WorldWideScience

Sample records for access programs evidence

  1. Evidence-based policy versus morality policy: the case of syringe access programs.

    Science.gov (United States)

    de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

    2015-01-01

    Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

  2. Increasing access to evidence-based smoking cessation treatment: effectiveness of a free nicotine patch program among Chinese immigrants.

    Science.gov (United States)

    Shelley, Donna; Nguyen, Nam; Peng, Cha-Hui; Chin, Margaret; Chang, Ming-der; Fahs, Marianne

    2010-04-01

    Pharmacotherapy substantially increases smoking cessation rates. However, programs to reduce barriers to this evidence-based treatment may not improve access among high risk immigrant non English speaking populations. This study estimates the effectiveness of a tailored free nicotine patch (NRT) program among Chinese American smokers living in New York City (NYC). Between July 2004 and May 2005 NRT was distributed to 375 smokers through two community-based organizations that serve the Asian American population in NYC. Participants completed an in person baseline survey and a 4-month follow-up telephone survey. Using an intention to treat analysis the abstinence rate at 4 months was 26.7% (100/375). Predictors of cessation included higher levels of self efficacy at baseline, not smoking while using the patch and concern about personal health risks. Distribution through easy to access, culturally competent local community organizations increased the reach of a free nicotine patch program and assisted smokers in quitting.

  3. 77 FR 66052 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... delivered, cable-affiliated RSNs in the 2010 Program Access Order. 3. With respect to the first element (the... exclusive contract involving a cable-affiliated RSN is an ``unfair act.'' In the 2010 Program Access Order... Agreements 18. ACA also urges the Commission to revise the program access rules to prohibit cable-affiliated...

  4. Evidence Aid: Using Systematic Reviews to Improve Access to Evidence for Humanitarian Emergencies

    Directory of Open Access Journals (Sweden)

    Mike Clarke

    2017-10-01

    Full Text Available Evidence Aid is an international initiative to improve access to reliable evidence that will help people and organisations make well-informed decisions about interventions, actions and strategies in the disaster setting. It focuses on systematic reviews as the most reliable source of research evidence, maximising the power of existing research, avoiding undue emphasis on single studies and reducing the waste associated with research that is ignored or not accessible to decision makers. Evidence Aid is knowledge champion for influencers of the humanitarian sector, including funders, policy makers, NGOs, and humanitarian professionals. Evidence Aid was established by members of the Cochrane Collaboration after the Indian Ocean tsunami of December 2004. It provides access to information relevant to disaster risk reduction, planning, response, recovery, resilience and rehabilitation. This presentation will discuss the need for Evidence Aid, and describes its activities.Find out more about Mike.

  5. Notified Access: Extending Remote Memory Access Programming Models for Producer-Consumer Synchronization

    KAUST Repository

    Belli, Roberto; Hoefler, Torsten

    2015-01-01

    Remote Memory Access (RMA) programming enables direct access to low-level hardware features to achieve high performance for distributed-memory programs. However, the design of RMA programming schemes focuses on the memory access and less on the synchronization. For example, in contemporary RMA programming systems, the widely used producer-consumer pattern can only be implemented inefficiently, incurring in an overhead of an additional round-trip message. We propose Notified Access, a scheme where the target process of an access can receive a completion notification. This scheme enables direct and efficient synchronization with a minimum number of messages. We implement our scheme in an open source MPI-3 RMA library and demonstrate lower overheads (two cache misses) than other point-to-point synchronization mechanisms for each notification. We also evaluate our implementation on three real-world benchmarks, a stencil computation, a tree computation, and a Colicky factorization implemented with tasks. Our scheme always performs better than traditional message passing and other existing RMA synchronization schemes, providing up to 50% speedup on small messages. Our analysis shows that Notified Access is a valuable primitive for any RMA system. Furthermore, we provide guidance for the design of low-level network interfaces to support Notified Access efficiently.

  6. Notified Access: Extending Remote Memory Access Programming Models for Producer-Consumer Synchronization

    KAUST Repository

    Belli, Roberto

    2015-05-01

    Remote Memory Access (RMA) programming enables direct access to low-level hardware features to achieve high performance for distributed-memory programs. However, the design of RMA programming schemes focuses on the memory access and less on the synchronization. For example, in contemporary RMA programming systems, the widely used producer-consumer pattern can only be implemented inefficiently, incurring in an overhead of an additional round-trip message. We propose Notified Access, a scheme where the target process of an access can receive a completion notification. This scheme enables direct and efficient synchronization with a minimum number of messages. We implement our scheme in an open source MPI-3 RMA library and demonstrate lower overheads (two cache misses) than other point-to-point synchronization mechanisms for each notification. We also evaluate our implementation on three real-world benchmarks, a stencil computation, a tree computation, and a Colicky factorization implemented with tasks. Our scheme always performs better than traditional message passing and other existing RMA synchronization schemes, providing up to 50% speedup on small messages. Our analysis shows that Notified Access is a valuable primitive for any RMA system. Furthermore, we provide guidance for the design of low-level network interfaces to support Notified Access efficiently.

  7. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP).

    Science.gov (United States)

    O'Dare Wilson, Kellie

    2017-04-01

    Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.

  8. Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Herrera, Christine; Hanning, Rhona; Lessio, Anne; Rush, Brian

    2013-01-01

    In public health and chronic disease prevention there is increasing priority for effective use of evidence in practice. In Ontario, Canada, despite various models being advanced, public health practitioners are seeking ways to identify and apply evidence in their work in practical and meaningful ways. In a companion article, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Assessment Tool,” we describe use of a tool to assess and strengthen program planning and implementation processes using 19 criteria derived from best and promising practices literature. In this article, we describe use of a complementary Program Evidence Tool to identify, synthesize, and apply a range of evidence sources to strengthen the content of chronic disease prevention programming. The Program Evidence Tool adapts tools of evidence-based medicine to the unique contexts of community-based health promotion and chronic disease prevention. Knowledge management tools and a guided dialogue process known as an Evidence Forum enable community stakeholders to make appropriate use of evidence in diverse social, political, and structural contexts. Practical guidelines and worksheets direct users through 5 steps: 1) define an evidence question, 2) develop a search strategy, 3) collect and synthesize evidence, 4) interpret and adapt evidence, and 5) implement and evaluate. We describe the Program Evidence Tool’s benefits, strengths, challenges, and what was learned from its application in 4 Ontario public health departments. The Program Evidence Tool contributes to the development and understanding of the complex use of evidence in community-based chronic disease prevention. PMID:23721788

  9. Association of mandated language access programming and quality of care provided by mental health agencies.

    Science.gov (United States)

    McClellan, Sean R; Snowden, Lonnie

    2015-01-01

    This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.

  10. 49 CFR 28.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

  11. 32 CFR 1699.149 - Program accessibility: discrimination prohibited.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Program accessibility: discrimination prohibited... CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as... participation in, or otherwise be subject to discrimination under any program or activity conducted by the...

  12. Spontaneous diffusion of an effective skin cancer prevention program through Web-based access to program materials.

    Science.gov (United States)

    Hall, Dawn M; Escoffery, Cam; Nehl, Eric; Glanz, Karen

    2010-11-01

    Little information exists about the diffusion of evidence-based interventions, a process that can occur naturally in organized networks with established communication channels. This article describes the diffusion of an effective skin cancer prevention program called Pool Cool through available Web-based program materials. We used self-administered surveys to collect information from program users about access to and use of Web-based program materials. We analyzed the content of e-mails sent to the official Pool Cool Web site to obtain qualitative information about spontaneous diffusion. Program users were dispersed throughout the United States, most often learning about the program through a Web site (32%), publication (26%), or colleague (19%). Most respondents (86%) reported that their pool provided educational activities at swimming lessons. The Leader's Guide (59%) and lesson cards (50%) were the most commonly downloaded materials, and most respondents reported using these core items sometimes, often, or always. Aluminum sun-safety signs were the least frequently used materials. A limited budget was the most commonly noted obstacle to sun-safety efforts at the pool (85%). Factors supporting sun safety at the pool centered around risk management (85%) and health of the pool staff (78%). Diffusion promotes the use of evidence-based health programs and can occur with and without systematic efforts. Strategies such as providing well-packaged, user-friendly program materials at low or no cost and strategic advertisement of the availability of program materials may increase program use and exposure. Furthermore, highlighting the benefits of the program can motivate potential program users.

  13. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

  14. Access to Investigational Drugs: FDA Expanded Access Programs or "Right-to-Try" Legislation?

    Science.gov (United States)

    Holbein, M E Blair; Berglund, Jelena P; Weatherwax, Kevin; Gerber, David E; Adamo, Joan E

    2015-10-01

    The Food and Drug Administration Expanded Access (EA) program and "Right-to-Try" legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. The FDA EA program includes Single Patient-Investigational New Drug (SP-IND), Emergency SP-IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. "Right-to-Try" legislation bypasses some of these steps, but provides no regulatory or safety oversight. The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP-IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. © 2015 Wiley Periodicals, Inc.

  15. A novel IPTV program multiplex access system to EPON

    Science.gov (United States)

    Xu, Xian; Liu, Deming; He, Wei; Lu, Xi

    2007-11-01

    With the rapid development of high speed networks, such as Ethernet Passive Optical Network (EPON), traffic patterns in access networks have evolved from traditional text-oriented service to the mixed text-, voice- and video- based services, leading to so called "Triple Play". For supporting IPTV service in EPON access network infrastructure, in this article we propose a novel IPTV program multiplex access system to EPON, which enables multiple IPTV program source servers to seamlessly access to IPTV service access port of optical line terminal (OLT) in EPON. There are two multiplex schemes, namely static multiplex scheme and dynamic multiplex scheme, in implementing the program multiplexing. Static multiplex scheme is to multiplex all the IPTV programs and forward them to the OLT, regardless of the need of end-users. While dynamic multiplex scheme can dynamically multiplex and forward IPTV programs according to what the end-users actually demand and those watched by no end-user would not be multiplexed. By comparing these two schemes, a reduced traffic of EPON can be achieved by using dynamic multiplex scheme, especially when most end-users are watching the same few IPTV programs. Both schemes are implemented in our system, with their hardware and software designs described.

  16. Evidence supporting broader access to safe legal abortion.

    Science.gov (United States)

    Faúndes, Anibal; Shah, Iqbal H

    2015-10-01

    Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal condition for abortion is met. The present article aims to contribute to a better understanding that one can be in favor of greater access to safe abortion services, while at the same time not be "in favor of abortion," by reviewing the evidence that indicates that criminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates. Copyright © 2015. Published by Elsevier Ireland Ltd.

  17. Access to Investigational Drugs: FDA Expanded Access Programs or “Right‐to‐Try” Legislation?

    Science.gov (United States)

    Berglund, Jelena P.; Weatherwax, Kevin; Gerber, David E.; Adamo, Joan E.

    2015-01-01

    Abstract Purpose The Food and Drug Administration Expanded Access (EA) program and “Right‐to‐Try” legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. Methods FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. Results The FDA EA program includes Single Patient‐Investigational New Drug (SP‐IND), Emergency SP‐IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. “Right‐to‐Try” legislation bypasses some of these steps, but provides no regulatory or safety oversight. Conclusion The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP‐IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. PMID:25588691

  18. Use of Evidence in the Implementation of Social Programs: A Qualitative Study from Chile.

    Science.gov (United States)

    Flores, Rodrigo; Naranjo, Carola; Hein, Andreas

    2016-01-01

    Through this qualitative, empirical study the authors aim to explore and describe the sources of knowledge that are used to guide intervention practice by social workers in Chile. Particular attention was paid to factors that may facilitate or hinder the use of research-based evidence to guide social interventions design, implementation, and outcome evaluation. In order to explore these issues, 25 semi-structured interviews with social workers from Chilean social service non-profit organizations were conducted. The main findings suggest that social workers do not use research-based evidence to support their social interventions due to various personal organizational constraints (e.g., lack of time, lack of access to resources for disseminating evidence, lack of English command). In addition, no evaluation processes of social programs which will support evidence-based effectiveness could be found. One key barrier to support use of evidence and evidence production may be related to the fact that most non-governmental organizations maintain a hierarchical and vertical relationship with state agencies (program design, oversight, and funding) for social program development.

  19. The development of accessibility indicators for distance learning programs

    Directory of Open Access Journals (Sweden)

    Sheryl Burgstahler

    2006-12-01

    Full Text Available A study was undertaken to explore program policies and practices related to the accessibility of American distance learning courses to qualified students with disabilities. A literature review was conducted, a draft list of accessibility indicators was created, examples of applications of the indicators in existing distance learning programs were collected, the indicators were systematically applied to one distance learning program, input from a variety of distance learning programs was used to further refine the indicators, and these programs were encouraged to adopt the indicators and make use of resources provided by the project. Results of this exploratory work suggest that incorporating accessibility considerations into policies, procedures and communications of a program requires consideration of the unique needs of students, course designers, instructors and evaluators; involves approval and implementation at a variety of administrative levels; and is an ongoing process that may be implemented in incremental steps.

  20. Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception

    Science.gov (United States)

    Bailey, Martha J.

    2014-01-01

    This paper assembles new evidence on some of the longer-term consequences of U.S. family planning policies, defined in this paper as those increasing legal or financial access to modern contraceptives. The analysis leverages two large policy changes that occurred during the 1960s and 1970s: first, the interaction of the birth control pill’s introduction with Comstock-era restrictions on the sale of contraceptives and the repeal of these laws after Griswold v. Connecticut in 1965; and second, the expansion of federal funding for local family planning programs from 1964 to 1973. Building on previous research that demonstrates both policies’ effects on fertility rates, I find suggestive evidence that individuals’ access to contraceptives increased their children’s college completion, labor force participation, wages, and family incomes decades later. PMID:25339778

  1. 75 FR 34941 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-06-21

    ... Commission's Program Access Rules and Examination of Programming Tying Arrangements AGENCY: Federal... Program Access Rules and Examination of Programming Tying Arrangements, MB Docket No. 07-198, FCC 10-17... information collection is contained in Sections 4(i), 303(r), and 628 of the Communications Act of 1934, as...

  2. Pediatric Diabetes Telemedicine Program Improves Access to Care for Rural Families: Role of APRNs.

    Science.gov (United States)

    Smith, Nancy Marie; Satyshur, Rosemarie DiMauro

    2016-01-01

    Type 1 diabetes mellitus has increased in children by 23% from 2001 to 2009. Rural communities additionally have increased disparities related to access barriers and a large minority population with poorer overall health. Research evidence supports telemedicine as an effective alternative to bring preventive diabetes care to remote areas. This article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program at a rural pediatric outpatient specialty clinic in partnership with a tertiary center telemedicine network. The telemedicine program quality improvement (QI) project explored caregiver satisfaction with a convenience sample of caregivers (N = 14) using a nine-item Telemedicine Diabetes Caregiver Satisfaction Survey (TDCSS), with responses ranging from 1 = strongly disagree to 5 = strongly agree. Findings indicate caregivers were highly satisfied with communication/ privacy (M = 4.8), access to care (M = 4.1), and quality of services (M = 5.0). The multidisciplinary collaborative teamwork, continuous QI, and dependable technology were integral to the quality of the telemedicine clinical initiative. APRNs provided technology expertise, interdisciplinary collaboration leadership, care coordination, and advocacy for policy changes. Results demonstrate that telemedicine and APRN leadership can help implement innovative programs into rural communities to improve access to care, healthcare cost, and outcomes.

  3. Evidence Supporting Broader Access To Safe Legal Abortion

    OpenAIRE

    Faundes; Anibal; Shah; Iqbal H.

    2016-01-01

    Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal con...

  4. Programming and Technology for Accessibility in Geoscience

    Science.gov (United States)

    Sevre, E.; Lee, S.

    2013-12-01

    Many people, students and professors alike, shy away from learning to program because it is often believed to be something scary or unattainable. However, integration of programming into geoscience education can be a valuable tool for increasing the accessibility of content for all who are interested. It is my goal to dispel these myths and convince people that: 1) Students with disabilities can use programming to increase their role in the classroom, 2) Everyone can learn to write programs to simplify daily tasks, 3) With a deep understanding of the task, anyone can write a program to do a complex task, 4) Technology can be combined with programming to create an inclusive environment for all students of geoscience, and 5) More advanced knowledge of programming and technology can lead geoscientists to create software to serve as assistive technology in the classroom. It is my goal to share my experiences using technology to enhance the classroom experience as a way of addressing the aforementioned issues. Through my experience, I have found that programming skills can be included and learned by all to enhance the content of courses without detracting from curriculum. I hope that, through this knowledge, geoscience courses can become more accessible for people with disabilities by including programming and technology to the benefit of all involved.

  5. Availability and accessibility of evidence-based information resources provided by medical libraries in Australia.

    Science.gov (United States)

    Ritchie, A; Sowter, B

    2000-01-01

    This article reports on the results of an exploratory survey of the availability and accessibility of evidence-based information resources provided by medical libraries in Australia. Although barriers impede access to evidence-based information for hospital clinicians, the survey revealed that Medline and Cinahl are available in over 90% of facilities. In most cases they are widely accessible via internal networks and the Internet. The Cochrane Library is available in 69% of cases. The Internet is widely accessible and most libraries provide access to some full-text, electronic journals. Strategies for overcoming restrictions and integrating information resources with clinical workflow are being pursued. State, regional and national public and private consortia are developing agreements utilising on-line technology. These could produce cost savings and more equitable access to a greater range of evidence-based resources.

  6. JASPAR RESTful API: accessing JASPAR data from any programming language.

    Science.gov (United States)

    Khan, Aziz; Mathelier, Anthony

    2018-05-01

    JASPAR is a widely used open-access database of curated, non-redundant transcription factor binding profiles. Currently, data from JASPAR can be retrieved as flat files or by using programming language-specific interfaces. Here, we present a programming language-independent application programming interface (API) to access JASPAR data using the Representational State Transfer (REST) architecture. The REST API enables programmatic access to JASPAR by most programming languages and returns data in eight widely used formats. Several endpoints are available to access the data and an endpoint is available to infer the TF binding profile(s) likely bound by a given DNA binding domain protein sequence. Additionally, it provides an interactive browsable interface for bioinformatics tool developers. This REST API is implemented in Python using the Django REST Framework. It is accessible at http://jaspar.genereg.net/api/ and the source code is freely available at https://bitbucket.org/CBGR/jaspar under GPL v3 license. aziz.khan@ncmm.uio.no or anthony.mathelier@ncmm.uio.no. Supplementary data are available at Bioinformatics online.

  7. Evidence and Feasibility of Implementing an Integrated Wellness Program in Northeast Georgia.

    Science.gov (United States)

    Flanigan, Amber; Salm Ward, Trina

    2017-08-01

    Evidence for the connection between physical and mental health is growing, as is interest in providing a holistic, mind-body approach to improving mental health and wellness. A needs assessment in northeast Georgia identified several regional health priorities, including mental health and substance abuse, access to care, and cardiovascular health. The study's purpose is threefold: to (1) review evidence for integrated mind-body wellness services, (2) explore the feasibility of implementing wellness services in a small mental health agency serving northeast Georgia, and (3) conduct a brief survey assessing interest in a wellness program. The literature search identified articles within the past 10 years with these key words: "yoga," "mental health," "wellness program," "complementary alternative medicine," "tai chi," "mindfulness," "meditation," and "nutrition." The survey was distributed to the agency's affiliates. The literature review identified strong evidence for an integrated mind-body wellness program that includes yoga, tai chi, mindfulness meditation, and nutrition education. Among 73 survey respondents, 86 percent indicated interest in wellness services, and 85 percent agreed that wellness services are important to mental health and well-being. Authors suggest a model to incorporate a holistic wellness program to complement mental health services and help facilitate physical and mental health. © 2017 National Association of Social Workers.

  8. 41 CFR 105-8.152 - Program accessibility: Assignment of space.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Program accessibility: Assignment of space. 105-8.152 Section 105-8.152 Public Contracts and Property Management Federal Property...-8.152 Program accessibility: Assignment of space. (a) When GSA assigns or reassigns space to an...

  9. [Project evidência [evidence]: research and education about accessing scientific databases in Azores].

    Science.gov (United States)

    Soares, Hélia; Pereira, Sandra M; Neves, Ajuda; Gomes, Amy; Teixeira, Bruno; Oliveira, Carolina; Sousa, Fábio; Tavares, Márcio; Tavares, Patrícia; Dutra, Raquel; Pereira, Hélder Rocha

    2013-04-01

    Project Evidência [Evidence] intends to promote the use of scientific databases among nurses. This study aims to design educational interventions that facilitate nurses' access to these databases, to determine nurses' habits regarding the use of scientific databases, and to determine the impact that educational interventions on scientific databases have on Azorean nurses who volunteered for this project. An intervention project was conducted, and a quantitative descriptive survey was designed to evaluate the impact two and five months after the educational intervention. This impact was investigated considering certain aspects, namely, the nurses' knowledge, habits and reasons for using scientific databases. A total of 192 nurses participated in this study, and the primary results indicate that the educational intervention had a positive impact based not only on the increased frequency of using platforms or databases of scientific information (DSIs) s but also on the competence and self-awareness regarding its use and consideration of the reasons for accessing this information.

  10. Ocean Drilling Program: Web Site Access Statistics

    Science.gov (United States)

    web site ODP/TAMU Science Operator Home Ocean Drilling Program Web Site Access Statistics* Overview See statistics for JOIDES members. See statistics for Janus database. 1997 October November December

  11. Open-Access Physical Activity Programs for Older Adults: A Pragmatic and Systematic Review.

    Science.gov (United States)

    Balis, Laura E; Strayer, Thomas; Ramalingam, NithyaPriya; Wilson, Meghan; Harden, Samantha M

    2018-01-10

    Open-access, community-based programs are recommended to assist older adults in meeting physical activity guidelines, but the characteristics, impact, and scalability of these programs is less understood. The Land-Grant University Cooperative Extension System, an organization providing education through county-based educators, functions as a delivery system for these programs. A systematic review was conducted to determine characteristics of effective older adult physical activity programs and the extent to which programs delivered in Extension employ these characteristics. A systematic review of peer-reviewed and grey literature was conducted from August 2016 to February 2017. The review was limited to open-access (available to all), community-based physical activity interventions for older adults (≥65 years of age). The peer-reviewed literature search was conducted in PubMed and EBSCOhost; the grey literature search for Extension interventions was conducted through Extension websites, Land-Grant Impacts, and the Journal of Extension. Sixteen peer-reviewed studies and 17 grey literature sources met inclusion criteria and were analyzed. Peer-reviewed and Extension programs were similar in their limited use of behavioral theories and group-based strategies. Compared to Extension programs, those in the peer-reviewed literature were more likely to use a combination of physical activity components and be delivered by trained professionals. The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Environmental Research Division's Data Access Program (ERDDAP)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — ERDDAP (the Environmental Research Division's Data Access Program) is a data server that gives you a simple, consistent way to download subsets of scientific...

  13. Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

    Science.gov (United States)

    Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

    2018-03-01

    Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have 45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

  14. 49 CFR 28.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 28.150 Section 28.150 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28...

  15. Technological Innovation and Cooperation for Foreign Information Access Program

    Science.gov (United States)

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

    The Technological Innovation and Cooperation for Foreign Information Access (TICFIA) Program supports projects focused on developing innovative technologies for accessing, collecting, organizing, preserving, and disseminating information from foreign sources to address the U.S.' teaching and research needs in international education and foreign…

  16. 76 FR 2686 - Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and...

    Science.gov (United States)

    2011-01-14

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 10-2320] Video Programming and Emergency Access Advisory... appointment of members of the Video Programming and Emergency Access Advisory Committee (``Committee'' or... change of the Committee's popular name to the Video Programming Accessibility Advisory Committee (``VPAAC...

  17. 12 CFR 410.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: Existing facilities. 410.150 Section 410.150 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  18. 12 CFR 410.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: Discrimination prohibited. 410.149 Section 410.149 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  19. 77 FR 6113 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2012-02-07

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 12-15] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding the provision of video description, access to emergency programming, and access to user...

  20. The Impact of Financial Access on Firm Growth: Evidence from ...

    African Journals Online (AJOL)

    The Impact of Financial Access on Firm Growth: Evidence from Ethiopian Grain Traders and Millers. ... Ethiopian Journal of Economics ... the necessary investment to provide effective marketing services for the transformation of agriculture.

  1. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    Science.gov (United States)

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

  2. Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

    2013-01-01

    Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

  3. 77 FR 24301 - Revision of the Commission's Program Access Rules

    Science.gov (United States)

    2012-04-23

    ... afforded to multichannel video programming distributors by the program access rules--the prohibition on exclusive contracts involving satellite- delivered, cable-affiliated programming. The current exclusive... sections 4(i), 303(r), 616, and 628 of the Communications Act of 1934, as amended. Total Annual Burden: 43...

  4. Stellar Atmospheric Modelling for the ACCESS Program

    Science.gov (United States)

    Morris, Matthew; Kaiser, Mary Elizabeth; Bohlin, Ralph; Kurucz, Robert; ACCESS Team

    2018-01-01

    A goal of the ACCESS program (Absolute Color Calibration Experiment for Standard Stars) is to enable greater discrimination between theoretical astrophysical models and observations, where the comparison is limited by systematic errors associated with the relative flux calibration of the targets. To achieve these goals, ACCESS has been designed as a sub-orbital rocket borne payload and ground calibration program, to establish absolute flux calibration of stellar targets at flight candidates, as well as a selection of A and G stars from the CALSPEC database. Stellar atmosphere models were generated using Atlas 9 and Atlas 12 Kurucz stellar atmosphere software. The effective temperature, log(g), metallicity, and redenning were varied and the chi-squared statistic was minimized to obtain a best-fit model. A comparison of these models and the results from interpolation between grids of existing models will be presented. The impact of the flexibility of the Atlas 12 input parameters (e.g. solar metallicity fraction, abundances, microturbulent velocity) is being explored.

  5. 76 FR 21741 - Twenty-First Century Communications and Video Programming Accessibility Act; Announcement of Town...

    Science.gov (United States)

    2011-04-18

    ... equipment distribution program for people who are deaf-blind. In addition, the law will fill accessibility... Programming Accessibility Act; Announcement of Town Hall Meeting AGENCY: Federal Communications Commission... The Twenty-First Century Communications and Video Programming Accessibility Act (the Act or CVAA...

  6. 47 CFR 76.1507 - Competitive access to satellite cable programming.

    Science.gov (United States)

    2010-10-01

    ... programming. 76.1507 Section 76.1507 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... access to satellite cable programming. (a) Any provision that applies to a cable operator under §§ 76... provides video programming on its open video system, except as limited by paragraph (a) (1)-(3) of this...

  7. Object oriented programming techniques applied to device access and control

    International Nuclear Information System (INIS)

    Goetz, A.; Klotz, W.D.; Meyer, J.

    1992-01-01

    In this paper a model, called the device server model, has been presented for solving the problem of device access and control faced by all control systems. Object Oriented Programming techniques were used to achieve a powerful yet flexible solution. The model provides a solution to the problem which hides device dependancies. It defines a software framework which has to be respected by implementors of device classes - this is very useful for developing groupware. The decision to implement remote access in the root class means that device servers can be easily integrated in a distributed control system. A lot of the advantages and features of the device server model are due to the adoption of OOP techniques. The main conclusion that can be drawn from this paper is that 1. the device access and control problem is adapted to being solved with OOP techniques, 2. OOP techniques offer a distinct advantage over traditional programming techniques for solving the device access problem. (J.P.N.)

  8. 76 FR 57989 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-09-19

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 11-1527] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... programming, and the interoperability and user interface of the equipment used to deliver video programming...

  9. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Science.gov (United States)

    2010-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... 47 Telecommunication 4 2010-10-01 2010-10-01 false Applicability of program access rules to common carriers and affiliates. 76.1004 Section 76.1004 Telecommunication FEDERAL COMMUNICATIONS COMMISSION...

  10. 34 CFR 395.12 - Access to program and financial information.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Access to program and financial information. 395.12... information. Each blind vendor under this part shall be provided access to all financial data of the State... annual financial reports, provided that such disclosure does not violate applicable Federal or State laws...

  11. Evaluation of an open-access CBT-based Internet program for social anxiety: Patterns of use, retention, and outcomes.

    Science.gov (United States)

    Dryman, M Taylor; McTeague, Lisa M; Olino, Thomas M; Heimberg, Richard G

    2017-10-01

    Internet-delivered cognitive-behavioral therapy (ICBT) has been established as both efficacious and effective in reducing symptoms of social anxiety. However, most research has been conducted in controlled settings, and little is known regarding the utility of such programs in an open-access format. The present study examined the use, adherence, and effectiveness of Joyable, an open-access, Internet-delivered, coach-supported CBT-based intervention for social anxiety. Participants were 3,384 registered users (Mage [SD] = 29.82 [7.89]; 54% male) that created an account between 2014 and 2016. Characteristics of use, factors related to attrition and adherence, and within-group outcomes were examined. The primary outcome measure was the Social Phobia Inventory. On average, participants remained in the program for 81.02 days (SD = 60.50), during which they completed 12.14 activities (SD = 11.09) and 1.53 exposures (SD = 3.18). About half (57%) had contact with a coach. Full adherence to the program was achieved by 16% of participants, a rate higher than previously published open-access studies of ICBT. Social anxiety symptoms were significantly reduced for participants that engaged in the program, with medium within-group effects from baseline through the cognitive restructuring module (d = 0.63-0.76) and large effects from baseline through the exposure module (d = 1.40-1.83). Response rates were high (72%). Exposures and coach contact were significant predictors of retention and outcome. This open-access online CBT-based program is effective in reducing social anxiety symptoms and has the potential to extend Internet-based mental health services to socially anxious individuals unwilling or unable to seek face-to-face evidence-based therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Hand Society and Matching Program Web Sites Provide Poor Access to Information Regarding Hand Surgery Fellowship.

    Science.gov (United States)

    Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T

    2016-08-01

    The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.

  13. 75 FR 9691 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-03-03

    ... involving programming they own, that impede competition in the video distribution market. See H.R. Rep. No... availability of programming and charging discriminatory prices to non- cable technologies.'' H.R. Rep. No. 102... Access Rules and Examination of Programming Tying Arrangements; Final Rule #0;#0;Federal Register / Vol...

  14. Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

    Science.gov (United States)

    Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

    2017-12-01

    There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, pemployee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Does Access to Finance Lower Firms’ Cost of Capital? Empirical Evidence from International Manufacturing Data

    NARCIS (Netherlands)

    Lashitew, Addisu A.

    2011-01-01

    Lack of access to finance is argued to be one of the most binding constraints for firm growth. There is, however, limited empirical evidence on the relationship between access to finance and the cost of capital. This paper uses international manufacturing data to analyze the effect of access to

  16. 19 CFR 201.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-04-01

    .... 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination... agency's facilities are inaccessible to or unusable by handicapped persons, be denied the benefits of, be...

  17. Evaluation of the content and accessibility of microsurgery fellowship program websites.

    Science.gov (United States)

    Silvestre, Jason; Vargas, Christina R; Ho, Olivia; Lee, Bernard T

    2015-10-01

    Microsurgery fellowship applicants utilize Internet-based resources such as the San Francisco Match (SF Match) to manage their applications. In deciding where to apply, applicants rely on advice from mentors and online resources including microsurgery fellowship websites (MFWs). The purpose of this study was to evaluate the content and accessibility of MFWs. While microsurgery is practiced by many surgical specialties, this study focused on MFWs for programs available in the 2014 Microsurgery Fellowship Match. Program lists from the American Society for Reconstructive Microsurgery (ASRM) and the San Francisco Match (SF Match) were analyzed for the accessibility of MFW links. MFWs were evaluated for education and recruitment content, and MFW comprehensiveness was compared on the basis of program characteristics using chi square tests. Of the 25 fellowships available, only 18 had websites (72%). SF Match and ASRM listed similar programs (96% overlap) and provided website links (89%, 76%), but only a minority connected directly to the MFW (38%, 23%). A minority of programs were responsive via email inquiry (36%). MFWs maintained minimal education and recruitment content. MFW comprehensiveness was not associated with program characteristics. MFWs are often not readily accessible and contain limited information for fellowship applicants. Given the relative low-cost of website development, MFWs may be improved to facilitate fellow recruitment. © 2015 Wiley Periodicals, Inc.

  18. 49 CFR 28.151 - Program accessibility: New construction and alterations.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: New construction and alterations. 28.151 Section 28.151 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION...

  19. 28 CFR 513.43 - Inmate access to certain Bureau Program Statements.

    Science.gov (United States)

    2010-07-01

    ... Statements. 513.43 Section 513.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL... simple local access procedures described in this section to review certain Bureau Program Statements... 28 CFR), local access is available through the institution law library. (b) For a current Bureau...

  20. Professional Access 2013 programming

    CERN Document Server

    Hennig, Teresa; Hepworth, George; Yudovich, Dagi (Doug)

    2013-01-01

    Authoritative and comprehensive coverage for building Access 2013 Solutions Access, the most popular database system in the world, just opened a new frontier in the Cloud. Access 2013 provides significant new features for building robust line-of-business solutions for web, client and integrated environments.  This book was written by a team of Microsoft Access MVPs, with consulting and editing by Access experts, MVPs and members of the Microsoft Access team. It gives you the information and examples to expand your areas of expertise and immediately start to develop and upgrade projects. Exp

  1. 12 CFR 410.151 - Program accessibility: New construction and alterations.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: New construction and alterations. 410.151 Section 410.151 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  2. Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

    Science.gov (United States)

    McClellan, Sean R.

    2013-01-01

    Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

  3. Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

    Science.gov (United States)

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

  4. Open access of evidence-based publications: the case of the orthopedic and musculoskeletal literature.

    Science.gov (United States)

    Yammine, Kaissar

    2015-11-01

    The open access model, where researchers can publish their work and make it freely available to the whole medical community, is gaining ground over the traditional type of publication. However, fees are to be paid by either the authors or their institutions. The purpose of this paper is to assess the proportion and type of open access evidence-based articles in the form of systematic reviews and meta-analyses in the field of musculoskeletal disorders and orthopedic surgery. PubMed database was searched and the results showed a maximal number of hits for low back pain and total hip arthroplasty. We demonstrated that despite a 10-fold increase in the number of evidence-based publications in the past 10 years, the rate of free systematic reviews in the general biomedical literature did not change for the last two decades. In addition, the average percentage of free open access systematic reviews and meta-analyses for the commonest painful musculoskeletal conditions and orthopedic procedures was 20% and 18%, respectively. Those results were significantly lower than those of the systematic reviews and meta-analyses in the remaining biomedical research. Such findings could indicate a divergence between the efforts engaged at promoting evidence-based principles and those at disseminating evidence-based findings in the field of musculoskeletal disease and trauma. The high processing fee is thought to be a major limitation when considering open access model for publication. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  5. The Significance of Ongoing Teacher Support in Earth Science Education Programs: Evidence from the GLOBE Program

    Science.gov (United States)

    Penuel, B.; Korbak, C.; Shear, L.

    2003-12-01

    The GLOBE program provides a rich context for examining issues concerning implementation of inquiry-oriented, scientist-driven educational programs, because the program has both a history of collecting evaluation data on implementation and mechanisms for capturing program activity as it occurs. In this paper, researchers from SRI International's evaluation team explore the different roles that regional partners play in preparing and supporting teachers to implement the GLOBE Program, an international inquiry-based Earth science education initiative that has trained over 14,000 teachers worldwide. GLOBE program evaluation results show the program can be effective in increasing students' inquiry skills, but that the program is also hard for teachers to implement (Means et al., 2001; Penuel et al., 2002). An analysis of GLOBE's regional partner organizations, which are tasked with preparing teachers to implement its data collection and reporting protocols with students, shows that some partners are more successful than others. This paper reports findings from a quantitative analysis of the relationship between data reporting and partner support activities and from case studies of two such regional partners focused on analyzing what makes them successful. The first analysis examined associations between partner training and support activities and data reporting. For this analysis, we used data from the GLOBE Student Data Archive matched with survey data collected from a large sample of GLOBE teachers as part of SRI's Year 5 evaluation of GLOBE. Our analyses point to the central importance of mentoring and material support to teachers. We found that incentives, mentoring, and other on-site support to teachers have a statistically significant association with higher data reporting levels. We also found that at present, teachers access these supports less often than they access listservs and e-mail communication with teachers after GLOBE training. As a follow-up to this

  6. Access to special education for exceptional students in French immersion programs: An equity issue

    Directory of Open Access Journals (Sweden)

    Nancy Wise

    2011-06-01

    Full Text Available Abstract Exceptional pupils enrolled in Canadian French immersion programs rarely have access to the same range of special education programs and services that are available to students in the regular English program. More often than not, students with special needs are encouraged to transfer to English programs to access necessary support services. This counselling-out process perpetuates the elitist status commonly attributed to French immersion programs. From a critical pedagogy perspective, this inquiry examines the lack of incentive on the part of multiple French immersion stakeholders to accommodate students with special needs. It further attempts to unveil the myths created by these stakeholders to better understand this discriminatory educational practice. The impact of federal and provincial funding models on access to special education programs and services is discussed, and the application of funding allocations by English-language district school boards is explored. The inquiry concludes with recommendations to promote more inclusionary practices.

  7. Women's experiences accessing a women-centered cardiac rehabilitation program: a qualitative study.

    Science.gov (United States)

    Rolfe, Danielle E; Sutton, Erica J; Landry, Mireille; Sternberg, Len; Price, Jennifer A D

    2010-01-01

    The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI. Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility. Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation. While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address

  8. 25 CFR 170.128 - Are housing access roads and housing streets eligible for IRR Program funding?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Are housing access roads and housing streets eligible for... INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Irr Housing Access Roads § 170.128 Are housing access roads and housing streets eligible for IRR...

  9. Developing and testing evidence-based weight management in Australian pharmacies: A Healthier Life Program.

    Science.gov (United States)

    Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

    2015-10-01

    Pharmacies represent a valuable opportunity to deliver weight management services, rather than just the routine supply of weight-loss products. In order to provide optimal services and translation of evidence-based weight management in community pharmacy, a best practice model program was designed and pilot tested to facilitate implementation of such services in pharmacies in Australia. To develop and pilot a pharmacist-delivered, evidence-based, non-product-centred weight management service for community pharmacy in Australia. Setting Sydney, New South Wales, Australia. A pharmacy-based weight management service called the A Healthier Life Program (AHLP), for overweight and obese individuals, was developed based on current Australian weight management guidelines and recommendations made by key stakeholders. The pharmacist undertook training to acquire specific competencies to deliver the program. The AHLP involved six individual face-to-face sessions with the pharmacist over 3 months. The intervention targeted three areas: diet, physical activity and behavioural change. Weight, BMI, waist circumference, blood pressure, dietary intake, and physical activity levels at 3 months were compared with values at baseline. Qualitative feedback on participants' satisfaction and willingness to pay were also analysed. Eight pharmacies provided the AHLP between February and December 2013. Thirty-four participants were enrolled in the AHLP; mean age 50.7 years (SD 15.7) and mean BMI 34.3 kg/m(2) (SD 5.3). Of the 22 (65%) participants who completed the program, six had achieved the target weight loss of ≥5%. The mean change in weight was -3.5 kg (95% CI -4.8, -2.2) and waist circumference -2.0 cm (95% CI -2.8, -1.3) for program completers at 3 months. Furthermore, participants reported overall positive experiences of the program, and identified accessibility of the pharmacy and high comfort level with the pharmacist, as the major advantages. The AHLP was well received and

  10. Structural barriers in access to medical marijuana in the USA-a systematic review protocol.

    Science.gov (United States)

    Valencia, Celina I; Asaolu, Ibitola O; Ehiri, John E; Rosales, Cecilia

    2017-08-07

    There are 43 state medical marijuana programs in the USA, yet limited evidence is available on the demographic characteristics of the patient population accessing these programs. Moreover, insights into the social and structural barriers that inform patients' success in accessing medical marijuana are limited. A current gap in the scientific literature exists regarding generalizable data on the social, cultural, and structural mechanisms that hinder access to medical marijuana among qualifying patients. The goal of this systematic review, therefore, is to identify the aforementioned mechanisms that inform disparities in access to medical marijuana in the USA. This scoping review protocol outlines the proposed study design for the systematic review and evaluation of peer-reviewed scientific literature on structural barriers to medical marijuana access. The protocol follows the guidelines set forth by the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist. The overarching goal of this study is to rigorously evaluate the existing peer-reviewed data on access to medical marijuana in the USA. Income, ethnic background, stigma, and physician preferences have been posited as the primary structural barriers influencing medical marijuana patient population demographics in the USA. Identification of structural barriers to accessing medical marijuana provides a framework for future policies and programs. Evidence-based policies and programs for increasing medical marijuana access help minimize the disparity of access among qualifying patients.

  11. Quality, language, subdiscipline and promotion were associated with article accesses on Physiotherapy Evidence Database (PEDro).

    Science.gov (United States)

    Yamato, Tiê P; Arora, Mohit; Stevens, Matthew L; Elkins, Mark R; Moseley, Anne M

    2018-03-01

    To quantify the relationship between the number of times articles are accessed on the Physiotherapy Evidence Database (PEDro) and the article characteristics. A secondary aim was to examine the relationship between accesses and the number of citations of articles. The study was conducted to derive prediction models for the number of accesses of articles indexed on PEDro from factors that may influence an article's accesses. All articles available on PEDro from August 2014 to January 2015 were included. We extracted variables relating to the algorithm used to present PEDro search results (research design, year of publication, PEDro score, source of systematic review (Cochrane or non-Cochrane)) plus language, subdiscipline of physiotherapy, and whether articles were promoted to PEDro users. Three predictive models were examined using multiple regression analysis. Citation and journal impact factor were downloaded. There were 29,313 articles indexed in this period. We identified seven factors that predicted the number of accesses. More accesses were noted for factors related to the algorithm used to present PEDro search results (synthesis research (i.e., guidelines and reviews), recent articles, Cochrane reviews, and higher PEDro score) plus publication in English and being promoted to PEDro users. The musculoskeletal, neurology, orthopaedics, sports, and paediatrics subdisciplines were associated with more accesses. We also found that there was no association between number of accesses and citations. The number of times an article is accessed on PEDro is partly predicted by how condensed and high quality the evidence it contains is. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  12. 41 CFR 51-10.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-07-01

    ...: Discrimination prohibited. 51-10.149 Section 51-10.149 Public Contracts and Property Management Other Provisions Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.149 Program accessibility...

  13. Policies and programs to facilitate access to targeted cancer therapies in Thailand.

    Directory of Open Access Journals (Sweden)

    Rosarin Sruamsiri

    Full Text Available Increasing access to clinically beneficial targeted cancer medicines is a challenge in every country due to their high cost. We describe the interplay of innovative policies and programs involving multiple stakeholders to facilitate access to these medicines in Thailand, as well as the utilization of selected targeted therapies over time.We selected two medicines on the 2013 Thai national list of essential medicines (NLEM [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product.Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007-2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366-923 to 3683 (95% CI 2,748-4,618; for imatinib from 103 (95% CI 72-174 to 350 (95% CI 307-398; and for trastuzumab from 68 (95% CI 45-118 to 412 (95% CI 344-563.Government, payers, and manufacturers implemented multi-pronged approaches to facilitate access to targeted cancer therapies for the Thai population, which differed by medicine. Routine monitoring is needed to assess clinical and economic impacts of these

  14. Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

    Science.gov (United States)

    Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

    2009-01-01

    Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

  15. Structural barriers in access to medical marijuana in the USA?a systematic review protocol

    OpenAIRE

    Valencia, Celina I.; Asaolu, Ibitola O.; Ehiri, John E.; Rosales, Cecilia

    2017-01-01

    Background There are 43 state medical marijuana programs in the USA, yet limited evidence is available on the demographic characteristics of the patient population accessing these programs. Moreover, insights into the social and structural barriers that inform patients? success in accessing medical marijuana are limited. A current gap in the scientific literature exists regarding generalizable data on the social, cultural, and structural mechanisms that hinder access to medical marijuana amon...

  16. Evaluating the Navy’s Enlisted Accessions Testing Program Based on Future Talent Needs

    Science.gov (United States)

    2017-03-01

    NAVY’S ENLISTED ACCESSIONS TESTING PROGRAM BASED ON FUTURE TALENT NEEDS by Shereka F. Riley March 2017 Thesis Advisor: Joseph Sullivan Co...REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE EVALUATING THE NAVY’S ENLISTED ACCESSIONS TESTING PROGRAM BASED ON FUTURE TALENT ...public release. Distribution is unlimited. 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) In recent years, non-defense related industries

  17. Factors facilitating and inhibiting implementation of easy accessible sporting programs.

    NARCIS (Netherlands)

    Ooms, L.; Veenhof, C.

    2012-01-01

    Introduction: The organized sport sector has been identified as a potential setting for physical activity promotion. In The Netherlands, ten national sporting organizations were funded to develop and implement easy accessible sporting programs, especially for the least active population groups. A

  18. 77 FR 6479 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2012-02-08

    ... Commercial Access; Development of Competition and Diversity in Video Programming Distribution and Carriage... contained in the Second Report and Order, FCC 11-119, pertaining to carriage of video programming vendors by multichannel video programming distributors (program carriage rules). This notice is consistent with the Secord...

  19. 76 FR 60651 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2011-09-29

    ... programming services seeking access through their conduit.''); H.R. Rep. No. 102-628 (1992), at 41 (``[T]he... Programming Distribution and Carriage; Revision of the Commission's Program Carriage Rules; Final Rule and... Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY...

  20. How to start a minimal access mitral valve program.

    Science.gov (United States)

    Hunter, Steven

    2013-11-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: "clinical effectiveness", including reduced length of hospital stay, "risk management effectiveness", including conversion to sternotomy and aortic dissection, "patient experience" including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper.

  1. An Accessible User Interface for Geoscience and Programming

    Science.gov (United States)

    Sevre, E. O.; Lee, S.

    2012-12-01

    The goal of this research is to develop an interface that will simplify user interaction with software for scientists. The motivating factor of the research is to develop tools that assist scientists with limited motor skills with the efficient generation and use of software tools. Reliance on computers and programming is increasing in the world of geology, and it is increasingly important for geologists and geophysicists to have the computational resources to use advanced software and edit programs for their research. I have developed a prototype of a program to help geophysicists write programs using a simple interface that requires only simple single-mouse-clicks to input code. It is my goal to minimize the amount of typing necessary to create simple programs and scripts to increase accessibility for people with disabilities limiting fine motor skills. This interface can be adapted for various programming and scripting languages. Using this interface will simplify development of code for C/C++, Java, and GMT, and can be expanded to support any other text based programming language. The interface is designed around the concept of maximizing the amount of code that can be written using a minimum number of clicks and typing. The screen is split into two sections: a list of click-commands is on the left hand side, and a text area is on the right hand side. When the user clicks on a command on the left hand side the applicable code is automatically inserted at the insertion point in the text area. Currently in the C/C++ interface, there are commands for common code segments that are often used, such as for loops, comments, print statements, and structured code creation. The primary goal is to provide an interface that will work across many devices for developing code. A simple prototype has been developed for the iPad. Due to the limited number of devices that an iOS application can be used with, the code has been re-written in Java to run on a wider range of devices

  2. An evidence-based rehabilitation program for tracheoesophageal speakers

    NARCIS (Netherlands)

    Jongmans, P.; Rossum, M.; As-Brooks, C.; Hilgers, F.; Pols, L.; Hilgers, F.J.M.; Pols, L.C.W.; van Rossum, M.; van den Brekel, M.W.M.

    2008-01-01

    Objectives: to develop an evidence-based therapy program aimed at improving tracheoesophageal speech intelligibility. The therapy program is based on particular problems found for TE speakers in a previous study as performed by the authors. Patients/Materials and Methods: 9 male laryngectomized

  3. Internet access, awareness and utilisation of web based evidence: a survey of ANZ and Singaporean radiation oncology registrars in 2003

    International Nuclear Information System (INIS)

    Wong, K.; Veness, M.

    2003-01-01

    The past decade has seen an 'explosion' in electronically archived evidence available on the Internet. Access to, and awareness of, pre-appraised web based evidence such as is available at the Cochrane Library, and more recently the Cancer Library, is now easily accessible to both clinicians and patients. A postal survey was recently sent out to all Radiation Oncology registrars in Australia, New Zealand and Singapore. The aim of the survey was to ascertain previous training in literature searching and critical appraisal, the extent of Internet access and use of web based evidence and awareness of databases including the Cochrane Library. Sixty six (66) out of ninety (90) registrars responded (73% response rate). Fifty five percent of respondents had previously undertaken some form of training related to literature searching or critical appraisal. The majority (68%) felt confident in performing a literature search, although 80% of respondents indicated interest in obtaining further training. The majority (68%) reported accessing web-based evidence for literature searching in the previous week, and 92% in the previous month. Nearly all respondents (89%) accessed web-based evidence at work. Most (94%) were aware of the Cochrane Library with 48% of respondents having used this database. Sixty-eight percent were aware of the Cancer Library. In 2000 a similar survey revealed only 68% of registrars aware and 30% having used the Cochrane Library. These findings reveal almost universal access to the Internet and use of web-based evidence amongst Radiation Oncology registrars. There has been a marked increase in awareness and use of the Cochrane Library with the majority also aware of the recently introduced Cancer Library

  4. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement.

    Science.gov (United States)

    Mina, D Santa; Sabiston, C M; Au, D; Fong, A J; Capozzi, L C; Langelier, D; Chasen, M; Chiarotto, J; Tomasone, J R; Jones, J M; Chang, E; Culos-Reed, S N

    2018-04-01

    Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer.

  5. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement

    Science.gov (United States)

    Mina, D. Santa; Sabiston, C.M.; Au, D.; Fong, A.J.; Capozzi, L.C.; Langelier, D.; Chasen, M.; Chiarotto, J.; Tomasone, J.R.; Jones, J.M.; Chang, E.; Culos-Reed, S.N.

    2018-01-01

    Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks (“pathways”) that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer. PMID:29719431

  6. Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

  7. Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

    Science.gov (United States)

    Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

    2014-01-01

    Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

  8. Moving from College Aspiration to Attainment: Learning from One College Access Program

    Science.gov (United States)

    Dyce, Cherrel Miller; Albold, Cheryll; Long, Deborah

    2013-01-01

    Using data from a survey of 75 parents and high school students who were eligible for a college access program, this article examines parents' and students' college aspirations and their confidence in fulfilling that goal. The authors argue that pre-college preparation programs can benefit from the non-economic forms of capital that these families…

  9. Non-Selective Lexical Access in Late Arabic-English Bilinguals: Evidence from Gating.

    Science.gov (United States)

    Boudelaa, Sami

    2018-02-07

    Previous research suggests that late bilinguals who speak typologically distant languages are the least likely to show evidence of non-selective lexical access processes. This study puts this claim to test by using the gating task to determine whether words beginning with speech sounds that are phonetically similar in Arabic and English (e.g., [b,d,m,n]) give rise to selective or non-selective lexical access processes in late Arabic-English bilinguals. The results show that an acoustic-phonetic input (e.g., [bæ]) that is consistent with words in Arabic (e.g., [bædrun] "moon") and English (e.g., [bæd] "bad") activates lexical representations in both languages of the bilingual. This non-selective activation holds equally well for mixed lists with words from both Arabic and English and blocked lists consisting only of Arabic or English words. These results suggest that non-selective lexical access processes are the default mechanism even in late bilinguals of typologically distant languages.

  10. Availability and accessibility of subsidized mammogram screening program in peninsular Malaysia: A preliminary study using travel impedance approach.

    Science.gov (United States)

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who

  11. 77 FR 5027 - Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to...

    Science.gov (United States)

    2012-02-01

    ...] Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to the... entitled ``Food and Drug Administration Transparency Initiative: Exploratory Program to [[Page 5028

  12. A constructive Indian country response to the evidence-based program mandate.

    Science.gov (United States)

    Walker, R Dale; Bigelow, Douglas A

    2011-01-01

    Over the last 20 years governmental mandates for preferentially funding evidence-based "model" practices and programs has become doctrine in some legislative bodies, federal agencies, and state agencies. It was assumed that what works in small sample, controlled settings would work in all community settings, substantially improving safety, effectiveness, and value-for-money. The evidence-based "model" programs mandate has imposed immutable "core components," fidelity testing, alien programming and program developers, loss of familiar programs, and resource capacity requirements upon tribes, while infringing upon their tribal sovereignty and consultation rights. Tribal response in one state (Oregon) went through three phases: shock and rejection; proposing an alternative approach using criteria of cultural appropriateness, aspiring to evaluability; and adopting logic modeling. The state heard and accepted the argument that the tribal way of knowing is different and valid. Currently, a state-authorized tribal logic model and a review panel process are used to approve tribal best practices for state funding. This constructive response to the evidence-based program mandate elevates tribal practices in the funding and regulatory world, facilitates continuing quality improvement and evaluation, while ensuring that practices and programs remain based on local community context and culture. This article provides details of a model that could well serve tribes facing evidence-based model program mandates throughout the country.

  13. Duct Remediation Program: Engineered access research and construction

    International Nuclear Information System (INIS)

    Beckman, T.D.; Davis, M.M.; Karas, T.M.

    1992-01-01

    The Rocky Flats Plant, Duct Remediation mission concentrated on removing Plutonium Oxide from the process ductwork in the primary Plutonium processing facility. When possible, remediation took place from existing process gloveboxes. Fifteen locations were identified, however, that required accessing duct runs where no process gloveboxes existed. The building's second floor utility areas had many locations where long, inaccessible duct runs were prevalent. Consequently, an extensive program for design, procurement and construction was initiated to contain and isolate ducts for penetration when existing glovebox sites were not present

  14. Stability of children's insurance coverage and implications for access to care: evidence from the Survey of Income and Program Participation.

    Science.gov (United States)

    Buchmueller, Thomas; Orzol, Sean M; Shore-Sheppard, Lara

    2014-06-01

    Even as the number of children with health insurance has increased, coverage transitions--movement into and out of coverage and between public and private insurance--have become more common. Using data from 1996 to 2005, we examine whether insurance instability has implications for access to primary care. Because unobserved factors related to parental behavior and child health may affect both the stability of coverage and utilization, we estimate the relationship between insurance and the probability that a child has at least one physician visit per year using a model that includes child fixed effects to account for unobserved heterogeneity. Although we find that unobserved heterogeneity is an important factor influencing cross-sectional correlations, conditioning on child fixed effects we find a statistically and economically significant relationship between insurance coverage stability and access to care. Children who have part-year public or private insurance are more likely to have at least one doctor's visit than children who are uninsured for a full year, but less likely than children with full-year coverage. We find comparable effects for public and private insurance. Although cross-sectional analyses suggest that transitions directly between public and private insurance are associated with lower rates of utilization, the evidence of such an effect is much weaker when we condition on child fixed effects.

  15. Evidence of eligibility manipulation for conditional cash transfer programs

    Directory of Open Access Journals (Sweden)

    Sergio Firpo

    2014-09-01

    Full Text Available This paper assesses whether eligibility for conditional cash transfer programs has been manipulated, as well as the impact of this phenomenon on time allocation within households. To perform this analysis, we use data from the 2006 PNAD (Brazilian national household survey and investigate the eligibility manipulation for the Bolsa Família (Family Stipend program during this time period. The program assists families with a monthly per capita income of around R$120.00 (US$60.00. By applying the tests developed by McCrary (2008, we find suggestive evidence that individuals manipulate their income by voluntarily reducing their labor supply in order to become eligible to the program. Moreover, the reduction in labor supply is greater among women, especially single or divorced mothers. This evidence raises some concern about the unintended consequences related to the eligibility criteria utilized by Bolsa Família, as well as the program's impact on individuals living in extreme poverty.

  16. The Relationship Between Exclusions from Gambling Arcades and Accessibility: Evidence from a Newly Introduced Exclusion Program in Hesse, Germany.

    Science.gov (United States)

    Strohäker, Tanja; Becker, Tilman

    2018-02-28

    An exclusion system for gambling arcades has been introduced recently in the state of Hesse. The aim of this paper is to identify significant predictors that are useful in explaining the variation of exclusions between different Hessian communities. Next to socio-demographic factors, we control for three different accessibility variables in two models: the number of electronic gambling machines (EGMs) in model I, and the number of locations and density of gambling machines at a location in model II. We disentangle the association between EGMs and exclusions of model I into a location and a clustering effect. Considering the socio-demographic variables, the explanatory power of our cross-sectional models is rather low. Only the age group of the 30-39 years old and those who are not in a partnership (in model I) yield significant results. As self-exclusion systems reduce availability for the group of vulnerable players, this analysis provides evidence for the assumption that the two groups-pathological gamblers and vulnerable players-seem to have little overlap concerning sociodemographic characteristics. The accessibility variables, on the other hand, turn out to be significantly associated with the number of exclusions. All three of them are statistically significant and their association is positive. The results of model II show that the location effect is more pronounced then the clustering effect of EGMs, i.e. the effect of an additional single-licensed arcade on the number of exclusions is stronger than the increase in the number of license at one location.

  17. How to start a minimal access mitral valve program

    OpenAIRE

    Hunter, Steven

    2013-01-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate t...

  18. Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population.

    Science.gov (United States)

    Thomas, Mary-Powel; Ammann, Gabriela; Brazier, Ellen; Noyes, Philip; Maybank, Aletha

    2017-12-01

    Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support. To address this issue, the New York City Department of Health and Mental Hygiene's Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along with prenatal and postpartum visits. Between 2010 and 2015, 489 infants were born to women enrolled in the program. Data indicate that By My Side is a promising model of support for Healthy Start projects nationwide. Compared to the project area, program participants had lower rates of preterm birth (6.3 vs. 12.4%, p < 0.001) and low birthweight (6.5 vs. 11.1%, p = 0.001); however, rates of cesarean birth did not differ significantly (33.5 vs. 36.9%, p = 0.122). Further research is needed to explore possible reasons for this finding, and to examine the influence of doula support on birth outcomes among populations with high rates of chronic disease and stressors such as poverty, racism, and exposure to violence. However, feedback from participants indicates that doula support is highly valued and helps give women a voice in consequential childbirth decisions. Available evidence suggests that doula services may be an important component of an effort to address birth inequities.

  19. Social media and gamification: Engaging vulnerable parents in an online evidence-based parenting program.

    Science.gov (United States)

    Love, Susan M; Sanders, Matthew R; Turner, Karen M T; Maurange, Marianne; Knott, Theresa; Prinz, Ronald; Metzler, Carol; Ainsworth, Andrew T

    2016-03-01

    The aim of this study was to examine the feasibility (accessibility, engagement and impact) of adding social media and gaming features (e.g., social sharing with anonymity, badges to incentivize skills practice, an accredited facilitator for support) and access via smartphones to an evidenced-based parenting program, Triple P Online. The highly vulnerable population included 155 disadvantaged, high-risk parents (e.g., 76% had a family annual income of less than $15,000; 41% had been incarcerated; 38% were in drug/alcohol treatment; and 24% had had a child removed due to maltreatment). The ethnic groups most commonly identified were African American (24%) and Hispanic (66%). Respondents were primarily mothers (86%) from five community programs in Los Angeles. The study used a single group repeated measures design (pre, post, 6-month follow-up). Data collected included standardized self-report measures, post-intervention focus groups and interviews, website usage reports, and Google Analytics. Significant multivariate ANOVA time effects were found, demonstrating reductions in child behavioral problems, reduced lax/permissive and over-reactive parenting, and decreased parental stress. No effects were found for parental confidence, attributions, or depression and anxiety (which were in the normal range at baseline). Positive effects were maintained or improved at 6-month follow-up. The participants engaged in the online community and valued its flexibility, anonymity, and shared learning. This foundational implementation trial provides support for future rigorous evaluation of social media and gaming features as a medium for increasing parental engagement in evidence-based parenting programs online--a public health approach to protect and improve the development of vulnerable children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Dual Language Immersion Program Equity and Access: Is There Equity for All Students?

    Science.gov (United States)

    Fernandez, Patricia Espinoza

    2016-01-01

    This is a mixed methods study of K-12 school administrators with dual language immersion school leadership expertise. The paramount research focus was to identify equity and access issues in dual language immersion programs serving grades K-12, as identified by school administrators who have led such programs. A total pool of 498 were invited to…

  1. The Arts and 504, A Handbook for Accessible Arts Programming. Revised.

    Science.gov (United States)

    National Endowment for the Arts, Washington, DC.

    This handbook is designed to assist arts organizations in complying with disability access regulations. It details how to include the needs of disabled people into programming efforts and also provides information on the Arts Endowment's 504 Regulation, which applies to federally funded organizations, and the 1990 Americans with Disabilities Act…

  2. 77 FR 24169 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2012-04-23

    ... for the 2013 Market Access Program (MAP). The intended effect of this notice is to solicit...-term agricultural trade strategy and a program effectiveness time line against which results can be... part of the FAS resource allocation strategy to fund applicants who can demonstrate performance and...

  3. 76 FR 21325 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2011-04-15

    ... for the 2012 Market Access Program (MAP). The intended effect of this notice is to solicit...-term agricultural trade strategy and a program effectiveness time line against which results can be... part of the FAS resource allocation strategy to fund applicants who can demonstrate performance and...

  4. 75 FR 26194 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2010-05-11

    ... for the 2011 Market Access Program (MAP). The intended effect of this notice is to solicit... considers whether the applicant provides a clear, long-term agricultural trade strategy and a program... the greatest growth potential. These factors are part of the FAS resource allocation strategy to fund...

  5. Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study.

    Science.gov (United States)

    Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz

    2013-11-01

    To examine access to health programs at workplace as a determinant of presenteeism among adults. Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders. Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions. This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

  6. Promoting physical therapists’ of research evidence to inform clinical practice: part 1 - theoretical foundation, evidence, and description of the PEAK program

    Science.gov (United States)

    2014-01-01

    Background There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists’ integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura’s social cognitive theory and Malcolm Knowles’s adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. Discussion The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a “Best Practices List” - a list of locally generated, evidence-based, actionable behaviors relevant to the groups’ clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. Summary This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program

  7. Promoting physical therapists' of research evidence to inform clinical practice: part 1--theoretical foundation, evidence, and description of the PEAK program.

    Science.gov (United States)

    Tilson, Julie K; Mickan, Sharon

    2014-06-25

    There is a need for theoretically grounded and evidence-based interventions that enhance the use of research evidence in physical therapist practice. This paper and its companion paper introduce the Physical therapist-driven Education for Actionable Knowledge translation (PEAK) program, an educational program designed to promote physical therapists' integration of research evidence into clinical decision-making. The pedagogical foundations for the PEAK educational program include Albert Bandura's social cognitive theory and Malcolm Knowles's adult learning theory. Additionally, two complementary frameworks of knowledge translation, the Promoting Action on Research Implementation in Health Services (PARiHS) and Knowledge to Action (KTA) Cycle, were used to inform the organizational elements of the program. Finally, the program design was influenced by evidence from previous attempts to facilitate the use of research in practice at the individual and organizational levels. The 6-month PEAK program consisted of four consecutive and interdependent components. First, leadership support was secured and electronic resources were acquired and distributed to participants. Next, a two-day training workshop consisting of didactic and small group activities was conducted that addressed the five steps of evidence based practice. For five months following the workshop, participants worked in small groups to review and synthesize literature around a group-selected area of common clinical interest. Each group contributed to the generation of a "Best Practices List" - a list of locally generated, evidence-based, actionable behaviors relevant to the groups' clinical practice. Ultimately, participants agreed to implement the Best Practices List in their clinical practice. This, first of two companion papers, describes the underlying pedagogical theories, knowledge translation frameworks, and research evidence used to derive the PEAK program - an educational program designed to

  8. 78 FR 23893 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2013-04-23

    ... inviting proposals for the 2014 Market Access Program (MAP). The intended effect of this notice is to... strategy and a program effectiveness time line against which results can be measured at specific intervals... allocation strategy to fund applicants who can demonstrate performance and address the objectives of the GPRA...

  9. Feedback to providers improves evidence-based implantable cardioverter-defibrillator programming and reduces shocks.

    Science.gov (United States)

    Silver, Marc T; Sterns, Laurence D; Piccini, Jonathan P; Joung, Boyoung; Ching, Chi-Keong; Pickett, Robert A; Rabinovich, Rafael; Liu, Shufeng; Peterson, Brett J; Lexcen, Daniel R

    2015-03-01

    Implantable cardioverter-defibrillator (ICD) shocks are associated with increased anxiety, health care utilization, and potentially mortality. The purpose of the Shock-Less Study was to determine if providing feedback reports to physicians on their adherence to evidence-based shock reduction programming could improve their programming behavior and reduce shocks. Shock-Less enrolled primary prevention (PP) and secondary prevention (SP) ICD patients between 2009 and 2012 at 118 study centers worldwide and followed patients longitudinally after their ICD implant. Center-specific therapy programming reports (TPRs) were delivered to each center 9 to 12 months after their first enrollment. The reports detailed adherence to evidence-based programming targets: number of intervals to detect ventricular fibrillation (VF NID), longest treatment interval (LTI), supraventricular tachycardia (SVT) discriminators (Wavelet, PR Logic), SVT limit, Lead Integrity Alert (LIA), and antitachycardia pacing (ATP). Clinicians programmed ICDs at their discretion. The primary outcome measure was the change in utilization of evidence-based shock reduction programming before (phase I, n = 2694 patients) and after initiation of the TPR (phase II, n = 1438 patients). Patients implanted after feedback reports (phase II) were up to 20% more likely to have their ICDs programmed in line with evidence-based shock reduction programming (eg, VF NID in PP patients 30/40 in 33.5% vs 18.6%, P programming feedback reports improves adherence to evidence-based shock reduction programming and is associated with lower risk of ICD shocks. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  10. Accessing Secondary Markets as a Capital Source for Energy Efficiency Finance Programs: Program Design Considerations for Policymakers and Administrators

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Martin, E. Fadrhonc [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thompson, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-02-01

    Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources with the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.

  11. Access to non-pecuniary benefits: does gender matter? Evidence from six low- and middle-income countries.

    Science.gov (United States)

    Gupta, Neeru; Alfano, Marco

    2011-10-19

    Gender issues remain a neglected area in most approaches to health workforce policy, planning and research. There is an accumulating body of evidence on gender differences in health workers' employment patterns and pay, but inequalities in access to non-pecuniary benefits between men and women have received little attention. This study investigates empirically whether gender differences can be observed in health workers' access to non-pecuniary benefits across six low- and middle-income countries. The analysis draws on cross-nationally comparable data from health facility surveys conducted in Chad, Côte d'Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. Probit regression models are used to investigate whether female and male physicians, nurses and midwives enjoy the same access to housing allowance, paid vacations, in-service training and other benefits, controlling for other individual and facility-level characteristics. While the analysis did not uncover any consistent pattern of gender imbalance in access to non-monetary benefits, some important differences were revealed. Notably, female nursing and midwifery personnel (the majority of the sample) are found significantly less likely than their male counterparts to have accessed in-service training, identified not only as an incentive to attract and retain workers but also essential for strengthening workforce quality. This study sought to mainstream gender considerations by exploring and documenting sex differences in selected employment indicators across health labour markets. Strengthening the global evidence base about the extent to which gender is independently associated with health workforce performance requires improved generation and dissemination of sex-disaggregated data and research with particular attention to gender dimensions.

  12. Feasibility of the evidence-based cognitive telerehabilitation program Remind for patients with primary brain tumors.

    Science.gov (United States)

    van der Linden, Sophie D; Sitskoorn, Margriet M; Rutten, Geert-Jan M; Gehring, Karin

    2018-05-01

    Many patients with primary brain tumors experience cognitive deficits. Cognitive rehabilitation programs focus on alleviating these deficits, but availability of such programs is limited. Our large randomized controlled trial (RCT) demonstrated positive effects of the cognitive rehabilitation program developed by our group. We converted the program into the iPad-based cognitive rehabilitation program ReMind, to increase its accessibility. The app incorporates psychoeducation, strategy training and retraining. This pilot study in patients with primary brain tumors evaluates the feasibility of the use of the ReMind-app in a clinical (research) setting in terms of accrual, attrition, adherence and patient satisfaction. The intervention commenced 3 months after resective surgery and patients were advised to spend 3 h per week on the program for 10 weeks. Of 28 eligible patients, 15 patients with presumed low-grade glioma or meningioma provided informed consent. Most important reason for decline was that patients (7) experienced no cognitive complaints. Participants completed on average 71% of the strategy training and 76% of the retraining. Some patients evaluated the retraining as too easy. Overall, 85% of the patients evaluated the intervention as "good" or "excellent". All patients indicated that they would recommend the program to other patients with brain tumors. The ReMind-app is the first evidence-based cognitive telerehabilitation program for adult patients with brain tumors and this pilot study suggests that postoperative cognitive rehabilitation via this app is feasible. Based on patients' feedback, we have expanded the retraining with more difficult exercises. We will evaluate the efficacy of ReMind in an RCT.

  13. Microcredit, family planning programs, and contraceptive behavior: evidence from a field experiment in Ethiopia.

    Science.gov (United States)

    Desai, Jaikishan; Tarozzi, Alessandro

    2011-05-01

    The impact of community-based family planning programs and access to credit on contraceptive use, fertility, and family size preferences has not been established conclusively in the literature. We provide additional evidence on the possible effect of such programs by describing the results of a randomized field experiment whose main purpose was to increase the use of contraceptive methods in rural areas of Ethiopia. In the experiment, administrative areas were randomly allocated to one of three intervention groups or to a fourth control group. In the first intervention group, both credit and family planning services were provided and the credit officers also provided information on family planning. Only credit or family planning services, but not both, were provided in the other two intervention groups, while areas in the control group received neither type of service. Using pre- and post-intervention surveys, we find that neither type of program, combined or in isolation, led to an increase in contraceptive use that is significantly greater than that observed in the control group. We conjecture that the lack of impact has much to do with the mismatch between women's preferred contraceptive method (injectibles) and the contraceptives provided by community-based agents (pills and condoms).

  14. The National Access to Antiretroviral Program for PHA (NAPHA) in Thailand.

    Science.gov (United States)

    Chasombat, Sanchai; Lertpiriyasuwat, Cheewanan; Thanprasertsuk, Sombat; Suebsaeng, Laksami; Lo, Ying Ru

    2006-07-01

    To describe the development, components, initial results and lessons learned from Thailand's National Access to Antiretroviral Program for People living with HIV/AIDS (NAPHA), a historical review was conducted and program monitoring was analyzed. The national antiretroviral therapy program at different levels of the public health system was implemented with all major program components; ARV protocol development, health care professional training, drug supply chain management, laboratory network formation, monitoring and evaluation, and multi-sector and PHA involvement since 2001, which was based on elements of research, pilot projects, training, national guideline development, experiences and policy making. A national monitoring system was developed to monitor the progress of the program. From February 2001 to December 2004, the monitoring reports received from implementing hospitals showed that 58,133 cases had received antiretroviral therapy (ART), and 85% (49,477) of them were continuing to take ARV drugs. In conclusion, the NAPHA was implemented nationwide with comprehensive systems. The reports indicate achievement of expansion of the ART program. Lessons learned from the program initiation and scaling up show local leadership, comprehensive training, adherence, and coordination are essential to program effectiveness and sustainability.

  15. Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults.

    Science.gov (United States)

    Washburn, Lisa T; Cornell, Carol E; Phillips, Martha; Felix, Holly; Traywick, LaVona

    2014-09-01

    The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability. All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability. Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders. Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.

  16. Health Care Access and Use Among Low-Income Children on Subsidized Insurance Programs in California.

    OpenAIRE

    Christopher Trenholm; Anna Saltzman; Shanna Shulman; Michael Cousineau; Dana Hughes

    2008-01-01

    This paper summarizes the CaliforniaKids and Healthy Kids programs—county-based insurance programs in California for low-income children. The study examined features of both programs, use of basic health care services by the children enrolled, and typical experiences accessing inpatient and other high-cost care. Children enrolled in the two programs made substantial use of outpatient health care, despite important variation in program features. The study concludes with recommendations on ho...

  17. HIV/AIDS programmes should focus on improved access.

    Science.gov (United States)

    Manning, A

    2000-10-14

    This paper discusses the need for HIV/AIDS programs in sub-Saharan countries to focus more on improved access to information to empower poor people living in remote areas. It is noted that despite Glaxo Wellcome's move to reduce the cost of antiretroviral therapy, it is unlikely to have an impact on most of those infected with or affected by HIV/AIDS, since concerns regarding lack of sustainability, bureaucratic administration, and communication difficulties predominate in the country. In this regard, it is therefore recommended that national HIV/AIDS programs be balanced with the needs of both the community and the individual and in prevention and care. Health workers should be explicit in confronting traditional beliefs, such as those about gender roles and traditional medicine, in prevention campaigns. Moreover, there is also an urgent need to improve access to condoms; strengthen health programs such as directly observed treatment short-term (DOTS) courses for tuberculosis and the syndromic approach to sexually transmitted disease treatment; and improve practical support to communities caring for those who are sick and the orphans. Lastly, all partners working with prevention programs should use the more positive community attitudes towards HIV/AIDS issues seen in many sub-Saharan countries to develop evidence-based programs that focus more on improved access and less on sustainability.

  18. Factors influencing law enforcement decisions to adopt an evidence-based robbery prevention program.

    Science.gov (United States)

    Cabell, A; Casteel, C; Chronister, T; Nocera, M; Vladutiu, C J; Peek-Asa, C

    2013-12-01

    Homicide is the leading cause of workplace death among small retail and service businesses in the United States. Evidence-based programs have been shown to reduce robbery and robbery-related crimes in small retail businesses; however, reaching small businesses with programs has been difficult. As small businesses typically have no corporate backing or trade affiliation, police departments have been identified as potential vehicles for program dissemination. A national sample of 300 law enforcement agencies was surveyed to identify facilitators and barriers to adoption and sustainability of an evidence-based program. The questionnaire was developed using behavioral theory concepts and administered via telephone. Preliminary findings suggest the primary facilitators to program adoption included organizational capacity factors such as staff buy-in, dedicated personnel and financial support. Competing responsibilities was the primary barrier identified by agencies. Agency size and program complexity were identified as potential predictors of program adoption. Identifying agency and program-specific characteristics that influence program adoption by law enforcement agencies will be valuable for marketing programs to agencies that have the infrastructure to support and sustain program dissemination. Understanding these factors will optimize the reach of evidence-based strategies to small businesses.

  19. Access to non-pecuniary benefits: does gender matter? Evidence from six low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Alfano Marco

    2011-10-01

    Full Text Available Abstract Background Gender issues remain a neglected area in most approaches to health workforce policy, planning and research. There is an accumulating body of evidence on gender differences in health workers' employment patterns and pay, but inequalities in access to non-pecuniary benefits between men and women have received little attention. This study investigates empirically whether gender differences can be observed in health workers' access to non-pecuniary benefits across six low- and middle-income countries. Methods The analysis draws on cross-nationally comparable data from health facility surveys conducted in Chad, Côte d'Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. Probit regression models are used to investigate whether female and male physicians, nurses and midwives enjoy the same access to housing allowance, paid vacations, in-service training and other benefits, controlling for other individual and facility-level characteristics. Results While the analysis did not uncover any consistent pattern of gender imbalance in access to non-monetary benefits, some important differences were revealed. Notably, female nursing and midwifery personnel (the majority of the sample are found significantly less likely than their male counterparts to have accessed in-service training, identified not only as an incentive to attract and retain workers but also essential for strengthening workforce quality. Conclusion This study sought to mainstream gender considerations by exploring and documenting sex differences in selected employment indicators across health labour markets. Strengthening the global evidence base about the extent to which gender is independently associated with health workforce performance requires improved generation and dissemination of sex-disaggregated data and research with particular attention to gender dimensions.

  20. Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

    Science.gov (United States)

    Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

    Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

  1. Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

    Directory of Open Access Journals (Sweden)

    Michael J. Stewart

    2013-02-01

    Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

  2. Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

    Directory of Open Access Journals (Sweden)

    Michael J. Stewart

    2013-02-01

    Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt.Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis.Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

  3. Good, now keep going: challenging the status quo in STEM pipeline and access programs

    Science.gov (United States)

    Wiseman, Dawn; Herrmann, Randy

    2018-03-01

    This contribution engages in conversation with McMahon, Griese, and Kenyon (this issue) to consider how the SURE program they describe represents a pragmatic approach to addressing the issue of underrepresentation of Indigenous people in STEM post-secondary programs. We explore how such programs are generally positioned and how they might be positioned differently to challenge the status quo within Western post-secondary institutions. The challenge arises from moving beyond the immediate pragmatics of addressing an identifiable issue framed as a problem to considering how post-secondary institutions and people developing access recruitment programs might begin unlearning colonialism.

  4. Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

    Science.gov (United States)

    Choma, Kim; McKeever, Amy E

    2015-02-01

    The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

  5. Access 2010 Programmer's Reference

    CERN Document Server

    Hennig, Teresa; Griffith, Geoffrey L

    2010-01-01

    A comprehensive guide to programming for Access 2010 and 2007. Millions of people use the Access database applications, and hundreds of thousands of developers work with Access daily. Access 2010 brings better integration with SQL Server and enhanced XML support; this Wrox guide shows developers how to take advantage of these and other improvements. With in-depth coverage of VBA, macros, and other programming methods for building Access applications, this book also provides real-world code examples to demonstrate each topic.: Access is the leading database that is used worldwide; While VBA rem

  6. Evidence-Based Programming within Cooperative Extension: How Can We Maintain Program Fidelity While Adapting to Meet Local Needs?

    Science.gov (United States)

    Olson, Jonathan R.; Welsh, Janet A.; Perkins, Daniel F.

    2015-01-01

    In this article, we describe how the recent movement towards evidence-based programming has impacted Extension. We review how the emphasis on implementing such programs with strict fidelity to an underlying program model may be at odds with Extension's strong history of adapting programming to meet the unique needs of children, youth, families,…

  7. Evidence for Policy Making: Health Services Access and Regional Disparities in Kerman

    Directory of Open Access Journals (Sweden)

    Mina Anjomshoa

    2013-12-01

    Full Text Available Background and purpose: Health indices, regarding to their role in the development of society, are one of the most important indices at national level. Success of national development programs is largely dependent on the establishment of appropriate goals at the health sector, among which access to healthcare facilities is an essential requirement. The aim of this study was to examine the disparities in health services access across the Kerman province. Materials and Methods: This was a cross-sectional study. Study sample included the cities of Kerman province, ranked based on 15 health indices. Data was collected from statistical yearbook. The indices were weighted using Shannon entropy, then using the TOPSIS technique and the result were classified into three categories in terms of the level of development across towns. Results: The findings showed distinct regional disparities in health services across Kerman province and the significant difference was observed between the cities in terms of development. Shannon entropy introduced the number of pharmacologist per 10 thousand people as the most important indicator and the number of rural active health center per 1000 people as the less important indicator. According to TOPSIS, Kerman town (0.719 and Fahraj (0.1151 ranked the first and last in terms of access to health services respectively. Conclusion: There are significant differences between cities of Kerman province in terms of access to health care facilities and services. Therefore, it is recommended that officials and policy-makers determine resource allocation priorities according to the degree of development for a balanced and equitable distribution of health care facilities.

  8. Will the Pell Grant Have the Ability To Provide Access and Choice to Low-Income Students in the Future?

    Science.gov (United States)

    Lechuga, Vicente M.

    This paper provides a basic understanding of the Pell Grant program and summarizes the evidence regarding its effectiveness. The Basic Educational Opportunities Program, known as the Pell Grant program, began in 1973 as a means of providing disadvantaged students access to a postsecondary education. The Pell Grant program has tried to keep up with…

  9. Phase I - Smart Grid Data Access Pilot Program: Utilizing STEM Education as a Catalyst for Residential Consumer Decision Making and Change

    Energy Technology Data Exchange (ETDEWEB)

    Lishness, Alan [Gulf Of Maine Research Inst., Portland, ME (United States); Peake, Leigh [Gulf Of Maine Research Inst., Portland, ME (United States)

    2014-11-19

    Under Phase I of the Smart Grid Data Access Pilot Program, the Gulf of Maine Research Institute (GMRI) partnered with Central Maine Power (CMP), and the Maine Mathematics and Science Alliance (MMSA) and engaged key vendors Tilson Government Services, LLC (Tilson), and Image Works to demonstrate the efficacy of PowerHouse, an interactive online learning environment linking middle school students with their home electricity consumption data provided through CMP’s Advanced Metering Infrastructure (AMI). The goal of the program is to harness the power of youth to alter home energy consumption behaviors using AMI data. Successful programs aimed at smoking cessation, recycling, and seat belt use have demonstrated the power of young people to influence household behaviors. In an era of increasing concern about energy costs, availability, and human impacts on global climate, GMRI sought to demonstrate the effectiveness of a student-focused approach to understanding and managing household energy use. We also sought to contribute to a solid foundation of science-literate students who can analyze evidence to find solutions to increasingly complex energy challenges.

  10. Validation of an instrument to assess evidence-based practice knowledge, attitudes, access, and confidence in the dental environment.

    Science.gov (United States)

    Hendricson, William D; Rugh, John D; Hatch, John P; Stark, Debra L; Deahl, Thomas; Wallmann, Elizabeth R

    2011-02-01

    This article reports the validation of an assessment instrument designed to measure the outcomes of training in evidence-based practice (EBP) in the context of dentistry. Four EBP dimensions are measured by this instrument: 1) understanding of EBP concepts, 2) attitudes about EBP, 3) evidence-accessing methods, and 4) confidence in critical appraisal. The instrument-the Knowledge, Attitudes, Access, and Confidence Evaluation (KACE)-has four scales, with a total of thirty-five items: EBP knowledge (ten items), EBP attitudes (ten), accessing evidence (nine), and confidence (six). Four elements of validity were assessed: consistency of items within the KACE scales (extent to which items within a scale measure the same dimension), discrimination (capacity to detect differences between individuals with different training or experience), responsiveness (capacity to detect the effects of education on trainees), and test-retest reliability. Internal consistency of scales was assessed by analyzing responses of second-year dental students, dental residents, and dental faculty members using Cronbach coefficient alpha, a statistical measure of reliability. Discriminative validity was assessed by comparing KACE scores for the three groups. Responsiveness was assessed by comparing pre- and post-training responses for dental students and residents. To measure test-retest reliability, the full KACE was completed twice by a class of freshman dental students seventeen days apart, and the knowledge scale was completed twice by sixteen faculty members fourteen days apart. Item-to-scale consistency ranged from 0.21 to 0.78 for knowledge, 0.57 to 0.83 for attitude, 0.70 to 0.84 for accessing evidence, and 0.87 to 0.94 for confidence. For discrimination, ANOVA and post hoc testing by the Tukey-Kramer method revealed significant score differences among students, residents, and faculty members consistent with education and experience levels. For responsiveness to training, dental students

  11. The Process of Adoption of Evidence-based Tobacco Use Prevention Programs in California Schools

    Science.gov (United States)

    Little, Melissa A.; Pokhrel, Pallav; Sussman, Steve; Rohrbach, Louise Ann

    2014-01-01

    Although there are a number of research-validated substance use prevention programs available for wide-scale dissemination, very little is known about the factors that influence adoption of evidence-based prevention programs in schools. We tested a model of the mechanisms of program adoption in schools that was guided by diffusion of innovations and social ecological theories. Cross-sectional data were collected from a sample of school district and county office of education tobacco use prevention education coordinators throughout California. Structural equation modeling was used to test the effects of community- and organizational variables on the adoption of prevention programs via school administrators’ beliefs and the organization’s receipt of funding for the program. Results supported the hypothesis that the process of adoption begins with forming beliefs about the program, leading to adoption through the receipt of funding. In addition, we found direct effects of various community- and organizational-level factors on beliefs, receipt of funding, and adoption. These results are likely to inform policies that affect school districts’ use of evidence-based substance use prevention programming, which should ultimately lead to reductions in negative health outcomes among adolescents. Specifically, this study identifies various factors that could be targeted for improvement to enhance evidence-based program adoption. To our knowledge, this is the first study to empirically elucidate the process of adoption of evidence-based tobacco prevention programs in schools. PMID:24398826

  12. Changes in sport and physical activity behavior after participation in easily accessible sporting programs.

    NARCIS (Netherlands)

    Ooms, L.; Veenhof, C.

    2014-01-01

    Introduction: The Dutch government stimulates sport and physical activity opportunities in the neighborhood to make it easier for people to adopt a physically active lifestyle. Seven National Sports Federations (NSFs) were funded to develop easily accessible sporting programs, targeted at groups

  13. Unpacking the performance of a mobile health information messaging program for mothers (MomConnect) in South Africa: evidence on program reach and messaging exposure.

    Science.gov (United States)

    LeFevre, Amnesty E; Dane, Pierre; Copley, Charles J; Pienaar, Cara; Parsons, Annie Neo; Engelhard, Matt; Woods, David; Bekker, Marcha; Benjamin, Peter; Pillay, Yogan; Barron, Peter; Seebregts, Christopher John; Mohan, Diwakar

    2018-01-01

    Despite calls to address broader evidence gaps in linking digital technologies to outcome and impact level health indicators, limited attention has been paid to measuring processes pertaining to the performance of programs. In this paper, we assess the program reach and message exposure of a mobile health information messaging program for mothers (MomConnect) in South Africa. In this descriptive study, we draw from system generated data to measure exposure to the program through registration attempts and conversions, message delivery, opt-outs and drop-outs. Using a logit model, we additionally explore determinants for early registration, opt-outs and drop-outs. From August 2014 to April 2017, 1 159 431 women were registered to MomConnect; corresponding to half of women attending antenatal care 1 (ANC1) and nearly 60% of those attending ANC1 estimated to own a mobile phone. In 2016, 26% of registrations started to get women onto MomConnect did not succeed. If registration attempts were converted to successful registrations, coverage of ANC1 attendees would have been 74% in 2016 and 86% in 2017. When considered as percentage of ANC1 attendees with access to a mobile phone, addressing conversion challenges bring registration coverage to an estimated 83%-89% in 2016 and 97%-100% in 2017. Among women registered, nearly 80% of expected short messaging service messages were received. While registration coverage and message delivery success rates exceed those observed for mobile messaging programs elsewhere, study findings highlight opportunities for program improvement and reinforce the need for rigorous and continuous monitoring of delivery systems.

  14. Internet access is NOT restricted globally to high income countries: so why are evidenced based prevention and treatment programs for mental disorders so rare?

    Science.gov (United States)

    Watts, Sarah E; Andrews, Gavin

    2014-08-01

    Mental disorders are widespread and universal. They are frequently accompanied by considerable harmful consequences for the individual and come at a significant economic cost to a community. Yet while effective evidence based prevention and treatment exists, there are a number of barriers to access, implement and disseminate. Cognitive behavior therapy programs, such as those available at www.thiswayup.com.au are widely available using the Internet in high income countries, such as Australia. With the ubiquitous uptake of Internet users globally, it is suggested that low and middle income countries should consider ways to embrace and scale up these cost effective programs. An explanation of why and some suggestions as to how this can be done are presented. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  15. Design and management of database using microsoft access program: application in neurointerventional unit

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seon Moon; Jeong, Gyeong Un; Kim, Tae Il; Cha, Ji Hyeon; Pyun, Hae Wook; Woo, Ryu Chang; Kim, Ho Sung; Suh, Dae Chul [University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

    2005-10-15

    Complex clinical information in cerebral angiointervention unit requires effective management of statistical analysis for the classification of diagnosis and intervention including follow-up data from the interventional treatment. We present an application of Microsoft Access program for the management of patient data in cerebral angiointervention unit which suggests practical methods in recording and analyzing the patient data. Since January 2002, patient information from cerebral angiointervention was managed by a database with over 4000 patients. We designed a program which incorporates size items; Table, Query, Form, Report, Page and Macro. Patient data, follow-up data and information regarding diagnosis and intervention were established in the Form section, related by serial number, and connected to each other to an independent Table. Problems in running the program were corrected by establishing Entity Relationship (ER) diagnosis of Tables to define relationships between Tables. Convenient Queries, Forms and Reports were created to display expected information were applied from selected Tables. The relationship program which incorporated six items conveniently provided the number of cases per year, incidence of disease, lesion site, and case analysis based on interventional treatment. We were able to follow the patients after the interventional procedures by creating queries and reports. Lists of disease and patients files were identified easily each time by the Macro function. In addition, product names, size and characteristics of materials used were indexed and easily available. Microsoft Access program is effective in the management of patient data in cerebral angiointervention unit. Accumulation of large amounts of complex data handled by multiple users may require client/sever solutions such as a Microsoft SQL Server.

  16. Improving the care of people with traumatic brain injury through the Neurotrauma Evidence Translation (NET program: protocol for a program of research

    Directory of Open Access Journals (Sweden)

    Green Sally E

    2012-08-01

    Full Text Available Abstract The Neurotrauma Evidence Translation (NET program was funded in 2009 to increase the uptake of research evidence in the clinical care of patients who have sustained traumatic brain injury. This paper reports the rationale and plan for this five-year knowledge translation research program. The overarching aims of the program are threefold: to improve outcomes for people with traumatic brain injury; to create a network of neurotrauma clinicians and researchers with expertise in knowledge translation and evidence-based practice; and to contribute knowledge to the field of knowledge translation research. The program comprises a series of interlinked projects spanning varying clinical environments and disciplines relevant to neurotrauma, anchored within four themes representing core knowledge translation activities: reviewing research evidence; understanding practice; developing and testing interventions for practice change; and building capacity for knowledge translation in neurotrauma. The program uses a range of different methods and study designs, including: an evidence fellowship program; conduct of and training in systematic reviews; mixed method study designs to describe and understand factors that influence current practices (e.g., semi-structured interviews and surveys; theory-based methods to develop targeted interventions aiming to change practice; a cluster randomised trial to test the effectiveness of a targeted theory-informed intervention; stakeholder involvement activities; and knowledge translation events such as consensus conferences.

  17. Do Payments Pay Off? Evidence from Participation in Costa Rica's PES Program.

    Directory of Open Access Journals (Sweden)

    R A Arriagada

    Full Text Available Payments for environmental services (PES are often viewed as a way to simultaneously improve conservation outcomes and the wellbeing of rural households who receive the payments. However, evidence for such win-win outcomes has been elusive. We add to the growing literature on conservation program impacts by using primary household survey data to evaluate the socioeconomic impacts of participation in Costa Rica's PES program. Despite the substantial cash transfers to voluntary participants in this program, we do not detect any evidence of impacts on their wealth or self-reported well-being using a quasi-experimental design. These results are consistent with the common claim that voluntary PES do not harm participants, but they beg the question of why landowners participate if they do not benefit. Landowners in our sample voluntarily renewed their contracts after five years in the program and thus are unlikely to have underestimated their costs of participation. They apparently did not invest additional income from the program in farm inputs such as cattle or hired labor, since both decreased as a result of participation. Nor do we find evidence that participation encouraged moves off-farm. Instead, semi-structured interviews suggest that participants joined the program to secure their property rights and contribute to the public good of forest conservation. Thus, in order to understand the social impacts of PES, we need to look beyond simple economic rationales and material outcomes.

  18. Time Discounting and Credit Market Access in a Large-Scale Cash Transfer Programme

    Science.gov (United States)

    Handa, Sudhanshu; Martorano, Bruno; Halpern, Carolyn; Pettifor, Audrey; Thirumurthy, Harsha

    2017-01-01

    Summary Time discounting is thought to influence decision-making in almost every sphere of life, including personal finances, diet, exercise and sexual behavior. In this article we provide evidence on whether a national poverty alleviation program in Kenya can affect inter-temporal decisions. We administered a preferences module as part of a large-scale impact evaluation of the Kenyan Government’s Cash Transfer for Orphans and Vulnerable Children. Four years into the program we find that individuals in the treatment group are only marginally more likely to wait for future money, due in part to the erosion of the value of the transfer by inflation. However among the poorest households for whom the value of transfer is still relatively large we find significant program effects on the propensity to wait. We also find strong program effects among those who have access to credit markets though the program itself does not improve access to credit. PMID:28260842

  19. Time Discounting and Credit Market Access in a Large-Scale Cash Transfer Programme.

    Science.gov (United States)

    Handa, Sudhanshu; Martorano, Bruno; Halpern, Carolyn; Pettifor, Audrey; Thirumurthy, Harsha

    2016-06-01

    Time discounting is thought to influence decision-making in almost every sphere of life, including personal finances, diet, exercise and sexual behavior. In this article we provide evidence on whether a national poverty alleviation program in Kenya can affect inter-temporal decisions. We administered a preferences module as part of a large-scale impact evaluation of the Kenyan Government's Cash Transfer for Orphans and Vulnerable Children. Four years into the program we find that individuals in the treatment group are only marginally more likely to wait for future money, due in part to the erosion of the value of the transfer by inflation. However among the poorest households for whom the value of transfer is still relatively large we find significant program effects on the propensity to wait. We also find strong program effects among those who have access to credit markets though the program itself does not improve access to credit.

  20. Teaching evidence-based practice in a distance education occupational therapy doctoral program: strategies for professional growth and advancing the profession.

    Science.gov (United States)

    Reynolds, Stacey

    2010-01-01

    ABSTRACT The Centennial Vision of the American Occupational Therapy Association (AOTA) projects that by 2017 all occupational therapy (OT) practice areas will be supported by evidence. Achieving this goal requires preparing clinicians with the skills to assimilate, analyze, and apply research to their areas of practice and communicate the value of OT services to consumers and payers. These skills are at the heart of evidence-based practice (EBP). Educators must be prepared to teach EBP skills in both entry-level and postprofessional programs. This article outlines how EBP can be taught to postprofessional occupational therapy clinical doctoral students using a distance education format. Key features of a successful EBP course include having access to full-text electronic articles, opportunities for students to explore the literature in their own areas of interest, consistent and timely feedback on written work and discussion topics, and opportunities to collaborate with peers.

  1. Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.

    Science.gov (United States)

    Hunt, Anne W; De Feo, Luciano; Macintyre, Jennifer; Greenspoon, Dayna; Dick, Talia; Mah, Katherine; Paniccia, Melissa; Provvidenza, Christine; Reed, Nick

    2016-08-17

    Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g. Internet). The objective of this study was to develop, implement and evaluate the feasibility of an evidence-informed self-management education program for concussion recovery in youth. Synthesis of best evidence, principles of knowledge translation and exchange, and expert opinion were integrated within a self-management program framework to develop a comprehensive curriculum. The program was implemented and evaluated in a children's rehabilitation hospital within a universal health care system. A retrospective secondary analysis of anonymous data from a program evaluation survey was used to evaluate program feasibility, to identify features of importance to program participants and to assess changes in participants' knowledge. The program, "Concussion & You" includes a comprehensive, evidence informed, population specific curriculum that teaches participants practical strategies for management of return to school and play, sleep, nutrition, relaxation and energy conservation. A 'wheel of health' is used to facilitate participants' self-management action plan. Results from eighty-seven participant surveys indicate that the program is feasible and participant knowledge increased in all areas of the program with the highest changes reported in knowledge about sleep hygiene, rest and energy conservation. Findings indicate that "Concussion & You" is a feasible program that is acceptable to youth and their families, and fills a health system service gap.

  2. Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project).

    Science.gov (United States)

    Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb

    2018-04-01

    The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

  3. Assessing Program Efficiency: A Time and Motion Study of the Mental Health Emergency Care — Rural Access Program in NSW Australia

    Directory of Open Access Journals (Sweden)

    Emily Saurman

    2014-07-01

    Full Text Available The Mental Health Emergency Care-Rural Access Program (MHEC-RAP is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas.

  4. Planning for Sustainability of an Evidence-Based Mental Health Promotion Program in Canadian Elementary Schools.

    Science.gov (United States)

    Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena

    2015-09-01

    Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.

  5. Qigong in Cancer Care: Theory, Evidence-Base, and Practice

    Directory of Open Access Journals (Sweden)

    Penelope Klein

    2017-01-01

    Full Text Available Background: The purpose of this discussion is to explore the theory, evidence base, and practice of Qigong for individuals with cancer. Questions addressed are: What is qigong? How does it work? What evidence exists supporting its practice in integrative oncology? What barriers to wide-spread programming access exist? Methods: Sources for this discussion include a review of scholarly texts, the Internet, PubMed, field observations, and expert opinion. Results: Qigong is a gentle, mind/body exercise integral within Chinese medicine. Theoretical foundations include Chinese medicine energy theory, psychoneuroimmunology, the relaxation response, the meditation effect, and epigenetics. Research supports positive effects on quality of life (QOL, fatigue, immune function and cortisol levels, and cognition for individuals with cancer. There is indirect, scientific evidence suggesting that qigong practice may positively influence cancer prevention and survival. No one Qigong exercise regimen has been established as superior. Effective protocols do have common elements: slow mindful exercise, easy to learn, breath regulation, meditation, emphasis on relaxation, and energy cultivation including mental intent and self-massage. Conclusions: Regular practice of Qigong exercise therapy has the potential to improve cancer-related QOL and is indirectly linked to cancer prevention and survival. Wide-spread access to quality Qigong in cancer care programming may be challenged by the availability of existing programming and work force capacity.

  6. Condoms and sexual health education as evidence: impact of criminalization of in-call venues and managers on migrant sex workers access to HIV/STI prevention in a Canadian setting.

    Science.gov (United States)

    Anderson, S; Shannon, K; Li, J; Lee, Y; Chettiar, J; Goldenberg, S; Krüsi, A

    2016-11-17

    Despite a large body of evidence globally demonstrating that the criminalization of sex workers increases HIV/STI risks, we know far less about the impact of criminalization and policing of managers and in-call establishments on HIV/STI prevention among sex workers, and even less so among migrant sex workers. Analysis draws on ethnographic fieldwork and 46 qualitative interviews with migrant sex workers, managers and business owners of in-call sex work venues in Metro Vancouver, Canada. The criminalization of in-call venues and third parties explicitly limits sex workers' access to HIV/STI prevention, including manager restrictions on condoms and limited onsite access to sexual health information and HIV/STI testing. With limited labour protections and socio-cultural barriers, criminalization and policing undermine the health and human rights of migrant sex workers working in -call venues. This research supports growing evidence-based calls for decriminalization of sex work, including the removal of criminal sanctions targeting third parties and in-call venues, alongside programs and policies that better protect the working conditions of migrant sex workers as critical to HIV/STI prevention and human rights.

  7. Android Access Control Extension

    Directory of Open Access Journals (Sweden)

    Anton Baláž

    2015-12-01

    Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.

  8. An "Evidence-Based" Professional Development Program for Physics Teachers Focusing on Knowledge Integration

    Science.gov (United States)

    Berger, Hana

    This dissertation is concerned with the design and study of an evidence-based approach to the professional development of high-school physics teachers responding to the need to develop effective continuing professional development programs (CPD) in domains that require genuine changes in teachers' views, knowledge, and practice. The goals of the thesis were to design an evidence-based model for the CPD program, to implement it with teachers, and to study its influence on teachers' knowledge, views, and practice, as well as its impact on students' learning. The program was developed in three consecutive versions: a pilot, first, and second versions. Based on the pilot version (that was not part of this study), we developed the first version of the program in which we studied difficulties in employing the evidence-based and blended-learning approaches. According to our findings, we modified the strategies for enacting these approaches in the second version of the program. The influence of the program on the teachers and students was studied during the enactment of the second version of the program. The model implemented in the second version of the program was characterized by four main design principles: 1. The KI and evidence aspects are acquired simultaneously in an integrated manner. 2. The guidance of the teachers follows the principles of cognitive apprenticeship both in the evidence and the KI aspects. 3. The teachers experience the innovative activities as learners. 4. The program promotes continuity of teachers' learning through a structured "blended learning" approach. The results of our study show that this version of the program achieved its goals; throughout the program the teachers progressed in their knowledge, views, and practice concerning the knowledge integration, and in the evidence and learner-centered aspects. The results also indicated that students improved their knowledge of physics and knowledge integration skills that were developed

  9. Determinants of access to credit for SMEs: evidence at the level of the firm in Latin America

    Directory of Open Access Journals (Sweden)

    Héctor Alberto Botello Peñaloza

    2015-07-01

    Full Text Available The financing allows companies to address their economic resources to obtain external activities at different terms. However, there are flaws in the credit markets that limit this process, especially in SMEs. Taking into account the above, the objective of the paper is to investigate the determinants of access to credit for these businesses in Latin America. The analysis is based on a discrete choice model compound from the internal and external characteristics of the firms. It is evident that the size and technological capability are the most influential variables for access to funding markets, due to its ability to generate competitive advantages.

  10. TimeSet: A computer program that accesses five atomic time services on two continents

    Science.gov (United States)

    Petrakis, P. L.

    1993-01-01

    TimeSet is a shareware program for accessing digital time services by telephone. At its initial release, it was capable of capturing time signals only from the U.S. Naval Observatory to set a computer's clock. Later the ability to synchronize with the National Institute of Standards and Technology was added. Now, in Version 7.10, TimeSet is able to access three additional telephone time services in Europe - in Sweden, Austria, and Italy - making a total of five official services addressable by the program. A companion program, TimeGen, allows yet another source of telephone time data strings for callers equipped with TimeSet version 7.10. TimeGen synthesizes UTC time data strings in the Naval Observatory's format from an accurately set and maintained DOS computer clock, and transmits them to callers. This allows an unlimited number of 'freelance' time generating stations to be created. Timesetting from TimeGen is made feasible by the advent of Becker's RighTime, a shareware program that learns the drift characteristics of a computer's clock and continuously applies a correction to keep it accurate, and also brings .01 second resolution to the DOS clock. With clock regulation by RighTime and periodic update calls by the TimeGen station to an official time source via TimeSet, TimeGen offers the same degree of accuracy within the resolution of the computer clock as any official atomic time source.

  11. Intellectual property rights vs. public access rights: ethical aspects of the DeCSS decryptation program

    Directory of Open Access Journals (Sweden)

    Robert Vaagan

    2005-01-01

    Full Text Available Introduction. In 1999-2000, a Norwegian youth cracked a DVD-access code and published a decryptation program on the Internet. He was sued by the US DVD Copy Control Association (DVD-CCA and the Norwegian Motion Picture Association (MAP, allies of the US Motion Picture Association of America (MPAA, arrested by Norwegian police and charged with data crime. Two Norwegian court rulings in 2003 unanimously ruled that the program did not amount to a breach of Norwegian law, and he was fully acquitted. In the US, there have been related cases, some with other outcomes. Method. Based on a theoretical framework developed by Zwass, the paper discusses these court rulings and the wider issues of intellectual property rights versus public access rights. Analysis. The DVD-Jon case illustrates that intellectual property rights can conflict with public access rights, as the struggle between proprietary software and public domain software, as well as the SPARC and Open Archives Initiative reflect. Results. An assessment of the DVD-Jon case based on the Zwass framework does not give a clear information ethics answer. The analysis depends on whether one ascribes to consequentialist (e.g., utilitarian or de-ontological reflection, and also on which side of the digital gap is to be accorded most weight. Conclusion. While copyright interests are being legally strengthened, there may be ethically- grounded access rights that outweigh property rights.

  12. Building evidence for sustainability of food and nutrition intervention programs in developing countries.

    Science.gov (United States)

    Kim, Sunny S; Rogers, Beatrice L; Coates, Jennifer; Gilligan, Daniel O; Sarriot, Eric

    2013-09-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, "Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries," provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs.

  13. Evidence-Based Practice Knowledge, Attitude, Access and Confidence: A comparison of dental hygiene and dental students.

    Science.gov (United States)

    Santiago, Victoria; Cardenas, Melissa; Charles, Anne Laure; Hernandez, Estefany; Oyoyo, Udochukwu; Kwon, So Ran

    2018-04-01

    Purpose: The purpose of this study was to evaluate whether current educational strategies at a dental institution in the United States made a difference in dental hygiene (DNHY) and dental students' (D3) learning outcomes in the four domains of evidence-based practice (EBP), knowledge, attitude, accessing evidence, and confidence (KACE), following a 12-week research design course. Methods: All participants DNHY (n=19) and D3 (n=96) enrolled in the research design course at Loma Linda University completed a paper KACE survey distributed on the first day of class. Students completed the KACE survey once more at the end of the 12-week course. Pre- and post-survey results were compared both within and between the DNHY and D3 student groups to identify the learning outcomes in the four domains of EBP; knowledge, attitude, accessing evidence, and confidence in EBP. Descriptive statistics were conducted to profile all variables in the study; the level of significance was set at α=0.05. Results: All DNHY students (n=19) completed the pre and post KACE surveys; of the D3 (n=96) students enrolled in the course 82% (n=79) competed the post-survey. Comparison of the survey results showed that both DNHY and D3 students demonstrated statistically significant increases in their level of knowledge and attitude (p 0.05). Conclusion: DNHY and D3 students increased their knowledge and developed more positive attitudes towards EBP following a 12-week research design course. Study results identify improvement areas for EBP knowledge acquisition including determining levels of evidence, analysis of study results, and evaluating the appropriateness of research study designs through the use of validated EBP survey instrument. Copyright © 2018 The American Dental Hygienists’ Association.

  14. Adopting an Evidence-Based Lifestyle Physical Activity Program: Dissemination Study Design and Methods.

    Science.gov (United States)

    Dunn, Andrea L; Buller, David B; Dearing, James W; Cutter, Gary; Guerra, Michele; Wilcox, Sara; Bettinghaus, Erwin P

    2012-06-01

    BACKGROUND: There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. PURPOSE: This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. METHODS: Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program's textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. RESULTS: Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government

  15. All in One Stop? The Accessibility of Work Support Programs at One-Stop Centers.

    Science.gov (United States)

    Richer, Elise; Kubo, Hitomi; Frank, Abbey

    The accessibility of work support programs at one-stop centers was examined in a study during which 33 telephone directors or managers of one-stop centers in 22 states were interviewed by telephone. The interviews established the existence of extensive differences between one-stop centers from the standpoint of all aspects of their operation,…

  16. Evidence & Gap Maps: A tool for promoting evidence informed policy and strategic research agendas.

    Science.gov (United States)

    Snilstveit, Birte; Vojtkova, Martina; Bhavsar, Ami; Stevenson, Jennifer; Gaarder, Marie

    2016-11-01

    A range of organizations are engaged in the production of evidence on the effects of health, social, and economic development programs on human welfare outcomes. However, evidence is often scattered around different databases, web sites, and the gray literature and is often presented in inaccessible formats. Lack of overview of the evidence in a specific field can be a barrier to the use of existing research and prevent efficient use of limited resources for new research. Evidence & Gap Maps (EGMs) aim to address these issues and complement existing synthesis and mapping approaches. EGMs are a new addition to the tools available to support evidence-informed policymaking. To provide an accessible resource for researchers, commissioners, and decision makers, EGMs provide thematic collections of evidence structured around a framework which schematically represents the types of interventions and outcomes of relevance to a particular sector. By mapping the existing evidence using this framework, EGMs provide a visual overview of what we know and do not know about the effects of different programs. They make existing evidence available, and by providing links to user-friendly summaries of relevant studies, EGMs can facilitate the use of existing evidence for decision making. They identify key "gaps" where little or no evidence from impact evaluations and systematic reviews is available and can be a valuable resource to inform a strategic approach to building the evidence base in a particular sector. The article will introduce readers to the concept and methods of EGMs and present a demonstration of the EGM tool using existing examples. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Dietary Interventions in Multiple Sclerosis: Development and Pilot-Testing of an Evidence Based Patient Education Program.

    Science.gov (United States)

    Riemann-Lorenz, Karin; Eilers, Marlene; von Geldern, Gloria; Schulz, Karl-Heinz; Köpke, Sascha; Heesen, Christoph

    2016-01-01

    Dietary factors have been discussed to influence risk or disease course of multiple sclerosis (MS). Specific diets are widely used among patients with MS. To design and pilot-test an evidence based patient education program on dietary factors in MS. We performed a systematic literature search on the effectiveness of dietary interventions in MS. A web-based survey among 337 patients with MS and 136 healthy controls assessed knowledge, dietary habits and information needs. An interactive group education program was developed and pilot-tested. Fifteen randomised-controlled trials (RCTs) were included in the systematic review. Quality of evidence was low and no clear benefit could be seen. Patients with MS significantly more often adhered to a `Mediterranean Diet`(29.7% versus 14.0%, ppilot test of our newly developed patient education program with 13 participants showed excellent comprehensibility and the MS-specific content was judged as very important. However, the poor evidence base for dietary approaches in MS was perceived disappointing. Development and pilot-testing of an evidence-based patient education program on nutrition and MS is feasible. Patient satisfaction with the program suffers from the lack of evidence. Further research should focus on generating evidence for the potential influence of lifestyle habits (diet, physical activity) on MS disease course thus meeting the needs of patients with MS.

  18. Building Sustainable Professional Development Programs: Applying Strategies From Implementation Science to Translate Evidence Into Practice.

    Science.gov (United States)

    Baldwin, Constance D; Chandran, Latha; Gusic, Maryellen E

    2017-01-01

    Multisite and national professional development (PD) programs for educators are challenging to establish. Use of implementation science (IS) frameworks designed to convert evidence-based intervention methods into effective health care practice may help PD developers translate proven educational methods and models into successful, well-run programs. Implementation of the national Educational Scholars Program (ESP) is used to illustrate the value of the IS model. Four adaptable elements of IS are described: (1) replication of an evidence-based model, (2) systematic stages of implementation, (3) management of implementation using three implementation drivers, and (4) demonstration of program success through measures of fidelity to proven models and sustainability. Implementation of the ESP was grounded on five established principles and methods for successful PD. The process was conducted in four IS stages over 10 years: Exploration, Installation, Initial Implementation, and Full Implementation. To ensure effective and efficient processes, attention to IS implementation drivers helped to manage organizational relationships, build competence in faculty and scholars, and address leadership challenges. We describe the ESP's fidelity to evidence-based structures and methods, and offer three examples of sustainability efforts that enabled achievement of targeted program outcomes, including academic productivity, strong networking, and career advancement of scholars. Application of IS frameworks to program implementation may help other PD programs to translate evidence-based methods into interventions with enhanced impact. A PD program can follow systematic developmental stages and be operationalized by practical implementation drivers, thereby creating successful and sustainable interventions that promote the academic vitality of health professions educators.

  19. Access Customized Forms

    OpenAIRE

    Cosma Emil; Jeflea Victor

    2010-01-01

    By using Word, Excel or PowerPoint one can automate routine operations using the VBA language (Visual Basic for Applications). This language is also used in Access, allowing access to data stored in tables or queries. Thus, Access and VBA resources can be used together. Access is designed for programming forms and reports (among other things), so there won’t be found any of the VBA editor’s specific forms.

  20. The Devil Is in the Details: Examining the Evidence for "Proven" School-Based Drug Abuse Prevention Programs

    Science.gov (United States)

    Gandhi, Allison Gruner; Murphy-Graham, Erin; Petrosino, Anthony; Chrismer, Sara Schwartz; Weiss, Carol H.

    2007-01-01

    In an effort to promote evidence-based practice, government officials, researchers, and program developers have developed lists of model programs in the prevention field. This article reviews the evidence used by seven best-practice lists to select five model prevention programs. The authors' examination of this research raises questions about the…

  1. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs.

    Science.gov (United States)

    Wilson, David

    2015-06-01

    There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

  2. A knowledge management tool for public health: health-evidence.ca

    Directory of Open Access Journals (Sweden)

    Dobbins Maureen

    2010-08-01

    Full Text Available Abstract Background The ultimate goal of knowledge translation and exchange (KTE activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are

  3. Charter Halibut Limited Access Program

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This limited access system limits the number of charter vessels that may participate in the guided sport fishery for halibut in area 2C and 3A. NMFS issues a charter...

  4. Increasing access into higher education: Insights from the 2011 African Network on Evidence-to-Action on Disability Symposium - Education Commission.

    Science.gov (United States)

    Lyner-Cleophas, Marcia; Swart, Estelle; Chataika, Tsitsi; Bell, Diane

    2014-01-01

    This article provides some insights into the challenges regarding inclusion in higher education of students with disabilities. It does this by elucidating aspects of the proceedings of the Education Commission at the African Network on Evidence-to-Action on Disability (AfriNEAD) Symposium, which took place in Zimbabwe in November 2011. The presentations specifically focused on the education of people with disabilities from early childhood through to higher education. This article, however, is informed by presentations focusing on increasing access to higher education. The article is focused on the implementation of evidence in practice, research and policies stemming from rigorous debate and scientific foundations, whilst taking into account the dynamic realities of the higher education context. Themes such as the systemic approach needed for inclusion to be successful, increasing access and the dynamic role of students with disabilities are highlighted.

  5. Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

    Science.gov (United States)

    Kelsey, Meredith; Layzer, Jean

    2014-03-01

    This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  6. 76 FR 19356 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-04-07

    ... you will need and tell us how to contact you if we need more information. Make your request as early...-418-2498 (voice), 202-418-1169 (TTY), or [email protected] (e-mail); or Alison Neplokh, Media Bureau... or digital broadcast television; accessible user interfaces on video programming devices; and...

  7. Effectiveness of strategies to encourage general practitioners to accept an offer of free access to online evidence-based information: a randomised controlled trial.

    Science.gov (United States)

    Buchan, Heather; Lourey, Emma; D'Este, Catherine; Sanson-Fisher, Rob

    2009-10-20

    This study examined the effectiveness of seven different interventions designed to increase the proportion of general practitioners (GPs) accepting an offer of free access to an online evidence-based resource. Australian GPs (n = 14,000) were randomly selected and assigned to seven intervention groups, with each receiving a different letter. Seven different strategies were used to encourage GPs to accept an offer of two years free access to an online evidence-based resource (BMJ Clinical Evidence). The first group received a standard letter of offer with no experimental demands. Groups two to seven received a standard letter of offer outlining the requirements of the study. They were asked to complete an initial online questionnaire, agree to complete a 12-month follow-up questionnaire, and agree to having data about their usage of the online evidence-based resource provided to researchers. Groups three to seven also had additional interventions included in the letter of offer: access to an online tutorial in use of the resource (group three); provision of a pamphlet with statements from influential opinion leaders endorsing the resource (group four); offer of eligibility to receive professional development points (group five); offer of eligibility for a prize of $500 for registration at a medical conference of their choice (group six); and a combination of some of the above interventions (group seven). In the group with no research demands, 27% accepted the offer. Average acceptance across all other groups was 10%. There was no advantage in using additional strategies such as financial incentives, opinion leader support, offer of professional development points, or an educational aid over a standard letter of offer to increase acceptance rates. This study showed low acceptance rates of the offer of access to the online resource when there was an associated requirement of response to a short online questionnaire and non-obtrusive monitoring of GP behaviour in terms

  8. Individual- and area-level disparities in access to the road network, subway system and a public bicycle share program on the Island of Montreal, Canada.

    Science.gov (United States)

    Fuller, Daniel; Gauvin, Lise; Kestens, Yan

    2013-02-01

    Few studies have examined potential disparities in access to transportation infrastructures, an important determinant of population health. To examine individual- and area-level disparities in access to the road network, public transportation system, and a public bicycle share program in Montreal, Canada. Examining associations between sociodemographic variables and access to the road network, public transportation system, and a public bicycle share program, 6,495 adult respondents (mean age, 48.7 years; 59.0 % female) nested in 33 areas were included in a multilevel analysis. Individuals with lower incomes lived significantly closer to public transportation and the bicycle share program. At the area level, the interaction between low-education and low-income neighborhoods showed that these areas were significantly closer to public transportation and the bicycle share program controlling for individual and urbanicity variables. More deprived areas of the Island of Montreal have better access to transportation infrastructure than less-deprived areas.

  9. DO FAMILY PLANNING PROGRAMS DECREASE POVERTY? EVIDENCE FROM PUBLIC CENSUS DATA

    Science.gov (United States)

    Bailey, Martha J.; Malkova, Olga; Norling, Johannes

    2014-01-01

    This paper provides new evidence that family planning programs are associated with a decrease in the share of children and adults living in poverty. Our research design exploits the county roll-out of U.S. family planning programs in the late 1960s and early 1970s and examines their relationship with poverty rates in the short and longer-term in public census data. We find that cohorts born after federal family planning programs began were less likely to live in poverty in childhood and that these same cohorts were less likely to live in poverty as adults. PMID:25346655

  10. Rating the strength of scientific evidence: relevance for quality improvement programs.

    Science.gov (United States)

    Lohr, Kathleen N

    2004-02-01

    To summarize an extensive review of systems for grading the quality of research articles and rating the strength of bodies of evidence, and to highlight for health professionals and decision-makers concerned with quality measurement and improvement the available "best practices" tools by which these steps can be accomplished. Drawing on an extensive review of checklists, questionnaires, and other tools in the field of evidence-based practice, this paper discusses clinical, management, and policy rationales for rating strength of evidence in a quality improvement context, and documents best practices methods for these tasks. After review of 121 systems for grading the quality of articles, 19 systems, mostly specific, met a priori scientific standards for grading systematic reviews, randomized controlled trials, observational studies, and diagnostic tests; eight systems (of 40 reviewed) met similar standards for rating the overall strength of evidence. All can be used as is or adapted for particular types of evidence reports or systematic reviews. Formally grading study quality and rating overall strength of evidence, using sound instruments and procedures, can produce reasonable levels of confidence about the science base for parts of quality improvement programs. With such information, health care professionals and administrators concerned with quality improvement can understand better the level of science (versus only clinical consensus or opinion) that supports practice guidelines, review criteria, and assessments that feed into quality assurance and improvement programs. New systems are appearing and research is needed to confirm the conceptual and practical underpinnings of these grading and rating systems, but the need for those developing systematic reviews, practice guidelines, and quality or audit criteria to understand and undertake these steps is becoming increasingly clear.

  11. Vascular Access in Children

    International Nuclear Information System (INIS)

    Krishnamurthy, Ganesh; Keller, Marc S.

    2011-01-01

    Establishment of stable vascular access is one of the essential and most challenging procedures in a pediatric hospital. Many clinical specialties provide vascular service in a pediatric hospital. At the top of the “expert procedural pyramid” is the pediatric interventional radiologist, who is best suited and trained to deliver this service. Growing awareness regarding the safety and high success rate of vascular access using image guidance has led to increased demand from clinicians to provide around-the-clock vascular access service by pediatric interventional radiologists. Hence, the success of a vascular access program, with the pediatric interventional radiologist as the key provider, is challenging, and a coordinated multidisciplinary team effort is essential for success. However, there are few dedicated pediatric interventional radiologists across the globe, and also only a couple of training programs exist for pediatric interventions. This article gives an overview of the technical aspects of pediatric vascular access and provides useful tips for obtaining vascular access in children safely and successfully using image guidance.

  12. [Use of evidence in heath policies and programs contributions of the instituto nacional de salud].

    Science.gov (United States)

    Gutierrez, Ericson L; Piazza, Marina; Gutierrez-Aguado, Alfonso; Hijar, Gisely; Carmona, Gloria; Caballero, Patricia; Reyes, Nora; Canelo, Carlos; Aparco, Juan Pablo; Tejada, Romina A; Bolaños-Díaz, Rafael; Saravia, Silvia; Gozzer, Ernesto

    2016-01-01

    This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.

  13. Do difficulties in accessing in-hours primary care predict higher use of out-of-hours GP services? Evidence from an English National Patient Survey.

    Science.gov (United States)

    Zhou, Yin; Abel, Gary; Warren, Fiona; Roland, Martin; Campbell, John; Lyratzopoulos, Georgios

    2015-05-01

    It is believed that some patients are more likely to use out-of-hours primary care services because of difficulties in accessing in-hours care, but substantial evidence about any such association is missing. We analysed data from 567,049 respondents to the 2011/2012 English General Practice Patient Survey who reported at least one in-hours primary care consultation in the preceding 6 months. Of those respondents, 7% also reported using out-of-hours primary care. We used logistic regression to explore associations between use of out-of-hours primary care and five measures of in-hours access (ease of getting through on the telephone, ability to see a preferred general practitioner, ability to get an urgent or routine appointment and convenience of opening hours). We illustrated the potential for reduction in use of out-of-hours primary care in a model where access to in-hours care was made optimal. Worse in-hours access was associated with greater use of out-of-hours primary care for each access factor. In multivariable analysis adjusting for access and patient characteristic variables, worse access was independently associated with increased out-of-hours use for all measures except ease of telephone access. Assuming these associations were causal, we estimated that an 11% relative reduction in use of out-of-hours primary care services in England could be achievable if access to in-hours care were optimal. This secondary quantitative analysis provides evidence for an association between difficulty in accessing in-hours care and use of out-of-hours primary care services. The findings can motivate the development of interventions to improve in-hour access. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Newborn access and care in a health attention program

    Directory of Open Access Journals (Sweden)

    Poliana Remundini de Lima

    2016-03-01

    Full Text Available A cross-sectional study aimed to describe the access and integrality of attention to children before one year old, born between January of 2010 and December of 2012 in a Brazilian city, in a newborn attention program. From the 24.560 children, 55.0% were users of the Unified Health System (SUS; 10.1% children presented low weight at birth; 6,332 (46.9% children received BCG vaccine at the nursing consultation day; 13,590 (79.5% children had neonatal screening being less than seven days old; 17,035 (69.4% children were vaccinated for Hepatitis B at birth. Within SUS users, 68% of children went to nursing consultation at their first week of life and, 37.8% went to a medical consultation being 10 days old. The study presents information of care after birth at the primary healthcare as potential instrument to coordinate assistance to this clientele.

  15. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs.

    Directory of Open Access Journals (Sweden)

    David Wilson

    2015-06-01

    Full Text Available There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

  16. International dissemination of evidence-based practice, open access and the IACAPAP textbook of child and adolescent mental health.

    Science.gov (United States)

    Rey, Joseph M; Omigbodun, Olayinka Olusola

    2015-01-01

    Dramatic changes have occurred in both publishing and teaching in the last 20 years stemming from the digital and Internet revolutions. Such changes are likely to grow exponentially in the near future aided by the trend to open access publishing. This revolution has challenged traditional publishing and teaching methods that-largely but not exclusively due to cost-are particularly relevant to professionals in low and middle income countries. The digital medium and the Internet offer boundless opportunities for teaching and training to people in disadvantaged regions. This article describes the development of the IACAPAP eTextbook of child and adolescent mental health, its use, accessibility, and potential impact on the international dissemination of evidence-based practice.

  17. Microfinance Programs in Uganda: An Analysis of Household ...

    African Journals Online (AJOL)

    This paper identifies a model of low-income household participation in microfinance credit programs and the effects on investment behavior from repeated access to these institutions using evidence from household survey data. The primary focus is on changes in household investment behavior, not the assessment of ...

  18. Increasing access into higher education: Insights from the 2011 African Network on Evidence-to-Action on Disability Symposium – Education Commission

    Directory of Open Access Journals (Sweden)

    Marcia Lyner-Cleophas

    2014-06-01

    Full Text Available This article provides some insights into the challenges regarding inclusion in higher education of students with disabilities. It does this by elucidating aspects of the proceedings of the Education Commission at the African Network on Evidence-to-Action on Disability (AfriNEAD Symposium, which took place in Zimbabwe in November 2011. The presentations specifically focused on the education of people with disabilities from early childhood through to higher education. This article, however, is informed by presentations focusing on increasing access to higher education. The article is focused on the implementation of evidence in practice, research and policies stemming from rigorous debate and scientific foundations, whilst taking into account the dynamic realities of the higher education context. Themes such as the systemic approach needed for inclusion to be successful, increasing access and the dynamic role of students with disabilities are highlighted.

  19. Increasing access into higher education: Insights from the 2011 African Network on Evidence-to-Action on Disability Symposium – Education Commission

    Science.gov (United States)

    Swart, Estelle; Chataika, Tsitsi; Bell, Diane

    2014-01-01

    This article provides some insights into the challenges regarding inclusion in higher education of students with disabilities. It does this by elucidating aspects of the proceedings of the Education Commission at the African Network on Evidence-to-Action on Disability (AfriNEAD) Symposium, which took place in Zimbabwe in November 2011. The presentations specifically focused on the education of people with disabilities from early childhood through to higher education. This article, however, is informed by presentations focusing on increasing access to higher education. The article is focused on the implementation of evidence in practice, research and policies stemming from rigorous debate and scientific foundations, whilst taking into account the dynamic realities of the higher education context. Themes such as the systemic approach needed for inclusion to be successful, increasing access and the dynamic role of students with disabilities are highlighted. PMID:28730011

  20. Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries12

    Science.gov (United States)

    Kim, Sunny S.; Rogers, Beatrice L.; Coates, Jennifer; Gilligan, Daniel O.; Sarriot, Eric

    2013-01-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, “Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries,” provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs. PMID:24038245

  1. Resource List--Using Evidence-Based Programs as the Foundation of Comprehensive Sex Education

    Science.gov (United States)

    Advocates for Youth, 2015

    2015-01-01

    Decades of research have identified dozens of programs that are effective in helping young people reduce their risk for pregnancy, HIV, and STDs. These evidence-based programs utilize strategies that include the provision of accurate, honest information about abstinence as well as contraception and can serve as the foundation for comprehensive sex…

  2. Agglomeration, accessibility and industrial location: evidence from spanish municipalities

    OpenAIRE

    Alañón Pardo, Ángel; Arauzo Carod, Josep María

    2011-01-01

    This paper deals with the location decisions of manufacturing firms in Spain. We analyse how agglomeration economies and transport accessibility influence the location decisions of firms at municipality level and in three industries. The main empirical contributions of this paper are the econometric techniques used (spatial econometric models) and some of the explanatory variables (local gross domestic product, road accessibility, and the characteristics of firms in neighbouring municipalitie...

  3. Impact of School Flu Vaccine Program on Student Absences

    Science.gov (United States)

    Plaspohl, Sara S.; Dixon, Betty T.; Streater, James A.; Hausauer, Elizabeth T.; Newman, Christopher P.; Vogel, Robert L.

    2014-01-01

    Literature provides evidence that school attendance correlates with academic performance and student success. Influenza is a contributing factor to school absences. Primary prevention for influenza includes immunization. School-located influenza vaccine (SLIV) programs provide greater access for students to be immunized. A retrospective review of…

  4. Perspectives of People Living with HIV on Access to Health Care: Protocol for a Scoping Review.

    Science.gov (United States)

    Asghari, Shabnam; Maybank, Allison; Hurley, Oliver; Modir, Hilary; Farrell, Alison; Marshall, Zack; Kendall, Claire; Johnston, Sharon; Hogel, Matthew; Rourke, Sean B; Liddy, Clare

    2016-05-18

    Strategies to improve access to health care for people living with human immunodeficiency virus (PLHIV) have demonstrated limited success. Whereas previous approaches have been informed by the views of health providers and decision-makers, it is believed that incorporating patient perspectives into the design and evaluations of health care programs will lead to improved access to health care services. We aim to map the literature on the perspectives of PLHIV concerning access to health care services, to identify gaps in evidence, and to produce an evidence-informed research action plan to guide the Living with HIV program of research. This scoping review includes peer-reviewed and grey literature from 1946 to May 2014 using double data extraction. Variations of the search terms "HIV", "patient satisfaction", and "health services accessibility" are used to identify relevant literature. The search strategy is being developed in consultation with content experts, review methodologists, and a librarian, and validated using gold standard studies identified by those stakeholders. The inclusion criteria are (1) the study includes the perspectives of PLHIV, (2) study design includes qualitative, quantitative, or mixed methods, and (3) outcome measures are limited to patient satisfaction, their implied needs, beliefs, and desires in relation to access to health care. The papers are extracted by two independent reviewers, including quality assessment. Data is then collated, summarized, and thematically analyzed. A total of 12,857 references were retrieved, of which 326 documents were identified as eligible in pre-screening, and 64 articles met the inclusion criteria (56% qualitative studies, 38% quantitative studies and 6% mixed-method studies). Only four studies were conducted in Canada. Data synthesis is in progress and full results are expected in June, 2016. This scoping review will record and characterize the extensive body of literature on perspectives of PLHIV

  5. Overcoming barriers in HPV vaccination and screening programs

    Directory of Open Access Journals (Sweden)

    Alex Vorsters

    2017-12-01

    Full Text Available The Human Papillomavirus Prevention and Control Board brought together experts to discuss optimizing HPV vaccination and screening programs.Board members reviewed the safety profile of licensed HPV vaccines based on clinical and post-marketing data, reaching a consensus that current safety data is reassuring.Successful vaccination programs used well-coordinated communication campaigns, integrating (social media to spread awareness. Communication of evidence supporting vaccine effectiveness had beneficial effects on the perception of the vaccine. However, anti-vaccination campaigns have threatened existing programs in many countries.Measurement and monitoring of HPV vaccine confidence over time could help understand the nature and scale of waning confidence, define issues and intervene appropriately using context-specific evidence-based strategies. Finally, a broad group of stakeholders, such as teachers, health care providers and the media should also be provided with accurate information and training to help support prevention efforts through enhanced understanding of the risks and benefits of vaccination.Similarly, while cervical cancer screening through population-based programs is highly effective, barriers to screening exist: awareness in countries with population-based screening programs, access for vulnerable populations, and access and affordability in low- and middle-income countries. Integration of primary and secondary prevention has the potential to accelerate the decrease in cervical cancer incidence. Keywords: (max 6 Human papillomavirus, Vaccine, Screening, Barriers, Vaccine confidence

  6. IDA: An Intelligent Data Access Program

    National Research Council Canada - National Science Library

    Sagalowicz, Daniel

    1977-01-01

    .... The first component of LADDER is INLAND (Informal Natural Language Access to Navy Data), which allows the user to ask questions in English about information contained in databases similar to those currently...

  7. Enabling Highly-Scalable Remote Memory Access Programming with MPI-3 One Sided

    Directory of Open Access Journals (Sweden)

    Robert Gerstenberger

    2014-01-01

    Full Text Available Modern interconnects offer remote direct memory access (RDMA features. Yet, most applications rely on explicit message passing for communications albeit their unwanted overheads. The MPI-3.0 standard defines a programming interface for exploiting RDMA networks directly, however, it's scalability and practicability has to be demonstrated in practice. In this work, we develop scalable bufferless protocols that implement the MPI-3.0 specification. Our protocols support scaling to millions of cores with negligible memory consumption while providing highest performance and minimal overheads. To arm programmers, we provide a spectrum of performance models for all critical functions and demonstrate the usability of our library and models with several application studies with up to half a million processes. We show that our design is comparable to, or better than UPC and Fortran Coarrays in terms of latency, bandwidth and message rate. We also demonstrate application performance improvements with comparable programming complexity.

  8. Community Impact of Pharmacy-Randomized Intervention to Improve Access to Syringes and Services for Injection Drug Users

    Science.gov (United States)

    Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

    2014-01-01

    Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…

  9. The fetal programming of food preferences: current clinical and experimental evidence.

    Science.gov (United States)

    Dalle Molle, R; Bischoff, A R; Portella, A K; Silveira, P P

    2015-09-28

    Increased energy consumption is one of the major factors implicated in the epidemic of obesity. There is compelling evidence, both clinical and experimental, that fetal paucity of nutrients may have programming effects on feeding preferences and behaviors that can contribute to the development of diseases. Clinical studies in different age groups show that individuals born small for their gestational age (SGA) have preferences towards highly caloric foods such as carbohydrates and fats. Some studies have also shown altered eating behaviors in SGA children. Despite an apparent discrepancy in different age groups, all studies seem to converge to an increased intake of palatable foods in SGA individuals. Small nutrient imbalances across lifespan increase the risk of noncommunicable diseases in adult life. Homeostatic factors such as altered responses to leptin and insulin and alterations in neuropeptides associated with appetite and satiety are likely involved. Imbalances between homeostatic and hedonic signaling are another proposed mechanism, with the mesocorticolimbic dopaminergic pathway having differential reward and pleasure responses when facing palatable foods. Early exposure to undernutrition also programs hypothalamic-pituitary-adrenal axis, with SGA having higher levels of cortisol in different ages, leading to chronic hyperactivity of this neuroendocrine axis. This review summarizes the clinical and experimental evidence related to fetal programming of feeding preferences by SGA.

  10. A Pilot Study for Linking Adolescent Patients to an Interactive Tobacco Prevention Program

    Directory of Open Access Journals (Sweden)

    Karen S. Calabro

    2017-04-01

    Full Text Available Context: The American Academy of Pediatrics and professional guidelines recommend intervening with adolescents about avoiding tobacco use in the health-care setting. Barriers in the clinical setting limit consistent provision of this critical service. Objectives: This pilot study compared 2 approaches for referring adolescents to an evidence-based tobacco prevention and cessation program in the outpatient setting. Secondary aims assessed tobacco use, knowledge, and program evaluation. Design, Setting, and Participants: The study setting was a medical and dental clinic. Participants aged 13 to 18 received tobacco advice and instructions to work through “A Smoking Prevention Interactive Experience.” The program addresses health concerns of adolescents about tobacco use and is founded on behavioral change theories. The link to access it is featured on the website of the National Cancer Institute’s Research-Tested Interventions. Participants (N = 197 were randomized to 1 of 2 approaches (ie, a program link via e-mail or referral by a printed card. Results: The program was accessed by 57% (112 of 197 of participants. Both referral approaches were equally effective. Non-Hispanics were twice as likely to access the program as Hispanics (adjusted odds ratio = 2.1, 95% confidence interval = 1.2-3.8, P < .05. Over 95% of participants identified themselves as nonusers of tobacco and evaluated the program as beneficial in increasing knowledge and motivation to remain tobacco-free. Conclusion: Linking adolescent patients to an evidence-based tobacco prevention/cessation program at a community health clinic was highly promising and feasible. We present conclusions for future research.

  11. The Social Construction of "Evidence-Based" Drug Prevention Programs: A Reanalysis of Data from the Drug Abuse Resistance Education (DARE) Program

    Science.gov (United States)

    Gorman, Dennis M.; Huber, J. Charles, Jr.

    2009-01-01

    This study explores the possibility that any drug prevention program might be considered "evidence-based" given the use of data analysis procedures that optimize the chance of producing statistically significant results by reanalyzing data from a Drug Abuse Resistance Education (DARE) program evaluation. The analysis produced a number of…

  12. An evaluation of the availability, accessibility, and quality of online content of vascular surgery training program websites for residency and fellowship applicants.

    Science.gov (United States)

    Huang, Bryant Y; Hicks, Taylor D; Haidar, Georges M; Pounds, Lori L; Davies, Mark G

    2017-12-01

    Vascular surgery residency and fellowship applicants commonly seek information about programs from the Internet. Lack of an effective web presence curtails the ability of programs to attract applicants, and in turn applicants may be unable to ascertain which programs are the best fit for their career aspirations. This study was designed to evaluate the presence, accessibility, comprehensiveness, and quality of vascular surgery training websites (VSTW). A list of accredited vascular surgery training programs (integrated residencies and fellowships) was obtained from four databases for vascular surgery education: the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, Fellowship and Residency Electronic Interactive Database, and Society for Vascular Surgery. Programs participating in the 2016 National Resident Matching Program were eligible for study inclusion. Accessibility of VSTW was determined by surveying the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, and Fellowship and Residency Electronic Interactive Database for the total number of programs listed and for the presence or absence of website links. VSTW were analyzed for the availability of recruitment and education content items. The quality of VSTW was determined as a composite of four dimensions: content, design, organization, and user friendliness. Percent agreements and kappa statistics were calculated for inter-rater reliability. Eighty-nine of the 94 fellowship (95%) and 45 of the 48 integrated residencies (94%) programs participating in the 2016 Match had a VSTW. For program recruitment, evaluators found an average of 12 of 32 content items (35.0%) for fellowship programs and an average of 12 of 32 (37%) for integrated residencies. Only 47.1% of fellowship programs (53% integrated residencies) specified the number of positions available for the 2016 Match, 20% (13% integrated residencies) indicated alumni

  13. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Manlove J

    2015-04-01

    Full Text Available Jennifer Manlove, Heather Fish, Kristin Anderson Moore Child Trends, Bethesda, MD, USA Background: US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs, highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods: This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results: Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome. We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use. Conclusion: Future efforts should

  14. Event-related potential evidence of accessing gender stereotypes to aid source monitoring.

    Science.gov (United States)

    Leynes, P Andrew; Crawford, Jarret T; Radebaugh, Anne M; Taranto, Elizabeth

    2013-01-23

    Source memory for the speaker's voice (male or female) was investigated when semantic knowledge (gender stereotypes) could and could not inform the episodic source judgment while event-related potentials (ERPs) were recorded. Source accuracy was greater and response times were faster when stereotypes could predict the speaker's voice at test. Recollection supported source judgments in both conditions as indicated by significant parietal "old/new" ERP effects (500-800ms). Prototypical late ERP effects (the right frontal "old/new" effect and the late posterior negativity, LPN) were evident when source judgment was based solely on episodic memory. However, these two late ERP effects were diminished and a novel, frontal-negative ERP with left-central topography was observed when stereotypes aided source judgments. This pattern of ERP activity likely reflects activation of left frontal or left temporal lobes when semantic knowledge, in the form of a gender stereotype, is accessed to inform the episodic source judgment. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries12

    OpenAIRE

    Kim, Sunny S.; Rogers, Beatrice L.; Coates, Jennifer; Gilligan, Daniel O.; Sarriot, Eric

    2013-01-01

    After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, “Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries,” provided not only frameworks for conceptualizing sustain...

  16. Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Margolis, Amy Lynn; Roper, Allison Yvonne

    2014-03-01

    After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.

  17. Evidence in promoting positive parenting through the Program-Guide to Develop Emotional Competences

    Directory of Open Access Journals (Sweden)

    Raquel-Amaya Martínez-González

    2016-07-01

    Full Text Available This study aims at providing evidence of the effectiveness of the Program-Guide to Develop Emotional Competences in promoting positive parenting. Contextual, institutional, methodological and professional issues were taken into account to develop a social innovation experience to support parenting as a preventive measure to family conflicts. The study describes both the contents of the Program-Guide and the methodological and evaluation issues that trained professionals need to consider when delivering the Program-Guide to families in natural contexts. Information was gathered and analyzed from 259 parents with children of ages 1-18 who participated in 26 parent training groups. A pre- and post-test design showed that after finishing the sessions parents perceived themselves more competent as parents according to the five dimensions of parenting competences considered: (1 emotional self-regulation abilities; (2 self-esteem and assertiveness; (3 communication strategies; (4 strategies to solve conflicts and to negotiate; and (5 strategies to establish coherent norms, limits and consequences to promote positive discipline. The study presents a discussion on these results from evidence-based parenting programs, as well as some strengths and limitations of the study, together with some suggestions for further research.

  18. Access Denied! Contrasting Data Access in the United States and Ireland

    Directory of Open Access Journals (Sweden)

    Grogan Samuel

    2016-07-01

    Full Text Available The ability of an Internet user to access data collected about himself as a result of his online activity is a key privacy safeguard. Online, data access has been overshadowed by other protections such as notice and choice. This paper describes attitudes about data access. 873 US and Irish Internet users participated in a survey designed to examine views on data access to information held by online companies and data brokers. We observed low levels of awareness of access mechanisms along with a high desire for access in both participant groups. We tested three proposed access systems in keeping with industry programs and regulatory proposals. User response was positive. We conclude that access remains an important privacy protection that is inadequately manifested in practice. Our study provides insight for lawmakers and policymakers, as well as computer scientists who implement these systems.

  19. Value-Based Payment Reform and the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015: A Primer for Plastic Surgeons.

    Science.gov (United States)

    Squitieri, Lee; Chung, Kevin C

    2017-07-01

    In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.

  20. 76 FR 26927 - National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the Access to...

    Science.gov (United States)

    2011-05-10

    ... commenters requested that the NOP facilitate a means to obtain organic certification and grass-fed..., can elect to pursue claims, such as grass-fed, in addition to and separate from organic certification...-11-07] National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the Access to...

  1. The rapid access palliative radiotherapy program: blueprint for initiation of a one-stop multidisciplinary bone metastases clinic.

    Science.gov (United States)

    Fairchild, A; Pituskin, E; Rose, B; Ghosh, S; Dutka, J; Driga, A; Tachynski, P; Borschneck, J; Gagnon, L; Macdonnell, S; Middleton, J; Thavone, K; Carstairs, S; Brent, D; Severin, D

    2009-02-01

    Radiotherapy (RT) for palliation of pain due to bone metastases (BM) is effective but underutilized likely due to the traditional practice of separate clinic visits for consultation, treatment planning, and RT delivery. However, recent evidence proves one RT treatment is as effective as multiple for analgesia, enabling investigation of an alternative model of RT delivery, the rapid access palliative radiotherapy program (RAPRP). Prior to the start of the program, needs assessment was performed to determine the composition of the optimal team. Screening tools were implemented to streamline holistic, multidisciplinary assessment. An advertising strategy, treatment and research protocols, and mechanisms for patient feedback were established. After RAPRP implementation, patient outcomes such as symptom relief were tracked. Eighty-six patients with painful BM were referred over the 25-week pilot. Median age was 69.9 years; 64% had prostate cancer, and median performance status was 70. Patient-rated pain was on average 6.1/10 at baseline, improving to 2.6/10 by week 4 post-RT. On average, 6.2 symptoms were reported (baseline) compared to 5.2 (week 4). Team members assessed 10-100% of patients and were successful in stabilizing or improving all symptoms in >75% contacted at week 4. One hundred percent of patients surveyed were satisfied with their experience. Early needs assessment was advantageous in determining the optimal team and methods of assessment for our 'one-stop' BM clinic. This approach was successful in improving pain and other symptoms, and the convenience of seeing multiple providers on 1 day was appreciated by the patients.

  2. Disability and employee benefits receipt: evidence from the U.S. Vocational Rehabilitation Services Program.

    Science.gov (United States)

    Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong

    2012-01-01

    Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.

  3. 50 CFR 648.60 - Sea scallop area access program requirements.

    Science.gov (United States)

    2010-10-01

    ... subsequent fishing year. For example, a vessel that terminates an Elephant Trunk Access Area trip on December...) Elephant Trunk Access Area. For the 2010 fishing year, the observer set-aside for the Elephant Trunk Access... Area. For the 2010 fishing year, the research set-aside for the Elephant Trunk Access Area is 277,060...

  4. Do Parent Education Programs Promote Healthy Post-Divorce Parenting? Critical Distinctions and a Review of the Evidence

    Science.gov (United States)

    Sigal, Amanda; Sandler, Irwin; Wolchik, Sharlene; Braver, Sanford

    2009-01-01

    Most parent education programs are designed to improve child well-being following divorce by changing some aspect of parenting. However, there has been relatively little discussion of what aspects of parenting are most critical and the effectiveness of programs to change different aspects of parenting. This paper addresses these issues by: 1. Distinguishing three aspects of post-divorce parenting that have been targeted in parent education programs; 2. Reviewing evidence of the relations between each aspect of parenting and the well-being of children and; 3. Critically reviewing evidence that parent education programs have been successful in changing each aspect of post-divorce parenting. PMID:21552360

  5. Substance Abuse Intensive Outpatient Programs: Assessing the Evidence

    Science.gov (United States)

    McCarty, Dennis; Braude, Lisa; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Delphin-Rittmon, Miriam E.

    2014-01-01

    Objective Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This article assesses their evidence base. Methods Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. They identified 12 individual studies and one review published between 1995 and 2012. They chose from three levels of research evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results Based on the quality of trials, diversity of settings, and consistency of outcomes, the level of evidence for IOP research was considered high. Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up. However, substantial variability in the operationalization of IOPs and outcome measures was apparent. Conclusions IOPs are an important part of the continuum of care for alcohol and drug use disorders. They are as effective as inpatient treatment for most individuals seeking care. Public and commercial health plans should consider IOP treatment as a covered health benefit. Standardization of the elements included in IOPs may improve their quality and effectiveness. PMID:24445620

  6. Ecological and environmental data as under-utilized national resources: results of the TIE/ACCESS program

    Energy Technology Data Exchange (ETDEWEB)

    Armentano, T.V.; Loucks, O.L.

    1979-06-01

    The goal of The Institute of Energy (TIE) 1977 to 1979 ACCESS program was to define the national need for ecological and environmental data and the extent to which present data documentation and archiving are meeting this need. The principal steps focussed on current data documentation and research in government, private and academic sectors of the natural science technical community, particularly as they bear on the accessibility of environmental data to secondary users. The extent to which existing data services are satisfying the needs of data users also was emphasized. The results indicate that the potential contributions which existing data and models could make are not being achieved because of inconsistencies in data documentation, inadequate communication between data suppliers and data users, and a lack of overall coordination of the data bases in national research and monitoring programs. A nationally coordinated network is proposed which focuses on regional data centers and ties together the hierarchy of data bases (national, state, and local) with the broad spectrum of potential users. The network concept includes immediate development of a comprehensive catalog of data resources in each region, with later production of a data abstract journal as one of two methods for communicating between regional and local data centers and the user community.

  7. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    Science.gov (United States)

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

  8. Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

    Science.gov (United States)

    Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

    2016-08-01

    Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

  9. Implementation and outcomes of an evidence-based precepting program for burn nurses.

    Science.gov (United States)

    Robbins, Johnnie R; Valdez-Delgado, Krystal K; Caldwell, Nicole W; Yoder, Linda H; Hayes, Elizabeth J; Barba, Michaèl G; Greeley, Hope L; Mitchell, Colleen; Mann-Salinas, Elizabeth A

    2017-11-01

    There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty. The Iowa Model of Evidence-based Practice served as the model for this project. A working group was formed consisting of nurse scientists, clinical nurse leaders, clinical nurse specialists, lead preceptors, staff nurse preceptors and wound care coordinators. A systematic review of the literature was conducted focusing on nurse transition; preceptor development and transitioning nurse training programs with competency assessment, ongoing multifaceted evaluation and retention strategies were created. The evidence-based Vermont Nurses in Partnership (VNIP) Clinical Transition Framework was selected and subsequent education was provided to all Burn Center leaders and staff. Benchmarks for basic knowledge assessment (BKAT) and burn wound care were established among current staff by work site and education level to help evaluate transitioning nurses. Policies were modified to count each preceptor/transitioning nurse dyad as half an employee on the schedule. Multiple high-fidelity simulation scenarios were created to expand hands-on opportunities. From September 2012-December 2013, 110 (57% acute care nursing) Burn Center staff attended the VNIP Clinical Coaching Course, to include 34 interdisciplinary staff (rehabilitation, education, respiratory therapy, and outpatient clinic staff) and 100% of identified preceptors (n=33). A total of 30 new nurses participated in the transition program: 26 (87%) completed, 3 (10%) did not complete

  10. A workplace intervention program and the increase in HIV knowledge, perceived accessibility and use of condoms among young factory workers in Thailand.

    Science.gov (United States)

    Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote

    2017-12-01

    Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.

  11. Open versus Controlled-Access Data | Office of Cancer Genomics

    Science.gov (United States)

    OCG employs stringent human subjects’ protection and data access policies to protect the privacy and confidentiality of the research participants. Depending on the risk of patient identification, OCG programs data are available to the scientific community in two tiers: open or controlled access. Both types of data can be accessed through its corresponding OCG program-specific data matrix or portal. Open-access Data

  12. Putting out the welcome mat-targeting outreach efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program.

    Science.gov (United States)

    Dybdal, Kristin; Blewett, Lynn A; Pintor, Jessie Kemmick; Johnson, Kelli

    2015-01-01

    An evaluation of the Minnesota Community Application Agent (MNCAA) Program was conducted for the MN Minnesota Department of Human Services and funded by the Health Resources and Services Administration's State Health Access Program grant. The MNCAA evaluation assessed effectiveness in reaching disparate populations, explored overall program value, and sought lessons applicable to the Navigator programs required under the Affordable Care Act. Mixed-methods approach using quantitative analysis of tracking and payment data and interviews with key informants to elicit "lessons learned" about the MNCAA program. The MNCAA program offers incentive payments and technical assistance to community partner organizations that assist individuals in applying for public health care coverage. A total of 140 unique community organizations participated in the MNCAA program in 2008 to 2012. Outreach staff and directors from participating MNCAAs and state/local government officials were interviewed. The article highlights a strategy for targeting outreach to individuals eligible for Medicaid coverage or subsidies under the Affordable Care Act by presenting evaluation findings from a unique outreach program to increase access to care for vulnerable populations in Minnesota. Almost two-thirds of applicants were successfully enrolled but lengthy waiting periods persisted. Seventy percent of applications came from health care organizations. Only 13% of applicants assisted by MNCAAs were new to public health care programs. Most MNCAAs believed that the incentive payment-$25 per successful enrollee-was insufficient. Significant expertise in enrolling individuals in public health care programs exists within a core group of community organizations. Incentives to leverage the capacity of community organizations must be accompanied by recruiting and training. Outreach providers and navigators also need timely access to client information. More investment in financial incentives will be required.

  13. Asia Oceania Guidelines for the Implementation of Programs for Cervical Cancer Prevention and Control

    Science.gov (United States)

    Ngan, Hextan Y. S.; Garland, Suzanne M.; Bhatla, Neerja; Pagliusi, Sonia R.; Chan, Karen K. L.; Cheung, Annie N. Y.; Chu, Tang-Yuan; Domingo, Efren J.; Qiao, You Lin; Park, Jong Sup; Tay, Eng Hseon; Supakarapongkul, Wisit

    2011-01-01

    This paper aims to provide evidence-based recommendations for health professionals, to develop a comprehensive cervical cancer program for a clinic, a community, or a country. Ensuring access to healthcare is the responsibility of all societies, and the Asia Oceania Research Organisation in Genital Infections and Neoplasia (AOGIN) is committed to working collaboratively with governments and health professionals to facilitate prevention programs, to protect girls and women from cervical cancer, a disease that globally affects 500,000 and kills nearly 300,000 women annually, just over half of whom are in the Asia Oceania region. We share the vision that a comprehensive program of vaccination, screening, and treatment should be made accessible to all girls and women in the world. The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed. PMID:21559068

  14. Asia Oceania Guidelines for the Implementation of Programs for Cervical Cancer Prevention and Control

    International Nuclear Information System (INIS)

    Ngan, H. Y. S.; Chan, K. K. L.; Cheung, A. N. Y.; Garland, S. M.

    2011-01-01

    This paper aims to provide evidence-based recommendations for health professionals, to develop a comprehensive cervical cancer program for a clinic, a community, or a country. Ensuring access to health care is the responsibility of all societies, and the Asia Oceania Research Organisation in Genital Infections and Neoplasia (AOGIN) is committed to working collaboratively with governments and health professionals to facilitate prevention programs, to protect girls and women from cervical cancer, a disease that globally affects 500,000 and kills nearly 300,000 women annually, just over half of whom are in the Asia Oceania region. We share the vision that a comprehensive program of vaccination, screening, and treatment should be made accessible to all girls and women in the world. The primary purpose of these guidelines is to provide information on scientific evidence on the different modalities and approaches of cervical cancer prevention programs, for high resource and low resource settings. The secondary purpose is to provide an overview of the current situation of cervical cancer control and prevention in various Asian Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed.

  15. Correlates of Access to Business Research Databases

    Science.gov (United States)

    Gottfried, John C.

    2010-01-01

    This study examines potential correlates of business research database access through academic libraries serving top business programs in the United States. Results indicate that greater access to research databases is related to enrollment in graduate business programs, but not to overall enrollment or status as a public or private institution.…

  16. Lessons learned from a data-driven college access program: The National College Advising Corps.

    Science.gov (United States)

    Horng, Eileen L; Evans, Brent J; Antonio, Anthony L; Foster, Jesse D; Kalamkarian, Hoori S; Hurd, Nicole F; Bettinger, Eric P

    2013-01-01

    This chapter discusses the collaboration between a national college access program, the National College Advising Corps (NCAC), and its research and evaluation team at Stanford University. NCAC is currently active in almost four hundred high schools and through the placement of a recent college graduate to serve as a college adviser provides necessary information and support for students who may find it difficult to navigate the complex college admission process. The advisers also conduct outreach to underclassmen in an effort to improve the school-wide college-going culture. Analyses include examination of both quantitative and qualitative data from numerous sources and partners with every level of the organization from the national office to individual high schools. The authors discuss balancing the pursuit of evaluation goals with academic scholarship. In an effort to benefit other programs seeking to form successful data-driven interventions, the authors provide explicit examples of the partnership and present several examples of how the program has benefited from the data gathered by the evaluation team. © WILEY PERIODICALS, INC.

  17. "Utstein style" spreadsheet and database programs based on Microsoft Excel and Microsoft Access software for CPR data management of in-hospital resuscitation.

    Science.gov (United States)

    Adams, Bruce D; Whitlock, Warren L

    2004-04-01

    In 1997, The American Heart Association in association with representatives of the International Committee on Resuscitation (ILCOR) published recommended guidelines for reviewing, reporting and conducting in-hospital cardiopulmonary resuscitation (CPR) outcomes using the "Utstein style". Using these guidelines, we developed two Microsoft Office based database management programs that may be useful to the resuscitation community. We developed a user-friendly spreadsheet based on MS Office Excel. The user enters patient variables such as name, age, and diagnosis. Then, event resuscitation variables such as time of collapse and CPR team arrival are entered from a "code flow sheet". Finally, outcome variables such as patient condition at different time points are recorded. The program then makes automatic calculations of average response times, survival rates and other important outcome measurements. Also using the Utstein style, we developed a database program based on MS Office Access. To promote free public access to these programs, we established at a website. These programs will help hospitals track, analyze, and present their CPR outcomes data. Clinical CPR researchers might also find the programs useful because they are easily modified and have statistical functions.

  18. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE)

    DEFF Research Database (Denmark)

    Raiten, Daniel J; Sakr Ashour, Fayrouz A; Ross, A Catharine

    2015-01-01

    of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs......; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations......./Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible...

  19. An Analysis of Naval Officer Accession Programs

    National Research Council Canada - National Science Library

    Lehner, William D

    2008-01-01

    ... Training Corps, and Officer Candidate School. Three areas are covered: historical patterns in officer accessions and historical changes in Navy pre-commissioning training and education philosophy and policy...

  20. Access to major overseas research facilities

    International Nuclear Information System (INIS)

    Bolderman, J. W.

    1997-01-01

    This paper will describe four schemes which have been established to permit Australian researchers access to some of the most advanced overseas research facilities. These include, access to Major Research Facilities Program, the Australian National Beamline Facility at the Photon Factory, the Australian Synchrotron Research Program and the ISIS Agreement. The details of each of these programs is discussed and the statistics on the scientific output provided. All programs are managed on behalf of the Department of Industry, Science and Tourism by the Australian Nuclear Science and Technology Organisation. One hundred and thirteen senior scientists plus forty, one postgraduate, students were supported through these schemes during the 1996-1997 financial year

  1. Educating change agents: a qualitative descriptive study of graduates of a Master's program in evidence-based practice.

    Science.gov (United States)

    Hole, Grete Oline; Brenna, Sissel Johansson; Graverholt, Birgitte; Ciliska, Donna; Nortvedt, Monica Wammen

    2016-02-25

    Health care professionals are expected to build decisions upon evidence. This implies decisions based on the best available, current, valid and relevant evidence, informed by clinical expertise and patient values. A multi-professional master's program in evidence-based practice was developed and offered. The aims of this study were to explore how students in this program viewed their ability to apply evidence-based practice and their perceptions of what constitute necessary conditions to implement evidence-based practice in health care organizations, one year after graduation. A qualitative descriptive design was chosen to examine the graduates' experiences. All students in the first two cohorts of the program were invited to participate. Six focus-group interviews, with a total of 21 participants, and a telephone interview of one participant were conducted. The data was analyzed thematically, using the themes from the interview guide as the starting point. The graduates reported that an overall necessary condition for evidence-based practice to occur is the existence of a "readiness for change" both at an individual level and at the organizational level. They described that they gained personal knowledge and skills to be "change-agents" with "self-efficacy, "analytic competence" and "tools" to implement evidence based practice in clinical care. An organizational culture of a "learning organization" was also required, where leaders have an "awareness of evidence- based practice", and see the need for creating "evidence-based networks". One year after graduation the participants saw themselves as "change agents" prepared to improve clinical care within a learning organization. The results of this study provides useful information for facilitating the implementation of EBP both from educational and health care organizational perspectives.

  2. Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

    Science.gov (United States)

    Brickle, Colleen M; Self, Karl D

    2017-09-01

    The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  3. Access to and coverage of renal replacement therapy in minorities and ethnic groups in Venezuela.

    Science.gov (United States)

    Bellorin-Font, Ezequiel; Pernalete, Nidia; Meza, Josefina; Milanes, Carmen Luisa; Carlini, Raul G

    2005-08-01

    Access to and coverage of renal replacement therapy in minorities and ethnic groups in Venezuela. Numerous studies have documented the presence of racial and minority disparities regarding the impact of renal disease and access to renal replacement therapy (RRT). This problem is less well documented in Latin America. Venezuela, like most countries in the region, is subject to severe constraints in the allocation of resources for high-cost chronic diseases, which limits the access of patients with chronic kidney disease to RRT. Although access to health care is universal, there is both a deficit in coverage and disparity in the access to RRT, largely as a result of socioeconomic limitations and budget constrains. With current rising trends of the incidence of end-stage renal disease (ESRD) and costs of medical technology, the long-term goal of complete RRT coverage will become increasingly out of reach. Current evidence suggests that prevention of progression of renal disease is possible at relatively low cost and broad coverage. Based on this evidence, the Ministry of Health has redesigned its policy with respect to renal disease based on 4 elements: 1. Prevention by means of early detection and referral to multidisciplinary health teams, as well as promotion of health habits in the community. 2. Prevention of progression of renal disease by pharmacologic and nonpharmacologic means. 3. An increase in the rate of coverage and reduction of disparities in the access to dialysis. 4. An increase in the rates of renal transplantation through better organ procurement programs and reinforcement of transplant centers. However, the projected increase in the number of patients with ESKD receiving RRT will represent a serious burden to the health care system. Therefore, implementation of these policies will require the involvement of international agencies as well as an adequate partnership between nephrologists and health care planners, so that meeting the increasing demands

  4. CE: Original Research: Exploring Clinicians' Perceptions About Sustaining an Evidence-Based Fall Prevention Program.

    Science.gov (United States)

    Porter, Rebecca B; Cullen, Laura; Farrington, Michele; Matthews, Grace; Tucker, Sharon

    2018-05-01

    : Purpose: This study aimed to address the knowledge gap between implementing and sustaining evidence-based fall prevention practices for hospitalized patients by exploring perspectives of the interprofessional health care team. A qualitative design was used to capture insights from clinicians across disciplines in a large midwestern academic medical center. Four homogenous semistructured focus groups and three individual interviews involving a total of 20 clinicians were conducted between October 2013 and March 2014. Audio-recorded data were transcribed and analyzed using inductive qualitative analysis. Two primary themes emerged from participants regarding the sustainability of an evidence-based fall prevention program: communication patterns within the interprofessional health care team and influences of hospital organizational practices and elements. Several subthemes also emerged. Participants gave nursing staff primary responsibility for fall risk assessment and prevention. Individual professional perceptions and practices, as well as organizational characteristics, affect the sustainability of evidence-based fall prevention practices. While all team members recognized patient falls as a significant quality and safety issue, most believed that direct care nurses hold primary responsibility for leading fall prevention efforts. The data support the importance of effective interprofessional team communication and organizational practices in sustaining an evidence-based fall prevention program across inpatient units. Furthermore, the data call into question the wisdom in labeling quality indicators as "nursing sensitive"; the evidence indicates that a team approach is best.

  5. Home Delivery Medicament Program: access, inactivity and cardiovascular risk.

    Science.gov (United States)

    Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê

    2016-10-10

    to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). verificar causas de inatividade no Programa Remédio em Casa, referidas por usuários de Unidade Básica de Saúde de São Paulo, comparando-as às registradas pelo programa e analisando-as no modelo teórico Conceito de Acesso à Saúde. estudo transversal entrevistando 111 usuários inativos; e documental, nos registros do programa. metade dos usuários desconhecia a condição de inatividade. Constatadas discrepâncias nas informações usuário versus programa, observando-se diferentes níveis de concordância: Falta de médico e funcion

  6. The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development.

    Science.gov (United States)

    Chang, Amy L; Pribbenow, Christine M

    2016-05-01

    The American Society for Microbiology (ASM) established its ASM-NSF (National Science Foundation) Biology Scholars Program (BSP) to promote undergraduate education reform by 1) supporting biologists to implement evidence-based teaching practices, 2) engaging life science professional societies to facilitate biologists' leadership in scholarly teaching within the discipline, and 3) participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM) reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL) to more than 270 participants ("scholars") from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER). To identify the BSP's long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program's 2010-2014 scholars (n = 127) and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life sciences and helps

  7. Integrating the Principles of Effective Intervention into Batterer Intervention Programming: The Case for Moving Toward More Evidence-Based Programming.

    Science.gov (United States)

    Radatz, Dana L; Wright, Emily M

    2016-01-01

    The majority of batterer intervention program (BIP) evaluations have indicated they are marginally effective in reducing domestic violence recidivism. Meanwhile, correctional programs used to treat a variety of offenders (e.g., substance users, violent offenders, and so forth) that adhere to the "principles of effective intervention" (PEI) have reported significant reductions in recidivism. This article introduces the PEI-the principles on which evidence-based practices in correctional rehabilitation are based-and identifies the degree to which they are currently integrated into BIPs. The case is made that batterer programs could be more effective if they incorporate the PEI. Recommendations for further integration of the principles into BIPs are also provided. © The Author(s) 2015.

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

    Science.gov (United States)

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

    2003-12-01

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

  9. Learning to Thrive: Building Diverse Scientists’ Access to Community and Resources through the BRAINS Program

    Science.gov (United States)

    Margherio, Cara; Horner-Devine, M. Claire; Mizumori, Sheri J. Y.; Yen, Joyce W.

    2016-01-01

    BRAINS: Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health–funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants’ career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. PMID:27587858

  10. A qualitative study of programs for parents with serious mental illness and their children: building practice-based evidence.

    Science.gov (United States)

    Nicholson, Joanne; Hinden, Beth R; Biebel, Kathleen; Henry, Alexis D; Katz-Leavy, Judith

    2007-10-01

    The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. Challenges in program implementation and sustainability are identified. Qualitative methods are useful, particularly when studying existing programs, in taking steps toward building the evidence base for effective programs for parents with serious mental illness and their children.

  11. [Publicly funded programs of psychotherapy in Australia and England].

    Science.gov (United States)

    Vasiliadis, Helen-Maria; Dezetter, Anne

    Quebec's HealthCommissioner on the performance of the health system clearly highlighted gaps in the collaboration between primary care physicians and mental health specialists, decreased accessibility and inequity in access to effective mental health services such as psychotherapy.Objectives The aim of this article was to describe the implementation of two publicly funded programs of psychotherapy in Australia and England with similar gatekeeper systems to the one in Quebec.Findings Following the Access to Allied Psychological Services (ATAPS) program introduced in Australia in 2003, one of the most important initiatives from the Council of Australian Governments' National Action Plan on Mental Health 2006-2011 was the Better Access Initiative which commenced in 2006. The plan included AUD1.2 billion in funding for integrating and improving the mental health care system. The purpose of Better Access was to improve the treatment and management of mental illnesses and increasing community access to mental health professionals and providing more affordable mental health care. GPs were encouraged to work more closely with mental health professionals. Under this program, these professionals are able to provide mental health services on a fee-for-service basis subsidized through Medicare. Access to psychological therapies is provided through private providers, rather than through fund holding arrangements. As of 2009 in Australia, 2 million people (1 in 11) had received over 11.2 million subsidized mental health services. A recent study showed clinical improvements in patients with depression associated with Better Access, concluding that the program is meeting previously unmet mental health needs.In the case of England, the IAPT - Improving Access to psychological Therapies-program enabled primary care trusts (PCTs) to implement evidence-based psychological therapies as recommended by National Institute for Health and Clinical Excellence for people suffering from

  12. Effectiveness of Structured Teacher Adaptations to an Evidence-Based Summer Literacy Program

    Science.gov (United States)

    Kim, James S.; Burkhauser, Mary A.; Quinn, David M.; Guryan, Jonathan; Kingston, Helen Chen; Aleman, Kirsten

    2017-01-01

    The authors conducted a cluster-randomized trial to examine the effectiveness of structured teacher adaptations to the implementation of an evidence-based summer literacy program that provided students with (a) books matched to their reading level and interests and (b) teacher scaffolding for summer reading in the form of end-of-year comprehension…

  13. Household electricity access, availability and human well-being: Evidence from India

    International Nuclear Information System (INIS)

    Ahmad, Sohail; Mathai, Manu V.; Parayil, Govindan

    2014-01-01

    According to the 2011 Census of India, over 31% of India's 1.2 billion people lived in nearly 8000 towns and cities; the remaining 830 million people lived in over 638,000 villages. About 55% of rural households and 93% of urban households had access to electricity. The 2005 Indian Human Development Survey showed that on average, electricity availability (hours of supply per day) in rural and urban households were 14 and 19 h, respectively (Desai et al., 2007). Using nationally representative data from Indian Human Development Survey, this study estimated the impact of electricity access and availability on two attributes of human well-being, viz. education and health attainment. It found a significant positive relationship between electricity availability and well-being in rural and urban households. Electricity accessibility, revealed a significant positive relationship only for rural households. The paper concludes with implications for electricity policy and infrastructure choices. - Graphical abstract: Impact of electricity security on the attributes of human well-being. - Highlights: • Nexus between well-being, and electricity access and availability is quantified. • Electricity access is positively associated with well-being in rural but not urban. • Electricity availability negatively associates with morbidity and absenteeism. • Electricity security as human well-being enabler seeks nuanced policy attention. • Decentralized rapidly deployable modular technologies and microgrids are advocated

  14. Access to major overseas research facilities

    Energy Technology Data Exchange (ETDEWEB)

    Bolderman, J. W. [Australian Nuclear Science and Technology Organisation, Lucas Heights, NSW (Australia)

    1997-12-31

    This paper will describe four schemes which have been established to permit Australian researchers access to some of the most advanced overseas research facilities. These include, access to Major Research Facilities Program, the Australian National Beamline Facility at the Photon Factory, the Australian Synchrotron Research Program and the ISIS Agreement. The details of each of these programs is discussed and the statistics on the scientific output provided. All programs are managed on behalf of the Department of Industry, Science and Tourism by the Australian Nuclear Science and Technology Organisation. One hundred and thirteen senior scientists plus forty, one postgraduate, students were supported through these schemes during the 1996-1997 financial year. 1 fig.

  15. Evidence and Obesity Prevention: Developing Evidence Summaries to Support Decision Making

    Science.gov (United States)

    Clark, Rachel; Waters, Elizabeth; Armstrong, Rebecca; Conning, Rebecca; Allender, Steven; Swinburn, Boyd

    2013-01-01

    Public health practitioners make decisions based on research evidence in combination with a variety of other influences. Evidence summaries are one of a range of knowledge translation options used to support evidence-informed decision making. The literature relevant to obesity prevention requires synthesis for it to be accessible and relevant to…

  16. 75 FR 4409 - Ryan White HIV/AIDS Program Part D-Coordinated HIV Services and Access to Research for Women...

    Science.gov (United States)

    2010-01-27

    ... HIV/AIDS Program Part D--Coordinated HIV Services and Access to Research for Women, Infants, Children... Orange County Health Department, Orlando, Florida, that will ensure continuity of Part D HIV/AIDS care and treatment services without disruption to HIV/ AIDS-infected women, infants and children in Orange...

  17. The academic, economic and societal impacts of Open Access: an evidence-based review.

    Science.gov (United States)

    Tennant, Jonathan P; Waldner, François; Jacques, Damien C; Masuzzo, Paola; Collister, Lauren B; Hartgerink, Chris H J

    2016-01-01

    Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for research communities if

  18. The academic, economic and societal impacts of Open Access: an evidence-based review

    Science.gov (United States)

    Tennant, Jonathan P.; Waldner, François; Jacques, Damien C.; Masuzzo, Paola; Collister, Lauren B.; Hartgerink, Chris. H. J.

    2016-01-01

    Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for research communities if

  19. A cluster randomized Hybrid Type III trial testing an implementation support strategy to facilitate the use of an evidence-based practice in VA homeless programs.

    Science.gov (United States)

    Smelson, David A; Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Sawh, Leon; Glickman, Mark

    2015-05-28

    The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is one of the largest initiatives to end Veteran homelessness. However, mental health and substance use disorders continue to reduce client stability and impede program success. HUD-VASH programs do not consistently employ evidence-based practices that address co-occurring mental health and substance use disorders. This paper presents a study protocol to evaluate the implementation of an evidence-based, co-occurring disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) in HUD-VASH using an implementation strategy called Getting To Outcomes (GTO). In three large VA Medical Centers, this Hybrid Type III trial will randomize case managers and their clients by HUD-VASH sub-teams to receive either MISSION-Vet Implementation as Usual (IU-standard training and access to the MISSION-Vet treatment manuals) or MISSION-Vet implementation augmented by GTO. In addition to testing GTO, effectiveness of the treatment (MISSION-Vet) will be assessed using existing Veteran-level data from the HUD-VASH data monitoring system. This project will compare GTO and IU case managers and their clients on the following variables: (1) fidelity to the MISSION-Vet intervention; (2) proportion of time the Veteran is housed; (3) mental health, substance use, and functional outcomes among Veterans; and (4) factors key to the successful deployment of a new treatment as specified by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. This project is an important step for developing an implementation strategy to increase adoption of evidence-based practice use in VA homeless programs, and to further examine efficacy of MISSION-Vet in HUD-VASH. This project has important implications for program managers, policy makers, and researchers within the homelessness field. VA Central IRB approval

  20. Perceived barriers to completing an e-learning program on evidence-based medicine.

    Science.gov (United States)

    Gagnon, Marie-Pierre; Légaré, France; Labrecque, Michel; Frémont, Pierre; Cauchon, Michel; Desmartis, Marie

    2007-01-01

    The Continuing Professional Development Center of the Faculty of Medicine at Laval University offers an internet-based program on evidence-based medicine (EBM). After one year, only three physicians out of the 40 who willingly paid to register had completed the entire program. This descriptive study aimed to identify physicians' beliefs regarding their completion of this online program. Using theoretical concepts from the Theory of Planned Behaviour, a semi-structured telephone interview guide was developed to assess respondents' attitudes, perceived subjective norms, perceived obstacles and facilitating conditions with respect to completing this internet-based program. Three independent reviewers performed content analysis of the interview transcripts to obtain an appropriate level of reliability. Findings were shared and organised according to theoretical categories of beliefs. A total of 35 physicians (88% response rate) were interviewed. Despite perceived advantages to completing the internet-based program, barriers remained, especially those related to physicians' perceptions of time constraints. Lack of personal discipline and unfamiliarity with computers were also perceived as important barriers. This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME) program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.

  1. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence.

    Science.gov (United States)

    Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson

    2015-01-01

    US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants - sexual activity, number of sexual partners, condom use, and other contraceptive use - among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent-youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent-youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts, rigorously evaluate programs that appear promising, and

  2. Implementing a Healthy Food Distribution Program: A Supply Chain Strategy to Increase Fruit and Vegetable Access in Underserved Areas.

    Science.gov (United States)

    DeFosset, Amelia R; Kwan, Allison; Rizik-Baer, Daniel; Gutierrez, Luis; Gase, Lauren N; Kuo, Tony

    2018-05-24

    Increasing access to fresh produce in small retail venues could improve the diet of people in underserved communities. However, small retailers face barriers to stocking fresh produce. In 2014, an innovative distribution program, Community Markets Purchasing Real and Affordable Foods (COMPRA), was launched in Los Angeles with the aim of making it more convenient and profitable for small retailers to stock fresh produce. Our case study describes the key processes and lessons learned in the first 2 years of implementing COMPRA. Considerable investments in staff capacity and infrastructure were needed to launch COMPRA. Early successes included significant week-to-week increases in the volume of produce distributed. Leveraging partnerships, maintaining a flexible operational and funding structure, and broadly addressing store owners' needs contributed to initial gains. We describe key challenges and next steps to scaling the program. Lessons learned from implementing COMPRA could inform other jurisdictions considering supply-side approaches to increase access to healthy food.

  3. The ASM-NSF Biology Scholars Program: An Evidence-Based Model for Faculty Development

    Directory of Open Access Journals (Sweden)

    Amy L. Chang

    2016-05-01

    Full Text Available The American Society for Microbiology (ASM established its ASM-NSF (National Science Foundation Biology Scholars Program (BSP to promote undergraduate education reform by 1 supporting biologists to implement evidence-based teaching practices, 2 engaging life science professional societies to facilitate biologists’ leadership in scholarly teaching within the discipline, and 3 participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL to more than 270 participants (“scholars” from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER. To identify the BSP’s long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program’s 2010­–2014 scholars (n = 127 and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life

  4. Access to finance - An unfinished agenda

    NARCIS (Netherlands)

    Beck, T.H.L.; Demirgüc-Kunt, A.

    2008-01-01

    Recent data compilations show that many poor and nonpoor people in many developing countries face a high degree of financial exclusion and high barriers in access to finance. Theory and empirical evidence point to the critical role that improved access to finance has in promoting growth and reducing

  5. Investigating the Utilization of Research Evidence in the 4-H Youth Development Program

    Directory of Open Access Journals (Sweden)

    Lynette H. Bikos

    2011-06-01

    Full Text Available This study investigated the acquisition, interpretation, and utilization of research evidence in the 4-H Youth Development Program from the frame of Social Cognitive Theory. Utilizing Consensual Qualitative Research, we interviewed twenty 4-H faculty, staff, and volunteers from seven states. Results indicated four domains, which covered participants’ definitions of research utilization, their experiences utilizing research, the process of acquiring and distributing research, and barriers and facilitators to research utilization. Participants described research use primarily in terms of improving 4-H programs. They discussed their level of confidence (i.e. self-efficacy in finding and applying research evidence and their beliefs about the outcomes of research utilization (i.e. outcomes expectancy. Participants mentioned such barriers as not knowing where to look for research, lack of time, lack of funding, and difficulty applying research findings to their work. The facilitators included support from other 4-H colleagues and availability of 4-H specific conferences, publications, and curriculum databases.

  6. Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study

    Directory of Open Access Journals (Sweden)

    Jack Susan M

    2011-11-01

    Full Text Available Abstract Background Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. Methods A descriptive qualitative study was conducted to explore: 1 the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2 how decision makers at different levels report using research evidence; and 3 factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Results Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. Conclusions There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence

  7. Does Access to Foreign Markets shape Internal Migration? Evidence from Brazil

    OpenAIRE

    Laura Hering; Rodrigo Paillacar

    2014-01-01

    This paper investigates how internal migration is affected by Brazil’s increased integration into the world economy. It analyzes the impact of regional differences in access to foreign demand on sector-specific bilateral migration rates between the Brazilian states for the years 1995 to 2003. Using international trade data, a foreign market access measure is computed at the sectoral level,...

  8. Current strategies for improving access and adherence to antiretroviral therapies in resource-limited settings

    Directory of Open Access Journals (Sweden)

    Scanlon ML

    2013-01-01

    Full Text Available Michael L Scanlon,1,2 Rachel C Vreeman1,21Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA; 2USAID, Academic Model Providing Access to Healthcare (AMPATH Partnership, Eldoret, KenyaAbstract: The rollout of antiretroviral therapy (ART significantly reduced human immunodeficiency virus (HIV-related morbidity and mortality, but good clinical outcomes depend on access and adherence to treatment. In resource-limited settings, where over 90% of the world’s HIV-infected population resides, data on barriers to treatment are emerging that contribute to low rates of uptake in HIV testing, linkage to and retention in HIV care systems, and suboptimal adherence rates to therapy. A review of the literature reveals limited evidence to inform strategies to improve access and adherence with the majority of studies from sub-Saharan Africa. Data from observational studies and randomized controlled trials support home-based, mobile and antenatal care HIV testing, task-shifting from doctor-based to nurse-based and lower level provider care, and adherence support through education, counseling and mobile phone messaging services. Strategies with more limited evidence include targeted HIV testing for couples and family members of ART patients, decentralization of HIV care, including through home- and community-based ART programs, and adherence promotion through peer health workers, treatment supporters, and directly observed therapy. There is little evidence for improving access and adherence among vulnerable groups such as women, children and adolescents, and other high-risk populations and for addressing major barriers. Overall, studies are few in number and suffer from methodological issues. Recommendations for further research include health information technology, social-level factors like HIV stigma, and new research directions in cost-effectiveness, operations, and implementation. Findings from this review make a

  9. Worker programs and resource use: Evidence from better work jordan

    Science.gov (United States)

    Robins, Nathan

    This paper examines data collected for the Better Work program in Jordan which aims to protect laborers in the garment industry from poor working conditions. Data are examined to look for benefits to the factories participating in the program beyond improved compliance with labor law. In particular, potential impacts to firm energy use are examined and correlations are tested between electricity use rates and measures of worker outcomes and a number of factory traits such as size and production input costs. Evidence was found to back up work done in Vietnam with regard to resource use and distribution of electricity expenses. It was also found that the type of data being collected is not ideal for examinations of energy, and more direct methods are desirable, and that considerable production obstacles are worker skill level, electricity prices, and to a greater degree in Jordan than in previously examined countries, water prices.

  10. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... hospitals and improve access to healthcare by keeping essential services in rural communities. To accomplish this goal, ...

  11. Can conditional cash transfer programs generate equality of opportunity in highly unequal societies? Evidence from Brazil

    Directory of Open Access Journals (Sweden)

    Simone Bohn

    2014-09-01

    Full Text Available This article examines whether the state, through conditional cash transfer programs (CCT, can reduce the poverty and extremely poverty in societies marred by high levels of income concentration. We focus on one of the most unequal countries in the globe, Brazil, and analyze the extent to which this country's CCT program - Bolsa Família (BF, Family Grant program - is able to improve the life chances of extremely poor beneficiaries, through the three major goals of PBF: First, to immediately end hunger; second, to create basic social rights related to healthcare and education; finally, considering also complementary policies, to integrate adults into the job market. The analysis relies on a quantitative survey with 4,000 beneficiaries and a qualitative survey comprised of in-depth interviews with 38 program's participants from all the regions of the country in 2008, it means that this study is about the five first years of the PBF. In order to answer the research questions, we ran four probit analyses related: a the determinants of the realization of prenatal care; b the determinants of food security among BF beneficiaries, c the determinants that adult BF recipients will return to school, d the determinants that a BF beneficiary will obtain a job. Important results from the study are: First, those who before their participation on PBF were at the margins have now been able to access healthcare services on a more regular basis. Thus, the women at the margins who were systematically excluded - black women, poorly educated and from the North - now, after their participation in the CCT program, have more access to prenatal care and can now count with more availability of public healthcare network. Second, before entering the Bolsa Família program, 50.3% of the participants faced severe food insecurity. This number went down to 36.8% in very five years. Men are more likely than women; non-blacks more likely than blacks; and South and Centre

  12. Marginalized Student Access to Technology Education

    Science.gov (United States)

    Kurtcu, Wanda M.

    The purpose of this paper is to investigate how a teacher can disrupt an established curriculum that continues the cycle of inequity of access to science, technology, engineering, and math (STEM) curriculum by students in alternative education. For this paper, I will focus on the technology components of the STEM curriculum. Technology in the United States, if not the world economy, is developing at a rapid pace. Many areas of day to day living, from applying for a job to checking one's bank account online, involve a component of science and technology. The 'gap' in technology education is emphasized between the 'haves and have-nots', which is delineated along socio-economic lines. Marginalized students in alternative education programs use this equipment for little else than remedial programs and credit recovery. This level of inequity further widens in alternative education programs and affects the achievement of marginalized students in credit recovery or alternative education classes instead of participation technology classes. For the purposes of this paper I focus on how can I decrease the inequity of student access to 21st century technology education in an alternative education program by addressing the established curriculum of the program and modifying structural barriers of marginalized student access to a technology focused curriculum.

  13. 47 CFR 76.1003 - Program access proceedings.

    Science.gov (United States)

    2010-10-01

    ... this part with the following additions or changes: (b) Prefiling notice required. Any aggrieved... address and telephone number of each defendant; (2) Evidence that supports complainant's belief that the... has for believing that such evidence of damages exists; and (D) A detailed outline of the methodology...

  14. Science-based occupations and the science curriculum: Concepts of evidence

    Science.gov (United States)

    Aikenhead, Glen S.

    2005-03-01

    What science-related knowledge is actually used by nurses in their day-to-day clinical reasoning when attending patients? The study investigated the knowledge-in-use of six acute-care nurses in a hospital surgical unit. It was found that the nurses mainly drew upon their professional knowledge of nursing and upon their procedural understanding that included a common core of concepts of evidence (concepts implicitly applied to the evaluation of data and the evaluation of evidence - the focus of this research). This core included validity triangulation, normalcy range, accuracy, and a general predilection for direct sensual access to a phenomenon over indirect machine-managed access. A cluster of emotion-related concepts of evidence (e.g. cultural sensitivity) was also discovered. These results add to a compendium of concepts of evidence published in the literature. Only a small proportion of nurses (one of the six nurses in the study) used canonical science content in their clinical reasoning, a result consistent with other research. This study also confirms earlier research on employees in science-rich workplaces in general, and on professional development programs for nurses specifically: canonical science content found in a typical science curriculum (e.g. high school physics) does not appear relevant to many nurses' knowledge-in-use. These findings support a curriculum policy that gives emphasis to students learning how to learn science content as required by an authentic everyday or workplace context, and to students learning concepts of evidence.

  15. Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People.

    Science.gov (United States)

    Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna

    2017-03-24

    Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the

  16. Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People

    Science.gov (United States)

    Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna

    2017-01-01

    ABSTRACT Background: Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention—youth-friendly social franchisee training and quality monitoring—with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Methods: Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees—private providers accredited by MSM—are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher

  17. Inequities in access to inpatient rehabilitation after stroke: an international scoping review.

    Science.gov (United States)

    Lynch, Elizabeth A; Cadilhac, Dominique A; Luker, Julie A; Hillier, Susan L

    2017-12-01

    Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched. Results Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and the United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions. Conclusion Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.

  18. Evidence, models, conservation programs and limits to management

    Science.gov (United States)

    Nichols, J.D.

    2012-01-01

    Walsh et al. (2012) emphasized the importance of obtaining evidence to assess the effects of management actions on state variables relevant to objectives of conservation programs. They focused on malleefowl Leipoa ocellata, ground-dwelling Australian megapodes listed as vulnerable. They noted that although fox Vulpes vulpes baiting is the main management action used in malleefowl conservation throughout southern Australia, evidence of the effectiveness of this action is limited and currently debated. Walsh et al. (2012) then used data from 64 sites monitored for malleefowl and foxes over 23 years to assess key functional relationships relevant to fox control as a conservation action for malleefowl. In one set of analyses, Walsh et al. (2012) focused on two relationships: fox baiting investment versus fox presence, and fox presence versus malleefowl population size and rate of population change. Results led to the counterintuitive conclusion that increases in investments in fox control produced slight decreases in malleefowl population size and growth. In a second set of analyses, Walsh et al. (2012) directly assessed the relationship between investment in fox baiting and malleefowl population size and rate of population change. This set of analyses showed no significant relationship between investment in fox population control and malleefowl population growth. Both sets of analyses benefited from the incorporation of key environmental covariates hypothesized to influence these management relationships. Walsh et al. (2012) concluded that "in most situations, malleefowl conservation did not effectively benefit from fox baiting at current levels of investment." In this commentary, I discuss the work of Walsh et al. (2012) using the conceptual framework of structured decision making (SDM). In doing so, I accept their analytic results and associated conclusions as accurate and discuss basic ideas about evidence, conservation and limits to management.

  19. Evidence-based librarianship: searching for the needed EBL evidence.

    Science.gov (United States)

    Eldredge, J D

    2000-01-01

    This paper discusses the challenges of finding evidence needed to implement Evidence-Based Librarianship (EBL). Focusing first on database coverage for three health sciences librarianship journals, the article examines the information contents of different databases. Strategies are needed to search for relevant evidence in the library literature via these databases, and the problems associated with searching the grey literature of librarianship. Database coverage, plausible search strategies, and the grey literature of library science all pose challenges to finding the needed research evidence for practicing EBL. Health sciences librarians need to ensure that systems are designed that can track and provide access to needed research evidence to support Evidence-Based Librarianship (EBL).

  20. Increasing Access for Economically Disadvantaged Students: The NSF/CSEM & S-STEM Programs at Louisiana State University

    Science.gov (United States)

    Wilson, Zakiya S.; Iyengar, Sitharama S.; Pang, Su-Seng; Warner, Isiah M.; Luces, Candace A.

    2012-10-01

    Increasing college degree attainment for students from disadvantaged backgrounds is a prominent component of numerous state and federal legislation focused on higher education. In 1999, the National Science Foundation (NSF) instituted the "Computer Science, Engineering, and Mathematics Scholarships" (CSEMS) program; this initiative was designed to provide greater access and support to academically talented students from economically disadvantaged backgrounds. Originally intended to provide financial support to lower income students, this NSF program also advocated that additional professional development and advising would be strategies to increase undergraduate persistence to graduation. This innovative program for economically disadvantaged students was extended in 2004 to include students from other disciplines including the physical and life sciences as well as the technology fields, and the new name of the program was Scholarships for Science, Technology, Engineering and Mathematics (S-STEM). The implementation of these two programs in Louisiana State University (LSU) has shown significant and measurable success since 2000, making LSU a Model University in providing support to economically disadvantaged students within the STEM disciplines. The achievement of these programs is evidenced by the graduation rates of its participants. This report provides details on the educational model employed through the CSEMS/S-STEM projects at LSU and provides a path to success for increasing student retention rates in STEM disciplines. While the LSU's experience is presented as a case study, the potential relevance of this innovative mentoring program in conjunction with the financial support system is discussed in detail.

  1. The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.

    Science.gov (United States)

    McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R

    2012-06-01

    Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.

  2. Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America.

    Science.gov (United States)

    Stadler, Walter M; Figlin, Robert A; McDermott, David F; Dutcher, Janice P; Knox, Jennifer J; Miller, Wilson H; Hainsworth, John D; Henderson, Charles A; George, Jeffrey R; Hajdenberg, Julio; Kindwall-Keller, Tamila L; Ernstoff, Marc S; Drabkin, Harry A; Curti, Brendan D; Chu, Luis; Ryan, Christopher W; Hotte, Sebastien J; Xia, Chenghua; Cupit, Lisa; Bukowski, Ronald M

    2010-03-01

    The Advanced Renal Cell Carcinoma Sorafenib (ARCCS) program made sorafenib available to patients with advanced renal cell carcinoma (RCC) before regulatory approval. In this nonrandomized, open-label expanded access program, 2504 patients from the United States and Canada were treated with oral sorafenib 400 mg twice daily. Safety and efficacy were explored overall and in subgroups of patients including those with no prior therapy, nonclear cell (nonclear cell) RCC, brain metastases, prior bevacizumab treatment, and elderly patients. Sorafenib was approved for RCC 6 months after study initiation, at which time patients with no prior therapy or with nonclear cell RCC could enroll in an extension protocol for continued assessment for a period of 6 months. The most common grade > or =2 drug-related adverse events were hand-foot skin reaction (18%), rash (14%), hypertension (12%), and fatigue (11%). In the 1891 patients evaluable for response, complete response was observed in 1 patient, partial response in 67 patients (4%), and stable disease for at least 8 weeks in 1511 patients (80%). Median progression-free survival in the extension population was 36 weeks (95% confidence interval [CI], 33-45 weeks; censorship rate, 56%); median overall survival in the entire population was 50 weeks (95% CI, 46-52 weeks; censorship rate, 63%). The efficacy and safety results were similar across the subgroups. Sorafenib 400 mg twice daily demonstrated activity and a clinically acceptable toxicity profile in all patient subsets enrolled in the ARCCS expanded access program (clinicaltrials.gov identifier: NCT00111020).

  3. Breaking The Link Between Legal Access To Alcohol And Motor Vehicle Accidents: Evidence From New South Wales.

    Science.gov (United States)

    Lindo, Jason M; Siminski, Peter; Yerokhin, Oleg

    2016-07-01

    A large literature has documented significant public health benefits associated with the minimum legal drinking age in the USA, particularly because of the resulting effects on motor vehicle accidents. These benefits form the primary basis for continued efforts to restrict youth access to alcohol. It is important to keep in mind that policymakers have a wide variety of alcohol-control options available to them, and understanding how these policies may complement or substitute for one another can improve policy making moving forward. Towards this end, we propose that investigating the causal effects of the minimum legal drinking age in New South Wales, Australia, provides a particularly informative case study, because Australian states are among the world leaders in their efforts against drunk driving. Using an age-based regression discontinuity design applied to restricted-use data from several sources, we find no evidence that legal access to alcohol has effects on motor vehicle accidents of any type in New South Wales, despite having large effects on drinking and on hospitalizations due to alcohol abuse. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Credit market access in Uganda: evidence from household survey data 1999/2000

    Directory of Open Access Journals (Sweden)

    FN Okurut

    2013-07-01

    Full Text Available This study investigated the individual and household characteristics that influenced credit market access in Uganda using household data for 1999/2000. The results suggest that credit market access was significantly influenced by gender, household wealth, age, regional location, and urban/rural location.

  5. Building an evidence base for community health: a review of the quality of program evaluations.

    Science.gov (United States)

    Jolley, Gwyn M; Lawless, Angela P; Baum, Fran E; Hurley, Catherine J; Fry, Denise

    2007-11-01

    An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.

  6. Access to Formal Banking and Household Finances: Experimental Evidence from India

    OpenAIRE

    Somville, Vincent; Vandewalle, Lore

    2017-01-01

    Access to formal banking is spreading across the world. Obtaining a bank account may transform how people manage their finances, and affect their savings and consumption. We report from a field experiment that randomly provides access to a bank account to a representative sample of villagers in rural India. The treated keep relatively important savings on their account, but reduce their other savings by a similar amount. Their household’s overall savings and expenditures do not change. We ide...

  7. The Effects of a 12-Week Walking Program on Community-Dwelling Older Adults

    Science.gov (United States)

    Cheng, Shun-Ping; Tsai, Tzu-I; Lii, Yun-Kung; Yu, Shu; Chou, Chen-Liang; Chen, I-Ju

    2009-01-01

    Walking is a popular and easily accessible form of physical activity. However, walking instruction for older adults is based on the evidence gathered from younger populations. This study evaluated walking conditions, strength, balance, and subjective health status after a 12-week walking-training program in community-dwelling adults greater than…

  8. Hot Idea or Hot Air: A Systematic Review of Evidence for Two Widely Marketed Youth Suicide Prevention Programs and Recommendations for Implementation

    Science.gov (United States)

    Wei, Yifeng; Kutcher, Stan; LeBlanc, John C.

    2015-01-01

    Introduction: Youth suicide is highly related to mental disorders. While communities and schools are marketed to with a plethora of suicide prevention programs, they often lack the capacity to choose evidence-based programs. Methods: We conducted a systematic review of two youth suicide prevention programs to help determine if the quality of evidence available justifies their wide spread dissemination. We searched Medline, PsycINFO, EMBASE, CINAHL, the Cochrane Library, Campbell Collaboration SPECTR database, SocIndex, Sociological Abstracts, Social Services Abstracts, ERIC, Social Work Abstracts, Research Library, and Web of Science, for relevant studies. We included studies/systematic reviews/meta-analysis that evaluated the effectiveness, cost-effectiveness, and/or safety of Signs of Suicide (SOS) and Yellow Ribbon (YR) suicide prevention programs that target adolescents. We applied the Office of Justice Program What Works Repository (OJP-R) to evaluate the quality of the included studies as effective, effective with reservation, promising, inconclusive evidence, insufficient evidence, and ineffective. Two SOS studies were ranked as “inconclusive evidence” based on the OJP-R. One SOS study was ranked as having “insufficient evidence” on OJP-R. The YR study was ranked as “ineffective” using OJP-R. We only included studies in peer-reviewed journals in English and therefore may have missed reports in grey literature or non-English publications. Results: We cannot recommend that schools and communities implement either the SOS or YR suicide prevention programs. Purchasers of these programs should be aware that there is no evidence that their use prevents suicide. Conclusions: Academics and organizations should not overstate the positive impacts of suicide prevention interventions when the evidence is lacking. PMID:26336375

  9. Constructing "Packages" of Evidence-Based Programs to Prevent Youth Violence: Processes and Illustrative Examples From the CDC's Youth Violence Prevention Centers.

    Science.gov (United States)

    Kingston, Beverly; Bacallao, Martica; Smokowski, Paul; Sullivan, Terri; Sutherland, Kevin

    2016-04-01

    This paper describes the strategic efforts of six National Centers of Excellence in Youth Violence Prevention (YVPC), funded by the U.S. Centers for Disease Control and Prevention, to work in partnership with local communities to create comprehensive evidence-based program packages to prevent youth violence. Key components of a comprehensive evidence-based approach are defined and examples are provided from a variety of community settings (rural and urban) across the nation that illustrate attempts to respond to the unique needs of the communities while maintaining a focus on evidence-based programming and practices. At each YVPC site, the process of selecting prevention and intervention programs addressed the following factors: (1) community capacity, (2) researcher and community roles in selecting programs, (3) use of data in decision-making related to program selection, and (4) reach, resources, and dosage. We describe systemic barriers to these efforts, lessons learned, and opportunities for policy and practice. Although adopting an evidence-based comprehensive approach requires significant upfront resources and investment, it offers great potential for preventing youth violence and promoting the successful development of children, families and communities.

  10. Automated Eukaryotic Gene Structure Annotation Using EVidenceModeler and the Program to Assemble Spliced Alignments

    Energy Technology Data Exchange (ETDEWEB)

    Haas, B J; Salzberg, S L; Zhu, W; Pertea, M; Allen, J E; Orvis, J; White, O; Buell, C R; Wortman, J R

    2007-12-10

    EVidenceModeler (EVM) is presented as an automated eukaryotic gene structure annotation tool that reports eukaryotic gene structures as a weighted consensus of all available evidence. EVM, when combined with the Program to Assemble Spliced Alignments (PASA), yields a comprehensive, configurable annotation system that predicts protein-coding genes and alternatively spliced isoforms. Our experiments on both rice and human genome sequences demonstrate that EVM produces automated gene structure annotation approaching the quality of manual curation.

  11. A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative.

    Science.gov (United States)

    Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

    Research evidence suggests that access to health care is the key influential factor for improved population health outcomes and health care system sustainability. Although the importance of addressing barriers in access to health care across European countries is well documented, little has been done to improve the situation. This is due to different definitions, approaches and policies, and partly due to persisting disparities in access within and between European countries. To bridge this gap, the Patient Access Partnership (PACT) developed (a) the '5As' definition of access, which details the five critical elements (adequacy, accessibility, affordability, appropriateness, and availability) of access to health care, (b) a multi-stakeholders' approach for mapping access, and (c) a 13-item questionnaire based on the 5As definition in an effort to address these obstacles and to identify best practices. These tools are expected to contribute effectively to addressing access barriers in practice, by suggesting a common framework and facilitating the exchange of knowledge and expertise, in order to improve access to health care between and within European countries. © 2016 S. Karger AG, Basel.

  12. HIV Prevention Among Transgender Populations: Knowledge Gaps and Evidence for Action.

    Science.gov (United States)

    Poteat, Tonia; Malik, Mannat; Scheim, Ayden; Elliott, Ayana

    2017-08-01

    The purpose of this review is to summarize the available evidence-based HIV prevention interventions tailored for transgender people. A limited number of evidence-based HIV prevention interventions have been tested with transgender populations. Most existing interventions target behavior change among transgender women, with only one HIV prevention program evaluated for transgender men. Studies addressing biomedical interventions for transgender women are ongoing. Few interventions address social and structural barriers to HIV prevention, such as stigma, discrimination, and poverty. Evidence-based multi-level interventions that address the structural, biomedical, and behavioral risks for HIV among transgender populations, including transgender men, are needed to address disparities in HIV prevalence. Future research should address not only pre-exposure prophylaxis uptake and condom use but also structural barriers that limit access to these prevention strategies.

  13. Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program.

    Science.gov (United States)

    Renfro, Mindy; Bainbridge, Donna B; Smith, Matthew Lee

    2016-01-01

    Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. Despite the limited number of participants ( n  = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more

  14. The importance of considering the evidence in the MTP 2014 Amendment debate in India – unsubstantiated arguments should not impede improved access to safe abortion

    Directory of Open Access Journals (Sweden)

    Mandira Paul

    2015-03-01

    Full Text Available With the objective to improve access to safe abortion services in India, the Ministry of Health and Welfare, with approval of the Law Ministry, published draft amendments of the MTP Act on October 29, 2014. Instead of the expected support, the amendments created a heated debate within professional medical associations of India. In this commentary, we review the evidence in response to the current discourse with regard to the amendments. It would be unfortunate if unsubstantiated one-sided arguments would impede the intention of improving access to safe abortion care in India.

  15. Judicialization of access to medicines in Minas Gerais state, Southeastern Brazil.

    Science.gov (United States)

    Machado, Marina Amaral de Ávila; Acurcio, Francisco de Assis; Brandão, Cristina Mariano Ruas; Faleiros, Daniel Resende; Guerra, Augusto Afonso; Cherchiglia, Mariângela Leal; Andrade, Eli Iola Gurgel

    2011-06-01

    To analyze the profile of claimants and medicines demanded in lawsuits. Descriptive study that examined 827 lawsuits with 1,777 demands of access to medicines in the period between July 2005 and June 2006 in the state of Minas Gerais, Southeastern Brazil. There were examined the type of health care provided to claimants and their attorneyship. The medicines were described based on the following: drug registration at the National Health Surveillance Agency (Anvisa); wheter they were essential medicines; supply in the Brazilian Health System programs; and evidence of drug efficacy. More than 70% of the claimants were provided care in the private health system and 60.3% hired private lawyers. The most common diagnosis of claimants was rheumatoid arthritis (23.1%) and the immunosuppressant agents were the most frequent demand medicines (mainly adalimumab and etanercept). Approximately 5% of the medicines demanded were not registered at Anvisa, 19.6% were included in the Brazilian List of Essential Medicine, 24.3% were included in the High-Cost Drug Program and 53.9% showed consistent evidence of efficacy. Among the medicines that were not available in Brazilian Health System, 79.0% had therapeutic alternatives in drug programs. The phenomenon of judicialization of health in Brazil can point out failures in the public health system as some medicines demanded are included in its lists. However, it is a barrier for rational drug use and application of the National Drug Policy guidelines, especially when there are demanded medicines with no evidence of efficacy and that are not included in Brazilian Health System standards.

  16. Parallel programming of saccades during natural scene viewing: evidence from eye movement positions.

    Science.gov (United States)

    Wu, Esther X W; Gilani, Syed Omer; van Boxtel, Jeroen J A; Amihai, Ido; Chua, Fook Kee; Yen, Shih-Cheng

    2013-10-24

    Previous studies have shown that saccade plans during natural scene viewing can be programmed in parallel. This evidence comes mainly from temporal indicators, i.e., fixation durations and latencies. In the current study, we asked whether eye movement positions recorded during scene viewing also reflect parallel programming of saccades. As participants viewed scenes in preparation for a memory task, their inspection of the scene was suddenly disrupted by a transition to another scene. We examined whether saccades after the transition were invariably directed immediately toward the center or were contingent on saccade onset times relative to the transition. The results, which showed a dissociation in eye movement behavior between two groups of saccades after the scene transition, supported the parallel programming account. Saccades with relatively long onset times (>100 ms) after the transition were directed immediately toward the center of the scene, probably to restart scene exploration. Saccades with short onset times (programming of saccades during scene viewing. Additionally, results from the analyses of intersaccadic intervals were also consistent with the parallel programming hypothesis.

  17. Postabortion Care: 20 Years of Strong Evidence on Emergency Treatment, Family Planning, and Other Programming Components.

    Science.gov (United States)

    Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren

    2016-09-28

    Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30-70 percentage points within 1-3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women family planning

  18. Minimalist Program and its fundamental improvements in syntactic theory: evidence from Agreement Asymmetry in Standard Arabic

    Directory of Open Access Journals (Sweden)

    Nasser Al-Horais

    2012-11-01

    Full Text Available Normal 0 21 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:auto; mso-para-margin-right:1.0cm; mso-para-margin-bottom:auto; mso-para-margin-left:2.0cm; text-align:justify; text-indent:-1.0cm; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi; mso-ansi-language:EN-US; mso-fareast-language:EN-US;} The Minimalist Program is a major line of inquiry that has been developing inside Generative Grammar since the early nineties, when it was proposed by Chomsky  (1993, 1995. In that time, Chomsky (1998: 5 presents Minimalist Program as a program, not as a theory, but today, Minimalist Program lays out a very specific view of the basis of syntactic grammar that, when compared to other formalisms, is often taken to look very much like a theory. The prime concern of this paper, however, is  to provide a comprehensive and accessible introduction to the art of minimalist approach to the theory of grammar. In this regard, this paper discusses some new ideas articulated recently by Chomsky, and have led to several fundamental improvements in syntactic theory  such as changing the function of movement and the Extended Projection Principle (EPP feature, or proposing new theories such as Phases and Feature Inheritance. In order to evidence the significance of these fundamental improvements, the current paper provides a minimalist analysis to account for agreement and word-order asymmetry in Stranded Arabic. This fresh minimalist account meets the challenges (to the basic tenets of syntactic theory occurred

  19. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE).

    Science.gov (United States)

    Raiten, Daniel J; Sakr Ashour, Fayrouz A; Ross, A Catharine; Meydani, Simin N; Dawson, Harry D; Stephensen, Charles B; Brabin, Bernard J; Suchdev, Parminder S; van Ommen, Ben

    2015-05-01

    An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations. © 2015 American Society for Nutrition.

  20. 45 CFR 98.31 - Parental access.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Parental access. 98.31 Section 98.31 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.31 Parental access. The...

  1. A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity.

    Science.gov (United States)

    McDougle, Leon; Way, David P; Lee, Winona K; Morfin, Jose A; Mavis, Brian E; Matthews, De'Andrea; Latham-Sadler, Brenda A; Clinchot, Daniel M

    2015-08-01

    The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.

  2. A Multi-level Examination of how the Organizational Context Relates to Readiness to Implement Prevention and Evidence-Based Programming in Community Settings

    Science.gov (United States)

    Chilenski, Sarah M.; Olson, Jonathan R.; Schulte, Jill A.; Perkins, Daniel F.; Spoth, Richard

    2015-01-01

    Prior theoretical and empirical research suggests that multiple aspects of an organization’s context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization’s readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization’s readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization’s morale was also found to be a strong predictor of an organization’s readiness. The findings of the current study are discussed in terms of implications for prevention and intervention. PMID:25463014

  3. Adapting Evidence-Based Prevention Approaches for Latino Adolescents: The Familia Adelante Program - Revised

    Directory of Open Access Journals (Sweden)

    Richard C. Cervantes

    2012-12-01

    Full Text Available Behavioral health is defined as the absence of mental illness or substance use problems and the presence of positive emotional well being. Although many U.S. Hispanic youth are at increased risk for substance abuse, suicidality, teen pregnancy, unsafe sexual practices and HIV, there exists a lack of available evidence-based practices for Hispanic youth which promotes behavioral health and HIV prevention. The objective of the current research was to adapt and revise the Familia Adelante (FA Program, a behavioral health, drug intervention and prevention program to incorporate an HIV prevention component. Through qualitative community based participatory methods, including an expert panel and members of the target population, the curriculum was redesigned to integrate effective HIV risk reduction strategies. The process of adapting the intervention is described in this paper, as well as recommendations for future research in program adaptation.

  4. 78 FR 31769 - Accessible Emergency Information; Apparatus Requirements for Emergency Information and Video...

    Science.gov (United States)

    2013-05-24

    ... and equipment and better access video programming.'' \\7\\ \\7\\ H.R. Rep. No. 111-563, 111th Cong., 2d... Video Accessibility Act of 2010 (``CVAA''), the Commission adopts rules requiring video programming distributors and video programming providers (including program owners) to make televised emergency information...

  5. Analysis of Evidence Supporting the Educational Leadership Constituent Council 2011 Educational Leadership Program Standards

    Science.gov (United States)

    Tucker, Pamela D.; Anderson, Erin; Reynolds, Amy L.; Mawhinney, Hanne

    2016-01-01

    This document analysis provides a summary of the research from high-impact journals published between 2008 and 2013 with the explicit purpose of determining the extent to which the current empirical evidence supports the individual 2011 Educational Leadership Constituent Council Program Standards and their elements. We found that the standards are…

  6. Access to Experimental Cancer Drugs

    Science.gov (United States)

    An experimental drug has been tested in the lab and with animals and approved for testing in people by the FDA, but can’t yet be advertised, sold, or prescribed. Experimental drugs may be available through clinical trials or expanded access programs - learn more about these programs and how to talk to your doctor.

  7. Acceptability of evidence-based neonatal care practices in rural Uganda - implications for programming.

    Science.gov (United States)

    Waiswa, Peter; Kemigisa, Margaret; Kiguli, Juliet; Naikoba, Sarah; Pariyo, George W; Peterson, Stefan

    2008-06-21

    Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children). We also did 10 key informant interviews with health workers and traditional birth attendants. Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation and health systems barriers including the financial burden. Male

  8. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice.

    Science.gov (United States)

    Breckenridge-Sproat, Sara T; Throop, Meryia D; Raju, Dheeraj; Murphy, Deborah A; Loan, Lori A; Patrician, Patricia A

    2015-01-01

    This study tested the effectiveness of a dynamic educational and mentoring program, facilitated by unit-level mentors, to introduce, promote, and sustain an evidence-based practice (EBP) culture among nurses in a military healthcare setting. The need to identify gaps in practice, apply principles of EBP, and advance scientific applications in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. The Advancing Research through Close Collaboration Model guided the intervention and study. Three instruments were used: the Organizational Readiness for System-wide Integration of Evidence-Based Practice, EBP Beliefs, and EBP Implementation scales. The study took place in 3 military hospitals simultaneously undergoing facility and staff integration. Data were collected from staff nurses in the inpatient nursing units before and after a facilitated education and mentoring intervention. Three hundred sixty nurses (38%) completed baseline, and 325 (31%) completed follow-up surveys. Scores improved on all 3 measures following implementation of the program; however, the differences were statistically significant only for the Organizational Readiness for System-wide Integration of Evidence-Based Practice scale (70.96 vs 77.63, t = -3.95, P culture may diffuse among individuals in an organization, even while experiencing significant change. It also demonstrates that a unit-level mentored EBP program is sustainable despite changes in organizational structure and workforce composition.

  9. The information divide: publishing and access issues | Baker ...

    African Journals Online (AJOL)

    Some global and local developments in information access and the Open Access movement are highlighted, and the National Library of South Africa\\'s interim strategies to bridge the information and digital divide are identified. However, it becomes evident that unless librarians, information consumers, publishers, ...

  10. Access to justice: evaluating law, health and human rights programmes in Kenya.

    Science.gov (United States)

    Gruskin, Sofia; Safreed-Harmon, Kelly; Ezer, Tamar; Gathumbi, Anne; Cohen, Jonathan; Kameri-Mbote, Patricia

    2013-11-13

    In Kenya, human rights violations have a marked impact on the health of people living with HIV. Integrating legal literacy and legal services into healthcare appears to be an effective strategy to empower vulnerable groups and address underlying determinants of health. We carried out an evaluation to collect evidence about the impact of legal empowerment programmes on health and human rights. The evaluation focused on Open Society Foundation-supported legal integration activities at four sites: the Academic Model of Providing Access to Healthcare (AMPATH) facility, where the Legal Aid Centre of Eldoret (LACE) operates, in Eldoret; Kenyatta National Hospital's Gender-based Violence Recovery Centre, which hosts the COVAW legal integration program; and Christian Health Association of Kenya (CHAK) facilities in Mombasa and Naivasha. In consultation with the organizations implementing the programs, we designed a conceptual logic model grounded in human rights principles, identified relevant indicators and then coded structure, process and outcome indicators for the rights-related principles they reflect. The evaluation included a resource assessment questionnaire, a review of program records and routine data, and semi-structured interviews and focus group discussions with clients and service providers. Data were collected in May-August 2010 and April-June 2011. Clients showed a notable increase in practical knowledge and awareness about how to access legal aid and claim their rights, as well as an enhanced ability to communicate with healthcare providers and to improve their access to healthcare and justice. In turn, providers became more adept at identifying human rights violations and other legal difficulties, which enabled them to give clients basic information about their rights, refer them to legal aid and assist them in accessing needed support. Methodological challenges in evaluating such activities point to the need to strengthen rights-oriented evaluation

  11. Examining data access and use in science

    Energy Technology Data Exchange (ETDEWEB)

    Yan, E.; Zhao, M.

    2016-07-01

    In this research-in-progress paper, we provide preliminary evidence of data access and use in scientific literature based on a content analysis of 600 stratified sampled PLOS ONE publications. Results show that data access and use varied greatly from one paper to another in terms of how datasets were collected, referenced, and curated. (Author)

  12. Effectiveness of a grant program's efforts to promote synergy within its funded initiatives: perceptions of participants of the Southern Rural Access Program

    Science.gov (United States)

    Pathman, Donald E; Chuang, Emmeline; Weiner, Bryan J

    2008-01-01

    Background Foundations and public agencies commonly fund focused initiatives for individual grantees. These discrete, stand-alone initiatives can risk failure by being carried out in isolation. Fostering synergy among grantees' initiatives is one strategy proposed for promoting the success and impact of grant programs. We evaluate an explicit strategy to build synergy within the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP), which awarded grants to collaboratives within eight southeastern U.S. states to strengthen basic health care services in targeted rural counties. Methods We interviewed 39 key participants of the SRAP, including the program director within each state and the principal subcontractors heading the program's funded initiatives that supported heath professionals' recruitment, retention and training, made loans to health care providers, and built networks among providers. Interews were recorded and transcribed. Two investigators independently coded the transcripts and a third investigator distilled the main points. Results Participants generally perceived that the SRAP yielded more synergies than other grant programs in which they had participated and that these synergies added to the program's impact. The synergies most often noted were achieved through relationship building among grantees and with outside agencies, sharing information and know-how, sharing resources, combining efforts to yield greater capacity, joining voices to advocate for common goals, and spotting gaps in services offered and then filling these gaps. The SRAP's strategies that participants felt fostered synergy included targeting funding to culturally and geographically similar states, supporting complementary types of initiatives, promoting opportunities to network through semi-annual meetings and regular conference calls, and the advocacy efforts of the program's leadership. Participants noted that synergies were sometimes hindered by turf issues and

  13. Effectiveness of a grant program's efforts to promote synergy within its funded initiatives: perceptions of participants of the Southern Rural Access Program

    Directory of Open Access Journals (Sweden)

    Weiner Bryan J

    2008-12-01

    Full Text Available Abstract Background Foundations and public agencies commonly fund focused initiatives for individual grantees. These discrete, stand-alone initiatives can risk failure by being carried out in isolation. Fostering synergy among grantees' initiatives is one strategy proposed for promoting the success and impact of grant programs. We evaluate an explicit strategy to build synergy within the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP, which awarded grants to collaboratives within eight southeastern U.S. states to strengthen basic health care services in targeted rural counties. Methods We interviewed 39 key participants of the SRAP, including the program director within each state and the principal subcontractors heading the program's funded initiatives that supported heath professionals' recruitment, retention and training, made loans to health care providers, and built networks among providers. Interews were recorded and transcribed. Two investigators independently coded the transcripts and a third investigator distilled the main points. Results Participants generally perceived that the SRAP yielded more synergies than other grant programs in which they had participated and that these synergies added to the program's impact. The synergies most often noted were achieved through relationship building among grantees and with outside agencies, sharing information and know-how, sharing resources, combining efforts to yield greater capacity, joining voices to advocate for common goals, and spotting gaps in services offered and then filling these gaps. The SRAP's strategies that participants felt fostered synergy included targeting funding to culturally and geographically similar states, supporting complementary types of initiatives, promoting opportunities to network through semi-annual meetings and regular conference calls, and the advocacy efforts of the program's leadership. Participants noted that synergies were sometimes

  14. Optimizing data access in the LAMPF control system

    International Nuclear Information System (INIS)

    Schaller, S.C.; Corley, J.K.; Rose, P.A.

    1985-01-01

    The LAMPF control system data access software offers considerable power and flexibility to application programs through symbolic device naming and an emphasis on hardware independence. This paper discusses optimizations aimed at improving the performance of the data access software while retaining these capabilities. The only aspects of the optimizations visible to the application programs are ''vector devices'' and ''aggregate devices.'' A vector device accesses a set of hardware related data items through a single device name. Aggregate devices allow run-time optimization of references to groups of unrelated devices. Optimizations not visible on the application level include careful handling of: network message traffic; the sharing of global resources; and storage allocation

  15. 25 CFR 170.122 - Can a tribe close a cultural access road?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can a tribe close a cultural access road? 170.122 Section... ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170.122 Can a tribe close a cultural access road? (a) A tribe with jurisdiction over a cultural...

  16. Improving Access and Systems of Care for Evidence-Based Childhood Obesity Treatment: Conference Key Findings and Next Steps

    Science.gov (United States)

    Wilfley, Denise E.; Staiano, Amanda E.; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G.; Dietz, William H.; Cook, Stephen

    2017-01-01

    Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care. PMID:27925451

  17. 25 CFR 170.121 - What is a cultural access road?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is a cultural access road? 170.121 Section 170.121 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Use of Irr and Cultural Access Roads § 170...

  18. 25 CFR 170.127 - What terms apply to access roads?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What terms apply to access roads? 170.127 Section 170.127 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Irr Housing Access Roads § 170.127 What...

  19. Students' Motivation to Access Academic Advising Services

    Science.gov (United States)

    Henning, Marcus A.

    2009-01-01

    The interrelationships between motivation for choosing a program of study, intention to access academic advisors, academic difficulty, and actual appointments with academic advisors were based on student self-reports of motivation and intentions. In addition, academic achievement measures and data on student access to academic advisors were…

  20. Competition and rural primary care programs.

    Science.gov (United States)

    Ricketts, T C

    1990-04-01

    Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of clinics. The programs were found to compete in terms of: (1) price, (2) service mix, (3) staff availability, (4) structural accessibility, (5) outreach, and (6) targeting a segment of the market. The competitive strategies employed by the clinics had consequences that affected their productivity and financial stability. The strategies were related to the perceived missions of the programs, and depended heavily upon the degree of isolation of the program and the targeting of the services. The competitive strategy chosen by a particular program could not be predicted based on service area population and apparent competitors in the service area. The goals and objectives of the programs had more to do with their competitive responses than with market characteristics. Moreover, the chosen strategies may not meet the demands of those markets.

  1. Role of Information Professionals in Knowledge Management Programs: Empirical Evidence from Canada

    Directory of Open Access Journals (Sweden)

    la Ajiferuke

    2003-01-01

    Full Text Available The implementation of a knowledge management program in an organization has the potential of im-proving customer services, quickly bringing new products to market, and reducing cost of business operations. Information technologies are often used in knowledge management programs in informing clients and employees of latest innovation/development in the business sector as well as sharing knowledge among the employees. The key professionals involved in knowledge management programs are information technologists and human resource managers but the information professionals also have a role to play as they are traditionally known as good managers of explicit knowledge. Hence, the aim of this study is to provide empirical evidence of the role of information professionals in knowledge management programs. 386 information professionals working in Canadian organizations were selected from the Special Libraries Association's Who's Who in Special Libraries 2001/2002, and a questionnaire with a stamped self-addressed envelope for its return was sent to each one of them. 63 questionnaires were completed and returned, and 8 in-depth interviews conducted. About 59% of the information professionals surveyed are working in organizations that have knowledge management programs with about 86% of these professionals being involved in the programs. Factors such as gender, age, and educational background (i.e. highest educational qualifications and discipline did not seem to have any relationship with involvement in knowledge management programs. Many of those involved in the programs are playing key roles, such as the design of the information architecture, development of taxonomy, or con-tent management of the organization's intranet. Others play lesser roles, such as providing information for the intranet, gathering competitive intelligence, or providing research services as requested by the knowledge management team.

  2. Access to effective health care

    DEFF Research Database (Denmark)

    Høy, Bente

    2015-01-01

    Access to effective healthcare is in particular challenging for vulnerable and socially disadvantaged patients. Patients with chronic conditions are over-represented in these lower socioeconomic (LSES) groups. No generic review integrating the evidence on Self-Management support interventions in ...

  3. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE)12345

    Science.gov (United States)

    Raiten, Daniel J; Ashour, Fayrouz A Sakr; Ross, A Catharine; Meydani, Simin N; Dawson, Harry D; Stephensen, Charles B; Brabin, Bernard J; Suchdev, Parminder S; van Ommen, Ben

    2015-01-01

    An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations. PMID:25833893

  4. An evaluation of two large scale demand side financing programs for maternal health in India: the MATIND study protocol

    Directory of Open Access Journals (Sweden)

    Sidney Kristi

    2012-08-01

    Full Text Available Abstract Background High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSYand Chiranjeevi Yojana (CY, were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. Methods/designs The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. Discussion The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making

  5. An evaluation of two large scale demand side financing programs for maternal health in India: the MATIND study protocol.

    Science.gov (United States)

    Sidney, Kristi; de Costa, Ayesha; Diwan, Vishal; Mavalankar, Dileep V; Smith, Helen

    2012-08-27

    High maternal mortality in India is a serious public health challenge. Demand side financing interventions have emerged as a strategy to promote access to emergency obstetric care. Two such state run programs, Janani Suraksha Yojana (JSY)and Chiranjeevi Yojana (CY), were designed and implemented to reduce financial access barriers that preclude women from obtaining emergency obstetric care. JSY, a conditional cash transfer, awards money directly to a woman who delivers in a public health facility. This will be studied in Madhya Pradesh province. CY, a voucher based program, empanels private obstetricians in Gujarat province, who are reimbursed by the government to perform deliveries of socioeconomically disadvantaged women. The programs have been in operation for the last seven years. The study outlined in this protocol will assess and compare the influence of the two programs on various aspects of maternal health care including trends in program uptake, institutional delivery rates, maternal and neonatal outcomes, quality of care, experiences of service providers and users, and cost effectiveness. The study will collect primary data using a combination of qualitative and quantitative methods, including facility level questionnaires, observations, a population based survey, in-depth interviews, and focus group discussions. Primary data will be collected in three districts of each province. The research will take place at three levels: the state health departments, obstetric facilities in the districts and among recently delivered mothers in the community. The protocol is a comprehensive assessment of the performance and impact of the programs and an economic analysis. It will fill existing evidence gaps in the scientific literature including access and quality to services, utilization, coverage and impact. The implementation of the protocol will also generate evidence to facilitate decision making among policy makers and program managers who currently work with or

  6. NUDAT. System for access to nuclear data. Summary description

    International Nuclear Information System (INIS)

    Dunford, C.L.; Kinsey, R.R.

    1998-01-01

    The NUDAT program with its associated database provides access to nuclear properties and some nuclear reaction data. The program has interfaces for WWW, Telnet online access, and PC. The database contains the following information: level and gamma-ray adopted properties from ENSDF; nuclear ground and metastable state properties; radioactive decay radiations from ENSDF; thermal neutron cross sections and resonance integrals as published in 'Neutron Cross Sections', Vol. 1. The online version is accessible through the IAEA's WWW site or through the Telnet online service NDIS, the PC version is available by FTP or on CD-ROM. (author)

  7. Description of a multi-university education and collaborative care child psychiatry access program: New York State's CAP PC.

    Science.gov (United States)

    Kaye, D L; Fornari, V; Scharf, M; Fremont, W; Zuckerbrot, R; Foley, C; Hargrave, T; Smith, B A; Wallace, J; Blakeslee, G; Petras, J; Sengupta, S; Singarayer, J; Cogswell, A; Bhatia, I; Jensen, P

    2017-09-01

    Although, child mental health problems are widespread, few get adequate treatment, and there is a severe shortage of child psychiatrists. To address this public health need many states have adopted collaborative care programs to assist primary care to better assess and manage pediatric mental health concerns. This report adds to the small literature on collaborative care programs and describes one large program that covers most of New York state. CAP PC, a component program of New York State's Office of Mental Health (OMH) Project TEACH, has provided education and consultation support to primary care providers covering most of New York state since 2010. The program is uniquely a five medical school collaboration with hubs at each that share one toll free number and work together to provide education and consultation support services to PCPs. The program developed a clinical communications record to track information about all consultations which forms the basis of much of this report. 2-week surveys following consultations, annual surveys, and pre- and post-educational program evaluations have also been used to measure the success of the program. CAP PC has grown over the 6years of the program and has provided 8013 phone consultations to over 1500 PCPs. The program synergistically provided 17,523 CME credits of educational programming to 1200 PCPs. PCP users of the program report very high levels of satisfaction and self reported growth in confidence. CAP PC demonstrates that large-scale collaborative consultation models for primary care are feasible to implement, popular with PCPs, and can be sustained. The program supports increased access to child mental health services in primary care and provides child psychiatric expertise for patients who would otherwise have none. Copyright © 2017. Published by Elsevier Inc.

  8. A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol.

    Science.gov (United States)

    Geddie, Hannah; Dobrow, Mark J; Hoch, Jeffrey S; Rabeneck, Linda

    2012-06-01

    Health-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this "contextual evidence" is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into "evidence-based policy" decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT) or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement. This study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include policy briefs, reports, meeting minutes, media

  9. 47 CFR 76.971 - Commercial leased access terms and conditions.

    Science.gov (United States)

    2010-10-01

    ... operators that have not satisfied their statutory leased access requirements shall accommodate part-time..., educational and governmental access programming, provided that the operator's franchise agreement requires it... leased commercial channels. Cable operators may impose reasonable insurance requirements on leased access...

  10. Teaching Accessibility Standards to Generation Y Students

    Science.gov (United States)

    Klitzing, Sandra

    2011-01-01

    The Americans with Disabilities Act (ADA) of 1990 mandated that facilities and programs are accessible, so people with disabilities can be included in all aspects of community life including recreation (Dattilo, 2002). Understanding accessibility standards is not an easy task. Educators are faced with the challenge of teaching technical content,…

  11. Project Baiterek: A Patient Access Program to Improve Clinical Outcomes and Quality of Life in Children with Type 1 Diabetes in Kazakhstan.

    Science.gov (United States)

    Muratalina, Aigul; Smith-Palmer, Jayne; Nurbekova, Akmaral; Abduakhassova, Gulmira; Zhubandykova, Leila; Roze, Stéphane; Karamalis, Manolis; Shamshatova, Gulzhakhan; Demessinov, Adi; D'Agostino, Nicola Dunne; Lynch, Peter; Yedigarova, Larisa; Klots, Motty; Valentine, William; Welsh, John; Kaufman, Francine

    2015-09-01

    Diabetes is a key driver in the rise of noncommunicable diseases globally. It causes expensive and burdensome short- and long-term complications, with both an economic and social impact. In many countries, however, access to care and disease management in type 1 diabetes is suboptimal, increasing the risk for complications. In 2011, Project Baiterek was initiated as a collaborative effort between the Kazakhstan Ministry of Health, industry (Medtronic Plc), local physicians, and the Diabetes Association of the Republic of Kazakhstan to enhance patient access to continuous subcutaneous insulin infusion (CSII) therapy. It was the first countrywide project to provide equity and universal access to insulin pump therapy among children with type 1 diabetes, increasing pump use from zero to two-thirds of this population in less than 3 years. The project also involved instigating longitudinal data collection, and long-term clinical outcomes continue to be monitored. Here, we provide an overview of the clinical, quality-of-life, and economic outcomes to date associated with providing CSII therapy to children with type 1 diabetes in Kazakhstan. Initial clinical data show that CSII therapy improved clinical outcomes and quality of life for patients entered into the program and that CSII therapy was cost-effective relative to multiple daily injection therapy. The positive outcomes of Project Baiterek provide a template for similar patient access programs in other settings, and its framework could be adapted to initiatives to change health care infrastructures and standards of care for other noncommunicable diseases. Copyright © 2015. Published by Elsevier Inc.

  12. Obesity prevention programs and policies: practitioner and policy-maker perceptions of feasibility and effectiveness.

    Science.gov (United States)

    Cleland, Verity; McNeilly, Briohny; Crawford, David; Ball, Kylie

    2013-09-01

    The aims of this study were to map obesity prevention activity being implemented by government, non-government, and community-based organizations; to determine practitioner and policy-maker perceptions of the feasibility and effectiveness of a range of evidence-based obesity prevention strategies; and to determine practitioner and policy-maker perceptions of preferred settings for obesity prevention strategies. This study involved a cross-sectional survey of 304 public health practitioners and policy-makers from government, non-government, and community organizations across Victoria, Australia. Participants reported their organizations' current obesity prevention programs and policies, their own perceptions of the feasibility and effectiveness of strategies to prevent obesity and their preferred settings for obesity prevention. Thirty-nine percent had an obesity prevention policy, and 92% were implementing obesity prevention programs. The most common programs focused on education, skill-building, and increasing access to healthy eating/physical activity opportunities. School curriculum-based initiatives, social support for physical activity, and family-based programs were considered the most effective strategies, whereas curriculum-based initiatives, active after-school programs, and providing access to and information about physical activity facilities were deemed the most feasible strategies. Schools were generally perceived as the most preferred setting for obesity prevention. Many organizations had obesity prevention programs, but far fewer had obesity prevention policies. Current strategies and those considered feasible and effective are often mismatched with the empirical literature. Systems to ensure better alignment between researchers, practitioners, and policy-makers, and identifying effective methods of translating empirical evidence into practice and policy are required. Copyright © 2012 The Obesity Society.

  13. Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature.

    Science.gov (United States)

    Cancelliere, Carol; Cassidy, J David; Ammendolia, Carlo; Côté, Pierre

    2011-05-26

    Presenteeism is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem.Workplace health promotion (WHP) is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism. The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (≥ 18 years of age), and examined the impacts of WHP programs implemented at the workplace. The Effective Public Health Practice Project Tool for Quantitative Studies was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism. After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies). These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management. This review is limited to English publications. A large number of reviewed studies (70%) were inadmissible due to issues of bias, thus limiting the amount of primary evidence. The uncertainties surrounding

  14. Are workplace health promotion programs effective at improving presenteeism in workers? a systematic review and best evidence synthesis of the literature

    Directory of Open Access Journals (Sweden)

    Cassidy J David

    2011-05-01

    Full Text Available Abstract Background Presenteeism is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem. Workplace health promotion (WHP is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism. Methods The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (≥ 18 years of age, and examined the impacts of WHP programs implemented at the workplace. The Effective Public Health Practice Project Tool for Quantitative Studies was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism. Results After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies. These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management. Limitations: This review is limited to English publications. A large number of reviewed studies (70% were inadmissible due to issues of bias, thus limiting

  15. Network Access Control For Dummies

    CERN Document Server

    Kelley, Jay; Wessels, Denzil

    2009-01-01

    Network access control (NAC) is how you manage network security when your employees, partners, and guests need to access your network using laptops and mobile devices. Network Access Control For Dummies is where you learn how NAC works, how to implement a program, and how to take real-world challenges in stride. You'll learn how to deploy and maintain NAC in your environment, identify and apply NAC standards, and extend NAC for greater network security. Along the way you'll become familiar with what NAC is (and what it isn't) as well as the key business drivers for deploying NAC.Learn the step

  16. Lessons from the Social Innovation Fund: Supporting Evaluation to Assess Program Effectiveness and Build a Body of Research Evidence

    Science.gov (United States)

    Zandniapour, Lily; Deterding, Nicole M.

    2018-01-01

    Tiered evidence initiatives are an important federal strategy to incentivize and accelerate the use of rigorous evidence in planning, implementing, and assessing social service investments. The Social Innovation Fund (SIF), a program of the Corporation for National and Community Service, adopted a public-private partnership approach to tiered…

  17. Promoting transparency, accountability, and access through a multi-stakeholder initiative: lessons from the medicines transparency alliance.

    Science.gov (United States)

    Vian, Taryn; Kohler, Jillian C; Forte, Gilles; Dimancesco, Deirdre

    2017-01-01

    Barriers to expanding access to medicines include weak pharmaceutical sector governance, lack of transparency and accountability, inadequate attention to social services on the political agenda, and financing challenges. Multi-stakeholder initiatives such as the Medicines Transparency Alliance (MeTA) may help overcome these barriers. Between 2008 and 2015, MeTA engaged stakeholders in the pharmaceutical sectors of seven countries (Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda, and Zambia) to promote access goals through greater transparency. We reviewed archival data to document MeTA activities and results related to transparency and accountability in the seven countries where it was implemented. We identified common themes and content areas, noting specific activities used to make information transparent and accessible, how data were used to inform discussions, and the purpose and timing of meetings and advocacy activities to help set priorities and influence governance decisions. The cross-case analysis looked for pathways which might link the MeTA strategies to results such as better policies or program improvements. Countries used evidence gathering, open meetings, and proactive information dissemination to increase transparency. MeTA fostered policy dialogue to bring together the many government, civil society and private company stakeholders concerned with access issues, and provided them with information to understand barriers to access at policy, organizational, and community levels. We found strong evidence that transparency was enhanced. Some evidence suggests that MeTA efforts contributed to new policies and civil society capacity strengthening although the impact on government accountability is not clear. MeTA appears to have achieved its goal of creating a multi-stakeholder shared policy space in which government, civil society, and private sector players can come together and have a voice in the national pharmaceutical policy making process

  18. Breastfeeding Support in a Community Pharmacy: Improving Access through the Well Babies at Walgreens Program.

    Science.gov (United States)

    Lenell, Amy; Friesen, Carol A; Hormuth, Laura

    2015-11-01

    Well Babies at Walgreens is a unique community-based corporate partnership program that offers breastfeeding support by a lactation professional in a private room at the pharmacy. Walgreens is a community pharmacy chain with more than 8000 locations in the United States, Puerto Rico, and the US Virgin Islands. The primary goal of Well Babies is to support breastfeeding women using a model that is expandable to other Walgreens pharmacy sites. The Well Babies program offers drop-in services, with a professional consultation by a lactation consultant and baby weight check, if desired. Well Babies creators are developing a business plan for Walgreens and a toolkit that would help other stores implement the program. An additional goal is to improve continuity of care for breastfeeding by engaging pharmacists as vital members of the health care team. Offering breastfeeding support at a pharmacy improves access and encourages support persons to attend while simultaneously allowing the family to complete other errands. This initiative included education for pharmacists to improve the recommendations they make for breastfeeding mothers and to improve awareness among pharmacists of the benefits associated with breastfeeding and the need to preserve the breastfeeding relationship. The first drop-in location opened in April 2012. Grant funding from the US Centers for Disease Control and Prevention, awarded to the Indiana State Department of Health, made it possible to open a second drop-in location in June 2013. Future plans include developing an employee lactation program and expanding Well Babies at Walgreens at other store locations. © The Author(s) 2015.

  19. Accessibility versus accuracy in retrieving spatial memory: evidence for suboptimal assumed headings.

    Science.gov (United States)

    Yerramsetti, Ashok; Marchette, Steven A; Shelton, Amy L

    2013-07-01

    Orientation dependence in spatial memory has often been interpreted in terms of accessibility: Object locations are encoded relative to a reference orientation that affords the most accurate access to spatial memory. An open question, however, is whether people naturally use this "preferred" orientation whenever recalling the space. We tested this question by asking participants to locate buildings on a familiar campus from various imagined locations, without specifying the heading to be assumed. We then used these pointing judgments to infer the approximate heading participants assumed at each location. Surprisingly, each location showed a unique assumed heading that was consistent across participants and seemed to reflect episodic or visual properties of the space. This result suggests that although locations are encoded relative to a reference orientation, other factors may influence how people choose to access the stored information and whether they appeal to long-term spatial memory or other more sensory-based stores. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  20. Assessing Awareness and Use of Evidence-Based Programs for Cancer Control in Puerto Rico

    Science.gov (United States)

    Calo, William A.; Fernández, María E.; Rivera, Mirza; Díaz, Elba C.; Correa-Fernández, Virmarie; Pattatucci, Angela; Wetter, David W.

    2012-01-01

    The Community Cancer Control Outreach Program (CCCOP) is a community-academic partnership aimed at developing and implementing a cancer control outreach, research, and training program in Puerto Rico. The CCCOP surveyed 56 partners to assess their awareness, training needs, and use of resources related to evidence-based programs (EBPs). Despite relatively high levels (70%) of confidence in adopting EBPs, there were low levels of awareness (37%) and use (25%) of existing EBPs resources. Respondents’ who had used EBPs resources were more likely to have positive beliefs about EBPs than nonusers (p<0.05). Training needs were high among respondents and no significant differences were found between those who had and had not used existing EBPs resources. These findings can guide the development of training tools and technical assistance to increase the use of EBPs for Latino audiences. PMID:22528632

  1. Evolving provider payment models and patient access to innovative medical technology.

    Science.gov (United States)

    Long, Genia; Mortimer, Richard; Sanzenbacher, Geoffrey

    2014-12-01

    Abstract Objective: To investigate the evolving use and expected impact of pay-for-performance (P4P) and risk-based provider reimbursement on patient access to innovative medical technology. Structured interviews with leading private payers representing over 110 million commercially-insured lives exploring current and planned use of P4P provider payment models, evidence requirements for technology assessment and new technology coverage, and the evolving relationship between the two topics. Respondents reported rapid increases in the use of P4P and risk-sharing programs, with roughly half of commercial lives affected 3 years ago, just under two-thirds today, and an expected three-quarters in 3 years. All reported well-established systems for evaluating new technology coverage. Five of nine reported becoming more selective in the past 3 years in approving new technologies; four anticipated that in the next 3 years there will be a higher evidence requirement for new technology access. Similarly, four expected it will become more difficult for clinically appropriate but costly technologies to gain coverage. All reported planning to rely more on these types of provider payment incentives to control costs, but didn't see them as a substitute for payer technology reviews and coverage limitations; they each have a role to play. Interviews limited to nine leading payers with models in place; self-reported data. Likely implications include a more uncertain payment environment for providers, and indirectly for innovative medical technology and future investment, greater reliance on quality and financial metrics, and increased evidence requirements for favorable coverage and utilization decisions. Increasing provider financial risk may challenge the traditional technology adoption paradigm, where payers assumed a 'gatekeeping' role and providers a countervailing patient advocacy role with regard to access to new technology. Increased provider financial risk may result in an

  2. Improving Nigerian health policymakers' capacity to access and utilize policy relevant evidence: outcome of information and communication technology training workshop.

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima

    2015-01-01

    Information and communication technology (ICT) tools are known to facilitate communication and processing of information and sharing of knowledge by electronic means. In Nigeria, the lack of adequate capacity on the use of ICT by health sector policymakers constitutes a major impediment to the uptake of research evidence into the policymaking process. The objective of this study was to improve the knowledge and capacity of policymakers to access and utilize policy relevant evidence. A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point likert scale according to the degree of adequacy; 1 = grossly inadequate, 4 = very adequate was employed. This study was conducted in Ebonyi State, south-eastern Nigeria and the participants were career health policy makers. A two-day intensive ICT training workshop was organized for policymakers who had 52 participants in attendance. Topics covered included: (i). intersectoral partnership/collaboration; (ii). Engaging ICT in evidence-informed policy making; use of ICT for evidence synthesis; (iv) capacity development on the use of computer, internet and other ICT. The pre-workshop mean of knowledge and capacity for use of ICT ranged from 2.19-3.05, while the post-workshop mean ranged from 2.67-3.67 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 8.3%-39.1%. Findings of this study suggest that policymakers' ICT competence relevant to evidence-informed policymaking can be enhanced through training workshop.

  3. The experience of Australian project leaders in encouraging practitioners to adopt research evidence in their clinical practice.

    Science.gov (United States)

    Henderson, Amanda J; Davies, Jan; Willet, Michaela R

    2006-11-01

    This paper describes a qualitative program evaluation which sought to identify factors that either assist or impede the adoption of clinical evidence in everyday practice. Thirteen Australian projects were funded in a competitive grant program to adopt innovative strategies to improve the uptake of research evidence in everyday clinical practice. Project leaders' reports were analysed to collate common themes related to 1) critical elements in successful application of research knowledge, 2) barriers to implementing evidence, and 3) lessons for other organisations that might implement a similar project. Despite the diversity of the methods used to establish projects and the range of topics and clinical settings, many similarities were identified in the perceived critical success elements, barriers, and lessons for adopting clinical evidence. Eighteen themes emerged across the data including: leadership support; key stakeholder involvement; practice changes; communication; resources; education of staff; evaluation of outcomes; consumers; knowledge gaps; adoption/implementing staff; access to knowledge; risk assessment; collaboration; effectiveness of clinical research evidence; structure/organisation; cultural barriers; previous experiences; and information technology. Leaders of projects to adopt evidence in clinical practice identified barriers, critical success elements and lessons that impacted on their projects. A range of influences on the adoption of evidence were identified, and this knowledge can be used to assist others undertaking similar projects.

  4. OPTICA: Our Path Together Initiating Cultural Access. Final Report.

    Science.gov (United States)

    Jackson, Susan, Comp.

    This final report describes the activities and outcomes of OPTICA (Our Path Together Initiating Cultural Access) programs. For each program an information sheet indicates the goal, total participation, status of the goal, and activities of the program. Programs included: (1) Hands On: ASL Creative Story Telling, a program that used children's…

  5. Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

    Science.gov (United States)

    Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

    2017-11-09

    Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

  6. Acceptability of evidence-based neonatal care practices in rural Uganda – implications for programming

    Directory of Open Access Journals (Sweden)

    Kiguli Juliet

    2008-06-01

    Full Text Available Abstract Background Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. Methods We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children. We also did 10 key informant interviews with health workers and traditional birth attendants. Results Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. Conclusion The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation

  7. Access and Barriers to Postsecondary Education: Evidence from the Youth in Transition Survey

    Science.gov (United States)

    Finnie, Ross; Wismer, Andrew; Mueller, Richard E.

    2015-01-01

    We exploit the Youth in Transition Survey, Cohort A, to investigate access and barriers to postsecondary education (PSE). We first look at how access to PSE by age 21 is related to family characteristics, including family income and parental education. We find that the effects of the latter significantly dominate those of the former. Among the 25%…

  8. Long-term climate change assessment study plan for the Hanford Site Permanent Isolation Barrier Development Program

    International Nuclear Information System (INIS)

    Petersen, K.L.; Chatters, J.C.; Waugh, W.J.

    1993-05-01

    The Hanford Site Permanent Isolation Barrier Development Program (Barrier Development Program) was organized to develop the technology needed to provide an in-place disposal capability for low-level nuclear waste for the US Department of Energy at the Hanford Site in south-central Washington. The goal of the Barrier Development Program is to provide defensible evidence that final barrier design(s) will adequately control water infiltration, plant and animal intrusion, and wind and water erosion for a minimum of 1,000 yr; to isolate wastes from the accessible environment; and to use markers to warn inadvertent human intruders. Evidence for barrier performance will be obtained by conducting laboratory experiments, field tests, computer modeling, and other studies that establish confidence in the barrier's ability to meet its 1,000-yr design life

  9. Moving evidence-based drug abuse prevention programs from basic science to practice: "bridging the efficacy-effectiveness interface".

    Science.gov (United States)

    August, Gerald J; Winters, Ken C; Realmuto, George M; Tarter, Ralph; Perry, Cheryl; Hektner, Joel M

    2004-01-01

    This article examines the challenges faced by developers of youth drug abuse prevention programs in transporting scientifically proven or evidence-based programs into natural community practice systems. Models for research on the transfer of prevention technology are described with specific emphasis given to the relationship between efficacy and effectiveness studies. Barriers that impede the successful integration of efficacy methods within effectiveness studies (e.g., client factors, practitioner factors, intervention structure characteristics, and environmental and organizational factors) are discussed. We present a modified model for program development and evaluation that includes a new type of research design, the hybrid efficacy-effectiveness study that addresses program transportability. The utility of the hybrid study is illustrated in the evaluation of the Early Risers "Skills for Success" prevention program.

  10. A systematic review of the evidence concerning the economic impact of employee-focused health promotion and wellness programs.

    Science.gov (United States)

    Lerner, Debra; Rodday, Angie Mae; Cohen, Joshua T; Rogers, William H

    2013-02-01

    To assess the evidence regarding the economic impact of worker health promotion programs. Peer-reviewed research articles were identified from a database search. Included articles were published between January 2000 and May 2010, described a study conducted in the United States that used an experimental or quasi-experimental study design and analyzed medical, pharmacy (direct), and/or work productivity (indirect) costs. A multidisciplinary review team, following specific criteria, assessed research quality. Of 2030 retrieved articles, 44 met study inclusion criteria. Of these, 10 were of sufficient quality to be considered evidentiary. Only three analyzed direct and indirect costs. Evidence regarding economic impact is limited and inconsistent. Higher-quality research is needed to demonstrate the value of specific programs.

  11. Female-owned businesses and access to finance: evidence from the ...

    African Journals Online (AJOL)

    Thus, they do not have the same access to sources of information and capital. Female-owned businesses tend to rely on informal finance sources because of the unwillingness of the formal sector to lend to them. Female-owned clients are also effectively shut out from the formal market due to high collateral requirements ...

  12. Utilizing Secondary Agricultural Education Programs to Deliver Evidence-Based Grain Safety Training for Young and Beginning Workers.

    Science.gov (United States)

    Cheng, Yuan-Hsin; Field, William E; Tormoehlen, Roger L; French, Brian F

    2017-01-01

    Purdue University's Agricultural Safety and Health Program (PUASHP) has collaborated with secondary agricultural education programs, including FFA Chapters, for over 70 years to deliver and promote agricultural safety and health programming. With support from a U.S. Department of Labor Susan Harwood Program grant, PUASHP utilized a Developing a Curriculum (DACUM) process to develop, implement, and evaluate an evidence-based curriculum for use with young and beginning workers, ages 16-20, exposed to hazards associated with grain storage and handling. The primary audience was students enrolled in secondary agricultural education programs. A review of the literature identified a gap in educational resources that specifically addresses this target population. The curriculum developed was based on fatality and injury incident data mined from Purdue's Agricultural Confined Space Incident Database and input from a panel of experts. The process identified 27 learning outcomes and finalized a pool of test questions, supported by empirical evidence and confirmed by a panel of experts. An alignment process was then completed with the current national standards for secondary agricultural education programs. Seventy-two youth, ages 16-20, enrolled in secondary-school agricultural education programs, and a smaller group of post-secondary students under the age of 21 interested in working in the grain industry pilot tested the curriculum. Based on student and instructor feedback, the curriculum was refined and submitted to OSHA for approval as part of OSHA's online training resources. The curriculum was delivered to 3,665 students, ages 16-20. A total of 346 pre- and post-tests were analyzed, and the results used to confirm content validity and assess knowledge gain. Findings led to additional modifications to curriculum content, affirmed knowledge gain, and confirmed appropriateness for use with secondary agricultural education programs. The curriculum has been promoted

  13. Essential Medicines in Nigeria: Foregrounding Access to Affordable ...

    African Journals Online (AJOL)

    (EM) given the fact that it established the criterion for medicines classification as well ... AIDS, malaria, tuberculosis, and access to essential medicines. Lancet .... Vaccines, and Health Commodities: Report of the WHO-MSH Consultative Meeting, ... Prepared for the Strategies for Enhancing Access to Medicines Program.

  14. Screening of spontaneous castor bean accesses for genetic ...

    African Journals Online (AJOL)

    ... discriminant power between the castor bean accesses, being the multivariate analysis efficient in this process. The castor bean accesses ACS-001 CRSP and ACS-001-MASP are promising for introduction in genetic improvement programs of this culture. Keywords: Ricinus communis L., genotype, multivariate statistics, ...

  15. Accessibility and content of individualized adult reconstructive hip and knee/musculoskeletal oncology fellowship web sites.

    Science.gov (United States)

    Young, Bradley L; Cantrell, Colin K; Patt, Joshua C; Ponce, Brent A

    2018-06-01

    Accessible, adequate online information is important to fellowship applicants. Program web sites can affect which programs applicants apply to, subsequently altering interview costs incurred by both parties and ultimately impacting rank lists. Web site analyses have been performed for all orthopaedic subspecialties other than those involved in the combined adult reconstruction and musculoskeletal (MSK) oncology fellowship match. A complete list of active programs was obtained from the official adult reconstruction and MSK oncology society web sites. Web site accessibility was assessed using a structured Google search. Accessible web sites were evaluated based on 21 previously reported content criteria. Seventy-four adult reconstruction programs and 11 MSK oncology programs were listed on the official society web sites. Web sites were identified and accessible for 58 (78%) adult reconstruction and 9 (82%) MSK oncology fellowship programs. No web site contained all content criteria and more than half of both adult reconstruction and MSK oncology web sites failed to include 12 of the 21 criteria. Several programs participating in the combined Adult Reconstructive Hip and Knee/Musculoskeletal Oncology Fellowship Match did not have accessible web sites. Of the web sites that were accessible, none contained comprehensive information and the majority lacked information that has been previously identified as being important to perspective applicants.

  16. Enhancing Ocean Research Data Access

    Science.gov (United States)

    Chandler, Cynthia; Groman, Robert; Shepherd, Adam; Allison, Molly; Arko, Robert; Chen, Yu; Fox, Peter; Glover, David; Hitzler, Pascal; Leadbetter, Adam; Narock, Thomas; West, Patrick; Wiebe, Peter

    2014-05-01

    The Biological and Chemical Oceanography Data Management Office (BCO-DMO) works in partnership with ocean science investigators to publish data from research projects funded by the Biological and Chemical Oceanography Sections and the Office of Polar Programs Antarctic Organisms & Ecosystems Program at the U.S. National Science Foundation. Since 2006, researchers have been contributing data to the BCO-DMO data system, and it has developed into a rich repository of data from ocean, coastal and Great Lakes research programs. While the ultimate goal of the BCO-DMO is to ensure preservation of NSF funded project data and to provide open access to those data, achievement of those goals is attained through a series of related phases that benefits from active collaboration and cooperation with a large community of research scientists as well as curators of data and information at complementary data repositories. The BCO-DMO is just one of many intermediate data management centers created to facilitate long-term preservation of data and improve access to ocean research data. Through partnerships with other data management professionals and active involvement in local and global initiatives, BCO-DMO staff members are working to enhance access to ocean research data available from the online BCO-DMO data system. Continuing efforts in use of controlled vocabulary terms, development of ontology design patterns and publication of content as Linked Open Data are contributing to improved discovery and availability of BCO-DMO curated data and increased interoperability of related content available from distributed repositories. We will demonstrate how Semantic Web technologies (e.g. RDF/XML, SKOS, OWL and SPARQL) have been integrated into BCO-DMO data access and delivery systems to better serve the ocean research community and to contribute to an expanding global knowledge network.

  17. Evidence-Based Programs for Older Adults: A Disconnect Between U.S. National Strategy and Local Senior Center Implementation.

    Science.gov (United States)

    Bobitt, Julie; Schwingel, Andiara

    2017-01-01

    While U.S. national policies have been developed to support evidence-based (EB) lifestyle programs for older adults, there has been limited research to determine the extent to which these programs actually reach local communities. This study sought to identify factors that impact the implementation of EB physical activity, nutrition, and chronic disease management programs at regional (Area Agencies on Aging [AAAs]) and community levels (senior Centers [SCs]). Interviews were conducted with directors of four AAAs and 12 SCs to understand their perspectives on EB program implementation. Narratives revealed differences between AAAs and SCs regarding knowledge about EB programs and reasons to promote and adopt these programs. The only agreement occurred when discussing concerns about funding and program inflexibility. Substantial gaps exist between how EB lifestyle programs are promoted and implemented at the regional and community levels.

  18. Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

    Science.gov (United States)

    Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

    2014-12-14

    The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision

  19. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice

    Science.gov (United States)

    2015-03-24

    Melnyk and Eileen Fineout-Overholt, who graciously and consistently support military nursing science. Building a Unit-Level Mentored Program...Rosenberg W, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: What it is and what it isn’t. BMJ. 1996;312(7023):71-72.doi: http

  20. Barriers to the implementation and uptake of simulation-based training programs in general surgery: a multinational qualitative study.

    Science.gov (United States)

    Hosny, Shady G; Johnston, Maximilian J; Pucher, Philip H; Erridge, Simon; Darzi, Ara

    2017-12-01

    Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis. All data were anonymized and results pooled. A total of 37 individuals participated in the study. Seventeen experts (Program Directors and Surgical Attendings with an interest in surgical education) and 20 residents drawn from the United States, Canada, United Kingdom, France, and Japan were interviewed. Barriers to simulation-based training were identified based on key themes including financial cost, access, and translational benefit. Participants described cost (89%) and access (76%) as principal barriers to uptake. Common facilitators included a mandatory requirement to complete simulation training (78%) and on-going assessment of skills (78%). Participants felt that simulation training could improve patient outcomes (76%) but identified a lack of evidence to demonstrate benefit (38%). There was a consensus that simulation training has not been widely implemented (70%). There are multiple barriers to the implementation of surgical simulation training programs, however, there is agreement that these programs could potentially improve patient outcomes. Identifying these barriers enable the targeted use of facilitators to deliver simulation training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. INOVASI MEDIA PEMBELAJARAN KEARSIPAN ELECTRONIK ARSIP (E-ARSIP BERBASIS MICROSOFT OFFICE ACCESS

    Directory of Open Access Journals (Sweden)

    Ahmad Saeroji

    2014-12-01

    Full Text Available Microsoft Office Access (Ms Access is a database management system which is a Relational Database Management System. The database in Microsoft Access is a set of objects consisting of tables, queries, forms, reports. Archival system is basically to store useful various files for organizations with the specific rules so the files can be found quickly and easily. Therefore; Microsoft Office Access is an appropriate breakthrough to build archival application systems based on Microsoft Office Access. It is not only easy to be operated but also available a package of Microsoft Office program. One of the most important benefits of the database is to facilitate the access to the data. The ease of accessing the data is the implication of the order data since it is the prerequisite of a good database. The database of archiving system is an application or system design which allows the archives storage digitally. The objective of the e-archives application program using Microsoft Access is to facilitate the delivery of material practices of electronic filing (e-archives. The purposes of the scientific study are: (1 to determine the basic concept and scope of Electronic archives (e-archives, (2 To know how to use the media of electronic archives (E-archives aided Microsoft Office Access in the learning activities for Vocational students of Office Administration program.

  2. INOVASI MEDIA PEMBELAJARAN KEARSIPAN ELECTRONIK ARSIP (E-ARSIP BERBASIS MICROSOFT OFFICE ACCESS

    Directory of Open Access Journals (Sweden)

    Ahmad Saeroji

    2016-01-01

    Full Text Available Microsoft Office Access (Ms Access is a database management system which is a Relational Database Management System. The database in Microsoft Access is a set of objects consisting of tables, queries, forms, reports. Archival system is basically to store useful various files for organizations with the specific rules so the files can be found quickly and easily. Therefore; Microsoft Office Access is an appropriate breakthrough to build archival application systems based on Microsoft Office Access. It is not only easy to be operated but also available a package of Microsoft Office program. One of the most important benefits of the database is to facilitate the access to the data. The ease of accessing the data is the implication of the order data since it is the prerequisite of a good database. The database of archiving system is an application or system design which allows the archives storage digitally. The objective of the e-archives application program using Microsoft Access is to facilitate the delivery of material practices of electronic filing (e-archives. The purposes of the scientific study are: (1 to determine the basic concept and scope of Electronic archives (e-archives, (2 To know how to use the media of electronic archives (E-archives aided Microsoft Office Access in the learning activities for Vocational students of Office Administration program.

  3. Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

    Science.gov (United States)

    Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

    2016-03-01

    In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Food Security and Women's Access to Natural Resources workshop; a brief report.

    Science.gov (United States)

    1997-01-01

    This article describes the workshop on Food Security and Women's Access to Natural Resources, held in January 1997 in Mumbai, India. The workshop was organized jointly by the Tata Institute of Social Sciences and the Indian Association of Women's Studies. The aim was to examine the food security situation in Maharashtra and Gujarat states in the west, the initiative to build alternative institutions, legal changes augmenting industrialization, and how traditional rights to common property resources can be legalized and how the poor can have access to new resources. The workshop organizers were unable to obtain experts on some topics. Core discussion centered on changes in industrialization, natural resources, gender and food security; access to natural resources and poverty alleviation programs; initiatives to create food security; and laws related to access to land and water. Discussions revealed the alienation of small and marginal farmers, landless laborers, and artisans from their livelihoods and survival strategies for these disenfranchised groups. The design of drought eradication and water conservation programs did not permit women and men working at construction sites to have access to the program assets. Case studies revealed situations in which women won the right of access to community water and then negotiated for land in lease. The women used landowners to negotiate credit and access development program assets, but normal channels of the National Bank of Agricultural Research and Development could have provided these benefits. Participants discussed how governments can be held accountable and how public funds could be used to revamp poverty alleviation and asset creation programs. All agreed that macrolevel development should give priority to agricultural development and legal constraints or problems. Five follow-up activities are identified.

  5. 77 FR 66025 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... distribution market if the prohibition were lifted.'' Accordingly, we rely on ``economic theory and predictive... incentive and the ability to harm competition and diversity in the distribution of video programming by entering into exclusive contracts. We undertake the same analysis here. Below, we consider the ``incentive...

  6. Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

    Science.gov (United States)

    Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

    2014-03-01

    In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  7. Does training people to administer take-home naloxone increase their knowledge? Evidence from Australian programs.

    Science.gov (United States)

    Dietze, Paul M; Draper, Bridget; Olsen, Anna; Chronister, Karen J; van Beek, Ingrid; Lintzeris, Nicholas; Dwyer, Robyn; Nelson, Marina; Lenton, Simon

    2018-02-22

    Take-home naloxone (THN) programs have been operating in Australia since 2012 in a variety of settings. We examine whether THN programs were effective in increasing knowledge about opioid overdose and appropriate responses in program participants. Data were obtained from pre- and post-training questionnaires administered as part of the early evaluations of THN naloxone programs operated in Sydney (n = 67), Melbourne (n = 280), Perth (n = 153) and Canberra (n = 183). Pooled data from comparable items, analysed in the domains specified in previously-developed evaluation scales, were compared using repeated-measures analysis of variance and random effects logistic regression. Results pre- and post-training were compared as well as results across sites. High levels of knowledge about overdose risks and signs and appropriate actions to take were observed at baseline and this generally improved over time. No substantial differences were identified across cities. Knowledge also increased with participant age but the improvements over time were similar in each age group. There were small differences by participant gender with knowledge generally higher among females. THN programs are effective in improving knowledge related to overdose response. Major improvements in knowledge were limited to overdose recognition and effect of naloxone suggesting that education may best be focused on overdose signs and the use of naloxone among populations accessed through these programs. A focus on younger people also appears warranted. Further work is needed to understand the impact of training and knowledge on actual behaviours around overdose events. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  8. The Judicialization of Health and the Quest for State Accountability: Evidence from 1,262 Lawsuits for Access to Medicines in Southern Brazil

    Science.gov (United States)

    Socal, Mariana P.; Amon, Joseph J.

    2016-01-01

    Abstract The impact of increasing numbers of lawsuits for access to medicines in Brazil is hotly debated. Government officials and scholars assert that the “judicialization of health” is driven by urban elites and private interests, and is used primarily to access high-cost drugs. Using a systematic sample of 1,262 lawsuits for access to medicines filed against the southern Brazilian state of Rio Grande do Sul, we assess these claims, offering empirical evidence that counters prevailing myths and affirms the heterogeneity of the judicialization phenomenon. Our findings show that the majority of patient-litigants are in fact poor and older individuals who do not live in major metropolitan areas and who depend on the state to provide their legal representation, and that the majority of medicines requested were already on governmental formularies. Our data challenge arguments that judicialization expands inequities and weakens the universal health care system. Our data also suggest that judicialization may serve as a grassroots instrument for the poor to hold the state accountable. Failing to acknowledge regional differences and attempting to fit all data into one singular narrative may be contributing to a biased interpretation of the nature of judicialization, and limiting the understanding of its drivers, consequences, and implications at local levels. PMID:27781011

  9. Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia.

    Science.gov (United States)

    Kranker, Keith

    2016-03-01

    In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Frames of scientific evidence: How journalists represent the (un)certainty of molecular medicine in science television programs.

    Science.gov (United States)

    Ruhrmann, Georg; Guenther, Lars; Kessler, Sabrina Heike; Milde, Jutta

    2015-08-01

    For laypeople, media coverage of science on television is a gateway to scientific issues. Defining scientific evidence is central to the field of science, but there are still questions if news coverage of science represents scientific research findings as certain or uncertain. The framing approach is a suitable framework to classify different media representations; it is applied here to investigate the frames of scientific evidence in film clips (n=207) taken from science television programs. Molecular medicine is the domain of interest for this analysis, due to its high proportion of uncertain and conflicting research findings and risks. The results indicate that television clips vary in their coverage of scientific evidence of molecular medicine. Four frames were found: Scientific Uncertainty and Controversy, Scientifically Certain Data, Everyday Medical Risks, and Conflicting Scientific Evidence. They differ in their way of framing scientific evidence and risks of molecular medicine. © The Author(s) 2013.

  11. Access to Higher Education in Canada: Equality of Opportunity vs. Equality of Results.

    Science.gov (United States)

    Anisef, Paul

    1983-01-01

    Discusses the issue of access to higher education in Canada and suggests that those who do not gain entry share common social and cultural properties. Recommends three strategies for enhancing accessibility: a monitoring system, compensatory education programs, and financial assistance programs. (JAC)

  12. Translating Theory Into Practice: Implementing a Program of Assessment.

    Science.gov (United States)

    Hauer, Karen E; O'Sullivan, Patricia S; Fitzhenry, Kristen; Boscardin, Christy

    2018-03-01

    A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school. A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement. Implementation incorporated stakeholder engagement, use of multiple assessment tools, design of a coaching program, and creation of a learner performance dashboard. The assessment team monitors adherence to principles defining the program of assessment and gathers and responds to regular feedback from key stakeholders, including faculty, staff, and students. Next steps include systematically collecting evidence for validity of individual assessments and the program overall. Iterative review of student performance data informs curricular improvements. The program of assessment also highlights technology needs that will be addressed with information technology experts. The outcome ultimately will entail showing evidence of validity that the program produces physicians who engage in lifelong learning and provide high-quality patient care.

  13. 45 CFR 2490.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

    .... 2490.149 Section 2490.149 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.149 Program...

  14. Increasing Wage Gap, Spatial Structure and Market Access: Evidence from Swedish Micro Data

    OpenAIRE

    Nabavi, Pardis

    2015-01-01

    The new economic geography predicts that the wage gap will increase with accessibility to markets but does not consider the impact of spatial proximity. In contrast, urban economic theory explains wage differences by density without accounting for accessibility. Using a rich Swedish micro-panel, we empirically examine the two rival theories for males and females separately, controlling for individual, firm and regional characteristics. The regression results indicate that wage dispersion is c...

  15. Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders (FallPAIDD: A Modified Otago Exercise Program

    Directory of Open Access Journals (Sweden)

    Mindy Renfro

    2016-12-01

    Full Text Available INTRODUCTION: Evidence-based fall prevention (EBFP programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD such as Alzheimer’s disease and related dementias (ADRD, cerebral vascular accident (CVA, or traumatic brain injury (TBI. BACKGROUND: Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers, but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to healthcare and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury are on the rise and require effective and efficient prevention. METHODS: A modified group-based version of the Otago Exercise Program (OEP was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre and post-intervention using the Center for Disease Control and Prevention’s (CDC STopping Elderly Accidents Deaths and Injuries (STEADI tool kit. Participants participated in progressive once weekly, one-hour group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. RESULTS: Despite the limited number of participants (n=15 and short length of participation, improvements were observed in the 30-Second Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. DISCUSSION: Promising results of this preliminary project underline the need for further study

  16. Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence.

    Science.gov (United States)

    Brown, Sharon A; García, Alexandra A; Zuñiga, Julie A; Lewis, Kimberly A

    2018-01-05

    The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM. Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017. The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions-healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors-were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24 weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive. The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes. Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. MLF user program

    International Nuclear Information System (INIS)

    Kamiyama, Takashi; Ikeda, Yujiro

    2008-01-01

    The user program of J-PARC/MLF is overviewed. Since MLF will be one of the major neutron facilities in the world, an international standard system for the user program is expected. It is also expected to establish a system to promote users from industries. The MLF user program is based on the IUPAP recommendation on the selection of proposals. Both open and closed accesses, biannual, regular, rapid accesses, etc. will be provided. All the features in the system are being introduced to maximize both scientific and engineering outputs from MLF. (author)

  18. KAUST Open Access policy

    KAUST Repository

    Baessa, Mohamed A.

    2017-03-07

    The transition to open access (OA) is being driven by funders, libraries, researchers and publishers around the world, and is having an impact on us all. It is inevitable that different countries, organisations and disciplines are moving at different rates towards an OA model, and it is this that we will focus on in this session. Drawing on experiences from across Europe and the Middle East we will provide perspectives from both a global publisher and institutions based in the region. Taylor & Francis take a flexible, evidence-based approach to open access, providing a choice of publication routes for our authors, and a choice of agreements for our library customers. Carolyn will outline some of the open access developments, opportunities and challenges at Taylor & Francis. The library plays a critical role in facilitating open access for their researchers, from managing a repository to providing support and information on the OA publication process to their authors. Janis Tyhurst and Dr Imad Bachir will each give an overview of how this is being managed by their institution. There will be an opportunity for questions and discussion with the panel.

  19. Access is mainly a second-order process: SDT models whether phenomenally (first-order) conscious states are accessed by reflectively (second-order) conscious processes.

    Science.gov (United States)

    Snodgrass, Michael; Kalaida, Natasha; Winer, E Samuel

    2009-06-01

    Access can either be first-order or second-order. First order access concerns whether contents achieve representation in phenomenal consciousness at all; second-order access concerns whether phenomenally conscious contents are selected for metacognitive, higher order processing by reflective consciousness. When the optional and flexible nature of second-order access is kept in mind, there remain strong reasons to believe that exclusion failure can indeed isolate phenomenally conscious stimuli that are not so accessed. Irvine's [Irvine, E. (2009). Signal detection theory, the exclusion failure paradigm and weak consciousness-Evidence for the access/phenomenal distinction? Consciousness and Cognition.] partial access argument fails because exclusion failure is indeed due to lack of second-order access, not insufficient phenomenally conscious information. Further, the enable account conforms with both qualitative differences and subjective report, and is simpler than the endow account. Finally, although first-order access may be a distinct and important process, second-order access arguably reflects the core meaning of access generally.

  20. Finding and applying evidence during clinical rounds: the "evidence cart".

    Science.gov (United States)

    Sackett, D L; Straus, S E

    1998-10-21

    Physicians need easy access to evidence for clinical decisions while they care for patients but, to our knowledge, no investigators have assessed use of evidence during rounds with house staff. To determine if it was feasible to find and apply evidence during clinical rounds, using an "evidence cart" that contains multiple sources of evidence and the means for projecting and printing them. Descriptive feasibility study of use of evidence during 1 month (April 1997) and anonymous questionnaire (May 1997). General medicine inpatient service. Medical students, house staff, fellows, and attending consultant. Evidence cart that included 2 secondary sources developed by the department (critically appraised topics [CATs] and Redbook), Best Evidence, JAMA Rational Clinical Examination series, the Cochrane Library, MEDLINE, a physical examination textbook, a radiology anatomy textbook, and a Simulscope, which allows several people to listen simultaneously to the same signs on physical examination. Number of times sources were used, type of sources searched and success of searches, time needed to search, and whether the search affected patient care. The evidence cart was used 98 times, but could not be taken on bedside rounds because of its bulk; hard copies of several sources were taken instead. When the evidence cart was used during team rounds and student rounds, some sources could be accessed quickly enough (10.2-25.4 seconds) to be practical on our service. Of 98 searches, 79 (81%) sought evidence that could affect diagnostic and/or treatment decisions. Seventy-one (90%) of 79 searches regarding patient management were successful, and when assessed from the perspective of the most junior team members responsible for each patient's evaluation and management, 37 (52%) of the 71 successful searches confirmed their current or tentative diagnostic or treatment plans, 18 (25%) led to a new diagnostic skill, an additional test, or a new management decision, and 16 (23

  1. 22 CFR 711.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... result in a fundamental alteration in the nature of a program or activity or in undue financial and....150 Section 711.150 Foreign Relations OVERSEAS PRIVATE INVESTMENT CORPORATION ADMINISTRATIVE PROVISIONS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY...

  2. Free Access Does Not Necessarily Encourage Practitioners to Use Online Evidence Based Information Tools. A Review of: Buchan, H., Lourey, E., D’Este, C., & Sanson-Fisher, R. (2009. Effectiveness of strategies to encourage general practitioners to accept an offer of free access to online evidence-based information: A randomised controlled trial. Implementation Science, 4, article 68.

    Directory of Open Access Journals (Sweden)

    Heather Ganshorn

    2010-12-01

    Full Text Available Objectives – To determine which strategies were most effective for encouraging general practitioners (GPs to sign up for free access to an online evidence based information resource; and to determine whether those who accepted the offer differed in their sociodemographic characteristics from those who did not.Design – Descriptive marketing research study.Setting – Australia’s public healthcare system.Subjects – 14,000 general practitioners (GPs from all regions of Australia.Methods – Subjects were randomly selected by Medicare Australia from its list of GPs that bill it for services. Medicare Australia had 18,262 doctors it deemed eligible; 14,000 of these were selected for a stratified random sample. Subjects were randomized to one of 7 groups of 2,000 each. Each group received a different letter offering two years of free access to BMJ Clinical Evidence, an evidence based online information tool. Randomization was done electronically, and the seven groups were stratified by age group, gender, and location. The interventions given to each group differed as follows:• Group 1: Received a letter offering 2 years of free access, with no further demands on the recipient.• Group 2: Received a letter offering 2 years of free access, but on the condition that they complete an initial questionnaire and another one at 12 months, as well as allowing the publisher to provide de-personalized usage data to the researchers.• Group 3: Same as Group 2, but with the additional offer of an online tutorial to assist them with using the resource.• Group 4: Same as Group 2, but with an additional pamphlet with positive testimonials about the resource from Australian medical opinion leaders.• Group 5: Same as Group 2, but with an additional offer of professional development credits towards their required annual totals.• Group 6: Same as Group 2, but with an additional offer to be entered to win a prize of $500 towards registration at a

  3. Open access phone triage for veterans with suspected malignant pleural mesothelioma.

    Science.gov (United States)

    Siegert, Charles Jeff; Fisichella, Piero Marco; Moseley, Jennifer M; Shoni, Melina; Lebenthal, Abraham

    2017-01-01

    Phone triaging patients with suspected malignant pleural mesothelioma (MPM) within the Veterans Healthcare Administration (VHA) system offers a model for rapid, expert guided evaluation for patients with rare and treatable diseases within a national integrated healthcare system. To assess feasibility of national open access telephone triage using evidence-based treatment recommendations for patients with MPM, measure timelines of the triage and referral process and record the impact on "intent to treat" for patients using our service. A retrospective study. The main outcome measures were: (1) ability to perform long distance phone triage, (2) to assess the speed of access to a mesothelioma surgical specialist for patients throughout the entire VHA, and (3) to determine if access to a specialist would alter the plan of care. Sixty veterans were screened by our phone triage program, 38 traveled an average of 997 miles to VA Boston Healthcare system. On average, 14 d elapsed from initial phone contact until the patient was physically evaluated in our general thoracic clinic in Boston. The treatment plan was altered for 71% of patients evaluated at VA Boston Healthcare system based on 2012 International Mesothelioma Interest Group guidelines. Our initial experience demonstrates that in-network centralized care for Veterans with MPM is feasible within the VHA. National open access phone triage improves access to expert surgical advice and can be delivered in a timely manner for Veterans using our service. Guideline-based treatment recommendations ("intent to treat") changed the therapeutic course for the majority of patients who used our service. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Patient and program factors that bridge the detoxification-treatment gap: a structured evidence review.

    Science.gov (United States)

    Timko, Christine; Below, Maureen; Schultz, Nicole R; Brief, Deborah; Cucciare, Michael A

    2015-05-01

    Although completion of detoxification (detox) and a successful transition from detox to substance use disorder (SUD) treatment and/or mutual-help groups are associated with better SUD outcomes, many patients do not complete detox or do not receive SUD care following detox. The purpose of this structured evidence review, summarizing data extraction on a yield of 26 articles, is to identify patient, program, and system factors associated with the outcomes of completion of alcohol detox and successful transitions from alcohol detox to SUD treatment and mutual-help group participation. The review found wide variability among studies in the rates at which patients complete a detox episode (45 to 95%) and enter SUD treatment or mutual-help groups after detox (14 to 92%). Within program factors, behavioral practices that contribute to both detox completion and transitioning to SUD care after detox entail involving the patient's family and utilizing motivational-based approaches. Such practices should be targeted at younger patients, who are less likely to complete detox. Although more studies using a randomized controlled trial design are needed, the evidence suggests that barriers to detox completion and transition to SUD care can be overcome to improve patient outcomes. Published by Elsevier Inc.

  5. GO RIO: Achieving Universal Access to Mass Transit

    Science.gov (United States)

    Martinez, Ted, Jr.; Castaneda-Calleros, Russell

    2009-01-01

    GO RIO is a universal access, mass-transit program that has been offered to all students who are registered full-time at Rio Hondo College. Through an agreement with five local transit agencies, full-time students can obtain a pass that provides full access seven days a week throughout the entire semester.

  6. 5 CFR 1636.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... facilities. 1636.150 Section 1636.150 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL...

  7. Data-Dictionary-Editing Program

    Science.gov (United States)

    Cumming, A. P.

    1989-01-01

    Access to data-dictionary relations and attributes made more convenient. Data Dictionary Editor (DDE) application program provides more convenient read/write access to data-dictionary table ("descriptions table") via data screen using SMARTQUERY function keys. Provides three main advantages: (1) User works with table names and field names rather than with table numbers and field numbers, (2) Provides online access to definitions of data-dictionary keys, and (3) Provides displayed summary list that shows, for each datum, which data-dictionary entries currently exist for any specific relation or attribute. Computer program developed to give developers of data bases more convenient access to the OMNIBASE VAX/IDM data-dictionary relations and attributes.

  8. Bridging the gap to evidence-based eye care

    Directory of Open Access Journals (Sweden)

    Richard Wormald

    2004-10-01

    Full Text Available In the first article in this series, I touched on the enormous challenge to make access to information equal for those who need it at the time and place when they need it. Only if this is achieved can we successfully promote an evidence-based approach to health care. The move towards open access publishing is taking us some way to achieving this. However, there are further gaps to be bridged if we are to turn eye care workers into evidence-based practitioners. We can define an evidence-based practitioner as one who combines their individual knowledge and expertise with the best available external clinical evidence from systematic research.

  9. The Wired Island: The First Two Years of Public Access To Cable Television In Manhattan.

    Science.gov (United States)

    Othmer, David

    A review is presented of the first two years of free public access programing on New York City's cable television (CATV) systems. The report provides some background information on franchising, public access to CATV in New York City, and Federal Communications Commission regulations. It also deals with the public access programing developed; it…

  10. Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level.

    Science.gov (United States)

    O'Connell, Thomas S; Bedford, K Juliet A; Thiede, Michael; McIntyre, Di

    2015-06-09

    A key element of the global drive to universal health coverage is ensuring access to needed health services for everyone, and to pursue this goal in an equitable way. This requires concerted efforts to reduce disparities in access through understanding and acting on barriers facing communities with the lowest utilisation levels. Financial barriers dominate the empirical literature on health service access. Unless the full range of access barriers are investigated, efforts to promote equitable access to health care are unlikely to succeed. This paper therefore focuses on exploring the nature and extent of non-financial access barriers. We draw upon two structured literature reviews on barriers to access and utilization of maternal, newborn and child health services in Ghana, Bangladesh, Vietnam and Rwanda. One review analyses access barriers identified in published literature using qualitative research methods; the other in published literature using quantitative analysis of household survey data. We then synthesised the key qualitative and quantitative findings through a conjoint iterative analysis. Five dominant themes on non-financial access barriers were identified: ethnicity; religion; physical accessibility; decision-making, gender and autonomy; and knowledge, information and education. The analysis highlighted that non-financial factors pose considerable barriers to access, many of which relate to the acceptability dimension of access and are challenging to address. Another key finding is that quantitative research methods, while yielding important findings, are inadequate for understanding non-financial access barriers in sufficient detail to develop effective responses. Qualitative research is critical in filling this gap. The analysis also indicates that the nature of non-financial access barriers vary considerably, not only between countries but also between different communities within individual countries. To adequately understand access barriers as a

  11. A Demonstration of Evidence-Based Action Research Using Information Dashboard in Introductory Programming Education

    OpenAIRE

    Matsuzawa , Yoshiaki; Tanaka , Yoshiki; Kitani , Tomoya; Sakai , Sanshiro

    2017-01-01

    Part 3: Computer Science Education and Its Future Focus and Development; International audience; In this paper, we demonstrated an evidence-based action research in an introductory programming class with the use of an information dashboard which provides coding metrics to visualize students’ engagement of their assignments. The information dashboard was designed for teachers to improve their classroom teaching using the same coding metrics which was verified in our previous research [9]. The ...

  12. Assessing the Efficacy of Restricting Access to Barbecue Charcoal for Suicide Prevention in Taiwan: A Community-Based Intervention Trial

    Science.gov (United States)

    Chen, Ying-Yeh; Chen, Feng; Chang, Shu-Sen; Wong, Jacky; Yip, Paul S F

    2015-01-01

    Objective Charcoal-burning suicide has recently been spreading to many Asian countries. There have also been several cases involving this new method of suicide in Western countries. Restricting access to suicide means is one of the few suicide-prevention measures that have been supported by empirical evidence. The current study aims to assess the effectiveness of a community intervention program that restricts access to charcoal to prevent suicide in Taiwan. Methods and Findings A quasi-experimental design is used to compare method-specific (charcoal-burning suicide, non-charcoal-burning suicide) and overall suicide rates in New Taipei City (the intervention site, with a population of 3.9 million) with two other cities (Taipei City and Kaohsiung City, the control sites, each with 2.7 million residents) before (Jan 1st 2009- April 30th 2012) and after (May 1st 2012-Dec. 31st 2013) the initiation of a charcoal-restriction program on May 1st 2012. The program mandates the removal of barbecue charcoal from open shelves to locked storage in major retail stores in New Taipei City. No such restriction measure was implemented in the two control sites. Generalized linear regression models incorporating secular trends were used to compare the changes in method-specific and overall suicide rates before and after the initiation of the restriction measure. A simulation approach was used to estimate the number of lives saved by the intervention. Compared with the pre-intervention period, the estimated rate reduction of charcoal-burning suicide in New Taipei City was 37% (95% CI: 17%, 50%) after the intervention. Taking secular trends into account, the reduction was 30% (95% CI: 14%, 44%). No compensatory rise in non-charcoal-burning suicide was observed in New Taipei City. No significant reduction in charcoal-burning suicide was observed in the other two control sites. The simulation approach estimated that 91 (95%CI [55, 128]) lives in New Taipei City were saved during the 20

  13. Harvard Law School Proxy Access Roundtable

    OpenAIRE

    Bebchuk, Lucian Arye; Hirst, Scott

    2010-01-01

    This paper contains the proceedings of the Proxy Access Roundtable that was held by the Harvard Law School Program on Corporate Governance on October 7, 2009. The Roundtable brought together prominent participants in the debate - representing a range of perspectives and experiences - for a day of discussion on the subject. The day’s first two sessions focused on the question of whether the Securities and Exchange Commission should provide an access regime, or whether it should leave the adopt...

  14. NASA Access Mechanism - Graphical user interface information retrieval system

    Science.gov (United States)

    Hunter, Judy F.; Generous, Curtis; Duncan, Denise

    1993-01-01

    Access to online information sources of aerospace, scientific, and engineering data, a mission focus for NASA's Scientific and Technical Information Program, has always been limited by factors such as telecommunications, query language syntax, lack of standardization in the information, and the lack of adequate tools to assist in searching. Today, the NASA STI Program's NASA Access Mechanism (NAM) prototype offers a solution to these problems by providing the user with a set of tools that provide a graphical interface to remote, heterogeneous, and distributed information in a manner adaptable to both casual and expert users. Additionally, the NAM provides access to many Internet-based services such as Electronic Mail, the Wide Area Information Servers system, Peer Locating tools, and electronic bulletin boards.

  15. NASA access mechanism: Graphical user interface information retrieval system

    Science.gov (United States)

    Hunter, Judy; Generous, Curtis; Duncan, Denise

    1993-01-01

    Access to online information sources of aerospace, scientific, and engineering data, a mission focus for NASA's Scientific and Technical Information Program, has always been limited to factors such as telecommunications, query language syntax, lack of standardization in the information, and the lack of adequate tools to assist in searching. Today, the NASA STI Program's NASA Access Mechanism (NAM) prototype offers a solution to these problems by providing the user with a set of tools that provide a graphical interface to remote, heterogeneous, and distributed information in a manner adaptable to both casual and expert users. Additionally, the NAM provides access to many Internet-based services such as Electronic Mail, the Wide Area Information Servers system, Peer Locating tools, and electronic bulletin boards.

  16. Increasing access to emergency contraception through online prescription requests.

    Science.gov (United States)

    Averbach, Sarah; Wendt, Jacqueline Moro; Levine, Deborah K; Philip, Susan S; Klausner, Jeffrey D

    2010-01-01

    To describe a pilot program, Plan B Online Prescription Access, to provide easy access to prescriptions for emergency contraception via the Internet. We measured electronic prescriptions for Plan B (Duramed Pharmaceuticals, Cincinnati, Ohio) by month over time. Pharmacists faxed patient-generated prescriptions back to the Department of Public Health for confirmation. Despite no marketing, within the first 18 months of the program, 152 electronic prescriptions for Plan B were requested by 128 female San Francisco residents. Seventy-eight prescriptions were filled (51%) by pharmacists. If correctly marketed, online prescriptions for Plan B have the potential to be an effective means of increasing emergency contraception access in both urban and rural settings across the United States. Further user-acceptability studies are warranted.

  17. Accessing world knowledge : Evidence from N400 and reaction time priming

    NARCIS (Netherlands)

    Chwilla, D.J.; Kolk, H.H.J.

    2005-01-01

    How fast are we in accessing world knowledge? In two experiments, we tested for priming for word triplets that described a conceptual script (e.g., DIRECTOR-BRIBE-DISMISSAL) but were not associatively related and did not share a category relationship. Event-Related Brain Potentials were used to

  18. Mexico's "Telesecundaria" Program and Equitable Access to Resources

    Science.gov (United States)

    Craig, Dana; Etcheverry, Jose; Ferris, Stefan

    2016-01-01

    This Note provides an analysis of Mexico's "Telesecundaria" program within the context of Mexico's new education reform framework offering a succinct background of the project, as well as key policy lessons that can be useful for other jurisdictions interested in the development of distance education programs. This Note uses a literature…

  19. Designing, testing, and implementing a sustainable nurse home visiting program: right@home.

    Science.gov (United States)

    Goldfeld, Sharon; Price, Anna; Kemp, Lynn

    2018-05-01

    Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

  20. Improving Access to Health Care Among New Zealand’s Maori Population

    Science.gov (United States)

    Ellison-Loschmann, Lis; Pearce, Neil

    2006-01-01

    The health status of indigenous peoples worldwide varies according to their unique historical, political, and social circumstances. Disparities in health between Maoris and non-Maoris have been evident for all of the colonial history of New Zealand. Explanations for these differences involve a complex mix of components associated with socioeconomic and lifestyle factors, availability of health care, and discrimination. Improving access to care is critical to addressing health disparities, and increasing evidence suggests that Maoris and non-Maoris differ in terms of access to primary and secondary health care services. We use 2 approaches to health service development to demonstrate how Maori-led initiatives are seeking to improve access to and quality of health care for Maoris. PMID:16507721

  1. Visual accessibility in graphic design: A client–designer communication failure

    OpenAIRE

    Cornish, Katie; Goodman-Deane, Joy; Ruggeri, Kai; Clarkson, P. John

    2015-01-01

    It is essential that graphic design is visually clear and accessible. However, evidence suggests that a lack of consideration is given to visual accessibility in print-based graphic design. Furthermore, effective client-designer communication is a vital component in this. This paper investigates current graphic design practice, with regard to visual accessibility, specifically focussing on client-designer communication. A survey of 122 graphic designers and clients identified that these two g...

  2. Accessible Earth: Enhancing diversity in the Geosciences through accessible course design

    Science.gov (United States)

    Bennett, R. A.; Lamb, D. A.

    2017-12-01

    The tradition of field-based instruction in the geoscience curriculum, which culminates in a capstone geological field camp, presents an insurmountable barrier to many disabled students who might otherwise choose to pursue geoscience careers. There is a widespread perception that success as a practicing geoscientist requires direct access to outcrops and vantage points available only to those able to traverse inaccessible terrain. Yet many modern geoscience activities are based on remotely sensed geophysical data, data analysis, and computation that take place entirely from within the laboratory. To challenge the perception of geoscience as a career option only for the non-disabled, we have created the capstone Accessible Earth Study Abroad Program, an alternative to geologic field camp for all students, with a focus on modern geophysical observation systems, computational thinking, data science, and professional development.In this presentation, we will review common pedagogical approaches in geosciences and current efforts to make the field more inclusive. We will review curricular access and inclusivity relative to a wide range of learners and provide examples of accessible course design based on our experiences in teaching a study abroad course in central Italy, and our plans for ongoing assessment, refinement, and dissemination of the effectiveness of our efforts.

  3. Is open access sufficient? A review of the quality of open-access nursing journals.

    Science.gov (United States)

    Crowe, Marie; Carlyle, Dave

    2015-02-01

    The present study aims to review the quality of open-access nursing journals listed in the Directory of Open Access Journals that published papers in 2013 with a nursing focus, written in English, and were freely accessible. Each journal was reviewed in relation to their publisher, year of commencement, number of papers published in 2013, fee for publication, indexing, impact factor, and evidence of requirements for ethics and disclosure statements. The quality of the journals was assessed by impact factors and the requirements for indexing in PubMed. A total of 552 were published in 2013 in the 19 open-access nursing journals that met the inclusion criteria. No journals had impact factors listed in Web of Knowledge, but three had low Scopus impact factors. Only five journals were indexed with PubMed. The quality of the 19 journals included in the review was evaluated as inferior to most subscription-fee journals. Mental health nursing has some responsibility to the general public, and in particular, consumers of mental health services and their families, for the quality of papers published in open-access journals. The way forward might involve dual-platform publication or a process that enables assessment of how research has improved clinical outcomes. © 2014 Australian College of Mental Health Nurses Inc.

  4. National preceptor development program (PDP): Influential evidence and theory. The first of a 3-part series.

    Science.gov (United States)

    Mulherin, Katrina; Walter, Sheila; Cox, Craig D

    2018-03-01

    Priority #3 of the Canadian Experiential Education Project for Pharmacy provided evidence-based guidance for the design and implementation of a national approach to preceptor development. In this first article (of three), findings from the project and recommendations to achieve a high-quality preceptor development program (PDP) are presented. A multi-method approach including detailed semi-structured interviews, classic literature review, and advisory committee feedback was employed. The research team performed an integrated analysis of all data to achieve the objectives of Priority #3. Fifteen formal interviews, 167 articles and two stakeholder meetings informed findings. Experiential Education programs exhibited commonality in content and usually delivered programs online using modules or live lectures. Not all programs required preceptor education despite it being mandated by academic accreditors. Academics' perceptions varied regarding pharmacists' baseline knowledge, skills and attitudes prior to engaging in the preceptor role. A national approach to a PDP was desired if jurisdictional content was accommodated. Copious interprofessional literature of generally fair quality did not identify superior preceptor development approaches although there were numerous descriptions of interventions. Only 29 articles measured educational outcomes. Outcomes included satisfaction rates, self-efficacy and perceived knowledge, skill retention, skill implementation and participation rates. Twelve recommendations were identified to guide successful development of a national PDP. In the absence of good evidence, adult educational theory provided a basis for an effective PDP. Findings from Priority #3 may be relevant not only to pharmacy in Canada but other health professions and counterparts in other western nations with similar approaches to professional education. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Radiotherapy access in Belgium: How far are we from evidence-based utilisation?

    Science.gov (United States)

    Lievens, Y; De Schutter, H; Stellamans, K; Rosskamp, M; Van Eycken, L

    2017-10-01

    Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed. AUPs and advised radiotherapy were calculated overall and by cancer type for 110,810 unique cancer diagnoses in 2009-2010. Radiotherapy utilisation was derived from reimbursement data and distinguished between palliative and curative intent external beam radiotherapy (EBRT) and/or brachytherapy (BT). Sensitivity analyses regarding the influence of the follow-up period, the survival length and patient's age were performed. Advised radiotherapy was calculated based on broad treatment categories as reported at MDT meetings. The overall AUP of 37% (39% including BT) was lower than the OUP of 53%, but in line with advised radiotherapy (35%). Large variations by tumour type were observed: in some tumours (e.g. lung and prostate cancer) AUP was considerably lower than OUP, whereas in others there was reasonable concordance (e.g. breast and rectal cancer). Overall, 84% of treatments started within 9 months following diagnosis. Survival time influenced AUP in a cancer type-dependent way. Elderly patients received less radiotherapy. Although the actually delivered radiotherapy in Belgium aligns well to MDT advices, it is lower than the evidence-based optimum. Further analysis of potential barriers is needed for radiotherapy forecasting and planning, and in order to promote adequate access to radiotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. 28 CFR 54.415 - Access to course offerings.

    Science.gov (United States)

    2010-07-01

    ..., music, and adult education courses. (b)(1) With respect to classes and activities in physical education... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 54.415 Access to course offerings. (a) A...

  7. 6 CFR 17.415 - Access to course offerings.

    Science.gov (United States)

    2010-01-01

    ..., home economics, music, and adult education courses. (b)(1) With respect to physical education classes... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 17.415 Access to course...

  8. 75 FR 32341 - Import Administration IA ACCESS Pilot Program

    Science.gov (United States)

    2010-06-08

    ... submitted electronically need not also be submitted in hard copy. Persons wishing to submit written comments in hard copy should file one signed original and two copies of each set of comments to the address... . Any questions concerning file formatting, document conversion, access on the Internet, or other...

  9. Social Reproduction and College Access: Current Evidence, Context, and Potential Alternatives

    Science.gov (United States)

    Serna, Gabriel R.; Woulfe, Rebecca

    2017-01-01

    Social reproduction theory identifies schooling as a primary means for the perpetuation of the dominant class's ideologies, values, and power. The ability to access college is so closely tied to these constructs that it contributes to this dominance and marginalization. Social stratification is not only mirrored in higher education, but the…

  10. Effects of Job Accessibility Improved by Public Transport System: Natural Experimental Evidence from the Copenhagen Metro

    DEFF Research Database (Denmark)

    Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

    2015-01-01

    This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail ...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...

  11. An Investigation of Unified Memory Access Performance in CUDA

    Science.gov (United States)

    Landaverde, Raphael; Zhang, Tiansheng; Coskun, Ayse K.; Herbordt, Martin

    2015-01-01

    Managing memory between the CPU and GPU is a major challenge in GPU computing. A programming model, Unified Memory Access (UMA), has been recently introduced by Nvidia to simplify the complexities of memory management while claiming good overall performance. In this paper, we investigate this programming model and evaluate its performance and programming model simplifications based on our experimental results. We find that beyond on-demand data transfers to the CPU, the GPU is also able to request subsets of data it requires on demand. This feature allows UMA to outperform full data transfer methods for certain parallel applications and small data sizes. We also find, however, that for the majority of applications and memory access patterns, the performance overheads associated with UMA are significant, while the simplifications to the programming model restrict flexibility for adding future optimizations. PMID:26594668

  12. Predictive access control for distributed computation

    DEFF Research Database (Denmark)

    Yang, Fan; Hankin, Chris; Nielson, Flemming

    2013-01-01

    We show how to use aspect-oriented programming to separate security and trust issues from the logical design of mobile, distributed systems. The main challenge is how to enforce various types of security policies, in particular predictive access control policies — policies based on the future beh...... behavior of a program. A novel feature of our approach is that we can define policies concerning secondary use of data....

  13. Accession Medical Standards Analysis and Research Activity (AMSARA), 2016 Annual Report

    Science.gov (United States)

    2016-11-01

    NOTES The original document contains color photos. And four Supplemental Applicants and Accessions tables for: Army, Air Force, Marine, and Navy 14...accession characteristics and risk of attrition in the accessed population. T\\.VO manuscripts focus on the Assessment of Recruit Motivation and Strength...programs to improve military readiness by maximizing both the accession and retention of motivated and capable recruits. This report provides abstracts

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Asked Questions Resources Educational Resources Educational Resources E-Learning Entering Resident Readiness Assessment Evidence-Based Decisions in ... Optimal Access Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications Optimal Access Resources Members Contact Us ...

  15. Health promotion in schools: a multi-method evaluation of an Australian School Youth Health Nurse Program.

    Science.gov (United States)

    Banfield, Michelle; McGorm, Kelly; Sargent, Ginny

    2015-01-01

    Health promotion provides a key opportunity to empower young people to make informed choices regarding key health-related behaviours such as tobacco and alcohol use, sexual practices, dietary choices and physical activity. This paper describes the evaluation of a pilot School Youth Health Nurse (SYHN) Program, which aims to integrate a Registered Nurse into school communities to deliver health promotion through group education and individual sessions. The evaluation was guided by the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. The objectives were to explore: 1) whether the Program was accessible to the high school students; 2) the impacts of the Program on key stakeholders; 3) which factors affected adoption of the Program; 4) whether implementation was consistent with the Program intent; and 5) the long-term sustainability of the Program. Research included retrospective analysis of Program records, administration of a survey of student experiences and interviews with 38 stakeholders. This evaluation provided evidence that the SYHN Program is reaching students in need, is effective, has been adopted successfully in schools, is being implemented as intended and could be maintained with sustained funding. The nurses deliver an accessible and acceptable primary health care service, focused on health promotion, prevention and early intervention. After some initial uncertainty about the scope and nature of the role, the nurses are a respected source of health information in the schools, consulted on curriculum development and contributing to whole-of-school health activities. Findings demonstrate that the SYHN model is feasible and acceptable to the students and schools involved in the pilot. The Program provides health promotion and accessible primary health care in the school setting, consistent with the Health Promoting Schools framework.

  16. Publish or perish, and pay--the new paradigm of open-access journals.

    Science.gov (United States)

    Tzarnas, Stephanie; Tzarnas, Chris D

    2015-01-01

    The new open-access journal business model is changing the publication landscape and residents and junior faculty should be aware of these changes. A national survey of surgery program directors and residents was performed. Open-access journals have been growing over the past decade, and many traditional printed journals are also sponsoring open-access options (the hybrid model) for accepted articles. Authors need to be aware of the new publishing paradigm and potential costs involved in publishing their work. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Creating community-based access to primary healthcare for the uninsured through strategic alliances and restructuring local health department programs.

    Science.gov (United States)

    Scotten, E Shirin L; Absher, Ann C

    2006-01-01

    In 2003, the Wilkes County Health Department joined with county healthcare providers to develop the HealthCare Connection, a coordinated and continuous system of low-cost quality care for uninsured and low-income working poor. Through this program, local providers of primary and specialty care donate specialty care or ancillary services not provided by the Health Department, which provides case management for the program. Basing their methods on business models learned through the UNC Management Academy for Public Health, planners investigated the best practices for extending healthcare coverage to the underinsured and uninsured, analyzed operational costs, discovered underutilized local resources, and built capacity within the organization. The HealthCare Connection is an example of how a rural community can join together in a common business practice to improve healthcare access for uninsured and/or low-income adults.

  18. Access to bank finance for Scottish SMEs.

    OpenAIRE

    North, David J.; Baldock, Robert; Deakins, David; Whittam, Geoff

    2008-01-01

    There is evidence that some SMEs may still face difficulties in accessing bank finance from lenders (CEEDR, 2007). This paper reports an in-depth study into demand and supply side issues relating to access to bank finance by Scottish SMEs and whether there is still market\\ud failure associated with good, bankable business cases from SMEs that do not receive finance. We argue that our study utilises innovative methodology and is relatively rare as a robust study in this area. We combine demand...

  19. An Analysis of Naval Officer Accession Programs

    National Research Council Canada - National Science Library

    Lehner, William D

    2008-01-01

    This thesis conducts an extensive literature review of prior studies on the three major commissioning programs for United States naval officers the United States Naval Academy, Naval Reserve Officers...

  20. Effects of Job Accessibility Improved by Public Transport System: Natural Experimental Evidence from the Copenhagen Metro

    DEFF Research Database (Denmark)

    Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick

    2015-01-01

    This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail...... and Metro system resulting from the construction of a new terminal Metro station connecting southern townships to Copenhagen city centre. The results show that public transport based job accessibility has a positive and permanent effect on individual earnings. The increase in earnings is associated...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...

  1. Nuclear information access system

    International Nuclear Information System (INIS)

    Ham, C. H.; Yang, M. H.; Yoon, S. W.

    1998-01-01

    The energy supply in the countries, which have abundant energy resources, may not be affected by accepting the assertion of anti-nuclear and environment groups. Anti-nuclear movements in the countries which have little energy resources may cause serious problem in securing energy supply. Especially, it is distinct in Korea because she heavily depends on nuclear energy in electricity supply(nuclear share in total electricity supply is about 40%).The cause of social trouble surrounding nuclear energy is being involved with various circumstances. However, it is very important that we are not aware of the importance of information access and prepared for such a situation from the early stage of nuclear energy's development. In those matter, this paper analyzes the contents of nuclear information access system in France and Japan which have dynamic nuclear development program and presents the direction of the nuclear access regime through comparing Korean status and referring to progresses of the regime

  2. Migration Performance for Legacy Data Access

    Directory of Open Access Journals (Sweden)

    Kam Woods

    2008-12-01

    Full Text Available We present performance data relating to the use of migration in a system we are creating to provide web access to heterogeneous document collections in legacy formats. Our goal is to enable sustained access to collections such as these when faced with increasing obsolescence of the necessary supporting applications and operating systems. Our system allows searching and browsing of the original files within their original contexts utilizing binary images of the original media. The system uses static and dynamic file migration to enhance collection browsing, and emulation to support both the use of legacy programs to access data and long-term preservation of the migration software. While we provide an overview of the architectural issues in building such a system, the focus of this paper is an in-depth analysis of file migration using data gathered from testing our software on 1,885 CD-ROMs and DVDs. These media are among the thousands of collections of social and scientific data distributed by the United States Government Printing Office (GPO on legacy media (CD-ROM, DVD, floppy disk under the Federal Depository Library Program (FDLP over the past 20 years.

  3. Devolution's policy impact on non-emergency medical transportation in State Children's Health Insurance Programs.

    Science.gov (United States)

    Borders, Stephen; Blakely, Craig; Ponder, Linda; Raphael, David

    2011-01-01

    Proponents of devolution often maintain that the transfer of power and authority of programs enables local officials to craft policy solutions that better align with the needs of their constituents. This article provides one of the first empirical evaluations of this assumption as it relates to non-emergency medical transportation (NEMT) in the State Children's Health Insurance Program (SCHIP). NEMT programs meet a critical need in the areas in which they serve, directly targeting this single key access barrier to care. Yet states have great latitude in making such services available. The authors utilize data from 32 states to provide a preliminary assessment of devolution's consequences and policy impact on transportation-related access to care. Their findings provide mixed evidence on devolution's impact on policy outcomes. Proponents of devolution can find solace in the fact that several states have gone beyond federally mandated minimum requirements to offer innovative programs to remove transportation barriers to care. Detractors of devolution will find continued pause on several key issues, as a number of states do not offer NEMT to their SCHIP populations while cutting services and leaving over $7 billion in federal matching funding unspent.

  4. Publishing in Open Access Journals

    International Development Research Centre (IDRC) Digital Library (Canada)

    mbrunet

    While most open access journals are peer‐reviewed and high quality, there are a number of ... Publisher has a negative reputation (e.g., documented examples in Chronicle of Higher Education, ... A key part of Canada's aid program, IDRC supports research in developing countries to promote growth and development.

  5. Challenges in Obtaining Property Access: The FUSRAP Maywood Site Experience - 13433

    International Nuclear Information System (INIS)

    Kollar, William

    2013-01-01

    The Formerly Utilized Sites Remedial Action Program (FUSRAP) is the US government program started in 1974 to identify, investigate and clean up or control sites that became contaminated as a result of the nation's early atomic programs. Many of these sites are not owned by the federal government and therefore require owner permission to enter. The experience in pursuing such access at the FUSRAP Maywood Superfund Site (the Maywood Site or the Site) in Bergen County, New Jersey, is extensive. Since the US Army Corps of Engineers (the Corps) assumed responsibility for the Maywood Site from the US Department of Energy in 1997, at least 186 separate property access agreements (known in FUSRAP as a Real Estate Right-of- Entry or ROE) have been executed between the Corps and approximately 55 different land owners and tenant occupants at the Maywood Site (agreement renewals with the same owners over time account for the difference). Maywood's experience during the Corps' tenure, reflected here in three case studies of representative property access efforts, offers some lessons and best practices that may apply to other remedial programs. While the Site Community Relations Manager (the author of this paper) managed the property access task, multi-disciplinary support from across the project was also critical to success in this endeavor. (authors)

  6. Pediatric central venous access devices: nursing interventions

    Directory of Open Access Journals (Sweden)

    Duffy EA

    2017-05-01

    Full Text Available Elizabeth A Duffy, Kathryn N Nelson Department of Health Behavior and Biological Sciences, The University of Michigan School of Nursing, Ann Arbor, MI, USA Abstract: A central venous catheter (CVC is an indwelling catheter that provides permanent or temporary stable venous access for both acute and chronically ill pediatric patients. These catheters provide stable venous access that can be used for a variety of medical purposes including drawing blood, hemodynamic monitoring, infusion of intravenous medications, infusion of intravenous fluids, chemotherapy, blood products, and parenteral nutrition. Each day, nurses access and care for CVCs in infants, children, and adolescents; the precision of this care can prevent life-threatening complications. The purpose of this review and the case study is to highlight the importance and components of evidence-based nursing practice in pediatric CVC care. A historical perspective of CVC care is provided in conjunction with current national initiatives to improve patient outcomes for children with CVCs. Infection prevention, clinical practice guidelines, quality improvement, and evidence-based care bundles are discussed. Keywords: pediatric nursing, central venous catheters, central line-associated bloodstream infection, care bundles, pediatric case study 

  7. Institutional Profile: University of California San Diego Pharmacogenomics Education Program (PharmGenEd™): bridging the gap between science and practice.

    Science.gov (United States)

    Kuo, Grace M; Ma, Joseph D; Lee, Kelly C; Halpert, James R; Bourne, Philip E; Ganiats, Theodore G; Taylor, Palmer

    2011-02-01

    Clinical application of evidence-based pharmacogenomics information has the potential to help healthcare professionals provide safe and effective medication management to patients. However, there is a gap between the advances of pharmacogenomics discovery and the health professionals' knowledge regarding pharmacogenomics testing and therapeutic uses. Furthermore, pharmacogenomics education materials for healthcare professionals have not been readily available or accessible. Pharmacogenomics Education Program (PharmGenEd™) is an evidence-based pharmacogenomics education program developed at the University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences and the School of Medicine (CA, USA), with funding support from the Centers for Disease Control and Prevention. Program components include continuing education modules, train-the-trainer materials and shared curriculum modules based on therapeutic topics, and virtual communities with online resources.

  8. Excellence, Equity, and Access: Educators' Perceptions of Students in Open Access Advanced Placement Courses

    Science.gov (United States)

    King, Justyna Plichta

    2010-01-01

    This dissertation examines educators' perceptions regarding open access Advanced Placement (AP) program courses and their impact on non-traditional AP students in one suburban school district. The data were collected during the 2009-2010 school year through a 15-item Likert scale (and one open-ended item) survey which was disseminated during…

  9. “Basically... porn is everywhere”: a rapid evidence assessment on the effects that access and exposure to pornography has on children and young people

    OpenAIRE

    Horvath, M.; Alys, L.; Massey, K.; Pina, A.; Scally, M.; Adler, J.

    2013-01-01

    This Rapid Evidence Assessment (REA) was commissioned by the Office of the Children’s Commissioner (OCC) as part of its Inquiry into Child Sexual Exploitation in Gangs and Groups (CSEGG). It was conducted by a consortium led by Middlesex University, to explore the effects that exposure and access to pornography have on children and young people. The CSEGG Inquiry was launched in October 2011 to better understand the scale, scope, extent and nature of child sexual exploitation in gangs and gro...

  10. Corporate Health and Wellness and the Financial Bottom Line: Evidence From South Africa.

    Science.gov (United States)

    Conradie, Christina Susanna; van der Merwe Smit, Eon; Malan, Daniel Pieter

    2016-02-01

    The research objective was to test the hypothesis that corporate health and wellness contributed positively to South African companies' financial results. The past share market performance of eligible healthy companies, based on Discovery's Healthy Company Index, was tracked under three investment scenarios and compared with the market performance on the basis of the JSE FTSE All Share Index. The evidence supports the hypothesis that a culture of health and wellness provides a financial advantage, in so far as the portfolio of healthy companies consistently outperformed the market over the selected simulations. Given the limitations of the investigation, namely small sample size, the brevity of the period of investigation, and the reliance on accessibility sampling, the research provides the first and preliminary evidence supportive of the direct financial benefits of companies' wellness programs.

  11. Gambling accessibility: a scale to measure gambler preferences.

    Science.gov (United States)

    Moore, Susan M; Thomas, Anna C; Kyrios, Michael; Bates, Glen; Meredyth, Denise

    2011-03-01

    Geographic closeness of gambling venues is not the only aspect of accessibility likely to affect gambling frequency. Perceived accessibility of gambling venues may include other features such as convenience (e.g., opening hours) or "atmosphere". The aim of the current study was to develop a multidimensional measure of gamblers' perceptions of accessibility, and present evidence for its reliability and validity. We surveyed 303 gamblers with 43 items developed to measure different dimensions of accessibility. Factor analysis of the items produced a two factor solution. The first, Social Accessibility related to the level at which gambling venues were enjoyed because they were social places, provided varying entertainment options and had a pleasant atmosphere. The second factor, Accessible Retreat related to the degree to which venues were enjoyed because they were geographically and temporally available and provided a familiar and anonymous retreat with few interruptions or distractions. Both factors, developed as reliable subscales of the new Gambling Access Scale, demonstrated construct validity through their correlations with other gambling-related measures. Social Accessibility was moderately related to gambling frequency and amount spent, but not to problem gambling, while, as hypothesised, Accessible Retreat was associated with stronger urges to gamble and gambling problems.

  12. 77 FR 47440 - Office of the Assistant Secretary for Office of Disability Employment Program Accessible...

    Science.gov (United States)

    2012-08-08

    ... employment and creating accessible human resource management systems (e.g., accessible online job application... to develop and operate the Accessible Technology Action Center (ATAC), a new national resource to..., coordinate and publicize resources on accessible technology in the workplace; (2) promote effective employer...

  13. 75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

    Science.gov (United States)

    2010-01-15

    ... complying with DOT's over- the-road bus accessibility regulation. The authorizing legislation calls for..., 915 Chicago, IL 60606, Tel. 312-353- Second Avenue, Suite 3142, 2789. Seattle, WA 98174-1002, Tel. 206...

  14. Small scale farmers’ access to and participation in markets : The case of the P4P program in western Kenya

    OpenAIRE

    Skjöldevald, Maja

    2012-01-01

    The purpose of this thesis is to understand how small scale farmers navigate the market to access and participate in the formal maize market to improve their revenue, utilising the case of the P4P program inKenya. The empirical material was collected during fieldwork in Kenya. Qualitative methods were found to be the most suitable for this thesis. The methods that was utilised were a case study strategy, semi structured interviews, focus groups, observations and analysis of secondary sources....

  15. Ottawa panel evidence-based clinical practice guidelines for aerobic walking programs in the management of osteoarthritis.

    Science.gov (United States)

    Loew, Laurianne; Brosseau, Lucie; Wells, George A; Tugwell, Peter; Kenny, Glen P; Reid, Robert; Maetzel, Andreas; Huijbregts, Maria; McCullough, Carolyn; De Angelis, Gino; Coyle, Douglas

    2012-07-01

    To update the Evidence-Based Clinical Practice Guidelines (EBCPGs) on aerobic walking programs for the management of osteoarthritis (OA) of the knee. A literature search was conducted using the electronic databases MEDLINE, PubMed, and the Cochrane Library for all studies related to aerobic walking programs for OA from 1966 until February 2011. The literature search found 719 potential records, and 10 full-text articles were included according to the selection criteria. The Ottawa Methods Group established the inclusion and exclusion criteria regarding the characteristics of the population, by selecting adults of 40 years old and older who were diagnosed with OA of the knee. Two reviewers independently extracted important information from each selected study using standardized data extraction forms, such as the interventions, comparisons, outcomes, time period of the effect measured, and study design. The statistical analysis was reported using the Cochrane collaboration methods. An improvement of 15% or more relative to a control group contributes to the achievement of a statistically significant and clinically relevant progress. A specific grading system for recommendations, created by the Ottawa Panel, used a level system (level I for randomized controlled studies and level II for nonrandomized articles). The strength of the evidence of the recommendations was graded using a system with letters: A, B, C+, C, D, D+, or D-. Evidence from 7 high-quality studies demonstrated that facility, hospital, and home-based aerobic walking programs with other therapies are effective interventions in the shorter term for the management of patients with OA to improve stiffness, strength, mobility, and endurance. The greatest improvements were found in pain, quality of life, and functional status (grades A, B, or C+). A common limitation inherent to the EBCPGs is the heterogeneity of studies included with regards to the characteristics of the population, the interventions, the

  16. [Access to medicines prescribed for acute health conditions in adults in South and Northeast Brazil].

    Science.gov (United States)

    Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto

    2016-01-01

    This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.

  17. High Optical Access Trap 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Maunz, Peter Lukas Wilhelm [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-01-26

    The High Optical Access (HOA) trap was designed in collaboration with the Modular Universal Scalable Ion-trap Quantum Computer (MUSIQC) team, funded along with Sandia National Laboratories through IARPA's Multi Qubit Coherent Operations (MQCO) program. The design of version 1 of the HOA trap was completed in September 2012 and initial devices were completed and packaged in February 2013. The second version of the High Optical Access Trap (HOA-2) was completed in September 2014 and is available at IARPA's disposal.

  18. Decoupled Access-Execute on ARM big.LITTLE

    OpenAIRE

    Weber, Anton

    2016-01-01

    Decoupled Access-Execute (DAE) presents a novel approach to improve power efficiency with a combination of compile-time transformations and Dynamic Voltage Frequency Scaling (DVFS). DAE splits regions of the program into two distinct phases: a memory-bound access phase and a compute-bound execute phase. DVFS is used to run the phases at different frequencies, thus conserving energy while caching data from main memory and performing computations at maximum performance. This project analyses th...

  19. Striving for evidence-based practice innovations through a hybrid model journal club: A pilot study.

    Science.gov (United States)

    Wilson, Marian; Ice, Suzanna; Nakashima, Cathy Y; Cox, Lynn Annette; Morse, Elizabeth C; Philip, Ginu; Vuong, Ellen

    2015-05-01

    The purpose of this study was to pilot a "hybrid" style journal club and determine whether measurable effects could be detected over 8-weeks' time on evidence-based practice ability, desire, behaviors, use, and barriers. Journal clubs have been suggested as a method to increase nurses' confidence with using research evidence to guide practice. However, it is yet unknown how nurse educators can best implement effective programs for clinicians with varying schedules, education levels, and research skills. Thirty-six participants from one large urban United States hospital (72% registered nurses) were invited to access bi-weekly interdisciplinary journal club activities. Nurse educators created curriculum focused on clinical problem solving that was offered via in-person sessions or a social media site. A pretest-posttest no control group design was used to measure impacts of those engaged in journal club activities. Data were collected using a combination of validated evidence-based practice instruments and program participation records. A two-tailed paired t test showed significant increases over 8weeks' time in evidence-based practice use (p=.002) and behaviors (p=.007). Slight preference for in-person sessions was reported, although greater participation was reflected in online activities. Mean satisfaction ratings were high; however, attrition rates suggest that more is needed to maximize clinician engagement. A hybrid method using online and in-person sessions was feasible and adaptive for varying learning styles and work schedules. Positive changes in measurements were detected among journal club participants. Instruments were identified that may be useful for trialing similar programs intended to increase evidence-based practice self-efficacy, use, behaviors, and ability. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Parents Plus Systemic, Solution-Focused Parent Training Programs: Description, Review of the Evidence Base, and Meta-Analysis.

    Science.gov (United States)

    Carr, Alan; Hartnett, Dan; Brosnan, Eileen; Sharry, John

    2017-09-01

    Parents Plus (PP) programs are systemic, solution-focused, group-based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child-focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta-analysis of 10 controlled studies for child behavior problems compares favorably with those of meta-analyses of other well-established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front-line mental health and educational professionals. © 2016 Family Process Institute.

  1. EntrezAJAX: direct web browser access to the Entrez Programming Utilities

    Directory of Open Access Journals (Sweden)

    Pallen Mark J

    2010-06-01

    Full Text Available Abstract Web applications for biology and medicine often need to integrate data from Entrez services provided by the National Center for Biotechnology Information. However, direct access to Entrez from a web browser is not possible due to 'same-origin' security restrictions. The use of "Asynchronous JavaScript and XML" (AJAX to create rich, interactive web applications is now commonplace. The ability to access Entrez via AJAX would be advantageous in the creation of integrated biomedical web resources. We describe EntrezAJAX, which provides access to Entrez eUtils and is able to circumvent same-origin browser restrictions. EntrezAJAX is easily implemented by JavaScript developers and provides identical functionality as Entrez eUtils as well as enhanced functionality to ease development. We provide easy-to-understand developer examples written in JavaScript to illustrate potential uses of this service. For the purposes of speed, reliability and scalability, EntrezAJAX has been deployed on Google App Engine, a freely available cloud service. The EntrezAJAX webpage is located at http://entrezajax.appspot.com/

  2. Exercise program for children and adolescents with leukemia and lymphoma during treatment: A comprehensive review.

    Science.gov (United States)

    Zucchetti, Giulia; Rossi, Francesca; Chamorro Vina, Carolina; Bertorello, Nicoletta; Fagioli, Franca

    2018-05-01

    An exercise program (EP) during cancer treatment seems to be a valid strategy against physiological and quality-of-life impairments, but scientific evidence of benefits among pediatric patients is still limited. This review summarizes the literature focused on randomized controlled trials of EP offered to patients during leukemia and lymphoma treatment. Studies published up to June 2017 were selected from multiple databases and assessed by three independent reviewers for methodological validity. The review identified eight studies, but several types of bias have to be avoided to provide evidence-based recommendations accessible to patients, families, and professionals. © 2018 Wiley Periodicals, Inc.

  3. Barriers to implementing evidence-based practice in a private ...

    African Journals Online (AJOL)

    , individual perceptions that underpin clinical decision-making, lack of access to information required for EBP, inadequate sources to access evidence, inability to synthesise the literature available, and resistance to change. Barriers related to ...

  4. Consumer engagement and the development, evaluation and dissemination of evidence-based parenting programs

    Science.gov (United States)

    Sanders, Matthew R.; Kirby, James N.

    2013-01-01

    A consumer perspective can contribute much to enhancing the “ecological fit” of population level parenting interventions so they meet the needs of parents. This approach involves building relationships with consumer groups and soliciting consumer input into the relevance and acceptability of interventions, clarifying the enablers and barriers to engagement and involvement of parents, and clarifying variables that influence a parent’s program completion. The adoption of a more collaborative approach to working with consumers is important if meaningful population level change in the prevalence of serious social, emotional and behavioral problems in children and young people is to be achieved. Parents seeking assistance for their children’s behavior come from a diverse range of socioeconomic backgrounds, educational levels, cultures and languages. This paper examines consumer engagement strategies that can be employed throughout the process of program development, evaluation, training and dissemination and in “scaling up” the intervention. We argue that a multi-level public health approach to parenting intervention requires a strong consumer perspective to enable interventions to be more responsive to the preferences and needs of families and to ensure improved population reach of interventions. Examples from large scale dissemination trials are used to illustrate how consumer input can result in an increasingly differentiated suite of evidence-based parenting programs. PMID:22440062

  5. Socioeconomic Inequalities in Green Space Quality and Accessibility-Evidence from a Southern European City.

    Science.gov (United States)

    Hoffimann, Elaine; Barros, Henrique; Ribeiro, Ana Isabel

    2017-08-15

    Background : The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in geographic accessibility and quality of green spaces across Porto neighbourhoods (Portugal). Methods : Accessibility was evaluated using a Geographic Information System and all the green spaces were audited using the Public Open Space Tool. Kendall's tau-b correlation coefficients and ordinal regression were used to test whether socioeconomic differences in green space quality and accessibility were statistically significant. Results : Although the majority of the neighbourhoods had an accessible green space, mean distance to green space increased with neighbourhood deprivation. Additionally, green spaces in the more deprived neighbourhoods presented significantly more safety concerns, signs of damage, lack of equipment to engage in active leisure activities, and had significantly less amenities such as seating, toilets, cafés, etc. Conclusions : Residents from low socioeconomic positions seem to suffer from a double jeopardy; they lack both individual and community resources. Our results have important planning implications and might contribute to understanding why deprived communities have lower physical activity levels and poorer health.

  6. The educational impact of the Specialty Care Access Network-Extension of Community Healthcare Outcomes program.

    Science.gov (United States)

    Salgia, Reena J; Mullan, Patricia B; McCurdy, Heather; Sales, Anne; Moseley, Richard H; Su, Grace L

    2014-11-01

    With the aging hepatitis C cohort and increasing prevalence of fatty liver disease, the burden on primary care providers (PCPs) to care for patients with liver disease is growing. In response, the Veterans Administration implemented initiatives for primary care-specialty referral to increase PCP competency in complex disease management. The Specialty Care Access Network-Extension of Community Healthcare Outcomes (SCAN-ECHO) program initiative was designed to transfer subspecialty knowledge to PCPs through case-based distance learning combined with real-time consultation. There is limited information regarding the initiative's ability to engage PCPs to learn and influence their practice. We surveyed PCPs to determine the factors that led to their participation in this program and the educational impact of participation. Of 51 potential participants, 24 responded to an anonymous survey. More than 75% of respondents participated more than one time in a SCAN-ECHO clinic. Providers were motivated to participate by a desire to learn more about liver disease, to apply the knowledge gained to future patients, and to save their patients time traveling to another center for specialty consultation. Seventy-one percent responded that the didactic component and case-based discussion were equally important. It is important that participation changed clinical practice: 75% of providers indicated they had personally discussed the information they learned from the case presentations with their colleague(s), and 42% indicated they helped a colleague care for their patient with the knowledge learned during discussions of other participants' cases. This study shows that the SCAN-ECHO videoconferencing program between PCPs and specialists can educate providers in the delivery of specialty care from a distance and potentially improve healthcare delivery.

  7. Access to and use of research by rural nurses.

    Science.gov (United States)

    Winters, C A; Lee, H J; Besel, J; Strand, A; Echeverri, R; Jorgensen, K P; Dea, J E

    2007-01-01

    The use of relevant research findings to inform clinical practice is important for nurses, regardless of setting. Although there have been studies addressing the use of research among various practitioners, little is known about how nurses in rural areas access health information (specifically research findings), nor how such findings are incorporated into daily practice. The purpose of this study was to explore rural nurses' access, use and perceived usefulness of research for rural practice. The study was conducted in a sparsely populated state located in the western part of the USA. An ethnographic method was chosen to answer the research questions for this descriptive study. Semi-structured interviews were conducted with 29 rural nurses from nine communities by graduate nursing students enrolled in a rural nursing course following in-class instruction and practice. Field notes taken by the students supplemented the interview data. The students' notes included a windshield survey or description of the context and location within which the participants lived and/or practiced as well as the interviewers' observations, thoughts and impressions about the research project. Interviews were audiotaped and transcribed verbatim. Once transcribed, the interview narratives, windshield data and field notes were analyzed by the students for common themes; the students then wrote and submitted papers to the faculty addressing the themes that emerged from their interviews. The analysis conducted by the faculty members included four sources of data: transcriptions of interviews; field notes; windshield data; and students' papers. The process of identifying themes was facilitated by using the software program NUD*IST (QSR International; Melbourne, VIC, Australia). Demographic information was entered into the Statistical Package for Social Scientists (SPSS Inc; Chicago, IL, USA) to compile descriptive information about the sample. Twenty-seven female and two male nurses

  8. 7 CFR 37.9 - Access to establishments or records; record retention.

    Science.gov (United States)

    2010-01-01

    ... STANDARD CONTAINER REGULATIONS PROGRAM TO ASSESS ORGANIC CERTIFYING AGENCIES § 37.9 Access to... processes associated with an approved certification program. Records and documents shall be retained for at...

  9. Improving awareness, accountability, and access through health coaching

    Science.gov (United States)

    Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

    2015-01-01

    Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483

  10. Bilingual visual word recognition and lexical access

    NARCIS (Netherlands)

    Dijkstra, A.F.J.; Kroll, J.F.; Groot, A.M.B. de

    2005-01-01

    In spite of the intuition of many bilinguals, a review of empirical studies indicates that during reading under many circumstances, possible words from different languages temporarily become active. Such evidence for "language non-selective lexical access" is found using stimulus materials of

  11. Channel Access Algorithm Design for Automatic Identification System

    Institute of Scientific and Technical Information of China (English)

    Oh Sang-heon; Kim Seung-pum; Hwang Dong-hwan; Park Chan-sik; Lee Sang-jeong

    2003-01-01

    The Automatic Identification System (AIS) is a maritime equipment to allow an efficient exchange of the navigational data between ships and between ships and shore stations. It utilizes a channel access algorithm which can quickly resolve conflicts without any intervention from control stations. In this paper, a design of channel access algorithm for the AIS is presented. The input/output relationship of each access algorithm module is defined by drawing the state transition diagram, dataflow diagram and flowchart based on the technical standard, ITU-R M.1371. In order to verify the designed channel access algorithm, the simulator was developed using the C/C++ programming language. The results show that the proposed channel access algorithm can properly allocate transmission slots and meet the operational performance requirements specified by the technical standard.

  12. Banking behavior under uncertainty: Evidence from the US Sulfur Dioxide Emissions Allowance trading program

    International Nuclear Information System (INIS)

    Rousse, Olivier; Sevi, Benoit

    2006-02-01

    The aim of this paper is to examine portfolio management of emission allowances in the US Sulfur Dioxide Emissions Allowance Trading Program, to determine whether utilities have a real motive to bank when risk increases. We test a theoretical model linking the motivation of the firm to accumulate permits in order to prepare itself to face a risky situation in the future. Empirical estimation using data for years 2001 to 2004 provides evidence of a relationship between banking behavior and uncertainty the utility is facing with. (authors)

  13. Signal detection theory, the exclusion failure paradigm and weak consciousness--evidence for the access/phenomenal distinction?

    Science.gov (United States)

    Irvine, Elizabeth

    2009-06-01

    Block [Block, N. (2005). Two neural correlates of consciousness. Trends in Cognitive Science, 9, 46-52] and Snodgrass (2006) claim that a signal detection theory (SDT) analysis of qualitative difference paradigms, in particular the exclusion failure paradigm, reveals cases of phenomenal consciousness without access consciousness. This claim is unwarranted on several grounds. First, partial cognitive access rather than a total lack of cognitive access can account for exclusion failure results. Second, Snodgrass's Objective Threshold/Strategic (OT/S) model of perception relies on a problematic 'enable' approach to perception that denies the possibility of intentional control of unconscious perception and any effect of following different task instructions on the presence/absence of phenomenal consciousness. Many of Block's purported examples of phenomenal consciousness without cognitive access also rely on this problematic approach. Third, qualitative difference paradigms may index only a subset of access consciousness. Thus, qualitative difference paradigms like exclusion failure cannot be used to isolate phenomenal consciousness, any attempt to do so still faces serious methodological problems.

  14. SCI Hospital in Home Program: Bringing Hospital Care Home for Veterans With Spinal Cord Injury.

    Science.gov (United States)

    Madaris, Linda L; Onyebueke, Mirian; Liebman, Janet; Martin, Allyson

    2016-01-01

    The complex nature of spinal cord injury (SCI) and the level of care required for health maintenance frequently result in repeated hospital admissions for recurrent medical complications. Prolonged hospitalizations of persons with SCI have been linked to the increased risk of hospital-acquired infections and development or worsening pressure ulcers. An evidence-based alternative for providing hospital-level care to patients with specific diagnoses who are willing to receive that level of care in the comfort of their home is being implemented in a Department of Veterans Affairs SCI Home Care Program. The SCI Hospital in Home (HiH) model is similar to a patient-centered interdisciplinary care model that was first introduced in Europe and later tested as part of a National Demonstration and Evaluation Study through Johns Hopkins School of Medicine and School of Public Health. This was funded by the John A. Hartford Foundation and the Department of Veterans Affairs. The objectives of the program are to support veterans' choice and access to patient-centered care, reduce the reliance on inpatient medical care, allow for early discharge, and decrease medical costs. Veterans with SCI who are admitted to the HiH program receive daily oversight by a physician, daily visits by a registered nurse, access to laboratory services, oxygen, intravenous medications, and nursing care in the home setting. In this model, patients may typically access HiH services either as an "early discharge" from the hospital or as a direct admit to the program from the emergency department or SCI clinic. Similar programs providing acute hospital-equivalent care in the home have been previously implemented and are successfully demonstrating decreased length of stay, improved patient access, and increased patient satisfaction.

  15. Behavioral change of pharmacists by online evidence-based medicine-style education programs.

    Science.gov (United States)

    Aoshima, Syuichi; Kuwabara, Hidenori; Yamamoto, Masahiro

    2017-12-01

    Although e-learning evidence-based medicine (EBM) courses have proven useful in improving the knowledge and skills of residents, it was still unclear for pharmacists in non-English-speaking countries. Thus, we investigated the behavioral change of Japanese pharmacists who participated in an EBM-style e-learning educational program available online. This EBM-style e-learning program, the Japanese Journal Club for Clinical Pharmacists, was operated by three pharmacists through Skype. It comprised an online questionnaire administered to the program viewers. Two frequencies, the opportunity to be aware of EBM practices and that of reading an article, were compared before and after viewing the broadcast. Frequencies were classified into five categories: "almost every day," "1-2 times a week," "1-2 times a month," "1-2 times a year," and "not at all." The changes before and after viewing the broadcast were evaluated using a Wilcoxon signed-rank test. The announcement of the questionnaire survey on the web was conducted during the journal club on August 24 and September 7, 2014. The maximum number of simultaneous audiences at the time was 113 persons. Among them, we analyzed data from 36 people who answered the questionnaire. Among these, "1-2 times a week" and "almost every day" were increased, whereas "not at all" was greatly reduced. Indeed, a significant difference was observed in overall change of each frequency before and after viewing the broadcast ( P education of pharmacists.

  16. Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

    Science.gov (United States)

    Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

    2015-11-25

    The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase

  17. PathwayAccess: CellDesigner plugins for pathway databases.

    Science.gov (United States)

    Van Hemert, John L; Dickerson, Julie A

    2010-09-15

    CellDesigner provides a user-friendly interface for graphical biochemical pathway description. Many pathway databases are not directly exportable to CellDesigner models. PathwayAccess is an extensible suite of CellDesigner plugins, which connect CellDesigner directly to pathway databases using respective Java application programming interfaces. The process is streamlined for creating new PathwayAccess plugins for specific pathway databases. Three PathwayAccess plugins, MetNetAccess, BioCycAccess and ReactomeAccess, directly connect CellDesigner to the pathway databases MetNetDB, BioCyc and Reactome. PathwayAccess plugins enable CellDesigner users to expose pathway data to analytical CellDesigner functions, curate their pathway databases and visually integrate pathway data from different databases using standard Systems Biology Markup Language and Systems Biology Graphical Notation. Implemented in Java, PathwayAccess plugins run with CellDesigner version 4.0.1 and were tested on Ubuntu Linux, Windows XP and 7, and MacOSX. Source code, binaries, documentation and video walkthroughs are freely available at http://vrac.iastate.edu/~jlv.

  18. Efforts to secure universal access to HIV/AIDS treatment: a comparison of BRICS countries.

    Science.gov (United States)

    Sun, Jing; Boing, Alexandra Crispim; Silveira, Marysabel P T; Bertoldi, Andréa D; Ziganshina, Liliya E; Khaziakhmetova, Veronica N; Khamidulina, Rashida M; Chokshi, Maulik R; McGee, Shelley; Suleman, Fatima

    2014-02-01

    This article illustrates how the BRICS countries have been building their focused leadership, making important high level commitment and national policy changes, and improving their health systems, in addressing the HIV/AIDS epidemics in respective settings. Specific aspects are focused on efforts of creating public provisions to secure universal access to ARVs from the aspects of active responsive system and national program, health system strengthening, fostering local production of ARVs, supply chain management, and information system strengthening. Challenges in each BRICS country are analyzed respectively. The most important contributors to the success of response to HIV/AIDS include: creating legal basis for healthcare as a fundamental human right; political commitment to necessary funding for universal access and concrete actions to secure equal quality care; comprehensive system to secure demands that all people in need are capable of accessing prevention, treatment and care; active community involvement; decentralization of the management system considering the local settings; integration of treatment and prevention; taking horizontal approach to strengthen health systems; fully use of the TRIPS flexibility; and regular monitoring and evaluation to serve evidence based decision making. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  19. Off-Grid Electricity Access and its Impact on Micro-Enterprises: Evidence from Rural Uganda

    Science.gov (United States)

    Muhoro, Peter N.

    The history of development shows convincingly that no country has substantially reduced poverty without massively increasing the use of electricity. The development of micro-enterprises in rural areas of Uganda is linked with increased access and use of electricity services. In this study, I combine quantitative and qualitative methods, including informal surveys, intra-business energy allocation studies and historical analysis, to analyze off-grid electricity access among micro-enterprises in rural western Uganda. I explore the linkages between of grid electricity access and the influence it has on micro- enterprises. Data is obtained from 56 micro-enterprises located in 11 village-towns within 3 districts in Uganda. In studying the micro-enterprises. the focus is on the services that are provided by electricity from modern energy carriers. The type of equipment used, forms of transportation, technical support, level of understanding and education of the entrepreneur, financing for energy equipment, and the role of donors are discussed in this thesis. Qualitative methods are used to allow for new insights and prioritization of concepts to emerge from the field rattier than from theory. Micro-enterprises in rural Uganda create income for the poor; they are resources for poverty reduction. With price adjustments, it becomes possible for those who live below the poverty line, nominally less than $1 a day, to afford the products and services and therefore mitigating the vicious cycle of poverty. Energy consumption among the micro-enterprises is at an average of 0.13kWh/day. The cost of accessing this amount of electricity attributes to about 50% of total revenue. I find that the "practices" used in off-grid electricity access lead to situations where the entrepreneurs have to evaluate pricing and output of products and services to generate higher profits. Such numbers indicate the need for appropriate technologies and profitable policies to be implemented. The data

  20. 41 CFR 101-4.415 - Access to course offerings.

    Science.gov (United States)

    2010-07-01

    ..., music, and adult education courses. (b)(1) With respect to classes and activities in physical education... EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 101-4.415 Access to course offerings. (a) A...

  1. 42 CFR 51.42 - Access to facilities and residents.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to... such monitoring have access to the minor or adult with a legal guardian. The system shall take no... request, by the P&A system when: (1) An incident is reported or a complaint is made to the P&A system; (2...

  2. Accessible Earth: An accessible study abroad capstone for the geoscience curriculum

    Science.gov (United States)

    Bennett, R. A.; Lamb, D. A.

    2017-12-01

    International capstone field courses offer geoscience-students opportunities to reflect upon their knowledge, develop intercultural competence, appreciate diversity, and recognize themselves as geoscientists on a global scale. Such experiences are often described as pivotal to a geoscientist's education, a right of passage. However, field-based experiences present insurmountable barriers to many students, undermining the goal of inclusive excellence. Nevertheless, there remains a widespread belief that successful geoscientists are those able to traverse inaccessible terrain. One path forward from this apparent dilemma is emerging as we take steps to address a parallel challenge: as we move into the 21st century the geoscience workforce will require an ever increasing range of skills, including analysis, modeling, communication, and computational proficiency. Computer programing, laboratory experimentation, numerical simulation, etc, are inherently more accessible than fieldwork, yet equally valuable. Students interested in pursuing such avenues may be better served by capstone experiences that align more closely with their career goals. Moreover, many of the desirable learning outcomes attributed to field-based education are not unique to immersion in remote inaccessible locations. Affective and cognitive gains may also result from social bonding through extended time with peers and mentors, creative synthesis of knowledge, project-based learning, and intercultural experience. Developing an inclusive course for the geoscience curriculum requires considering all learners, including different genders, ages, physical abilities, familial dynamics, and a multitude of other attributes. The Accessible Earth Study Abroad Program endeavors to provide geoscience students an inclusive capstone experience focusing on modern geophysical observation systems (satellite based observations and permanent networks of ground-based instruments), computational thinking and methods of

  3. Challenges in Obtaining Property Access: The FUSRAP Maywood Site Experience - 13433

    Energy Technology Data Exchange (ETDEWEB)

    Kollar, William [Shaw Environmental, Inc., 100 West Hunter Avenue, Maywood, NJ 07607 (United States)

    2013-07-01

    The Formerly Utilized Sites Remedial Action Program (FUSRAP) is the US government program started in 1974 to identify, investigate and clean up or control sites that became contaminated as a result of the nation's early atomic programs. Many of these sites are not owned by the federal government and therefore require owner permission to enter. The experience in pursuing such access at the FUSRAP Maywood Superfund Site (the Maywood Site or the Site) in Bergen County, New Jersey, is extensive. Since the US Army Corps of Engineers (the Corps) assumed responsibility for the Maywood Site from the US Department of Energy in 1997, at least 186 separate property access agreements (known in FUSRAP as a Real Estate Right-of- Entry or ROE) have been executed between the Corps and approximately 55 different land owners and tenant occupants at the Maywood Site (agreement renewals with the same owners over time account for the difference). Maywood's experience during the Corps' tenure, reflected here in three case studies of representative property access efforts, offers some lessons and best practices that may apply to other remedial programs. While the Site Community Relations Manager (the author of this paper) managed the property access task, multi-disciplinary support from across the project was also critical to success in this endeavor. (authors)

  4. Evidence-based care: an innovation to improve nursing practice ...

    African Journals Online (AJOL)

    Evidence-based care: an innovation to improve nursing practice globally. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... best available evidence from research findings, expert ideas from specialists in the various health ... need to be addressed to enhance utilization of the best available evidence in nursing practice.

  5. Development, implementation and evaluation of an evidence-based program for introduction of new health technologies and clinical practices in a local healthcare setting.

    Science.gov (United States)

    Harris, Claire; Garrubba, Marie; Allen, Kelly; King, Richard; Kelly, Cate; Thiagarajan, Malar; Castleman, Beverley; Ramsey, Wayne; Farjou, Dina

    2015-12-28

    This paper reports the process of establishing a transparent, accountable, evidence-based program for introduction of new technologies and clinical practices (TCPs) in a large Australian healthcare network. Many countries have robust evidence-based processes for assessment of new TCPs at national level. However many decisions are made by local health services where the resources and expertise to undertake health technology assessment (HTA) are limited and a lack of structure, process and transparency has been reported. An evidence-based model for process change was used to establish the program. Evidence from research and local data, experience of health service staff and consumer perspectives were incorporated at each of four steps: identifying the need for change, developing a proposal, implementation and evaluation. Checklists assessing characteristics of success, factors for sustainability and barriers and enablers were applied and implementation strategies were based on these findings. Quantitative and qualitative methods were used for process and outcome evaluation. An action research approach underpinned ongoing refinement to systems, processes and resources. A Best Practice Guide developed from the literature and stakeholder consultation identified seven program components: Governance, Decision-Making, Application Process, Monitoring and Reporting, Resources, Administration, and Evaluation and Quality Improvement. The aims of transparency and accountability were achieved. The processes are explicit, decisions published, outcomes recorded and activities reported. The aim of ascertaining rigorous evidence-based information for decision-making was not achieved in all cases. Applicants proposing new TCPs provided the evidence from research literature and local data however the information was often incorrect or inadequate, overestimating benefits and underestimating costs. Due to these limitations the initial application process was replaced by an Expression of

  6. Do entrepreneurial food systems innovations impact rural economies and health? Evidence and gaps.

    Science.gov (United States)

    Sitaker, Marilyn; Kolodinsky, Jane; Jilcott Pitts, Stephanie B; Seguin, Rebecca A

    A potential solution for weakened rural economies is the development of local food systems, which include affordable foods sources for consumers and economically feasible structures for producers. Local food systems are purported to promote sustainability, improve local economies, increase access to healthy foods, and improve the local diets. Four entrepreneurial food systems innovations that support local economies include farmers' markets, community supported agriculture, farm to institution programs and food hubs. We review current literature to determine whether innovations for aggregation, processing, distribution and marketing in local food systems: 1) enable producers to make a living; 2) improve local economies; 3) provide local residents with greater access to affordable, healthy food; and 4) contribute to greater consumption of healthy food among residents. While there is some evidence for each, more transdisciplinary research is needed to determine whether entrepreneurial food systems innovations provide economic and public health benefits.

  7. No evidence-based restoration without a sound evidence base: a reply to Guldemond et al.

    CSIR Research Space (South Africa)

    Ntshotsho, P

    2012-03-01

    Full Text Available Evidence-based practice is not possible without an evidence base. Guldemond et al. confuse our attempt at assessing the status of the evidence base of restoration programs in South Africa with attempting to assess whether restoration is evidence...

  8. Spanish Clinical Guidelines on Vascular Access for Haemodialysis.

    Science.gov (United States)

    Ibeas, José; Roca-Tey, Ramon; Vallespín, Joaquín; Moreno, Teresa; Moñux, Guillermo; Martí-Monrós, Anna; Del Pozo, José Luis; Gruss, Enrique; Ramírez de Arellano, Manel; Fontseré, Néstor; Arenas, María Dolores; Merino, José Luis; García-Revillo, José; Caro, Pilar; López-Espada, Cristina; Giménez-Gaibar, Antonio; Fernández-Lucas, Milagros; Valdés, Pablo; Fernández-Quesada, Fidel; de la Fuente, Natalia; Hernán, David; Arribas, Patricia; Sánchez de la Nieta, María Dolores; Martínez, María Teresa; Barba, Ángel

    2017-11-01

    Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing [SEDEN]), along with the methodological support of the Cochrane Center, has updated the Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain a similar structure, in that they review the evidence without compromising the educational aspects. However, on one hand, they provide an update to methodology development following the guidelines of the GRADE system in order to translate this systematic review of evidence into recommendations that facilitate decision-making in routine clinical practice, and, on the other hand, the guidelines establish quality indicators which make it possible to monitor the quality of healthcare. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Community and school mental health professionals' knowledge and use of evidence based substance use prevention programs.

    Science.gov (United States)

    Evans, Steven W; Randy Koch, J; Brady, Christine; Meszaros, Peggy; Sadler, Joanna

    2013-07-01

    Youth with learning and behavioral problems are at elevated risk for substance use during adolescence. Although evidence-based substance use prevention and screening practices are described in the literature, the extent with which these are provided to these youth is unclear. Mental health professionals in schools and community mental health centers are in an ideal position to conduct substance use screening and prevention practices since they have frequent contact with this high risk group. In order to determine whether these mental health professionals were using evidence based substance use screening and prevention programs with these youth, we analyzed 345 completed surveys from mental health professionals in schools and community clinics throughout a mid-Atlantic state. Results indicated that a large portion of the respondents were unfamiliar with evidence based practices and they were infrequently used. Implications for the division of labor at schools and community mental health centers are discussed in relation to time allotment and priority for these procedures.

  10. Validity evidence for the Fundamentals of Laparoscopic Surgery (FLS) program as an assessment tool: a systematic review.

    Science.gov (United States)

    Zendejas, Benjamin; Ruparel, Raaj K; Cook, David A

    2016-02-01

    The Fundamentals of Laparoscopic Surgery (FLS) program uses five simulation stations (peg transfer, precision cutting, loop ligation, and suturing with extracorporeal and intracorporeal knot tying) to teach and assess laparoscopic surgery skills. We sought to summarize evidence regarding the validity of scores from the FLS assessment. We systematically searched for studies evaluating the FLS as an assessment tool (last search update February 26, 2013). We classified validity evidence using the currently standard validity framework (content, response process, internal structure, relations with other variables, and consequences). From a pool of 11,628 studies, we identified 23 studies reporting validity evidence for FLS scores. Studies involved residents (n = 19), practicing physicians (n = 17), and medical students (n = 8), in specialties of general (n = 17), gynecologic (n = 4), urologic (n = 1), and veterinary (n = 1) surgery. Evidence was most common in the form of relations with other variables (n = 22, most often expert-novice differences). Only three studies reported internal structure evidence (inter-rater or inter-station reliability), two studies reported content evidence (i.e., derivation of assessment elements), and three studies reported consequences evidence (definition of pass/fail thresholds). Evidence nearly always supported the validity of FLS total scores. However, the loop ligation task lacks discriminatory ability. Validity evidence confirms expected relations with other variables and acceptable inter-rater reliability, but other validity evidence is sparse. Given the high-stakes use of this assessment (required for board eligibility), we suggest that more validity evidence is required, especially to support its content (selection of tasks and scoring rubric) and the consequences (favorable and unfavorable impact) of assessment.

  11. Program of neuropsychological stimulation of cognition in students: Emphasis on executive functions - development and evidence of content validity

    Directory of Open Access Journals (Sweden)

    Caroline de Oliveira Cardoso

    Full Text Available ABSTRACT Objective: The goal of this study was to describe the construction process and content validity evidence of an early and preventive intervention program for stimulating executive functions (EF in Elementary School children within the school environment. Methods: The process has followed the recommended steps for creating neuropsychological instruments: internal phase of program organization, with literature search and analyses of available materials in the classroom; program construction; analysis by expert judges; data integration and program finalization. To determine the level of agreement among the judges, a Content Validity Index (CVI was calculated. Results: Content validity was evidenced by the agreement among the experts with regards to the program, both in general and for each activity. All steps taken were deemed necessary because they contributed to the identification of positive aspects and possible flaws in the process Conclusion: The steps also helped to adapt stimuli and improve program tasks and activities. Methodological procedures implemented in this study can be adopted by other researchers to create or adapt neuropsychological stimulation and rehabilitation programs. Furthermore, the methodological approach allows the reader to understand, in detail, the technical and scientific rigor adopted in devising this program.

  12. LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

    Directory of Open Access Journals (Sweden)

    Melanie Austin-McCain

    2015-04-01

    Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.

  13. Considerations for expanding community exercise programs incorporating a healthcare-recreation partnership for people with balance and mobility limitations: a mixed methods evaluation.

    Science.gov (United States)

    Salbach, Nancy M; Howe, Jo-Anne; Baldry, Diem; Merali, Saira; Munce, Sarah E P

    2018-04-02

    To increase access to safe and appropriate exercise for people with balance and mobility limitations, community organizations have partnered with healthcare providers to deliver an evidence-based, task-oriented group exercise program in community centers in Canada. We aimed to understand challenges and solutions to implementing this program model to inform plans for expansion. At a 1-day meeting, 53 stakeholders (healthcare/recreation personnel, program participants/caregivers, researchers) identified challenges to program implementation that were captured by seven themes: Resources to deliver the exercise class (e.g., difficulty finding instructors with the skills to work with people with mobility limitations); Program marketing (e.g., to foster healthcare referrals); Transportation (e.g., particularly from rural areas); Program access (e.g., program full); Maintaining program integrity; Sustaining partnerships (i.e., with healthcare partners); and Funding (e.g., to deliver program or register). Stakeholders prioritized solutions to form an action plan. A survey of individuals supervising 28 programs revealed that people with stroke, acquired brain injury, multiple sclerosis, and Parkinson's disease register at 95-100% of centers. The most prevalent issues with program fidelity across centers were not requiring a minimum level of walking ability (32%), class sizes exceeding 12 (21%), and instructor-to-participant ratios exceeding 1:4 (19%). Findings provide considerations for program expansion.

  14. Chromosome numbers and meiotic behavior of some Paspalum accessions

    Directory of Open Access Journals (Sweden)

    Eleniza de Victor Adamowski

    2005-12-01

    Full Text Available Chromosome number and meiotic behavior were evaluated in 36 Brazilian accessions of the grass Paspalum (which had never previously been analyzed to determinate which accessions might be useful in interspecific hybridizations. The analysis showed that one accession of Paspalum coryphaeum was diploid (2n = 2x = 20 and one accession of Paspalum conspersum hexaploid (2n = 6x = 60, the remaining 34 accessions being tetraploid (2n = 4x = 40. The pairing configuration was typical for the ploidy level i.e. in the diploid, chromosomes paired as 10 bivalents, in tetraploids as bi-, tri- and quadrivalents, and in hexaploid as 30 bivalents. A low frequency of meiotic abnormalities (less than 10% was observed in the diploid, hexaploid and some tetraploid accessions, although the majority of tetraploid accessions showed a high frequency of meiotic irregularities. The use of accessions with a low frequency of meiotic abnormalities in breeding programs is discussed.

  15. BIODIVERSITY OF NATIONAL SQUASH CULTIVAR ACCESSIONS

    Directory of Open Access Journals (Sweden)

    A. F. Bukharov

    2017-01-01

    Full Text Available The squash is one of  the most  ancient plants, bearing numerous qualities. The squash gave high yield and is unpretentious plant, the fruit of which is long-stored and can be used as boiled, stewed, baked, fried product, and be added to bread, mush and pudding, and be prepared as puree, jam, candied fruit and other meals. Owing to useful characteristics the squash is a valuable source or raw  material for  food  canning  industry,  for  health-care and functional foodstuff production. Its best cultivar accessions contain to 30% of dry matter, to 12% of sugars  and  to  36%  of  carotene.  The  species  of  squash includes 4 subspecies and 20 varieties. One accession that came from Spain in 1937 served as an initial breeding accession for many other table cultivars for long time. For 80 years of national breeding program the many cultivars for  table  use have been released. There are the classic cultivars, such as ‘Mramornaya’, ‘Stolovaya Zimnaya’,  Gribovskaya Zimnaya’,  ‘Donskaya  Sladkaya’, ‘Michurinskaya’ that are selected or developed from first Spanish accession. This richness and originality of cultivar squash accessions should be carefully preserved. There are the new generation cultivars, such as ‘Kroshka’, ‘Malishka’,    ‘Rossiyanka’,    ‘Konfetka’,    ‘Moskvichka’, ‘Vnuchka’ and many others, which are short-tendrils and suitable for  modern  mechanized cultivation  technology. Moreover the development of new cultivars, bearing resistance to biotic and abiotic stress is the main goal of nearest breeding program.

  16. Obstacles to implementing evidence-based practice in Belgium: a context-specific qualitative evidence synthesis including findings from different health care disciplines.

    Science.gov (United States)

    Hannes, K; Goedhuys, J; Aertgeerts, B

    2012-01-01

    A number of barriers to the implementation of evidence-based practice have already been inventoried. However, little attention has been given to their context-specific nature. This qualitative evidence synthesis examines commonalities in the obstacles perceived by different groups of health care practitioners working in the Belgian health care system and sets out to discuss potential strategies to bridge some of these barriers. We actively searched for primary studies addressing our topic of interest in international and national databases (1990 to May 2008), consulted experts and screened references of retrieved studies. We opted for the meta-aggregative approach, developed by the Joanna Briggs Institute, to analyse our findings. The findings indicate that (1) evidence might have a limited role in decision-making processes; (2) aspects other than quality of care steer the evidence-based practice agenda; (3) some health care providers benefit less from evidence-based practice than others and (4) there is a lack of competences to put the evidence-based principles in practice. Belgian policy makers might consider health care system characteristics from and strategies developed or suggested by others to respond to country-specific obstacles. Examples include but are not limited to; (a) providing incentives for patient-centred care coordination and patient communication, (b) supporting practitioners interested in applying research-related activities, (c) considering direct access systems and interprofessional learning to respond to the demand for autonomous decision-making from satellite professional groups, (d) systematically involving allied health professionals in important governmental advisory boards, (e) considering pharmaceutical companies perceived as 'the enemy' an ally in filling in research gaps, (f) embedding the evaluation of evidence-based knowledge and skills in examinations (g) moving from (in)formative learning to transformative learning and (h

  17. Accessing Safe Deliveries in Tanzania (IMCHA) | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Few healthcare workers are trained to offer emergency obstetrical care, so timely ... With better access to skilled care and emergency services, the project aims to ... training program as it relates to health service delivery and health outcomes.

  18. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments - United States, 2015-2017.

    Science.gov (United States)

    DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Yembra, Debbie; Armour, Brian S

    2018-04-06

    Cigarette smoking prevalence among Medicaid enrollees (25.3%) is approximately twice that of privately insured Americans (11.8%), placing Medicaid enrollees at increased risk for smoking-related disease and death (1). Medicaid spends approximately $39 billion annually on treating smoking-related diseases (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications* are effective in helping tobacco users quit (3). Although state Medicaid coverage of tobacco cessation treatments improved during 2014-2015, coverage was still limited in most states (4). To monitor recent changes in state Medicaid cessation coverage for traditional (i.e., nonexpansion) Medicaid enrollees, the American Lung Association collected data on coverage of a total of nine cessation treatments: individual counseling, group counseling, and seven FDA-approved cessation medications † in state Medicaid programs during July 1, 2015-June 30, 2017. The American Lung Association also collected data on seven barriers to accessing covered treatments, such as copayments and prior authorization. As of June 30, 2017, 10 states covered all nine of these treatments for all enrollees, up from nine states as of June 30, 2015; of these 10 states, Missouri was the only state to have removed all seven barriers to accessing these cessation treatments. State Medicaid programs that cover all evidence-based cessation treatments, remove barriers to accessing these treatments, and promote covered treatments to Medicaid enrollees and health care providers would be expected to reduce smoking, smoking-related disease, and smoking-attributable federal and state health care expenditures (5-7).

  19. Open Access in Higher Education–Strategies for Engaging Diverse Student Cohorts

    Directory of Open Access Journals (Sweden)

    Luisa Signor

    2014-07-01

    Full Text Available With growth in online education, students gain tertiary qualifications through a mode more suited to their demographics such as work and life balance, learning styles and geographical accessibility. Inevitably this has led to a growth in diversity within student cohorts.The case study described in this paper illustrates strategies based on informed learning design for educating diverse student cohorts in an online program offered by Swinburne University of Technology. The case, an open-access, undergraduate information systems program, attracts mature age students studying while balancing employment and family commitments. The program’s open-access facet is the ‘no entry requirements’ such as prerequisite studies. Hence, many students enter the program via non-traditional pathways bringing significant differences in experience and consequent skill bases. The program’s innovative pedagogy encourages students to engage via active learning with tailored assessments, interactive communication via discussion boards and facilitated real-time sessions and formative feedback which include audio components.

  20. OpenCourseWare, Global Access and the Right to Education: Real access or marketing ploy?

    Directory of Open Access Journals (Sweden)

    Henk Huijser

    2008-02-01

    Full Text Available This paper explores the potential opportunities that OpenCourseWare (OCW offers in providing wider access to tertiary education, based on the ideal of ‘the right to education’. It first discusses the wider implications of OCW, and its underlying philosophy, before using a case study of a tertiary preparation program (TPP at the University of Southern Queensland (USQ to draw out the issues involved in offering a program that is created in a particular national and social context on a global scale. This paper draws specific attention to the digital divide, its effects in national and global contexts, and the particular obstacles this presents with regards to OCW. This paper argues that OCW provides many opportunities, both in terms of access to education and in terms of student recruitment and marketing for universities. To take full advantage of those opportunities, however, requires a concerted effort on the part of tertiary education institutions, and it requires a vision that is fundamentally informed by, and committed to, the principle of ‘the right to education’.

  1. Optimizing suicide prevention programs and their implementation in Europe (OSPI Europe): an evidence-based multi-level approach.

    LENUS (Irish Health Repository)

    Hegerl, Ulrich

    2009-01-01

    BACKGROUND: Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. METHOD: The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. DISCUSSION: This multi-centre research seeks to overcome major

  2. Optimizing suicide prevention programs and their implementation in Europe (OSPI-Europe): An evidence-based multi-level approach

    LENUS (Irish Health Repository)

    Hegerl, Ulrich

    2009-11-23

    Abstract Background Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. Method The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. Discussion This multi-centre research seeks to overcome major

  3. Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

    Science.gov (United States)

    Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

    2015-11-01

    Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence.

    Science.gov (United States)

    Gunnell, David; Knipe, Duleeka; Chang, Shu-Sen; Pearson, Melissa; Konradsen, Flemming; Lee, Won Jin; Eddleston, Michael

    2017-10-01

    Pesticide self-poisoning accounts for 14-20% of suicides worldwide. Regulation aimed at restricting access to pesticides or banning highly hazardous pesticides is one approach to reducing these deaths. We systematically reviewed the evidence of the effectiveness of pesticide regulation in reducing the incidence of pesticide suicides and overall suicides. We did a systematic review of the international evidence. We searched MEDLINE, PsycINFO, and Embase for studies published between Jan 1, 1960, and Dec 31, 2016, which investigated the effect of national or regional bans, and sales or import restrictions, on the availability of one or more pesticides and the incidence of suicide in different countries. We excluded other interventions aimed at limiting community access to pesticides. We extracted data from studies presenting pesticide suicide data and overall suicide data from before and after national sales restrictions. Two reviewers independently assessed papers for inclusion, extracted data, and assessed risk of bias. We undertook a narrative synthesis of the data in each report, and where data were available for the years before and after a ban, we pooled data for the 3 years before and the 3 years after to obtain a crude estimate of the effect of the ban. This study is registered through PROSPERO, number CRD42017053329. We identified 27 studies undertaken in 16 countries-five low-income or middle-income countries (Bangladesh, Colombia, India, Jordan and Sri Lanka), and 11 high-income countries (Denmark, Finland, Germany, Greece, Hungary, Ireland, Japan, South Korea, Taiwan, UK, and USA). Assessments largely focused on national bans of specific pesticides (12 studies of bans in six countries-Jordan, Sri Lanka, Bangladesh, Greece [Crete], South Korea, and Taiwan) or sales restrictions (eight studies of restrictions in five countries- India, Denmark, Ireland, the UK and the USA). Only five studies used optimum analytical methods. National bans on commonly ingested

  5. AVLIS industrial access program

    International Nuclear Information System (INIS)

    1984-01-01

    This document deals with the procurements planned for the construction of an Atomic Vapor Laser Isotope Separation (AVLIS) production plant. Several large-scale AVLIS facilities have already been built and tested; a full-scale engineering demonstration facility is currently under construction. The experience gained from these projects provides the procurement basis for the production plant construction and operation. In this document, the status of the AVLIS process procurement is presented from two viewpoints. The AVLIS Production Plant Work Breakdown Structure is referenced at the level of the items to be procured. The availability of suppliers for the items at this level is discussed. In addition, the work that will result from the AVLIS enrichment plant project is broken down by general procurement categories (construction, mechanical equipment, etc.) and the current AVLIS suppliers are listed according to these categories. A large number of companies in all categories are currently providing AVLIS equipment for the Full-Scale Demonstration Facility in Livermore, California. These companies form an existing and expanding supplier network for the AVLIS program. Finally, this document examines the relationship between the AVLIS construction project/operational facility and established commercial suppliers. The goal is to utilize existing industrial capability to meet the needs of the project in a competitive procurement situation. As a result, costs and procurement risks are both reduced because the products provided come from within the AVLIS suppliers' experience base. At the same time, suppliers can benefit by the potential to participate in AVLIS technology spin-off markets. 35 figures

  6. AVLIS industrial access program

    Energy Technology Data Exchange (ETDEWEB)

    1984-11-15

    This document deals with the procurements planned for the construction of an Atomic Vapor Laser Isotope Separation (AVLIS) production plant. Several large-scale AVLIS facilities have already been built and tested; a full-scale engineering demonstration facility is currently under construction. The experience gained from these projects provides the procurement basis for the production plant construction and operation. In this document, the status of the AVLIS process procurement is presented from two viewpoints. The AVLIS Production Plant Work Breakdown Structure is referenced at the level of the items to be procured. The availability of suppliers for the items at this level is discussed. In addition, the work that will result from the AVLIS enrichment plant project is broken down by general procurement categories (construction, mechanical equipment, etc.) and the current AVLIS suppliers are listed according to these categories. A large number of companies in all categories are currently providing AVLIS equipment for the Full-Scale Demonstration Facility in Livermore, California. These companies form an existing and expanding supplier network for the AVLIS program. Finally, this document examines the relationship between the AVLIS construction project/operational facility and established commercial suppliers. The goal is to utilize existing industrial capability to meet the needs of the project in a competitive procurement situation. As a result, costs and procurement risks are both reduced because the products provided come from within the AVLIS suppliers' experience base. At the same time, suppliers can benefit by the potential to participate in AVLIS technology spin-off markets. 35 figures.

  7. Access to essential medicines in Pakistan: policy and health systems research concerns.

    Directory of Open Access Journals (Sweden)

    Shehla Zaidi

    Full Text Available INTRODUCTION: Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i gaps related to access to essential medicine in Pakistan; and ii prioritization of emerging policy and research concerns. METHODS: An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. FINDINGS: A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. CONCLUSION: Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda.

  8. Vascular access surveillance: case study of a false paradigm.

    Science.gov (United States)

    Paulson, William D; Moist, Louise; Lok, Charmaine E

    2013-01-01

    The hemodialysis vascular access surveillance controversy provides a case study of how enthusiasm for a new test or treatment can lead to adoption of a false paradigm. Paradigms are the beliefs and assumptions shared by those in a field of knowledge, and are commonly included in clinical practice guidelines. The guidelines of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative recommend that arteriovenous vascular accesses undergo routine surveillance for detection and correction of stenosis. This recommendation is based on the paradigm that surveillance of access blood flow or dialysis venous pressure combined with correction of stenosis improves access outcomes. However, the quality of evidence that supports this paradigm has been widely criticized. We tested the validity of the surveillance paradigm by applying World Health Organization (WHO) criteria for evaluating screening tests to a literature review of published vascular access studies. These criteria include four components: undesired condition, screening test, intervention, and desired outcome. The WHO criteria show that surveillance as currently practiced fails all four components and provides little or no significant benefit, suggesting that surveillance is a false paradigm. Once a paradigm is established, however, challenges to its validity are usually resisted even as new evidence indicates the paradigm is not valid. Thus, it is paramount to apply rigorous criteria when developing guidelines. Regulators may help promote needed changes in paradigms when cost and safety considerations coincide. © 2013 Wiley Periodicals, Inc.

  9. Excluding Orphan Drugs from the 340B Drug Discount Program: the Impact on 18 Critical Access Hospitals

    Directory of Open Access Journals (Sweden)

    Madeline Carpinelli Wallack

    2012-01-01

    Full Text Available Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs for all drugs except those designated as “orphan.” Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs. Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals’ current cost. Results: The 18 CAHs’ purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings. Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.

  10. 76 FR 66089 - Access Authorization Program for Nuclear Power Plants

    Science.gov (United States)

    2011-10-25

    ..., the public can gain entry into ADAMS, which provides text and image files of the NRC's public... ML112060028. The regulatory analysis may be found in ADAMS under Accession Number ML112060032. Regulatory...; e-mail: [email protected] . SUPPLEMENTARY INFORMATION: I. Introduction The NRC is issuing a...

  11. Channel access: A software bus for the LAACS

    International Nuclear Information System (INIS)

    Hill, J.O.

    1990-01-01

    The host processor for a code running within a distributed process control system is often predetermined by constraints built into the software architecture of the control system. Input/output (I/O) channels directly connected to the host processors are usually easier to access in software than channels on remote processors. It is often difficult to modernize selective parts of a control system's software while leaving the other parts unchanged. Likewise, software developed at one laboratory is often difficult to integrate into a control system developed at another laboratory. Software that runs in one machine or operating-system architecture is often unable to communicate with control-system software running on a different platform. For the Los Alamos Accelerator Control System (LAACS) we have attempted to address the above difficulties with a software communication facility which we call Channel Access. Channel Access provides a 'software bus' that allows programs to be connected through a network to I/O channels on real-time processors in a manner similar to the way in which hardware modules are integrated within a standardized hardware bus such as CAMAC or VME. We have already placed an operator interface on Channel Access and we are currently designing alarm, archiving and sequencing tools as well. Numerous application-specific programs use Channel Access. This paper describes the unique feature of this approach and its performance as an integral part of the Los Alamos Accelerator Control System. (orig.)

  12. Translating Evidence Based Violence and Drug Use Prevention to Obesity Prevention: Development and Construction of the Pathways Program

    Science.gov (United States)

    Sakuma, Kari-Lyn K.; Riggs, Nathaniel R.; Pentz, Mary Ann

    2012-01-01

    Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health,…

  13. Evaluation of the AccessIT Project and the Distance LearningProgramme on Digitization

    Directory of Open Access Journals (Sweden)

    Bülent Yılmaz

    2013-11-01

    Full Text Available AccessIT is an EU-funded project under EU’s Education and Culture Program aiming to digitize a certain amount of sources that are part of the cultural heritage, to transfer them to Europeana, and to sustain the education infrastructure to achieve this goal in the partner countries of Greece, Poland, Serbia, Turkey and UK. In this study, in addition to the general evaluation of the AccessIT Project, it is aimed to investigate the awareness of participants in thefield on digitization and digital content management, their self-efficiency perceptions, and to evaluate the education program based on the data acquired from the survey of544participants who were enrolled in the distance education program offered within the scope of the project.It was found out in the study that the AccessIT Project has had an important function in Turkey and the distance education program significantly contributed to participants ’ self-efficiency perceptions about digitization.

  14. Evidence-based clinical practice, [corrected] evidence-based medicine and the Cochrane collaboration.

    Science.gov (United States)

    Gambrill, E

    1999-03-01

    Encouraging professionals in training and later to consider practice-related research findings when making important clinical decisions is an on-going concern. Evidenced-Based Medicine (EBM) and the Cochrane Collaboration (CC) provide a source of tools and ideas for doing so, as well as a roster of colleagues who share this interest. Evidenced-based medicine involves integrating clinical expertise with the best available external evidence from systematic research as well as considering the values and expectations of patients/clients. Advantage can be taken of educational formats developed in EBM, such as problem-based learning and critical-appraisal workshops in which participants learn how to ask key answerable questions related to important clinical practice questions (e.g., regarding effectiveness, accuracy of assessment measures, prediction, prevention, and quality of clinical practice guidelines) and to access and critically appraise related research. The Cochrane Collaboration is a world-wide network of centers that prepare, maintain, and disseminate high-quality systematic reviews on the efficacy of healthcare. These databases allow access to evidence related to clinical practice decisions. Forging reciprocal working relationships with those involved in EBM reciprocal and the CC should contribute to the pursuit of shared goals such as basing clinical decisions on the best-available evidence and involving clients as informed consumers.

  15. Online Access Patterns and Students

    Directory of Open Access Journals (Sweden)

    Nasir Butrous

    2011-04-01

    Full Text Available The paper follows accessing patterns of five cohorts of postgraduate students enrolled in a core unit within a master of business administration (MBA program. The unit is designed to provide numerous opportunities for student participation in Discussion Boards using Blackboard technology. Discussion Boards create numerous opportunities for interaction amongst online learners to share and exchange their experiences, creating a sense of a virtual community. Relationships between accessing patterns for each week of the semester for each student are explored in relation to their performance using course statistics generated by the Blackboard technology. Close examination of the significant differences in access patterns to the course window and its components of communication, content, and student areas reveal middle of the semester (week 7 as the common critical point that differentiates high achieving students from low achieving students. Identifying critical points provides the faculty staff member an opportunity to introduce intervention strategies in order to improve the learning experience of all the students.

  16. Transfer Entails Communication: The Public Understanding of (Social) Science as a Stage and a Play for Implementing Evidence-Based Prevention Knowledge and Programs.

    Science.gov (United States)

    Bromme, Rainer; Beelmann, Andreas

    2018-04-01

    Many social science-based interventions entail the transfer of evidence-based knowledge to the "target population," because the acquisition and the acceptance of that knowledge are necessary for the intended improvement of behavior or development. Furthermore, the application of a certain prevention program is often legitimated by a reference to science-based reasons such as an evaluation according to scientific standards. Hence, any implementation of evidence-based knowledge and programs is embedded in the public understanding of (social) science. Based on recent research on such public understanding of science, we shall discuss transfer as a process of science communication.

  17. [Vascular access guidelines for hemodialysis].

    Science.gov (United States)

    Rodríguez Hernández, J A; González Parra, E; Julián Gutiérrez, J M; Segarra Medrano, A; Almirante, B; Martínez, M T; Arrieta, J; Fernández Rivera, C; Galera, A; Gallego Beuter, J; Górriz, J L; Herrero, J A; López Menchero, R; Ochando, A; Pérez Bañasco, V; Polo, J R; Pueyo, J; Ruiz, Camps I; Segura Iglesias, R

    2005-01-01

    Quality of vascular access (VA) has a remarkable influence in hemodialysis patients outcomes. Dysfunction of VA represents a capital cause of morbi-mortality of these patients as well an increase in economical. Spanish Society of Neprhology, aware of the problem, has decided to carry out a revision of the issue with the aim of providing help in comprehensión and treatment related with VA problems, and achieving an homogenization of practices in three mayor aspects: to increase arteriovenous fistula utilization as first vascular access, to increment vascular access monitoring practice and rationalise central catheters use. We present a consensus document elaborated by a multidisciplinar group composed by nephrologists, vascular surgeons, interventional radiologysts, infectious diseases specialists and nephrological nurses. Along six chapters that cover patient education, creation of VA, care, monitoring, complications and central catheters, we present the state of the art and propose guidelines for the best practice, according different evidence based degrees, with the intention to provide help at the professionals in order to make aproppiate decissions. Several quality standars are also included.

  18. Benin - Access to Land - Rural

    Data.gov (United States)

    Millennium Challenge Corporation — This evaluation presents evidence from the first large-scale randomized controlled trial of a land formalization program. This study examines the links between land...

  19. Health insurers promoting employee wellness: strategies, program components and results.

    Science.gov (United States)

    Murphy, Brigid M; Schoenman, Julie A; Pirani, Hafiza

    2010-01-01

    To examine health insurance companies' role in employee wellness. Case studies of eight insurers. Wellness activities in work, clinical, online, and telephonic settings. Senior executives and wellness program leaders from Blue Cross Blue Shield health insurers and from one wellness organization. Telephone interviews with 20 informants. Health insurers were engaged in wellness as part of their mission to promote health and reduce health care costs. Program components included the following: education, health risk assessments, incentives, coaching, environmental consultation, targeted programming, onsite biometric screening, professional support, and full-time wellness staff. Programs relied almost exclusively on positive incentives to encourage participation. Results included participation rates as high as 90%, return on investment ranging from $1.09 to $1.65, and improved health outcomes. Health insurers have expertise in developing, implementing, and marketing health programs and have wide access to employers and their employees' health data. These capabilities make health insurers particularly well equipped to expand the reach of wellness programming to improve the health of many Americans. By coupling members' medical data with wellness-program data, health insurers can better understand an individual's health status to develop and deliver targeted interventions. Through program evaluation, health insurers can also contribute to the limited but growing evidence base on employee wellness programs.

  20. Developing an integrated evidence-based medicine curriculum for family medicine residency at the University of Alberta.

    Science.gov (United States)

    Allan, G Michael; Korownyk, Christina; Tan, Amy; Hindle, Hugh; Kung, Lina; Manca, Donna

    2008-06-01

    There is general consensus in the academic community that evidence-based medicine (EBM) teaching is essential. Unfortunately, many postgraduate programs have significant weakness in their EBM programs. The Family Medicine Residency committee at the University of Alberta felt their EBM curriculum would benefit from critical review and revision. An EBM Curriculum Committee was created to evaluate previous components and develop new strategies as needed. Input from stakeholders including faculty and residents was sought, and evidence regarding the teaching and practical application of EBM was gathered. The committee drafted goals and objectives, the primary of which were to assist residents to (1) become competent self-directed, lifelong learners with skills to effectively and efficiently keep up to date, and 2) develop EBM skills to solve problems encountered in daily practice. New curriculum components, each evidence based, were introduced in 2005 and include a family medicine EBM workshop to establish basic EBM knowledge; a Web-based Family Medicine Desktop promoting easier access to evidence-based Internet resources; a brief evidence-based assessment of the research project enhancing integration of EBM into daily practice; and a journal club to support peer learning and growth of rapid appraisal skills. Issues including time use, costs, and change management are discussed. Ongoing evaluation of the curriculum and its components is a principal factor of the design, allowing critical review and adaptation of the curriculum. The first two years of the curriculum have yielded positive feedback from faculty and statistically significant improvement in multiple areas of residents' opinions of the curriculum and comfort with evidence-based practice.

  1. An electronically controlled automatic security access gate

    Directory of Open Access Journals (Sweden)

    Jonathan A. ENOKELA

    2014-11-01

    Full Text Available The security challenges being encountered in many places require electronic means of controlling access to communities, recreational centres, offices, and homes. The electronically controlled automated security access gate being proposed in this work helps to prevent an unwanted access to controlled environments. This is achieved mainly through the use of a Radio Frequency (RF transmitter-receiver pair. In the design a microcontroller is programmed to decode a given sequence of keys that is entered on a keypad and commands a transmitter module to send out this code as signal at a given radio frequency. Upon reception of this RF signal by the receiver module, another microcontroller activates a driver circuitry to operate the gate automatically. The codes for the microcontrollers were written in C language and were debugged and compiled using the KEIL Micro vision 4 integrated development environment. The resultant Hex files were programmed into the memories of the microcontrollers with the aid of a universal programmer. Software simulation was carried out using the Proteus Virtual System Modeling (VSM version 7.7. A scaled-down prototype of the system was built and tested. The electronically controlled automated security access gate can be useful in providing security for homes, organizations, and automobile terminals. The four-character password required to operate the gate gives the system an increased level of security. Due to its standalone nature of operation the system is cheaper to maintain in comparison with a manually operated type.

  2. Multiple access to sterile syringes for injection drug users: vending machines, needle exchange programs and legal pharmacy sales in Marseille, France.

    Science.gov (United States)

    Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y

    2001-03-01

    In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel

  3. Evaluating the Influence of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Allocation Package on Healthy Food Availability, Accessibility, and Affordability in Texas.

    Science.gov (United States)

    Lu, Wenhua; McKyer, E Lisako J; Dowdy, Diane; Evans, Alexandra; Ory, Marcia; Hoelscher, Deanna M; Wang, Suojin; Miao, Jingang

    2016-02-01

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was implemented to improve the health of pregnant women and children of low socioeconomic status. In 2009, the program was revised to provide a wider variety of healthy food choices (eg, fresh fruits, vegetables, and whole-grain items). The purpose of this study was to evaluate (1) the impact of the revised WIC Nutrition Program's food allocation package on the availability, accessibility, and affordability of healthy foods in WIC-authorized grocery stores in Texas; and (2) how the impact of the policy change differed by store types and between rural and urban regions. WIC-approved stores (n=105) across Texas were assessed using a validated instrument (88 items). Pre- (June-September 2009) and post-new WIC package implementation (June-September 2012) audits were conducted. Paired-sample t tests were conducted to compare the differences between pre- and post-implementation audits on shelf width and number of varieties (ie, availability), visibility (ie, accessibility), and inflation-adjusted price (ie, affordability). Across the 105 stores, post-implementation audits showed increased availability in terms of shelf space for most key healthy food options, including fruit (PFood visibility increased for fresh juices (Pfoods such as fruits (Pbread (Pbread (Pfood availability and visibility were observed in stores of different types and in different locations, although smaller or fewer effects were noted in small stores and stores in rural regions. Implementation of the revised WIC food package has generally improved availability and accessibility, but not affordability, of healthy foods in WIC-authorized stores in Texas. Future studies are needed to explore the impact of the revised program on healthy food option purchases and consumption patterns among Texas WIC participants. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  4. Development of an evidence-based training program for laparoscopic hysterectomy on a virtual reality simulator.

    Science.gov (United States)

    Crochet, Patrice; Aggarwal, Rajesh; Knight, Sophie; Berdah, Stéphane; Boubli, Léon; Agostini, Aubert

    2017-06-01

    Substantial evidence in the scientific literature supports the use of simulation for surgical education. However, curricula lack for complex laparoscopic procedures in gynecology. The objective was to evaluate the validity of a program that reproduces key specific components of a laparoscopic hysterectomy (LH) procedure until colpotomy on a virtual reality (VR) simulator and to develop an evidence-based and stepwise training curriculum. This prospective cohort study was conducted in a Marseille teaching hospital. Forty participants were enrolled and were divided into experienced (senior surgeons who had performed more than 100 LH; n = 8), intermediate (surgical trainees who had performed 2-10 LH; n = 8) and inexperienced (n = 24) groups. Baselines were assessed on a validated basic task. Participants were tested for the LH procedure on a high-fidelity VR simulator. Validity evidence was proposed as the ability to differentiate between the three levels of experience. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on experienced surgeons' performances. Outcome measures were simulator-derived metrics and Objective Structured Assessment of Technical Skills (OSATS) scores. Quantitative analysis found significant inter-group differences between experienced intermediate and inexperienced groups for time (1369, 2385 and 3370 s; p < 0.001), number of movements (2033, 3195 and 4056; p = 0.001), path length (3390, 4526 and 5749 cm; p = 0.002), idle time (357, 654 and 747 s; p = 0.001), respect for tissue (24, 40 and 84; p = 0.01) and number of bladder injuries (0.13, 0 and 4.27; p < 0.001). Learning curves plateaued at the 2nd to 6th repetition. Further qualitative analysis found significant inter-group OSATS score differences at first repetition (22, 15 and 8, respectively; p < 0.001) and second repetition (25.5, 19.5 and 14; p < 0.001). The VR program for LH accrued validity evidence and

  5. A comparative review of the isotretinoin pregnancy risk management programs across four continents.

    Science.gov (United States)

    Kovitwanichkanont, Tom; Driscoll, Tim

    2018-03-06

    Isotretinoin has revolutionized the treatment of severe acne vulgaris, a condition which if left untreated may result in significant socio-psychological implications for those affected. Timely access to isotretinoin therapy is important to avoid the risks of potential physical and emotional scarring. However, due to its high risks of teratogenicity, isotretinoin must be used with care in females of childbearing potential. Since isotretinoin's introduction, numerous risk management programs have been implemented across the world in an attempt to prevent isotretinoin use in pregnancy. This paper aims to provide an evidence-based review of the risk management programs for isotretinoin in Australia, Europe, Singapore, New Zealand, and the United States of America. The effectiveness of these programs and the factors leading to isotretinoin exposure in pregnancy are critically analyzed in an effort to inform the future direction with respect to designing the ideal regulatory program. Stringent risk management programs, such as the iPLEDGE in the US and Pregnancy Prevention Program (PPP) in Europe, may not be effective in reducing the risks of fetal exposure to isotretinoin when used alone. There is evidence that such strenuous regulation results in increased fear of teratogenic risks but does not translate into a reduced rate of pregnancies exposed to isotretinoin. A successful program must prioritize education about effective contraception, while minimizing any extraneous requirements, to ensure that women are not inadvertently undertreated for acne. © 2018 The International Society of Dermatology.

  6. An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

    Science.gov (United States)

    Fitch, Dale

    2014-01-01

    This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

  7. Variability among Capsicum baccatum accessions from Goiás, Brazil, assessed by morphological traits and molecular markers.

    Science.gov (United States)

    Martinez, A L A; Araújo, J S P; Ragassi, C F; Buso, G S C; Reifschneider, F J B

    2017-07-06

    Capsicum peppers are native to the Americas, with Brazil being a significant diversity center. Capsicum baccatum accessions at Instituto Federal (IF) Goiano represent a portion of the species genetic resources from central Brazil. We aimed to characterize a C. baccatum working collection comprising 27 accessions and 3 commercial cultivars using morphological traits and molecular markers to describe its genetic and morphological variability and verify the occurrence of duplicates. This set included 1 C. baccatum var. praetermissum and 29 C. baccatum var. pendulum with potential for use in breeding programs. Twenty-two morphological descriptors, 57 inter-simple sequence repeat, and 34 random amplified polymorphic DNA markers were used. Genetic distance was calculated through the Jaccard similarity index and genetic variability through cluster analysis using the unweighted pair group method with arithmetic mean, resulting in dendrograms for both morphological analysis and molecular analysis. Genetic variability was found among C. baccatum var. pendulum accessions, and the distinction between the two C. baccatum varieties was evident in both the morphological and molecular analyses. The 29 C. baccatum var. pendulum genotypes clustered in four groups according to fruit type in the morphological analysis. They formed seven groups in the molecular analysis, without a clear correspondence with morphology. No duplicates were found. The results describe the genetic and morphological variability, provide a detailed characterization of genotypes, and discard the possibility of duplicates within the IF Goiano C. baccatum L. collection. This study will foment the use of this germplasm collection in C. baccatum breeding programs.

  8. No accession-specific effect of rhizosphere soil communities on the growth and competition of Arabidopsis thaliana accessions.

    Directory of Open Access Journals (Sweden)

    Anna G Aguilera

    Full Text Available Soil communities associated with specific plant species affect individual plants' growth and competitive ability. Limited evidence suggests that unique soil communities can also differentially influence growth and competition at the ecotype level. Previous work with Arabidopsis thaliana has shown that accessions produce distinct and reproducible rhizosphere bacterial communities, with significant differences in both species composition and relative abundance. We tested the hypothesis that soil communities uniquely affect the growth and reproduction of the plant accessions with which they are associated. Specifically, we examined the growth of four accessions when exposed to their own soil communities and the communities generated by each of the other three accessions. To do this we planted focal accessions inside a ring of six plants that created a "background" soil community. We grew focal plants in this design in three separate soil treatments: non-sterile soil, sterilized soil, and "preconditioned" soil. We preconditioned soil by growing accessions in non-sterile soil for six weeks before the start of the experiment. The main experiment was harvested after seven weeks of growth and we recorded height, silique number, and dry weight of each focal plant. Plants grown in the preconditioned soil treatment showed less growth relative to the non-sterile and sterile soil treatments. In addition, plants in the sterile soil grew larger than those in non-sterile soil. However, we saw no interaction between soil treatment and background accession. We conclude that the soil communities have a negative net impact on Arabidopsis thaliana growth, and that the unique soil communities associated with each accession do not differentially affect growth and competition of study species.

  9. Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence.

    Science.gov (United States)

    Reilly, Rachel; Evans, Katharine; Gomersall, Judith; Gorham, Gillian; Peters, Micah D J; Warren, Steven; O'Shea, Rebekah; Cass, Alan; Brown, Alex

    2016-04-06

    Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Given

  10. Computer Access and Flowcharting as Variables in Learning Computer Programming.

    Science.gov (United States)

    Ross, Steven M.; McCormick, Deborah

    Manipulation of flowcharting was crossed with in-class computer access to examine flowcharting effects in the traditional lecture/laboratory setting and in a classroom setting where online time was replaced with manual simulation. Seventy-two high school students (24 male and 48 female) enrolled in a computer literacy course served as subjects.…

  11. Achieving Access to the General Curriculum for Students with Mental Retardation.

    Science.gov (United States)

    Wehmeyer, Michael L.; Lattin, Dana; Agran, Martin

    2001-01-01

    This article reviews requirements in the Individuals with Disabilities Education Act for providing access to the general education curriculum, examines the intent of the language, and proposes a decision-making model to enable Individualized Education Program teams to reach curriculum decisions that provide such access for students with mental…

  12. Exaggerating Accessible Differences: When Gender Stereotypes Overestimate Actual Group Differences.

    Science.gov (United States)

    Eyal, Tal; Epley, Nicholas

    2017-09-01

    Stereotypes are often presumed to exaggerate group differences, but empirical evidence is mixed. We suggest exaggeration is moderated by the accessibility of specific stereotype content. In particular, because the most accessible stereotype contents are attributes perceived to differ between groups, those attributes are most likely to exaggerate actual group differences due to regression to the mean. We tested this hypothesis using a highly accessible gender stereotype: that women are more socially sensitive than men. We confirmed that the most accessible stereotype content involves attributes perceived to differ between groups (pretest), and that these stereotypes contain some accuracy but significantly exaggerate actual gender differences (Experiment 1). We observe less exaggeration when judging less accessible stereotype content (Experiment 2), or when judging individual men and women (Experiment 3). Considering the accessibility of specific stereotype content may explain when stereotypes exaggerate actual group differences and when they do not.

  13. Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

    Science.gov (United States)

    Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

    2016-01-01

    Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high

  14. Assessing capacity for sustainability of effective programs and policies in local health departments

    Science.gov (United States)

    Tabak, Rachel G.; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C.

    2015-01-01

    Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High

  15. Improving access to malaria medicine through private-sector subsidies in seven African countries.

    Science.gov (United States)

    Tougher, Sarah; Mann, Andrea G; Ye, Yazoume; Kourgueni, Idrissa A; Thomson, Rebecca; Amuasi, John H; Ren, Ruilin; Willey, Barbara A; Ansong, Daniel; Bruxvoort, Katia; Diap, Graciela; Festo, Charles; Johanes, Boniface; Kalolella, Admirabilis; Mallam, Oumarou; Mberu, Blessing; Ndiaye, Salif; Nguah, Samual Blay; Seydou, Moctar; Taylor, Mark; Wamukoya, Marilyn; Arnold, Fred; Hanson, Kara; Goodman, Catherine

    2014-09-01

    Improving access to quality-assured artemisinin combination therapies (ACTs) is an important component of malaria control in low- and middle-income countries. In 2010 the Global Fund to Fight AIDS, Tuberculosis, and Malaria launched the Affordable Medicines Facility--malaria (AMFm) program in seven African countries. The goal of the program was to decrease malaria morbidity and delay drug resistance by increasing the use of ACTs, primarily through subsidies intended to reduce costs. We collected data on price and retail markups on antimalarial medicines from 19,625 private for-profit retail outlets before and 6-15 months after the program's implementation. We found that in six of the AMFm pilot programs, prices for quality-assured ACTs decreased by US$1.28-$4.34, and absolute retail markups on these therapies decreased by US$0.31-$1.03. Prices and markups on other classes of antimalarials also changed during the evaluation period, but not to the same extent. In all but two of the pilot programs, we found evidence that prices could fall further without suppliers' losing money. Thus, concerns may be warranted that wholesalers and retailers are capturing subsidies instead of passing them on to consumers. These findings demonstrate that supranational subsidies can dramatically reduce retail prices of health commodities and that recommended retail prices communicated to a wide audience may be an effective mechanism for controlling the market power of private-sector antimalarial retailers and wholesalers. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Health Care Access Among Deaf People.

    Science.gov (United States)

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with eve