Sample records for address unmet national

  1. The Diagnosis of CAD in Women: Addressing the Unmet Need—A Report from the National Expert Roundtable Meeting

    Ladapo, Joseph L.; Monane, Mark; Lansky, Alexandra; Skoufalos, Alexandria; Nash, David B.


    Abstract A multistakeholder panel comprising experts in the fields of clinical cardiology, medical technology innovation, women's health research and policy analysis, personalized medicine, payers (including self-insured employers), patient advocacy, and health economics was convened at the Heart House in Washington, DC. The following points emerged as key concepts: (1) Diagnostic challenges in the evaluation of women with symptoms suggestive of obstructive coronary artery disease (CAD) result from: (a) presentation with atypical symptoms and lower pretest probability of disease compared to men, (b) fatty tissue and breast tissue attenuation on cardiac imaging leading to false positive findings, and (c) the presence of microvascular CAD. (2) Diagnostic challenges lead to both over-testing of low-risk women and under-testing of high-risk women. (3) Efforts should be directed toward increasing clinician, clinical professional society, and consumer awareness and understanding of sex-specific differences between men and women in the pathophysiology of CAD. (4) Multiple health care stakeholders should be made aware of new advances in genomic approaches to address the challenges of diagnosing obstructive CAD; specifically, the Corus CAD gene expression test, which was shown to have high sensitivity and negative predictive value in a recent clinical trial. As such, it has promise as a tool to help clinicians to rule out obstructive CAD as a cause of a patient's symptoms. (Population Health Management 2015;18:86–92) PMID:25714757

  2. Addressing unmet needs in the treatment of COPD

    Francesco Patalano


    Full Text Available The burden of chronic obstructive pulmonary disease (COPD is considerable, both socially and economically. Central to COPD management is the use of long-acting bronchodilators, which provide patients with optimal bronchodilation and improvements in symptoms. The once-daily, long-acting β2-agonist indacaterol, the long-acting muscarinic antagonist glycopyrronium, and the indacaterol/glycopyrronium fixed-dose combination QVA149 have all been shown to significantly improve lung function and patient-reported outcomes. The ability to take medication appropriately is important. Easy to use, low resistance devices may help patients take their medication and achieve good drug deposition. There is a need to optimise COPD management by treating the right patients with the right therapy at the right time during the course of their disease. Herein, we present a view on the current COPD management landscape and current unmet needs, and look to the future of COPD treatment and how patient care can be optimised.

  3. Addressing the burden of epilepsy: Many unmet needs.

    Beghi, Ettore


    the presence of comorbidity. Although in several countries the costs of epilepsy are met by the national health systems, out-of-pocket costs may be a relevant fraction of the overall costs, especially in countries where the public management of health care is suboptimal or non-existent. Epilepsy strongly affects patients' independence, psychological health and emotional adjustment. Epilepsy impairs all aspects of health-related quality of life. Awareness and attitudes of the public about epilepsy may significantly affect the burden of the disease. All these factors add to the burden of the disease. However, many of the factors implicated in the onset of epilepsy, its course and treatment can be favorably addressed with appropriate strategic plans. More research is needed to investigate and manage the medical and psychosocial implications of epilepsy. PMID:26952026

  4. Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

    Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin


    Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems. PMID:27337850

  5. 78 FR 3005 - Creating an Alternative Approval Pathway for Certain Drugs Intended to Address Unmet Medical Need...


    ... processes and have led to major advances in the treatment of conditions such as cystic fibrosis, HIV... fostering the application of scientific advances to the treatment of disease through drug development, including the use of novel approaches that can facilitate development of treatment for unmet...

  6. 2015 Address Ranges National Geodatabase

    US Census Bureau, Department of Commerce — The 2015 TIGER Geodatabases are extracts of selected nation based and state based geographic and cartographic information from the U.S. Census Bureau's Master...

  7. 77 FR 11116 - Draft National Plan To Address Alzheimer's Disease


    ... HUMAN SERVICES Draft National Plan To Address Alzheimer's Disease AGENCY: Office of the Assistant.... SUMMARY: HHS is soliciting public input on the draft National Plan to Address Alzheimer's Disease, which... Alzheimer's disease. Coordinate Alzheimer's disease research and services across all federal...

  8. Notation for national and international telephone numbers, e-mail addresses and Web addresses

    International Telecommunication Union. Geneva


    Recommendation E.123 defines a standard way to write telephone numbers, e-mail addresses, and web addresses. It recommends the following formats (when dialing the area code is optional for local calling): Telephone number: National notation (042) 123 4567 International notation +31 (0)42 123 4567 E-mail address: Internet address / URL: It also recommends that a hypen (-), space ( ), or period (.) can be used to visually separate groups of numbers. The parentheses are used to indicate digits that are sometimes not dialed. a slash (/) is used to indicate alternate numbers. This information is important if you want to make sure people know how to dail a phone number in a specific country.

  9. The nation's first consortium to address waste management issues

    On July 26, 1989, the secretary of the Department of Energy (DOE), Admiral James Watkins, announced approval of the Waste-Management Education and Research Consortium (WERC). The consortium is composed of New Mexico State University (NMSU), the University of New Mexico, the New Mexico Institute of Mining and Technology, Los Alamos National Laboratory, and Sandia National Laboratories. This pilot program is expected to form a model for other regional and national programs. The WERC mission is to expand the national capability to address issues associated with the management of hazardous, radioactive, and solid waste. Research, technology transfer, and education/training are the three areas that have been identified to accomplish the objectives set by the consortium. The members of the consortium will reach out to the DOE facilities, other government agencies and facilities, and private institutions across the country. Their goal is to provide resources for solutions to waste management problems

  10. Creating a National Coalition to Address Tractor Overturn Fatalities.

    Tinc, P J; Ayers, P D; May, J J; Purschwitz, M A; Sorensen, J A


    Tractor overturns continue to be the leading cause of death on U.S. farms. While rollover protective structures (ROPS) are effective in preventing these fatalities, they are underutilized due to a number of barriers. Past programs in the U.S. and abroad have targeted this area of agricultural safety; however, a national program is not yet in place for U.S. farmers. This study seeks to build a national partnership to address tractor overturn fatalities by increasing the number of tractors with ROPS. A diverse, multisector steering committee has been organized and is working together using Whole System in a Room methods. This method brings together partners from nine stakeholder groups to identify and commit to a collaborative solution to the issue. PMID:26204786

  11. National Institutes of Health addresses the science of diversity.

    Valantine, Hannah A; Collins, Francis S


    The US biomedical research workforce does not currently mirror the nation's population demographically, despite numerous attempts to increase diversity. This imbalance is limiting the promise of our biomedical enterprise for building knowledge and improving the nation's health. Beyond ensuring fairness in scientific workforce representation, recruiting and retaining a diverse set of minds and approaches is vital to harnessing the complete intellectual capital of the nation. The complexity inherent in diversifying the research workforce underscores the need for a rigorous scientific approach, consistent with the ways we address the challenges of science discovery and translation to human health. Herein, we identify four cross-cutting diversity challenges ripe for scientific exploration and opportunity: research evidence for diversity's impact on the quality and outputs of science; evidence-based approaches to recruitment and training; individual and institutional barriers to workforce diversity; and a national strategy for eliminating barriers to career transition, with scientifically based approaches for scaling and dissemination. Evidence-based data for each of these challenges should provide an integrated, stepwise approach to programs that enhance diversity rapidly within the biomedical research workforce. PMID:26392553

  12. Fathers of the Nation: Barack Obama Addresses Nelson Mandela

    Elisa Bordin


    Full Text Available This essay analyzes Barack Obama’s Nelson Mandela Memorial speech together with other seminal texts of Obama’s political and personal creed, such as his book Dreams from My Father (1995 and his speech “A More Perfect Union” (2008. This reading becomes helpful to understand Mandela’s transnational power, which Obama uses to comment on the United States by comparing Madiba to other American “fathers of the nation.” Thus, he uproots Mandela’s from a specifically South African legacy, expands his figure, and addresses him as a transnational father of his own nation, whose power, influence, and example transcend South African borders. As a consequence of this enlargement and transnational validation of Mandela’s figure, the speech delivered at the Memorial becomes an occasion to tackle American past and future, while the memory of Madiba and his driving example in Obama’s life serve to reinforce previous positions conveyed in other discourses by the American President, such as the “A More Perfect Union” speech delivered in Philadelphia in 2008.

  13. Addressing environmental justice under the National Environment Policy Act at Sandia National Laboratories/New Mexico

    Cohen, T.M.; Bleakly, D.R.


    Under Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, the Department of Energy (DOE) and Sandia National Laboratories New Mexico (SNL) are required to identify and address, as appropriate, disproportionately high, adverse human health or environmental effects of their activities on minority and low-income populations. The National Environmental Policy Act (NEPA) also requires that environmental justice issues be identified and addressed. This presents a challenge for SNL because it is located in a culturally diverse area. Successfully addressing potential impacts is contingent upon accurately identifying them through objective analysis of demographic information. However, an effective public participation process, which is necessarily subjective, is also needed to understand the subtle nuances of diverse populations that can contribute to a potential impact, yet are not always accounted for in a strict demographic profile. Typically, there is little or no coordination between these two disparate processes. This report proposes a five-step method for reconciling these processes and uses a hypothetical case study to illustrate the method. A demographic analysis and community profile of the population within 50 miles of SNL were developed to support the environmental justice analysis process and enhance SNL`s NEPA and public involvement programs. This report focuses on developing a methodology for identifying potentially impacted populations. Environmental justice issues related to worker exposures associated with SNL activities will be addressed in a separate report.

  14. National Conference on Outdoor Leadership. 2008 Keynote Address

    Louv, Richard


    In this keynote address, Richard Louv laments that today's children lack direct connection to nature. Over the past 15 years, he interviewed families across the country about the changes in their lives, including their relationship with nature. With few exceptions, even in rural areas, parents say the same thing: Most children aren't playing…

  15. National building stocks: addressing energy consumption or decarbonization?

    Herring, Horace


    The Building Research & Information special issue titled 'Climate Change: National Building Stocks' (2007) focused attention on the potential that the national building stock has in reducing CO2 emissions. However, can this potential be realized? To do so requires faith in energy models that suggest that demolition, new build, and the refurbishing of existing homes with insulation measures can deliver massive energy savings by 2050. But why, in the future, can there be increased efficiency an...

  16. The capability of national education systems to address ethnic diversity

    Charl C. Wolhuter


    Full Text Available Modern societies have become much more complex in recent decades, also in terms of ethnic identities and differences. The question arose whether education systems were capable of addressing the needs of ethnic and other minorities in countries across the globe. After examining a cross-section of education systems (in Australia, Canada, China, Israel, Malaysia, Rwanda, Russia and South Africa with the aid of a set of specially developed criteria, it was concluded that these systems seemed to comply with the criteria in various ways, albeit in different measures and in several configurations. It is recommended that policy makers apply such criteria for enhancing the capability of an education system to address the needs of ethnic minorities and to meet the demands of increased social complexity.

  17. Addressing language barriers: building response capacity for a changing nation.

    Partida, Yolanda


    The absence of universally available language services is a national healthcare system failure, the burden of which is suffered by patients with limited English proficiency and their healthcare providers. Conceptualizing mandatory provision of language access as an unfair, unfunded mandate ignores massive and fundamental social changes taking place. Overcoming language barriers is essential to safe, quality health care. This paper, informed by the experience of Hablamos Juntos, a national demonstration project funded by the Robert Wood Johnson Foundation, argues that national and health industry investments are needed to develop population-based approaches supported by communication and information technology, and that these investments may prove useful to improving healthcare communication for English-speaking patients as well. PMID:17957423

  18. Addressing a Nation's Challenge: Graduate Programs in Gerontology in Israel

    Carmel, Sara; Lowenstein, Ariela


    Like other developed nations, Israel has rapidly aged. This demographic revolution has created new challenges for Israeli society. We describe the societal background, including the emerging societal needs, solutions, and problems, as well as the professional principles, which guided us in developing the first two Israeli academic programs in…

  19. Unmet needs in the management of schizophrenia.

    Torres-González, Francisco; Ibanez-Casas, Inmaculada; Saldivia, Sandra; Ballester, Dinarte; Grandón, Pamela; Moreno-Küstner, Berta; Xavier, Miguel; Gómez-Beneyto, Manuel


    Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Within this block, the effects of the current economic difficulties shown in recent literature have been considered as well. Because no patient is static, a third block has reviewed evolving needs according to the clinical staging model. The fourth block has been dedicated to integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental

  20. Fathers of the Nation: Barack Obama Addresses Nelson Mandela


    This essay analyzes Barack Obama’s Nelson Mandela Memorial speech together with other seminal texts of Obama’s political and personal creed, such as his book Dreams from My Father (1995) and his speech “A More Perfect Union” (2008). This reading becomes helpful to understand Mandela’s transnational power, which Obama uses to comment on the United States by comparing Madiba to other American “fathers of the nation.” Thus, he uproots Mandela’s from a specifically South African legacy, expands h...

  1. Unmet needs in the transition to adulthood: 18- to 30-year-old people with hemophilia.

    Quon, Doris; Reding, Mark; Guelcher, Chris; Peltier, Skye; Witkop, Michelle; Cutter, Susan; Buranahirun, Cathy; Molter, Don; Frey, Mary Jane; Forsyth, Angela; Tran, Duc Bobby; Curtis, Randall; Hiura, Grant; Levesque, Justin; de la Riva, Debbie; Compton, Matthew; Iyer, Neeraj N; Holot, Natalia; Cooper, David L


    Young adults with hemophilia face unique challenges during the transition to adulthood, including issues associated with switching from pediatric to adult hematology care, building mature interpersonal relationships, and establishing an independent career with an assurance of medical insurance coverage. A greater understanding of these challenges is essential for developing effective strategies to address the specific needs of this population. These challenges may be differentiated from those of older adults with hemophilia in large part because of more extensive childhood prophylaxis and safer factor products, resulting in fewer joint problems and lower rates of HIV and HCV infections. This analysis of the changing nature and unmet needs of today's young adults entering into adult hemophilia treatment centers, as well as potential strategies for optimally addressing these needs, was developed following roundtable discussions between patients, caregivers, hematologists, and other health care professionals participating in comprehensive care. Challenges identified among young adults with hemophilia include psychosocial issues related to maturity, personal responsibility, and increased independence, as well as concerns regarding when and with whom to share information about one's hemophilia, limited awareness of educational and financial resources, and a low perceived value of regular hematology care. The initiatives proposed herein highlight important opportunities for health care professionals at pediatric and adult hemophilia treatment centers, as well as national organizations, community groups, and career counselors, to address key unmet needs of this patient population. PMID:26619193

  2. Unmet needs in the management of schizophrenia

    Torres-González F


    integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental health specialist, and other specialists. Keywords: schizophrenia, needs, unmet needs, severe mental disorders

  3. Managing the unmet psychosocial and information needs of patients with cancer

    Abrahamson, Kathleen, RN,MS


    Kathleen Abrahamson1, Morgan Durham1, Rebekah Fox21Department of Public Health, Western Kentucky University, Bowling Green, KY, USA; 2Department of Communication, Texas State University, San Marcos, TX, USAAbstract: In this article, we synthesize current literature regarding the unmet needs of cancer patients, with a specific focus on interventions that address psychosocial distress, social support, and information deficits. Research indicates many patients diagnosed with cancer express unmet...

  4. Which unmet needs contribute to behavior problems in persons with advanced dementia?

    Cohen-Mansfield, Jiska; Dakheel-Ali, Maha; Marx, Marcia S; Thein, Khin; Regier, Natalie G


    The Unmet Needs Model states that problem behaviors of people with dementia result from unmet needs stemming from a decreased ability to communicate those needs and to provide for oneself. The purpose of this study is to describe the unmet needs of persons with dementia exhibiting behavior problems. Eighty-nine residents with dementia from six Maryland nursing homes were assessed by research assistants and nursing assistants for their unmet needs using multiple assessment tools. Three unmet needs per resident were identified on average, with informants rating boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activity as the most prevalent needs. Discomfort was associated with higher levels of verbally agitated behaviors (e.g., complaining). Based on results and independent ratings of pain, the authors estimate notable under-detection of discomfort and pain by both types of informants. The study demonstrates methodologies for uncovering unmet needs among persons with dementia and highlights the importance of developing programs that address those unmet needs, especially social and activity needs of nursing home residents. The detection of pain, and possibly that of discomfort, may require a different methodology. PMID:25933478

  5. Global Neurosurgery: The Unmet Need.

    Park, Kee B; Johnson, Walter D; Dempsey, Robert J


    Globally, the lack of access to basic surgical care causes 3 times as much deaths as HIV/AIDS, tuberculosis, and malaria combined. The magnitude of this unmet need has been described recently, and the numbers are startling. Major shifts in global health agenda have highlighted access to essential and emergency surgery as a high priority. A broad examination of the current global neurosurgical efforts to improve access has revealed some strengths, particularly in the realm of training; however, the demand grossly outstrips the supply; most people in low-income countries do not have access to basic surgical care, either due to lack of availability or affordability. Projects that help create a robust and resilient health system within low- and middle-income countries require urgent implementation. In this context, concurrent scale-up of human resources, investments in capacity building, local data collection, and analysis for accurate assessment are essential. In addition, through process of collaboration and consensus building within the neurosurgical community, a unified voice of neurosurgery is necessary to effectively advocate for all those who need neurosurgical care wherever, whenever. PMID:26732963

  6. Unmet Healthcare Needs in People with Disabilities: Comparison with the General Population in Korea

    Hwang, Byungkwan; Chun, Sung-Min; Park, Jong-Hyock; Shin, Hyung-Ik


    Objective To determine the degree of disparity in unmet healthcare needs between people with disabilities and the general population in South Korea, and to analyze their perspective reasons. Method Survey results of 9,744 subjects that participated in the 4th Korea National Health and Nutrition Examination Survey and 7,000 people that participated in the 2008 Survey of Disabled people were used in this population-based cross-sectional study. Unmet healthcare needs were identified as reporting...

  7. Provision of neuropsychiatry services: variability and unmet need.

    Agrawal, Niruj; Bhattacharya, Rahul; Rickards, Hugh


    Aims and method Neuropsychiatry services remain underdeveloped and underprovided. Previous studies have shown variability in service provision in the UK. In this survey we approached all mental health and neuropsychiatric service providers within London to map current neuropsychiatric service provision and explore perceived barriers. Results All the specialist mental health service providers responded. There was huge variability in neuropsychiatric service provision within different parts of London. There was evidence of significant unmet need and variability in service pathways. Lack of earmarked funds for neuropsychiatry and disjointed funding stream for such services were identified by providers as a barrier. Clinical implications This study provides further evidence of an ongoing lack of adequate neuropsychiatric service provision. Reasons for variability and unmet need are discussed. Adoption of a previously proposed hub-and-spoke model of service provision and the removal of commissioning barriers through uniform national commissioning may help deal with this problem. PMID:26755990

  8. National Forum: How Schools and Parents Can Work Together to Address Bullying

    Australian Government Department of Education, Employment and Workplace Relations, 2012


    On 31 July 2012 the Minister for School Education, Early Childhood and Youth, Peter Garrett convened the "National Forum: How schools and parents can work together to address bullying" at Parliament House. The Forum brought together principals, parents groups, young people, as well as experts in education, child welfare, psychology and marketing…

  9. Beyond the "National Container": Addressing Methodological Nationalism in Higher Education Research

    Shahjahan, Riyad A.; Kezar, Adrianna J.


    This essay argues that there is a need for higher education researchers to become aware of methodological nationalism (MN) and take steps to reframe their scholarship in new ways. It illuminates two characteristics of MN prevalent in higher education research and suggests that although a few researchers have attempted to move beyond MN in the…

  10. Unmet need for contraception in Vietnam: who needs what and when.

    Ross, J A; Pham, S B


    The Vietnam 1988 survey established the first national estimates for reproductive preferences and behavior. It created a unique baseline for levels and differentials, both for the marked differences between North and South, and for various social and demographic categories. It also provided the first national data for program guidance, including information on unmet need. Unmet need for contraception has been extensively documented for much of the developing world, but its structure is not yet well understood. This study differentiates unmet-need couples by several demographic characteristics, by time since the last birth, and by features identified through a computer search program. Past investigations have emphasized the per cent with unmet need within various population subgroups, but some of those subgroups are small, whereas the national family planning program must be oriented to subgroups with large absolute numbers of unmet need couples. Unmet-need couples are selective, whether by reference to the married population or by reference to other couples who also wish to avoid pregnancy but are using a method. Most unmet-need couples are younger than users, have fewer children and, especially, are closer to their last birth. Surprisingly, most have never used a contraceptive method before, even though Vietnam has had a vigorous family planning program and 49 per cent of all couples in the survey reported some experience with a modern contraceptive method. In terms of sheer numbers, those in need are distributed very widely throughout the country. The most disadvantaged segments of the population have both high percentages and large numbers in need, but the concentration of the national program upon a single contraceptive method restricts their options. PMID:9325656

  11. Strategies to Address Identified Education Gaps in the Preparation of a National Security Workforce



    This report will discuss strategies available to address identified gaps and weaknesses in education efforts aimed at the preparation of a skilled and properly trained national security workforce.The need to adequately train and educate a national security workforce is at a critical juncture. Even though there are an increasing number of college graduates in the appropriate fields, many of these graduates choose to work in the private sector because of more desirable salary and benefit packages. This is contributing to an inability to fill vacant positions at NNSA resulting from high personnel turnover from the large number of retirements. Further, many of the retirees are practically irreplaceable because they are Cold War scientists that have experience and expertise with nuclear weapons.

  12. Supervision Strategies and Approaches for Female Parolees: Examining the Link between Unmet Needs and Parolee Outcome

    Schram, Pamela J.; Koons-Witt, Barbara A.; Williams, Frank P., III; McShane, Marilyn D.


    A number of parolees are returning to the community with programming needs that may not have been addressed during their incarceration; these unmet needs may subsequently affect their successful reintegration into the community. Although there is an increasing female parole population, there has been a paucity of research concerning female…

  13. Currently Married Women with an Unmet Need for Contraception in Eritrea: Profile and Determinants

    Roderic Beaujot


    Full Text Available Eritrea’s contraceptive prevalence rate is one of the lowest in sub-Saharan Africa and its fertility has only started to decline. Using data from the 2002 Eritrea Demographic and Health Survey (EDHS, this study examines the determinants of unmet need for family planning that is the discrepancy between fertility goals and actual contraceptive use. More than one-quarter of currently married women are estimated to have an unmet need and this has remained unchanged since 1995. The most important reason for unmet need is lack of knowledge of methods or of a source of supply. Currently married women with higher parity, and low autonomy, low or medium household economic status, and who know no method of contraception or source of supply are identified as the most likely to have an unmet need. Addressing the unmet need for family planning entails not merely greater knowledge of or access to contraceptive services, but also the enhancement of the status of women.

  14. Unmet needs, quality of life and support networks of people with dementia living at home

    Oomman Sabu


    Full Text Available Abstract Background There is lack of evidence about the unmet needs of people with dementia (PWD living at home and the predictors of high levels of unmet needs. The main aim of this study was to identify the relationship between unmet needs, social networks and quality of life of PWD living at home. Methods One hundred and fifty two community dwelling PWD and 128 carers were interviewed about PWD's needs, social networks, quality of life and other functional and psychological factors. All the interviews with PWD were carried out at their homes. Interviews with carers were undertaken either at PWD's home, their own home or at the health centre. Whenever possible, PWD and carers were interviewed separately. The data collection took place between November 2005 and July 2007. The majority of participants (129, 84.9% were recruited from National Health Services (NHS and the rest (23, 15.1% were recruited from other organisations such as social services and voluntary organizations in the UK. Results The most frequent unmet needs for PWD were daytime activities (77, 50.7%, company (60, 39.5%, and help with psychological distress (47, 30.9%. Higher number of behavioural and psychological symptoms, low-community involvement social networks, having a younger carer and higher carer's anxiety were found to be predictors of higher unmet needs in PWD. Social networks and behavioural and psychological symptoms had an indirect effect on PWD's self-rated quality of life through unmet needs. Conclusions Interventions aiming to reduce unmet needs, through the treatment of behavioural and psychological symptoms and the involvement of PWD in the community, would potentially improve PWD's quality of life.

  15. Unmet needs of bipolar disorder patients

    Hajda M


    Full Text Available Miroslav Hajda,1 Jan Prasko,1 Klara Latalova,1 Radovan Hruby,2 Marie Ociskova,1 Michaela Holubova,1,3 Dana Kamaradova,1 Barbora Mainerova1 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Outpatient Psychiatric Department, Martin, Slovak Republic; 3Department of Psychiatry, Regional Hospital Liberec, Liberec, Czech Republic Background: Bipolar disorder (BD is a serious mental illness with adverse impact on the lives of the patients and their caregivers. BD is associated with many limitations in personal and interpersonal functioning and restricts the patients’ ability to use their potential capabilities fully. Bipolar patients long to live meaningful lives, but this goal is hard to achieve for those with poor insight. With progress and humanization of society, the issue of patients’ needs became an important topic. The objective of the paper is to provide the up-to-date data on the unmet needs of BD patients and their caregivers. Methods: A systematic computerized examination of MEDLINE publications from 1970 to 2015, via the keywords “bipolar disorder”, “mania”, “bipolar depression”, and “unmet needs”, was performed. Results: Patients’ needs may differ in various stages of the disorder and may have different origin and goals. Thus, we divided them into five groups relating to their nature: those connected with symptoms, treatment, quality of life, family, and pharmacotherapy. We suggested several implications of these needs for pharmacotherapy and psychotherapy. Conclusion: Trying to follow patients’ needs may be a crucial point in the treatment of BD patients. However, many needs remain unmet due to both medical and social factors. Keywords: bipolar disorder, unmet needs, stigma, treatment, medication, quality of life, family, psychotherapy

  16. Unmet Need for Family Planning: Implication for Under-five Mortality in Nigeria

    Adedini, Sunday Adepoju; Odimegwu, Clifford; Imasiku, Eunice Ntwala; Ononokpono, Dorothy Ngozi


    ABSTRACT There are gaps in evidence on whether unmet need for family planning has any implication for under-five mortality in Nigeria. This study utilized 2008 Nigeria Demographic and Health Survey data to examine the effect of unmet need on under-five mortality. Cox regression analysis was performed on 28,647 children born by a nationally-representative sample of 18,028 women within the five years preceding the survey. Findings indicated elevated risks of under-five death for children whose ...

  17. Unmet need for family planning among married women of reproductive age group in urban Tamil Nadu

    Malini M Bhattathiry


    Full Text Available Context: Unmet need for family planning (FP, which refers to the condition in which there is the desire to avoid or post-pone child bearing, without the use of any means of contraception, has been a core concept in the field of international population for more than three decades. Objectives: The very objective of this study is to determine the prevalence of "unmet need for FP" and its socio-demographic determinants among married reproductive age group women in Chidambaram. Materials and Methods: The study was a community-based cross-sectional study of married women of the reproductive age group, between 15 and 49 years. The sample size required was 700. The cluster sampling method was adopted. Unmarried, separated, divorced and widows were excluded. Results: The prevalence of unmet need for FP was 39%, with spacing as 12% and limiting as 27%. The major reason for unmet need for FP among the married group was 18%, for low perceived risk of pregnancy, 9%, feared the side effects of contraception 5% lacked information on contraceptives, 4% had husbands who opposed it and 3% gave medical reasons. Higher education, late marriage, more than the desired family size, poor knowledge of FP, poor informed choice in FP and poor male participation were found to be associated with high unmet need for FP. Conclusion: Unmet need for younger women was spacing of births, whereas for older women, it was a limitation of births. Efforts should be made to identify the issues in a case by case approach. Male participation in reproductive issues should be addressed.

  18. Reviewing the Unmet Needs of Patients with Multiple Sclerosis.

    Mehr, Stanton R; Zimmerman, Marj P


    Significant innovations in the treatment of patients with multiple sclerosis (MS) have primarily addressed the frequency of flare-ups in relapsing-remitting MS (RRMS). Many advances have been made in this area, and the medical community may be on the verge of a serious discussion of what constitutes a truly effective MS treatment. Certainly, it is important to further delay MS flare-ups and more effectively treat RRMS symptoms. However, great strides in reducing or preventing MS-related disability and providing neuroprotection have been elusive. Many unmet needs are still voiced by patients with MS, clinicians, and caregivers. Current information on the need for progress in various areas is reviewed in this article, including psychosocial care, treatments for progressive MS, biomarker identification, functional outcome measures, individualization of treatment, reducing side effects of medications, and improving medication adherence. PMID:26702334

  19. Advanced Test Reactor National Scientific User Facility: Addressing advanced nuclear materials research

    John Jackson; Todd Allen; Frances Marshall; Jim Cole


    The Advanced Test Reactor National Scientific User Facility (ATR NSUF), based at the Idaho National Laboratory in the United States, is supporting Department of Energy and industry research efforts to ensure the properties of materials in light water reactors are well understood. The ATR NSUF is providing this support through three main efforts: establishing unique infrastructure necessary to conduct research on highly radioactive materials, conducting research in conjunction with industry partners on life extension relevant topics, and providing training courses to encourage more U.S. researchers to understand and address LWR materials issues. In 2010 and 2011, several advanced instruments with capability focused on resolving nuclear material performance issues through analysis on the micro (10-6 m) to atomic (10-10 m) scales were installed primarily at the Center for Advanced Energy Studies (CAES) in Idaho Falls, Idaho. These instruments included a local electrode atom probe (LEAP), a field-emission gun scanning transmission electron microscope (FEG-STEM), a focused ion beam (FIB) system, a Raman spectrometer, and an nanoindentor/atomic force microscope. Ongoing capability enhancements intended to support industry efforts include completion of two shielded, irradiation assisted stress corrosion cracking (IASCC) test loops, the first of which will come online in early calendar year 2013, a pressurized and controlled chemistry water loop for the ATR center flux trap, and a dedicated facility intended to house post irradiation examination equipment. In addition to capability enhancements at the main site in Idaho, the ATR NSUF also welcomed two new partner facilities in 2011 and two new partner facilities in 2012; the Oak Ridge National Laboratory, High Flux Isotope Reactor (HFIR) and associated hot cells and the University California Berkeley capabilities in irradiated materials analysis were added in 2011. In 2012, Purdue University’s Interaction of Materials

  20. Unmet health care needs for persons with environmental sensitivity

    Gibson PR; Kovach S; Lupfer A


    Pamela Reed Gibson, Shannon Kovach, Alexis LupferDepartment of Psychology, James Madison University, Harrisonburg, VA, USAAbstract: Studies of unmet health care needs have shown that women, people with poor health, and people with lower socioeconomic status are more likely to report having unmet health care needs. In this study, we examined the types of and reasons for unmet health care needs in 465 people with environmental sensitivities. A second area of inquiry involved negative reactions ...

  1. Perceived Competence in Addressing Student Substance Abuse: A National Survey of Middle School Counselors

    Burrow-Sanchez, Jason J.; Lopez, Adriana L.; Slagle, Clark P.


    Background: Student substance abuse is a serious concern for middle school personnel. School counselors are most likely to deliver mental health services, including substance abuse, in school settings. However, limited research is available on the perceived competence of middle school counselors for addressing student substance abuse concerns. The…

  2. Literacy: A Route to Addressing Child Poverty? National Literacy Trust Research Review

    National Literacy Trust, 2011


    This short document reviews research into the role of low literacy in poverty and disadvantage. It sets out evidence for the impact of parental engagement in home learning and the significance of attitudes, aspirations and literacy development. The National Literacy Trust hopes that this is a useful resource for those with responsibility for, and…

  3. Epigenetics and Systemic Lupus Erythematosus: Unmet Needs.

    Meroni, Pier Luigi; Penatti, Alessandra Emiliana


    Systemic lupus erythematosus (SLE) is a chronic relapsing-remitting autoimmune disease affecting several organs. Although the management of lupus patients has improved in the last years, several aspects still remain challenging. More sensitive and specific biomarkers for an early diagnosis as well as for monitoring disease activity and tissue damage are needed. Genome-wide association and gene mapping studies have supported the genetic background for SLE susceptibility. However, the relatively modest risk association and the studies in twins have suggested a role for environmental and epigenetic factors, as well as genetic-epigenetic interaction. Accordingly, there is evidence that differences in DNA methylation, histone modifications, and miRNA profiling can be found in lupus patients versus normal subjects. Moreover, impaired DNA methylation on the inactive X-chromosome was suggested to explain, at least in part, the female prevalence of the disease. Epigenetic markers may be help in fulfilling the unmet needs for SLE by offering new diagnostic tools, new biomarkers for monitoring disease activity, or to better characterize patients with a silent clinical disease but with an active serology. Anti-DNA, anti-phospholipid, and anti-Ro/SSA autoantibodies are thought to be pathogenic for glomerulonephritis, recurrent thrombosis and miscarriages, and neonatal lupus, respectively. However, tissue damage occurs occasionally or, in some patients, only in spite of the persistent presence of the antibodies. Preliminary studies suggest that epigenetic mechanisms may explain why the damage takes place in some patients only or at a given time. PMID:26206675

  4. Addressing Child Poverty: How Does the United States Compare With Other Nations?

    Smeeding, Timothy; Thévenot, Céline


    Poverty during childhood raises a number of policy challenges. The earliest years are critical in terms of future cognitive and emotional development and early health outcomes, and have long-lasting consequences on future health. In this article child poverty in the United States is compared with a set of other developed countries. To the surprise of few, results show that child poverty is high in the United States. But why is poverty so much higher in the United States than in other rich nations? Among child poverty drivers, household composition and parent's labor market participation matter a great deal. But these are not insurmountable problems. Many of these disadvantages can be overcome by appropriate public policies. For example, single mothers have a very high probability of poverty in the United States, but this is not the case in other countries where the provision of work support increases mothers' labor earnings and together with strong public cash support effectively reduces child poverty. In this article we focus on the role and design of public expenditure to understand the functioning of the different national systems and highlight ways for improvements to reduce child poverty in the United States. We compare relative child poverty in the United States with poverty in a set of selected countries. The takeaway is that the United States underinvests in its children and their families and in so doing this leads to high child poverty and poor health and educational outcomes. If a nation like the United States wants to decrease poverty and improve health and life chances for poor children, it must support parental employment and incomes, and invest in children's futures as do other similar nations with less child poverty. PMID:27044705

  5. Facing safety and security challenges: A national and international perspective (Opening address)

    This international conference on Effective Nuclear Regulatory Systems is more than a gathering of senior regulators and of nuclear technologists; it is truly an international assembly of those who implement nuclear safety, security and emergency preparedness. The sessions should have a definitive underlying theme and purpose that support the objectives of the conference. A common understanding of the purpose of regulation in general and nuclear regulation in particular, should provide the connectivity between every one of us, independent of country or organization. A good starting point for the common understanding of regulation would be to note that regulation is done for the well-being of our people, for the common good, with full consideration of the national interests, and of international law and agreements. Nuclear regulation is a disciplined national tool for establishing predictable safety and security frameworks. It works by establishing and improving technical and legal structures to define the acceptable safety case that serves the public interest. Senior nuclear regulators, you and I, are coming together, in Moscow, in winter, in 2006, to make a statement regarding our responsibilities and to deliver a series of products, sustained by a common understanding of nuclear regulation. Moreover, we are here because we care about our nations and because we can and want to work together, better. In this regard, I present for your thoughtful consideration here, as a purpose, the objective stated by the Nuclear Regulatory Commission (NRC) in its current strategic plan: to enable the use and management of radioactive materials and nuclear fuels for beneficial civilian purposes in a manner that protects public health and safety and the environment, promotes the security of our nation, and provides for regulatory actions that are open, effective, efficient, realistic and timely. With that purpose in mind, it becomes clear why our presence here today is important. In

  6. [State of unmet medical needs in France in 2006: necessity of reinforcing research effort].

    Jouan-Flahault, Chrystel; Billon, Nathalie; Castaigne, Alain; Henry, Yves-Dominique; Omnes, Carole; Puech, Alain; Rosilio, Myriam; Lassale, Catherine


    Leem (French Pharmaceutical Companies) realized an inventory of unmet medical needs in 2006 in France for 12 pathologies. All of them are considered as national public health priorities by the law of August 9th, 2004. Allied to the epidemiological projections, analyses concerned various stages and/or pathology forms, impact of guidelines in clinical practice, therapeutic strategies, marketed therapeutics and pharmacological products in an advanced phase of clinical development. With more than 100 products listed in clinical phase III or pre-registration/marketed for those pathologies, French Pharmaceutical Companies contribute, quasi exclusively, to the development of innovative pharmaceutical products to answer unmet medical needs. This study illustrates the necessity of French Government to support therapeutic innovation led by Pharmaceutical Companies in France. PMID:18206102

  7. Addressing Waste Management Issues for D and D of Excess Facilities at Oak Ridge National Laboratory

    Since the Manhattan Project, Oak Ridge National Laboratory (ORNL) has been engaged in developing and demonstrating nuclear and radiochemical processes at the laboratory and pilot plant scale. Many of these processes were later implemented in Department of Energy (DOE) production facilities across the U.S. and in producing radioisotopes for medical and industrial applications. These activities have resulted in a large variety of unique remote handled legacy wastes and contaminated hot cell facilities. The DOE has established the Integrated Facility Disposition Project (IFDP) to dispose of the legacy waste and to deactivate, decontaminate and decommission (D and D) ∼300 facilities no longer needed for the Oak Ridge mission. The IFDP will be required to characterize, treat, package, and dispose of a variety of waste streams, including remote handled solid waste streams for which no treatment capability currently exists at ORNL. In addition, the existing waste management systems at ORNL are thirty plus years old and are reaching the end of their design life. They will require replacement and/or significant upgrades in order to meet the future needs of the IFDP. Difficult-to-handle remote handled solid materials that must be dispositioned include materials that contain approximately 27 million curies (Sr-90 equivalents) with dose rates as high as one million R/hr. The materials that must be handled range from less than inch in all dimensions to extremely large components; the largest identified to date are 9'x9'x9', 34 ton casks. Included in this list are a number of Radioisotope Thermoelectric Generators (RTG) containing ∼104-106 curies of cesium or strontium and hazardous components (e.g., mercury and other heat transfer and heat sensing materials) that must be dismantled to allow recovery and segregation of the radioisotope from the hazardous materials and repackaging of the materials to meet waste acceptance criteria. A number of materials will require 'down


    Mohammad Waseem Faraz


    Full Text Available INTRODUCTI ON: Family planning is a “way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes, and responsible decisions by individuals and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country”. 1 The concept of unmet need for contraception has been central to international family planning programs and research for more than forty years, but it has perhaps never been more salient to research and practice than it is now. Over the past decade, the rising rates of contraceptive use have reduced the unmet need for family planning in most countries. However the unmet need remains persistently high or is increasing in developing countries like India, indicating that greater efforts are needed to understand and address the causes of unm et need. OBJECTIVES: 1 To assess the Unmet need for family planning among married women of reproductive age group (15 – 44 years. 2 To identify certain socio - demographic factors associated with unmet need for family planning. 3 To determine the reasons for non - usage of contraceptive use. MATERIALS AND METHODS: A cross - sectional study was carried out in the Urban health training Centre of Department of Community Medicine. The study population included 924 married women aged 15 - 44 years. The data was collected u sing pre te st ed profor m a and was analyzed using percentages and Chi - Square test. RESULTS : The unmet need for family planning was 28.9% in the study population. The overall unmet need is low at the beginning of reproductive age, but it increased and reached a peak in the mid - twenties & then declined. The literacy status among women with unmet needs is plays a vital role. Want of child in future was quoted as the main reason for non - use of contraceptives. CONCLUSION: Despite a fair knowledge about the family planning methods, various socio - cultural and problems

  9. A regional approach to unmet needs in anaphylaxis.

    Minale, P; Bignardi, D; Troise, C; Voltolini, S; Dignetti, P


    .3%. Anaphylaxis diagnosis was considered likely if any 1 of 3 criteria is satisfied within minutes to hours: acute onset of illness with involvement of skin, mucosal surface, or both, and at least 1 of the following: respiratory compromise, hypotension, or end-organ dysfunction; 2 or more of the following occur rapidly after exposure to a likely allergen: involvement of skin or mucosal surface, respiratory compromise, hypotension, or persistent gastrointestinal symptoms; hypotension develops after exposure to a known allergen for that patient: age-specific low blood pressure or decreased systolic blood pressure more than 30% compared with baseline. Of 205 patients reported, 132 were classified as severe anaphylaxis; other 73 cases reported were 12 drugs related angioedema (mostly NSAID related), 9 ACEi related angioedema, 3 ereditary C1inh deficiency angioedema, 24 istaminergic idiopatic angioedema, 14 urticaria angioedema, 6 severe asthma, 2 latex reactions; in three patients a proper diagnosis was not achieved due to refuse / impossibility to perform diagnostic workout. Hymenoptera venom and food proved to be the main triggers, followed by drugs. 100% patients at risk of anaphylaxis received self-injectable adrenaline, pertinent education and individual action plan. In the same period, even though short, there were only two readmissions to ED. First result seems to confirm the usefulness of our approach to address some of unmet needs in anaphylaxis management, as recently pointed out by ICON guidelines (4). PMID:27152604

  10. Pharmaceutical nanotechnology : unmet needs in drug delivery

    Crommelin, D.J.A.; Park, K.; Florence, A.


    Nanotechnology has been gaining interest within and outside the scientific community. Conferences addressing different aspects of this rapidly growing field are organized at many different places. In May 2009 the LTS Academy organized a two-day workshop to discuss the relevance of nanotechnology to

  11. Risk factors for perceived unmet medical needs in human immunodeficiency virus-infected adults in Seoul, Korea.

    Kang, Cho Ryok; Bang, Ji Hwan; Cho, Sung-Il; Kim, Kui Nam; Lee, Hee-Jin; Lee, Young Hwa; Ryu, Bo Yeong; Cho, Soo Kyung; Oh, Myoung-Don; Lee, Jong-Koo


    To identify the factors associated with perceived unmet medical needs in human immunodeficiency virus (HIV)-infected adults, we analyzed the results from a series of city-wide cross-sectional surveys of HIV-infected adults living in Seoul, Korea. Multivariate logistic regression analysis was used to identify factors related to unmet medical needs. Among the 775 subjects included in the study, 15.4% had perceived unmet medical needs. Significant factors included age group (35-49 years; adjusted odds ratio [aOR], 1.80; 95% confidence interval [CI], 1.06-3.06), lower monthly income (aOR, 3.75 for the <$900/mo group and 2.44 for the $900-$1800/mo group; 95% CI, 1.68-8.35 and 1.18-5.04, respectively), beneficiaries of the National Medical Aid Program (aOR, 1.78; 95% CI, 1.01-3.17), recent CD4 cell counts <500/µL (aOR, 1.53; 95% CI, 1.01-2.33). Taken together, these data reveal strong associations of middle age and low socioeconomic status with perceived unmet medical needs among HIV-infected adults. PMID:27009447

  12. Integrating Collaboration, Adaptive Management, and Scenario-Planning to Address Rapid Change: Experiences at Las Cienegas National Conservation Area

    Caves, J. K.; Bodner, G.; Simms, K.; Fisher, L.; Robertson, T.


    There is growing recognition that public lands cannot be managed as islands; rather, land management must address the ecological, social, and temporal complexity that often spans jurisdictions and traditional planning horizons. Collaborative decision-making and adaptive management (CAM) have been promoted as methods to reconcile competing societal demands and respond to complex ecosystem dynamics. We present the experiences of land managers and stakeholders in using CAM at Las Cienegas National Conservation Area (LCNCA), a highly valued site under the jurisdiction of the Bureau of Land Management (BLM). The CAM process at Las Cienegas is marked by strong stakeholder engagement, with four core elements: 1) shared watershed goals with measurable resource objectives; 2) mechanisms to incorporate new information into decision-making; 3) efforts to make information increasingly relevant and reliable; and 4) shared learning to improve both the process and management actions. The combination of stakeholder engagement and adaptive management has led to agreement on contentious issues, more innovative solutions, and more effective land management. Yet the region is now experiencing rapid changes outside managers' control—including climate change, human population growth, and reduced federal budgets—with large but unpredictable impacts on natural resources. While CAM experience provides a strong foundation for making the difficult and contentious management decisions that such changes are likely to require, neither collaboration nor adaptive management provides a sufficient structure for addressing uncontrollable and unpredictable change. As a result, LCNCA is exploring two specific modifications to CAM that may better address emerging challenges, including: 1) Creating nested resource objectives to distinguish between those objectives which may be crucial from those which may hinder a flexible response to climate change, and 2) Incorporating scenario planning into CAM

  13. The Unmet Need for Mental Health Services among Probationers' Children

    Phillips, Susan D.; Venema, Rachel; Roque, Lorena


    This study explores the unmet need for mental health services among children with parents on probation. A group of 77 probationers provided information on 170 children. Information about children's need for mental health services was based on the Child Behavior Checklist and information about children's receipt of mental health services was based…

  14. Unmet health care needs for persons with environmental sensitivity

    Gibson PR


    Full Text Available Pamela Reed Gibson, Shannon Kovach, Alexis LupferDepartment of Psychology, James Madison University, Harrisonburg, VA, USAAbstract: Studies of unmet health care needs have shown that women, people with poor health, and people with lower socioeconomic status are more likely to report having unmet health care needs. In this study, we examined the types of and reasons for unmet health care needs in 465 people with environmental sensitivities. A second area of inquiry involved negative reactions to general anesthesia. Results showed that the most common barriers to receiving care were the inability to find a provider who understands environmental sensitivities and a lack of accessibility due to chemical and electromagnetic exposures in health care environments. Lower income and poorer health (longer illness, a worsening or fluctuating course of illness, and a higher level of disability were significantly correlated with the total number of reported unmet health care needs. Some people with environmental sensitivities reported having negative reactions to anesthesia of long duration; most common were nausea and vomiting, fatigue, and reduced cognitive ability.Keywords: environmental sensitivity, chemical sensitivity, electrohypersensitivity, chemical hypersensitivity, chemical intolerance, contested illness

  15. Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study

    Ashley Wilder Smith


    Full Text Available Introduction: Cancer for adolescents and young adults (AYA differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under- or inadequately served by current support services, which may affect health-related quality of life (HRQOL.Methods: We examined unmet service needs and HRQOL in the National Cancer Institute’s Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE study, a population-based cohort (n=484, age 15-39, diagnosed with cancer 6-14 months prior, in 2007-2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical and health insurance variables.Results: Over one-third of respondents reported at least one unmet service need. The most common were financial (16%, mental health (15%, and support group (14% services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p’s<0.0001. Specific unmet services were related to particular outcomes (e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p’s<0.001. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains.Discussion: Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental

  16. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    Sekandi Juliet


    Full Text Available Abstract Background Mulago National Referral Hospital (MNRH, Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23 and focus group discussions (n=7 were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies, staff inadequacies (knowledge, motivation, and professionalism, overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism

  17. Precompetitive Data Sharing as a Catalyst to Address Unmet Needs in Parkinson’s Disease

    Stephenson, Diane; Hu, Michele T.; Romero, Klaus; Breen, Kieran; Burn, David; Ben-Shlomo, Yoav; Bhattaram, Atul; Isaac, Maria; Venuto, Charles; Kubota, Ken; Little, Max A.; Friend, Stephen; Lovestone, Simon; Morris, Huw R.; Grosset, Donald; Sutherland, Margaret; Gallacher, John; Williams-Gray, Caroline; Bain, Lisa J.; Avil’es, Enrique; Marek, Ken; Toga, Arthur W.; Stark, Yafit; Gordon, Mark Forrest; Ford, Steve


    Parkinson’s disease is a complex heterogeneous disorder with urgent need for disease-modifying therapies. Progress in successful therapeutic approaches for PD will require an unprecedented level of collaboration. At a workshop hosted by Parkinson’s UK and co-organized by Critical Path Institute’s (C-Path) Coalition Against Major Diseases (CAMD) Consortiums, investigators from industry, academia, government and regulatory agencies agreed on the need for sharing of data to enable future success. Government agencies included EMA, FDA, NINDS/NIH and IMI (Innovative Medicines Initiative). Emerging discoveries in new biomarkers and genetic endophenotypes are contributing to our understanding of the underlying pathophysiology of PD. In parallel there is growing recognition that early intervention will be key for successful treatments aimed at disease modification. At present, there is a lack of a comprehensive understanding of disease progression and the many factors that contribute to disease progression heterogeneity. Novel therapeutic targets and trial designs that incorporate existing and new biomarkers to evaluate drug effects independently and in combination are required. The integration of robust clinical data sets is viewed as a powerful approach to hasten medical discovery and therapies, as is being realized across diverse disease conditions employing big data analytics for healthcare. The application of lessons learned from parallel efforts is critical to identify barriers and enable a viable path forward. A roadmap is presented for a regulatory, academic, industry and advocacy driven integrated initiative that aims to facilitate and streamline new drug trials and registrations in Parkinson’s disease. PMID:26406139


    The Office of Solid Waste and Emergency Response (OSWER) has identified the development of improved methods for measuring, monitoring, and characterizing complex wastes in soils, sediments, biota, and groundwater as a priority under GOAL 3: LAND PRESERVATION AND RESTORATION:Prese...

  19. Necessidade insatisfeita por métodos anticoncepcionais no Brasil Unmet contraception needs in Brazil

    Luciane Santiago Tavares


    childbearing, but are not using any conceptive method, that is, women with an unmet contraceptive need. The objective of this study is to describe the magnitude of the unmet contraceptive needs among Brazilian married women, as well as to identify the factors associated with this need. The information used is from the National Demographics and Health Survey carried out in Brazil in 1996. In order to identify the determinants associated with the unmet contraceptive needs, a multinomial model was used, with the outcome variable classified into three categories: need for spacing births, need for limiting births, and no need. The analysis conducted along with this work showed a strong association between factors related to the life cycle (age and number of children and unmet contraception needs. In relation to socioeconomic factors, the high likelihood of unmet contraceptive needs among women from the Northeast region stands out. It has also been shown that women with a higher educational level are less prone to have an unmet need for limiting births. The analysis points out the need of an appropriate and universal program for family planning services to assure full support to women's health.

  20. Opening address

    The impact of the Chernobyl accident on health has been dramatic but different than expected. It has posed a tremendous health, social and economic burden on the people of Belarus, the Russian Federation and Ukraine. Now the picture of the impact of the accident on health and environment is clearer and the agenda can further move towards development and focused health programmes. The work of the Chernobyl Forum, which allowed this important objective to be reached, is an example of the multiplied added value that different United Nations agencies working together can achieve when addressing complex problems affecting large communities in an independent, comprehensive and credible way. This model should be the basis for future action with the Member States towards reconstruction, development and better health

  1. Unmet Supportive Care Needs among Breast Cancer Survivors of Community-Based Support Group in Kuching, Sarawak

    Emmanuel Joseph Fong


    Full Text Available Background. Recognizing the needs of cancer survivors is one of the important aspects in healthcare delivery. This study aimed to determine the prevalence of unmet supportive care needs and its associated factors among the breast cancer survivors of community-based support group in Kuching, Sarawak. Materials and Methods. This was a cross-sectional study using Supportive Care Needs Survey (SCNS-SF34. All the members of community-based breast cancer support groups in Kuching were invited. A total of 101 respondents were face-to-face interviewed after the consent was obtained. Data was entered and analyzed using SPSS version 20. Results. The respondents endorsed health system and information domain with the highest mean score (2.48; 95% CI: 2.32–2.64. Top 10 items with “moderate to high” level unmet needs had a prevalence of 14.9% to 34.7% of respondents indicating need. Significantly higher level of unmet needs was associated with survivors who were younger (less than 60 years old, had higher education attainment, were unemployed, had survival duration of up to 5 years, and were undergoing active treatment. Conclusion. Systematic delivery of health information which is targeted, culturally sensitive, and linguistically appropriate for addressing younger age, education level, employment status, length of survivorship, and treatment stage should be considered not only at hospital-based setting but also at the community-based support groups.

  2. Unmet Supportive Care Needs among Breast Cancer Survivors of Community-Based Support Group in Kuching, Sarawak

    Fong, Emmanuel Joseph; Cheah, Whye Lian


    Background. Recognizing the needs of cancer survivors is one of the important aspects in healthcare delivery. This study aimed to determine the prevalence of unmet supportive care needs and its associated factors among the breast cancer survivors of community-based support group in Kuching, Sarawak. Materials and Methods. This was a cross-sectional study using Supportive Care Needs Survey (SCNS-SF34). All the members of community-based breast cancer support groups in Kuching were invited. A total of 101 respondents were face-to-face interviewed after the consent was obtained. Data was entered and analyzed using SPSS version 20. Results. The respondents endorsed health system and information domain with the highest mean score (2.48; 95% CI: 2.32–2.64). Top 10 items with “moderate to high” level unmet needs had a prevalence of 14.9% to 34.7% of respondents indicating need. Significantly higher level of unmet needs was associated with survivors who were younger (less than 60 years old), had higher education attainment, were unemployed, had survival duration of up to 5 years, and were undergoing active treatment. Conclusion. Systematic delivery of health information which is targeted, culturally sensitive, and linguistically appropriate for addressing younger age, education level, employment status, length of survivorship, and treatment stage should be considered not only at hospital-based setting but also at the community-based support groups. PMID:27239346

  3. Parenting-by-gender interactions in child psychopathology: attempting to address inconsistencies with a Canadian national database

    Thabane Lehana


    Full Text Available Abstract Background Research has shown strong links between parenting and child psychopathology. The moderating role of child gender is of particular interest, due to gender differences in socialization history and in the prevalence of psychiatric disorders. Currently there is little agreement on how gender moderates the relationship between parenting and child psychopathology. This study attempts to address this lack of consensus by drawing upon two theories (self-salience vs. gender stereotyped misbehaviour to determine how child gender moderates the role of parenting, if at all. Methods Using generalized estimating equations (GEE associations between three parenting dimensions (hostile-ineffective parenting, parental consistency, and positive interaction were examined in relationship to child externalizing (physical aggression, indirect aggression, and hyperactivity-inattention and internalizing (emotional disorder-anxiety dimensions of psychopathology. A sample 4 and 5 year olds from the National Longitudinal Survey of Children and Youth (NLSCY were selected for analysis and followed over 6 years (N = 1214. Two models with main effects (Model 1 and main effects plus interactions (Model 2 were tested. Results No child gender-by-parenting interactions were observed for child physical aggression and indirect aggression. The association between hostile-ineffective parenting and child hyperactivity was stronger for girls, though this effect did not reach conventional levels of statistical significance (p = .059. The associations between parenting and child emotional disorder did vary as a function of gender, where influences of parental consistency and positive interaction were stronger for boys. Discussion Despite the presence of a few significant interaction effects, hypotheses were not supported for either theory (i.e. self-salience or gender stereotyped misbehaviour. We believe that the inconsistencies in the literature regarding child gender

  4. Unmet needs among men with human immunodeficiency virus in community mental health care: a cross-sectional study.

    Durbin, Anna; Sirotich, Frank; Antoniou, Tony; Roesslein, Kay; Durbin, Janet; Lunsky, Yona


    While community-based mental health services play an important role in caring for persons with HIV (human immunodeficiency virus) and co-existing mental health disorders, the extent to which their support needs are addressed in this setting is unknown. Accordingly, we examined if HIV infection was associated with unmet support needs among men living with and without HIV receiving community mental health care. This cross-sectional study examined 215 men (135 living with HIV and 80 without HIV) receiving case management services in urban Ontario. Using the Camberwell Assessment of Need, we ascertained the prevalence of support needs in 13 domains grouped into three clusters: Basic needs (accommodation, food, benefits, and money management); self-care/functional needs (daytime activities, self-care, and looking after the home); and health/safety needs (physical, psychological distress, psychotic symptoms, safety to self, and safety to others). We used generalized estimating equations with a logit link to examine the association between HIV and unmet need in each domain. Compared to HIV-negative men, men with HIV were more likely to have mood and concurrent disorders, and intellectual and developmental disabilities. Following multivariable analyses, men with HIV had greater unmet needs related to food (odds ratio + 95% confidence interval: 9.36 (4.03, 21.75), p HIV receiving community mental health support had greater unmet need in basic and health domains than HIV-negative men receiving such support. Further research is required to develop and evaluate interventions to best support community-dwelling persons with HIV and mental health disorders. PMID:26971736

  5. Insect Consumption to Address Undernutrition, a National Survey on the Prevalence of Insect Consumption among Adults and Vendors in Laos.

    Hubert Barennes

    Full Text Available Insect consumption (entomophagy is a potentially high nutritious and healthy source of food with high fat, protein, vitamin, fiber and micronutrient content. At least 2 billion people globally eat insects (over 1900 edible species though this habit is regarded negatively by others. There is a limited amount of data on the perception and consumption of insects. We conducted a national cross-sectional survey in the Lao People's Democratic Republic (Laos to assess the prevalence and characteristics of insect consumption among adult lay people and insect vendors.We conducted a multi stage randomized national survey in 1303 households in 96 villages in 16 Lao provinces. Three insect vendors or collectors per village were also included. A standardized pretested questionnaire addressed the following issues: socioeconomic characteristics, type of insects consumed and frequency of consumption, reasons and trends in consumption as well as reports on side effects, over the last 10 years.A total of 1059 adults (Sex ratio F/M: 1.2, 30 ethnic groups, and 256 vendors were enrolled. A total of 1025 (96.8% lay people were currently insect consumers, 135 (13.0% daily or weekly consumers, and 322 (31.1% consumed several times per month. For the majority (575, 55.6% the consumption was infrequent (less than a few times per year and only 22 (2% had never eaten insects. Consumption started in childhood. Insect availability was seasonal (670, 63.2% and respondents would have eaten more insects, if they had been more available (919, 86.7%. Hmong and Leu ethnic groups had significantly lower consumption levels than the general population. Eggs of weaver ants, short-tailed crickets, crickets, grasshoppers, and cicadas were the top 5 insects consumed. Consumption had decreased in the last decade, mostly due to less availability (869; 84.0% and change of life (29; 5.5%. Of 1059, 80 (7.5% reported allergy problems and 106 (10.0% reported some use in traditional medicine. A

  6. Expanding the National Drug Abuse Treatment Clinical Trials Network to address the management of substance use disorders in general medical settings

    Tai B


    Full Text Available Betty Tai, Steven Sparenborg, Udi E Ghitza, David Liu Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA Abstract: The Patient Protection and Affordable Care Act (2010 and the Mental Health Parity and Addiction Equity Act (2008 expand substance use disorder (SUD care services in the USA into general medical settings. Care offered in these settings will engage substance-using patients in an integrated and patient-centered environment that addresses physical and mental health comorbidities and follows a chronic care model. This expansion of SUD services presents a great need for evidence-based practices useful in general medical settings, and reveals several research gaps to be addressed. The National Drug Abuse Treatment Clinical Trials Network of the National Institute on Drug Abuse can serve an important role in this endeavor. High-priority research gaps are highlighted in this commentary. A discussion follows on how the National Drug Abuse Treatment Clinical Trials Network can transform to address changing patterns in SUD care to efficiently generate evidence to guide SUD treatment practice within the context of recent US health care legislation. Keywords: Patient Protection and Affordable Care Act, National Drug Abuse Treatment Clinical Trials Network, substance use disorders, practice-based research network, electronic health records

  7. Opening address

    Full text: Honourable Representatives of His Majesty King Mohammed VI and of the Government of Morocco, representatives of sponsoring organizations, distinguished participants, on behalf of the Director General of the IAEA, it is my pleasure and privilege to welcome you to this International Conference on National Infrastructures for Radiation Safety: Towards Effective and Sustainable Systems. I would like to express my sincere appreciation to His Majesty King Mohammed VI for his patronage, to the Government of Morocco and the University Mohammed V, Agdal, for hosting this conference in the beautiful and historic city of Rabat, and to the local organizers for their diligent planning and gracious hospitality. I would also like to thank the four organizations that are co-operating with the IAEA in holding this conference: the World Health Organization, the Pan American Health Organization, the International Labour Organization, the European Commission and the OECD/Nuclear Energy Agency. National infrastructure for radiation safety has emerged as an issue of international concern over the last two decades. Systematic and strategic consideration of infrastructure has become widely recognized as an essential prerequisite for safety. The first IAEA conference to address the topic was in Munich, Germany, in 1990. The 1996 edition of the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (known as the Basic Safety Standards or BSS) highlighted the issue, and the IAEA's technical co-operation Model Project for Upgrading Radiation Protection Infrastructure was introduced to help address it. The Model Project has helped, and continues to help, more than 85 IAEA Member States to work towards the goal of a radiation safety infrastructure in accordance with the Basic Safety Standards. A great deal has been achieved, but this work is not complete. Furthermore, not all States are members of the IAEA or the Model

  8. "War on Terror" Is a Curative: Recontextualization and Political Myth-Making in Gloria Macapagal-Arroyo's 2002-2004 State of the Nation Addresses

    Navera, Gene Segarra


    The article examines the State of the Nation addresses (SONA) delivered by Philippine President Gloria Macapagal-Arroyo (2001-2010) from 2002-2004, during which time she actively invoked the need to engage in the U.S. government-led "global war on terror." It specifically investigates how these presidential speeches recontextualized the war on…

  9. Poverty in the midst of plenty: unmet needs and distribution of health care resources in South Korea.

    Jongho Heo

    Full Text Available BACKGROUND: The unmet needs for health care have been used as an alternative measurement to monitor equity in health services. We sought to examine contextual influences on unmet needs for health care whereas precedent studies have been focused on individual characteristics on them. METHODS AND FINDINGS: The current study conducted multilevel logistic regression analysis to assess the effects of individual- and contextual-level predictors in meeting individual health care needs in South Korea. We sampled 7,200 individuals over the age of 19 in the Fourth Korea National Health and Nutrition Examination Survey in 2009. Included in the regression model were individual predictors such as demographic variables, socio-economic status, and self-rated health; the density of beds and physicians in public and private sectors within different regions were used as contextual-level predictors. This study showed the inverse association between unmet needs and regional resources in private sectors after controlling for the effects of individual-level predictors. CONCLUSION: Our findings suggest that increasing regional resources in private sectors might produce inefficiency in the health care system and inequity in access to health services, particularly where the competition in private health care sectors was highly stimulated under the fee-for-service reimbursement scheme. Policies for the reallocation of health care resources and for reduction of individual health care costs are needed in Korea.

  10. Medical innovation, unmet medical needs, and the drug pipeline.

    Mather, Charles M


    This paper outlines and illustrates the working of a theoretical approach from the social sciences for analyzing medical innovation, unmet medical need, and the drug pipeline. Using the social history of three drugs made from recombinant DNA (insulin, human growth hormone, and tissue-plasminogen activator) the paper shows how drugs can be both technically and organizationally efficient while the needs they satisfy can be created or identified. The paper posits that drugs that require more organizational efficiency tend to satisfy identified, rather then created needs. Key words: Recombinant DNA, technical efficiency, organizational efficiency, anthropology. PMID:16493177

  11. Unmet need for family planning in South Africa 1998 Malawi 2000 / Tshegofatso Queen Molebatsi

    Molebatsi, Tshegofatso Queen


    Introduction: Unmet need for family planning is high in most African countries including South Africa and Malawi as witnessed by high levels of teenage pregnancies, unwanted births and unsafe abortion. As such unmet need for family planning was added to the fifth Millennium Development Goal (MDG) as an indicator for tracking progress on improving maternal health. Objective: The primary objective of the study is to determine the correlates of unmet need for family planning among women of re...

  12. Focus on relationship between the caregivers unmet needs and other caregiving outcomes in cancer palliative care

    Buscemi, Valérie; Font Guiteras, Antoni; Viladrich, M. C.,


    Objetive: Study the relationships between caregivers unmet needs and others caregiving outcomes in palliative care and cancer, which is a first and necessary step to offer adequate supporting intervention. Methods: 59 caregivers participated in a research that examined the caregiving outcomes using an Unmet Needs Questionnaire, the Hospital Anxiety and Depression Scale, and the Bakas Caregiving Outcomes Scale. Results and conclusions: Results showed a high average of unmet needs, especially e...

  13. Unmet needs, quality of life and support networks of people with dementia living at home

    Oomman Sabu; Galboda Kumari; Woods Bob; Miranda-Castillo Claudia; Olojugba Charles; Orrell Martin


    Abstract Background There is lack of evidence about the unmet needs of people with dementia (PWD) living at home and the predictors of high levels of unmet needs. The main aim of this study was to identify the relationship between unmet needs, social networks and quality of life of PWD living at home. Methods One hundred and fifty two community dwelling PWD and 128 carers were interviewed about PWD's needs, social networks, quality of life and other functional and psychological factors. All t...

  14. Why Has It Taken So Long to Address the Problems Created by Uranium Mining in the Navajo Nation?

    Brugge, Doug


    Following the start of uranium mining after World War II, progress toward addressing the hazards it created for workers and nearby communities was slow, taking many decades. This essay asks why it took so long and suggests several factors that might have contributed. PMID:26463258

  15. Poverty and working status in changes of unmet health care need in old age.

    Park, Sojung; Kim, BoRin; Kim, Soojung


    This study examined relationships between socioeconomic disadvantage and unmet health care needs among older adults in Korea adjusting for predisposing and health need factors. We examined how older adults' low-income status and working status affect unmet needs for healthcare over time, and how the association varies by reason for unmet needs (i.e. financial or non-financial). We used three waves of data (2009, 2011, 2012) from the Korea Health Panel (KHP) survey and a multinomial logistic mixed model to analyze how low socioeconomic disadvantages affects changes in unmet healthcare needs independently and in combination. Results showed that near-poor elders were more likely to experience increased risk of unmet need due to non-financial constraints over time. When working, near-poor elders risk of unmet healthcare needs due to financial and non-financial factors increases substantially over time. Across societies, different subgroups of older adults may be at risk of unmet healthcare needs, contingent on healthcare policies. Our finding suggests that in Korea, near-poor working elders are the vulnerable subgroup at highest risk of unmet healthcare needs. This finding provides much-needed evidence of heterogeneity of vulnerability in unmet healthcare needs and can be used to design more affordable and accessible programs and services for this group. PMID:27025977

  16. Determinants of Unmet Need for Family Planning In a Developing Country: An Observational Cross Sectional Study

    Saima Nazir, Anshu Mittal, Bhupinder K Anand, RKD Goel, Jagjeet Singh, Arshad Rashid


    Conclusion: Education, income, occupation, knowledge about contraception, communication with partner regarding family planning, media accessibility, gender preference were identified as the contributing factors for Unmet Need."

  17. The unmet need for Emergency Obstetric Care in Tanga Region, Tanzania

    Mtatifikolo Ferdinand


    Full Text Available Abstract Background Improving maternal health by reducing maternal mortality constitutes the fifth Millennium Development Goal and represents a key public health challenge in the United Republic of Tanzania. In response to the need to evaluate and monitor safe motherhood interventions, this study aims at assessing the coverage of obstetric care according to the Unmet Obstetric Need (UON concept by obtaining information on indications for, and outcomes of, major obstetric interventions. Furthermore, we explore whether this concept can be operationalised at district level. Methods A two year study using the Unmet Obstetric Need concept was carried out in three districts in Tanga Region, Tanzania. Data was collected prospectively at all four hospitals in the region for every woman undergoing a major obstetric intervention, including indication and outcome. The concept was adapted to address differentials in access to emergency obstetric care between districts and between rural and urban areas. Based upon literature and expert consensus, a threshold of 2% of all deliveries was used to define the expected minimum requirement of major obstetric interventions performed for absolute maternal indications. Results Protocols covering 1,260 complicated deliveries were analysed. The percentage of major obstetric interventions carried out in response to an absolute maternal indication was only 71%; most major obstetric interventions (97% were caesarean sections. The most frequent indication was cephalo-pelvic-disproportion (51%. The proportion of major obstetric interventions for absolute maternal indications performed amongst women living in urban areas was 1.8% of all deliveries, while in rural areas it was only 0.7%. The high proportion (8.3% of negative maternal outcomes in terms of morbidity and mortality, as well as the high perinatal mortality of 9.1% (still birth 6.9%, dying within 24 hours 1.7%, dying after 24 hours 0.5% raise concern about the

  18. Vaginal biological and sexual health--the unmet needs.

    Graziottin, A


    The vagina is a most neglected organ. It is usually clinically considered with a minimalistic view, as a 'connecting tube' for a number of physiologic functions: passage of menstrual blood, intercourse, natural conception and delivery. Unmet needs include, but are not limited to, respect of vaginal physiologic biofilms; diagnosis and care of the optimal tone of the levator ani, which surrounds and partly support it; care of its anatomic integrity at and after delivery and at pelvic/vaginal surgery; care of long-term consequences of pelvic radiotherapy; long-term care of the atrophic changes it will undergo after the menopause, unless appropriate, at least local, estrogen therapy is used; appreciation and respect of its erotic meaning, as a loving, receptive, 'bonding' organ for the couple. The vaginal erotic value is key as a non-visible powerful center of femininity and sexuality, deeply and secretly attractive in terms of taste, scent (together with the vulva), touch and proprioception. The most welcoming when lubrication, softness and vaginal orgasm award the woman and the partner with the best of pleasures. Prevention of sexual/vaginal abuse is a very neglected unmet need, as well. Who cares? PMID:26366794

  19. National Institute of Justice (NIJ): improving the effectiveness of law enforcement via homeland security technology improvements (Keynote Address)

    Morgan, John S.


    Law enforcement agencies play a key role in protecting the nation from and responding to terrorist attacks. Preventing terrorism and promoting the nation"s security is the Department of Justice"s number one strategic priority. This is reflected in its technology development efforts, as well as its operational focus. The National Institute of Justice (NIJ) is the national focal point for the research, development, test and evaluation of technology for law enforcement. In addition to its responsibilities in supporting day-to-day criminal justice needs in areas such as less lethal weapons and forensic science, NIJ also provides critical support for counter-terrorism capacity improvements in state and local law enforcement in several areas. The most important of these areas are bomb response, concealed weapons detection, communications and information technology, which together offer the greatest potential benefit with respect to improving the ability to law enforcement agencies to respond to all types of crime including terrorist acts. NIJ coordinates its activities with several other key federal partners, including the Department of Homeland Security"s Science and Technology Directorate, the Technical Support Working Group, and the Department of Defense.

  20. Parenting-by-gender interactions in child psychopathology: attempting to address inconsistencies with a Canadian national database

    Thabane Lehana; Odueyungbo Adefowope; Browne Dillon T; Byrne Carolyn; Smart Lindsay A


    Abstract Background Research has shown strong links between parenting and child psychopathology. The moderating role of child gender is of particular interest, due to gender differences in socialization history and in the prevalence of psychiatric disorders. Currently there is little agreement on how gender moderates the relationship between parenting and child psychopathology. This study attempts to address this lack of consensus by drawing upon two theories (self-salience vs. gender stereot...

  1. Opening address

    The opening address by the host country started by thanking to the International Atomic Energy Agency for holding this important scientific event in in Morocco. The themes to be considered by this conference are among the priorities of the Scientific Research Department in its endeavour to promote scientific research in the field of nuclear science and technology for peaceful uses in Morocco. By so doing, this Department is following and supporting the efforts being made by our country to provide training, and elaborate rules and regulations, and to create infrastructure, acquire material and, equipment and encourage qualified and active researchers. Hence, the convening of this conference responds to a strategic interest of our country, which, similar to other countries, is committed to the achievement of comprehensive and sustainable development for the protection of human kind and the environment. This is considered nowadays as a strategic and vital objective as it entails the protection of people from radiation and against all kinds of professional risks and health hazards. Morocco attaches great importance to radiation safety issues. Our country adhered to all international conventions related to nuclear safety. It is in the process of adapting its internal regulations to international norms and standards, and it is making progress towards the establishment of a national safety body which meets those norms and standards, with the assistance of the IAEA. For this purpose, a standing committee for the follow-up of nuclear affairs has been created on the basis of Royal Instructions, and placed under the authority of the Prime Minister. Its task is to serve as a think-tank on nuclear safety issues and to make proposals on ways and means of reinforcing radiation safety measures. It goes without saying that the peaceful uses of nuclear energy must meet the safety standards elaborated by the IAEA. However, we are convinced that the elaboration of safety standards

  2. Opening address

    Nuclear terrorism has been recognized as a potential threat to human security and economic prosperity since at least the 1970s. Evidence of Al Qaeda's interest in acquiring nuclear material came to light during the 1990s. However, it is since the attacks of 11 September 2001 that the risk of nuclear terrorist acts has come to be a widespread public and governmental concern, for understandable reasons, and that efforts to combat illicit trafficking, which could lead to nuclear or other radioactive materials falling into the hands of terrorists, have intensified. Six years on, it makes sense to take stock of what has been achieved in the combat to stem illicit trafficking and of where further actions - actions of individual States and cooperative international actions - might usefully be initiated. The IAEA has maintained an Illicit Trafficking Database since 1995. Information reported to this database confirms that concerns about illicit trafficking in nuclear material are justified. Database information points to persistent theft and loss of radioactive sources. States' international obligations relevant to international nuclear trafficking are based on the Convention on the Physical Protection of Nuclear Material (CPPNM), the International Convention for the Suppression of Acts of Nuclear Terrorism, the United Nations Security Council Resolution 1540, which deals with weapons of mass destruction, including nuclear weapons and non-State actors, and the United Nations Security Council Resolution 1375, which requires all States to take the necessary steps to prevent the commission of terrorist acts, including early warning to other States. In addition to these legally binding instruments, there is the non-binding Code of Conduct on the Safety and Security of Radioactive Sources, which Member States of the IAEA agreed in 2003. The Code addresses the establishment of an adequate system of regulatory control, from the production of radioactive sources to their final

  3. Keynote address

    DOE biomass R ampersand D programs have the potential to provide America with both plentiful, clean-burning domestic transportation fuels and cost-competitive industrial and utility fuels, benefiting energy security in the United States. Biofuels developed under our programs will also help improve air quality, reduce greenhouse gases, reduce the large daily quantities of waste we produce, and revitalize rural America. These research motivations have been documented in the National Energy Strategy. DOE looks forward to expanding its biofuels research program and to forging a partnership with private sector for cost-shared commercialization of new fuels and vehicle technologies. Many alternative fuels (e.g., ethanol, methanol, compressed natural gas, propane, or electricity) are candidates for gaining market share. Indeed, there may be significant regional variation in the future fuel mix. Alcohol fuels from biomass, particularly ethanol, have the potential to make a major contribution. Currently, ethanol in the United States is almost entirely made from corn; and the limitations of that process are well known (e.g., costly feedstock, end product requiring subsidy to be competitive, use of fossil fuels in renewable feedstock production and processing, and potential adverse impact of corn ethanol production on the price of food). To address these concerns, the DOE biofuels program is pursuing an ambitious research program to develop the technologies needed to convert these crops into alternative transportation fuels, primarily cellulose-based ethanol and methanol. Program R ampersand D has reduced the estimated cost per gallon of cellulose-based ethanol from $3.60 in 1980 to the current $1.35, with a program goal of $0.60 by the year 2000. DOE is also investigating the thermochemical conversion of biomass to methanol. The program goal is to achieve commercial production of methanol (like ethanol) at the gasoline equivalent of $0.90 per gallon by the year 2000. 4 figs

  4. Recommendations for strengthening the national systems and the international regime for combating of illicit trafficking. Keynote address/session 10

    Full text: Illicit trafficking activities involving nuclear material and equipment are acts of nuclear proliferation. The threat of illicit trafficking is an international concern and the consequences of illicit trafficking, such as war or terrorist attacks using illegally manufactured nuclear weapons, might affect any country. As long as these materials and equipment remain a potential for theft and smuggling due to insufficient security and control conditions, there is a possibility that proliferators or terrorist groups may illegally take possession of such materials and equipment for illicit purposes. A precondition for preventing illicit trafficking is the existence of effective national systems for supervision and control of nuclear material and equipment, including physical protection and export/import control, based on an accurate and complete legislation. In addition thereto, national systems for combating of illicit trafficking, through prevention and detection within a state's territory or across its borders, incorporate such components as: supervision and control of nuclear operations; organisation of operator activities through quality assurance, internal control, security culture, etc.; law enforcement functions (police, intelligence, customs, investigation, prosecution, penalties and sanctions); and procedures for co-ordination and co-operation between supervising and law enforcement authorities. According to a joint Swedish-Norwegian-Latvian study, there are imperfections in many national systems for combating of illicit trafficking, such as: Incomplete legislation on nuclear non-proliferation and safety, physical protection and export/import control; Unclear or overlapping responsibilities between national supervision and law enforcement authorities, leading to poor co-operation and co-ordination of preventing and detecting measures; Incomplete rules and regulations concerning operator functions and responsibilities, including requirements on

  5. A Comparative Perspective on National Policies Addressing Genetically Modified Organisms. How Does the Us - European Union Debate on this Topic Affect Other Countries?

    DRAGOȘ Dacian C.; Bogdana NEAMŢU


    The paper explores the topic of genetically modified organisms (hereafter GMOs) and focuses on national and international regulatory approaches to this field. The analysis herein addresses a multitude of interconnected issues on GMOs as the authors’ intention is to explain how a policy problem that is environmental in nature can generate debates and consequences that go beyond the realm and scope of environmental policy. Each of the sections of the paper could be expanded into an autonomous p...

  6. Assessment of the National Wind Coordinating Collaborative: Addressing Environmental and Siting Issues Associated with Wind Energy Development

    Van Cleve, Frances B.; States, Jennifer C.


    The National Wind Coordinating Collaborative (NWCC) is a consensus-based stakeholder group comprised of representatives from the utility, wind industry, environmental, consumer, regulatory, power marketer, agricultural, tribal, economic development, and state and federal government sectors. The purpose of the NWCC is to support the development of an environmentally, economically, and politically sustainable commercial market for wind power (NWCC 2010). The NWCC has been funded by the U.S. Department of Energy (DOE) since its inception in 1994. In order to evaluate the impact of the work of the NWCC and how this work aligns with DOE’s strategic priorities, DOE tasked Pacific Northwest National Laboratory (PNNL) to conduct a series of informal interviews with a small sample of those involved with NWCC.

  7. Insect Consumption to Address Undernutrition, a National Survey on the Prevalence of Insect Consumption among Adults and Vendors in Laos

    Barennes, Hubert; Phimmasane, Maniphet; Rajaonarivo, Christian


    Background Insect consumption (entomophagy) is a potentially high nutritious and healthy source of food with high fat, protein, vitamin, fiber and micronutrient content. At least 2 billion people globally eat insects (over 1900 edible species) though this habit is regarded negatively by others. There is a limited amount of data on the perception and consumption of insects. We conducted a national cross-sectional survey in the Lao People’s Democratic Republic (Laos) to assess the prevalence an...

  8. Unmet Health Care Service Needs of Children With Disabilities in Penang, Malaysia.

    Tan, Seok Hong


    Information on unmet health care needs reveal problems that are related to unavailability and inaccessibility of services. The study objectives were to determine the prevalence, and the reasons for unmet service needs among children with disabilities in the state of Penang, Malaysia. Caregivers of children with disabilities aged 0 to 12 years registered with the Penang Social Welfare Department in 2012 answered a self-administered mailed questionnaire. A total of 305 questionnaires were available for analysis (response rate 37.9%). Services that were very much needed and yet highly unmet were dental services (49.6% needed, 59.9% unmet), dietary advice (30.9% needed, 63.3% unmet), speech therapy (56.9% needed, 56.8% unmet), psychology services (25.5% needed, 63.3% unmet), and communication aids (33.0% needed, 79.2% unmet). Access problems were mainly due to logistic issues and caregivers not knowing where to obtain services. Findings from this study can be used to inform strategies for service delivery and advocacy for children with disabilities in Penang, Malaysia. PMID:26122314

  9. Unmet needs in cancer rehabilitation during the early cancer trajectory - a nationwide patient survey

    Veloso, Astrid Gisèle; Sperling, Cecilie; Holm, Lise Vilstrup; Nicolaisen, Anne; Rottmann, Nina; Thayssen, Susanne; Christensen, René Depont; Lehmann Knudsen, Janne; Hansen, Dorte Gilså


    A cancer diagnosis may lead to psychosocial problems and physical symptoms that can be relieved during rehabilitation. The aim of this study was to analyse patient-perceived unmet needs of rehabilitation close to time of diagnosis, i.e. frequencies of unmet needs and the association with...

  10. Opening address

    and become more technical. Involving experts from all fields is then crucial for success. This perception is reflected in the goals of this meeting. It is designed as an extensive information exchange forum between decision makers, regulators, radiation and waste safety specialists, and the nuclear industry. It is this mix which promises high efficiency with respect to solving the problems that you are addressing. I am sure that the safe termination of practices involving radioactive materials during the decommissioning of nuclear installations is one of the major challenges that industrialized nations will have to face during the next decades

  11. Fulfilling an Unmet Need: Roles for Clinical Pharmacists in Preconception Care.

    DiPietro Mager, Natalie A


    Preconception care refers to a set of interventions that identify and address biomedical, behavioral, and social risks to a woman's health that may negatively impact a future pregnancy. A great need for preconception care currently exists in the United States, and women's attitudes about discussions with health care providers about healthy and safe pregnancies are positive. Clinical pharmacists are well positioned to work with other health care and public health professionals to ensure that all women of childbearing potential have access to preconception care. As part of the collaborative health care team, clinical pharmacists can directly provide services or support and referrals to other members of the health care team or to community resources through clinical-community linkages. Specifically, clinical pharmacists can provide education, counseling, and/or services to women to address family planning, medication and disease state management, immunizations, screenings, health promotion, and substance use. Clinical pharmacists can also impact preconception care through drug information services, advocacy, and research. Preconception care services can be incorporated into daily pharmacy practice, and there are potential means for reimbursement. Multiple roles exist for clinical pharmacists to fulfill unmet needs in preconception care. PMID:26846305

  12. Understanding the political economy and key drivers of energy access in addressing national energy access priorities and policies

    Globally, 1.5 billion people lack access to electricity and nearly 3 billion lack access to modern cooking energy options. Of the world’s “energy poor”, 95% are in Asia and Sub-Saharan Africa. Within Asia, almost 80% of electricity-deprived and 86% of biomass-dependent populations are in the “Big 5” countries: Bangladesh, China, India, Indonesia, and Pakistan. In this paper, we discuss the broad contours of the political economy of energy access in these countries. The political economy is assessed through an examination of three sustainability objectives: accessibility of physical infrastructure; energy service delivery; and conformance to social goals. The key areas of concern include emphasis on supply-driven grid electricity; vested power dynamics favouring affluent and urban areas; unreliability of energy service provision; and misdirected and misappropriated subsidies. The above-mentioned issues are responsible for limiting accelerated achievement of universal energy access in the “Big 5” countries and need to be addressed through innovative approaches. The paper emphasizes the need for firm commitments, policy convergence, and the implementation of 'pro-poor' equitable energy policies through a broad-based energy framework of bench-marked, technology-neutral energy provisioning that ensures reliability and equity. It highlights the need for reorienting of the subsidy regime and incorporating energy service delivery indicators in monitoring and reporting mechanisms. - Highlights: ► Limited emphasis on improved cooking programmes relative to electrification schemes. ► Strong disparity between rural and urban electrification and LPG access. ► Grid extension and subsidy on cooking fuels has limited success. ► Electricity access does not indicate transition to better cooking options. ► Technology neutrality in choosing suitable alternatives may led to improved access. ► There is need to re-orient energy subsidies and incentives.

  13. Prevalence of unmet need for contraception in urban slum communities, Mumbai

    Shahina Begum


    Full Text Available Background: Unmet need for family planning is a tool to monitor the family planning program. Hence, the objective of study is to examine the prevalence of unmet need for family planning among women living in urban slum communities, Mumbai. Methods: The cross-sectional survey was conducted among currently married women aged 18-39 years and having at least one child. A total of 2797 women were selected using systematic random sampling. Information on demographic characteristics, their contraceptive behaviour and fertility intention were collected by face to face interview using structured questionnaire. Chi square test was applied and p <0.05 was considered as significant. Results: About 59.4% were currently using family planning methods and 40.6% have reported unmet need for family planning. Awareness of contraceptive methods among women with unmet need for family planning was universal. The prevalence of unmet need for family planning significantly decreased as the age and number of children increased. The prevalence of unmet need was significantly higher than met need for family planning among women having one child as compared to women having 2 or more children. Conclusions: A significant gap was observed between met and unmet need for family planning among younger women and having one child. The study emphasises the need for family planning programs to focus on younger couples having one child. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 627-630

  14. Opening address

    Full text: The International Labour Organization (ILO), is very pleased to be associated with this International Conference on National Infrastructures for Radiation Safety. On behalf of the Director General, Mr. J. Somavia, I would like to congratulate the national organizer and host, the University Mohammed V, Agdal, and the Government of Morocco, the IAEA and the other co-operating organizations: the World Health Organization, the Pan American Health Organization, the European Commission and the OECD/Nuclear Energy Agency for taking this initiative. When flying here to Morocco yesterday, I read newspaper reports about the results of the investigations related to the disaster of the Columbia space shuttle. The findings were as follows: the United States National Aeronautics and Space Administration (NASA), must establish a safety culture within itself. NASA was well aware of the problem of falling insulation material but did not take it seriously before the disaster. The workers in the Chernobyl power plant knew the hazards and safety rules but did not take them seriously. Every day, more than 5000 people die from occupational accidents and work related diseases as the hazards are not taken seriously. Some of them are caused by ionizing radiation. We in the ILO expect enterprises and workplaces to follow proper occupational safety and health management systems so as to avoid accidents, diseases and other problems at work. Equally, we must expect national leadership, sound nationwide management, for radiation safety, which means: National policy setting, which usually results in national standards and laws; National structures and mechanisms, that is, who is in charge of what; Responsibilities and accountabilities set, and resources allocated; National action plans, a national programme;Implementation of these plans;Follow-up, monitoring, review, feedback to enhance the process using selected indicators; Continuous improvement in measurable steps at national level

  15. Association between unmet needs and quality of life of cancer patients

    Hansen, Dorte Gilså; Larsen, Pia Veldt; Holm, Lise Vilstrup;


    patients diagnosed between 1 October 2007 and 30 September 2008 was established. At 14 months following diagnosis participants completed a questionnaire including health-related quality of life (EORTC QLQ C-30), psychological distress (POMS-SF), and unmet needs with regard to physical, emotional, family.......2%). Overall, 60.1% expressed an unmet need of rehabilitation in at least one area, physical and emotional problems being the most frequent (40.0% and 37.5%). For all scales of the EORTC QLQ C-30 and POMS, significant adjusted mean differences were observed between patients with unmet needs in at least one...

  16. Irritable bowel syndrome: the burden and unmet needs in Europe.

    Quigley, E M M


    Irritable bowel syndrome affects approximately 10-15% of the European population, although prevalence rates vary depending on the classification used and the country surveyed. This may be due to differences in patterns of medical care and diagnosis of the condition. Up to 70% of individuals with irritable bowel syndrome may not have been formally diagnosed. The disorder affects 1.5-3 times as many women as men and poses a significant economic burden in Europe, estimated at euro 700-euro 1600 per person per year. It also reduces quality of life and is associated with psychological distress, disturbed work and sleep, and sexual dysfunction. It is a chronic disorder, which affects many individuals for more than 10 years. Most patients are managed in primary care, although some are referred to gastroenterologists and other specialists. Patients with irritable bowel syndrome undergo more abdomino-pelvic surgery than the general population. We propose that a positive diagnosis of the condition may avoid the delay in diagnosis many patients experience. We conclude that, in Europe, there are significant unmet needs including lack of familiarity with irritable bowel syndrome, difficulties in diagnosis and lack of effective treatments for the multiple symptoms of the disorder. The development of pan-European guidelines for irritable bowel syndrome will benefit patients with this condition in Europe.

  17. IP Addressing


    tut quiz anim This interactive tutorial covers the following: The concept of halving a binary number space., Using the halving concept to explain how the Internet IP space is segmented into the A, B, and C address classifications., How the first octet ranges for the A, B, and C IP space are produced.In this tutorial, explanations are illustrated by simple animations. Students are asked to observe number patterns, and check their observations against automated 'answers.' There is a qu...

  18. Inaugural Address

    Syed Yousaf Raza Gilani


    Sardar Aseff Ahmad Ali, Deputy Chairman, Planning Commission, Dr Rashid Amjad, President, Pakistan Society of Development Economists, Honourable Ministers, Excellencies, Ladies and Gentlemen! It is indeed a privilege and honour to address this distinguished gathering of economists. I am very happy that this meeting is being attended by internationally acclaimed economists and academics from both within and outside the country. I am especially heartened to see that students of economics from a...

  19. Development of new treatment approaches for epilepsy: unmet needs and opportunities.

    French, Jacqueline A; White, H Steve; Klitgaard, Henrik; Holmes, Gregory L; Privitera, Michael D; Cole, Andrew J; Quay, Ellinor; Wiebe, Samuel; Schmidt, Dieter; Porter, Roger J; Arzimanoglou, Alexis; Trinka, Eugen; Perucca, Emilio


    A working group was created to address clinical "gaps to care" as well as opportunities for development of new treatment approaches for epilepsy. The working group primarily comprised clinicians, trialists, and pharmacologists. The group identified a need for better animal models for both efficacy and tolerability, and noted that animal models for potential disease-modifying or antiepileptogenic effect should mirror conditions in human trials. For antiseizure drugs (ASDs), current animal models have not been validated with respect to their relationship to efficacy in common epilepsy syndromes. The group performed an "expert opinion" survey of perceived efficacy of the available ASDs, and identified a specific unmet need for ASDs to treat tonic-atonic and myoclonic seizures. No correlation has as yet been demonstrated between animal models of tolerability and adverse effects (AEs), versus tolerability in humans. There is a clear opportunity for improved therapies in relation to dose-related AEs. The group identified common and rare epilepsy syndromes that could represent opportunities for clinical trials. They identified opportunities for antiepileptogenic (AEG) therapies in both adults and children, acknowledging that the presence of a biomarker would substantially improve the chances of a successful trial. However, the group acknowledged that disease-modifying therapies (given after the first seizure or after the development of epilepsy) would be easier to study than AEG therapies. PMID:23909849

  20. Opening address

    The supply of energy is the most important problem facing mankind today. Energy is necessary for economic development, and it is in the interests of the industrialized nations to ensure that the developing countries reach their economic potential. The need for the increased use of nuclear power is evident, and the CANDU reactor provides a simple, proven energy source; the 950 MW CANDU has potential applications in both industrialized and third world nations. The Canadian nuclear industry has an important role to play in the world, but must be rationalized in order to compete successfully in the international marketplace

  1. Unmet Needs for Psychosocial Care in Hematologic Malignancies and Hematopoietic Cell Transplant.

    Barata, Anna; Wood, William A; Choi, Sung Won; Jim, Heather S L


    Individuals diagnosed with hematologic malignancies experience significant unmet psychological, physical, informational, financial, and spiritual needs. The goal of the current review is to summarize and highlight recent research focused on these issues in the diagnosis and treatment periods and beyond. The review also describes the needs of adolescent and young adult (AYA) and pediatric patients. While a large body of research has reported on unmet needs among adult hematologic cancer patients, there is far less data regarding the challenges confronted by AYA and pediatric populations. Available data suggests that among all age groups, hematopoietic cell transplantation (HCT) is a risk factor for greater unmet needs. Recommendations for screening and evidence-based interventions to prevent or ameliorate unmet needs are provided. Future research is needed to develop additional evidence-based psychosocial interventions with a focus on hematologic cancer. PMID:27113094

  2. President's address

    The speaker discusses some of the economic problems facing the Canadian nuclear industry. The worldwide economic slowdown has caused a fall in energy needs in Canada as well as in other nations. Consequently the demand for uranium has fallen and the market for new reactors looks bleak. However, the speaker feels that a solution can be found using creativity and innovative thinking

  3. Keynote address

    This paper addresses various aspects of the bases underlying the nuclear third party liability regime, and also analyses the distinction between danger and risk and the manner in which damage caused by flood, mass unemployment (economic damage mainly) and certain diseases is dealt with in the absence of liability provisions similar to those applicable to nuclear incidents. It also is suggested that the State because of its duty under the Basic Law to ensure adequate energy supplies, should be co-responsible for liability questions along with the nuclear operator. (NEA)

  4. A comparative study between met & unmet need groups of contraception in rural area of Maharashtra, India

    Harsha M. Solanki; Chavan Mansi K. Chavan; Velhal Gajanan D; Mehul T. Parmar


    Objectives To compare met & unmet need groups of contraception with socio-economic, demographic, accessibility & family Planning (FP) related factors. Methods Community based cross-sectional, comparative study was conducted among 363 married women of reproductive age groups in rural area selected by stratified simple random technique. After collecting preliminary information, the study population then divided into two groups based on their contraceptive use i.e. MET Group & UNMET NEED Groups...

  5. Immigrant-Native Disparities in Perceived and Actual Met/Unmet Need for Medical Care.

    Howe Hasanali, Stephanie


    This study compares the unmet medical needs of foreign-born and U.S.-born adults. Both subjective and objective unmet medical needs are considered, and the roles of duration of U.S. residence, English language proficiency, and state-level destination type in explaining immigrants' unmet need are assessed. Multivariate analyses of the 2007-2009 Medical Expenditure Panel Survey reveal that immigrants reported less subjective unmet need and equal or greater objective unmet need vis-à-vis natives. Among immigrants only, living less than 5 years in the U.S. and in a new or traditional, high-skill destination state versus a traditional, low-skill state is significantly associated with greater objective, but not subjective, unmet need. While this study reinforces the importance of stable health insurance and, to a lesser extent, income for gaining entry to the formal healthcare system for both immigrants and natives, it also highlights the need to identify factors that influence immigrants' positive health-related perceptions, including characteristics of the healthcare system in origin countries. PMID:25204623

  6. Keynote Address

    Griffin, Mike


    Biography: Nominated by President George W. Bush and confirmed by the United States Senate, Michael Griffin began his duties as the 11th Administrator of the National Aeronautics and Space Administration on April 14, 2005. As Administrator, he leads the NASA team and manages its resources to advance the U.S. Vision for Space Exploration. Prior to being nominated as NASA Administrator, Griffin was serving as Space Department Head at Johns Hopkins University's Applied Physics Laboratory in Laur...

  7. Welcome Address


    @@  On behalf of the International Life Sciences Institute, I welcome you to Beijing and to the Third Asian Conference on Food Safety and Nutrition. Many of you will remember the first Asian conference on Food Safety held in Kuala Lumpur in 1990 and the second held in Bangkok in 1994. These meetings have been so successful that ILSI made the commitment to host such a conference periodically in order to provide a forum to share the latest information and to set new goals and priorities.   This year, we have broadened the scope of the agenda to include issues on nutrition. I want to thank all of our co-sponsors and members of the Planning Committee for preparing such a comprehensive and timely program. Some of the issues and challenges facing Asia that will be addressed at this meeting are:

  8. Opening address

    Adopted under Chapter VII of the United Nations Charter, Resolution 1540 (2004) - hereafter UNSCR 1540 - sets out several obligations and recommendations for United Nations Member States, including specific requirements regarding illicit trafficking in operational paragraph (OP) 3, where it decides that all States shall take and enforce measures to prevent WMD proliferation including: 'Develop and maintain appropriate effective border controls and law enforcement efforts to detect, deter, prevent and combat, including through international cooperation when necessary, the illicit trafficking and brokering in such items in accordance with their national legal authorities and legislation and consistent with international law'. UNSCR 1540 also created a committee to monitor and report on the measures taken by States to implement these obligations, known as the 1540 Committee. This paper discusses the gaps in national and international proliferation systems identified by the 1540 Committee. By creating obligations for States regarding non-State actors UNSCR 1540 supplements the existing NPT and other nuclear non-proliferation treaty regimes. The presentation looks more narrowly at eight questions of particular relevance to illicit trafficking in nuclear materials, which UNSCR 1540 broadly defines to include dual-use as well as special purpose items. The questions are whether a State has legislation specifically related to nuclear materials for border control, trading or brokering of nuclear items, and controls on transit, trans-shipment, re-export or import of nuclear items. The largest gaps exist in establishing legal frameworks for trans-shipments, trading or brokering of items and re-exports. The 1540 Committee recognizes the need to help the international community close these gaps. The 1540 Committee would like to work in even closer cooperation with the IAEA and other NGOs to develop mechanisms to share appropriate information and foster the global effort to

  9. Report of the TFOS/ARVO Symposium on global treatments for dry eye disease: an unmet need.

    Sullivan, David A; Hammitt, Katherine M; Schaumberg, Debra A; Sullivan, Benjamin D; Begley, Carolyn G; Gjorstrup, Per; Garrigue, Jean-Sébastien; Nakamura, Masatsugu; Quentric, Yann; Barabino, Stefano; Dalton, Michelle; Novack, Gary D


    In September 2010, a Symposium in Florence, Italy, was held to address the unmet need for global treatments for dry eye disease (DED). It was sponsored by The Tear Film & Ocular Surface Society (TFOS; and co-sponsored by the Association for Research in Vision & Ophthalmology ( The Symposium objectives were two-fold: first, to discuss accepted and emerging clinical endpoints of DED with regulatory experts from around the world; and second, to consider how to improve clinical trials of treatments for DED. The Symposium focused on the personal and collective burden of DED, as well as the developmental and regulatory challenges associated with generating new DED therapeutics. This article provides a synopsis of many of the presentations, discussions and recommendations of this Symposium. PMID:22482471

  10. Perceptions of unmet healthcare needs: what do Punjabi and Chinese-speaking immigrants think? A qualitative study

    Haggerty Jeannie L


    Full Text Available Abstract Background Unmet healthcare needs - the difference between healthcare services deemed necessary to deal with a particular health problem and the actual services received - is commonly measured by the question, "During the past 12 months, was there ever a time when you felt that you needed healthcare, but you didn't receive it?" In 2003, unmet needs were reported by 10% of immigrants in Canada, yet, little is known specifically about Chinese- or Punjabi-speaking immigrants' perceptions and reporting of unmet needs. Our study examined: 1 How are unmet healthcare needs conceptualized among Chinese- and Punjabi-speaking immigrants? 2 Are their primary healthcare experiences related to their unmet healthcare needs? Methods Twelve focus groups (6 Chinese, 6 Punjabi; n = 78 were conducted in Chinese or Punjabi and socio-demographic and health data were collected. Thematic analysis of focus group data examined the perceptions of unmet needs and any relationship to primary healthcare experiences. Results Our analysis revealed two overarching themes: 1 defining an unmet healthcare need and 2 identifying an unmet need. Participants had unmet healthcare needs in relation to barriers to accessing care, their lack of health system literacy, and when the health system was less responsive than their expectations. Conclusions Asking whether someone ever had a time when they needed healthcare but did not receive it can either underestimate or overestimate unmet need. Measuring unmet need using single items is likely insufficient since more detail in a revised set of questions could begin to clarify whether the reporting of an unmet need was based on an expectation or a clinical need. Who defines what an unmet healthcare need is depends on the context (insured versus uninsured health services, experience in two or more healthcare systems versus experience in one healthcare system and who is defining it (provider, patient, insurer.

  11. Opening address

    Recognizing the global danger of illicit trafficking of nuclear and radioactive material, governments have in recent years taken a number of steps which includes the Convention on the Physical Protection of Nuclear Material (CPPNM), the 2005 Amendments to the CPPNM, the International Convention of Acts of Nuclear Terrorism and the United Nations Security Council Resolution 1540. Perhaps more important than formal legal measures alone are the actions governments have initiated to institute practical cooperation in this field. Of course, the IAEA has been a leader in this effort, as reflected in the Nuclear Security Plan. Of the many areas where the IAEA has contributed, let me cite three: the development of the Code of Conduct on the Safety and Security of Radioactive Sources, the numerous efforts through technical assistance programmes to assess physical protection needs and to build national capacity to implement physical protection systems, and the collection and dissemination of information through the Illicit Trafficking Database. States are acting together to develop training and communications channels to facilitate intervention in an ongoing illicit transfer or to build national capacity to protect nuclear materials and respond to security threats. 60 nations have joined the Russian Federation and the USA as partners in the global initiative to Combat nuclear Terrorism. These visible forms of international cooperation are backed up by numerous bilateral assistance and cooperation programmes directed at improving physical protection, including during transport, consolidating and eliminating unused nuclear materials and radioactive sources, bolstering nuclear detection at ports and borders, strengthening the ability of law enforcement agencies to identify and prosecute nuclear smuggling cases, developing procedures and protocols to intervene in emergency situations involving nuclear or radioactive materials, and exchanging information on nuclear terrorism

  12. Inaugural address

    Joshi, P. S.


    From jets to cosmos to cosmic censorship P S Joshi Tata Institute of Fundamental Research, Homi Bhabha Road, Colaba, Mumbai 400005, India E-mail: 1. Introduction At the outset, I should like to acknowledge that part of the title above, which tries to capture the main flavour of this meeting, and has been borrowed from one of the plenary talks at the conference. When we set out to make the programme for the conference, we thought of beginning with observations on the Universe, but then we certainly wanted to go further and address deeper questions, which were at the very foundations of our inquiry, and understanding on the nature and structure of the Universe. I believe, we succeeded to a good extent, and it is all here for you in the form of these Conference Proceedings, which have been aptly titled as 'Vishwa Mimansa', which could be possibly translated as 'Analysis of the Universe'! It is my great pleasure and privilege to welcome you all to the ICGC-2011 meeting at Goa. The International Conference on Gravitation and Cosmology (ICGC) series of meetings are being organized by the Indian Association for General Relativity and Gravitation (IAGRG), and the first such meeting was planned and conducted in Goa in 1987, with subsequent meetings taking place at a duration of about four years at various locations in India. So, it was thought appropriate to return to Goa to celebrate the 25 years of the ICGC meetings. The recollections from that first meeting have been recorded elsewhere here in these Proceedings. The research and teaching on gravitation and cosmology was initiated quite early in India, by V V Narlikar at the Banares Hindu University, and by N R Sen in Kolkata in the 1930s. In course of time, this activity grew and gained momentum, and in early 1969, at the felicitation held for the 60 years of V V Narlikar at a conference in Ahmedabad, P C Vaidya proposed the formation of the IAGRG society, with V V Narlikar being the first President. This

  13. Opening address

    Full text: I have the pleasure to welcome you, on behalf of the OECD Nuclear Energy Agency to this important International Conference on National infrastructures for Radiation Safety. Let me congratulate the organizers of this conference for their decision to approach the Government of Morocco to host this meeting in the beautiful city of Rabat but, first of all, let me thank our host, His Majesty King Mohammed VI and the Government of Morocco, and the University Mohammed V, Agdal, for the kind hospitality and the beautiful setting here in Rabat, and for making this dream become a pleasant reality. We are convening here to discuss 'radiation safety infrastructure', a term which for outsiders - and probably also many of us - seems to be a bit fuzzy. Over the last decades, considerable progress has been made in radiation safety techniques, in measurement, monitoring, exposure prevention, and intervention techniques. In general, occupational exposure for workers has dropped continuously, as data from the Information System on Occupational Exposure (ISOE) system can demonstrate. Today, it is becoming clear that further progress cannot rely on improving hard techniques alone, but also has to focus on the soft issues: on institutional aspects, on aspects of information, organization, and finally, a safety culture - in a word, on infrastructure. On one side, sustainable infrastructures - at both the international and the national level - are essential in order to maintain the positive trend in radiation safety, in occupational exposure and, thus, to support the safe use of nuclear energy and radiation. On the other hand, effective national and international infrastructures are required to ensure the radiation safety and security of radioactive sources, and to avoid incidents and accidents with 'orphan' sources, which have become a major concern in recent years. The OECD/NEA is happy to provide the experience of its 28 member countries from Europe, North America and the

  14. Opening Address

    Yamada, T.


    Ladies and Gentlemen, it is my great honor and pleasure to present an opening address of the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3). On the behalf of the organizing committee, I certainly welcome all your visits to KGU Kannai Media Center belonging to Kanto Gakuin University, and stay in Yokohama. In particular, to whom come from abroad more than 17 countries, I would appreciate your participations after long long trips from your homeland to Yokohama. The first international workshop on "State of the Art in Nuclear Cluster Physics", called SOTANCP, was held in Strasbourg, France, in 2008, and the second one was held in Brussels, Belgium, in 2010. Then the third workshop is now held in Yokohama. In this period, we had the traditional 10th cluster conference in Debrecen, Hungary, in 2012. Thus we have the traditional cluster conference and SOTANCP, one after another, every two years. This obviously shows our field of nuclear cluster physics is very active and flourishing. It is for the first time in about 10 years to hold the international workshop on nuclear cluster physics in Japan, because the last cluster conference held in Japan was in Nara in 2003, about 10 years ago. The president in Nara conference was Prof. K. Ikeda, and the chairpersons were Prof. H. Horiuchi and Prof. I. Tanihata. I think, quite a lot of persons in this room had participated at the Nara conference. Since then, about ten years passed. So, this workshop has profound significance for our Japanese colleagues. The subjects of this workshop are to discuss "the state of the art in nuclear cluster physics" and also discuss the prospect of this field. In a couple of years, we saw significant progresses of this field both in theory and in experiment, which have brought better and new understandings on the clustering aspects in stable and unstable nuclei. I think, the concept of clustering has been more important than ever. This is true also in the

  15. Keynote address

    This keynote address describes the reasons why Ontario restructured its electricity sector to include open market competition. Much effort, time, money and expertise have been devoted to developing the Ontario competitive market. The 1997 White Paper issued by the Ontario Ministry of Energy, Science and Technology was the first paper to express the urgent need for change because the old system was failing. Prices increased by 60 per cent between 1986 and 1993. Although governments imposed a price freeze, it is recognized that such prices freezes cannot be sustained. Between 1980 and 1986, Ontario Hydro's debt rose from $12 billion to over $30 billion. The cause was attributed to poor business performance which was putting the taxpayers at risk. The author states that the potential and social benefits of competitive electricity markets are significant. Opening the power markets improves the efficiency of electricity systems and offers significant benefits. It is noted that restructuring does not mean deregulation. The Ontario Energy Board and the Independent Market Operator continue to regulate the market to ensure its proper operation and to protect consumers. In a properly functioning competitive market, prices change in response to market conditions. Electricity prices have generally declined where competitive markets have been introduced in other jurisdictions around the world. The author also cautions that it is easy to create unfounded fears about a competitive market and cited California as an example. California's problems arose from a lack of generating capacity, regulation which discouraged new power generation, inadequate transmission capacity, lack of snow in the northeast where hydropower is produced, and a consumer price cap that encouraged power consumption at a time when supply was short. The author notes that these factors do not exist in Ontario and that the competitive market should not be abandoned

  16. Opening address

    This opening address covers two main areas: first, a snapshot of the continuing threat and the recent changes having been made to the United Kingdom's counterterrorism structures to respond to it; and second, how the United Kingdom is combating nuclear terrorism through a range of measures covering physical security, decreasing vulnerability to attack and increasing resilience. Combating the threat of nuclear terrorism requires an international effort. Radiological and fissile materials are present throughout the world and, as such, it should be secured wherever it is found. All countries are encouraged to continue to enhance security and protection mechanisms for radiological and fissile material; and to develop contingency plans should the worst happen. The United Kingdom has responded to the very serious and real threat by consolidating and strengthening elements of its counterterrorist planning via the creation in May this year of the Office for Security and Counter-Terrorism (OSCT). These changes have been coupled with an unprecedented level of investment to enable the delivery of the United Kingdom counterterrorist strategy - known as CONTEST - through which we aim to (a) stop terrorist attacks; (b) where it cannot be stopped, to mitigate its impact; (c) strengthen our overall protection against terrorist attack; (d) stop people becoming terrorists or supporting violent extremism. In the case of radiological and nuclear terrorism, it is not sufficient merely to prepare for such an attack; one must also devote efforts to preventing such attacks in the first instance by intercepting dangerous materials before they reach their intended target; and by strengthening the protection of vulnerable places and detecting or mitigating any devices before they are placed or activated. As such, in terms of the United Kingdom's efforts on radiological and nuclear terrorism, there are three main strands to this work: physical protection of materials including the global

  17. Presidential address.

    Vohra, U


    The Secretary of India's Ministry of Health and Family Welfare serves as Chair of the Executive Council of the International Institute for Population Sciences in Bombay. She addressed its 35th convocation in 1993. Global population stands at 5.43 billion and increases by about 90 million people each year. 84 million of these new people are born in developing countries. India contributes 17 million new people annually. The annual population growth rate in India is about 2%. Its population size will probably surpass 1 billion by the 2000. High population growth rates are a leading obstacle to socioeconomic development in developing countries. Governments of many developing countries recognize this problem and have expanded their family planning programs to stabilize population growth. Asian countries that have done so and have completed the fertility transition include China, Japan, Singapore, South Korea, and Thailand. Burma, Malaysia, North Korea, Sri Lanka, and Vietnam have not yet completed the transition. Afghanistan, Bangladesh, Iran, Nepal, and Pakistan are half-way through the transition. High population growth rates put pressure on land by fragmenting finite land resources, increasing the number of landless laborers and unemployment, and by causing considerable rural-urban migration. All these factors bring about social stress and burden civic services. India has reduced its total fertility rate from 5.2 to 3.9 between 1971 and 1991. Some Indian states have already achieved replacement fertility. Considerable disparity in socioeconomic development exists among states and districts. For example, the states of Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh have female literacy rates lower than 27%, while that for Kerala is 87%. Overall, infant mortality has fallen from 110 to 80 between 1981 and 1990. In Uttar Pradesh, it has fallen from 150 to 98, while it is at 17 in Kerala. India needs innovative approaches to increase contraceptive prevalence rates

  18. Welcome Address

    Kiku, H.


    Ladies and Gentlemen, It is an honor for me to present my welcome address in the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3), as the president of Kanto Gakuin University. Particularly to those from abroad more than 17 countries, I am very grateful for your participation after long long trips from your home to Yokohama. On the behalf of the Kanto Gakuin University, we certainly welcome your visit to our university and stay in Yokohama. First I would like to introduce Kanto Gakuin University briefly. Kanto Gakuin University, which is called KGU, traces its roots back to the Yokohama Baptist Seminary founded in 1884 in Yamate, Yokohama. The seminary's founder was Albert Arnold Bennett, alumnus of Brown University, who came to Japan from the United States to establish a theological seminary for cultivating and training Japanese missionaries. Now KGU is a major member of the Kanto Gakuin School Corporation, which is composed of two kindergartens, two primary schools, two junior high schools, two senior high schools as well as KGU. In this university, we have eight faculties with graduate school including Humanities, Economics, Law, Sciences and Engineering, Architecture and Environmental Design, Human and Environmental Studies, Nursing, and Law School. Over eleven thousands students are currently learning in our university. By the way, my major is the geotechnical engineering, and I belong to the faculty of Sciences and Engineering in my university. Prof. T. Yamada, here, is my colleague in the same faculty. I know that the nuclear physics is one of the most active academic fields in the world. In fact, about half of the participants, namely, more than 50 scientists, come from abroad in this conference. Moreover, I know that the nuclear physics is related to not only the other fundamental physics such as the elementary particle physics and astrophysics but also chemistry, medical sciences, medical cares, and radiation metrology

  19. Unmet needs of women with breast cancer during and after primary treatment: A prospective study in Denmark

    von Heymann-Horan, A.B; Dalton, Susanne Oksbjerg; Dziekanska, Angelika;


    with unmet needs remained stable between four (42%) and eight months (40%). Unmet needs were reported for patient education, counselling and alternative treatment. The factors significantly associated with having unmet needs were younger age (OR 0.92; 95% CI 0.89-0.95), higher education (OR 2.49; 95% CI 1....... A total of 53% of women with breast cancer had unmet needs at some time between diagnosis and the end of primary treatment (eight months after diagnosis). A contextual understanding of unmet needs is necessary for planning cancer rehabilitation, as not only factors such as anxiety, physical functioning......Abstract Integrated plans will be required to ensure care and rehabilitation for the growing number of cancer survivors. Information is lacking, however, about the extent to which patients' rehabilitation needs are being met, and characteristics of patients who experience unmet needs after...

  20. Keynote address

    Radioactive waste management is definitely a field where an added value may be gained through international cooperation. However, the bases for international cooperation must remain very clear at all times. Waste management is essentially a matter of national jurisdiction. The approach to radioactive waste management is specific to each country, it may be influenced by the historical background of the waste management activities in the country, by the specific technical designs developed to ensure safe management, by the nature of geological formations (if underground disposal is sought), by the industrial infrastructure, by the corporate framework, by the national arrangements for safety regulation, etc. Industrial solutions for radioactive waste management exist or are emerging for most types of low and intermediate level waste. Disposing of low and intermediate level waste in surface facilities now represents a sound and proven industrial practice. A common objective for all countries is to have the availability of solutions for the entire set of waste categories. In the current context, the solutions for some categories appear to be less developed than for others. One may think more particularly of radium-bearing waste resulting from historical practices initiated as early as the beginning of the 20th century. Others may mention graphite waste originating from the former gas-graphite reactor system. The waste package is a key element in the waste management mechanism. It constitutes the basis of the safety approach. The care with which the specifications of the package are first defined, then controlled, through rigorous quality assurance procedures, is essential. The safe management of radioactive waste is achieved primarily through the reliability of the managers and of all the actors involved in waste disposal in carrying out their long term responsibilities. In order to properly implement their missions, they must be associated, at an early stage, with any

  1. Opening address

    Being fully aware of the IAEA's central and important roles in the field of nuclear security, Japan has cooperated closely with the IAEA in the field of nuclear security. One of Japan's efforts was holding a seminar on strengthening nuclear security in Asian countries in November 2006, making use of Japan's contribution to the IAEA Nuclear Security Fund. The seminar was organized for the first time in Asia to address nuclear security matters, in which more than 100 experts from 19 countries participated. Japan also hosted a seminar, aimed at promoting the accession to the international counterterrorism conventions and protocols, inviting government officials and experts from Asia Pacific countries. At the seminar, Japan presented its experience and lessons learned with regard to its ratification of relevant international conventions such as the International Convention for the Suppression of Acts of Nuclear Terrorism and the Convention on the Physical Protection of Nuclear Material. Japan has also provided assistance for capacity building in the field of physical protection measures, and is preparing three projects for Asian countries through the IAEA Nuclear Security Fund. In Thailand, Japan has a project aimed at improving physical protection of nuclear research facilities. In Vietnam, Japan plans to host a workshop on radiation detection equipment for border officials and is also preparing for a seminar aimed at capacity building of control on nuclear material in Vietnam. Japan is committed to continue its efforts to make the IAEA Comprehensive Safeguards Agreement together with an Additional Protocol the universally accepted verification standard for the peaceful use undertakings of the Nuclear Non-Proliferation Treaty. Japan's basic policy on bilateral nuclear cooperation agreements is as follows. Considering the dual nature of nuclear material and technology, Japan is of the view that three Ss, that is, S for 'safeguards' (non-proliferation), S for 'safety

  2. The National Historic Preservation Act is Not Your Problem, But How You are Addressing it for Your CERCLA Project May Be - 12344

    The 1995 Environmental Protection Agency (EPA) and U.S. Department of Energy (DOE) joint 'Policy on Decommissioning of Department of Energy Facilities Under CERCLA was developed so that decommissioning could occur in a manner that ensures protection of worker and public health and the environment, that is consistent with Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), that provides for stakeholder involvement, and that achieves risk reduction without unnecessary delay'. The source of the 'unnecessary delays' the joint policy intended to avert could be attributed to numerous factors such as obtaining permits, conducting administrative activities, or implementing regulatory processes that could yield, among other things, differing preferred alternatives. Why, you might ask, more than fifteen years later, does DOE continue to struggle through CERCLA projects with unnecessary delays? From problem identification, to determination of nature and extent, to alternative analysis and ultimately remedy selection and implementation, reaching a compliant and effective clean-up end-point can be a process that seems to mimic geologic timescales. The source of these delays is often the failure to use all of the tools the CERCLA process offers. As one example, renewed commitment to follow the CERCLA process to address the regulatory reviews pursuant to the National Historic Preservation Act (NHPA) is called for. Project managers implementing CERCLA actions in any agency, not only DOE, do not need to be apprehensive about using the CERCLA process for NHPA review but should welcome it. It is critical that methods are used that address substantive NHPA requirements clearly and consistently, and that they are shared and communicated as frequently as needed to interested and questioning stakeholders. (author)

  3. Opening address

    Last week we were reminded once again of the after-effects of Chernobyl. Unexpectedly high values of the radioactive substance caesium were found in moose meat from the south of Vaesterbotten County. A moose cow shot in Aengersjoe had 2000 becquerel per kilo meat, and a moose calf had almost 4000 becquerel. The caesium content in Swedish moose has varied after the 1986 reactor breakdown at Chernobyl. The explanation for this year's unusually high content appears to be that, due to the warm weather, the moose have eaten blueberries which contain more caesium than plants in wood clearings. Moose meat containing caesium reminds us of the vulnerability of our society. It reminds us that emissions cross borders and that ambitious, long term environmental policies must be adopted at the national but above all at the international level. Work on environmental objectives is an important component of Swedish efforts to overcome our environmental problems within a generation. In Sweden, our work is based on 15 environmental quality objectives. We have established subgoals, action strategies and follow-up mechanisms. In an international context it is, I venture to say, unique in its systematic structure. The Swedish Government and Riksdag have laid down that: - Human health and biological diversity shall be protected against harmful effects of radiation in the outdoor environment. - By the year 2010, the content in the environment of radioactive substances emitted from all activities and operations shall be so low that human health and biological diversity are protected. - By the year 2020 the annual number of cases of skin cancer caused by the sun shall not be higher than the figure for the year 2000. The risks involved in electromagnetic fields shall be continuously reviewed and necessary measures taken when such risks are identified. These objectives describe the quality and conditions for Sweden's environmental, natural and cultural resources that are ecologically

  4. Epidemiological Correlates Of Unmet Need For Contraception In Urban Slum Population

    Supriya Satish Patil*, MP Durgawale and SR Patil


    Full Text Available This study was undertaken to find out magnitude and identifying the different variables, which are associated with unmet need for contraception among married women in the age group of 15-44 yrs in an urban slum of Karad, Maharashtra. A cross-sectional community based study was carried out among married women aged 15-44 yrs. Personal interview method with house-to-house visit was adopted as the study method. In this study unmet need for contraception was found in 59 (45.1% women, need for spacing in 25 (19.1% and need for limiting birth in 34 (26% women. About 81.3% of women in the unmet group belong to the age 15-29 yrs. There was significant association between prevalence of unmet need and age, number of living children, education. There was no significant association found between occupation, religion and unmet need for contraception. The present study revealed that lack of information about contraceptive method and its sources (57.6% were the common reasons for non-acceptance of contraception. It can be concluded that health education campaigns are necessary to increase awareness and counseling of eligible couples on importance of small family norm is essential.

  5. Unmet need for family planning in Indonesia and the policy strategy of intervention in several countries



    Full Text Available The aims of this paper are to analyse the unmet need situation in Indonesia, identify determining factors and the intervention policy strategy in several countries. This paper was a literature study, taken from the data of the 2012 Indonesian Demographic and Health Survey (IDHS and various other sources. It is seen that unmet need level in Indonesia decreases from time to time. During the 1991 to 2012 IDHS, total unmet need decreased from 17% to 11% (4.5% for spacing and 6.9% for limiting. However, the number is considered still quiet high so an effort to solve it is needed. Determinants of unmet need can be associated with various factors such as demographical characteristic and social economic, education, culture, geographical access and condition in the area. Recommended to the government in order to develop policy strategy focused on intervention of unmet need determinants, improve financial resource allocation for access improvement of contraception service and develop capacity, improve service quality including staff training, and also public education in big scale to decrease social barriers. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1680-1685

  6. Opening address

    There is now universal recognition of the illicit trafficking problem and more uniform agreement on the need to take action to combat nuclear terrorism. In the past, security issues were considered strictly a national responsibility. It is now recognized that illicit trafficking not only concerns the protection of national borders but that there are vital international parameters. The IAEA's activities in the nuclear security field took a quantum leap in 2002 when it established its first Nuclear Security Plan for 2002-2005, including protection against illicit trafficking. We are now implementing the second plan for 2006-2009, which has been approved by our Board of Governors and the General Conference in 2005. The current Nuclear Security Plan for 2006-2009, which ranges over two bi-annual programme and budget periods, is comprehensive and identifies three activity areas, as well as activities supporting nuclear security. The first activity area is entitled 'Needs assessment, analysis and coordination' and is 'horizontal' in that it supports the implementation of the entire plan, and provides nuclear security relevant information, for purposes of information exchange to help prioritize activities and in support of operational activities. The ITDB programme is a cornerstone in the work to combat illicit trafficking. The second activity area, namely, prevention, aims at supporting sustainable capacity building in IAEA Member States to meet the threat of nuclear terrorism and of other criminal activities involving nuclear and other radioactive substances. Core activities include an effective accounting registry and physical protection, the implementation of a nuclear security culture and measures to sustain effective systems in the long term. Should prevention fail, it will be important to have a second line of defence, which is the third activity area in the plan, referred to as detection and response. This is the area which is of particular concern at this

  7. Cancer survivors and their partners: the assessment of unmet supportive care needs

    Our understanding of unmet supportive care needs of cancer survivors and their partners is limited. Most studies have focused on needs of patients undergoing treatment and on Quality of life or patient satisfaction. For the purpose of this research, cancer survivors are defined as persons who received a cancer diagnosis at least one year previously and are disease free. The aim of this study is to develop measures to assess unmet needs in survivors and their partners. After developing the questionnaire items it was piloted for validity in a wide sample of cancer patients from the radiation oncology department. 105 patients, all women, 101 with breast cancer and 40 partners participated. Psychological morbidity of depression and anxiety was recorded and was low. Quality of life for both survivors and partners was close to the US population mean. For patients top 4 unmet needs was 1. Anxiety about cancer returning (35%), current information (21%), understandable information (28%), ongoing case manager (25%). Unmet needs for partners were 1. Need to know all the doctors were communication (3.2%), need for local health services (2.8%), current information (2.1%) and help with managing concerns about the cancer returning (2.1%). 73% of partners reported at least one positive outcome from their partner's experience, significantly more than the survivors. In conclusion, interim analysis of the questionnaire reveals validity. Survivors report ongoing high levels of unmet needs 3-9 years after cancer diagnosis ( 30%). Less than 4% of partners report such unmet needs. There is significant correlation between needs of partners and survivors, many of which relate to issues of ongoing support and information delivery

  8. Addressing Parent-Child Conflict: Attachment-Based Interventions with Parents

    Kindsvatter, Aaron; Desmond, Kimberly J.


    This article describes the use of attachment theory to address parent-child conflict. The authors propose that parent-child conflict is attributable to the unmet attachment needs of both children and parents and that attachment insecurity results in problematic patterns of attachment in parent-child relationships. Three conversational frames are…

  9. Comprehensive care and pregnancy: The unmet care needs of pregnant women with a history of rape

    Munro, Michelle L.; Rietz, Melissa Foster


    This paper proposes a framework for assessing the unmet needs of rape survivors during pregnancy based on the Sexual Assault Nurse Examiner (SANE) practice level theory and an empirical exploration of rape survivors’ health status in pregnancy via a secondary analysis. Our findings indicate that there may be unmet needs in pregnancy related to all five post-assault comprehensive care components: (1) physical care, (2) pregnancy prevention, (3) sexually transmitted infection screening, (4) psychological care, and (5) legal care. Rape history and its current impact on the survivor predicted somatic disorders, substance use, unwanted pregnancy, infections, posttraumatic stress disorder, and recent abuse. PMID:23215990

  10. Investigating Unmet Health Needs in Primary Health Care Services in a Representative Sample of the Greek Population

    Evelina Pappa


    Full Text Available Unmet health care needs are determined as the difference between the services judged necessary and the services actually received, and stem from barriers related to accessibility, availability and acceptability. This study aims to examine the prevalence of unmet needs and to identify the socioeconomic and health status factors that are associated with unmet needs. A cross-sectional study was conducted in Greece in 2010 and involved data from 1,000 consenting subjects (>18 years old. Multiple binary logistic regression analysis was applied to investigate the predictors of unmet needs and to determine the relation between the socio-demographic characteristics and the accessibility, availability and acceptability barriers. Ninety nine participants (9.9% reported unmet health needs during the 12 months prior to the research. The most frequently self-reported reasons were cost and lack of time. Youth, parenthood, physician consultations, and poor mental health increased the likelihood of unmet needs. Women were less likely to report accessibility and availability than acceptability barriers. Educational differences were evident and individuals with primary and secondary education were associated with significantly more accessibility and availability barriers compared with those with tertiary education. Unmet health needs pose a significant challenge to the health care system, especially given the difficult current financial situation in Greece. It is believed that unmet health needs will continue to increase, which will widen inequalities in health and health care access.

  11. Radiological emergencies in industry (causes and consequences). Address at the second national course of Radiation Safety in Industry. Jun 5-7 2000 Guatemala

    The address discusses the following issues: review of accidents in industrial radiography, human factors, technical failures, factors that decrease risk, personnel training, design of equipment and recommendations

  12. Unmet Dental Needs and Barriers to Dental Care among Children with Autism Spectrum Disorders

    Lai, Bien; Milano, Michael; Roberts, Michael W.; Hooper, Stephen R.


    Mail-in pilot-tested questionnaires were sent to a stratified random sample of 1,500 families from the North Carolina Autism Registry. Multivariate logistic regression analysis was used to determine the significance of unmet dental needs and other predictors. Of 568 surveys returned (Response Rate = 38%), 555 were complete and usable. Sixty-five…

  13. Unmet Healthcare and Social Services Needs of Older Canadian Adults with Developmental Disabilities

    Shooshtari, Shahin; Naghipur, Saba; Zhang, Jin


    The authors sought to create a demographic, socioeconomic, and health-related profile of older (40+) Canadian adults with developmental disabilities (DD) residing in their communities, and to enhance current knowledge of their unmet health and social support services needs. They provide a secondary analysis of cross-sectional data from the 2001…

  14. The unmet treatment need for moderate to severe psoriasis: results of a survey and chart review.

    Christophers, E.; Griffiths, C.E.; Gaitanis, G.; Kerkhof, P.C.M. van de


    BACKGROUND: Conventional systemic therapies and phototherapy for psoriasis are limited by safety concerns that may preclude long-term treatment with these agents. OBJECTIVES: To estimate the unmet need for safe and effective treatments for psoriasis. METHODS: A survey was conducted at three psoriasi

  15. The unmet need in rheumatology: reports from the Targeted Therapies meeting 2016.

    Winthrop, Kevin L; Strand, Vibeke; van der Heijde, Désiréé M; Mease, Philip J; Crow, Mary K; Weinblatt, Michael; Bathon, Joan M; Buch, Maya H; Burmester, Gerd R; Dougados, Maxime; Kay, Jonathan; Mariette, Xavier; Breedveld, Ferry C; Kalden, Joachim R; Smolen, Josef S; Furst, Daniel E


    The 18th annual international Targeted Therapies meeting brought together over 100 leading scientists and clinicians from around the world in the field of rheumatology. During the meeting, breakout sessions were held consisting of 5 disease-specific groups each with 20-40 experts assigned to each group based on clinical or scientific expertise. Specific groups included: rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis/spondyloarthritis, systemic lupus erythematous, and other connective tissue diseases (e.g. Sjögren's, Behçet's, others). In each group, experts were asked to identify unmet needs in 3 categorical areas: basic/translational science, clinical science and therapeutic development, and clinical care. Needs were prioritised as primary or secondary. Overall, similar primary unmet needs were identified within each disease foci. Within translational science, these included the need for better understanding the heterogeneity within each disease, such that predictive tools for therapeutic response could be developed. Within clinical science and therapeutic trials, the ability to prevent progression to disease onset in those at risk, and the ability to cure disease were identified. A further unmet need was to develop new and accessible therapeutics, as well as to conduct strategic trials of currently approved therapies. Within the clinical care realm, improved co-morbidity management and patient-centered care were identified as unmet needs. Lastly, it was strongly felt there was a need to develop a scientific infrastructure for well-characterised, longitudinal cohorts married with biobanks and mechanisms to support data-sharing. This infrastructure could facilitate many of the unmet needs identified within each disease area. PMID:27586809

  16. Opinion of doctors about unmet needs of rural diabetics

    Rohit Dixit


    Results: All the doctors who were involved in the study had different opinion. MBBS doctors are more aware than BHMS/BAMS/BUMS doctors about the minimum degree required doing a diabetic practice legally in India. Both the group of doctors believed that the needs of diabetic population in rural India are not properly addressed; the reason behind this was lack of qualified doctors (according to majority of BHMS/BAMS/BUMS doctors and lack of awareness among the rural patients (according to MBBS doctors. Both the doctors believe that MBBS doctors with some fellowship courses in diabetes can manage diabetes effectively (except serious complications. Conclusions: Both the doctors believe that MBBS doctors with some fellowship courses in diabetes can manage diabetes effectively (except serious complications. In India only MD (general medicine and endocrinologists are technically qualified to treat diabetes. MCI should come forward and recognize the fellowship courses by regularizing them with proper guidelines and protocol set up for the institution providing such courses and allow those doctors to practice in rural areas, so that diabetics' needs are addressed properly. [Int J Basic Clin Pharmacol 2016; 5(1.000: 116-120

  17. Quantities and Units used in Radiation Safety. Address at the third national course of Radiation Safety in Radiology. May 22-24, 2000 Guatemala

    The address discusses the following issues: the radiological units, radiation dose units, radiation protection units and operational quantities used for individual monitoring recently introduced by the International Commission of Radiological Units

  18. Pharmacoresistant epilepsy: unmet needs in solving the puzzle(s).

    Weaver, Donald F; Pohlmann-Eden, Bernd


    Pharmacoresistant epilepsy is a significant medical problem. The 2nd Halifax International Epilepsy Conference & Retreat identified crucial needs, which if successfully addressed, will aid in paving the way to improved lives for people with pharmacoresistant epilepsy. These are needs: (1) for an evidence-based and dynamic definition of pharmacoresistant epilepsy; (2) for a comprehensive description of the natural history of pharmacoresistant epilepsy; (3) for a comprehensive description of the complications and comorbidities of pharmacoresistant epilepsy; (4) for a rigorous delineation of the epidemiology and socioeconomic impact of pharmacoresistant epilepsy; (5) for clinically meaningful diagnostic and prognostic physiologically based electroencephalography (EEG) biomarkers; (6) for clinically meaningful diagnostic and prognostic anatomically based (MRI Imaging) biomarkers; (7) for biomolecular/biochemical mechanistic understanding of etiopathogenesis for pharmacoresistant epilepsy; (8) for representative animal models of pharmacoresistant epilepsy; (9) for new and effective drugs or other novel treatments for pharmacoresistant epilepsy; and (10) to promote continuing research and research funding targeting pharmacoresistant epilepsy. PMID:23646978

  19. Special address by the Director of the Federal Radiation Protection Service, Prof. Akin Ojo at the opening ceremony of the national workshop on radiation protection and quality control in medical and industrial practices FRPS, Ibadan on Monday 15 November 1999

    A special address by the Director of the Federal Radiation Protection Service, Prof. Akin Ojo at the opening ceremony of the national workshop on radiation protection and quality control in medical and industrial practices held at the Federal Radiation Protection Service, Physics Dept. University of Ibadan from Monday 15 to Friday 19 November 1999

  20. Degenerative Mitral Stenosis: Unmet Need for Percutaneous Interventions.

    Sud, Karan; Agarwal, Shikhar; Parashar, Akhil; Raza, Mohammad Q; Patel, Kunal; Min, David; Rodriguez, Leonardo L; Krishnaswamy, Amar; Mick, Stephanie L; Gillinov, A Marc; Tuzcu, E Murat; Kapadia, Samir R


    Degenerative mitral stenosis (DMS) is an important cause of mitral stenosis, developing secondary to severe mitral annular calcification. With the increase in life expectancy and improved access to health care, more patients with DMS are likely to be encountered in developed nations. These patients are generally elderly with multiple comorbidities and often are high-risk candidates for surgery. The mainstay of therapy in DMS patients is medical management with heart rate control and diuretic therapy. Surgical intervention might be delayed until symptoms are severely limiting and cannot be managed by medical therapy. Mitral valve surgery is also challenging in these patients because of the presence of extensive calcification. Hence, there is a need to develop an alternative percutaneous treatment approach for patients with DMS who are otherwise inoperable or at high risk for surgery. In this review, we summarize the available data on the epidemiology of DMS and diagnostic considerations and current treatment strategies for these patients. PMID:27142604

  1. Multi-Sector Participation In The National Response To Prevent And Address The Hiv/Aids Epidemic In The Republic Of Cuba, 2007-2008

    Isora Ramos Valle; Isabel Louro Bernal; Ana Teresa Farinas Reinoso; Susana Llanusa; Nereida Rojo Pérez


    The development of a strong national response involving multiple sectors—including civil society—is an essential aspect of the social management of the HIV/AIDS epidemic. The goals of this response are to control the epidemic and improve the quality of life for people living with HIV/AIDS; this includes combating stigma and discrimination, as well as ensuring due compliance with the law. Cuba has a national program to prevent and control HIV/AIDS. Since 2003 Cuba’s national program has receiv...

  2. DOENEWS: Address of John S. Herrington, Secretary of Energy, at the National symposium on the superconducting super collider in Denver, Colorado, December 3, 1987

    In this address, the President's support for basic science is briefly discussed, and support for the Superconducting Super Collider in particular is emphasized. Perceived benefits of the Super Collider are discussed, including benefits to the world, training for scientists, maintaining American competitiveness. Federal support of science, including Congressional action, is discussed briefly

  3. Address Points - Volusia County Addresses (Point)

    NSGIC GIS Inventory (aka Ramona) — Situs Addresses for Volusia County. Maintained by Growth and Resource Management. Addresses are determined by the cities for their jurisdiction and by the County...

  4. Key Concepts for Estimating the Burden of Surgical Conditions and the Unmet Need for Surgical Care

    Bickler, Stephen; Ozgediz, Doruk; Gosselin, Richard; Spiegel, David; Hsia, Renee; Dunbar, Peter; McQueen, Kelly; Jamison, Dean; Weiser, Thomas Geoghegan


    Background: Surgical care is emerging as a crucial issue in global public health. Methodology is needed to assess the impact of surgical care from a public health perspective. Methods: A consensus opinion of a group of surgeons, anesthesiologists, and public health experts was established regarding the methodology for estimating the burden of surgical conditions and the unmet need for surgical care. Results: For purposes of analysis, we define surgical conditions as any disease state requirin...

  5. Uncertain Health Insurance Coverage and Unmet Children’s Health Care Needs

    DeVoe, Jennifer E.; Ray, Moira; Krois, Lisa; Carlson, Matthew J.


    Background and Objectives The State Children’s Health Insurance Program (SCHIP) has improved insurance coverage rates. However, children’s enrollment status in SCHIP frequently changes, which can leave families with uncertainty about their children’s coverage status. We examined whether insurance uncertainty was associated with unmet health care needs. Methods We compared self-reported survey data from 2,681 low-income Oregon families to state administrative data and identified children with uncertain coverage. We conducted cross-sectional multivariate analyses using a series of logistic regression models to test the association between uncertain coverage and unmet health care needs. Results The health insurance status for 13.2% of children was uncertain. After adjustments, children in this uncertain “gray zone” had higher odds of reporting unmet medical (odds ratio [OR] =1.73; 95% confidence interval [CI]=1.07, 2.79), dental (OR=2.41; 95% CI=1.63, 3.56), prescription (OR=1.64, 95% CI=1.08, 2,48), and counseling needs (OR=3.52; 95% CI=1.56, 7.98), when compared with publicly insured children whose parents were certain about their enrollment status. Conclusions Uncertain children’s insurance coverage was associated with higher rates of unmet health care needs. Clinicians and educators can play a role in keeping patients out of insurance gray zones by (1) developing practice interventions to assist families in confirming enrollment and maintaining coverage and (2) advocating for policy changes that minimize insurance enrollment and retention barriers. PMID:20135570

  6. Inequity in long-term care use and unmet need: two sides of the same coin

    García-Gómez, Pilar; Hernandez-Quevedo, Christina; Jiménez-Rubio, Dolores; Oliva, Juan


    International studies have shown evidence on inequity in use of health services of different kinds, depending on the type of health care service analysed. However, equity in the access to long-term care (LTC) services has received much less attention. We investigate the determinants of several LTC services and the existence of unmet need by the disabled population using unique data from a survey conducted on the disabled population in Spain in 2008. We further measure the level of horizontal ...

  7. The unmet need for Emergency Obstetric Care in Tanga Region, Tanzania

    Mtatifikolo Ferdinand; Hunger Claudia; Kuelker Rainer; Massawe Siriel; Prytherch Helen; Jahn Albrecht


    Abstract Background Improving maternal health by reducing maternal mortality constitutes the fifth Millennium Development Goal and represents a key public health challenge in the United Republic of Tanzania. In response to the need to evaluate and monitor safe motherhood interventions, this study aims at assessing the coverage of obstetric care according to the Unmet Obstetric Need (UON) concept by obtaining information on indications for, and outcomes of, major obstetric interventions. Furth...

  8. 32 CFR 516.7 - Mailing addresses.


    ... 32 National Defense 3 2010-07-01 2010-07-01 true Mailing addresses. 516.7 Section 516.7 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION General § 516.7 Mailing addresses. Mailing addresses for organizations referenced...

  9. Unmet needs and relationship challenges of head and neck cancer patients and their spouses.

    Badr, Hoda; Herbert, Krista; Reckson, Batya; Rainey, Hope; Sallam, Aminah; Gupta, Vishal


    In head and neck cancer (HNC), couple-based interventions may be useful for facilitating treatment completion, patient rehabilitation, and improving both partners' quality of life. With the goal of identifying targets for future interventions, we conducted a qualitative study to understand patient and spouse unmet needs and relationship challenges during curative radiotherapy for HNC. Semistructured interviews were conducted with six HNC patients (83% male) and six spouses (83% female) within 6 months of completing treatment. Interviews were audiotaped and transcribed using grounded theory analysis. Patients and spouses identified several unmet needs including better preparation regarding the severity of physical side effects, a clearer timeline for recovery, and strategies for dealing with their own and each other's emotional reactions. Caregiver's unmet needs included balancing competing roles/responsibilities, making time for self-care, and finding effective strategies for encouraging patient's self-care. Eighty-three percent of spouses and all patients reported increased conflict during treatment. Other relationship challenges included changes in intimacy and social/leisure activities. Findings suggest that couple-based interventions that emphasize the importance of managing physical and psychological symptoms through the regular practice of self-care routines may be beneficial for both patients and spouses. Likewise, programs that teach spouses ways to effectively motivate and encourage patients' self-care may help minimize conflict and help couples navigate HNC treatment and recovery together as a team. PMID:27269579

  10. Unmet need and psychological distress predict emergency department visits in community-dwelling elderly women: a prospective cohort study

    Quail Jacqueline M; Wolfson Christina; Lippman Abby


    Abstract Background Unmet need to perform activities of daily living (ADL) is associated with increased use of urgent health services by the elderly. However, the reported associations may be confounded by psychological distress. We examine the independent effects of unmet need and psychological distress upon emergency department (ED) visits. Methods We conducted a prospective study of randomly selected community-dwelling adults aged ≥ 75. We report here the results for women only (n = 530). ...

  11. A survey of cancer patients' unmet information and coordination needs in handovers -- a cross-sectional study

    Søndergaard, Eva Gad; Grøne, Bettina Haastrup; Wulff, Christian Nielsen; Larsen, Pia Veldt; Søndergaard, Jens


    handovers. The objectives of this study were to examine cancer patients' unmet needs for information and coordination in handovers and to analyse the association between patients' demographic and clinical characteristics and unmet information and coordination needs.......The care responsibilities for cancer patients are frequently handed over from one healthcare professional to another. These handovers are known to pose a threat to the safety of patients and the efficiency of the healthcare system. Little is known about specific needs of cancer patients in...

  12. Factors associated with unmet dental care needs in Canadian immigrants: an analysis of the longitudinal survey of immigrants to Canada

    Calvasina, Paola; Muntaner, Carles; Quiñonez, Carlos


    Background Immigrants are often considered to have poorer oral health than native born-populations. One possible explanation for immigrants’ poor oral health is lack of access to dental care. There is very little information on Canadian immigrants’ access to dental care, and unmet dental care needs. This study examines predictors of unmet dental care needs among a sample of adult immigrants to Canada over a three-point-five-year post-migration period. Methods A secondary data analysis was con...

  13. Addressing the Sexual and Reproductive Health Needs of Young People in Ethiopia: An Analysis of the Current Situation.

    Muntean, Nigina; Kereta, Worknesh; Mitchell, Kirstin R


    Young people in Ethiopia face a number of risks to their sexual and reproductive health, including adolescent pregnancy, sexual violence, and unmet need for family planning. This study explores the extent to which current service provision addresses the SRH needs of young Ethiopians . Methods included a comprehensive review of the academic and policy literature on young people's SRH and service provision in Ethiopia; and 14 semi-structured Key Informant Interviews. Factors affecting utilization of sexual and reproductive services by young people include: limited SRH knowledge, lack of open discussion of sexual matters, low status of women, cultural and logistical barriers, competing priorities among community health professionals, limited resources for health facilities, and negative attitudes of providers towards unmarried youth. While the antenatal needs of young married women are somewhat addressed, gaps exist in terms of services for unmarried youth, young men, rural youth and vulnerable groups. The national policy platform has created an enabling environment for addressing youth SRH needs but challenges to implementing these policies still persist. The way forward requires a focus on reducing barriers to utilization of services, and attention to underserved groups. It also requires resource mobilization, strong leadership and effective coordination between stakeholders and donors. PMID:26897917

  14. Idaho National Laboratory/Nuclear Power Industry Strategic Plan for Light Water Reactor Research and Development An Industry-Government Partnership to Address Climate Change and Energy Security

    Electric Power Research


    The dual issues of energy security and climate change mitigation are driving a renewed debate over how to best provide safe, secure, reliable and environmentally responsible electricity to our nation. The combination of growing energy demand and aging electricity generation infrastructure suggests major new capacity additions will be required in the years ahead.

  15. Preventing and Addressing Homophobic and Transphobic Bullying in Education: A Human Rights-Based Approach Using the United Nations Convention on the Rights of the Child

    Cornu, Christophe


    Homophobic and transphobic bullying in schools can have a serious effect on children and young people subjected to it at a crucial moment in their lives. It is an obstacle to the right to education, which is one of the basic universal human rights enshrined in the Universal Declaration of Human Rights and various United Nations Conventions. This…

  16. Multi-Sector Participation In The National Response To Prevent And Address The Hiv/Aids Epidemic In The Republic Of Cuba, 2007-2008

    Isora Ramos Valle


    Full Text Available The development of a strong national response involving multiple sectors—including civil society—is an essential aspect of the social management of the HIV/AIDS epidemic. The goals of this response are to control the epidemic and improve the quality of life for people living with HIV/AIDS; this includes combating stigma and discrimination, as well as ensuring due compliance with the law. Cuba has a national program to prevent and control HIV/AIDS. Since 2003 Cuba’s national program has received material and financial support from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Program evaluation is carried out by an independent team at ENSAP (National School of Public Health. This paper reports on results of one part of that evaluation: an assessment of the agencies and sectors who made up the organized social and national response to the HIV/AIDS epidemic. The evaluation primarily used qualitative analyses of the activities and tasks proposed by sectors in their 2006-2008 work plans. Visits were made to the provinces of Ciudad de la Habana, Matanzas, and Holguín. Qualitative techniques included in-depth interviews, semi-structured interviews, observation, and review of documentary evidence of all kinds (videos, reports, minutes, protocols, results of social research, and radio broadcast messages and varied depending on the particular features of each sector. We noted improvements in multi-sector participation in the prevention and response to the national HIV/AIDS epidemic. Conscious of their role, sectors generally carried out their programmed activities and had improved their organization, planning, and systematization; integration among the sectors was also better. These local initiatives provided evidence of a multi-sector response characterized by autonomy, emotional involvement, and an identification with the goals of the project; this went beyond simply meeting targets. Cross-sector work showed a marked increase and a

  17. Report of the Inaugural Meeting of the TFOS i(2) = initiating innovation Series: Targeting the Unmet Need for Dry Eye Treatment.

    Chao, Wendy; Belmonte, Carlos; Benitez Del Castillo, José M; Bron, Anthony J; Dua, Harminder S; Nichols, Kelly K; Novack, Gary D; Schrader, Stefan; Willcox, Mark D; Wolffsohn, James S; Sullivan, David A


    On March 21, 2015, a meeting was held in London, United Kingdom, to address the progress in targeting the unmet need for dry eye disease (DED) treatment. The meeting, which launched the i(2) = initiating innovation series, was sponsored by the Tear Film & Ocular Surface Society (TFOS; and supported by Dompé. The TFOS i(2) meeting was designed to review advances in the understanding of DED since publication of the 2007 TFOS International Dry Eye WorkShop (DEWS) report, and to help launch the highly anticipated sequel, DEWS II. The meeting was structured to discuss the scope of the DED problem, to review the clinical challenges of DED, and to consider the treatment challenges of DED. This article provides a synopsis of the presentations of this TFOS i(2) meeting. PMID:26774910

  18. Allegheny County Address Points

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains address points which represent physical address locations assigned by the Allegheny County addressing authority. Data is updated by County...

  19. Association between unmet needs and clinical status in patients with first episode of schizophrenia in Chile

    Natalia eJorquera


    Full Text Available Background: Schizophrenia is a severe mental disorder involving needs in several matters that are often not covered. A need is defined as a gap between the ideal state and the current state of a patient about a specific topic. Aim: To describe needs in patients with first episode of schizophrenia at the start of treatment, and to describe associated clinical factors. Methods: Observational descriptive cross-sectional design. Patients were over fifteen years old, with first episode schizophrenia, and admitted to treatment in the public health system from six district in two cities of Chile, between 2005 and 2006. Sociodemographic data, clinical evaluations of current psychosis based on the PANSS, and the time of untreated psychosis were obtained. A clinical interview, was carried out followed by the Camberwell Assessment of Need. Results: 29 patients were evaluated, 79.3% male, mean age 21.9 years old. The areas with more needs reported were; psychotic symptoms with 65.5% of sample, 21.1% of which reported it unmet; and daytime activities, where 44.8% of patients reported a need, 61.54% of them as unmet. The percentage of unmet needs correlated with PANSS score (r= 0.55; p=0.003, and with time of positive symptoms prior to diagnosis (r= 0.416; p=0.03. Discussion: Needs assessment in schizophrenia is necessary. It may affect its clinical course, be relevant in its management and help monitor recovery. Defining the main needs in people with first episode schizophrenia and associated factors allows for a better design of treatment strategies in order to obtain better therapeutic results and recovery.

  20. Measuring dementia carers' unmet need for services - an exploratory mixed method study

    Vickers James


    Full Text Available Abstract Background To ensure carers of people with dementia receive support, community services increasingly use measures of caregiver (carer burden to assess for unmet need. This study used Bradshaw's taxonomy of need to explore the link between measures of carer burden (normative need, service use (expressed need, and carer's stated need (felt need. Methods This mixed method exploratory study compared measures of carer burden with community services received and unmet needs, for 20 community-dwelling carer/care-recipient pairs. Results A simple one-item measure of carers' felt need for more services was significantly related to carer stress as measured on the GHQ-30. Qualitative data showed that there are many potential stressors for carers, other than those related to the care-giving role. We found a statistically significant rank correlation (p = 0.01 between carer's use of in-home respite and the care-recipient's cognitive and functional status which is likely to have been related to increased requirement for carer vigilance, effort and the isolation of spouse carers. Otherwise, there were no statistically significant relationships between carer burden or stress and level of service provision. Conclusion When carers are stressed or depressed, they can recognise that they would like more help from services, even if measures of carer burden and care recipient status do not clearly indicate unmet service needs. A question designed to elicit carer' felt need may be a better indicator of service need, and a red flag for recognising growing stress in carers of people with dementia. Assessment of service needs should recognise the fallibility of carer burden measures, given that carer stress may not only come from caring for someone with dementia, but can be significantly compounded by other life situations.

  1. Determinants of low family planning use and high unmet need in Butajira District, South Central Ethiopia

    Mekonnen Wubegzier


    Full Text Available Abstract Background The rapid population growth does not match with available resource in Ethiopia. Though household level family planning delivery has been put in place, the impact of such programs in densely populated rural areas was not studied. The study aims at measuring contraception and unmet need and identifying its determinants among married women. Methods A total of 5746 married women are interviewed from October to December 2009 in the Butajira Demographic Surveillance Area. Contraceptive prevalence rate and unmet need with their 95% confidence interval is measured among married women in the Butajira district. The association of background characteristics and family planning use is ascertained using crude and adjusted Odds ratio in logistic regression model. Results Current contraceptive prevalence rate among married women is 25.4% (95% CI: 24.2, 26.5. Unmet need of contraception is 52.4% of which 74.8% was attributed to spacing and the rest for limiting. Reasons for the high unmet need include commodities' insecurity, religion, and complaints related to providers, methods, diet and work load. Contraception is 2.3 (95% CI: 1.7, 3.2 times higher in urbanites compared to rural highlanders. Married women who attained primary and secondary plus level of education have about 1.3 (95% CI: 1.1, 1.6 and 2 (95% CI: 1.4, 2.9 times more risk to contraception; those with no child death are 1.3 (95% CI: 1.1, 1.5 times more likely to use contraceptives compared to counterparts. Besides, the odds of contraception is 1.3 (95% CI: 1.1, 1.6 and 1.5 (1.1, 2.0 times more likely among women whose partners completed primary and secondary plus level of education. Women discussing about contraception with partners were 2.2 (95% CI: 1.8, 2.7 times more likely to use family planning. Nevertheless, contraception was about 2.6 (95% CI: 2.1, 3.2 more likely among married women whose partners supported the use of family planning. Conclusions The local government

  2. Strengthening global physical protection practices; gaining better information on national practices for protection of weapons-usable material. Keynote address/session 3

    Full text: Unlike the Non-Proliferation Treaty requirement that non-nuclear-weapon parties provide 'safeguards' information to the IAEA on their nuclear materials and their state systems for accounting and control, there is no related requirement to provide information on state systems of physical protection. A review of 1997 IAEA and Stanford physical protection conference proceedings showed both the absence of information on important practices from many states and the great variation in practices from state to state. Besides the lack of internationally required standards for domestic protection, reasons for the variations described in Stanford-Sandia National Laboratories research include: differences in states' perceptions of the threats to their materials; differences in their abilities to pay the cost of stronger physical protection; differences in their laws and regulatory practices in general; and differences in their cultural attitudes - for example, attitudes toward whether to arm personnel guarding weapon-usable material or to require clearances for personnel with access to such material. The information presented to the 1997 IAEA and Stanford conferences was supplied voluntarily. The two global documents which provide norms for physical protection do not require submission of such information. These are the 1980 Convention on Physical Protection of Nuclear Material and the 1999 IAEA INFCIRC/225/Rev.4. This means that, without bilateral cooperation, no state can find out how other states are protecting their nuclear material. Yet, as IAEA Director General El Baradei has said, '[I]t is not a matter of indifference to other States whether and to what extent [physical protection] responsibility is fulfilled. ...The need for international cooperation becomes evident in situations - where the effectiveness of physical protection in one State depends on the taking by other States also of adequate measures to deter and defeat hostile actions against nuclear

  3. Breast cancer patients receiving postoperative radiotherapy: Distress, depressive symptoms and unmet needs of psychosocial support

    Background and purpose: The diagnosis and treatment of breast cancer can cause considerable psychological consequences, which may remain unrecognized and untreated. In this study, the prevalence of depressive symptoms and distress, and unmet needs for psychosocial support were assessed among breast cancer patients receiving postoperative radiotherapy. Material and methods: Out of 389 consecutive patients, 276 responded and comprised the final study group. Depressive symptoms were assessed with the Beck Depression Inventory. Distress was measured with the Distress Thermometer. Hospital records of the patients were examined for additional information. Results: Nearly one third of patients (32.1%) displayed depressive symptoms, and more than a quarter of patients (28.4%) experienced distress. Younger age (p = 0.001) and negative hormone receptor status (p = 0.008) were independent factors associated with distress. One quarter of the patients expressed an unmet need for psychosocial support, which was independently associated with depressive symptoms and/or distress (p = 0.001) and younger age (p = 0.006). Conclusions: During radiotherapy for breast cancer, the staff should have awareness of the higher risk of depression and distress in their patients and should consider screening tools to recognise distress and depressive symptoms. Special attention should be paid to younger patients.

  4. The impact of pain on quality of life and the unmet needs of pain management: results from pain sufferers and physicians participating in an Internet survey.

    McCarberg, Bill H; Nicholson, Bruce D; Todd, Knox H; Palmer, Trish; Penles, Leslie


    Pain is one of the most common medical complaints, but despite its prevalence, many individuals still suffer with unrelieved or undertreated pain. This marketing research survey was designed to determine the physical, psychological, and economic impact pain has on the lives of individuals suffering with pain and to identify the unmet needs of patients who have taken opioid medications to treat their pain. In addition, the survey sought to address the challenges physicians face when treating patients with pain. Pain sufferers were recruited through e-mail invitation to an Internet survey; 173,854 invitations were sent out, 22,018 people responded (12.7%), and 606 met the criteria for inclusion in the survey as pain sufferers. Of these, 359 people had moderate to moderately severe chronic pain and 247 people had moderate to moderately severe acute pain. Additionally, physicians currently treating pain were recruited through e-mail and postal mail invitations and 492 met eligibility criteria: 241 specialists (orthopedic or general surgeons, pain specialists or anesthesiologists), 125 primary care, and 126 emergency medicine physicians. Results of this survey supported what many physicians observe in their practice and hear from their patients, that pain has a negative impact on daily activities in the majority of pain sufferers. Many chronic pain sufferers reported that pain had deleterious effects on their mental health, employment status, sleep, and personal relationships. The impact of pain on patient quality of life and the unmet needs in pain management were recognized by the majority of physicians surveyed, with inadequate pain control, end-of-dose pain, and side effects associated with increased dosing reported as negative factors influencing their choice of pain medication. In conclusion, effective communication between physicians and patients is encouraged to not only improve overall pain management but also to establish shared treatment goals with functional

  5. Reach Address Database (RAD)

    U.S. Environmental Protection Agency — The Reach Address Database (RAD) stores the reach address of each Water Program feature that has been linked to the underlying surface water features (streams,...

  6. A Call to Action: An Address to the Tulsa Metropolitan Chamber of Commerce, A Response to the Report of the National Commission on Excellence in Education: A Nation at Risk.

    Zenke, Larry L.

    The Superintendent of Schools reports factual information about and briefly describes accomplishments of the Tulsa Public Schools to enable the Board of Directors of the Chamber of Commerce to assess the status of the schools vis-a-vis the Report of the National Commission on Excellence in Education. Recent scores of students on national…

  7. Traumatic brain injury: unmet support needs of caregivers and families in Florida.

    Christina Dillahunt-Aspillaga

    Full Text Available Sustaining a Traumatic Brain Injury results in familial strain due to the significant impact the injury has upon the role and function of individuals and their families at home and in the community. Using the Stress Process Model of Caregiving, a caregiver needs assessment survey was developed and conducted to better understand the needs of individuals with a Traumatic Brain Injury and their caregivers. Survey results indicate that caregivers experience many challenges including unmet needs in areas of relational supports such as maintaining relationships, long-term emotional and financial support for themselves and the survivor, and the need for a patient or caregiver advocate. Implications for future practice are presented.

  8. Assessing Unmet and Latent Demand for Pharmacists at the State Level

    Arora, Prachi; Mott, David A.; Chui, Michelle A.; Kreling, David H.


    Background Past reports suggest that a near balance has been reached in the supply and demand for pharmacists in the US. Although data on the level of supply of pharmacists is available, there is no continuous and systematic tracking of the level of demand (unmet and latent) for pharmacists at state level. Unmet demand, an established construct in pharmacy workforce, is important to measure the number of vacancies and assess pharmacist shortage consistently over time. Latent demand or potential demand is a novel construct and has never been measured in pharmacy workforce. With the increase in supply, it is important to measure the potential demand that could be budgeted in pharmacies in the near future. Objective The objective of this study was to measure the unmet and latent demand for pharmacists and explore the association between latent demand and workload characteristics in community and hospital pharmacies in Wisconsin in 2011-12. Methods The study used a cross-sectional, descriptive survey design. A sample of community pharmacies (n=1,064) and hospital pharmacies (n=126) licensed in Wisconsin in 2011-12 was identified. Key informants (managers/owners) of sampled pharmacies were sent a one-page cover letter explaining the purpose of the study and requesting participation and a three page survey form. The main outcome measures of the study were total number of FTE pharmacist positions vacant, presence of adequate staff size, additional number of FTE pharmacist positions needed to attain adequate staff size, prescription volume, daily census, hospital size and number of hours prescription department is open. Descriptive statistics were calculated for all the pharmacies collectively, then separately for community and hospital pharmacies. Pharmacy setting, vacancies and workload characteristics of pharmacies with and without latent demand were compared using chi-squared test of independence and/or t-test. Sample weights were calculated and used in all the

  9. Seniors’ unmet mobility needs – how important is a driving licence?

    Haustein, Sonja; Siren, Anu Kristiina


    Previous studies have come to different conclusions regarding how important a driving licence is for seniors to fulfil their mobility needs. We investigated this question based on three groups of Danish seniors: persons who were licensed as drivers (‘‘drivers’’); persons who have never been...... licensed drivers (‘‘never-drivers’’); and persons who recently gave up their licence (‘‘ex-drivers’’). Data were collected via standardised telephone interviews in 2012 among 863 individuals born in 1939/40. The three groups differed significantly in socio-demographics and health; never-drivers had the...... became insignificant for unmet shopping needs. The effect of never having had a licence was hardly affected by the inclusion of control variables. The results emphasise the importance of a driving licence in fulfilling seniors’ mobility needs. Contrary to our hypotheses, more experience with, and better...

  10. Reasons and Determinants for Perceiving Unmet Needs for Mental Health in Primary Care in Quebec

    Dezetter, Anne; Duhoux, Arnaud; Menear, Matthew; Roberge, Pasquale; Chartrand, Elise; Fournier, Louise


    Objective: To evaluate the mental health care needs perceived as unmet by adults in Quebec who had experienced depressive and (or) anxious symptomatology (DAS) in the previous 2 years and who used primary care services, and to identify the reasons associated with different types of unmet needs for care (UNCs) and the determinants of reporting UNCs. Method: Longitudinal data from the Dialogue Project were used. The sample consisted of 1288 adults who presented a common mental disorder and who consulted a general practitioner. The Hospital Anxiety and Depression Scale was used to measure DAS, and the Perceived Need for Care Questionnaire facilitated the assessment of the different types of UNCs and their motives. Results: About 40% of the participants perceived UNCs. Psychotherapy, help to improve ability to work, as well as general information on mental health and services were the most mentioned UNCs. The main reasons associated with reporting UNCs for psychotherapy and psychosocial interventions are “couldn’t afford to pay” and “didn’t know how or where to get help,” respectively. The factors associated with mentioning UNCs (compared with met needs) are to present a high DAS or a DAS that increased during the past 12 months, to perceive oneself as poor or to not have private health insurance. Conclusions: To reduce the UNCs and, further, to reduce DAS, it is necessary to improve the availability and affordability of psychotherapy and psychosocial intervention services, and to inform users on the types of services available and how to access them. PMID:26175326

  11. Unmet needs of outpatients with late-life depression; a comparison of patient, staff and carer perceptions

    Houtjes, Wim; Meijel, Berno van; Deeg, Dorly; Beekman, Aartjan


    There is evidence that late life depression is associated with high levels of unmet needs. Only a minority of the depressed patients appears to be adequately treated. Ninety-nine older patients (58-92 years), 96 informal carers and 85 health-care professionals were recruited from six outpatient fac

  12. Conference President's address

    The objective of the Conference is to promote the development of a coherent international policy on the protection of the environment from the effects of ionizing radiation and to foster information exchange on this subject. The organizers, the IAEA in cooperation with United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), the European Commission (EC) and the International Union of Radioecology (IUR), as well as the hosts of the conference, the Government of Sweden through the Swedish Radiation Protection Authority (SSI), are pleased that so nearly 300 delegates from 53 countries have been nominated by their governments to attend this meeting. Another objective is to discuss the implications of the ICRP's proposal for a framework to assess radiation effects in the environment. A framework for radiological protection of the environment must be practical and simple, as should be international standards for discharges into the environment that take account of such an approach. This is a task for the IAEA, in cooperation with other international organizations. This conference therefore provides an opportunity for you to influence the development of both ICRP and IAEA policy in this area. The background session today will give information on the current situation as well as social and political drivers for change. A number of organizations will provide an insight to the present status of international policies on the radiological protection related to releases to the environment. During the course of the conference, there will be five topical sessions that will cover selected subjects related to protection of the environment, such as stakeholders' views, case studies, approaches for non-radioactive pollutants, the state of current scientific knowledge and, finally, the implications of ICRP proposals for international safety standards. Keynote speakers will address key issues within each topical session, and a rapporteur will summarize the

  13. Emerging organisational models of primary healthcare and unmet needs for care: insights from a population-based survey in Quebec province

    Levesque Jean-Frédéric


    Full Text Available Abstract Background Reform of primary healthcare (PHC organisations is underway in Canada. The capacity of various types of PHC organizations to respond to populations’ needs remains to be assessed. The main objective of this study was to evaluate the association of PHC affiliation with unmet needs for care. Methods Population-based survey of 9205 randomly selected adults in two regions of Quebec, Canada. Outcomes Self-reported unmet needs for care and identification of the usual source of PHC. Results Among eligible adults, 18 % reported unmet needs for care in the last six months. Reasons reported for unmet needs were: waiting times (59 % of cases; unavailability of usual doctor (42 %; impossibility to obtain an appointment (36 %; doctors not accepting new patients (31 %. Regression models showed that unmet needs were decreasing with age and was lower among males, the least educated, and unemployed or retired. Controlling for other factors, unmet needs were higher among the poor and those with worse health status. Having a family doctor was associated with fewer unmet needs. People reporting a usual source of care in the last two-years were more likely to report unmet need for care. There were no differences in unmet needs for care across types of PHC organisations when controlling for affiliation with a family physician. Conclusion Reform models of primary healthcare consistent with the medical home concept did not differ from other types of organisations in our study. Further research looking at primary healthcare reform models at other levels of implementation should be done.

  14. Addressivity in cogenerative dialogues

    Hsu, Pei-Ling


    Ashraf Shady's paper provides a first-hand reflection on how a foreign teacher used cogens as culturally adaptive pedagogy to address cultural misalignments with students. In this paper, Shady drew on several cogen sessions to showcase his journey of using different forms of cogens with his students. To improve the quality of cogens, one strategy he used was to adjust the number of participants in cogens. As a result, some cogens worked and others did not. During the course of reading his paper, I was impressed by his creative and flexible use of cogens and at the same time was intrigued by the question of why some cogens work and not others. In searching for an answer, I found that Mikhail Bakhtin's dialogism, especially the concept of addressivity, provides a comprehensive framework to address this question. In this commentary, I reanalyze the cogen episodes described in Shady's paper in the light of dialogism. My analysis suggests that addressivity plays an important role in mediating the success of cogens. Cogens with high addressivity function as internally persuasive discourse that allows diverse consciousnesses to coexist and so likely affords productive dialogues. The implications of addressivity in teaching and learning are further discussed.

  15. Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare

    Tetsuji Yamada


    Full Text Available The purpose of this study is to investigate healthcare access disparity that will cause delayed and unmet healthcare needs for the elderly, and to examine health inequality and healthcare cost burden for the elderly. To produce clear policy applications, this study adapts a modified PRECEDE-PROCEED model for framing theoretical and experimental approaches. Data were collected from a large collection of the Community Tracking Study Household Survey 2003–2004 of the USA. Reliability and construct validity are examined for internal consistency and estimation of disparity and inequality are analyzed by using probit/ols regressions. The results show that predisposing factors (e.g., attitude, beliefs, and perception by socio-demographic differences are negatively associated with delayed healthcare. A 10% increase in enabling factors (e.g., availability of health insurance coverage, and usual sources of healthcare providers are significantly associated with a 1% increase in healthcare financing factors. In addition, information through a socio-economic network and support system has a 5% impact on an access disparity. Income, health status, and health inequality are exogenously determined. Designing and implementing easy healthcare accessibility (healthcare system and healthcare financing methods, and developing a socio-economic support network (including public health information are essential in reducing delayed healthcare and health inequality.

  16. Addressing the workforce pipeline challenge

    Leonard Bond; Kevin Kostelnik; Richard Holman


    A secure and affordable energy supply is essential for achieving U.S. national security, in continuing U.S. prosperity and in laying the foundations to enable future economic growth. To meet this goal the next generation energy workforce in the U.S., in particular those needed to support instrumentation, controls and advanced operations and maintenance, is a critical element. The workforce is aging and a new workforce pipeline, to support both current generation and new build has yet to be established. The paper reviews the challenges and some actions being taken to address this need.

  17. Addressing the workforce pipeline challenge

    A secure and affordable energy supply is essential for achieving U.S. national security, in continuing U.S. prosperity and in laying the foundations to enable future economic growth. To meet this goal the next generation energy workforce in the U.S., in particular those needed to support instrumentation, controls and advanced operations and maintenance, is a critical element. The workforce is aging and a new workforce pipeline, to support both current generation and new build has yet to be established. The paper reviews the challenges and some actions being taken to address this need. (authors)

  18. Addressing the nuclear misconception

    There is a perception, fostered and encouraged by the anti-nuclear groups, that the nuclear industry generates large quantities of waste with no idea how to deal with it, that it is unsafe, uneconomic, and environmentally damaging. The task is to change these perceptions, by demonstrating that the industry is not a problem in itself, but in fact provides solutions to problems. This paper, while primarily concerned with waste, addresses all of these issues as each has a bearing on the perception of the industry and therefore must be considered when addressing the issue of waste. The paper concludes that evidence exists to support the industry view, but that the mission of the industry should be to change the perception of the industry, by influencing and working together with its stake holders to address their concerns, rather than merely presenting more and more facts. (author)

  19. Addressing the nuclear misconception

    There is a perception, fostered and encouraged by the anti-nuclear groups, that the nuclear industry generates large quantities of waste with no idea how to deal with it, is unsafe, uneconomic, and environmentally damaging. The task of the industry is to change the perception by demonstrating that the industry provides solutions to problems, and is not a problem in itself. This paper, whilst primarily concerned with waste, addresses all of these issues as each has a bearing on the perception of the industry and therefore must be considered when addressing the issue of waste. The paper concludes that evidence exists to support the industry, but that the mission of the industry should be to change the perception of it, by influencing and working together with its stakeholders to address their concerns, rather than merely presenting more and more facts. (author)

  20. Unmet reproductive health needs among women in some West African countries: a systematic review of outcome measures and determinants

    Ayanore, Martin Amogre; Pavlova, Milena; Groot, Wim


    Background Identifying relevant measures of women’s reproductive health needs is critical to improve women’s chances of service utilization. The study aims to systematically review and analyze the adequacy of outcome measures and determinants applied in previous studies for assessing women reproductive health needs across West Africa. Methods Evidence on outcomes and determinants of unmet reproductive health needs among women of childbearing age in diverse multicultural, religious, and ethnic...

  1. Responding to the Needs of Children and Families After a Disaster: Linkages Between Unmet Needs and Caregiver Functioning

    Kilmer, Ryan P.; Gil-Rivas, Virginia


    Disasters may negatively influence caregivers’ ability to respond to the needs of their families. In this context, service organizations’ response to families’ needs may affect caregivers’ symptoms and parenting. Interviews were conducted with caregivers affected by Hurricane Katrina approximately 12-months (T1; N = 68) and 2 years post-hurricane (T2; N = 52). Caregivers reported high levels of service needs and unmet needs for themselves and their child(ren) and family at both time points. R...

  2. Characteristics, treatment patterns, and unmet needs of Japanese patients with atrial fibrillation

    Koretsune Y


    Full Text Available Yukihiro Koretsune,1 Bruno Rossi,2 Kazuya Iwamoto,3 Edward CY Wang,4 Marco DiBonaventura,5 Jean-Baptiste Briere41Institute for Clinical Research, Osaka National Hospital, Osaka, Japan; 2Market Access, Bayer Yakuhin Ltd., Osaka, Japan; 3Medical Affairs Cardiovascular and Neurology, Bayer Yakuhin Ltd., Osaka, Japan; 4Health Economics and Outcomes Research, Bayer Yakuhin Ltd., Osaka, Japan; 5Health Outcomes Practice, Kantar Health, New York, NY, USABackground: Data on characteristics, comorbidities, health outcomes, and treatment patterns of patients with atrial fibrillation (AF in Japan are scarce. The aim of this study was to address this gap in order to better understand the characteristics of Japanese AF patients.Methods and results: The 2008-2010 Japan National Health and Wellness Survey data sets were used in this study (N = 60,015. Demographics, health characteristics, stroke risk (using the CHA2DS2-VASc score, comorbidities, and health outcomes were all assessed. A total of 565 patients (0.94% self-reported a physician diagnosis of AF. Patients with AF reported a number of comorbidities, including another cardiovascular condition (87.08%, a urological condition (67.79%, and dyspepsia (37.35%. Patients with AF also reported significantly worse health status and significantly more resource use than did controls. Based on the CHA2DS2-VASc score, most patients (88.50% were at either moderate or high risk, yet only 64.25% of patients were currently being treated. Among those not currently treated, 42.57% had discontinued previous treatment. Among those currently treated, over a third reported nonadherent behaviors.Conclusion: Despite the disease burden and the high risk for a future stroke, not all patients are being treated according to guidelines. This treatment gap highlights the need for better therapeutic alternatives, in order to improve the management of patients with AF, in Japan.Keywords: stroke risk, health status, adherence

  3. Addressing Sexual Harassment

    Young, Ellie L.; Ashbaker, Betty Y.


    This article discusses ways on how to address the problem of sexual harassment in schools. Sexual harassment--simply defined as any unwanted and unwelcome sexual behavior--is a sensitive topic. Merely providing students, parents, and staff members with information about the school's sexual harassment policy is insufficient; schools must take…

  4. A new method to address unmet needs for extracting individual cell migration features from a large number of cells embedded in 3D volumes.

    Ivan Adanja

    Full Text Available BACKGROUND: In vitro cell observation has been widely used by biologists and pharmacologists for screening molecule-induced effects on cancer cells. Computer-assisted time-lapse microscopy enables automated live cell imaging in vitro, enabling cell behavior characterization through image analysis, in particular regarding cell migration. In this context, 3D cell assays in transparent matrix gels have been developed to provide more realistic in vitro 3D environments for monitoring cell migration (fundamentally different from cell motility behavior observed in 2D, which is related to the spread of cancer and metastases. METHODOLOGY/PRINCIPAL FINDINGS: In this paper we propose an improved automated tracking method that is designed to robustly and individually follow a large number of unlabeled cells observed under phase-contrast microscopy in 3D gels. The method automatically detects and tracks individual cells across a sequence of acquired volumes, using a template matching filtering method that in turn allows for robust detection and mean-shift tracking. The robustness of the method results from detecting and managing the cases where two cell (mean-shift trackers converge to the same point. The resulting trajectories quantify cell migration through statistical analysis of 3D trajectory descriptors. We manually validated the method and observed efficient cell detection and a low tracking error rate (6%. We also applied the method in a real biological experiment where the pro-migratory effects of hyaluronic acid (HA were analyzed on brain cancer cells. Using collagen gels with increased HA proportions, we were able to evidence a dose-response effect on cell migration abilities. CONCLUSIONS/SIGNIFICANCE: The developed method enables biomedical researchers to automatically and robustly quantify the pro- or anti-migratory effects of different experimental conditions on unlabeled cell cultures in a 3D environment.

  5. Nation

    Østergaard, Uffe


    Nation er et gammelt begreb, som kommer af det latinske ord for fødsel, natio. Nationalisme bygger på forestillingen om, at mennesker har én og kun én national identitet og har ret til deres egen nationalstat. Ordet og forestillingen er kun godt 200 år gammel, og i 1900-tallet har ideologien bredt...... sig over hele verden. Nationalisme er blevet global....

  6. Bioreactors Addressing Diabetes Mellitus

    Minteer, Danielle M.; Gerlach, Jorg C; Marra, Kacey G.


    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor develop...

  7. Holographic content addressable storage

    Chao, Tien-Hsin; Lu, Thomas; Reyes, George


    We have developed a Holographic Content Addressable Storage (HCAS) architecture. The HCAS systems consists of a DMD (Digital Micromirror Array) as the input Spatial Light Modulator (SLM), a CMOS (Complementary Metal-oxide Semiconductor) sensor as the output photodetector and a photorefractive crystal as the recording media. The HCAS system is capable of performing optical correlation of an input image/feature against massive reference data set stored in the holographic memory. Detailed system analysis will be reported in this paper.

  8. Addressing mathematics & statistics anxiety

    Kotecha, Meena


    This paper should be of interest to mathematics and statistics educators ranging from pre-university to university education sectors. It will discuss some features of the author’s teaching model developed over her longitudinal study conducted to understand and address mathematics and statistics anxiety, which is one of the main barriers to engaging with these subjects especially in non-specialist undergraduates. It will demonstrate how a range of formative assessments are used to kindle, as w...

  9. UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study.

    Price, David B; Scadding, Glenis; Bachert, Claus; Saleh, Hesham; Nasser, Shuaib; Carter, Victoria; von Ziegenweidt, Julie; Durieux, Alice M S; Ryan, Dermot


    Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies. PMID:27334893

  10. Address delivered in Vilnius

    Piłsudski, Józef


    Title: Przemówienie w Wilnie 20 kwietnia 1922 roku (Address delivered in Vilnius, 20 April, 1922) Originally published: Pisma-mowy-rozkazy, vol. V, Warsaw, Instytut Józefa Piłsudskiego, 1933, pp. 255–260. Language: PolishThe excerpt used is from the original About the author Józef Piłsudski [1867, Zułów (in the district of Święciany, Lit. Zalave/Švenčionys, present-day Lithuania) – 1935, Warsaw]: politician. Piłsudski was born to a family belonging to the Polish-speaking gentry in the Lithuan...

  11. Addressing Software Security

    Bailey, Brandon


    Historically security within organizations was thought of as an IT function (web sites/servers, email, workstation patching, etc.) Threat landscape has evolved (Script Kiddies, Hackers, Advanced Persistent Threat (APT), Nation States, etc.) Attack surface has expanded -Networks interconnected!! Some security posture factors Network Layer (Routers, Firewalls, etc.) Computer Network Defense (IPS/IDS, Sensors, Continuous Monitoring, etc.) Industrial Control Systems (ICS) Software Security (COTS, FOSS, Custom, etc.)

  12. Review of ICT-Based Services for Identified Unmet Needs in People with Dementia

    Lauriks, Steve; Reinersmann, Annika; van der Roest, Henriëtte Geralde; Meiland, Franka; Davies, Richard; Moelaert, Ferial; Mulvenna, Maurice D.; Nugent, Chris D.; Dröes, Rose-Marie

    Some of the needs that people with dementia and their informal carers currently perceive as insufficiently met by regular care and support services might be alleviated, or even be met, using modern Information and Communication Technology (ICT). The study described in this chapter was designed to provide an insight into the state of the art in ICT solutions that could contribute to meet the most frequently mentioned unmet needs by people with dementia and their informal carers. These needs can be summarized as (1) the need for general and personalized information; (2) the need for support with regard to symptoms of dementia; (3) the need for social contact and company; and (4) the need for health monitoring and perceived safety. Databases that were searched include PubMed, Cinahl, Psychinfo, Google (Scholar), INSPEC and IEEE. In total 22 websites and 46 publications were included that satisfied the following criteria: the article reports on people with dementia and/or their informal carers and discusses an ICT device that has been tested within the target group and has proven to be helpful. Within the first need area 18 relevant websites and three studies were included; within the second need area 4 websites and 20 publications were included. Within the third and fourth need area 11 and 12 publications were included, respectively. Most articles reported on uncontrolled studies. It is concluded that the informational websites offer helpful information for carers but seem less attuned to the person with dementia and do not offer personalized information. ICT solutions aimed at compensating for disabilities, such as memory problems and daily activities, demonstrate that people with mild to moderate dementia are capable of handling simple electronic equipment and can benefit from it in terms of more confidence and enhanced positive affect. Instrumental ICT support for coping with behavioural and psychological changes in dementia is relatively disregarded as yet, while

  13. Challenges, coping strategies, and unmet needs of families with a child with autism spectrum disorder in Goa, India.

    Divan, Gauri; Vajaratkar, Vivek; Desai, Miraj U; Strik-Lievers, Luisa; Patel, Vikram


    Autism Spectrum Disorders (ASD) are increasingly recognized in developing countries like India. However, little is known about the experiences of parents raising a child with ASD. This study aimed to describe the experiences of families in Goa, India with a view to understanding the unmet needs of families raising a child with ASD. Twenty in-depth interviews and nine focus group discussions were carried out with families of children with ASD and key community stakeholders such as special educators, teachers, and parents of typically developing children. This qualitative data was triangulated to explore the experiences, life impact, and unmet needs of raising a child with ASD. Key findings suggest that raising a child with ASD puts a tremendous strain on families due to competing commitments, often leading to initial social withdrawal with later reintegration into social networks. Second, the impact is multidimensional, involving the personal sphere but also extending into the wider community with negative experiences of discrimination. Third, parents actively respond to these challenges through a range of approaches with help from existing and new social support networks and health care providers. Fourth, professionals from the health, education, and religious sectors have a low awareness of the unique needs of families living with ASD which leads to a considerable economic and emotional burden on families. Finally, as a consequence of these experiences, several unmet needs can be identified, notably for supporting increasingly isolated families and the limited access to multidisciplinary evidence-based services for ASD. Autism Res 2012, 5: 190-200. © 2012 International Society for Autism Research, Wiley Periodicals, Inc. PMID:22473816

  14. Addressing Climate Crisis


    @@ A series of extreme global weather events,like floods in Pakistan and droughts in Russia,should serve as a call to the world to take action against climate change.But worries have been mounting since global climate talks stalled,partly due to rifts between developed and developing countries.What efforts should be made to force progress in the negotiating process? What role has China played in combating climate change? Su Wei,China's chief climate negotiator and Director-General of the Climate Change Department of the National Development and Reform Commission(NDRC),sat down with Beijing Review reporter Hu Yue to answer these questions and more.

  15. Addressing Climate Crisis


    A series of extreme global weather events,like floods in Pakistan and droughts in Russia,should serve as a call to the world to take action against climate change.But worries have been mounting since global climate talks stalled,partly due to rifts between developed and developing countries.What efforts should be made to force progress in the negotiating process?What role has China played in combating climate change?Su Wei,China’s chief climate negotiator and Director-General of the Climate Change Department of the National Development and Reform Commission(NDRC),sat down with Beijing Review reporter Hu Yue to answer these questions and more.Edited excerpts follow

  16. Study of family planning practices with special reference to unmet need among married women in rural area of Amravati district of Maharashtra

    VK Wasnik


    Full Text Available Background: At present various active programmes on family planning are running over the few decades but considerate number of people yet not motivated to adopt the family planning in their practical life. The study was conducted to find out the unmet need of family planning among the married woman of reproductive age in a rural area. Methods: Study design: Cross-sectional type of descriptive study. Settings: The study was conducted at Rajurwadi village under Primary Health Unit. Subjects: All the married women of reproductive age, residing in a selected village of Primary Health Unit were selected as the study subject.  Results: It was revealed from the present study that 27.7% of the respondents had unmet need for family planning. The reasons for unmet need were lack of knowledge, health concerns & Religious belief. Conclusion: Social correlates like age, religion & literacy sta­tus influenced the unmet needs of family planning. Good quality services and access to convenient methods are important to meet unmet need. 

  17. Road Map to Address Cognitive Health


    In this podcast, CDC’s Dr. Lynda Anderson highlights the important roles that states and communities can play in addressing cognitive health as part of overall health.  Created: 6/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/9/2014.

  18. Addressing Student Debt in the Classroom

    Perkins, David; Johnston, Tim; Lytle, Rick


    Student debt is a national concern. The authors address debt in the classroom to enhance students' understanding of the consequences of debt and the need for caution when financing their education. However, student feedback indicates this understanding has a delayed effect on borrowing behavior and underscores the importance of making difficult…

  19. 32 CFR Appendix B to Part 516 - Mailing Addresses


    ... 32 National Defense 3 2010-07-01 2010-07-01 true Mailing Addresses B Appendix B to Part 516 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Pt. 516, App. B Appendix B to Part 516—Mailing Addresses The following is...

  20. Is food allergen analysis flawed? Health and supply chain risks and a proposed framework to address urgent analytical needs.

    Walker, M J; Burns, D T; Elliott, C T; Gowland, M H; Mills, E N Clare


    Food allergy is an increasing problem for those affected, their families or carers, the food industry and for regulators. The food supply chain is highly vulnerable to fraud involving food allergens, risking fatalities and severe reputational damage to the food industry. Many facets are being pursued to ameliorate the difficulties including better food labelling and the concept of thresholds of elicitation of allergy symptoms as risk management tools. These efforts depend to a high degree on the ability reliably to detect and quantify food allergens; yet all current analytical approaches exhibit severe deficiencies that jeopardise accurate results being produced particularly in terms of the risks of false positive and false negative reporting. If we fail to realise the promise of current risk assessment and risk management of food allergens through lack of the ability to measure food allergens reproducibly and with traceability to an international unit of measurement, the analytical community will have failed a significant societal challenge. Three distinct but interrelated areas of analytical work are urgently needed to address the substantial gaps identified: (a) a coordinated international programme for the production of properly characterised clinically relevant reference materials and calibrants for food allergen analysis; (b) an international programme to widen the scope of proteomics and genomics bioinformatics for the genera containing the major allergens to address problems in ELISA, MS and DNA methods; (c) the initiation of a coordinated international programme leading to reference methods for allergen proteins that provide results traceable to the SI. This article describes in more detail food allergy, the risks of inapplicable or flawed allergen analyses with examples and a proposed framework, including clinically relevant incurred allergen concentrations, to address the currently unmet and urgently required analytical requirements. Support for the

  1. Observations of IPv6 Addresses

    Malone, David


    IPv6 addresses are longer than IPv4 addresses, and are so capable of greater expression. Given an IPv6 address, conventions and standards allow us to draw conclusions about how IPv6 is being used on the node with that address. We show a technique for analysing IPv6 addresses and apply it to a number of datasets. The datasets include addresses seen at a busy mirror server, at an IPv6-enabled TLD DNS server and when running traceroute across the production IPv6 network. The technique quantif...

  2. Welfare work addressing immigrants and refugees

    Øland, Trine

    integrationist visions in their quest to protect immigrants’ and refugees’ fundamental wellbeing and status as human beings with equal rights, group life and history. These opposing elements generate ambiguity and contradiction within integrationist welfare work. The ambition of the presentation is to enquire......In this presentation I will discuss the ways in which welfare workers addressing immigrants and refugees (re)produce integrationist visions, symbolizing society as an integrated whole and immigrants/refugees as a distraction to that whole. Paradoxically, welfare workers also oppose these......, nurses and more) addressing immigrants and refugees and their families and descendants in the Danish welfare nation-state....

  3. Ministerial Presentation: Philippines. Philippine National Presentation [International Ministerial Conference on Nuclear Energy in the 21. Century: Addressing Energy Needs and Environmental Challenges, Beijing (China), 20-22 April 2009

    generation that will result to sustainable and reasonably-priced electricity rates. We are however, confronted with the challenge that, on the average, about 60% of energy sources utilized in the power generation mix come from fossil fuels primarily oil, coal and natural gas. Moreover, the Philippines still has one of the highest power rates in Asia. That is yet another basis as to why we are seriously considering nuclear power since it provides a relatively competitive generation cost with the cheapest power source which is coal. Among power sources with high upfront costs like wind and solar, nuclear power has the cheapest generation cost. As we work to bring about access to affordable and sufficient electricity for every Filipino, we keep in mind that energy utilization must be consistent with the need for the protection and preservation of our planet's fragile ecosystems. Therefore, we are aiming to reduce the country's contribution to carbon dioxide emissions. The Philippines has taken proactive action by laying the groundwork to shift to a renewable energy system. As a signatory to the UN Framework Convention on Climate Change and the subsequent Kyoto Protocol, we are fully committed to doing our part in addressing global warming even though we are not legally bound to impose a national limitation on emissions. In our efforts to ensure that the use of energy must not damage our environment, we have to deal with the fact that renewable energy development is still costly. As such, nuclear power presents an appealing energy option since the complete nuclear power chain emits the least carbon which is about the same as wind and hydropower. For a developing and non oil-producing country like the Philippines, these are the merits we see in utilizing nuclear energy in power generation. We have already undertaken a nuclear power program in the past. Political circumstances then resulted to the mothballing of the Bataan Nuclear Power Plant, our lone nuclear power plant which

  4. Quality of Life and Unmet Need in People with Psychosis in the London Borough of Haringey, UK

    Maria Lambri


    Full Text Available Objectives. Deinstitutionalization of long-term psychiatric patients produced various community-based residential care facilities. However, inner-city areas have many patients with severe mental illness (SMI as well as deprivation, unemployment, and crime. This makes meeting their community needs complex. We undertook a needs assessment of service provision and consonance between service users’ evaluation of need and by care workers. Design. Cross-sectional study with random sample of SMI service users in four housing settings: rehabilitation units; high-supported; medium-supported; low-supported housing. Setting. London Borough of Haringey. Outcome Measures. 110 SMI service users and 110 keyworkers were interviewed, using Camberwell Assessment of Need; SF-36; Lancashire Quality-of-Life profile; demographic and clinical information. Results. People in “low-support” and “high-support” housing had similar symptom scores, though low support had significantly lower quality of life. Quality of life was positively predicted by self-reported mental-health score and negatively predicted by unmet-need score in whole sample and in medium-support residents. Residents’ and care-workers’ assessments of need differed considerably. Conclusions. Although patients’ housing needs were broadly met, those in low-supported housing fared least well. Attendance to self-reported mental health and unmet social needs to quality of life underpins planning of residential services for those with SMI. Social and personal needs of people in supported housing may be underestimated and overlooked; service providers need to prioritise these if concept of “recovery” is to advance.

  5. Integrating unmet needs into dementia health-related quality of life research and care: Introduction of the Hierarchy Model of Needs in Dementia.

    Schölzel-Dorenbos, C.J.M.; Meeuwsen, E.J.; Olde Rikkert, M.G.M.


    OBJECTIVES: To make an inventory of needs assessment instruments in dementia, to explore the interaction between unmet needs and health-related quality of life (HRQoL) and to relate these to the conceptual model of Maslow's Hierarchy of needs in order to design a dementia-specific model. METHODS: Na

  6. Gender, Race-Ethnicity, and Psychosocial Barriers to Mental Health Care: An Examination of Perceptions and Attitudes among Adults Reporting Unmet Need

    Ojeda, Victoria D.; Bergstresser, Sara M.


    Though researchers have described psychosocial barriers to mental health care-seeking, limited research has examined ways in which gender and race-ethnicity are associated with individuals' perceptions and attitudes. This study investigates correlates of psychosocial barriers to mental health care in a population of adults reporting unmet need for…

  7. On the 40th Anniversary of the Restoration of the Lawful Seat of the People's Republic of China in the United Nations Keynote Address at the Fourth Lanting Forum

    Wu Hailong


    Excellencies,Scholars and experts,Friends from the business commnmunity and the press,Ladies and gentlemen,The theme of this Lanting Forum is China and the United Nations (UN).This is of special significance,because this year marks the 40th anniversary of the restoration of the lawful seat of the People's Republic of China in the UN.

  8. Forest Policies Addressing Climate Change in China


    As a developing country with a large population and a fragile ecological environment, China is particularly vulnerable to the adverse effects of climate change. Beginning with the Rio Conference of 1992 China has played a progressively enhanced role in combating climate change. A series of policies and measures to address climate change have been taken in the overall context of national sustainable development strategy, making positive contributions to the mitigation and adaptation to climate change, among ...

  9. Addressing the UN Millennium Development Goals

    David Ojcius


    Full Text Available The United Nations Summit on the Millennium Development Goals concluded on 22 September 2010 with the adoption of a global action plan to achieve the eight anti-poverty goals by their 2015 target date and the announcement of major new commitments for women's and children's health and other initiatives against poverty, hunger and disease. FACTS Reports is determined to play an important role in communicating about specific field actions that address one or more of the Millenium Development Goa...

  10. Addressing the UN Millennium Development Goals

    David Ojcius; Jan Wallander


    The United Nations Summit on the Millennium Development Goals concluded on 22 September 2010 with the adoption of a global action plan to achieve the eight anti-poverty goals by their 2015 target date and the announcement of major new commitments for women's and children's health and other initiatives against poverty, hunger and disease. FACTS Reports is determined to play an important role in communicating about specific field actions that address one or more of the Millenium Development Goa...

  11. Partnerships as panacea for addressing global problems?

    Kolk, Ans


    textabstractThis chapter examines partnerships and their peculiarities, based on recent research from various disciplines, in the context of the large problems faced by (global) society. These problems are very complex, often cross national boundaries, and cannot easily be 'solved' by one single actor. Previous 'unilateral' attempts to address them have not been particularly successful, and there are limits to what a single actor can do. Cooperation also enables different actors to leverage t...

  12. Managing Psychological Stress in the MS Medical Visit: Patient Perspectives and Unmet Needs

    Senders, Angela; Sando, Kelsi; Wahbeh, Helané; Peterson, Amie; Shinto, Lynne


    Psychological stress can negatively impact multiple sclerosis (MS). To further understand how stress is addressed in the MS medical visit, 34 people with MS participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological wellbeing in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in MS. PMID:25527612

  13. Port virtual addressing for PC

    Instruments for nuclear signal measurements based on add-on card for a personal computer (PC) are designed often. Then one faces the problem of the addressing of data input/output devices which show an integration level or intelligence that makes the use of several port address indispensable, and these are limited in the PC. The virtual addressing offers the advantage of the occupation of few addresses to accede to many of these devices. The principles of this technique and the appliances of a solution in radiometric in a radiometric card based on programmed logic are discussed in this paper

  14. Reclaiming unused IPv4 addresses

    IT Department


    As many people might know, the number of IPv4 addresses is limited and almost all have been allocated (see here and here for more information).   Although CERN has been allocated some 340,000 addresses, the way these are allocated across the site is not as efficient as we would like. As we face an increasing demand for IPv4 addresses with the growth in virtual machines, the IT Department’s Communication Systems Group will be reorganising address allocation during 2016 to make more efficient use of the IPv4 address ranges that have been allocated to CERN. We aim, wherever possible, to avoid giving out fixed IP addresses, and have all devices connected to the campus network obtain an address dynamically each time they connect. As a first stage, starting in February, IP addresses that have not been used for more than 9 months will be reclaimed. No information about the devices concerned will be deleted from LANDB, but a new IP address will have to be requested if they are ever reconnected to t...

  15. An address by AECL's president

    This complete address given by Reid Morden, the President of Atomic Energy of Canada Limited, at the June 1997 meeting of the Canadian Nuclear Association. In his address, Morden discusses Canada's success in at home and abroad. He also corrects myths about nuclear energy

  16. From Unmet Clinical Need to Entrepreneurship: Taking Your Informatics Solution to Market

    Bowles, Kathryn H.; Heil, Eric


    This paper will describe the process for taking a decision support solution to market as a start-up business. The nurse inventor and Co-Founder of RightCare Solutions, Inc. will share the steps from answering a clinical question, to registering an invention, creating a business plan and company, obtaining venture funding, and launching a commercial product. We will share positives about the experience such as how to get start-up funds, gaining national exposure and access to an excellent team...

  17. Causes of childhood visual impairment and unmet low-vision care in blind school students in Ghana.

    Ntim-Amponsah, C T; Amoaku, W M K


    The purpose of this study was to determine the causes of childhood visual impairment and blindness in students of a school for blind children, to determine how many students had some residual vision, and to evaluate any unmet low-vision care. A survey of students in the blind school was conducted in two parts in May-June and then October 2003. The sample consisted of 201 students who became blind before the age of 16. Information was obtained from student interviews, doctors' referral notes and ophthalmic examination of all students who consented. Students with residual vision had low-vision assessments. These investigations were supplemented with active participation of the investigators in Parent-Teacher Association meetings and focus group discussions with parents. One hundred and ninety-nine students consented and were recruited, whereas two declined. Ninety-six became visually impaired within their first year of life and 33 by the age of 5 years. Pathology of the cornea and then the lens were the commonest causes of blindness. One hundred and eight students were totally blind, whereas 87 (43.7%) had some residual vision and formed the target for the second part of the study. Fifty-one out of 77 of this target group who turned up for low-vision examination had useful residual vision by the World Health Organisation (WHO) low-vision examination chart. Spectacle magnifiers aided two students to read normal print at N5 and N8, respectively. Different visual aids would help enhance the residual vision in some of the others. Emotional trauma was apparent in parents and teachers. Children who became blind later in life remained in shock for a longer time and adapted less well to their visual impairment. Visual impairment in the population is not uncommon. Some causes are preventable. There is a significant unmet need for low-vision care, particularly amongst children in Ghana, and perhaps many countries in the West Africa subregion. It is hoped that the findings from

  18. Caring for the brain tumor patient: Family caregiver burden and unmet needs

    Schubart, Jane R.; Kinzie, Mable B.; Farace, Elana


    The rapid onset and progression of a brain tumor, cognitive and behavioral changes, and uncertainty surrounding prognosis are issues well known to health practitioners in neuro-oncology. We studied the specific challenges that family caregivers face when caring for patients experiencing the significant neurocognitive and neurobehavioral disorders associated with brain tumors. We selected 25 family caregivers of adult brain tumor patients to represent the brain tumor illness trajectory (crisis, chronic, and terminal phases). Interviews documented caregiving tasks and decision-making and information and support needs. Themes were permitted to emerge from the data in qualitative analysis. We found that the family caregivers in this study provided extraordinary uncompensated care involving significant amounts of time and energy for months or years and requiring the performance of tasks that were often physically, emotionally, socially, or financially demanding. They were constantly challenged to solve problems and make decisions as care needs changed, yet they felt untrained and unprepared as they struggled to adjust to new roles and responsibilities. Because the focus was on the patient, their own needs were neglected. Because caregiver information needs are emergent, they are not always known at the time of a clinic visit. Physicians are frequently unable to address caregiver questions, a situation compounded by time constraints and cultural barriers. We provide specific recommendations for (1) improving the delivery of information; (2) enhancing communication among patients, families, and health care providers; and (3) providing psychosocial support for family caregivers. PMID:17993635

  19. International policies to address the greenhouse effect. An evaluation of international mechanisms to encourage developing country participation in global greenhouse gas control strategies, especially through the formulation of national programmes

    The political feasibility of strategies for North-South cooperation on climate change within individual countries is analyzed. The conditions under which developing countries would be willing to take action to address climate change and industrialised countries would be willing to support these actions are discussed. Unfortunately, the study indicates that at present there is very limited common ground between developing and industrialised countries. Perceptions of actors and interest groups within seven countries (USA, Germany, UK, India, Indonesia, Brazil and Kenya) on climate change and international climate change policies (instruments and mechanisms) are compared, applying regime theory, and building upon a qualitative content analysis of interviews and documents, and on interviews with experts. The study concludes that developing countries distrust the position of industrialised countries, that is bases upon clearly distinguishing global from local problems and causes of climate change, climate, environmental, economic, and social problems in developing countries. In emphasising distinctions, that in the view of developing countries are incorrect, misleading and detrimental, industrialised countries increase the political costs of North-South cooperation. A more practical approach is recommended, based upon a 'four wheel drive strategy' in which capacity building, Joint Implementation, 'traditional' development cooperation, and strategies to actualize 'dormant' interest groups can all play a role. The additional costs of such a strategy should be balanced against the additional benefits in terms of a relative decline in costs of global change policies. 352 refs

  20. Prostate cancer and supportive care: a systematic review and qualitative synthesis of men's experiences and unmet needs.

    King, A J L; Evans, M; Moore, T H M; Paterson, C; Sharp, D; Persad, R; Huntley, A L


    Prostate cancer is the second most common cancer in men worldwide, accounting for an estimated 1.1 million new cases diagnosed in 2012 ( Currently, there is a lack of specific guidance on supportive care for men with prostate cancer. This article describes a qualitative systematic review and synthesis examining men's experience of and need for supportive care. Seven databases were searched; 20 journal articles were identified and critically appraised. A thematic synthesis was conducted in which descriptive themes were drawn out of the data. These were peer support, support from partner, online support, cancer specialist nurse support, self-care, communication with health professionals, unmet needs (emotional support, information needs, support for treatment-induced side effects of incontinence and erectile dysfunction) and men's suggestions for improved delivery of supportive care. This was followed by the development of overarching analytic themes which were: uncertainty, reframing, and the timing of receiving treatment, information and support. Our results show that the most valued form of support men experienced following diagnosis was one-to-one peer support and support from partners. This review highlights the need for improved access to cancer specialist nurses throughout the care pathway, individually tailored supportive care and psychosexual support for treatment side effects. PMID:25630851

  1. Exploring the Unmet Needs of the Patients in the Outpatient Respiratory Medical Clinic: Patients versus Clinicians Perspectives

    Lone Birgitte Skov Jensen


    Full Text Available Aim. Developing a theoretical framework explaining patients’ behaviour and actions related to unmet needs during interactions with health care professionals in hospital-based outpatient respiratory medical clinics. Background. The outpatient respiratory medical clinic plays a prominent role in many patients’ lives regarding treatment and counselling increasing the need for a better understanding of patients’ perspective to the counselling of the health care professionals. Design. The study is exploratory and based on Charmaz’s interpretation of grounded theory. Methods. The study included 65 field observations with a sample of 43 patients, 11 doctors, and 11 nurses, as well as 30 interviews with patients, conducted through theoretical sampling from three outpatient respiratory medical clinics in Denmark. Findings. The patients’ efforts to share their significant stories triggered predominantly an adaptation or resistance behaviour, conceptualized as “fitting in” and “fighting back” behaviour, explaining the patients’ counterreactions to unrecognized needs during the medical encounter. Conclusion. Firstly this study allows for a better understanding of patients’ counterreactions in the time-pressured and, simultaneously, tight structured guidance program in the outpatient clinic. Secondly the study offers practical and ethical implications as to how health care professionals’ attitudes towards patients can increase their ability to support emotional suffering and increase patient participation and responsiveness to guidance in the lifestyle changes.

  2. Epilepsy therapy: anticonvulsants, lessons learned and unmet medical needs. Interview by Rona Williamson.

    Klitgaard, Henrik


    Henrik Klitgaard, PhD, is currently Vice-President, UCB Fellow, Neurosciences Therapeutic Area and is based in Braine-l'Alleud, Belgium. He received a PhD in Human Physiology in 1989 at the August Krogh Institute at the University of Copenhagen (Denmark). During his university career, Klitgaard worked at the Pasteur Institute in Paris (France) and at Harvard University (MA, USA). Klitgaard is a leading figure in the epilepsy research community, thanks to more than 80 peer-reviewed papers and 15 reviews and book chapters, as well as frequent lectures at top neuroscience and epilepsy science meetings. His memberships and accolades include a position on the US National Institute of Health's epilepsy advisory committee, membership of the Neurobiology Committees of both the International League Against Epilepsy and American Epilepsy Society and a seat on the Scientific Advisory Committee of the patient organization C.U.R.E. (Citizens United for Research in Epilepsy). For more than two decades, Klitgaard has conducted antiepileptic drug discovery in the pharmaceutical industry. He has contributed numerous publications on basic and applied aspects of epilepsy research and has frequently been an invited speaker at epilepsy congresses and meetings. During his career in the pharmaceutical industry, Klitgaard has been involved in the discovery and development of antiepileptic drugs at both Novo Nordisk A/S and UCB Pharma. He is also currently involved in the development of two clinical and several preclinical AED candidates. PMID:23253386

  3. Study of family planning practices with special reference to unmet need among married women in rural area of Amravati district of Maharashtra

    VK Wasnik; AK Jawarkar; DM Dhumale


    Background: At present various active programmes on family planning are running over the few decades but considerate number of people yet not motivated to adopt the family planning in their practical life. The study was conducted to find out the unmet need of family planning among the married woman of reproductive age in a rural area. Methods: Study design: Cross-sectional type of descriptive study. Settings: The study was conducted at Rajurwadi village under Primary Health Unit. Subjects: Al...

  4. Stigma, explanatory models and unmet needs of caregivers of children with developmental disorders in a low-income African country: a cross-sectional facility-based survey

    Tilahun, Dejene; Hanlon, Charlotte; Fekadu, Abebaw; Tekola, Bethlehem; Baheretibeb, Yonas; Hoekstra, Rosa Anna


    Background Understanding the perspectives of caregivers of children with developmental disorders living in low-income countries is important to inform intervention programmes. The purpose of this study was to examine the stigma experiences, explanatory models, unmet needs, preferred interventions and coping mechanisms of caregivers of children with developmental disorders in Ethiopia. Methods Participants comprised caregivers (n = 102) of children with developmental disorders attending two ch...

  5. Identifying the unmet health needs of patients with congenital hypogonadotropic hypogonadism using a web-based needs assessment: implications for online interventions and peer-to-peer support

    Dwyer, Andrew A; Quinton, Richard; Morin, Diane; Pitteloud, Nelly


    Background Patients with rare diseases such as congenital hypogonadotropic hypogonadism (CHH) are dispersed, often challenged to find specialized care and face other health disparities. The internet has the potential to reach a wide audience of rare disease patients and can help connect patients and specialists. Therefore, this study aimed to: (i) determine if web-based platforms could be effectively used to conduct an online needs assessment of dispersed CHH patients; (ii) identify the unmet...

  6. Unmet Needs Associated with Attention-Deficit/Hyperactivity Disorder in Eight European Countries as Reported by Caregivers and Adolescents: Results from Qualitative Research

    Sikirica, Vanja; Flood, Emuella; Dietrich, C. Noelle; Quintero, Javier; Harpin, Val; Hodgkins, Paul; Skrodzki, Klaus; Beusterien, Kathleen; Erder, M. Haim


    Introduction Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder characterized by inattention, impulsivity, and hyperactivity, the levels of which are inappropriately high for an individual’s developmental age. Objective The objective of this study was to explore the unmet needs of children/adolescents with ADHD and their caregivers in eight European countries. Methods Semi-structured interviews with 38 caregivers of children/adolescents (aged 6–17 years) with ADHD a...

  7. A Life’s Addresses

    Balle, Søren Hattesen


    number of different aspects of Koch’s own life such as marijuana, the Italian language, World War Two, etc. In this way, the book quite conventionally inscribes itself in the tradition of post-enlightenment apostrophic poetry as characterized by Culler, just as all its poems belong to the favourite......, are literally troped as and addressed in the manner of so many acquaintances, personal connections, relatives, friends, lovers, and family members in Koch’s life. My main claim is that Koch’s poetics in New Addresses is one that slightly dislocates the romantic dichotomy between the world of things...

  8. Opening Address [Technical Meeting/Workshop on Topical Issues on Infrastructure Development: Managing the Development of a National Infrastructure for Nuclear Power Plants, Vienna (Austria), 24-27 January 2012

    after the accident. The IAEA has taken a series of actions in response to the Fukushima accident, including the activation of the IAEA Incident and Emergency Centre immediately after the accident and sending several IAEA International Fact Finding Expert Missions to Japan. Currently, the IAEA is working hard to implement the IAEA Action Plan on Nuclear Safety, which was agreed at the Board of Governors last September. This Action Plan and its implementation will be explained later by my colleagues; I would like to point out that the development of the infrastructrure necessary for Member States embarking on nuclear power programme is one of the 12 areas covered in that action plan. I would like to stress that there is progress in Member States for the introduction of nuclear power. I had several opportunities in bilateral meetings to experience the commitment of senior officials in embarking countries. During the last two months, I visited two newcomer countries - Malaysia and UAE, and got first-hand information about their potential for a national nuclear program. During the side events of the last IAEA General Conference, senior officials from UAE, Turkey and Vietnam clearly expressed their commitments to nuclear power programmes with steady progress in the cooperation with vendor countries. I am impressed that these countries are working closely with vendor countries in developing the required physical infrastructure and human resources. Quite recently, I was informed that Belarus and Bangladesh had intergovernmental agreements with Russia to introduce nuclear power in their countries. So nuclear power remains an important option for energy supply. However, it is a fact that the public is concerned about nuclear safety, and several countries have experienced difficulties in national decisions to introduce nuclear power programmes. Although the situation differs among the countries, I hope that participants can learn good practices for public communication from the

  9. Agenda to address climate change

    This document looks at addressing climate change in the 21st century. Topics covered are: Responding to climate change; exploring new avenues in energy efficiency; energy efficiency and alternative energy; residential sector; commercial sector; industrial sector; transportation sector; communities; renewable energy; understanding forests to mitigate and adapt to climate change; the Forest Carbon budget; mitigation and adaptation

  10. Introduction to IP address management

    Rooney, Tim


    "The book begins with a basic overview of IP networking, followed by chapters describing each of the three core IPAM technologies: IPv4 and IPv6 addressing, DHCP, and DNS. The next three chapters describe IPAM management techniques and practice, followed by chapters on IPv4-IPv6 co-existence, security and the IPAM business case"--

  11. Keynote Address: Rev. Mark Massa

    Massa, Mark S.


    Rev. Mark S. Massa, S.J., is the dean and professor of Church history at the School of Theology and Ministry at Boston College. He was invited to give a keynote to begin the third Catholic Higher Education Collaborative Conference (CHEC), cosponsored by Boston College and Fordham University. Fr. Massa's address posed critical questions about…

  12. Communities Address Barriers to Connectivity.

    Byers, Anne


    Rural areas lag behind urban areas in access to information technologies. Public institutions play a critical role in extending the benefits of information technologies to those who would not otherwise have access. The most successful rural telecommunications plans address barriers to use, such as unawareness of the benefits, technophobia, the…

  13. Improved Secure Address Resolution Protocol

    Abhishek Samvedi; Sparsh Owlak; Vijay Kumar Chaurasia


    In this paper, an improved secure address resolution protocol is presented where ARP spoofing attack is prevented. The proposed methodology is a centralised methodology for preventing ARP spoofing attack. In the proposed model there is a central server on a network or subnet which prevents ARP spoofing attack.

  14. Rural-Urban Inequity in Unmet Obstetric Needs and Functionality of Emergency Obstetric Care Services in a Zambian District.

    Selia Ng'anjo Phiri

    Full Text Available Zambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district.A cross-sectional survey was conducted in 2011 as part of the 'Response to Accountable priority setting for Trust in health systems' (REACT project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities was used to assess deficit of life-saving interventions in urban and rural areas.A total of 2114 urban and 1226 rural childbirths occurring in emergency obstetric care facilities (excluding abortions were analysed. Facility childbirth constituted 81% of expected births in urban and 16% in rural areas. Based on the reference estimate that 1.4% of childbearing women were expected to need major obstetric intervention, unmet obstetric need was 77 of 106 women, thus 73% (95% CI 71-75% in rural areas whereas urban areas had no deficit. Major obstetric interventions for absolute maternal indications were higher in urban 2.1% (95% CI 1.60-2.71% than in rural areas 0.4% (95% CI 0.27-0.55%, with an urban to rural rate ratio of 5.5 (95% CI 3.55-8.76.Women in rural areas had deficient obstetric care. The likelihood of under-going a life-saving intervention was 5.5 times higher for women in urban than rural areas. Targeting rural women with life-saving services could substantially reduce this inequity and preventable deaths.

  15. 46 CFR 67.321 - Requirement to report change of address of managing owner.


    ... 46 Shipping 2 2010-10-01 2010-10-01 false Requirement to report change of address of managing... report change of address of managing owner. Upon the change of address of the managing owner of a documented vessel, the managing owner shall report the change of address to the National Vessel...

  16. Nanoscale content-addressable memory

    Davis, Bryan (Inventor); Principe, Jose C. (Inventor); Fortes, Jose (Inventor)


    A combined content addressable memory device and memory interface is provided. The combined device and interface includes one or more one molecular wire crossbar memories having spaced-apart key nanowires, spaced-apart value nanowires adjacent to the key nanowires, and configurable switches between the key nanowires and the value nanowires. The combination further includes a key microwire-nanowire grid (key MNG) electrically connected to the spaced-apart key nanowires, and a value microwire-nanowire grid (value MNG) electrically connected to the spaced-apart value nanowires. A key or value MNGs selects multiple nanowires for a given key or value.

  17. Caregivers for people with end-stage lung disease: Characteristics and unmet needs in the whole population

    David C Currow


    Full Text Available David C Currow1, Alicia Ward2, Katie Clark3, Catherine M Burns4, Amy P Abernethy1,51Department of Palliative and Supportive Services, Flinders University, Adelaide, Australia; 2Concord Repatriation General Hospital Palliative Care Department, Concord, Sydney, Australia; 3Notre Dame University, Darlinghurst, Sydney, Australia; 4Division of Medical Oncology, Department of Medicine, Duke University Medical Centre, Durham, North Carolina, USA; 5Division of Medical Oncology, Department of Medicine, Duke University Medical Centre, Durham, North Carolina, USAIntroduction: End-stage lung disease (ESLD (predominantly caused by chronic obstructive pulmonary disease and restrictive lung disease is a significant cause of death. Little is known about community care for people with ESLD especially in the period leading to death. This paper describes demographic characteristics of caregivers, and key characteristics of the deceased irrespective of specialist service utilization.Methods: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey conducted statewide. For the last eight years questions about end of life have been asked of 3000 respondents annually (participation rate 77.9%. Directly standardized to the whole population, this study describes people who cared for someone with ESLD until death.Results: One third (6370/18267 had someone die in the last five years from a terminal illness, 644 from ESLD (3.5% of respondents; 10.2% of deaths. One in five (20.8% provided physical care: 43 respondents provided day-to-day and 63 provided intermittent hands-on care for an average of 40.1 months (SD 56.9. Caregivers were on average 51.2 years old (range 17–85; SD 16.5 and one in five was a spouse. Additional support to provide physical care was an unmet need by 17% of caregivers. The deceased were an average of 73.9 years old (range 47–92; SD 10.4. Only 31.1% were assessed as ‘comfortable’ or ‘very comfortable

  18. Addressing concrete cracking in NPPs

    The phenomenon of concrete cracking is one of the most frequently encountered deterioration at NPPs as it has been shown by a wide Survey of NPPs performed by IAEA in 1994-95 It can be due to a multitude of causes such as the normal ageing process (shrinkage, creep, prestressing force loss) as well as exposure to the environment (temperature variation, moisture, freeze/thaw, etc) The above mentioned Survey has also shown that in 64% of cases, no action was taken or required. It became also obvious that there is a lack of guidance as when remedial actions are needed. The paper describes, with the help of a Flow Chart, the various stages to be considered, from the first step of identification of cracks, to the definition of causes, evaluation of extent of damage, evaluation of effect/implications (safety, reliability), to the final step of deciding if repair action is required. Finally, based upon a wide literature survey the paper proposes in a Chart format, Criteria for addressing concrete cracks in NPPs., when taking in considerations all these factors. This paper discusses the process which should lead to the selection of an effective repair method and proposes, based upon worldwide standards and literature, criteria which should lead to the decision whether to repair or not concrete cracks, after the cracks have been identified and evaluated, addressing the entire range of aspects involved. (author)

  19. Burden and Unmet Needs of Caregivers of Chronic Obstructive Pulmonary Disease Patients: A Systematic Review of the Volume and Focus of Research Output.

    Mansfield, Elise; Bryant, Jamie; Regan, Timothy; Waller, Amy; Boyes, Allison; Sanson-Fisher, Rob


    Caregivers of individuals with chronic obstructive pulmonary disease (COPD) experience significant burden. To develop effective interventions to support this vulnerable group, it is necessary to understand how this burden varies as a function of patient well-being and across the illness trajectory. This systematic review aimed to identify the number and type of data-based publications exploring the burden and unmet needs of caregivers of individuals with COPD. Medline, Embase, PsycINFO and Cochrane databases were searched for studies published between January 2000 and February 2014. Studies were eligible if they were quantitative studies examining unmet needs of, or burden on, adult caregivers of individuals with COPD. Eligible papers were categorised according to (i) type (i.e. descriptive, measurement and intervention studies); (ii) whether they measured associations between patient and caregiver burden and (iii) whether they measured caregiver burden longitudinally. Twenty-seven data-based papers met criteria for inclusion. There was a significant increase in the total number of publications over time. The majority of publications were descriptive studies (n = 25), with one measurement and one intervention study identified. Fourteen descriptive studies measured the relationship between patient or caregiver factors and caregiver burden. Only two studies measured caregiver burden over time. There are a number of gaps in the body of research examining burden and unmet needs of caregivers of individuals with COPD that preclude the development of effective interventions for this population. Greater research effort should be directed towards identifying rigorous measurement tools which more accurately characterise caregiver burden, so that evidence-based interventions can be developed. PMID:26979431

  20. The KAP-gap in Nepal: reasons for non-use of contraception among couples with an unmet need for family planning.

    Shrestha, A; Stoeckel, J; Tuladhar, J M


    This report summarizes the findings of a study designed to identify the reasons for non-use of family planning among Nepalese women who want to space or limit childbirth. The study's initial phase involved focus group sessions of women with unmet need for family planning who were asked their reasons for non-use. Researchers used this information to develop an in-depth questionnaire. Researchers then randomly selected a total sample of 5,152 women. After interviewing the women, researchers concluded that 31.6% the sample had unmet need for family planning. Consequently, researchers administered the questionnaire to the unmet demand population, which was almost equally divided among women who want to either spacing or limit childbirth. The study analyzes both reasons for the general non-use of contraception and reasons for the non-use of specific contraceptive methods (oral contraceptives, laparoscopy, and vasectomy). Although varying among the different contraceptive methods, the most commonly cited reasons were: 1) causes headache, weakness, nausea; 2) causes weight loss; 3) causes heavy bleeding; 4) insufficient money for nutritious foods; 5) causes weakness and cannot work; 6) currently in poor health; 7) husband disapproves; and 8) affects breastfeeding and dries breast-milk. Explaining the benefits of the study, the report indicates that the information can be incorporated into the training curriculum of health workers, and can be used to target information, education, and communication campaigns. Furthermore, evident in the responses that cite lack of nutritious foods and weakness, the study reveals that nutrition and food supplement programs could help increase contraceptive use. PMID:12343262

  1. Addressing viral resistance through vaccines

    Laughlin, Catherine; Schleif, Amanda; Heilman, Carole A


    Antimicrobial resistance is a serious healthcare concern affecting millions of people around the world. Antiviral resistance has been viewed as a lesser threat than antibiotic resistance, but it is important to consider approaches to address this growing issue. While vaccination is a logical strategy, and has been shown to be successful many times over, next generation viral vaccines with a specific goal of curbing antiviral resistance will need to clear several hurdles including vaccine design, evaluation and implementation. This article suggests that a new model of vaccination may need to be considered: rather than focusing on public health, this model would primarily target sectors of the population who are at high risk for complications from certain infections. PMID:26604979

  2. Addressing failures in exascale computing

    Snir, Marc; Wisniewski, Robert W.; Abraham, Jacob A.; Adve, Sarita; Bagchi, Saurabh; Balaji, Pavan; Belak, Jim; Bose, Pradip; Cappello, Franck; Carlson, William; Chien, Andrew A.; Coteus, Paul; Debardeleben, Nathan A.; Diniz, Pedro; Engelmann, Christian; Erez, Mattan; Saverio, Fazzari; Geist, Al; Gupta, Rinku; Johnson, Fred; Krishnamoorthy, Sriram; Leyffer, Sven; Liberty, Dean; Mitra, Subhasish; Munson, Todd; Schreiber, Robert; Stearly, Jon; Van Hensbergen, Eric


    We present here a report produced by a workshop on “Addressing Failures in Exascale Computing” held in Park City, Utah, August 4–11, 2012. The charter of this workshop was to establish a common taxonomy about resilience across all the levels in a computing system; discuss existing knowledge on resilience across the various hardware and software layers of an exascale system; and build on those results, examining potential solutions from both a hardware and software perspective and focusing on a combined approach. The workshop brought together participants with expertise in applications, system software, and hardware; they came from industry, government, and academia; and their interests ranged from theory to implementation. The combination allowed broad and comprehensive discussions and led to this document, which summarizes and builds on those discussions.

  3. Addressing Failures in Exascale Computing

    Snir, Marc [Argonne National Laboratory (ANL); Wisniewski, Robert [Intel Corporation; Abraham, Jacob [unknown; Adve, Sarita [University of Illinois, Urbana-Champaign; Bagchi, Saurabh [Purdue University; Balaji, Pavan [Argonne National Laboratory (ANL); Belak, J. [Lawrence Livermore National Laboratory (LLNL); Bose, Pradip [IBM T. J. Watson Research Center; Cappello, Franck [Argonne National Laboratory (ANL); Carlson, Bill [unknown; Chien, Andrew [University of Chicago; Coteus, Paul [IBM T. J. Watson Research Center; DeBardeleben, Nathan [Los Alamos National Laboratory (LANL); Diniz, Pedro [University of Southern California; Engelmann, Christian [ORNL; Erez, Mattan [University of Texas at Austin; Fazzari, Saverio [Booz Allen Hamilton; Geist, Al [ORNL; Gupta, Rinku [Argonne National Laboratory (ANL); Johnson, Fred [Science Applications International Corporation (SAIC), Oak Ridge, TN; Krishnamoorthy, Sriram [Pacific Northwest National Laboratory (PNNL); Leyffer, Sven [Argonne National Laboratory (ANL); Liberty, Dean [AMD; Mitra, Subhasish [Stanford University; Munson, Todd [Argonne National Laboratory (ANL); Schreiber, Rob [HP Labs; Stearley, Jon [Sandia National Laboratories (SNL); Van Hensbergen, Eric [ARM


    We present here a report produced by a workshop on Addressing failures in exascale computing' held in Park City, Utah, 4-11 August 2012. The charter of this workshop was to establish a common taxonomy about resilience across all the levels in a computing system, discuss existing knowledge on resilience across the various hardware and software layers of an exascale system, and build on those results, examining potential solutions from both a hardware and software perspective and focusing on a combined approach. The workshop brought together participants with expertise in applications, system software, and hardware; they came from industry, government, and academia, and their interests ranged from theory to implementation. The combination allowed broad and comprehensive discussions and led to this document, which summarizes and builds on those discussions.

  4. Building Footprints - Montana Structures/Addresses Framework

    NSGIC GIS Inventory (aka Ramona) — The Montana Structures/Addresses Framework is a statewide spatial database of structure and address points in the State of Montana. The Montana Structures/Addresses...

  5. Supportive care needs among Indigenous cancer patients in Queensland, Australia: less comorbidity is associated with greater practical and cultural unmet need.

    Diaz, A; Bernardes, C M; Garvey, G; Valery, P C


    Little is known about the supportive care needs (SCN) of Australian Indigenous cancer patients. This cross-sectional study investigated the association between comorbidity and SCN among newly diagnosed Indigenous cancer patients in Queensland. Comorbidity was ascertained from medical chart review using the Charlson Comorbidity Index (CCI) and SCN were measured using the Supportive Care Needs Assessment Tool for Indigenous Peoples (SCNAT-IP). Of 183 participants, 76 (42%) had no comorbidity (CCI = 0), 60 (33%) had had a CCI score of 1 and 47 (26%) had a CCI of two or more, with the most common condition being diabetes (30%). The most common moderate-high unmet need items varied between comorbidity groups, although all patients most frequently reported moderate-high unmet need in the Physical and Psychological and the Practical and Cultural needs domains. Patients with the greatest comorbidity (CCI ≥ 2) had significantly more reduced odds of practical and cultural needs than patients without comorbidity (OR 0.28, 95% CI 0.11-0.75). This appeared to be partially explained by time since diagnosis, age, whether they were receiving current treatment and residential remoteness. Patients' experience of chronic disease, hospitals and the healthcare system may better prepare them for the practical and cultural aspects of their cancer journey. PMID:26918689

  6. Quality of life, unmet needs, and iatrogenic injuries in rehabilitation of patients with Ehlers-Danlos Syndrome hypermobility type/Joint Hypermobility Syndrome.

    Bovet, Claire; Carlson, Matthew; Taylor, Matthew


    Ehlers-Danlos Syndrome, hypermobility type (EDS-HT) and the joint hypermobility syndrome (JHS) are connective tissue disorders that form an overlapping clinical syndrome and are associated with frequent medical visits and substantial morbidity. EDS-HT/JHS-associated pain correlates with poor quality of life. While physical therapy is the recommended treatment for EDS-HT/JHS, little is known about therapy-related patient experiences and iatrogenic injuries. We studied 38 adult EDS-HT/JHS patients, eliciting health-related quality of life (HRQoL) from 28 patients through the RAND SF-36 questionnaire. We also explored physical therapy experiences through focus groups with 13 patients. Our patients displayed poor HRQoL, with 71% reporting worse health over the past year. SF-36 scores were significantly lower than the scores of the average American population (P < 0.001 for 8 of 10 categories assessed), but were comparable to EDS-HT/JHS populations in Belgium, the Netherlands, Sweden, and Italy. Focus groups identified factors associated with: negative past physical therapy experiences, iatrogenic joint injuries, positive treatment experiences, and unmet rehabilitation needs. This group of EDS-HT/JHS patients has significant decrements in HRQoL and many unmet treatment needs, as well as a risk for iatrogenic injuries. We identify several approaches to help meet patients' needs and improve joint rehabilitation in patients with EDS-HT/JHS. © 2016 Wiley Periodicals, Inc. PMID:27273746

  7. Prediction of Unmet Primary Care Needs for the Medically Vulnerable Post-Disaster: An Interrupted Time-Series Analysis of Health System Responses

    Amy B. Martin


    Full Text Available Disasters serve as shocks and precipitate unanticipated disturbances to the health care system. Public health surveillance is generally focused on monitoring latent health and environmental exposure effects, rather than health system performance in response to these local shocks. The following intervention study sought to determine the long-term effects of the 2005 chlorine spill in Graniteville, South Carolina on primary care access for vulnerable populations. We used an interrupted time-series approach to model monthly visits for Ambulatory Care Sensitive Conditions, an indicator of unmet primary care need, to quantify the impact of the disaster on unmet primary care need in Medicaid beneficiaries. The results showed Medicaid beneficiaries in the directly impacted service area experienced improved access to primary care in the 24 months post-disaster. We provide evidence that a health system serving the medically underserved can prove resilient and display improved adaptive capacity under adverse circumstances (i.e., technological disasters to ensure access to primary care for vulnerable sub-groups. The results suggests a new application for ambulatory care sensitive conditions as a population-based metric to advance anecdotal evidence of secondary surge and evaluate pre- and post-health system surge capacity following a disaster.

  8. Gender: addressing a critical focus.

    Thornton, L; Wegner, M N


    The definition of gender was addressed at the Fourth World Conference on Women (Beijing, China). After extensive debate, the definition developed by the UN Population Fund in 1995 was adopted: "a set of qualities and behaviors expected from a female or male by society." The sustainability of family planning (FP) programs depends on acknowledgment of the role gender plays in contraceptive decision-making and use. For example, programs must consider the fact that women in many cultures do not make FP decisions without the consent of their spouse. AVSC is examining providers' gender-based ideas about clients and the effects of these views on the quality of reproductive health services. Questions such as how service providers can encourage joint responsibility for contraception without requiring spousal consent or how they can make men feel comfortable about using a male method in a society where FP is considered a woman's issue are being discussed. Also relevant is how service providers can discuss sexual matters openly with female clients in cultures that do not allow women to enjoy their sexuality. Another concern is the potential for physical violence to a client as a result of the provision of FP services. PMID:12294397

  9. Addressing verification challenges [International safeguards symposium on addressing verification challenges

    In his welcome address the Director General of the International Atomic Energy Agency (IAEA), Mr. M. ElBaradei, stated that safeguards activities are probably the most difficult task entrusted to an international organization and to determine all the details of a country's nuclear programme is a daunting challenge that raises a number of questions. There is an increase in nuclear power around the globe as a result of shortages of energy and concerns about energy independence and climate change. On the one hand, this is good, because without energy there is no hope for development on the other hand, however, it means that nuclear know-how and nuclear technology will continue to spread to more and more countries. There is also an increase in the number of countries interested in developing nuclear fuel cycle capabilities: sensitive fuel cycle activities, reprocessing and above all uranium enrichment. It even seems that some countries might be hedging their bets in order to have the know-how should they need to develop their own deterrence. Verifying enrichment or reprocessing facilities is quite difficult, and the so-called conversion time is extremely short. Thus, the IAEA is dealing with what is called 'virtual nuclear weapon States'. The IAEA has been talking for a number of years about the need to develop a new international or multinational approach to the fuel cycle in order to avoid a situation with nine nuclear weapon States and another 20 or 30 States having the capacity to develop nuclear weapons in a very short period of time. There is a need to remember that there is a linkage between nuclear disarmament and non-proliferation. Furthermore safeguards activities, though fundamentally technical in nature, are carried out in a political charged environment. The security dimension - that is, nuclear terrorism - also presents a new challenge, because State systems of accounting for and control of nuclear material are no longer simply tools for safeguards, but

  10. Addressing concerns and achieving expectations

    Miller, C.L. [Dept. of Energy, Washington, DC (United States)


    Approximately 2-1/2 years ago many of us were gathered here in Prague at a similar conference with a similar name, {open_quotes}Energy and Environment: Transitions in Eastern Europe.{close_quotes} Over 300 professionals from 26 nations attended. The objective of the conference was to: Facilitate the Solution of Long and Short Term Energy and Environmental Problems in Eastern Europe by Bringing Together People, ideas and technologies which could be applied to specific problems in a logical step-by-step manner. It was conceded at the time that the long term solution would consist of thoughtfully integrated steps and that the conference was the first step. We are here in the Czech Republic again this week to continue what was started. As before, this conference continues to: (1) Provide a forum to identify and discuss cost-effective environmentally acceptable energy and environmental technology options and their associated socioeconomic issues. (2) Stimulate the Formation of business partnerships (3) Identify key barrier issues hindering technology applications and identify implementation pathways that eliminate or avoid obstacles to progress.