity, we analyze the National Survey of Risk Factors [Encuesta Nacional de Factores de Riesgo] conducted in Argentina in 2009. We show that the survey provides important information for understanding inequalities in access to health services. However, the way in which the barriers to access to the health system are measured may underreport the problem by only capturing extreme situations. PMID:26676595

  7. Method for Secure Access to Oracle Database Based on Proxy Service%基于代理服务的Oracle数据库安全访问

    褚孔统; 宋建宇; 王国强

    2012-01-01

    The network transmission protocol of Oracle database is analyzed. Then, a method for the secure access to the Oracle database using proxy service is proposed to meet the high-standard confidentiality requirements of specific industries. The proxy service is used to capture the access- ing requests of Oracle database, encrypt messsages for transmission, decode and re-direct them to the Oracle database. The method can be used to secure the access to the Oracle database.%分析了Oracle数据库网络传输协议,提出了使用代理服务解决特定行业高保密要求的Oracle数据库安全访问方法。通过截获Oracle数据库访问请求,对报文进行加密传输、解析并重定向,达到Oracle数据库的安全访问目的。

  8. Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case-control study.

    Buckley, Claire M

    2013-09-03

    Lower extremity amputation (LEA) is a complication of diabetes and a marker of the quality of diabetes care. Clinical and sociodemographic determinants of LEA in people with diabetes are well known. However, the role of service-related factors has been less well explored. Early referral to secondary healthcare is assumed to prevent the occurrence of LEA. The objective of this study is to investigate a possible association between the timing of patient access to secondary healthcare services for diabetes management, as a key marker of service-related factors, and LEA in patients with diabetes.

  9. Flight Services and Aircraft Access: Active Flow Control Vertical Tail and Insect Accretion and Mitigation Flight Test

    Whalen, Edward A.

    2016-01-01

    This document serves as the final report for the Flight Services and Aircraft Access task order NNL14AA57T as part of NASA Environmentally Responsible Aviation (ERA) Project ITD12A+. It includes descriptions of flight test preparations and execution for the Active Flow Control (AFC) Vertical Tail and Insect Accretion and Mitigation (IAM) experiments conducted on the 757 ecoDemonstrator. For the AFC Vertical Tail, this is the culmination of efforts under two task orders. The task order was managed by Boeing Research & Technology and executed by an enterprise-wide Boeing team that included Boeing Research & Technology, Boeing Commercial Airplanes, Boeing Defense and Space and Boeing Test and Evaluation. Boeing BR&T in St. Louis was responsible for overall Boeing project management and coordination with NASA. The 757 flight test asset was provided and managed by the BCA ecoDemonstrator Program, in partnership with Stifel Aircraft Leasing and the TUI Group. With this report, all of the required deliverables related to management of this task order have been met and delivered to NASA as summarized in Table 1. In addition, this task order is part of a broader collaboration between NASA and Boeing.

  10. Seeking to understand: using generic qualitative research to explore access to medicines and pharmacy services among resettled refugees.

    Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

    2016-06-01

    Introduction There are challenges associated with selecting a qualitative research approach. In a field abundant with terminology and theories, it may be difficult for a pharmacist to know where and how to begin a qualitative research journey. The purpose of this paper is to provide insight into generic qualitative research and to describe the journey of data collection of a novice qualitative researcher in the quest to answer her research question: 'What are the barriers to accessing medicines and pharmacy services for resettled refugees in Queensland, Australia?' Methodology Generic qualitative research draws on the strengths of one or more qualitative approaches. The aim is to draw out participants' ideas about things that are 'outside themselves'; rather than focussing on their inner feelings the research seeks to understand a phenomenon, a process, or the perspectives of participants. Sampling is designed to obtain a broad range of opinions about events and experiences and data collection includes interviews, questionnaires or surveys; thematic analysis is often used to analyse data. When to use Generic qualitative research provides an opportunity to develop research designs that fit researchers' epistemological stance and discipline, with research choices, including methodology and methods, being informed by the research question. Limitations Generic qualitative research is one of many methodologies that may be used to answer a research question and there is a paucity of literature about how to do it well. There is also debate about its validity as a qualitative methodology. PMID:26873481

  11. The InterPro BioMart: federated query and web service access to the InterPro Resource.

    Jones, Philip; Binns, David; McMenamin, Conor; McAnulla, Craig; Hunter, Sarah

    2011-01-01

    The InterPro BioMart provides users with query-optimized access to predictions of family classification, protein domains and functional sites, based on a broad spectrum of integrated computational models ('signatures') that are generated by the InterPro member databases: Gene3D, HAMAP, PANTHER, Pfam, PIRSF, PRINTS, ProDom, PROSITE, SMART, SUPERFAMILY and TIGRFAMs. These predictions are provided for all protein sequences from both the UniProt Knowledge Base and the UniParc protein sequence archive. The InterPro BioMart is supplementary to the primary InterPro web interface (http://www.ebi.ac.uk/interpro), providing a web service and the ability to build complex, custom queries that can efficiently return thousands of rows of data in a variety of formats. This article describes the information available from the InterPro BioMart and illustrates its utility with examples of how to build queries that return useful biological information. Database URL: http://www.ebi.ac.uk/interpro/biomart/martview. PMID:21785143

  12. Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer and its impact on access to cancer services

    Bessarab Dawn

    2009-07-01

    Full Text Available Abstract Background Despite a lower overall incidence, Aboriginal Australians experience poorer outcomes from cancer compared with the non-Aboriginal population as manifested by higher mortality and lower 5-year survival rates. Lower participation in screening, later diagnosis of cancer, poor continuity of care, and poorer compliance with treatment are known factors contributing to this poor outcome. Nevertheless, many deficits remain in understanding the underlying reasons, with the recommendation of further exploration of Aboriginal beliefs and perceptions of cancer to help understand their care-seeking behavior. This could assist with planning and delivery of more effective interventions and better services for the Aboriginal population. This research explored Western Australian (WA Aboriginal peoples' perceptions, beliefs and understanding of cancer. Methods A total of 37 Aboriginal people from various geographical areas within WA with a direct or indirect experience of cancer were interviewed between March 2006 and September 2007. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. A social constructionist framework provided a theoretical basis for analysis. Interpretation occurred within the research team with member checking and the involvement of an Aboriginal Reference Group assisting with ensuring validity and reliability. Results Outcomes indicated that misunderstanding, fear of death, fatalism, shame, preference for traditional healing, beliefs such as cancer is contagious and other spiritual issues affected their decisions around accessing services. These findings provide important information for health providers who are involved in cancer-related service delivery. Conclusion These underlying beliefs must be specifically addressed to develop appropriate educational, screening and treatment approaches including models of

  13. The provision and impact of online patient access to their electronic health records (EHR and transactional services on the quality and safety of health care: systematic review protocol

    Freda Mold

    2013-09-01

    Full Text Available Background Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR. International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care.Objective To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care.Method Two reviewers independently searched 11 international databases during the period 1999–2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion .A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis.Prospero (International Prospective Register of Systematic Reviews registration number: crd42012003091.

  14. Recommendations for terminology and display for doppler echocardiography

    Doppler echocardiography has recently emerged as a major noninvasive technique with many applications in cardiology. To a large extent, this has been based upon a combination of clinical and engineering advances which now make possible the use of quantitative Doppler echocardiography in combination with two-dimensional imaging for measurement of volume flows, transvalve gradients, and other physiologic flow parameters which reflect cardiac function. It was the purpose of this Committee to provide a glossary of terms which could be used in standard fashion for papers and discussions related to Doppler echocardiography. As part of its task, the Committee also undertook an attempt to recommend a standard for display of Doppler information which would be useful, both for manufacturers and for clinicians. The document, therefore, includes: Section I, the Committee's recommendations for Doppler display. Section II, the glossary of Doppler terms, related to engineering and to clinical applications

  15. False Positive Dobutamine Stress Echocardiography Induced by Esmolol

    Ali Hosseinsabet

    2014-03-01

    Full Text Available Dobutamine stress echocardiography is one of the several noninvasive methods for detection of coronary artery disease (1. New regional wall motion abnormalities have been reported in dobutamine stress echocardiograpghy after intravenous beta blocker administration (2, 3 Thus, this method has been recommended for increasing the test sensitivity (4. The sensitivity, specificity, accuracy, and positive and negative predictive values of dobutamin stress echocardiography without beta blocker have been reported to be 84%, 92%, 87%, 95%, and 77%, respectively. Using beta blocker, on the other hand, these measures have been reported as 92%, 89%, 91%, 94%, and 87%, respectively (3. In theory, beta blocker induced false positive dobutamine stress echocardiography can occur (5.

  16. BioPortal: enhanced functionality via new Web services from the National Center for Biomedical Ontology to access and use ontologies in software applications

    Whetzel, Patricia L.; Noy, Natalya F.; Shah, Nigam H.; Alexander, Paul R.; Nyulas, Csongor; Tudorache, Tania; Musen, Mark A.

    2011-01-01

    The National Center for Biomedical Ontology (NCBO) is one of the National Centers for Biomedical Computing funded under the NIH Roadmap Initiative. Contributing to the national computing infrastructure, NCBO has developed BioPortal, a web portal that provides access to a library of biomedical ontologies and terminologies (http://bioportal.bioontology.org) via the NCBO Web services. BioPortal enables community participation in the evaluation and evolution of ontology content by providing features to add mappings between terms, to add comments linked to specific ontology terms and to provide ontology reviews. The NCBO Web services (http://www.bioontology.org/wiki/index.php/NCBO_REST_services) enable this functionality and provide a uniform mechanism to access ontologies from a variety of knowledge representation formats, such as Web Ontology Language (OWL) and Open Biological and Biomedical Ontologies (OBO) format. The Web services provide multi-layered access to the ontology content, from getting all terms in an ontology to retrieving metadata about a term. Users can easily incorporate the NCBO Web services into software applications to generate semantically aware applications and to facilitate structured data collection. PMID:21672956

  17. Do the Medicaid and Medicare programs compete for access to health care services? A longitudinal analysis of physician fees, 1998-2004.

    Howard, Larry L

    2014-09-01

    As the demand for publicly funded health care continues to rise in the U.S., there is increasing pressure on state governments to ensure patient access through adjustments in provider compensation policies. This paper longitudinally examines the fees that states paid physicians for services covered by the Medicaid program over the period 1998-2004. Controlling for an extensive set of economic and health care industry characteristics, the elasticity of states' Medicaid fees, with respect to Medicare fees, is estimated to be in the range of 0.2-0.7 depending on the type of physician service examined. The findings indicate a significant degree of price competition between the Medicaid and Medicare programs for physician services that is more pronounced for cardiology and critical care, but not hospital care. The results also suggest several policy levers that work to either increase patient access or reduce total program costs through changes in fees. PMID:24682916

  18. Barriers and facilitators adolescent females living with HIV face in accessing contraceptive services: a qualitative assessment of providers’ perceptions in western Kenya

    Jill M Hagey

    2015-09-01

    Full Text Available Introduction: Avoiding unintended pregnancies is important for the health of adolescents living with HIV and has the additional benefit of preventing potential vertical HIV transmission. Health facility providers represent an untapped resource in understanding the barriers and facilitators adolescents living with HIV face when accessing contraception. By understanding these barriers and facilitators to contraceptive use among adolescent females living with HIV, this study aimed to understand how best to promote contraception within this marginalized population. Methods: We conducted structured in-depth interviews with 40 providers at 21 Family AIDS Care & Education Services - supported clinics in Homabay, Kisumu and Migori counties in western Kenya from July to August 2014. Our interview guide explored the providers’ perspectives on contraceptive service provision to adolescent females living with HIV with the following specific domains: contraception screening and counselling, service provision, commodity security and clinic structure. Transcripts from the interviews were analyzed using inductive content analysis. Results: According to providers, interpersonal factors dominated the barriers adolescent females living with HIV face in accessing contraception. Providers felt that adolescent females fear disclosing their sexual activity to parents, peers and providers, because of repercussions of perceived promiscuity. Furthermore, providers mentioned that adolescents find seeking contraceptive services without a male partner challenging, because some providers and community members view adolescents unaccompanied by their partners as not being serious about their relationships or having multiple concurrent relationships. On the other hand, providers noted that institutional factors best facilitated contraception for these adolescents. Integration of contraception and HIV care allows easier access to contraceptives by removing the stigma of coming

  19. Role of echocardiography for assessment of cardiovascular haemodynamics during pregnancy

    Sonali S. Somani

    2016-01-01

    Conclusions: Present study shows significant functional changes in the cardiovascular dynamics during pregnancy. Doppler echocardiography provides an excellent noninvasive method for the evaluation and serial analysis of hemodynamic changes. These results will help in distinguishing abnormal echocardiographic changes from the normal physiologic changes of pregnancy. Therefore maternal echocardiography should be introduced into the antenatal management protocol, which will help to identify women at high risk to developing cardiovascular complications and there by early intervention. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 84-89

  20. An integrated tiered service delivery model (ITSDM based on local CD4 testing demands can improve turn-around times and save costs whilst ensuring accessible and scalable CD4 services across a national programme.

    Deborah K Glencross

    Full Text Available The South African National Health Laboratory Service (NHLS responded to HIV treatment initiatives with two-tiered CD4 laboratory services in 2004. Increasing programmatic burden, as more patients access anti-retroviral therapy (ART, has demanded extending CD4 services to meet increasing clinical needs. The aim of this study was to review existing services and develop a service-model that integrated laboratory-based and point-of-care testing (POCT, to extend national coverage, improve local turn-around/(TAT and contain programmatic costs.NHLS Corporate Data Warehouse CD4 data, from 60-70 laboratories and 4756 referring health facilities was reviewed for referral laboratory workload, respective referring facility volumes and related TAT, from 2009-2012.An integrated tiered service delivery model (ITSDM is proposed. Tier-1/POCT delivers CD4 testing at single health-clinics providing ART in hard-to-reach areas (350-1500 tests/day, serving ≥ 200 health-clinics. Tier-6 provides national support for standardisation, harmonization and quality across the organization.The ITSDM offers improved local TAT by extending CD4 services into rural/remote areas with new Tier-3 or Tier-2/POC-Hub services installed in existing community laboratories, most with developed infrastructure. The advantage of lower laboratory CD4 costs and use of existing infrastructure enables subsidization of delivery of more expensive POC services, into hard-to-reach districts without reasonable access to a local CD4 laboratory. Full ITSDM implementation across 5 service tiers (as opposed to widespread implementation of POC testing to extend service can facilitate sustainable 'full service coverage' across South Africa, and save>than R125 million in HIV/AIDS programmatic costs. ITSDM hierarchical parental-support also assures laboratory/POC management, equipment maintenance, quality control and on-going training between tiers.