WorldWideScience

Sample records for address unmet national

  1. Addressing unmet needs in the treatment of COPD

    Directory of Open Access Journals (Sweden)

    Francesco Patalano

    2014-09-01

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

  2. Pediatric medical devices: a look at significant US legislation to address unmet needs.

    Science.gov (United States)

    Samuels-Reid, Joy H; Blake, Erica D

    2014-03-01

    There are many barriers to the availability of medical devices intended for the pediatric population causing healthcare providers to use creative measures to address pediatric unmet device needs. The USA has taken significant legislative measures to spur medical device development and address the unmet needs in all pediatric subpopulations. For example, the Medical Device User Fee and Modernization Act of 2002 amended the Federal Food Drug and Cosmetic Act by adding new provisions intended to promote the development of safe and effective pediatric devices, and to protect the pediatric population during clinical trials. In 2004, the Medical Devices Technical Corrections Act was added to address potential difficulties in bringing pediatric devices to the market. Further, the Pediatric Medical Device Safety and Improvement Act of 2007 and the Food and Drug Administration Amendments Act of 2007 provided the FDA significant new responsibilities and authorities regarding pediatric use.

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

    Science.gov (United States)

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

    2015-12-01

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

  4. Potential for new antiretrovirals to address unmet needs in the management of HIV-1 infection.

    Science.gov (United States)

    Moyle, Graeme; Gatell, Jose; Perno, Carlo-Federico; Ratanasuwan, Winai; Schechter, Mauro; Tsoukas, Christos

    2008-06-01

    Despite the myriad advances in antiretroviral therapy since the original highly active antiretroviral therapy regimens were developed, there remain numerous important and pressing unmet needs that, if addressed, would substantially improve the quality of life and longevity of HIV-infected patients. The most achievable goals of antiretroviral (ARV) therapy in the near future are likely to be continued reduction in HIV-related morbidity and mortality; improved quality of life; and restoration and preservation of immune function: all of which are most effectively achieved through sustained suppression of HIV-1 RNA. The ability to achieve long-term viral load reduction will require new ARVs with few, manageable toxicities, and medications that are convenient to adhere to, with few drug interactions. This is particularly true for the large number of highly treatment-experienced patients in whom HIV has developed resistance to one or more ARVs. Development of therapies that allow convenient dosing schedules, that do not necessitate strict adherence to meal-related timing restrictions, and that remain active in the face of resistance mutations is paramount, and remains a significant unmet need. Of the large number of ARVs currently in development, this article focuses on three agents recently approved that have shown particular promise in addressing some of these unmet needs: the novel non-nucleoside reverse transcriptase inhibitor etravirine; the CCR5 antagonist maraviroc; and the integrase inhibitor raltegravir.

  5. Identifying and Addressing the Unmet Health Care Needs of Drug Court Clients.

    Science.gov (United States)

    Dugosh, Karen L; Festinger, David S; Lipkin, Jessica L

    2016-12-01

    Drug courts address issues such as employment and housing but largely miss the opportunity to address important health care issues. The current study examined the prevalence and correlates of chronic medical conditions among a sample of drug court clients who were participating in a clinical trial of an intervention to reduce HIV risk. A total of 256 clients completed a health survey at entry into the drug court program and 9 months post-entry. The baseline health survey included a comprehensive list of chronic medical conditions, and participants were asked to indicate which, if any, they had ever been diagnosed as having. They were also asked to indicate whether or not they were currently receiving treatment for each chronic condition that they endorsed. The follow-up survey was identical to the baseline survey, with the exception that it contained items reflecting (1) whether or not any member of the drug court team engaged in discussion with the client about each of the chronic conditions reported and (2) whether the client received a referral to medical care for endorsed conditions while in the drug court program. Results indicated that over 50% of clients reported at least one chronic condition and 21% reported more than one condition. Among those with chronic conditions, 71% reported having chronic conditions for which they were not currently receiving treatment. Unfortunately, drug court clients reported that the drug court team did little to address these unmet health needs. Findings from this study suggest that clients could benefit if drug court programs began to widen their focus to include addressing health-related issues.

  6. The current unmet need in type 2 diabetes mellitus: addressing glycemia and cardiovascular disease.

    Science.gov (United States)

    Levy, Philip

    2009-05-01

    The treatment of type 2 diabetes mellitus (T2DM) requires a multifaceted approach of both lifestyle modification (diet, exercise, weight control, smoking cessation) and pharmacological therapy. In addition to agents that improve hyperglycemia, patients often require treatments to address the additional cardiovascular (CV) risk factors of hypertension and dyslipidemia. Although the benefits of early, aggressive glycemic control are clearly established, treatment remains suboptimal. Many patients fail to achieve long-term glycemic control, with rates of patients with T2DM achieving target goals for hypertension and dyslipidemia also unsatisfactory. Several factors contribute to the failure to meet treatment goals. These include poor adherence by patients to lifestyle and pharmacological treatment, lack of understanding by patients of the long-term benefits of treatment, patient concerns about adverse effects leading to poor compliance, and failure of health care providers to initiate or intensify medications appropriately (termed clinical inertia). This article reviews the current state of T2DM treatment and the management of CV risk factors associated with T2DM, and identifies unmet treatment needs.

  7. Addressing Major Unmet Needs in Patients with Systolic Heart Failure: The Role of Ivabradine.

    Science.gov (United States)

    Pereira-Barretto, Antonio Carlos

    2016-04-01

    We reviewed clinical evidence for the use of ivabradine in systolic heart failure (HF), in which it appears to improve symptoms, improve quality of life, prevent hospitalization, and prolong survival, thereby addressing unmet needs in the management of HF. Ivabradine provides symptomatic benefits in HF on top of standard therapies, in terms of functional parameters and exercise capacity, and there is some evidence that this leads to improvements in quality of life in symptomatic HF patients, who may have dyspnea, altered exercise capacity, and fatigue. The SHIFT trial demonstrated that ivabradine has significant beneficial effects on major outcomes in HF. Ivabradine had a significant effect on pump failure death, which was reduced by 26 % (p = 0.014), with no effect on sudden cardiac death. This is an important result since pump failure death is currently the main cause of death in HF, and also because the reductions in mortality obtained with beta-blockers and spironolactone in the last 20 years appear to be mainly due to reduction in sudden death rather than reduction in pump failure death. Ivabradine also has a beneficial effect on hospital admissions (-26 %, p Ivabradine-treated patients are also at significantly lower risk of experiencing a second or third hospitalization for worsening HF. Ivabradine clearly has a key role to play in the management of HF by covering the main therapeutic objectives of symptoms, quality of life, and outcomes.

  8. Statistical considerations associated with a comprehensive regulatory framework to address the unmet need for new antibacterial therapies.

    Science.gov (United States)

    Dane, Aaron; Wetherington, Jeffrey D

    2014-01-01

    At present, there are situations in antibiotic drug development where the low number of enrollable patients with key problem pathogens makes it impossible to conduct fully powered non-inferiority trials in the traditional way. Recent regulatory changes have begun to address this situation. In parallel, statistical issues regarding the application of alternative techniques, balancing the unmet need with the level of certainty in the approval process, and the use of additional sources of data are critical areas to increase development feasibility. Although such approaches increase uncertainty compared with a traditional development program, this will be necessary to allow new agents to be made available. Identification of these risks and explicit discussion around requirements in these areas should help clarify the situation, and hence, the feasibility of developing drugs to treat the most concerning pathogens before the unmet need becomes even more acute than at present.

  9. Addressing the unmet needs of patients with persistent negative symptoms of schizophrenia: emerging pharmacological treatment options

    Directory of Open Access Journals (Sweden)

    Chue P

    2014-05-01

    Full Text Available Pierre Chue,1 Justine K Lalonde21Department of Psychiatry, University of Alberta, Edmonton, AB, Canada; 2Roche SAS, Medical Affairs Department, Boulogne-Billancourt, FranceAbstract: The negative symptoms of schizophrenia represent an impairment of normal emotional responses, thought processes and behaviors, and include blunting or flattening of affect, alogia/aprosody, avolition/apathy, anhedonia, and asociality. Negative symptoms contribute to a reduced quality of life, increased functional disability, increased burden of illness, and poorer long-term outcomes, to a greater degree than positive symptoms. Primary negative symptoms are prominent and persistent in up to 26% of patients with schizophrenia, and they are estimated to occur in up to 58% of outpatients at any given time. Negative symptoms respond less well to medications than positive symptoms, and to date treatment options for negative symptoms have been limited, with no accepted standard treatment. Modest benefits have been reported with a variety of different agents, including second-generation antipsychotics and add-on therapy with antidepressants and other pharmacological classes. Recent clinical research focusing on negative symptoms target novel biological systems, such as glutamatergic neurotransmission. Different approaches include: enhancing N-methyl-D-aspartate receptor function with agents that bind directly to the glycine ligand site or with glycine reuptake inhibitors; influencing the metabotropic glutamate receptor (mGluR2/3 with positive allosteric modulators; and stimulating nicotinic acetylcholine receptors. In conclusion, the lack of clearly efficacious pharmacological treatments for the management of negative symptoms represents a significant unmet need, especially considering the importance of these symptoms on patient outcomes. Hence, further research to identify and characterize novel pharmacological treatments for negative symptoms is greatly needed

  10. Emerging Developments in Pharmacists' Scope of Practice to Address Unmet Health Care Needs.

    Science.gov (United States)

    Burns, Anne L

    2016-09-01

    Pharmacists' comprehensive training is being leveraged in emerging patient care service opportunities that include prescriptive authority under collaborative practice agreements (CPAs) with prescribers or through state-based protocols. CPAs and state-based protocols expand pharmacists' scope of practice to allow the pharmacist to perform designated functions under the terms of the agreement or protocol. For patient-specific CPAs, this often includes initiating, modifying, or discontinuing therapy and ordering laboratory tests. For population-based CPAs and state-based protocols, pharmacists are often authorized to initiate medications to address a public health need. CPAs and state-based protocols are mechanisms to optimally use pharmacists' education and training.

  11. 2015 Address Ranges National Geodatabase

    Data.gov (United States)

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

  12. Moving from theory to practice: A participatory social network mapping approach to address unmet need for family planning in Benin.

    Science.gov (United States)

    Igras, Susan; Diakité, Mariam; Lundgren, Rebecka

    2017-07-01

    In West Africa, social factors influence whether couples with unmet need for family planning act on birth-spacing desires. Tékponon Jikuagou is testing a social network-based intervention to reduce social barriers by diffusing new ideas. Individuals and groups judged socially influential by their communities provide entrée to networks. A participatory social network mapping methodology was designed to identify these diffusion actors. Analysis of monitoring data, in-depth interviews, and evaluation reports assessed the methodology's acceptability to communities and staff and whether it produced valid, reliable data to identify influential individuals and groups who diffuse new ideas through their networks. Results indicated the methodology's acceptability. Communities were actively and equitably engaged. Staff appreciated its ability to yield timely, actionable information. The mapping methodology also provided valid and reliable information by enabling communities to identify highly connected and influential network actors. Consistent with social network theory, this methodology resulted in the selection of informal groups and individuals in both informal and formal positions. In-depth interview data suggest these actors were diffusing new ideas, further confirming their influence/connectivity. The participatory methodology generated insider knowledge of who has social influence, challenging commonly held assumptions. Collecting and displaying information fostered staff and community learning, laying groundwork for social change.

  13. Identifying and addressing unmet clinical needs in Ph-neg classical myeloproliferative neoplasms: a consensus-based SIE, SIES, GITMO position paper.

    Science.gov (United States)

    Barosi, Giovanni; Vannucchi, Alessandro M; De Stefano, Valerio; Pane, Fabrizio; Passamonti, Francesco; Rambaldi, Alessandro; Saglio, Giuseppe; Barbui, Tiziano; Tura, Sante

    2014-02-01

    This article presents the results of group discussion among experts from SIE, SIES and GITMO societies aimed at highlighting unmet challenges in the management of Ph-neg myeloproliferative neoplasms (MPNs). The issues analyzed were: diagnosis of prefibrotic myelofibrosis; diagnosis of Ph-neg MPNs in the setting of splanchnic vein thrombosis (SVT); management of low-risk PV and low-risk ET patients with JAK2V617F mutation; molecular biomarkers in the prognostic evaluation of myelofibrosis (MF); ruxolitinib therapy in low-risk MF; therapy in patients with SVT-associated Ph-neg MPN; indications of splenectomy in MF. For each of these issues, proposals for advancement in clinical research were addressed.

  14. Unmet needs: relevance to medical technology innovation?

    Science.gov (United States)

    McCarthy, Avril D; Sproson, Lise; Wells, Oliver; Tindale, Wendy

    2014-01-01

    This paper describes and discusses the role of unmet needs in the innovation of new medical technologies using the National Institute for Health Research Devices for Dignity (D4D) Healthcare Technology Co-operative as a case study. It defines an unmet need, providing a spectrum of classification and discusses the benefits and the challenges of identifying unmet need and its influence on the innovation process. The process by which D4D has captured and utilized unmet needs to drive technology innovation is discussed and examples given. It concludes by arguing that, despite the challenges, defining and reviewing unmet need is a fundamental factor in the success of medical technology innovation.

  15. The unmet need for a national surgical quality improvement curriculum: a systematic review.

    Science.gov (United States)

    Medbery, Rachel L; Sellers, Morgan M; Ko, Clifford Y; Kelz, Rachel R

    2014-01-01

    The Accreditation Council for Graduate Medical Education Next Accreditation System will require general surgery training programs to demonstrate outstanding clinical outcomes and education in quality improvement (QI). The American College of Surgeons-National Surgical Quality Improvement Project Quality In-Training Initiative reports the results of a systematic review of the literature investigating the availability of a QI curriculum. Using defined search terms, a systematic review was conducted in Embase, PubMed, and Google Scholar (January 2000-March 2013) to identify a surgical QI curriculum. Bibliographies from selected articles and other relevant materials were also hand searched. Curriculum was defined as an organized program of learning complete with content, instruction, and assessment for use in general surgical residency programs. Two independent observers graded surgical articles on quality of curriculum presented. Overall, 50 of 1155 references had information regarding QI in graduate medical education. Most (n = 24, 48%) described QI education efforts in nonsurgical fields. A total of 31 curricular blueprints were identified; 6 (19.4%) were specific to surgery. Targeted learners were most often post graduate year-2 residents (29.0%); only 6 curricula (19.4%) outlined a course for all residents within their respective programs. Plan, Do, Study, Act (n = 10, 32.3%), and Root Cause Analysis (n = 5, 16.1%) were the most common QI content presented, the majority of instruction was via lecture/didactics (n = 26, 83.9%), and only 7 (22.6%) curricula used validated tool kits for assessment. Elements of QI curriculum for surgical education exist; however, comprehensive content is lacking. The American College of Surgeons-National Surgical Quality Improvement Project Quality In-Training Initiative will build on the high-quality components identified in our review and develop data-centered QI content to generate a comprehensive national QI curriculum for use in

  16. 77 FR 11116 - Draft National Plan To Address Alzheimer's Disease

    Science.gov (United States)

    2012-02-24

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

  17. Unmet need for contraception among married women in an urban area of Puducherry, India

    Directory of Open Access Journals (Sweden)

    Bahiya Sulthana

    2015-01-01

    Full Text Available Background & objectives: Unmet need for contraception remains a national problem. The study was conducted in an urban area of Puducherry, India, among the eligible couples to assess the unmet need for contraception and to determine the awareness and pattern of use of contraceptives along with the socio-demographic factors associated with the unmet needs for contraception. Methods: This cross-sectional study included eligible couples with married women in age group of 15-45 yr as the study population (n=267. Probability proportional to size sampling followed by systematic random sampling was used. A pre-tested questionnaire was administered to collect data from the respondents. Double data entry and validation of data was done. Results: Unmet need for contraception was 27.3 per cent (95% CI: 22.3-33; unmet need for spacing and limiting was 4.9 and 22.5 per cent, respectively. Among those with unmet need (n=73, 50 per cent reported client related factors (lack of knowledge, shyness, etc.; and 37 per cent reported contraception related factors (availability, accessibility, affordability, side effects as a cause for unmet need. Interpretation & conclusions: Our study showed a high unmet need for contraception in the study area indicating towards a necessity to address user perspective to meet the contraception needs.

  18. Unmet Needs of Patients with Systemic Lupus Erythematosus

    Science.gov (United States)

    Danoff-Burg, Sharon; Friedberg, Fred

    2009-01-01

    The authors' goal was to assess unmet needs of patients with systemic lupus erythematosus (SLE). Participants (N = 112), who were recruited through the mailing list and support group meetings of a Lupus Alliance of America Affiliate, completed a survey based on prior research. All participants perceived at least 1 unmet need. The most frequently reported unmet needs were in the physical symptoms domain. Older patients were more likely than younger patients to have higher levels of unmet needs related to physical and psychological functioning. African American patients were more likely than white patients to have higher levels of unmet needs related to health services and information. Our findings document the high prevalence and variety of unmet needs among these patients, as well as variations among demographic groups. To address unmet needs of SLE patients, targeted referrals to patient educators, mental health professionals, and support organizations are important adjuncts to medical treatment. PMID:19297299

  19. The draft "National Plan" to address Alzheimer's disease - National Alzheimer's Project Act (NAPA).

    Science.gov (United States)

    Khachaturian, Zaven S; Khachaturian, Ara S; Thies, William

    2012-05-01

    This perspective updates the status of the "National Plan to Address Alzheimer's Disease" and the recommendations of the NAPA Advisory Council's Sub-committee on Research. Here, we identify some of the critical issues the future reiterations of the National Plan should consider during implementation phase of the plan. The Journal invites the scientific community to contribute additional ideas and suggestions towards a national research initiative.

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

    Directory of Open Access Journals (Sweden)

    Elisa Bordin

    2014-11-01

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

  1. Prevalence and profiles of unmet healthcare need in Thailand

    Directory of Open Access Journals (Sweden)

    Thammatacharee Noppakun

    2012-10-01

    Full Text Available Abstract Background In the light of the universal healthcare coverage that was achieved in Thailand in 2002, policy makers have raised concerns about whether there is still unmet need within the population. Our objectives were to assess the annual prevalence, characteristics and reasons for unmet healthcare need in the Thai population in 2010 and to compare our findings with relevant international literature. Methods A standard set of OECD unmet need questionnaires was used in a nationally-representative household survey conducted in 2010 by the National Statistical Office. The prevalence of unmet need among respondents with various socio-economic characteristics was estimated to determine an inequity in the unmet need and the reasons behind it. Results The annual prevalence of unmet need for outpatient and inpatient services in 2010 was 1.4% and 0.4%, respectively. Despite this low prevalence, there are inequities with relatively higher proportion of the unmet need among Universal Coverage Scheme members, and the poor and rural populations. There was less unmet need due to cost than there was due to geographical barriers. The prevalence of unmet need due to cost and geographical barriers among the richest and poorest quintiles were comparable to those of selected OECD countries. The geographical extension of healthcare infrastructure and of the distribution of health workers is a major contributing factor to the low prevalence of unmet need. Conclusions The low prevalence of unmet need for both outpatient and inpatient services is a result of the availability of well-functioning health services at the most peripheral level, and of the comprehensive benefit package offered free of charge by all health insurance schemes. This assessment prompts a need for regular monitoring of unmet need in nationally-representative household surveys.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-04-01

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

  3. Addressing Language Barriers: Building Response Capacity for a Changing Nation

    OpenAIRE

    Partida, Yolanda

    2007-01-01

    The absence of universally available language services is a national healthcare system failure, the burden of which is suffered by patients with limited English proficiency and their healthcare providers. Conceptualizing mandatory provision of language access as an unfair, unfunded mandate ignores massive and fundamental social changes taking place. Overcoming language barriers is essential to safe, quality health care. This paper, informed by the experience of Hablamos Juntos, a national dem...

  4. How Teacher Educators Can Address Our Nation's Financial Crisis

    Science.gov (United States)

    Dowdell, John; McElfresh, Dwight; Sikula, John

    2009-01-01

    This article from Ashland University reports on what one university, well known for its Teacher Education programs, is doing in an economically depressed state to address our country's financial crisis. Ohio has mandated that financial literacy be taught in high schools by 2010. Reported herein is what is being done to prepare teachers for this…

  5. Addressing Language Barriers: Building Response Capacity for a Changing Nation

    Science.gov (United States)

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Charl C. Wolhuter

    2012-11-01

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

  7. A State Policy Model to Address the Nation's Dropout Crisis

    Science.gov (United States)

    Chau, Yen

    2009-01-01

    By now people are all too familiar with the disheartening numbers: approximately 7,000 students drop out each day, which means nearly one-third of high school students will not graduate with their peers. The statistics are even more staggering for minority and low-income students, especially in the nation's largest urban districts, where less than…

  8. Enhancing consultating services to address national demands of strategic importance

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ As China's top advisory body in science and technology (S&T), over the past four years, CAS has completed nearly 60 consultative reports by pooling the collective wisdom of prestigious scientists across China. Focusing on issues related to the national drive for a comprehensive, balanced and sustainable social- economic development and major S&T strategies, these reports offered scientific insights for decision-making of the central authorities and attracted their close attention.

  9. Addressing a nation's challenge: graduate programs in gerontology in Israel.

    Science.gov (United States)

    Carmel, Sara; Lowenstein, Ariela

    2007-01-01

    Like other developed nations, Israel has rapidly aged. This demographic revolution has created new challenges for Israeli society. We describe the societal background, including the emerging societal needs, solutions, and problems, as well as the professional principles, which guided us in developing the first two Israeli academic programs in gerontology in Beer-Sheva and Haifa. We further discuss the structures of both programs and their accomplishments. Although both programs were guided by identical needs and principles, geared toward the same multidisciplinary target population, and are dynamic and responsive to the emerging needs and difficulties, they differ in structure. While Haifa's program is flexible, Beer-Sheva's program is structured and divided into three distinct programs, of which only one-the research track-is designed and tailored to the students' interest. The two programs have contributed to increasing interest and research in aging in Israel, enhancing professional cooperation within the universities and with the international scientific community, opening the labor market for the programs' graduates, creating fruitful collaborations with community services, and accelerating the improvement of elderly quality of care.

  10. A Comprehensive Analysis of the Current Status and Unmet Needs in Kidney Transplantation in Southeast Asia

    Directory of Open Access Journals (Sweden)

    Chitranon Chan-on

    2017-06-01

    Full Text Available To address the unmet needs in the face of a growing demand for end-stage renal failure management and kidney transplantation in Asia, we have conducted a critical analysis of published literature and national registries to evaluate clinical outcomes and the rates of organ donation in Southeast Asia and the challenges facing these regions with regards to regulation, choice of donor source, and funding. Based on the available data, suggestions are proposed for an advancement of rates of organ donation and access, with emphasis on improved regulation and public education.

  11. Unmet Health Care Needs of People with Disabilities: Population Level Evidence

    Science.gov (United States)

    McColl, Mary Ann; Jarzynowska, Anna; Shortt, S. E. D.

    2010-01-01

    The present study examined population level data on unmet needs for adults with physical, sensory and cognitive disabilities, using the National Population Health Survey. The study revealed that disabled adults (aged 20-64) reported more than three times as many unmet health care needs as their non-disabled counterparts. Even after controlling for…

  12. 78 FR 13776 - National Organic Program: Notice of Policies Addressing Kelp, Seeds and Planting Stock, Livestock...

    Science.gov (United States)

    2013-03-01

    ... Agricultural Marketing Service 7 CFR Part 205 National Organic Program: Notice of Policies Addressing Kelp... inspections. Alternative approaches that can demonstrate compliance with the Organic Foods Production Act...: Agricultural Marketing Service, USDA. ACTION: Notice of availability of final guidance. SUMMARY: The...

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

    Science.gov (United States)

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

    2012-01-01

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

  14. Treatment of gastrointestinal angiodysplasia and unmet needs.

    Science.gov (United States)

    Dray, Xavier; Camus, Marine; Coelho, Jessica; Ozenne, Violaine; Pocard, Marc; Marteau, Philippe

    2011-07-01

    Gastrointestinal angiodysplasia (GIAD) may either be asymptomatic or induce overt or obscure bleeding with a high risk of recurrence. Numerous therapeutic options are available but evidence bases are lacking. We conducted a comprehensive review of pharmacological and endoscopic treatments for previous or active bleeding GIAD and established the unmet needs of the clinicians. Clinical trials, series, and reports, having been selected through PubMed inquiry, manual searching, and reference list reviewing, were classified by levels of evidence. Controlled studies focusing on GIAD treatment, excluding other GI vascular malformations, are rare. Endoscopic destruction, preferably using non-contact endoscopic techniques, is most often proposed as a first-line treatment for GIAD (expert level). In addition, APC is preferred over Nd:Yag laser due to the lower risk of perforation (expert level). Pharmacological treatments for GIAD are considered either when endoscopy fails to access the AD or in order to prevent rebleeding for "chronic bleeding patients." Octreotide and oestroprogestative treatments are the best evaluated drugs; however, no appropriate comparison on cost-effectiveness and tolerance has been performed. The most effective therapeutic strategy for bleeding GIAD is currently inconclusive, and new trials should be performed to address unmet needs. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Shahjahan, Riyad A.; Kezar, Adrianna J.

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

    Young adults with hemophilia face unique challenges during the transition to adulthood, including issues associated with switching from pediatric to adult hematology care, building mature interpersonal relationships, and establishing an independent career with an assurance of medical insurance coverage. A greater understanding of these challenges is essential for developing effective strategies to address the specific needs of this population. These challenges may be differentiated from those of older adults with hemophilia in large part because of more extensive childhood prophylaxis and safer factor products, resulting in fewer joint problems and lower rates of HIV and HCV infections. This analysis of the changing nature and unmet needs of today's young adults entering into adult hemophilia treatment centers, as well as potential strategies for optimally addressing these needs, was developed following roundtable discussions between patients, caregivers, hematologists, and other health care professionals participating in comprehensive care. Challenges identified among young adults with hemophilia include psychosocial issues related to maturity, personal responsibility, and increased independence, as well as concerns regarding when and with whom to share information about one's hemophilia, limited awareness of educational and financial resources, and a low perceived value of regular hematology care. The initiatives proposed herein highlight important opportunities for health care professionals at pediatric and adult hemophilia treatment centers, as well as national organizations, community groups, and career counselors, to address key unmet needs of this patient population. © 2015 Wiley Periodicals, Inc.

  17. An introduction to the 2011 National Multicultural Conference & Summit keynote addresses.

    Science.gov (United States)

    Sánchez, Francisco J; Kawahara, Debra; Thomas, Lisa Rey; Worthington, Roger

    2011-07-01

    This article provides and introduction to the 2011 National Multicultural Conference & Summit Keynote Addresses. The authors explain that they chose to focus on the tension and possibilities within multicultural psychology at the seventh biennial National Multicultural Conference & Summit (NMCS), which was held on January 27-28, 2011, at The Westin-Seattle Hotel. During the 2-day conference, nearly 900 attendees engaged with one another and heard from experts in the field as we focused on the theme, "Unification through Diversity: Bridging Psychological Science & Practice in the Public Interest. Two key sets of presentations are highlighted.

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

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-06-30

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

  19. Challenges Addressing Unmet Need for Contraception: Voices of ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Management Team (CHMT) in Kilombero district. .... vis tenets of Christianity and Islam. .... The authors of this publication have no financial interests ... pregnancy and associated risk factors among young ... Washington D.C.; World Bank 1995.

  20. Unmet needs in the management of schizophrenia

    Directory of Open Access Journals (Sweden)

    Torres-González F

    2014-01-01

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

  1. Unmet Needs for Ancillary Services Among Hispanics/Latinos Receiving HIV Medical Care - United States, 2013-2014.

    Science.gov (United States)

    Korhonen, Lauren C; DeGroote, Nicholas P; Shouse, R Luke; Valleroy, Linda A; Prejean, Joseph; Bradley, Heather

    2016-10-14

    The prevalence of diagnosed human immunodeficiency virus (HIV) infection in Hispanics/Latinos in the United States is more than twice as high as the prevalence among non-Hispanic whites (1). Services that support retention in HIV medical care and assist with day-to-day living, referred to here as ancillary services, help persons living with HIV access HIV medical care, adhere to HIV treatment, and attain HIV viral suppression. The needs for these ancillary services among Hispanics/Latinos are not well described (2). To obtain nationally representative estimates of and reasons for unmet needs for such services among Hispanic/Latino adults receiving outpatient HIV medical care during 2013-2014, CDC analyzed data from the Medical Monitoring Project (MMP). The analysis found that Hispanics/Latinos in all age and sexual orientation/behavior subgroups reported substantial unmet needs, including 24% needing dental care, 21% needing eye or vision care, 15% needing food and nutrition services, and 9% needing transportation assistance. Addressing unmet needs for ancillary services among Hispanics/Latinos living with HIV might help increase access to HIV care, improve health outcomes, and reduce health disparities.

  2. Barriers to unmet needs among mothers of children with disabilities in Kelantan, Malaysia: A qualitative study

    Directory of Open Access Journals (Sweden)

    Surianti Sukeri, PhD

    2017-10-01

    Conclusions: Identification of the barriers to the attainment of unmet needs among mothers of disabled children is crucial for resolving the issue of unmet needs. Deeper understanding of these barriers may facilitate positive actions toward addressing the needs of these mothers and to alleviate the stress on mothers of disabled children. A concerted effort to coordinate services across all disciplines is required to dismantle these barriers by improving the provision of health care delivery and evaluation of welfare policies and services.

  3. President Barack Obama addresses the 146th annual meeting of the National Academy of Sciences.

    Science.gov (United States)

    2009-06-16

    On April 27, 2009, President Barack Obama addressed members of the National Academy of Sciences (NAS) gathered at its 146th annual meeting in Washington, D.C. In his speech, the president shared his plans to give science and technology a central role in the nation's future and an immediate place in America's economic renewal. He outlined steps he is taking to increase research spending, achieve energy independence, and improve science education. Included was what Mr. Obama cited as the largest commitment to scientific research in American history-devoting more than 3% of our gross domestic product to research and development. "Next, we are restoring science to its rightful place," Mr. Obama told a packed NAS auditorium audience. "Under my administration, the days of science taking a backseat to ideology are over." He appealed to scientists' sense of personal responsibility to reach and educate young Americans: "I want to challenge you to use your love and knowledge of science to spark a sense of wonder and excitement in a new generation." President Obama was welcomed to the National Academy of Sciences by President Ralph J. Cicerone and John P. Holdren, Assistant to the President for Science and Technology and Director of the White House Office of Science and Technology Policy. The following is a transcript of that speech.

  4. Extending the Reach of National Assessments: Addressing Local and Regional Needs

    Science.gov (United States)

    Lewis, K.; Carter, T.

    2016-12-01

    While climate change is global in scope, many impacts of greatest societal concern (and accompanying response decisions) occur on local to regional scales. The U.S. Global Change Research Program (USGCRP) is tasked with conducting quadrennial national climate assessments, and efforts for the fourth such assessment (NCA4) are underway. Recognizing that there is a growing appetite for climate information on more local scales, however, USGCRP is actively pursuing higher-resolution scientific information, while also seeking engagement with local and regional entities to ensure that NCA4 is well-positioned to address users' needs across geospatial scales. Effectively meeting user needs at regional scales requires robust observations and projections at sub-national scales, as well as a widespread network of agencies and organizations. We discuss our efforts to leverage existing relationships to identify potential users and their needs early in the assessment process. We also discuss plans for future mechanisms to engage additional regional stakeholders from resource managers to policy makers and scientists not only for quadrennial assessment but as part of a sustained process.

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

    Science.gov (United States)

    Agrawal, Niruj; Bhattacharya, Rahul; Rickards, Hugh

    2015-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    John Jackson; Todd Allen; Frances Marshall; Jim Cole

    2013-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Kathleen Abrahamson

    2010-11-01

    Full Text Available Kathleen Abrahamson1, Morgan Durham1, Rebekah Fox21Department of Public Health, Western Kentucky University, Bowling Green, KY, USA; 2Department of Communication, Texas State University, San Marcos, TX, USAAbstract: In this article, we synthesize current literature regarding the unmet needs of cancer patients, with a specific focus on interventions that address psychosocial distress, social support, and information deficits. Research indicates many patients diagnosed with cancer express unmet needs in terms of emotional distress, decision-making support, and practical concerns such as childcare, transportation, and financial assistance. Four types of system-level barriers to the meeting of patient psychosocial and information-based needs emerge from the literature: underidentification of needs due to inadequate assessment, time constraints on cancer care providers, lack of adequate reimbursement for psychosocial and information services, and barriers related to communication of disease-related information. There is also evidence that unmet need, especially unmet information need, is related to the level of patient health literacy. Patient empowerment through the resolution of unmet needs increases patient participation in care, and is especially crucial in regards to understanding risks and benefits of treatment. There is evidence that some interventions are effective for some patients, and that even relatively simple interventions can reduce psychosocial and information-based needs. The challenge is therefore to discover which intervention will be effective for each individual patient, and to attain the skills and resources necessary to intervene appropriately.Keywords: cancer, unmet need, health literacy, intervention

  8. Do unmet needs differ geographically for children with special health care needs?

    Science.gov (United States)

    Fulda, Kimberly G; Johnson, Katandria L; Hahn, Kristen; Lykens, Kristine

    2013-04-01

    The purpose of this study was to identify geographic differences in health indicators for children with special health care needs (CSHCN). It was hypothesized that geographic differences in unmet health care needs exist among CSHCN by region in the United States. Data were obtained from the National Survey of Children with Special Health Care Needs, 2005-2006. Nine variables representing unmet needs were analyzed by geographic region. The region with the highest percent of unmet needs was identified for each service. Logistic regression was utilized to determine differences by region after controlling for age, gender, ethnicity, race, federal poverty level, relationship of responder to child, insurance status, severity of condition, and size of household. A total of 40,723 CSHCN were represented. Crude analysis demonstrated that the greatest unmet need for routine preventive care, specialist care, prescription medications, physical/occupational/speech therapy, mental health care, and genetic counseling occurred in the West. The greatest unmet need for preventive dental care, respite care, and vision care occurred in the South. Significant differences between regions remained for six of the nine services after controlling for potential confounders. Geographic differences in unmet health care needs exist for CSHCN. Further delving into these differences provides valuable information for program and policy planning and development. Meeting the needs of CSHCN is important to reduce cost burden and improve quality of life for the affected child and care providers.

  9. Towards good principles for the design of a national addressing scheme

    CSIR Research Space (South Africa)

    Coetzee, S

    2011-07-01

    Full Text Available and maintenance, spatial demographic analysis and geo-marketing. Addressing schemes vary in different parts of the world, such as referencing to a road network or to a hierarchy of administrative areas; in informal settlements addresses can be informal, variable...

  10. Met and unmet palliative care needs of people living with HIV/AIDS ...

    African Journals Online (AJOL)

    to HIV/AIDS most of the time, with the most common symptom being pain. Participation in activities ... Addressing unmet palliative care needs would enhance the. QoL of PLWHA. ..... I need financial assistance so that my kids will continue to go to school. ... Regular visits at home help a lot because you feel not stigmatised or ...

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

    Science.gov (United States)

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

    2006-01-01

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

  12. Address by deputy president Cyril Ramaphosa at the 5th CSIR National Conference

    CSIR Research Space (South Africa)

    Ramaphosa, C

    2015-10-08

    Full Text Available and communications technology architecture for the National Health Insurance. We have also seen important successes in areas like HIV prevention and treatment, satellite building, paleontology, fluorochemicals, and technology for improved service delivery. 9...

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

    Directory of Open Access Journals (Sweden)

    Oomman Sabu

    2010-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Roderic Beaujot

    2011-01-01

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

  15. Epilepsy is associated with unmet health care needs compared to the general population despite higher health resource utilization--a Canadian population-based study.

    Science.gov (United States)

    Reid, Aylin Y; Metcalfe, Amy; Patten, Scott B; Wiebe, Samuel; Macrodimitris, Sophie; Jetté, Nathalie

    2012-02-01

    (1) To determine whether health resource utilization (HRU) and unmet health care needs differ for individuals with epilepsy compared to the general population or to those with another chronic condition (asthma, diabetes, migraine); and (2) to assess the association among epilepsy status, sociodemographic variables and HRU. Data on HRU were assessed using the 2001-2005 Canadian Community Health Surveys, a nationally representative population-based survey. Weighted estimates of association were produced as adjusted odds ratio with 95% confidence intervals, and logistic regression was used to explore the association between sociodemographic variables and HRU in those with epilepsy. All data on disease status, HRU, and unmet health care needs were self-reported. Individuals with epilepsy had the highest rate of hospitalizations and the highest mean number of consultations with physicians. Despite higher rates of consultation with psychologists and social workers compared to the general population, those with epilepsy were significantly more likely to say they had unmet mental health care needs. People with epilepsy were also less likely to use dental services compared to the general population. Epilepsy was a significant predictor of HRU in logistic regression models. Given the prevalence of psychiatric comorbidities in those with epilepsy, it is concerning that this group perceives unmet mental health care needs. It is also troublesome that there was decreased utilization of dental health care resources in those with epilepsy considering that these patients are more likely to have poor oral health. Although individuals with epilepsy use more health care services than the general population, this increase appears to be insufficient to address their health care needs. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

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

    Science.gov (United States)

    National Literacy Trust, 2011

    2011-01-01

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

  17. Addressing Conduct Disorder in Elementary School Children: An Application of the ASCA National Model

    Science.gov (United States)

    Demanchick, Stephen P.; Rangan, Malathi; Douthit, Kathryn

    2006-01-01

    The range of management strategies for school counselors dealing with conduct disorder in elementary school children can be expanded through an integration of several of the principles of the ASCA National Model[R]. This paper discusses ways the counselor can use the model to assist struggling children, teachers, administrators, and families as…

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

    Science.gov (United States)

    Smeeding, Timothy; Thévenot, Céline

    2016-04-01

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

  19. Participation in cancer rehabilitation and unmet needs

    DEFF Research Database (Denmark)

    Holm, Lise Vilstrup; Hansen, Dorte Gilså; Johansen, Christoffer

    2012-01-01

    PURPOSE: To investigate associations between cancer survivors' sex, age, and diagnosis in relation to their (1) need for rehabilitation, (2) participation in rehabilitation activities, and (3) unmet needs for rehabilitation in a 14-month period following date of diagnosis. METHODS: A population...... sex, age, and diagnosis, and the outcome variables for rehabilitation. RESULTS: A total of 3,439 patients participated, yielding an overall response rate of 70%. One third of the cancer patients reported a need for physical rehabilitation and one third for psychological rehabilitation. Half...... of the patients participated in at least one activity. Unmet needs were most often reported in psychological, sexual, and financial areas. Women expressed more needs, participated more often in rehabilitation activities, and had, to a higher extent, their emotional needs fulfilled. Breast cancer patients...

  20. A structured literature review of the burden of illness and unmet needs in patients with rheumatoid arthritis: a current perspective.

    Science.gov (United States)

    Taylor, Peter C; Moore, Adam; Vasilescu, Radu; Alvir, Jose; Tarallo, Miriam

    2016-05-01

    While rheumatologists often focus on treatment targets, for many patients with rheumatoid arthritis (RA), control over pain and fatigue, as well as sustaining physical function and quality of life (QoL), is of primary importance. This literature review aimed at examining patients' and physicians' treatment aspirations, and identifying the unmet needs for patients with RA receiving ongoing treatment. Searches were performed using MEDLINE, Embase, PsycINFO, and Econlit literature databases for articles published from 2004 to 2014 in the English language. Published literature was screened to identify articles reporting the unmet needs in RA. We found that, despite the wide range of available treatments, RA continues to pose a substantial humanistic and economic burden on patients, and there are still unmet needs across key domains such as pain, physical function, mental function, and fatigue. These findings suggest that there is a need for further treatment advances in RA that address these domains of contemporary unmet need.

  1. Guidelines for Estimating Unmetered Industrial Water Use

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, Brian K.

    2010-08-01

    The document provides a methodology to estimate unmetered industrial water use for evaporative cooling systems, steam generating boiler systems, batch process applications, and wash systems. For each category standard mathematical relationships are summarized and provided in a single resource to assist Federal agencies in developing an initial estimate of their industrial water use. The approach incorporates industry norms, general rules of thumb, and industry survey information to provide methodologies for each section.

  2. Unmet Diagnostic Needs in Infectious Disease

    Science.gov (United States)

    Blaschke, Anne J.; Hersh, Adam L.; Beekmann, Susan E.; Ince, Dilek; Polgreen, Philip M.; Hanson, Kimberly E.

    2014-01-01

    Accurate diagnosis is critical to providing appropriate care in infectious diseases. New technologies for infectious disease diagnostics are emerging, but gaps remain in test development and availability. The Emerging Infections Network surveyed Infectious Diseases physicians to assess unmet diagnostic needs. Responses reflected the urgent need to identify drug-resistant infections and highlighted the potential for early diagnosis to improve antibiotic stewardship. Information gained from this survey can help inform recommendations for new diagnostic test development in the future. PMID:25456043

  3. Unmet needs of bipolar disorder patients

    Directory of Open Access Journals (Sweden)

    Hajda M

    2016-06-01

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

  4. Unmet need for treatment for substance use disorders across race and ethnicity.

    Science.gov (United States)

    Mulvaney-Day, Norah; DeAngelo, Darcie; Chen, Chih-Nan; Cook, Benjamin L; Alegría, Margarita

    2012-09-01

    The objective was to analyze disparities in unmet need for substance use treatment and to observe variation across different definitions of need for treatment. Data were analyzed from the 2002 to 2005 National Survey of Drug Use and Health and the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regressions estimated the likelihood of specialty substance use treatment across the two data sets. Parallel variables for specialty, informal and any substance abuse treatment were created. Perceived need and normative need for substance use treatment were defined, with normative need stratified across lifetime disorder, past twelve month disorder, and heavy alcohol/any illicit drug use. Treatment rates were analyzed, comparing Blacks, Asians and Latinos to non-Latino whites across need definitions, and adjusting for age, sex, household income, marital status, education and insurance. Asians with past year substance use disorder had a higher likelihood of unmet need for specialty treatment than whites. Blacks with past year disorder and with heavy drinking/illicit drug use had significantly lower likelihood of unmet need. Latinos with past year disorder had a higher likelihood of unmet need for specialty substance abuse treatment. Asians with heavy drinking/illicit drug use had lower likelihood of unmet need. The findings suggest that pathways to substance abuse treatment differ across groups. Given high rates of unmet need, a broad approach to defining need for treatment is warranted. Future research to disentangle social and systemic factors from factors based on diagnostic criteria is necessary in the identification of need for treatment. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Ad/dressing the nation: drag and authenticity in post-apartheid South Africa.

    Science.gov (United States)

    Spruill, Jennifer

    2004-01-01

    This paper examines a style of drag in South Africa that features "traditional African" clothing. In a region in which homosexuality is denigrated as a colonial, European import and "unAfrican," the meaning of "traditional drag" is deeply inflected by the question of cultural authenticity. This dragging practice fits within a distinctly post-colonial production of tradition and its self-conscious display--in the form of attire--of a decidedly "gay" one. Traditional drag also responds to ongoing politics within and between lesbian and gay communities about racial "representivity" and "transformation." The paper focuses on displays of traditional drag at Johannesburg's Gay and Lesbian Pride Parade but also explores the complex politics of publicity and address suggested by varying contexts in which traditional dress and drag are mobilized.

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

    Directory of Open Access Journals (Sweden)

    Malini M Bhattathiry

    2014-01-01

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

  7. Factors affecting unmet need for family planning in married women of reproductive age group in urban slums of Lucknow

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    Anjali Pal

    2014-03-01

    Full Text Available Background: Unmet need for family planning signifies the gap between the reproductive intentions of couples and their actual contraceptive behaviour. The National Family Health Surveys carried out in India in 1992-93, 1998-99 and 2004-2005 have revealed that for a sizable proportion of the population in the reproductive age group, the need for contraceptive services are not met with despite the existence of a National Policy on family planning since 1983. This study was carried out to assess the extent of unmet need for family planning among married women of reproductive age group in urban slums of Lucknow and identify the various factors affecting it. Study design: Cross sectional Setting: four urban slums of Lucknow Participants: 414 married women in the age group of 15- 44 years Study variables: age, education, occupation, religion, parity Statistical analysis: chi- square test, logistic regression analysis, fisher’s exact test Results: the extent of unmet need among married women of reproductive age group was 53.1%. The unmet need was found to be significantly associated with age, number of living sons, discussion of family planning with husband, perception of husband’s view on family planning and husbands’ behaviour towards use of family planning method. Logistic regression analysis of unmet need showed that the lower age of the woman, lesser number of living sons and husband’s discouragement towards the use of FP method were correlated with the unmet need for Family Planning.

  8. DETERMINANTS OF UNMET NEED FOR FAMILY PLANNING IN SLUMS OF LUCKNOW

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    Mukesh

    2015-06-01

    Full Text Available INTRODUCTION: Understanding of family planning scenario among different societies and communities, which by and large reside in urban slum areas, might prove useful in increasing family planning acceptance by them and decreasing population growth. Unmet need is a valuable indicator for assessing the achievements of national family planning programs. OBJECTIVES: The present study was undertaken with the objectives to estimate unmet need for family planning among the married women of reproductive age group (15 - 49 years in urban slums of Lucknow and to determine the various factors that influence the unmet need. METHODS: A community based cross - sectional study was conducted in slums of Lucknow City from February 2014 to September 2014. A total 452 married women in reproductive age group were interviewed through house to house survey with the help of a pre - designed, pre - tested and semi - structured questionnaire. RESULTS: The total unmet need for family planning was 69.0%. Multivariate logistic regression revealed socioeconomic status upper lower and below (OR 2.7; 95% CI 1.5 - 5.1; p = 0.00; duration of marriage less than 1 year (OR 1.8; 95% CI 1.1 - 2.9; p = 0.01; less number of live issues (OR 1.6; 95% CI 1.1 - 2.5; p = 0.00; working status of women (OR 1.9; 95% CI 1.1 - 2.9; p = 0.03; social class i.e. OBC and SC/ST (OR 2.3; 95% CI 1.1 - 4.6; p = 0.02 were found to be independent predictors of unmet need of family planning. CONCLUSION: The present study revealed that unmet need for family planning was quite high among women belonging to social class i.e. OBC and SC/ST, with low socioeconomic status, duration of marriage less than one year less number of live issues and working status of the women.

  9. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia.

    Science.gov (United States)

    Edib, Zobaida; Kumarasamy, Verasingam; Binti Abdullah, Norlia; Rizal, A M; Al-Dubai, Sami Abdo Radman

    2016-02-22

    Addressing breast cancer patients' unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients' characteristics, and their unmet supportive care needs. A cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants' socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). The highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL. Most prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical

  10. Welcome Address

    OpenAIRE

    Shantanu Sengupta

    1983-01-01

    This article is part of the NEDA-PIDS Seminar-Workshop on the Philippine System of National Accounts. It outlines the seminar’s major objectives and the problems and issues that need to be addressed. It argues that coordination among institutions can lead to effective resolution to sensitive issues.

  11. Unmet needs for cardiovascular care in Indonesia.

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    Asri Maharani

    Full Text Available In the past twenty years the heaviest burden of cardiovascular diseases has begun to shift from developed to developing countries. However, little is known about the real needs for cardiovascular care in these countries and how well those needs are being met. This study aims to investigate the prevalence and determinants of unmet needs for cardiovascular care based on objective assessment.Multilevel analysis is used to analyse the determinants of met needs and multilevel multiple imputation is applied to manage missing data. The 2008 Indonesian Family Life Survey (IFLS4 survey is the source of the household data used in this study, while district data is sourced from the Ministry of Health and Ministry of Finance. The data shows that nearly 70% of respondents with moderate to high cardiovascular risk failed to receive cardiovascular care. Higher income, possession of health insurance and residence in urban areas are significantly associated with met needs for cardiovascular care, while health facility density and physician density show no association with them.The prevalence of unmet needs for cardiovascular care is considerable in Indonesia. Inequality persists as a factor in meeting needs for cardiovascular care as the needs of people with higher incomes and those living in urban areas are more likely to be met. Alleviation of poverty, provision of health care insurance for the poor, and improvement in the quality of healthcare providers are recommended in order to meet this ever-increasing need.

  12. Factors influencing pregnancy intentions and contraceptive use: an exploration of the 'unmet need for family planning' in Tanzania.

    Science.gov (United States)

    Rusibamayila, Asinath; Phillips, James; Kalollela, Admirabilis; Jackson, Elizabeth; Baynes, Colin

    2017-01-01

    Estimation of unmet need for contraception is pursued as a means of defining the climate of demand for services and the rationale for family planning programmes. The stagnation of levels of unmet need, as assessed by Demographic and Health Surveys, particularly in sub-Saharan Africa, has called into question the practical utility of this measure and its relevance to policies and programmes in settings where evidence-based guidance is needed the most. This paper presents evidence from qualitative research conducted in rural Tanzania that assesses the diverse context in which pregnancy intentions and contraceptive behaviours are formed. The multi-level sets of influences on intentions and behaviours - that is, the dichotomous components used to calculate unmet need for family planning - are reviewed and discussed. While results lend support to the concept that unmet need exists and that services should address it, they also attest to the synergistic influences of individual, spousal, organisational and societal factors that influence the implementation of childbearing preferences. Altogether, the analysis suggests that ways for assessing and addressing unmet need in Tanzania, and similar settings, be revised to reflect contextual influences that not only shape individual preferences, but constrain how individuals implement them.

  13. Heart failure patients' desires for spiritual care, perceived constraints, and unmet spiritual needs: relations with well-being and health-related quality of life.

    Science.gov (United States)

    Park, Crystal L; Sacco, Shane J

    2016-11-14

    Little information is available about HF patients' desires regarding having their healthcare providers address their spiritual concerns, feeling constrained in doing so, and the extent to which their spiritual needs go unmet. Nearly half of our sample reported high levels of unmet spiritual needs and reported moderately strong desires to have their doctor or other healthcare professional attend to their spiritual needs, and moderately strong feelings of constraint in doing so. Spiritual constraint and unmet spiritual needs were associated with poorer spiritual, psychological and physical well-being, but these effects varied, depending on patients' desire to discuss spiritual needs. These findings have important implications for clinical management of HF patients.

  14. License Address List

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Address list generated from National Saltwater Angler Registry. Used in conjunction with an address-based sample as per survey design.

  15. Borderline personality disorder and unmet needs.

    Science.gov (United States)

    Grambal, Ales; Prasko, Jan; Ociskova, Marie; Slepecky, Milos; Kotianova, Antonia; Sedlackova, Zuzana; Zatkova, Marta; Kasalova, Petra; Kamaradova, Dana

    2017-08-05

    Borderline personality disorder (BPD) is a disabling psychiatric condition with a chronic and challenging course. BPD is reflected as a disorder of self-regulation" and is associated with both psychological vulnerabilities and social relations that fail to support basic emotional needs. The objective of the paper is to provide the up-to-date data on the unmet needs of BPD patients and their families. A computerized search of the literature printed between January 1990 and May 2017 was conducted in PubMed, and additional papers were extracted using keywords "borderline personality disorder,"needs," "pharmacotherapy," "psychotherapy," "CBT," and "family" in various combinations. According to the eligibility criteria, 57 articles were chosen. Secondary articles from the reference lists of primarily identified papers have been selected for the eligibility and added to the first list (N=151). The results were divided into three categories: the needs connected with (1) the symptom control; (2) the treatment; (3) the quality of life. The needs connected with symptoms were described issues such as emotional needs, social interactions, self-harm, parasuicide, suicidality, comorbidity, mentalization, identity disturbance, moreover, barriers to treatment. The needs connected with the treatment described are focused on needs for early diagnosis, early intervention, holding environment, therapeutic relation, assertive community treatment, destigmatization, hospitalization, and primary care. The needs connected with the quality of life involve family needs, physical health, spiritual needs, advocacy needs, and needs for the separation-individuation. The part focused on implications for the treatment presented several treatment approaches, focusing mostly on the their basics and efficacy. Observing the patients' needs may be essential to the treatment of the individuals suffering from BPD. However, many needs remain unmet in the areas linked to medical, personal, and social

  16. People Power: A Report of the National Citizens Conference on Rehabilitation of the Disabled and Disadvantaged (Washington, D.C., June 24-27, 1969).

    Science.gov (United States)

    Social and Rehabilitation Service (DHEW), Washington, DC.

    Described are the proceedings of the National Citizens Conference on Rehabilitation including brief opening remarks and the text of the keynote address by Whitney M. Young. Topics of reported sessions are the unmet needs of special groups, case finding through public service advertising, environmental barriers and transportation, consumer…

  17. SOCIO - DEMOGRAPHIC FACTORS AND PREVALENCE OF UNMET NEED FOR FAMILY PLANNING IN URBAN AND RURAL FIELD PRACTICE AREAS OF M . R . MEDICAL COLLEGE , KALABURAGI

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    Mohammad Waseem Faraz

    2015-08-01

    Full Text Available Millions of women in developing countries would prefer to avoid a pregnancy by not using any form of contraception. Hence unmet need can be powerful concept for family planning programmes. Today, more than 220 million women in developing countries report having an unmet need for family planning at different stages of their reproductive lives. “Unmet need can be powerful concept for family planning programmes. First, it is based on women’s own statements, an answer to survey question. Second, it identifies the group most likely to be interested in contraception. Third, it poses a clear challenge to reach and serve these women”. OBJECTIVES : 1 To assess the magnitude of Unmet need for family planning among married women of reproductive age group (15 – 44 years. 2 To identify the socio - demographic factors associated with unmet need for family planning. MATERIALS AND METHODS : A cross - sectional study was carried out in the Urban and Rural health training Centers of Department of Community Medicine. The study population included 563 married women from rural and 924 married women from urban area aged 15 - 44 years. The data was collected using pre tested proforma and was analyzed using percentages and Chi - Square test. RESULTS : The unmet need for family planning was 28.9% in urban and 40.5% in rural study populations. The overall unmet need is low at the beginning of reproductive age, but it increased and reached a peak in the mid - twenties & then declined. CONCLUSION : Despite a fair knowledge about the family planning methods, various socio - cultural and problems were responsible for the gap between a woman’s expressed need and utilization of contraceptives. Addressing these problems and barriers would help in the long run to reduce the unmet need. KEYWORDS : Unmet needs; Contraception; Spacing; Limiting.

  18. Epigenetics and Systemic Lupus Erythematosus: Unmet Needs.

    Science.gov (United States)

    Meroni, Pier Luigi; Penatti, Alessandra Emiliana

    2016-06-01

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

  19. Unmet medical needs in systemic lupus erythematosus

    Science.gov (United States)

    2012-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease of diverse manifestations, with onset usually in young women in the third to fourth decade of life. The chronic nature of this relapsing remitting disease leads to organ damage accrual over time. Mortality and morbidity are increased in patients with SLE compared with the general population. Therapeutic advances over the last few decades have led to significant improvements in patient outcomes. Five-year survival has improved to over 90% from a low of 50% in the 1950s. However, multiple aspects of the management of SLE patients are still far from optimal. Early diagnosis remains a challenge; diagnostic delays leading to delay in definitive treatment are common. Monitoring treatment remains problematic due to the paucity of sensitive biomarkers. Current treatment regimens rely heavily on corticosteroids, even though corticosteroids are well known to cause organ damage. Treatment of refractory disease manifestations such as nephritis, recalcitrant cutaneous lesions and neurological involvement require new approaches with greater efficacy. Cognitive dysfunction is common in SLE patients, but early recognition and adequate treatment are yet to be established. Premature accelerated atherosclerosis remains a leading cause of morbidity and mortality. Fatigue is one of the most disabling symptoms, and contributes to the poor quality of life in patients with SLE. Ongoing research in SLE faces many challenges, including enrollment of homogeneous patient populations, use of reliable outcome measures and a standard control arm. The current review will highlight some of the outstanding unmet challenges in the management of this complex disease. PMID:23281889

  20. Cell therapy for heart disease after 15 years: Unmet expectations.

    Science.gov (United States)

    Nigro, Patrizia; Bassetti, Beatrice; Cavallotti, Laura; Catto, Valentina; Carbucicchio, Corrado; Pompilio, Giulio

    2017-02-21

    Over the past two decades cardiac cell therapy (CCT) has emerged as a promising new strategy to cure heart diseases at high unmet need. Thousands of patients have entered clinical trials for acute or chronic heart conditions testing different cell types, including autologous or allogeneic bone marrow (BM)-derived mononuclear or selected cells, BM- or adipose tissue-derived mesenchymal cells, or cardiac resident progenitors based on their potential ability to regenerate scarred or dysfunctional myocardium. Nowadays, the original enthusiasm surrounding the regenerative medicine field has been cushioned by a cumulative body of evidence indicating an inefficient or modest efficacy of CCT in improving cardiac function, along with the continued lack of indisputable proof for long-term prognostic benefit. In this review, we have firstly comprehensively outlined the positive and negative results of cell therapy studies in patients with acute myocardial infarction, refractory angina and chronic heart failure. Next, we have discussed cell therapy- and patient-related variables (e.g. cell intrinsic and extrinsic characteristics as well as criteria of patient selection and proposed methodologies) that might have dampened the efficacy of past cell therapy trials. Finally, we have addressed critical factors to be considered before embarking on further clinical trials.

  1. Disabled children in special education programs in Taiwan: use of mental health services and unmet needs.

    Science.gov (United States)

    Liang, Hsin-Yi; Chang, Hsueh-Ling

    2007-06-01

    Despite national health insurance coverage in Taiwan, many health care needs remain unmet. In the current study, the behavior and emotional problems of 1,042 disabled children in special education programs were evaluated using the Chinese version of the Child Behavior Checklist (CBCL-C) and the Teacher's Report Form (TRF). Using the 60th percentile on the two tests as a cutoff representing a clinical indication, students who reached this cutoff point but did not receive mental health services in the past six months were considered to have "unmet mental health needs." Of the special education students in the study 73.9% reached clinical indications, but did not receive mental health care.

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

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    Sekandi Juliet

    2011-03-01

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

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

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    Thabane Lehana

    2010-01-01

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

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

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    Tai B

    2014-07-01

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

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

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    Hubert Barennes

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

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

    OpenAIRE

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

    2015-01-01

    The Unmet Needs Model states that problem behaviors of people with dementia result from unmet needs stemming from a decreased ability to communicate those needs and to provide for oneself. The purpose of this study is to describe the unmet needs of persons with dementia exhibiting behavior problems. Eighty-nine residents from 6 Maryland nursing homes with dementia were assessed by research assistants and nursing assistants for their unmet needs using multiple assessment tools. Three unmet nee...

  7. Factors affecting unmet need for family planning in Eastern Sudan

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    Ali Abdel Aziem A

    2013-02-01

    Full Text Available Abstract Background In the developing countries millions of women in the reproductive age who don’t use contraceptives prefer to postpone or limit their birth. This indicates their failure to take necessary decision to prevent and avoid unwanted pregnancy. Methods A community-based cross sectional household survey was conducted to investigate unmet need for family planning and associated factors and total demand for family planning in Kassala, Eastern Sudan between 1st May and 31st July 2012. Results A total of 812 married women were enrolled in this study. Their mean age and parity was 31.8 (7.3 and 3.4 (1.8 respectively. Ever use of contraception was 25.4% (206/812 and 26.2% (213/812 were currently using contraception. Unmet need for spacing was 15.1% while unmet need for limiting was 0.7%. The pregnant and amenorrheic women whose the pregnancy or birth was unwanted and mistimed were 105 (13% and 130 (16% respectively. Using Westoff model the total unmet need was estimated as 44.8%. The total demand for family planning was 71%. In logistic regression model, while age, age at marriage, parity, residence and experience of child death were not associated with total unmet need for family planning, women education P=0.00, husband education P = 0.00 and woman’s occupation; housewife (OR=4.3; CI=2.5-7.2; P=0.00 were associated with the total unmet need. Conclusions Unmet need for family planning in Eastern Sudan was significantly higher among women with less than secondary education. Also; it is influenced by couple’s educational status and woman’s occupation. The results of this study necessitate the need for the programme managers to take into account the concept of reproductive health education.

  8. A STUDY TO ASSESS THE FACTORS DETERMINING THE UNMET NEED FOR CONTRACEPTIVE USAGE IN AN URBAN AREA RAJAPUR

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    Mohammad Waseem Faraz

    2015-08-01

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

  9. Assessment of Unmet Need for Contraception among eligible couples in Urban Slums of Raipur city of Chhattisgarh state

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    Nirmal Verma

    2014-06-01

    Full Text Available Background: India was the first country to launch National Family Planning Program in 1952. Even though various measures have been taken to encourage the usage of contraception but the achievement in this field was not to the extent expected due to various social and cultural factors. Objective: This study was planned to assess the prevalence and its determinants of unmet need for contraception among eligible couples in urban slums of Raipur city. Methodology: A cross sectional community based study was conducted using cluster sampling in urban slums of Raipur city from November 2011 to October 2012. During the study, 711 fecund married women, age group 15-49 years were included and predesigned and pretested proforma was used as a study tool. The obtained data were analyzed using appropriate statistical test. Results: Among all eligible married women 45 % were concentrated in the prime reproductive age 20-29 yrs. Majority of women were not educated. The total unmet need for family planning comes out to 32.9%. Age, Education, literacy, Occupation, Type of Family, No of living children, Birth Order , No of male child, No of female child , Husband literacy were the most significant predictor of unmet need. Conclusion: Percentage of unmet need is higher as compared to national data, so there is urgently need to ensure the same.

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

    Science.gov (United States)

    Navera, Gene Segarra

    2011-01-01

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

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

    Science.gov (United States)

    Navera, Gene Segarra

    2011-01-01

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

  12. Dry age-related macular degeneration: A currently unmet clinical need.

    Science.gov (United States)

    Girmens, Jean-François; Sahel, José-Alain; Marazova, Katia

    2012-08-01

    Age-related macular degeneration (AMD) is a leading cause of severe visual impairment and disability in older people worldwide. Although considerable advances in the management of the neovascular form of AMD have been made in the last decade, no therapy is yet available for the advanced dry form of AMD (geographic atrophy). This review focuses on current trends in the development of new therapies targeting specific pathophysiological pathways of dry AMD. Increased understanding of the complex mechanisms that underlie dry AMD will help to address this largely unmet clinical need.

  13. Using National Education Accounts to Help Address the Global Learning Crisis. Global Views. Policy Paper 2011-03

    Science.gov (United States)

    van der Gaag, Jacques; Abetti, Pauline

    2011-01-01

    This policy brief outlines how national education accounts (NEAs) are created, and why they are a vast improvement over current financial tracking systems in the education sector. Examples from the health sector illustrate the benefits of national accounts for improving public services, and their ubiquity highlights the poor state of affairs of…

  14. Association between unmet dental needs and school absenteeism because of illness or injury among U.S. school children and adolescents aged 6-17 years, 2011-2012.

    Science.gov (United States)

    Agaku, Israel T; Olutola, Bukola G; Adisa, Akinyele O; Obadan, Enihomo M; Vardavas, Constantine I

    2015-03-01

    We assessed the prevalence of dental disease among U.S. children and adolescents aged 6-17 years, as well as the impact of unmet dental needs on school absenteeism because of illness/injury within the past 12 months. Data were from the 2011/2012 National Survey of Children's Health (n=65,680). Unmet dental need was defined as lack of access to appropriate and timely preventive or therapeutic dental healthcare when needed within the past 12 months. The impact of unmet dental needs on school absenteeism was measured using a multivariate generalized linear model with Poisson probability distribution (pstudents with an unmet therapeutic dental need in the presence of a dental condition compared to those reporting no unmet dental need (β=0.25; p<0.001). Enhanced and sustained efforts are needed to increase access to dental services among underserved U.S. children and adolescents. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Alcoholic liver disease and pancreatitis: global health problems being addressed by the US National Institute on Alcohol Abuse and Alcoholism.

    Science.gov (United States)

    Warren, Kenneth R; Murray, Margaret M

    2013-08-01

    The review article summarizes the mission of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) with focus on the NIAAA's current and future research version for alcoholic liver disease and alcoholic pancreatitis.

  16. Multi-sectoral action for addressing social determinants of noncommunicable diseases and mainstreaming health promotion in national health programmes in India.

    Science.gov (United States)

    Arora, Monika; Chauhan, Kavita; John, Shoba; Mukhopadhyay, Alok

    2011-12-01

    Major noncommunicable diseases (NCDs) share common behavioral risk factors and deep-rooted social determinants. India needs to address its growing NCD burden through health promoting partnerships, policies, and programs. High-level political commitment, inter-sectoral coordination, and community mobilization are important in developing a successful, national, multi-sectoral program for the prevention and control of NCDs. The World Health Organization's "Action Plan for a Global Strategy for Prevention and Control of NCDs" calls for a comprehensive plan involving a whole-of-Government approach. Inter-sectoral coordination will need to start at the planning stage and continue to the implementation, evaluation of interventions, and enactment of public policies. An efficient multi-sectoral mechanism is also crucial at the stage of monitoring, evaluating enforcement of policies, and analyzing impact of multi-sectoral initiatives on reducing NCD burden in the country. This paper presents a critical appraisal of social determinants influencing NCDs, in the Indian context, and how multi-sectoral action can effectively address such challenges through mainstreaming health promotion into national health and development programs. India, with its wide socio-cultural, economic, and geographical diversities, poses several unique challenges in addressing NCDs. On the other hand, the jurisdiction States have over health, presents multiple opportunities to address health from the local perspective, while working on the national framework around multi-sectoral aspects of NCDs.

  17. 76 FR 31647 - Joint Industry Plan; Notice of Filing of a National Market System Plan to Address Extraordinary...

    Science.gov (United States)

    2011-06-01

    ... Equity Income Fund. DFJ WisdomTree Japan SmallCap Dividend Fund. DGS WisdomTree Emerging Markets SmallCap... Market Volatility by BATS Exchange, Inc., BATS Y-Exchange, Inc., Chicago Board Options Exchange... proposed Plan to Address Extraordinary Market Volatility (``Plan'').\\3\\ A copy of the proposed Plan is...

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

    Science.gov (United States)

    Brugge, Doug

    2016-02-01

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

  19. Pharmaceutical nanotechnology : unmet needs in drug delivery

    NARCIS (Netherlands)

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

    2010-01-01

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

  20. The relationship between caregiver impacts and the unmet needs of survivors of stroke

    Directory of Open Access Journals (Sweden)

    Andrew NE

    2015-07-01

    Full Text Available Nadine E Andrew,1 Monique F Kilkenny,1,2 Rebecca Naylor,3 Tara Purvis,1 Dominique A Cadilhac1,2 1Translational Public Health and Evaluation Division, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, 2Florey Institute of Neuroscience and Mental Health, Heidelberg, 3National Stroke Foundation, Melbourne, VIC, Australia Background: Caregivers play a crucial role in meeting the needs of survivors of stroke. Yet, little is known about how they are impacted by their caregiving role. Objectives: To describe the relationship between survivor long-term unmet needs (>12 months and caregiver impacts, and identify characteristics that are associated with reported moderate to severe impacts on caregivers. Method: This was a cross-sectional survey using data from the Australian Stroke Survivor and Carer Needs Survey. Community dwelling adults 12+ months poststroke and their caregivers participated. Caregivers and survivors were asked about the extent to which the domains of work, leisure and family, and friend and spousal relationships had been impacted using a Likert scale of responses. The extent to which survivor needs were being met was measured over the domains of health, everyday living, work, leisure, and finances, and the total number of unmet needs was calculated. The association between survivor unmet needs and caregiver impacts was assessed using multivariable logistic regression adjusted for caregiver and survivor characteristics. Results: Of the 738 completed survivor surveys, 369 contained matched caregiver data (survivors: median age, 71 years; 67% male (caregivers: median age, 64 years; 26% male. For caregivers, the domains of work, leisure, and friendships were most impacted. The odds of a caregiver experiencing moderate to extreme impacts increased with the number of reported survivor unmet needs. This was greatest for spousal (aOR [adjusted odds ratio]: 1.14; 95% CI [confidence interval

  1. Unmet Needs in the Treatment of Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Dickman, Ram; Maradey-Romero, Carla; Gingold-Belfer, Rachel; Fass, Ronnie

    2015-07-30

    Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder. Proton pump inhibitors have profoundly revolutionized the treatment of GERD. However, several areas of unmet need persist despite marked improvements in the ther-apeutic management of GERD. These include the advanced grades of erosive esophagitis, nonerosive reflux disease, main-tenance treatment of erosive esophagitis, refractory GERD, postprandial heartburn, atypical and extraesophageal manifestations of GERD, Barrett's esophagus, chronic protein pump inhibitor treatment, and post-bariatric surgery GERD. Consequently, any fu-ture development of novel therapeutic modalities for GERD (medical, endoscopic, or surgical), would likely focus on the afore-mentioned areas of unmet need.

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

    OpenAIRE

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

    2010-01-01

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

  3. Strengthening national capacities for researching on Social Determinants of Health (SDH) towards informing and addressing health inequities in Tanzania

    OpenAIRE

    Mtenga, Sally; Masanja, Irene M; Mamdani, Masuma

    2016-01-01

    Background Tanzania’s socio-economic development is challenged by sharp inequities between and within urban and rural areas, and among different socio-economic groups. This paper discusses the importance of strengthening SDH research, knowledge, relevant capacities and responsive systems towards addressing health inequities in Tanzania. Methods Based on a conceptual framework for building SDH research capacity, a mapping of existing research systems was undertaken between February and June 20...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-11-09

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

  5. Awareness, Use, and Unmet Need for Family Planning in Rural ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Awareness, Use, and Unmet Need for Family Planning in Rural ... India in the number of maternal deaths1,2. In ... for International Development of the United .... households within each selected community were ..... preaching sessions, radio jingles, and television ... stakeholders on the challenges documented here.

  6. Unmet health care needs for persons with environmental sensitivity

    Directory of Open Access Journals (Sweden)

    Gibson PR

    2015-01-01

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

  7. Unmet Needs in the Management of Cervical Dystonia

    NARCIS (Netherlands)

    Contarino, Maria Fiorella; Smit, Marenka; van den Dool, Joost; Volkmann, Jens; Tijssen, Marina A. J.

    2016-01-01

    Cervical dystonia (CD) is a movement disorder which affects daily living of many patients. In clinical practice, several unmet treatment needs remain open. This article focuses on the four main aspects of treatment. We describe existing and emerging treatment approaches for CD, including botulinum t

  8. Addressing malnutrition in young children in South Africa. Setting the national context for paediatric food-based dietary guidelines.

    Science.gov (United States)

    Bourne, Lesley T; Hendricks, Michael K; Marais, Debbie; Eley, Brian

    2007-10-01

    Despite various national nutrition and primary healthcare programmes being initiated in South Africa over the last decade, child health has deteriorated. This is seen by the rise in infant and child mortality rates, the high prevalence of preventable childhood diseases, e.g. diarrhoea and lower respiratory tract infections, and the coexistence of under-nutrition along with HIV/AIDS. Poor dietary intake, food insecurity and poor quality of basic services prevail within this precarious causal web. The national Integrated Nutrition Programme is a comprehensive nutrition strategy that focuses on children below 6 years old, at-risk pregnant and lactating women, and those affected by communicable and non-communicable diseases. Focus areas relevant to pre-school children include disease-specific nutrition treatment, support and counselling; growth monitoring and promotion (GMP); micronutrient malnutrition control; breastfeeding promotion, protection and support; contributions to household food security; nutrition interventions among HIV-infected children; and nutrition promotion, education and advocacy. Progress towards this includes the Baby-Friendly Hospital Initiative; mandatory fortification of maize meal and wheat flour with multiple micronutrients; vitamin A supplementation coverage and mandatory iodization of salt by legislation; the provision of free road-to-health charts for GMP; and the National School Nutrition Programme. Since 2003, the basis of the nutrition education strategy has been the locally developed food-based dietary guidelines (FBDGs), directed at adults and school-going children. This review sketches the backdrop to and motivation for the introduction of specifically targeted paediatric FBDGs, for mothers and caregivers of children from birth to age 7 years, as a national initiative.

  9. Precompetitive Data Sharing as a Catalyst to Address Unmet Needs in Parkinson's Disease.

    Science.gov (United States)

    Stephenson, Diane; Hu, Michele T; Romero, Klaus; Breen, Kieran; Burn, David; Ben-Shlomo, Yoav; Bhattaram, Atul; Isaac, Maria; Venuto, Charles; Kubota, Ken; Little, Max A; Friend, Stephen; Lovestone, Simon; Morris, Huw R; Grosset, Donald; Sutherland, Margaret; Gallacher, John; Williams-Gray, Caroline; Bain, Lisa J; Avilés, Enrique; Marek, Ken; Toga, Arthur W; Stark, Yafit; Forrest Gordon, Mark; Ford, Steve

    2015-01-01

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

  10. Strategies to Address Unmet Needs and Facilitate Return to Learn Guideline Adoption Following Concussion

    Science.gov (United States)

    Lyons, Vivian H.; Moore, Megan; Guiney, Roxanne; Ayyagari, Rajiv C.; Thompson, Leah; Rivara, Frederick P.; Fleming, Robin; Crawley, Deborah; Harper, Dawn; Vavilala, Monica S.

    2017-01-01

    Background: Many students do not receive return to learn (RTL) services upon return to academics following a concussion. Methods: Using a mixed-methods approach, we conducted a survey of RTL practices and experiences in Washington State schools between January 2015 and June 2015. We then held a statewide summit of RTL stakeholders and used a…

  11. Addressing Unmet Medical Needs in Type 1 Diabetes: A Review of Drugs under Development.

    Science.gov (United States)

    Mittermayer, Friedrich; Caveney, Erica; De Oliveira, Claudia; Alexander Fleming, G; Gourgiotis, Loukas; Puri, Mala; Tai, Li-Jung; Rick Turner, J

    2016-04-13

    The incidence of type 1 diabetes (T1D) is increasing worldwide and there is a very large need for effective therapies. Besides pramlintide, there are essentially no pharmacologic therapies other than insulin currently approved for the treatment of T1D. Drugs already in use for type 2 diabetes and many new drugs are under clinical development for T1D, including compounds with both established and new mechanisms of action. Most of the new compounds in clinical development are currently in Phase 1 and Phase 2. Drug classes discussed in this review include new insulins, SGLT inhibitors, GLP-1 agonists, immunomodulatory drugs including autoantigens and anti-cytokines, and agents that regenerate β-cells. In addition, considerations are provided with regard to the regulatory environment for the clinical development of drugs for T1D, with a focus on the United States Food and Drug Administration and the European Medicines Agency. Future opportunities, such as combination treatments of immunomodulatory and β-cell regenerating therapies, are also discussed.

  12. Addressing unmet medical needs in type 2 diabetes: a narrative review of drugs under development.

    Science.gov (United States)

    Mittermayer, Friedrich; Caveney, Erica; De Oliveira, Claudia; Gourgiotis, Loukas; Puri, Mala; Tai, Li-Jung; Turner, J Rick

    2015-01-01

    The global burden of type 2 diabetes is increasing worldwide, and successful treatment of this disease needs constant provision of new drugs. Twelve classes of antidiabetic drugs are currently available, and many new drugs are under clinical development. These include compounds with known mechanisms of action but unique properties, such as once-weekly DPP4 inhibitors or oral insulin. They also include drugs with new mechanisms of action, the focus of this review. Most of these compounds are in Phase 1 and 2, with only a small number having made it to Phase 3 at this time. The new drug classes described include PPAR agonists/modulators, glucokinase activators, glucagon receptor antagonists, anti-inflammatory compounds, G-protein coupled receptor agonists, gastrointestinal peptide agonists other than GLP-1, apical sodium-dependent bile acid transporter (ASBT) inhibitors, SGLT1 and dual SGLT1/SGLT2 inhibitors, and 11beta- HSD1 inhibitors.

  13. Addressing Unmet Medical Needs in Type 2 Diabetes: A Narrative Review of Drugs under Development

    OpenAIRE

    Mittermayer, Friedrich; Caveney, Erica; Oliveira,Claudia de; Gourgiotis, Loukas; Puri, Mala; Tai, Li-Jung (Bruce); J, Rick Turner

    2015-01-01

    The global burden of type 2 diabetes is increasing worldwide, and successful treatment of this disease needs constant provision of new drugs. Twelve classes of antidiabetic drugs are currently available, and many new drugs are under clinical development. These include compounds with known mechanisms of action but unique properties, such as once-weekly DPP4 inhibitors or oral insulin. They also include drugs with new mechanisms of action, the focus of this review. Most of these compounds are i...

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

    Directory of Open Access Journals (Sweden)

    Ashley Wilder Smith

    2013-04-01

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

  15. 75 FR 29560 - Identifying Unmet Public Health Needs and Facilitating Innovation in Medical Device Development...

    Science.gov (United States)

    2010-05-26

    ... No. FDA-2010-N-0237] Identifying Unmet Public Health Needs and Facilitating Innovation in Medical...) is announcing a public workshop entitled ``Identifying Unmet Public Health Needs and Facilitating... identify the most important unmet public health needs, the barriers to innovative medical...

  16. Identification of risk factors related to perceived unmet demands in patients with chronic stroke

    NARCIS (Netherlands)

    de Port, I. G. L. Van; Van den Bos, G. A. M.; Voorendt, M.; Kwakkel, G.; Lindeman, E.

    2007-01-01

    Purpose. To investigate the prevalence of unmet demands concerning autonomy and participation and to identify risk factors related to these unmet demands in patients with chronic stroke. Method. A cross-sectional study of 147 patients three years after stroke. We assessed perceived unmet care demand

  17. African American Women and HIV/AIDS: A National Call for Targeted Health Communication Strategies to Address a Disparity

    Science.gov (United States)

    Arya, Monisha; Behforouz, Heidi L.; Viswanath, Kasisomayajula

    2013-01-01

    Dr Arya is assistant professor of medicine in the section of infectious diseases at the Baylor College of Medicine and a health services researcher at the Houston Center for Quality of Care and Utilization Studies in Houston. Dr Behforouz is assistant professor of medicine at Harvard Medical School, medical and executive director of the Prevention and Access to Care and Treatment Project, and associate physician in the Brigham Internal Medicine Associates at Brigham and Women’s Hospital, Boston. Dr Viswanath is associate professor of society, human development and health at the Harvard School of Public Health and director of the Health Communication Core of the Dana-Farber/Harvard Cancer Center, Boston. At the time of manuscript submission, Dr Arya was a fellow in the division of infectious diseases at Beth Israel Deaconess Medical Center and Harvard Medical School. African American women are disproportionately affected by the HIV/AIDS epidemic in the United States. To address this disparity, the CDC released a call for targeted communication campaigns in African American communities. The mass media is an HIV/AIDS information source used by African Americans, and media initiatives can be cost-effective for delivering HIV prevention messages. Needed is research in communities at risk to determine the messages needed and the preferred formats and channels with which to deliver the messages so that targeted communication campaigns can be part of the multifaceted approach to ending the HIV/AIDS disparity affecting African American women. PMID:19271331

  18. Factors related to unmet oral health needs in older adults living in Chile.

    Science.gov (United States)

    Mariño, Rodrigo; Giacaman, Rodrigo A

    2014-01-01

    To assess the oral health status and treatment needs of an ambulant population of older adults, living in the Maule Region, Chile, and provide descriptive information on its distribution by selected socio-demographic characteristics. The source of primary data was the Regional Oral Health Survey. A stratified random sample of 438 older adults, aged 65-74 years, living independently in the community was orally examined, and underwent an oral health interview. The sample was largely a dentate one (74.9%); with a mean DMFT score of 25.7 (s.d. 6.5) and an average number of missing teeth of 22.4 (s.d. 5.8). Dentate participants had 41% of their restorative care needs unmet, and 68.4% needed oral hygiene instruction plus removal of calculus on their teeth. Almost 30.1% required complex periodontal therapy. 21% of those fully edentulous were in need of full dentures. Comparing these findings with existing data on the oral health of older adults in Chile, participants in this study appear to have lower missing teeth scores and less need for complex periodontal treatment. Inequities were apparent in the proportion of unmet restorative and prosthetics needs. Community-based preventive care programs specifically tailored to older adults are needed to address this challenge.

  19. UNMET NEEDS FOR HEALTH CARE SERVICES IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Elka Atanasova

    2016-09-01

    Full Text Available Background: In all European countries, an important policy objective is the equity of access to health care. The factors that affect access to health care can differ as the demand- and supply-side factors. Moreover, there are many tools to assess the extent of inequity in access to services. One simple tool is the assessing reports of unmet needs for health care. Purpose: The study has two objectives: to examine the evidence of self-reported unmet needs and to analyze the relationship between foregone medical care and both type of residence and socioeconomic status. Materials and Methods: We use data from the European Union Statistics on Income and Living Conditions. The access to health care is measured using the concept of unmet need for medical examination or treatment during the last 12 months. The relationship between foregone medical care and both type of residence and socioeconomic status is examined through the representative survey conducted in 2014. Results: The Eurostat results show that treatment costs are the most common reason for foregone medical care in Bulgaria. We observe a gradual decrease in the share of people who reported having unmet needs due to being too expensive. According to the 2014 survey, significant differences between urban and rural areas as well as among the income groups are identified. The results show the problems in access to health care services mainly in small towns and villages. Conclusion: Although major essential changes were made in the Bulgarian health care system, the equity problems remain an important challenge to policy-makers.

  20. How do national strategic plans for HIV and AIDS in southern and eastern Africa address gender-based violence? A women's rights perspective.

    Science.gov (United States)

    Gibbs, Andrew; Mushinga, Mildred; Crone, E Tyler; Willan, Samantha; Mannell, Jenevieve

    2012-12-15

    Gender-based violence (GBV) is a significant human rights violation and a key driver of the HIV epidemic in southern and eastern Africa. We frame GBV from a broad human rights approach that includes intimate partner violence and structural violence. We use this broader definition to review how National Strategic Plans for HIV and AIDS (NSPs) in southern and eastern Africa address GBV. NSPs for HIV and AIDS provide the national-level framework that shapes government, business, donor, and non-governmental responses to HIV within a country. Our review of these plans for HIV and AIDS suggests that attention to GBV is poorly integrated; few recognize GBV and program around GBV. The programming, policies, and interventions that do exist privilege responses that support survivors of violence, rather than seeking to prevent it. Furthermore, the subject who is targeted is narrowly constructed as a heterosexual woman in a monogamous relationship. There is little consideration of GBV targeting women who have non-conforming sexual or gender identities, or of the need to tackle structural violence in the response to HIV and AIDS. We suggest that NSPs are not sufficiently addressing the human rights challenge of tackling GBV in the response to HIV and AIDS in southern and eastern Africa. It is critical that they do so.

  1. Partners and close family members of long-term cancer survivors: health status, psychosocial well-being and unmet supportive care needs.

    Science.gov (United States)

    Turner, Daniel; Adams, Eike; Boulton, Mary; Harrison, Sian; Khan, Nada; Rose, Peter; Ward, Alison; Watson, Eila K

    2013-01-01

    A cancer diagnosis can have a profound impact on partners and close family members of patients. Little is currently known about the long-term impact. The objective of this study is to describe health status, levels of anxiety and depression, unmet supportive care needs and positive outcomes in the partners/family members of breast, prostate and colorectal cancer survivors 5-16 years post-diagnosis. Patients in a linked study were asked to invite a partner or other close family member to complete a self-administered postal questionnaire. Data were analysed by cancer site and time since diagnosis. Matched comparisons were made between cancer patients in the linked study and their partners. An expression of interest was received from 330 partners/family members, and 257 questionnaires (77.9%) were returned. Health status and levels of anxiety and depression were comparable with population norms. Respondents reported an average of 2.7 unmet needs from 34 possible options. Hospital parking, information about familial risk, help managing fear of recurrence and coordination of care were the most cited unmet needs. There was little variation in health status, psychological morbidity and unmet needs by cancer site or time since diagnosis. Concordance between patients and partners was low for anxiety but higher with respect to positive outcomes and some unmet needs. Most partners/family members of long-term cancer survivors report few ongoing issues. However, a small proportion (<10%) have high levels of anxiety and/or moderate or strong unmet needs. Strategies for identifying this group and addressing their needs are required, while allowing the majority to resume normal life. Copyright © 2011 John Wiley & Sons, Ltd.

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

    Directory of Open Access Journals (Sweden)

    Jongho Heo

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

  3. Mitral regurgitation — Unmet need for improved management strategies

    Directory of Open Access Journals (Sweden)

    Jean-Noel Trochu

    2014-12-01

    Conclusions: The current review represents one of the most comprehensive conducted in the medical/conservative management of MR. An increased risk of mortality and morbidity, which appeared to rise with greater severity, was associated with MR (versus no MR. An unmet need exists in the management of patients with severe symptomatic MR and a high surgical risk as they have a poor prognosis and limited treatment options. Further research into alternative medical strategies and patient management is needed to improve prognoses and reduce mortality and morbidity.

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

    Directory of Open Access Journals (Sweden)

    Mtatifikolo Ferdinand

    2007-08-01

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

  5. Addressing the gaps in diabetes care in first nations communities with the reorganizing the approach to diabetes through the application of registries (RADAR): the project protocol.

    Science.gov (United States)

    Eurich, Dean T; Majumdar, Sumit R; Wozniak, Lisa A; Soprovich, Allison; Meneen, Kari; Johnson, Jeffrey A; Samanani, Salim

    2017-02-06

    Type-2 diabetes rates in First Nations communities are 3-5 times higher than the general Canadian population, resulting in a high burden of disease, complications and comorbidity. Limited community nursing capacity, isolated environments and a lack of electronic health records (EHR)/registries lead to a reactive, disorganized approach to diabetes care for many First Nations people. The Reorganizing the Approach to Diabetes through the Application of Registries (RADAR) project was developed in alignments with federal calls for innovative, culturally relevant, community-specific programs for people with type-2 diabetes developed and delivered in partnership with target communities. RADAR applies both an integrated diabetes EHR/registry system (CARE platform) and centralized care coordinator (CC) service that will support local healthcare. The CC will work with local healthcare workers to support patient and community health needs (using the CARE platform) and build capacity in best practices for type-2 diabetes management. A modified stepped wedge controlled trial design will be used to evaluate the model. During the baseline phase, the CC will work with local healthcare workers to identify patients with type-2 diabetes and register them into the CARE platform, but not make any management recommendations. During the intervention phase, the CC will work with local healthcare workers to proactively manage patients with type-2 diabetes, including monitoring and recall of patients, relaying clinical information and coordinating care, facilitated through the shared use of the CARE platform. The RE-AIM framework will provide a comprehensive assessment of the model. The primary outcome measure will be a 10% improvement in any one of A1c, BP, or cholesterol over the baseline values. Secondary endpoints will address other diabetes care indicators including: the proportion of clinical measures completed in accordance with guidelines (e.g., foot and eye examination, receipt of

  6. Patterns of unmet supportive needs and relationship to quality of life in Chinese cancer patients.

    Science.gov (United States)

    Zhu, Lei; Yao, Juntao; Schroevers, Maya J; Zhang, Hongmei; Xie, Juan; Liu, Ailan; Fleer, Joke; Ranchor, Adelita V; Song, Zhangjun

    2017-09-05

    This study aimed to (1) identify distinct patterns of unmet needs in Chinese cancer patients; (2) examine whether socio-demographic and medical characteristics distinguished these patterns; and (3) examine whether people with distinct patterns reported differential Quality of Life (QoL). This cross-sectional study recruited 301 cancer patients from two hospitals in China. The 34-item Supportive Care Needs Survey Short-Form was used to measure unmet needs across five domains: physical and daily living, psychological, patient care and support, health systems and information, and sexuality. Latent class analysis was performed to identify patterns of unmet needs across these domains. Four patterns of unmet needs were identified, differing in levels and nature of unmet needs. Participants in Class 1 (47%) reported few unmet needs. Patients in Class 2 (15%) had moderate levels of unmet needs, displaying similar levels across five domains. People in Class 3 (25%) and Class 4 (13%) reported similarly high levels on "psychological", "health care system and information", "physical and daily living" and "patient care", but differing in "sexuality", with Class 3 reporting low levels while Class 4 high on "sexuality". None of socio-demographic and medical characteristics distinguished these patterns significantly. Compared to other classes, people in Class 1 reported highest levels of QoL. This study demonstrates the existence of four patterns of unmet supportive needs in Chinese cancer patients. Patients with few unmet needs reported the best QoL. This article is protected by copyright. All rights reserved.

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

    Science.gov (United States)

    Graziottin, A

    2015-01-01

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

  8. Welcome Address

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  9. Inaugural address

    Science.gov (United States)

    Joshi, P. S.

    2014-03-01

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

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

    Science.gov (United States)

    Tan, Seok Hong

    2015-11-01

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

  11. Does screening for distress efficiently uncover meetable unmet needs in cancer patients?

    NARCIS (Netherlands)

    van Scheppingen, C.; Schroevers, M.J.; Smink, Ans; van der Linden, Y.M.; Mul, V.E.; Langendijk, J.A.; Coyne, J.C.; Sanderman, R.

    2011-01-01

    Objectives: We evaluated screening for distress in terms of its ability to uncover unmet need for psychosocial services in cancer patients. Correlates of distress, need for services and met and unmet need for services were investigated. Methods: Immediately after cancer treatment (T1) and 2 months l

  12. Problems and unmet needs of patients discharged "home to self-care".

    NARCIS (Netherlands)

    Holland, D.E.; Mistiaen, P.; Bowles, K.H.

    2011-01-01

    Purpose of Study: The purpose of this study was to determine the extent to which patients discharged "home to self care" experienced problems and unmet needs. A secondary aim was to explore potential differences in problems and unmet needs between medical and surgical patients. Primary Practice Sett

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

    DEFF Research Database (Denmark)

    Veloso, Astrid Gisèle; Sperling, Cecilie; Holm, Lise Vilstrup

    2013-01-01

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

  14. Presidential address.

    Science.gov (United States)

    Vohra, U

    1993-07-01

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

  15. Unmet needs and research challenges for late-life mood disorders.

    Science.gov (United States)

    Ghio, Lucio; Vaggi, Marco; Amore, Mario; Ferrannini, Luigi; Natta, Werner

    2014-04-01

    Mood disorders are common and often under-recognised in older people whereby, together with the general ageing of the population, they are becoming a significant and growing public health problem worldwide. However, the need to address the problem of late life mood disorders in a real-world setting is met with a surprising lack of strong evidence in this field. Randomised clinical trials which focus on elderly mood disorders are not very common and the majority of them focus on pharmacological treatment of major depression. The aim of this study was to review first the main unmet needs and research challenges in late-life mood disorders as a basis to then review the state of the art evidence resulting from randomised clinical trials and the main critical aspects of their implementation. Comorbidity as well as polypharmacy, cognitive decline, unpredictable placebo response, and uncertainty on optimal duration of trials are some of the challenges the investigator has to address. Moreover, some methodological limitations of randomised clinical trials reduce the applicability of the results of such studies to common clinical practices and have encouraged some authors to investigate the existence of possible alternative research designs such as pragmatic randomised clinical trials.

  16. Welcome Address

    Science.gov (United States)

    Kiku, H.

    2014-12-01

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

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

    Science.gov (United States)

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

    2016-07-01

    While community-based mental health services play an important role in caring for persons with HIV (human immunodeficiency virus) and co-existing mental health disorders, the extent to which their support needs are addressed in this setting is unknown. Accordingly, we examined if HIV infection was associated with unmet support needs among men living with and without HIV receiving community mental health care. This cross-sectional study examined 215 men (135 living with HIV and 80 without HIV) receiving case management services in urban Ontario. Using the Camberwell Assessment of Need, we ascertained the prevalence of support needs in 13 domains grouped into three clusters: Basic needs (accommodation, food, benefits, and money management); self-care/functional needs (daytime activities, self-care, and looking after the home); and health/safety needs (physical, psychological distress, psychotic symptoms, safety to self, and safety to others). We used generalized estimating equations with a logit link to examine the association between HIV and unmet need in each domain. Compared to HIV-negative men, men with HIV were more likely to have mood and concurrent disorders, and intellectual and developmental disabilities. Following multivariable analyses, men with HIV had greater unmet needs related to food (odds ratio + 95% confidence interval: 9.36 (4.03, 21.75), p need domains]; psychological distress (OR: 2.39 (1.68, 3.41), p need in basic and health domains than HIV-negative men receiving such support. Further research is required to develop and evaluate interventions to best support community-dwelling persons with HIV and mental health disorders.

  18. Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

    Directory of Open Access Journals (Sweden)

    Cabral de Mello Meena

    2011-09-01

    Full Text Available Abstract Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for

  19. Opening address

    Science.gov (United States)

    Castagnoli, C.

    1994-01-01

    representation of the mole. Most of you, I presume, are neo-Pythagoreans, and consequently believe that a new definition and, maybe, a new realization of the unit of mass will be based on a number of atoms of silicon, a view which will certainly lead you to cross swords with the "electrical party". The importance of NA is also linked to the considerable and far-reaching return in other scientific and industrial fields. Finally, let me add that, ethically, the work of many persons all over the world and the money and energy they spend in order to add a decimal figure, may be an example of commitment to be given to our students. Last but not least, my warm thanks to the Director of the Istituto di Metrologia "G Colonnetti", where the experiment has been in progress since 1971, and to all the researchers involved in this work. I do hope that the National Council of Research will continue to support this important project. While wishing you a pleasant stay in Turin, I express the hope that our meeting will prove a fruitful opportunity for discussion and exchange of views.

  20. Health promotion interventions and policies addressing excessive alcohol use: A systematic review of national and global evidence as a guide to health-care reform in China

    Science.gov (United States)

    Li, Qing; Babor, Thomas F.; Zeigler, Donald; Xuan, Ziming; Morisky, Donald; Hovell, Melbourne F.; Nelson, Toben F.; Shen, Weixing; Li, Bing

    2014-01-01

    Aims Steady increases in alcohol consumption and related problems are likely to accompany China's rapid epidemiologic transition and profit-based marketing activities. We reviewed research on health promotion interventions and policies to address excessive drinking and to guide health-care reform. Methods We searched in Chinese and English language databases and included 21 studies in China published between 1980 and 2013 that covered each policy area from the WHO Global Strategy to Reduce the Harmful Use of Alcohol. We evaluated and compared preventive interventions to the global alcohol literature for cross-national applicability. Results In contrast with hundreds of studies in the global literature, 11 of 12 studies from mainland China were published in Chinese; six of ten in English were on taxation from Taiwan or Hong Kong. Most studies demonstrated effectiveness in reducing excessive drinking, and some reported the reduction of health problems. Seven were randomized controlled trials. Studies targeted schools, drink-driving, workplaces, the health sector, and taxation. Conclusions China is the world's largest alcohol market, yet there has been little growth in alcohol policy research related to health promotion interventions over the past decade. Guided by a public health approach, the WHO Global Strategy, and health reform experience in Russia, Australia, Mexico, and the USA, China could improve its public health response through better coordination and implementation of surveillance and evidence-based research, and through programmatic and legal responses such as public health law research, screening and early intervention within health systems, and the implementation of effective alcohol control strategies. PMID:25533866

  1. National Strategies for Addressing Climate Change Via Methane Emissions%甲烷排放与应对气候变化国家战略探析

    Institute of Scientific and Technical Information of China (English)

    张博; 陈国谦; 陈彬

    2012-01-01

    甲烷的全球变暖潜势是二氧化碳的72倍(20年水平),但其在大气中的寿命短于二氧化碳,可以作为优先减排对象.中国的甲烷排放十分突出,甲烷减排在应对气候变化国家战略中具有重要的基础性地位,然而在政策研究中,甲烷受到的关注程度远低于二氧化碳.本文基于甲烷排放研究的相关进展,首次系统性地论述了中国甲烷排放与应对气候变化国家战略之间的关系.主要结论是:甲烷排放的有效控制和减缓可以成为中国温室气体减排的重要组成部分,甲烷等温室气体的减排战略要用“系统减排”思路替代传统的“末端减排”思路;甲烷系统减排的策略和实施措施不仅需要重视主要排放部门(如煤炭开采与洗选业,农业)的直接末端减排,更需要突出强调建设活动、城市消费、资本投资和出口贸易等消费端的间接体现减排;在国际气候谈判中通过纳入甲烷排放,可以至少在五个方面丰富和支撑中国的国家立场,如从承诺“单位GDP二氧化碳减排”向承诺“单位GDP温室气体减排”转变.%Methane (CH4) is a potent greenhouse gas with the global warming potential 72 times greater than that of CO2 over a horizon of 20 years, though it remains in the atmosphere for a much shorter period. Stabilizing methane emissions as a potential policy target can dramatically contribute to greenhouse gas reduction in the near-term. Methane emission in China is remarkably important, which plays an important role in the making of national strategies for addressing climate change. In contrast with the ever-increasing focus for China's CO2 emission, policy research on CH4 emission receives relatively little attention. This study represents the first comprehensive effort to assess China's national strategies for addressing climate change by considering CH4 emission systematically based on the recent research progress. The main conclusions are as

  2. The stroke caregiver unmet resource needs scale: development and psychometric testing.

    Science.gov (United States)

    King, Rosemarie B; Hartke, Robert J; Lee, Jungwha; Raad, Jason

    2013-12-01

    The purposes of this study were to develop and validate a measure of unmet resource needs of the caregivers of survivors of stroke and to describe the caregivers' unmet needs during 1 year. A longitudinal, descriptive design was used to test the reliability and validity of the Unmet Resource Needs (URN) measure. Item development was based on literature review and preliminary study findings. A stress and coping conceptual model framed the hypotheses. Psychometric testing was based on 6-month postdischarge data (n = 166). Content and structural construct validity, internal consistency reliability through 1 year, and concurrent validity were tested. Change in URN over time was examined. Content validity was supported by floor and ceiling effects less than 5%. Principal axis factoring yielded a 12-item, two-factor solution reflecting general and technology unmet needs. Internal consistency reliability was satisfactory for the total scale and subscales at all times, excepting the baseline three-item technology scale (α = .56). Concurrent validity was supported by significant correlations with model constructs (threat, positive problem solving, depression, preparedness; p < .01) in the expected direction. Functional status and resource use were not associated with the URN. Repeated measures analysis of variance (n = 123) indicated a significant decrease in unmet needs from baseline to 3, 6, and 12 months postdischarge (p < .001). Nevertheless, 42% reported one or more unmet needs at year 1. Assessment and counseling on unmet needs is indicated throughout the caregiving trajectory to reduce negative outcomes.

  3. Unmet health, welfare and educational needs of disabled children in an impoverished South African peri-urban township.

    Science.gov (United States)

    Saloojee, G; Phohole, M; Saloojee, H; IJsselmuiden, C

    2007-05-01

    Childhood disability in South Africa has failed to receive adequate attention from governmental agencies, such as the health, education and social welfare departments, despite there being more than 1 million disabled children in the country. This study sought to assess the unmet rehabilitation, education and welfare needs of disabled children living in a peri-urban township. As no register of disabled children existed, snowball sampling was used to recruit a convenience sample of 156 disabled children living in Orange Farm township near Soweto, South Africa. Children's impairments, their health and educational needs, and the availability and utilization of services were assessed using a structured interview. Few disabled children attended pre-school (35%) or school (44%). Only a quarter (26%) of children in need of rehabilitation received such services. Children with motor impairments were more likely to receive rehabilitation than those with intellectual impairment (44% vs. 8%, P children entitled to a social assistance grant were receiving it. Lack of money, limited awareness about available services, and bureaucratic obstacles were the main reasons offered by caregivers for the low utilization of available services and resources. Children with disabilities living in Orange Farm are not enjoying the rights and services to which they are entitled. Innovative, co-ordinated service delivery strategies, and better-informed caregivers combined with community recognition of, and support for, the needs of disabled children are required to address these unmet needs.

  4. The long-term outcomes and unmet needs of a cohort of former long-stay patients in Melbourne, Australia.

    Science.gov (United States)

    Chopra, Prem; Herrman, Helen E

    2011-10-01

    Former long-stay patients with psychotic disorders have significant unmet needs. This study assessed the long-term outcomes for the original cohort of 18 residents of the Footbridge Community Care Unit (CCU), a residential psychiatric rehabilitation unit at St Vincent's Mental Health Melbourne. A review of case records and interviews were conducted for each member of the cohort 8 years after admission to the CCU. Members of the cohort were living in a variety of settings after discharge from the CCU. Despite significant gains during the period of residential rehabilitation in the CCU after hospital discharge, by the time of follow-up individuals were in general leading restricted lives characterised by a lack of stable residential and social supports. Most reported positively on the support provided in the CCU although later experiences of moving repeatedly from one setting to another were adverse. Five key unmet needs were identified: promotion of independence; stability in accommodation; stability in social networks; consistency of care; and addressing the theme of loss. A longitudinal perspective in management that focuses on stability in residential care is required for long-stay patients.

  5. Achievements, challenges and unmet needs for haemophilia patients with inhibitors

    Science.gov (United States)

    DARGAUD, Y.; PAVLOVA, A.; LACROIX-DESMAZES, S.; FISCHER, K.; SOUCIE, M.; CLAEYSSENS, S.; SCOTT, D.W.; d’OIRON, R.; LAVIGNE-LISSALDE, G.; KENET, G.; ETTINGSHAUSEN, C. ESCURIOLA; BOREL-DERLON, A.; LAMBERT, T.; PASTA, G.; NÉGRIER, C.

    2016-01-01

    Summary Over the past 20 years, there have been many advances in haemophilia treatment that have allowed patients to take greater control of their disease. However, the development of factor VIII (FVIII) inhibitors is the greatest complication of the disease and a challenge in the treatment of haemophilia making management of bleeding episodes difficult and surgical procedures very challenging. A meeting to discuss the unmet needs of haemophilia patients with inhibitors was held in Paris on 20 November 2014. Topics discussed were genetic and non-genetic risk factors for the development of inhibitors, immunological aspects of inhibitor development, FVIII products and inhibitor development, generation and functional properties of engineered antigen-specific T regulatory cells, suppression of immune responses to FVIII, prophylaxis in haemophilia patients with inhibitors, epitope mapping of FVIII inhibitors, current controversies in immune tolerance induction therapy, surgery in haemophilia patients with inhibitors and future perspectives for the treatment of haemophilia patients with inhibitors. A summary of the key points discussed is presented in this paper. PMID:26728503

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

    LENUS (Irish Health Repository)

    Quigley, E M M

    2012-02-03

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

  7. Factors associated with unmet needs in individuals with schizophrenia in Chile

    OpenAIRE

    Alvarado, Rubén; Torres González,Francisco; Schilling, Sara; Alvarado,Francisca; Domínguez, Carlos; Küstner,Berta Moreno; Aliste,Francisco

    2012-01-01

    OBJECTIVE: To evaluate the possible associations between different sociodemographic, clinical, and healthcare factors and the number of unmet needs among people being treated for schizophrenia. METHODS: The sample was made up of 141 subjects who were being treated at eight mental health service networks throughout Chile. Unmet need was assessed with the Camberwell Assessment of Need, which was specifically created for people with severe mental disorders. A multiple linear regression analysis ...

  8. The skin in autoimmune diseases-Unmet needs.

    Science.gov (United States)

    Kuhn, A; Landmann, A; Bonsmann, G

    2016-10-01

    Treatment of skin manifestations in systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and dermatomyositis (DM) is based on the results of only few randomized controlled trials. The first-line treatment for disfiguring and widespread cutaneous involvement in SLE is antimalarials, but some patients are therapy resistant. Recently, the monoclonal antibody belimumab was approved for SLE as an adjunct therapy for patients with autoantibody-positive disease who despite standard therapy show high disease activity, intolerance of other treatments, or an unacceptably high need for corticosteroids. However, a validated skin score has not been used to confirm the efficacy of belimumab on mucocutaneous manifestations. In SSc, another multi-systemic progressive disease, involvement of the lung, kidney, and the heart is frequently treated with corticosteroids and immunosuppressives, but therapeutic modalities for cutaneous lesions, such as skin sclerosis and digital ulcers, are limited. In the past years, treatment with the endothelin-receptor antagonist bosentan has been proven to reduce the occurrence of new digital ulcers in SSc patients but has no or limited effect on healing of digital ulcers. DM is an idiopathic autoimmune disease characterized by inflammation of the muscles and skin, which is treated with immunosuppressives. Corticosteroids are the first-line treatment for muscle involvement in DM, but skin lesions often flare by reduction or discontinuation. In summary, there is a high unmet need for new therapeutic strategies focusing on skin involvement in systemic autoimmune diseases. Therefore, innovative designs of randomized controlled trials with validated skin scores are warranted to develop new therapeutic strategies for patients with cutaneous manifestations.

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

    Science.gov (United States)

    Scholzel-Dorenbos, Carla J M; Meeuwsen, Els J; Olde Rikkert, Marcel G M

    2010-01-01

    To make an inventory of needs assessment instruments in dementia, to explore the interaction between unmet needs and health-related quality of life (HRQoL) and to relate these to the conceptual model of Maslow's Hierarchy of needs in order to design a dementia-specific model. Narrative review of literature on (measures of) needs of patients and caregivers and HRQoL determinants important in dementia. Relating these needs to individual goal setting instruments and Maslow's Hierarchy of needs model. The Camberwell Assessment of Needs for the Elderly (CANE) turns out to be a valid tool to assess needs of dementia patients, suitable for research and clinical use. The Carers' Needs Assessment for Dementia (CNA-D) is a valid instrument to assess needs of caregivers. Patients identified significantly fewer needs than (in)formal caregivers. The most important needs, that also determine large part of HRQoL, are need for information; support with regard to symptoms of dementia; social contact and company; and for health monitoring and safety. Goal attainment scaling in dementia is an important but not yet valid outcome measure, with only few data on feasibility in dementia patients. There are several instruments to assess needs of dementia patients and caregivers. Domains of unmet needs and HRQoL overlap. The Hierarchy Model of Needs in Dementia (HMND) offers a new theoretical framework to address the interplay between meeting of needs and improvement of HRQoL in dementia. By identifying unmet needs in dementia-research and focussing on unmet needs in dementia-care, much can be done to improve HRQoL.

  10. Addressing the challenges of cross-jurisdictional data linkage between a national clinical quality registry and government-held health data.

    Science.gov (United States)

    Andrew, Nadine E; Sundararajan, Vijaya; Thrift, Amanda G; Kilkenny, Monique F; Katzenellenbogen, Judith; Flack, Felicity; Gattellari, Melina; Boyd, James H; Anderson, Phil; Grabsch, Brenda; Lannin, Natasha A; Johnston, Trisha; Chen, Ying; Cadilhac, Dominique A

    2016-10-01

    To describe the challenges of obtaining state and nationally held data for linkage to a non-government national clinical registry. We reviewed processes negotiated to achieve linkage between the Australian Stroke Clinical Registry (AuSCR), the National Death Index, and state held hospital data. Minutes from working group meetings, national workshop meetings, and documented communications with health department staff were reviewed and summarised. Time from first application to receipt of data was more than two years for most state data-sets. Several challenges were unique to linkages involving identifiable data from a non-government clinical registry. Concerns about consent, the re-identification of data, duality of data custodian roles and data ownership were raised. Requirements involved the development of data flow methods, separating roles and multiple governance and ethics approvals. Approval to link death data presented the fewest barriers. To our knowledge, this is the first time in Australia that person-level data from a clinical quality registry has been linked to hospital and mortality data across multiple Australian jurisdictions. Implications for Public Health: The administrative load of obtaining linked data makes projects such as this burdensome but not impossible. An improved national centralised strategy for data linkage in Australia is urgently needed. © 2016 Public Health Association of Australia.

  11. Social Franchising: A Blockbuster to Address Unmet Need for Family Planning and to Advance Toward the FP2020 Goal.

    Science.gov (United States)

    2015-06-17

    Social franchising has scaled-up provision of voluntary family planning, especially long-acting reversible contraceptives, across Africa and Asia at a rapid and remarkable pace. The approach should be pursued vigorously, especially in countries with a significant private-sector presence, to advance the FP2020 goal of providing access to modern contraception to 120 million additional clients by 2020.

  12. 78 FR 3005 - Creating an Alternative Approval Pathway for Certain Drugs Intended to Address Unmet Medical Need...

    Science.gov (United States)

    2013-01-15

    ... requests to speak and will determine the amount of time allotted for each oral presentation, and the... the level of public participation. Attendance, Presentations, and Comments: Individuals who wish to..., fast- track designation), would this new pathway increase the therapeutic options for serious or...

  13. Precompetitive Data Sharing as a Catalyst to Address Unmet Needs in Parkinson’s Disease 1

    Science.gov (United States)

    Stephenson, Diane; Hu, Michele T.; Romero, Klaus; Breen, Kieran; Burn, David; Ben-Shlomo, Yoav; Bhattaram, Atul; Isaac, Maria; Venuto, Charles; Kubota, Ken; Little, Max A.; Friend, Stephen; Lovestone, Simon; Morris, Huw R.; Grosset, Donald; Sutherland, Margaret; Gallacher, John; Williams-Gray, Caroline; Bain, Lisa J.; Avilés, Enrique; Marek, Ken; Toga, Arthur W.; Stark, Yafit; Forrest Gordon, Mark; Ford, Steve

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Electric Power Research

    2007-11-01

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

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

    Science.gov (United States)

    Cornu, Christophe

    2016-01-01

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

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

    Science.gov (United States)

    Cornu, Christophe

    2016-01-01

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

  17. Unmet medical care and sexual health counseling needs-a cross-sectional study among university students in Uganda

    OpenAIRE

    Kyagaba, Emmanuel; Asamoah, Benedict Oppong; Emmelin, Maria; Agardh, Anette

    2014-01-01

    In 2010, unmet medical care and sexual health counseling needs were assessed among students at a Ugandan University. Unmet medical care need was associated with poor mental health, experience of sexual coercion, and poor self-rated health. Unmet sexual health counseling need was significantly associated with being female, coming from an urban area, low social participation, poor mental health status, experience of sexual coercion, poor self-rated health, inconsistent condom use, and having mu...

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

    Directory of Open Access Journals (Sweden)

    Isora Ramos Valle

    2010-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Supriya Satish Patil*, MP Durgawale and SR Patil

    2010-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Misnaniarti

    2016-06-01

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

  1. Unmet medical care and sexual health counseling needs-: a cross-sectional study among university students in Uganda.

    Science.gov (United States)

    Kyagaba, Emmanuel; Asamoah, Benedict Oppong; Emmelin, Maria; Agardh, Anette

    2014-08-01

    In 2010, unmet medical care and sexual health counseling needs were assessed among students at a Ugandan University. Unmet medical care need was associated with poor mental health, experience of sexual coercion, and poor self-rated health. Unmet sexual health counseling need was significantly associated with being female, coming from an urban area, low social participation, poor mental health status, experience of sexual coercion, poor self-rated health, inconsistent condom use, and having multiple sexual partners. Gender differences, poor mental health, sexual coercion, poor self-rated health, and risky sexual behavior must be considered when designing intervention models to reduce unmet health care needs among young people in this setting.

  2. Assessment of the Level of Satisfaction and Unmet Data Needs for Specialty Drug Formulary Decisions in the United States.

    Science.gov (United States)

    Choi, Yoonyoung; Navarro, Robert P

    2016-04-01

    Formulary management within a limited budget is critical, especially for specialty drugs, which are used for serious medical conditions and are very expensive. Despite attempts to summarize the pertinent evidence, it is uncertain whether data needs of formulary decision makers for specialty drugs are satisfied. To assess the level of satisfaction of specialty drug formulary decision makers with regards to the strength of current available data sources and unmet needs regarding clinical, economic, and unpublished evidence. This study targeted pharmacists and physicians involved with formulary decision making at health plans or pharmacy benefit management companies at the national, large regional, and local levels. 95 individuals were invited to participate (without compensation) in a 21-item, web-based survey (Qualtrics), which was open from June 14 to July 31, 2014. The responses were coded for descriptive and statistical analysis. Statistical analyses included the Kruskal-Wallis test, analysis of variance, and the Mann-Whitney-Wilcoxon test. Of 95 pharmacists or physicians, 40 respondents initiated the survey, and 33 respondents completed the survey (response rate = 34.7%). Drug formulary decision makers infrequently rated data evidence strength (17.1% "always"). Clinical data evidence strength was rated highest with published randomized controlled trials (RCTs; mean [SD] = 4.06 [0.87] of 5.0), while participant organizations' internal data were rated highest for economic data evidence strength (mean [SD] = 3.91 [1.07] of 5.0). Decision makers rated the highest unmet need as more data generated from head-to-head RCTs (mean [SD] = 2.94 [0.25] of 3.0) and cost-effectiveness analyses (mean [SD] = 2.53 [0.67] of 3.0). The participants believed manufacturers might be in the best position to satisfy their desire for head-to-head RCTs (mean [SD] = 4.31 [1.09] of 5.0). Despite a variety of data sources, drug formulary decision makers continue to rely on published RCTs or

  3. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Grace Mburu

    2017-01-01

    Full Text Available Background: Shortages of Human Resources for Health (HRH in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges.Aim: This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas.Setting: The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa.Methods: The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service. Qualitative data were collected from semi-structured interviews and analysed using thematic analysis.Results: Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas.Conclusion: South Africa’s HRH strategy for the Health Sector 2012/13–2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030

  4. Satisfaction with information and unmet information needs in men and women with cancer.

    Science.gov (United States)

    Faller, Hermann; Koch, Uwe; Brähler, Elmar; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Weis, Joachim; Boehncke, Anna; Hund, Bianca; Reuter, Katrin; Richard, Matthias; Sehner, Susanne; Szalai, Carina; Wittchen, Hans-Ulrich; Mehnert, Anja

    2016-02-01

    Information needs in cancer patients are high but often not fulfilled. This study aimed to examine the level of perceived information, information satisfaction, and unmet needs in a large sample of cancer patients. Further, we explored associations with emotional distress and quality of life accounting for gender. In a multicenter, cross-sectional study in Germany, 4020 cancer patients (mean age 58 years, 51 % women) were evaluated. We obtained self-reports of information level, information satisfaction, and unmet needs, measured depressive symptoms with the Patient Health Questionnaire (PHQ-9), symptoms of anxiety with the Generalized Anxiety Disorder Scale (GAD-7), and health-related quality of life with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Seventy-two to 88 % of participants reported to be well informed regarding various aspects of their disease, except of psychological support (38 %). However, unmet information needs were also prevalent in 36 to 48 %. Gender differences found were generally small. Although men felt less informed about psychological support, they expressed fewer needs for further information regarding this topic. Irrespective of gender, patients who were less satisfied with information received and had more unmet needs reported more anxiety, depression, and lower quality of life. Up to three quarters of those classified as most severely distressed reported unmet needs for information about psychological support. In this largest study to date, we found high levels of both information received and satisfaction with information, but also considerable amounts of unmet needs, particularly regarding psychological support. Provision of information about psychosocial support seems important to increase utilization of support offers among distressed cancer survivors.

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

    Directory of Open Access Journals (Sweden)

    Harsha M Solanki

    2013-03-01

    Full Text Available Objectives To compare met & unmet need groups of contraception with socio-economic, demographic, accessibility & family Planning (FP related factors. Methods Community based cross-sectional, comparative study was conducted among 363 married women of reproductive age groups in rural area selected by stratified simple random technique. After collecting preliminary information, the study population then divided into two groups based on their contraceptive use i.e. MET Group & UNMET NEED Groups. Then the role of socio-economic, demographic, accessibility & family Planning (FP related factors were studies to determine contraceptive use between these groups. Results Mean age of study subjects was 24.12 ± 4.45 years & average number of children per women was 2.02. Males were more literate than females (69.1% Vs 47.2%. 51.8% women were belonging to lower socio-economic status. Early marriages were still prevalent in this study (53.7%. Prevalence of met group of contraception was 59.2% & that of unmet need for contraception was 44.1%. Met groups were mainly from 20-29 years age group (46.6%; most of them (46.8% were literate & were from high socio-economic group (30.9% compared to unmet need groups. On comparison to unmet groups, most of the met group (33.9% got married after 18 years of age, residing within 5km area (26.4%, had visited to FP centre (49.0% & ever visited by FP staff (43.3%. Conclusion Education, income, marriage age, accessibility, FP staff related factors definitely has role among met & unmet need groups in their contraceptive use.

  6. Nurse's Desk: food bank-based outreach and screening to decrease unmet referral needs.

    Science.gov (United States)

    Larsson, Laura S; Kuster, Emilie

    2013-01-01

    The Nurse's Desk health screening project used the Intervention Wheel model to conduct outreach, screening, education, and referral for food bank clients (n = 506). Blood glucose, blood pressure, health care utilization, and unmet referral needs were assessed. Screening results identified 318 clients (62.8%) with 1 or more unmet referral needs, including 6 clients (3.16%) with capillary blood glucose more than 199 mg/dL and 132 (31.9%) with hypertension. Clients had higher-than-average systolic and diastolic blood pressures and undiagnosed diabetes than in the general population. A client-approved method for tracking completed referrals is needed for this potentially high-risk population.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    patients diagnosed between 1 October 2007 and 30 September 2008 was established. At 14 months following diagnosis participants completed a questionnaire including health-related quality of life (EORTC QLQ C-30), psychological distress (POMS-SF), and unmet needs with regard to physical, emotional, family-oriented......, sexual, work-related, and financial problems. Unmet needs were assessed through six ad hoc questions. Results. Questionnaires were received from 3439 of 4947 patients, resulting in a response rate of 70%. The three most frequent cancer types were breast (28.4%), prostate (14.6%) and colorectal cancer (15...

  8. The Children's Oral Health Initiative: An intervention to address the challenges of dental caries in early childhood in Canada's First Nation and Inuit communities.

    Science.gov (United States)

    Mathu-Muju, Kavita R; McLeod, James; Walker, Mary Lou; Chartier, Martin; Harrison, Rosamund L

    2016-08-15

    The objective of the Children's Oral Health Initiative (COHI) is to increase access to preventive oral health services provided to First Nations and Inuit (FN/I) children living on federal reserves and in remote communities. COHI targets preschool children; 5-7-year-olds; pregnant women; and parents/caregivers in FN/I communities. The program was piloted in 2004 by Health Canada and is potentially available to all FN/I communities. However, the community must consent to the program's implementation and agree to support a community member to be trained as a COHI aide. Dental therapists and hygienists screen eligible children, apply fluoride varnish and sealants to children's teeth, and stabilize active dental caries with glass ionomer. An innovation was the development of a community oral health worker, the COHI Aide. The COHI Aide is a community member who serves as an advocate for preventive oral health in the community and provides instruction to children, parent/caregivers and expectant mothers in preventing dental caries. COHI was piloted in 41 communities in 2004. By 2014, the program had expanded to 320 FN/I communities, which represents 55% of all eligible FN/I communities. In 2012, 23,085 children had received COHI preventive oral health services. The results demonstrate COHI's success as a preventive oral health care delivery model in remote communities. Implementation and delivery of preventive oral health services has been enhanced by the sustained presence of a community-based COHI Aide.

  9. Investigating unmet health needs in primary health care services in a representative sample of the Greek population.

    Science.gov (United States)

    Pappa, Evelina; Kontodimopoulos, Nick; Papadopoulos, Angelos; Tountas, Yannis; Niakas, Dimitris

    2013-05-17

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

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

    Directory of Open Access Journals (Sweden)

    Evelina Pappa

    2013-05-01

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

  11. Allegheny County Address Points

    Data.gov (United States)

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

  12. Allegheny County Address Points

    Data.gov (United States)

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

  13. Agriculture and Health Sectors Collaborate in Addressing Population Health.

    Science.gov (United States)

    Kaufman, Arthur; Boren, Jon; Koukel, Sonja; Ronquillo, Francisco; Davies, Cindy; Nkouaga, Carolina

    2017-09-01

    Population health is of growing importance in the changing health care environment. The Cooperative Extension Service, housed in each state's land grant university, has a major impact on population health through its many community-based efforts, including the Supplemental Nutrition Assistance Program - Education (SNAP-Ed) nutrition programs, 4-H youth engagement, health and wellness education, and community development. Can the agricultural and health sectors, which usually operate in parallel, mostly unknown to each other, collaborate to address population health? We set out to provide an overview of the collaboration between the Cooperative Extension Service and the health sector in various states and describe a case study of 1 model as it developed in New Mexico. We conducted a literature review and personally contacted states in which the Cooperative Extension Service is collaborating on a "Health Extension" model with academic health centers or their health systems. We surveyed 6 states in which Health Extension models are being piloted as to their different approaches. For a case study of collaboration in New Mexico, we drew on interviews with the leadership of New Mexico State University's Cooperative Extension Service in the College of Agricultural, Consumer and Environmental Sciences; the University of New Mexico (UNM) Health Science Center's Office for Community Health; and the personal experiences of frontline Cooperative Extension agents and UNM Health Extension officers who collaborated on community projects. A growing number of states are linking the agricultural Cooperative Extension Service with academic health centers and with the health care system. In New Mexico, the UNM academic health center has created "Health Extension Rural Offices" based on principles of the Cooperative Extension model. Today, these 2 systems are working collaboratively to address unmet population health needs in their communities. Nationally, the Cooperative Extension

  14. Commentary: How can family-based quasi-experimental designs and national registers be used to address confounding in risk factor studies of psychopathology? A reflection on Obel et al. (2016).

    Science.gov (United States)

    Larsson, Henrik

    2016-04-01

    Standard observational studies have reported a robust correlation between maternal smoking during pregnancy and risk of ADHD in offspring. In the accompanying article, Obel et al. used sibling-comparisons to explore the extent to which unmeasured familial confounding explains this association. This commentary highlights three important implications of the study. At a general level, Obel et al. illustrates how (1) family-based quasi-experimental designs and (2) national registers can be used to address confounding in risk factor studies of psychopathology. At a more specific level, the study suggests that maternal smoking during pregnancy is probably not a causal risk factor for ADHD.

  15. Unmet needs and health-related quality of life in young-onset dementia

    NARCIS (Netherlands)

    Bakker, C.; Vugt, M.E. de; Vliet, D. van; Verhey, F.; Pijnenburg, Y.A.; Vernooij-Dassen, M.J.; Koopmans, R.T.

    2014-01-01

    OBJECTIVES: Young-onset dementia (YOD) causes specific challenges and issues that are likely to affect health-related quality of life (HRQOL). This study explored patient and caregiver HRQOL and its association with unmet needs in YOD. METHODS: A cross-sectional design was used to study 215 communit

  16. Disparities in unmet dental need and dental care received by pregnant women in Maryland.

    Science.gov (United States)

    Singhal, Astha; Chattopadhyay, Amit; Garcia, A Isabel; Adams, Amy B; Cheng, Diana

    2014-09-01

    To examine prenatal dental care needs, utilization and oral health counseling among Maryland women who delivered a live infant during 2001-2003 and identify the factors associated with having a dental visit and having an unmet dental need during pregnancy. Pregnancy Risk Assessment Monitoring System is an ongoing population based surveillance system that collects information of women's attitudes and experiences before, during, and shortly after pregnancy. Logistic regression was used to model dental visits and unmet dental need using predictor variables for Maryland 2001-2003 births. Less than half of all women reported having a dental visit and receiving oral health advice during pregnancy. Twenty-five percent of women reported a need for dental care, of which 33 % did not receive dental care despite their perceived need. Multivariate modeling revealed that racial minorities, women who were not married and those with annual income dental visit. Women who were not married, had low annual income, were older than 40 years of age, had an unintended pregnancy and received prenatal care later than desired were most likely to have an unmet dental need during pregnancy. Despite reported needs and existing recommendations to include oral health as a component of prenatal care, less than half of pregnant women have a dental visit during their pregnancy. One-third of women with a dental problem did not have a dental visit highlighting the unmet need for dental care during pregnancy.

  17. Workplace accommodations and unmet needs specific to individuals who are deaf or hard of hearing.

    Science.gov (United States)

    Haynes, Scott; Linden, Maureen

    2012-09-01

    The purpose of this paper is to identify the workplace accommodations used by individuals who are deaf or hard of hearing, to report the perceived impact of the accommodations and to identify unmet needs with respect to workplace accommodations. Individuals who are deaf or hard of hearing participated in an online survey. Respondents identified with one of four levels of functional hearing ability and selected from descriptions of workplace accommodations. Each selection was ranked according to perceived importance, satisfaction and frequency of use. Respondents also commented on unmet needs. The most common accommodations were telephone aids (55%), co-worker helps (34%) and electronic communication (31%). Importance and frequency of use ranked high among most respondents (76% and 87%, respectively). However, perceived satisfaction ranked high among only 50% of respondents. The most common unmet needs were effective communication in groups and lack of co-worker support. Workplace accommodations are viewed as important and frequently used by individuals who are deaf or hard of hearing. However, satisfaction with the accommodations is marginal at best. Unmet needs remain in the areas of communication in meetings, support of co-workers and the development of a more universally accessible workplace environment.

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

    Science.gov (United States)

    Shooshtari, Shahin; Naghipur, Saba; Zhang, Jin

    2012-01-01

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

  19. Determinants of unmet need for contraception among Chinese migrants: a worksite-based survey

    NARCIS (Netherlands)

    Decat, P.; Zhang, W.-H.; Moyer, E.; Cheng, Y.; Wang, Z.-J.; Lu, C.-Y.; Wu, S.-Z.; Nadisauskiene, R.J.; Luchters, S.; Deveugele, M.; Temmerman, M.

    2011-01-01

    Background Considerable sexual and reproductive health (SRH) challenges have been reported among rural-to-urban migrants in China. Predictors thereof are urgently needed to develop targeted interventions. Study design A cross-sectional study assessed determinants of unmet need for contraception

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  2. Assessing needs for psychiatric treatment in prisoners: 2. Met and unmet need.

    Science.gov (United States)

    Jakobowitz, Sharon; Bebbington, Paul; McKenzie, Nigel; Iveson, Rachel; Duffield, Gary; Kerr, Mark; Killaspy, Helen

    2017-02-01

    In a companion paper, we established high levels of psychiatric morbidity in prisoners (Bebbington et al. Soc Psychiatry Psychiatr Epidemiol, 2016). In the current report, we evaluate how this morbidity translates into specific needs for treatment and the consequent implications for services. Mental health treatment needs and the extent to which they had been met were assessed in a representative sample of prisoners in a male and a female prison in London (Pentonville and Holloway). Prisoners were sampled at random in a sequential procedure based on the Local Inmate Data System. We targeted equal numbers of male remand, male sentenced, female remand, and female sentenced prisoners. Following structured assessment of psychosis, common mental disorders, PTSD, personality disorders and disorders of abuse, we used the MRC Needs for Care Assessment (NFCAS) to establish whether potential needs for care in ten areas of mental health functioning were met, unmet, or incapable of being met by services. Data on treatment experience were provided by 360 inmates. Eighty percent of females and 70% of males had at least one need for treatment. Over half (53.7%) of the needs of female prisoners were met, but only one third (36.5%) in males. Needs for medication were unmet in 32% of cases, while those for psychological treatment were unmet in 51%. Unmet needs for mental health treatment and care were common in the two prisons. This has adverse consequences both for individual prisoners and for the effective functioning of the criminal justice system.

  3. Cancer Disparities: Unmet Challenges in the Elimination of Disparities

    Science.gov (United States)

    Gehlert, Sarah; Colditz, Graham A.

    2012-01-01

    Background The first 20 years of publication of Cancer Epidemiology, Biomarkers & Prevention occurred during a period of increased attention to health disparities and advances in knowledge about their determinants. Yet, despite clear documentation of disparities and advanced understanding of determinants, we have made little headway in reducing disparities at the population level. Multilevel models, such as one produced by the Centers for Population Health and Health Disparities (CPHHD), hold promise for understanding the complex determinants of cancer disparities and their interactions as well as translating scientific discoveries into solutions. The CPHHD model maps across a range of scientific disciplines, from the biological to the social, each with its own disciplinary language and methods. The ability to work effectively across disciplinary boundaries is essential to framing comprehensive solutions. Methods After briefly characterizing the current state of knowledge about health disparities, we outline three major challenges faced by disparities researchers and practitioners and offer suggestions for addressing these challenges. Results These challenges are how to consider race and ethnicity in disparities research, how best to translate discoveries into public health solutions to cancer disparities, and how to create a research environment that supports the successful execution of multilevel research. Conclusions Attention to all three of the challenges outlined above is urgently needed to advance our efforts to eliminate cancer disparities. Impact Addressing the challenges outlined above will help to eliminate disparities in the future. PMID:21784956

  4. Opinion of doctors about unmet needs of rural diabetics

    Directory of Open Access Journals (Sweden)

    Rohit Dixit

    2016-02-01

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

  5. Links between depressive symptoms and unmet health and social care needs among older prisoners

    Science.gov (United States)

    O'Hara, Kate; Forsyth, Katrina; Webb, Roger; Senior, Jane; Hayes, Adrian Jonathan; Challis, David; Fazel, Seena; Shaw, Jenny

    2016-01-01

    Background: absolute numbers of older prisoners and their proportion of the total prison population are increasing. They have multiple health and social care needs that are prominent on entry into prison. No previous studies have identified older prisoners' health and social care needs at this crucial point. Objective: to examine unmet health and social care needs among older men entering prison and their links with depressive symptoms. Methods: a cross-sectional survey across nine prisons in the North of England was completed. One hundred male prisoners aged between 60 and 81 were interviewed, using the Camberwell Assessment of Need—Forensic short version (CANFOR-S) and Geriatric Depression Scale—Short Form (GDS-15). Descriptive statistics were generated and χ2 tests performed. Results: participants reported high levels of unmet needs as measured with the CANFOR-S, notably in the domains of knowledge about their condition and treatment (38%); psychological distress (34%); daytime activities (29%); benefits (28%); food (22%) and physical health (21%). The mean total number of unmet needs was 2.74, with a median of 2.0. More than half the sample (56%, 95% CI 45–66%) exhibited clinical signs of depression. A significant association between depressive symptomology and an unmet physical health need, as measured by the CANFOR-S, was detected (χ2 = 6.76, df = 1, P < 0.01). Conclusions: high levels of depressive symptoms were experienced by older prisoners on entry into prison. Personalised health and social care needs assessment and discrete depression screening are required on prison entry to facilitate effective management of unmet needs. PMID:26764402

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

    Science.gov (United States)

    Weaver, Donald F; Pohlmann-Eden, Bernd

    2013-05-01

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

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

    Science.gov (United States)

    Zenke, Larry L.

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

  8. Reach Address Database (RAD)

    Data.gov (United States)

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

  9. What is an address in South Africa?

    CSIR Research Space (South Africa)

    Coetzee, S

    2007-11-01

    Full Text Available numbers inside the security estate and therefore these addresses are not necessarily part of the municipal address database. If a person inside such a security estate wants to open a financial account, how can one verify that their address is valid? A... African addresses’, subsequently given the designation SANS 1883. The aim of the standard is not to devise a new system of addressing or to build a national address database, but rather to enable interoperability in address data sets and geographical...

  10. EAACI Food Allergy and Anaphylaxis Guidelines. Protecting consumers with food allergies: understanding food consumption, meeting regulations and identifying unmet needs.

    Science.gov (United States)

    Muraro, A; Hoffmann-Sommergruber, K; Holzhauser, T; Poulsen, L K; Gowland, M H; Akdis, C A; Mills, E N C; Papadopoulos, N; Roberts, G; Schnadt, S; van Ree, R; Sheikh, A; Vieths, S

    2014-11-01

    Individuals suffering from IgE-mediated food allergy usually have to practise life-long food allergen avoidance. This document aims to provide an overview of recent evidence-based recommendations for allergen risk assessment and management in the food industry and discusses unmet needs and expectations of the food allergic consumer in that context. There is a general duty of care on the food industry and obligations in European Union legislation to reduce and manage the presence of allergens alongside other food hazards. Current evidence enables quantification of allergen reference doses used to set-up reliable food safety management plans for some foods. However, further work is required to include a wider variety of foods and to understand the impact of the food matrix as well as additional factors which affect the progression and severity of symptoms as a function of dose. Major concerns have been raised by patients, carers and patient groups about the use of precautionary 'may contain' labelling to address the issue of unintended presence of allergens; these therefore need to be reconsidered. New and improved allergen detection methods should be evaluated for their application in food production. There is an urgent requirement for effective communication between healthcare professionals, patient organizations, food industry representatives and regulators to develop a better approach to protecting consumers with food allergies.

  11. The unmet need for safe abortion in Turkey: a role for medical abortion and training of medical students.

    Science.gov (United States)

    Mihciokur, Sare; Akin, Ayse; Dogan, Bahar Guciz; Ozvaris, Sevkat Bahar

    2015-02-01

    Abortion has been legal and safe in Turkey since 1983, but the unmet need for safe abortion services remains high. Many medical practitioners believe that the introduction of medical abortion would address this. However, since 2012 there has been political opposition to the provision of abortion services. The government has been threatening to restrict the law, and following an administrative change in booking of appointments, some hospital clinics that provided family planning and abortion services had to stop providing abortions. Thus, the availability of safe abortion depends not only on permissive legislation but also political support and the ability of health professionals to provide it. We conducted a study among university medical school students in three provinces on their knowledge of abortion and abortion methods, to try to understand their future practice intentions. Pre-tested, structured, self-administered questionnaires were answered by 209 final-year medical students. The students' level of knowledge of abortion and abortion methods was very low. More than three-quarters had heard of surgical abortion, but only 56% mentioned medical abortion. Although nearly 90% supported making abortion services available in Turkey, their willingness to provide surgical abortion (16%) or medical abortion (15%) was low, due to lack of knowledge. Abortion care, including medical abortion, needs to be included in the medical school curriculum in order to safeguard this women's health service. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  12. White spots in pharmaceutical pipelines-EMA identifies potential areas of unmet medical needs.

    Science.gov (United States)

    Papaluca, Marisa; Greco, Martina; Tognana, Enrico; Ehmann, Falk; Saint-Raymond, Agnès

    2015-05-01

    Unmet medical needs are a priority for organizations such as the WHO and major public-private initiatives, such as Innovative Medicines Initiative, were established to speed up the development of better and safer medicines for patients. To assist such projects, the EMA in its 'Road Map to 2015' considered the mapping of unmet medical needs as a priority. This study has identified medical conditions for which the EMA could not identify developments in the pharmaceutical pipelines, that is, 'white spots'. Our analysis was made using external data sources as well as mining data of the EMA. The main areas for white spots were oncology, infectious diseases and certain psychiatric conditions. According to our data and a review of literature, in a number of these white spots, diagnostic tools may even be missing. The identification of those conditions will benefit stakeholders, including regulators, research funding bodies and patients' organizations.

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

    DEFF Research Database (Denmark)

    Haustein, Sonja; Siren, Anu Kristiina

    2014-01-01

    Previous studies have come to different conclusions regarding how important a driving licence is for seniors to fulfil their mobility needs. We investigated this question based on three groups of Danish seniors: persons who were licensed as drivers (‘‘drivers’’); persons who have never been......, which were successively added to the models, health variables were most relevant, while socio-demographics and infrastructure played a minor role. When entering the health variables to the models, the effect of giving up a licence decreased but remained significant for unmet leisure needs, while...... it became insignificant for unmet shopping needs. The effect of never having had a licence was hardly affected by the inclusion of control variables. The results emphasise the importance of a driving licence in fulfilling seniors’ mobility needs. Contrary to our hypotheses, more experience with, and better...

  14. Habitual Sleep Duration, Unmet Sleep Need, and Excessive Daytime Sleepiness in Korean Adults

    OpenAIRE

    Hwangbo, Young; Kim, Won-Joo; Chu, Min Kyung; Yun, Chang-ho; Yang, Kwang Ik

    2016-01-01

    Background and Purpose Sleep need differs between individuals, and so the same duration of sleep will lead to sleep insufficiency in some individuals but not others. The aim of this study was to determine the separate and combined associations of both sleep duration and unmet sleep need with excessive daytime sleepiness (EDS) in Korean adults. Methods The participants comprised 2,769 Korean adults aged 19 years or older. They completed questionnaires about their sleep habits over the previous...

  15. Appreciation on Speech Made by the President in a National Address to America's School Children from Education Perspective%教育的视角:奥巴马2009年开学演讲赏析

    Institute of Scientific and Technical Information of China (English)

    壮国桢

    2011-01-01

    以美国总统巴拉克·奥巴马在2009年美国"开学日"对全美中小学生发表的电视演讲为例,从教育的视角分析了奥巴马以小见大、由近及远、由己及人的演讲风格和亲近感、幽默感、激励性的语言特色。%Based on the perspective of education,this paper analyzes the language features of the remarks by the president in a national address to America's school children,which shows Obama's speaking style,sense of intimacy,sense of humor and sense of motivating.

  16. Unmet social needs and teenage pregnancy in Ogbomosho, South-western Nigeria.

    Science.gov (United States)

    Salami, Kabiru K; Ayegboyin, Matthew; Adedeji, Isaac A

    2014-12-01

    Consistent high teenage pregnancy rates in South-western Nigeria are characteristically underpinned by the unmet social needs of the teenagers. To elicit intergenerational views on the influence of unmet social needs on teenage pregnancy. Through a descriptive and cross-sectional design, a total of 174 respondents who were either pregnant teenagers, teenage mothers during the survey or had been pregnant as teenagers, were interviewed, using questionnaire supplemented with 12 key informant interviews. With the mean age of 16.5 years, and educational status range of between primary and below (25.8%) and tertiary (9.8%) levels, only 39.7% respondents were married, about half (47.7%) remained single while others were separated (12.6%). Less than half (44.9%) of the respondents were engaged in occupational activities. The unmet material and financial supports expected from parents (43.1%), the lack of free education from government up till secondary school level (51.2%), the lack of sex education and knowledge needs for signs of maturity (53.4%) and discouragement from friends not to have boyfriend (66.1%) prone teenagers to unplanned pregnancy. Promotion of sexual education and parental care is encouraged as strategy against unplanned pregnancy among teenagers.

  17. Nation

    DEFF Research Database (Denmark)

    Østergaard, Uffe

    2014-01-01

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

  18. Unmet adolescent and young adult cancer survivors information and service needs: A population-based cancer registry study

    Science.gov (United States)

    Keegan, Theresa H.M.; Lichtensztajn, Daphne Y.; Kato, Ikuko; Kent, Erin E.; Wu, Xiao-Cheng; West, Michelle M.; Hamilton, Ann S.; Zebrack, Brad; Bellizzi, Keith M.; Smith, Ashley W.

    2012-01-01

    Purpose We described unmet information and service needs of adolescent and young adult (AYA) cancer survivors (15-39 years of age) and identified sociodemographic and health-related factors associated with these unmet needs. Methods We studied 523 AYAs recruited from 7 population-based cancer registries, diagnosed with acute lymphocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, germ cell cancer or sarcoma in 2007-08. Participants completed surveys a median of 11 months from diagnosis. Multivariable logistic regression analyses were used to estimate associations between unmet (information and service) needs and sociodemographic and health-related factors. Results More than half of AYAs had unmet information needs relating to their cancer returning and cancer treatments. AYAs needing services, but not receiving them, ranged from 29% for in-home nursing to 75% for a support group. The majority of AYAs who needed a pain management expert, physical/occupational therapist, mental health worker or financial advice on paying for health care did not receive services. In multivariable analyses, older participants, men, participants of non-White race/ethnicity, and participants who reported less than excellent general health, or fair/poor quality of care were more likely to report unmet information needs. Factors associated with both unmet service and information needs included physical health or emotional problems interfering with social activities or having ≥ 3 physical treatment-related symptoms. Conclusions Recently diagnosed AYA cancer survivors have substantial unmet information needs varying by demographic and health-related factors. Implications for Cancer Survivors We identified subgroups of AYA cancer survivors with high unmet needs that can be targeted for interventions and referrals. PMID:22457219

  19. Fear, opposition, ambivalence, and omission: Results from a follow-up study on unmet need for family planning in Ghana.

    Science.gov (United States)

    Staveteig, Sarah

    2017-01-01

    Despite a relatively strong family planning program and regionally modest levels of fertility, Ghana recorded one of the highest levels of unmet need for family planning on the African continent in 2008. Unmet need for family planning is a composite measure based on apparent contradictions between women's reproductive preferences and practices. Women who want to space or limit births but are not using contraception are considered to have an unmet need for family planning. The study sought to understand the reasons behind high levels of unmet need for family planning in Ghana. A mixed methods follow-up study was embedded within the stratified, two-stage cluster sample of the 2014 Ghana Demographic and Health Survey (GDHS). Women in 13 survey clusters who were identified as having unmet need, along with a reference group of current family planning users, were approached to be reinterviewed within an average of three weeks from their GDHS interview. Follow-up respondents were asked a combination of closed- and open-ended questions about fertility preferences and contraceptive use. Closed-ended responses were compared against the original survey; transcripts were thematically coded and analyzed using qualitative analysis software. Among fecund women identified by the 2014 GDHS as having unmet need, follow-up interviews revealed substantial underreporting of method use, particularly traditional methods. Complete postpartum abstinence was sometimes the intended method of family planning but was overlooked during questions about method use. Other respondents classified as having unmet need had ambivalent fertility preferences. In several cases, respondents expressed revised fertility preferences upon follow-up that would have made them ineligible for inclusion in the unmet need category. The reference group of family planning users also expressed unstable fertility preferences. Aversion to modern method use was generally more substantial than reported in the GDHS

  20. Unmet information needs and limited health literacy in newly diagnosed breast cancer patients over the course of cancer treatment.

    Science.gov (United States)

    Halbach, Sarah Maria; Ernstmann, Nicole; Kowalski, Christoph; Pfaff, Holger; Pförtner, Timo-Kolja; Wesselmann, Simone; Enders, Anna

    2016-09-01

    To investigate unmet information needs in newly diagnosed breast cancer patients over the course of cancer treatment and its association with health literacy. We present results from a prospective, multicenter cohort study (PIAT). Newly diagnosed breast cancer patients (N=1060) were surveyed directly after breast cancer surgery, 10 and 40 weeks later. Pooled linear regression modeling was employed analyzing changes in unmet information needs over time and its association with health literacy. Unmet information needs on side effects and medication and medical examination results and treatment options were high and increased during the first 10 weeks after breast cancer surgery. Considering health promotion and social issues, unmet information needs started high and decreased during post-treatment. Patients with limited health literacy had higher unmet information needs. Our results indicate a mismatch in information provision and breast cancer patients' information needs. Patients with limited health literacy may be at a distinct disadvantage in having their information needs met over the course of breast cancer treatment. Strategies are needed to reduce unmet information needs in breast cancer patients considering treatment-phase and health literacy and thereby enable them to better cope with their diseases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. 46 CFR 67.113 - Managing owner designation; address; requirement to report change of address.

    Science.gov (United States)

    2010-10-01

    ... change of address. The owner of each vessel must designate a managing owner on the Application for...) Whenever the address of the managing owner changes, the managing owner shall notify the Director, National... 46 Shipping 2 2010-10-01 2010-10-01 false Managing owner designation; address; requirement to...

  2. The Value of Addressing Patient Preferences.

    Science.gov (United States)

    Allen, Jeff D; Stewart, Mark D; Roberts, Samantha A; Sigal, Ellen V

    2017-02-01

    Recent scientific progress is, in some cases, leading to transformative new medicines for diseases that previously had marginal or even no treatment options. This offers great promise for people affected by these diseases, but it has also placed stress on the health care system in terms of the growing cost associated with some new interventions. Effort has been taken to create tools to help patients and health care providers assess the value of new medical innovations. These tools may also provide the basis for assessing the price associated with new medical products. Given the growing expenditures in health care, value frameworks present an opportunity to evaluate new therapeutic options in the context of other treatments and potentially lead to a more economically sustainable health care system. In summary, the contribution to meaningful improvements in health outcomes is the primary focus of any assessment of the value of a new intervention. A component of such evaluations, however, should factor in timely access to new products that address an unmet medical need, as well as the magnitude of that beneficial impact. To achieve these goals, value assessment tools should allow for flexibility in clinical end points and trial designs, incorporate patient preferences, and continually evolve as new evidence, practice patterns, and medical progress advance.

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

    Directory of Open Access Journals (Sweden)

    Natalia eJorquera

    2015-04-01

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

  4. Primary care physician assistant and advance practice nurses roles: Patient healthcare utilization, unmet need, and satisfaction.

    Science.gov (United States)

    Everett, Christine M; Morgan, Perri; Jackson, George L

    2016-12-01

    Team-based care involving physician assistants (PAs) and advance practice nurses (APNs) is one strategy for improving access and quality of care. PA/APNs perform a variety of roles on primary care teams. However, limited research describes the relationship between PA/APN role and patient outcomes. We examined multiple outcomes associated with primary care PA/APN roles. In this cross-sectional survey analysis, we studied adult respondents to the 2010 Health Tracking Household Survey. Outcomes included primary care and emergency department visits, hospitalizations, unmet need, and satisfaction. PA/APN role was categorized as physician only (no PA/APN visits; reference), usual provider (PA/APN provide majority of primary care visits) or supplemental provider (physician as usual provider, PA/APN provide a subset of visits). Multivariable logistic and multinomial logistic regressions were performed. Compared to people with physician only care, patients with PA/APNs as usual providers [5-9 visits RRR=2.4 (CI 1.8-3.4), 10+ visits RRR=3.0 (CI 2.0-4.5): reference 2-4 visits] and supplemental providers had increased risk of having 5 or more primary care visits [5-9 visits RRR=1.3 (CI 1.0-1.6)]. Patients reporting PA/APN as supplemental providers had increased risk of emergency department utilization [2+ visits: RRR 1.8 (CI 1.3, 2.5)], and lower satisfaction [very dissatisfied: RRR 1.8 (CI 1.03-3.0)]. No differences were seen for hospitalizations or unmet need. Healthcare utilization patterns and satisfaction varied between adults with PA/APN in different roles, but reported unmet need did not. These findings suggest a wide range of outcomes should be considered when identifying the best PA/APN role on primary care teams. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Addressing Ozone Layer Depletion

    Science.gov (United States)

    Access information on EPA's efforts to address ozone layer depletion through regulations, collaborations with stakeholders, international treaties, partnerships with the private sector, and enforcement actions under Title VI of the Clean Air Act.

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

    Science.gov (United States)

    Dillahunt-Aspillaga, Christina; Jorgensen-Smith, Tammy; Ehlke, Sarah; Sosinski, Melanie; Monroe, Douglas; Thor, Jennifer

    2013-01-01

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

  7. Addressivity in cogenerative dialogues

    Science.gov (United States)

    Hsu, Pei-Ling

    2014-03-01

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

  8. The Unmet Activities of Daily Living (ADL Needs of Dependent Elders and their Related Factors: An Approach from Both an Individual- and Area-Level Perspective

    Directory of Open Access Journals (Sweden)

    Yi-Hui Liu

    2012-09-01

    Conclusion: Our results show that social welfare expenditure moderates unmet needs by provision of services, which means that the positive effect of social welfare services cannot be ignored; therefore, the government should play a supervisory role. In addition, the definition and measurement of unmet needs must be further clarified to assess accurately the prevalence of such needs, and further research should be undertaken on the adverse consequences of unmet needs.

  9. A Community Based Cross-Sectional Study to Assess the Unmet Need of Family Planning in Urban Slums and It's Determinants in Western Part of India

    Directory of Open Access Journals (Sweden)

    Beena H Patel

    2014-02-01

    Conclusions: unmet need was higher in more fertile age-group therefore program should focus more on this age-group. Female education contributes significantly in reduction of unmet need. By encouraging inter-spousal communication and male participation for family planning decision-making is important in bridging the gap between met and unmet need. [Natl J Med Res 2014; 4(1.000: 7-9

  10. Addressing the workforce pipeline challenge

    Energy Technology Data Exchange (ETDEWEB)

    Leonard Bond; Kevin Kostelnik; Richard Holman

    2006-11-01

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

  11. Unmet counselling need amongst women accessing an induced abortion service in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Birdsey, Graeme; Crankshaw, Tamaryn L; Mould, Sean; Ramklass, Serela S

    2016-11-01

    Provision of objective, evidence-based counselling in the context of induced abortion services is considered global good practise. However, there is limited understanding over the counselling needs of women accessing abortion services, particularly in sub-Saharan Africa. This study aimed to explore the content and quality of pre-abortion counselling amongst women accessing an abortion service in South Africa as well as client experience of the counselling process. Perceptions of nurse counsellors were also sought. This was a mixed methods study conducted at a Choice of Termination of Pregnancy clinic based at a district level hospital in KwaZulu-Natal, South Africa. Sixty women requesting an abortion were interviewed via a semi-structured questionnaire. In-depth interviews were conducted with four nurses who provided pre-abortion counselling at the clinic. Interviews were coded for emergent themes and categories. Clinic nurses had widely variable counselling training and experience, ranging from less than 2 months to 8 years, but all clients reported that they had been treated with respect at their counselling session. The group-based counselling format and biomedical and health promotion content did not accommodate clients' differential counselling needs, which included requests for support from women experiencing intimate partner violence (IPV). There was limited provider awareness of client's additional counselling needs. Abortion counselling services should be tailored to clients' differential counselling needs. Group-based counselling followed by optional one-on-one counselling sessions is one possible strategy to address unmet client need in South Africa. Provision of abortion provider training in IPV is recommended as well as establishment of referral pathways for women experiencing IPV. Paying attention to the differential counselling needs of women seeking an abortion should be a key component to the provision of abortion services. In this way, abortion

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    , social support and demographic factors at the time of surgery and four and eight months after diagnosis. Associations between demographic and clinical factors at baseline and unmet needs four and eight months after diagnosis were examined in logistic regression models. Results. The percentage of women......Abstract Integrated plans will be required to ensure care and rehabilitation for the growing number of cancer survivors. Information is lacking, however, about the extent to which patients' rehabilitation needs are being met, and characteristics of patients who experience unmet needs after...... their diagnosis and throughout the disease trajectory. Material and methods. Consecutive women with newly diagnosed breast cancer, undergoing surgery at the Breast Surgery Clinic, Rigshospitalet, Denmark, between 2008 and 2009 (N = 261), completed questionnaires on their unmet needs, anxiety, physical functioning...

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

    Science.gov (United States)

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

    2016-09-01

    To identify the factors associated with perceived unmet medical needs in human immunodeficiency virus (HIV)-infected adults, we analyzed the results from a series of city-wide cross-sectional surveys of HIV-infected adults living in Seoul, Korea. Multivariate logistic regression analysis was used to identify factors related to unmet medical needs. Among the 775 subjects included in the study, 15.4% had perceived unmet medical needs. Significant factors included age group (35-49 years; adjusted odds ratio [aOR], 1.80; 95% confidence interval [CI], 1.06-3.06), lower monthly income (aOR, 3.75 for the needs among HIV-infected adults.

  14. Effect of Family Wealth and Attitudes toward Unmet Need for Family Planning Among Fertile Couples in Makassar, South Sulawesi, Indonesia

    Directory of Open Access Journals (Sweden)

    Rahmawati Azis

    2016-04-01

    Full Text Available One of the problems generated by unmet need for family planning is the occurrence of unwanted pregnancies, that could impact on abortion. Unmet need for family planning affected by various factors, both from within and from outside the woman. This study aimed to analyze the influence of socio-demographic characteristics, knowledge and attitudes towards family planning unmet need in women of childbearing age couple in Makassar, South Sulawesi. This study is analytic observational research. Cross-sectional design was applied to take sample from a total of 246 spouses of fertile age of respondents, with Systematic Random Sampling technique. For bivariate test, analysis chi-square was applied and logistic regression analysis for multivariate analysis. Studies show that there is no correlation characteristics of socio-demographic variables, only the level of wealthy significantly related to the unmet need for family planning. poorest respondents and poorer levels of prosperity, risk unmet need for family planning is almost 3 times more than respondents with wealthy ≥middle level (OR = 2.451; 95% CI 1.302, 4.615. The tendency of mothers who have a negative attitude, unmet need for family planning is almost 22 time than mothers who have a positive attitude (OR = 21.934; 95%CI = 8.812, 54.596. To increase the awareness and participation of all government institutions and community agencies, including the cooperation and support of religious leaders. In an effort to disseminate family planning information in the context of religion, so that misconceptions about contraceptive use can be improved. Service increase and competence of health workers planning to create awareness and empower women, especially mothers of poor families, to make choices appropriate contraception.

  15. Determinants of unmet need for family planning among women in Urban Cameroon: a cross sectional survey in the Biyem-Assi Health District, Yaoundé.

    Science.gov (United States)

    Ajong, Atem Bethel; Njotang, Philip Nana; Yakum, Martin Ndinakie; Essi, Marie José; Essiben, Felix; Eko, Filbert Eko; Kenfack, Bruno; Mbu, Enow Robinson

    2016-01-20

    With the unacceptably high level of unmet need for family planning in Sub-Saharan Africa, reducing unmet need is paramount in the fight against the high levels of induced abortions, maternal and neonatal morbi-mortality. A clear understanding of the determinants of unmet need for family planning is indispensable in this light. The objective of this study was to determine the prevalence of unmet need for family planning in Urban Cameroon while identifying major determinants of unmet need among women in a union in Urban Cameroon. A community based cross sectional study was conducted from March 2015 to April 2015 during which 370 women in a union were recruited using cluster multistep sampling in the Biyem-Assi Health District, Yaounde. Data were collected using a pretested and validated questionnaire. Proportions and their 95% confidence intervals were calculated with the Westoff/DHS method used to estimate unmet need for family planning and the odds ratio used as measure of association with statistical significant threshold set at p-value ≤ 0.05. Of the 370 eligible women included, the mean age was 29.9 ± 6.8 years, and 61.1% were married. The prevalence of unmet need for family planning was 20.4 (16.4-24.8)% with 14.2 (11.2-18.7)% having an unmet need for spacing and 6.2 (3.6-8.7)% an unmet need for limiting. Husband's approval of contraception had a statistically significant protective association with unmet need (AOR = 0.52 [0.30-0.92], p = 0.023), and discussion about family planning within the couple had a highly statistically significant protective association with unmet need (AOR = 0.39 [0.21-0.69], p = 0.001). The major reason for non-use of contraception among women with unmet need was the fear of side effects. The prevalence of unmet need of family planning among women in the Biyem-Assi Health District remains high. Husband's approval of contraception and couples' discussion about family planning are two major factors to be considered when planning

  16. Historic Sites and National Register of Historic Places, National and State register of Historic Sites. Also maintained is a buffer of 500 feet from those historic sites. Data includes the site name, site address, and national or state registered., Published in 2011, 1:1200 (1in=100ft) scale, City of Emporia / Lyon County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Historic Sites and National Register of Historic Places dataset current as of 2011. National and State register of Historic Sites. Also maintained is a buffer of 500...

  17. Addressing mathematics & statistics anxiety

    OpenAIRE

    Kotecha, Meena

    2015-01-01

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

  18. Influence of comorbidity on cancer patients’ rehabilitation needs, participation in rehabilitation activities and unmet needs

    DEFF Research Database (Denmark)

    Holm, L.V.; Hansen, D.G.; Kragstrup, Jakob;

    2014-01-01

    PURPOSE: This study aims to investigate possible associations between cancer survivors' comorbidity status and their (1) need for rehabilitation, (2) participation in rehabilitation activities and (3) unmet needs for rehabilitation in a 14-month period following date of diagnosis. METHODS: We...... performed a population-based cohort study including incident cancer patients diagnosed from 1 October 2007 to 30 September 2008 in two regions in Denmark. Fourteen months after diagnosis, participants completed a questionnaire measuring different aspects and dimensions of rehabilitation. Individual...... information on comorbidity was based on hospital contacts from 1994 and until diagnosis, subsequently classified according to the Charlson comorbidity index. Logistic regression analyses were used to explore the association between comorbidity and outcomes for rehabilitation. Analyses were conducted overall...

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

    Directory of Open Access Journals (Sweden)

    Christina Dillahunt-Aspillaga

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

  20. Exploring the Unmet Needs of the Patient in the Outpatient Respiratory Medical Clinic

    DEFF Research Database (Denmark)

    Jensen, Lone Birgitte; Brinkkjær, Ulf; Larsen, Kristian

    2015-01-01

    Aim. Developing a theoretical framework explaining patients’ behaviour and actions related to unmet needs during interactions with health care professionals in hospital-based outpatient respiratory medical clinics. Background. The outpatient respiratory medical clinic plays a prominent role in many...... patients’ lives regarding treatment and counselling increasing the need for a better understanding of patients’ perspective to the counselling of the health care professionals. Design. The study is exploratory and based on Charmaz’s interpretation of grounded theory. Methods. The study included 65 field...... an adaptation or resistance behaviour, conceptualized as “fitting in” and “fighting back” behaviour, explaining the patients’ counterreactions to unrecognized needs during the medical encounter. Conclusion. Firstly this study allows for a better understanding of patients’ counterreactions in the time...

  1. Less reduction of psychosocial problems among adolescents with unmet communication needs.

    Science.gov (United States)

    Jager, Margot; Reijneveld, Sijmen A; Almansa, Josue; Metselaar, Janneke; Knorth, Erik J; De Winter, Andrea F

    2017-04-01

    Patient-professional communication has been suggested to be a major determinant of treatment outcomes in psychosocial care for children and adolescents. However, the mechanisms involved are largely unknown and no longitudinal studies have been performed. Our aim was, therefore, to assess over the course of 1 year, the impact of patient-centered communication on psychosocial problems of adolescents in psychosocial care, including the routes mediating this impact. We obtained data on 315 adolescents, aged 12-18 years, enrolled in child and adolescent social or mental health care. We assessed patient-centered communication by comparing the needs and experiences of adolescents with regard to three aspects of communication: affective quality, information provision, and shared decision-making. Changes in psychosocial problems comprised those reported by adolescents and their parents between baseline and 1 year thereafter. Potential mediators were treatment adherence, improvement of understanding, and improvement in self-confidence. We found a relationship between unmet needs for affective quality, information provision, and shared decision-making and less reduction of psychosocial problems. The association between the unmet need to share in decision-making and less reduction of psychosocial problems were partially mediated by less improvement in self-confidence (30 %). We found no mediators regarding affective quality and information provision. Our findings confirm that patient-centered communication is a major determinant of treatment outcomes in psychosocial care for adolescents. Professionals should be aware that tailoring their communication to individual patients' needs is vital to the effectiveness of psychosocial care.

  2. Unmet needs and treatment seeking in high users of mental health services: role of illness perceptions.

    Science.gov (United States)

    Broadbent, Elizabeth; Kydd, Robert; Sanders, Deanna; Vanderpyl, Jane

    2008-02-01

    A small number of patients tend to use a disproportionately high amount of mental health services. Understanding the needs and behaviours of this group is important in order to improve patient management. Few studies have investigated the role that patients' perceptions about their mental illness play in guiding coping responses and treatment seeking. The aim of the present study was to investigate how illness perceptions in high users of mental health services were related to unmet needs and treatment-seeking behaviours. A total of 203 high users of mental health services were interviewed using the Brief Illness Perception Questionnaire, the Camberwell Assessment of Need and the Drug Attitude Inventory, and were also asked to report the number of visits they had made to the general practitioner in the past year. District Health Board clinical staff completed the Camberwell Assessment of Need and the Global Assessment of Functioning for each user. More negative perceptions about mental illness were associated with higher ratings of unmet needs by both patients and staff. Negative perceptions were also related to poorer attitudes towards medication, and lower functioning. Perceptions about the personal ability to control the illness were consistently associated with better outcomes. Patients' causal attributions could be categorized as social, psychological, biological and behavioural. More frequent visits to the general practitioner were associated with perceptions of more severe symptoms, greater concern and higher emotional responses to the illness, and psychosocial causal attributions. Illness perceptions provide a framework to assess patients' ideas about severe mental illness and a means by which to identify maladaptive beliefs. Interventions targeted at changing these beliefs may encourage better self-management.

  3. Bioreactors addressing diabetes mellitus.

    Science.gov (United States)

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

    2014-11-01

    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor development and an ever increasing diagnosis rate of diabetes, this review aims to highlight bioreactor history and emerging bioreactor technologies used for diabetes-related cell culture and therapies.

  4. Addressing Software Security

    Science.gov (United States)

    Bailey, Brandon

    2015-01-01

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

  5. Addressing Climate Crisis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

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

  6. Addressing Climate Crisis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ivan Adanja

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

  8. Road Map to Address Cognitive Health

    Centers for Disease Control (CDC) Podcasts

    2014-06-09

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

  9. Identifying and addressing mental health risks and problems in primary care pediatric settings: a model to promote developmental and cultural competence.

    Science.gov (United States)

    Godoy, Leandra; Carter, Alice S

    2013-01-01

    Young children, particularly uninsured children of color, suffer from mental health disturbances at rates similar to older children and adults, yet they have higher rates of unmet needs. To address unmet needs, efforts to identify mental health problems in primary care pediatric settings have grown in recent years, thanks in large part to expanded screening efforts. Yet, health disparities in early detection remain. Enhancing understanding of how early childhood mental health problems can be identified and addressed within pediatric settings is an important and growing area of research. The authors draw on theoretical models from public health policy, health psychology, and child development, including health beliefs, help seeking, transtheoretical, motivation to change, and dynamic systems, to better understand and address challenges to and disparities in identifying and addressing mental health problems in pediatric settings. These theories have not previously been applied to early mental health screening and identification efforts. Developmental and sociocultural considerations are highlighted in an effort to address and reduce higher rates of unmet needs among young, uninsured children of color. © 2013 American Orthopsychiatric Association.

  10. Historic Sites and National Register of Historic Places, National and State register of Historic Sites. Also maintained is a buffer of 500 feet from those historic sites. Data includes the site name, site address, and national or state registered., Published in 2011, 1:1200 (1in=100ft) scale, City of Emporia/Lyon County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Historic Sites and National Register of Historic Places dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Published Reports/Deeds...

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

    Directory of Open Access Journals (Sweden)

    Levesque Jean-Frédéric

    2012-07-01

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

  12. Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience

    Directory of Open Access Journals (Sweden)

    Markus Larsson

    2016-03-01

    Full Text Available Background: Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited. Objective: To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality. Design: In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex. Results: Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7–5.7; OR 2.0, 95% CI: 1.3–3.0, respectively. Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1–4.8, exposure to sexual coercion (OR 2.6, 95% CI: 1.7–3.9, frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9–5.8, and number of sexual partners (OR 1.9, 95% CI: 1.04–3.3. The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1–8.5; AOR 2.8, 95% CI: 1.3–5.8 and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6–7.1; AOR 2.7, 95% CI: 1.4–5.4 persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking. Conclusions: These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of

  13. Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience.

    Science.gov (United States)

    Larsson, Markus; Ross, Michael W; Tumwine, Gilbert; Agardh, Anette

    2016-01-01

    Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited. To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality. In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex. Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7-5.7; OR 2.0, 95% CI: 1.3-3.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1-4.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.7-3.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9-5.8), and number of sexual partners (OR 1.9, 95% CI: 1.04-3.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1-8.5; AOR 2.8, 95% CI: 1.3-5.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6-7.1; AOR 2.7, 95% CI: 1.4-5.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking. These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental

  14. Envelopes: presidential address.

    Science.gov (United States)

    Drukker, B H

    1998-12-01

    The fabric of medical care has been altered during the past 2 decades. Initially this alteration was furtive but it rapidly escalated, producing change that will be irrevocable. Physicians, dedicated to caring for their patients, frequently were found struggling in the wake of the changes in the health care system. In most situations they found themselves swept aside from crucial decision making because of timidity, practice obligations, and absence of knowledge related to "medical business." With about 600 managed care operations in the United States, physicians can no longer afford to sit in the stands and just watch the play on the field. Participation is crucial and must be accompanied by additional learning, such as masters degrees in business administration or MBAs. This will allow the new players to read the playbook of business medicine. Although on-the-job training is possible, it usually has a slow learning curve as a result of diluting the new assignment with practice obligations. Despite these formidable challenges, physicians must enter the local, state, and national arenas and participate. Despite change and reaction to change, physicians have an irrevocable trust that cannot be withdrawn or overlooked. It has been earned and pervades every facet of our professional careers. The physician has an uncompromising duty and privilege to care for his or her patient in the highest and most ethical manner, a duty that will remain forever. This will never change!

  15. Addressing the labour shortage

    Energy Technology Data Exchange (ETDEWEB)

    Riemer, J. [Alberta Economic Development, Edmonton, AB (Canada)

    2005-07-01

    Labour shortages are an increasing concern for companies in Alberta, where the economy is booming. This presentation provided statistics on labour shortages and Alberta's labour force. Between 1995 and 2004, employment in Alberta increased by more than 433,000 jobs, and is predicted to grow, but the natural population increase in the province is only 19,600 per year. It is expected that by 2010, immigrants will account for all growth in Canada's labour force. By 2020, an additional $100 billion of capital will be invested in Alberta, which is competing for labour with every other industrialized economy in the world. This presentation included a series of graphs and charts depicting Canada's national unemployment rate by province; Alberta's unemployment rate; oil sands capital expenditure; regional workforce requirements; and new jobs in the oil sands industry from 1998 to 2010. Employment requirements by trade were also highlighted along with projected labour shortages in 16 different trades. The author recommended that better long-term labour supply and demand models are needed along with rationalization and streamlining of credentials systems. Other solutions to labour shortages may include the removal of barriers to interprovincial and foreign workers; education and training; enhanced productivity; industry collaboration; and maximization of the labour pool to include women and Aboriginal workers. tabs., figs.

  16. Analyzing the Messages of the State of the Union Address

    Science.gov (United States)

    Kissling, Mark T.; Martell, Christopher C.

    2014-01-01

    In the era of smartphones and 24-hour news networks, the State of the Union address is a major event. All national media outlets--in print, on television, on the Internet--report on the address, some almost exclusively in the days leading up to and after the speech. In this article, considering their experiences teaching about the address, and…

  17. Addressing psychiatric comorbidity.

    Science.gov (United States)

    Woody, G E; McLellan, A T; O'Brien, C P; Luborsky, L

    1991-01-01

    Research studies indicate that addressing psychiatric comorbidity can improve treatment for selected groups of substance-abusing patients. However, the chances for implementing the necessary techniques on a large scale are compromised by the absence of professional input and guidance within programs. This is especially true in public programs, which treat some of the most disadvantaged, disturbed, and socially destructive individuals in the entire mental health system. One starting point for upgrading the level of knowledge and training of staff members who work in this large treatment system could be to develop a better and more authoritative information dissemination network. Such a system exists in medicine; physicians are expected to read appropriate journals and to guide their treatment decisions using the data contained in the journals. Standards of practice and methods for modifying current practice are within the tradition of reading new facts, studying old ones, and comparing treatment outcome under different conditions with what is actually being done. No such general system of information-gathering or -sharing exists, particularly in public treatment programs. One of the most flagrant examples of this "educational shortfall" can be found among those methadone programs that adamantly insist on prescribing no more than 30 to 35 mg/day for all patients, in spite of the overwhelming evidence that these dose levels generally are inadequate. In some cases, program directors are unaware of studies that have shown the relationship between dose and outcome. In other cases, they are aware of the studies but do not modify their practices accordingly. This example of inadequate dosing is offered as an example of one situation that could be improved by adherence to a system of authoritative and systematic information dissemination. Many issues in substance abuse treatment do not lend themselves to information dissemination as readily as that of methadone dosing

  18. Unmet need of contraception: a critical juncture toward family planning goals.

    Science.gov (United States)

    Haldar, Dibakar; Saha, Indranil; Paul, Bobby; Mukherjee, Abhijit; Ray, Tapobrata Guha

    2013-01-01

    India is the first country in the world to implement a family planning program, and this program has succeeded in generating universal knowledge about family planning methods. In spite of this, there exists a wide gap between knowledge and acceptance of family planning methods reflecting an unmet need for contraception. Different communication channels used to disseminate knowledge like television, radio, and newspapers aim to change the family planning methods. Being a didactic method, these have the least potential to change the attitudes of the people. This article represents the tip of the iceberg of the fate arising out of incomplete information provided through mass media not supported by a formal family planning program. One primipara woman after getting pregnant took an emergency contraceptive pill and attended a clinic with vaginal bleeding, abdominal pain, and pallor. Ultimately she underwent suction evacuation and survived. This indicates that mass media should not be a substitute, but rather a supplement to the routine program of the health worker to promote contraception.

  19. Measuring household consumption and waste in unmetered, intermittent piped water systems

    Science.gov (United States)

    Kumpel, Emily; Woelfle-Erskine, Cleo; Ray, Isha; Nelson, Kara L.

    2017-01-01

    Measurements of household water consumption are extremely difficult in intermittent water supply (IWS) regimes in low- and middle-income countries, where water is delivered for short durations, taps are shared, metering is limited, and household storage infrastructure varies widely. Nonetheless, consumption estimates are necessary for utilities to improve water delivery. We estimated household water use in Hubli-Dharwad, India, with a mixed-methods approach combining (limited) metered data, storage container inventories, and structured observations. We developed a typology of household water access according to infrastructure conditions based on the presence of an overhead storage tank and a shared tap. For households with overhead tanks, container measurements and metered data produced statistically similar consumption volumes; for households without overhead tanks, stored volumes underestimated consumption because of significant water use directly from the tap during delivery periods. Households that shared taps consumed much less water than those that did not. We used our water use calculations to estimate waste at the household level and in the distribution system. Very few households used 135 L/person/d, the Government of India design standard for urban systems. Most wasted little water even when unmetered, however, unaccounted-for water in the neighborhood distribution systems was around 50%. Thus, conservation efforts should target loss reduction in the network rather than at households.

  20. Pricing Unmetered Irrigation Water under Asymmetric Information and Full Cost Recovery

    Directory of Open Access Journals (Sweden)

    Alban Lika

    2016-12-01

    Full Text Available The objective of this study is to define an efficient pricing scheme for irrigation water in conditions of unmetered water use. The study is based on a principal-agent model and identifies a menu of contracts, defined as a set of payments and share of irrigated area, able to provide incentives for an efficient use of the resource by maximizing social welfare. The model is applied in the case study of the Çukas region (Albania where irrigation water is not metered. The results demonstrate that using a menu of contracts makes it possible to define a second best solution that may improve the overall social welfare derived from irrigation water use compared with the existing pricing structure, though, in the specific case study, the improvement is small. Furthermore, the results also suggest that irrigation water pricing policy needs to take into account different farm types, and that appropriate contract-type pricing schemes have a potential role in providing incentives to farmers to make irrigation choices to the social optimum.

  1. Clinical roundtable monograph: unmet needs in the treatment of chronic lymphocytic leukemia: integrating a targeted approach.

    Science.gov (United States)

    O'Brien, Susan M; Furman, Richard R; Byrd, John C; Smith, Ashbel

    2014-01-01

    Chronic lymphocytic leukemia (CLL) is the most frequently diagnosed hematologic malignancy in the United States. Although several features can be useful in the diagnosis of CLL, the most important is the immunophenotype.Two staging systems--the Binet system and the Rai classification--are used to assess risk. After diagnosis, the first major therapeutic decision is when to initiate therapy, as a watchful waiting approach is often appropriate for patients with asymptomatic disease. Once a patient has met the criteria for treatment, the choice of therapy is the next major decision. Younger patients (<65 years) often receive more aggressive treatment that typically consists of cytotoxic chemotherapy. There is a great unmet need concerning treatment of older patients with CLL, who often present with more comorbid conditions that can decrease their ability to tolerate particular regimens. The current standard of care for older patients with CLL is rituximab plus chlorambucil. The concept of targeted agents is currently an area of intense interest in CLL. The Bruton’s tyrosine kinase inhibitor ibrutinib is the targeted agent that is furthest along in clinical development. It is associated with an overall survival rate of 83%. Idelalisib targets the phosphatidyl inositol 3-kinase and is under evaluation in pivotal trials. Targeted agents offer much promise in terms of efficacy, toxicity, and oral availability. They will change the management of patients with CLL.

  2. Clinical roundtable monograph: Unmet needs in the management of chronic myelogenous leukemia.

    Science.gov (United States)

    Jabbour, Elias J; Bixby, Dale; Akard, Luke P

    2012-12-01

    Approximately 5,000 cases of chronic myelogenous leukemia (CML) are diagnosed each year in the United States. The introduction of tyrosine kinase inhibitors (TKIs) has dramatically improved survival time for many CML patients. Current first-line treatment options include imatinib and the second-generation agents nilotinib and dasatinib. Second- and third-line agents include nilotinib, dasatinib, bosutinib, and the new agent ponatinib. Despite the effectiveness of TKIs, some patients develop resistance or intolerance to these agents. A number of mutations of the BCR-ABL gene have been identified and are associated with TKI resistance. Patients may benefit from switching to a second-line TKI, undergoing hematopoietic stem cell transplant, or receiving newly emerging agents. Although early response is associated with improved patient outcome, clinicians lack tests that can determine which patients will benefit from which therapies. To ensure adequate response, patients should be monitored by both polymerase chain reaction and cytogenetic analysis of the bone marrow. This roundtable monograph reviews key unmet needs in patients with CML related to disease management and treatment options.

  3. Nurses' burnout and unmet nursing care needs of patients' relatives in a Turkish State Hospital.

    Science.gov (United States)

    Tekindal, Benian; Tekindal, Mustafa Agah; Pinar, Gul; Ozturk, Filiz; Alan, Sumeyra

    2012-02-01

    One of the biggest problems of work life today is burnout. With burnout, satisfaction of clients and service givers reduces. In this study, burnout levels of nurses working in the internal, surgical and intensive care units of a university hospital and the unmet needs of the patients' relatives related to nursing care were investigated. In the study, 225 nurses and 222 relatives of patients constituted the sample group of this study. Three separate forms were used in the study, namely, Nurse and Patient Relative Identification Form, the Maslach Burnout Inventory and the Nursing Services Satisfaction Inventory. In the study, burnout levels of the nurses were found to be high. Conditions like younger ages, scarcity of experience in the profession, lower levels of education, having chosen the profession and the unit they work in not willingly and working in environments like intensive care increase the burnout and as a result, expectations of the relatives of patients from nursing care are not fully met. Some suggestions have been made to make some regulations to prevent the burnout of nurses and to increase the satisfaction of relatives.

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

    Directory of Open Access Journals (Sweden)

    Tetsuji Yamada

    2015-02-01

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

  5. Allergy in Hong Kong: an unmet need in service provision and training.

    Science.gov (United States)

    Chan, Y T; Ho, H K; Lai, Christopher K W; Lau, C S; Lau, Y L; Lee, T H; Leung, T F; Wong, Gary W K; Wu, Y Y

    2015-02-01

    Many children in Hong Kong have allergic diseases and epidemiological data support a rising trend. Only a minority of children will grow out of their allergic diseases, so the heavy clinical burden will persist into adulthood. In an otherwise high-quality health care landscape in Hong Kong, allergy services and training are a seriously unmet need. There is one allergy specialist for 1.5 million people, which is low not only compared with international figures, but also compared with most other specialties in Hong Kong. The ratio of paediatric and adult allergists per person is around 1:460 000 and 1:2.8 million, respectively, so there is a severe lack of adult allergists, while the paediatric allergists only spend a fraction of their time working with allergy. There are no allergists and no dedicated allergy services in adult medicine in public hospitals. Laboratory support for allergy and immunology is not comprehensive and there is only one laboratory in the public sector supervised by accredited immunologists. These findings clearly have profound implications for the profession and the community of Hong Kong and should be remedied without delay. Key recommendations are proposed that could help bridge the gaps, including the creation of two new pilot allergy centres in a hub-and-spoke model in the public sector. This could require recruitment of specialists from overseas to develop the process if there are no accredited allergy specialists in Hong Kong who could fulfil this role.

  6. The Proper Solution that Manage National Examinations to Divulge Lies in a Comprehensive Approach to Address Both the Symptoms and Root Causes%解决国考频泄题须标本兼治

    Institute of Scientific and Technical Information of China (English)

    沈文银

    2012-01-01

    The frequency releases of national examinations to divulge the topic, directly harm the social bottom "line, leak off righteousness, enlarge his discontent. Because lawlessness, attack strength, management accountability mechanism defect. Recommendations from the national level standard national examination industry, reform of the state examination management system, integration of national examination management and examination of various resources, perfecting the judicial discipline, accountability mechanism, accelerate national database construction, actively cultivate social examinations.%国考频泄题,直接伤害社会底线,泄掉了正气,放大了民怨,祸国殃民。原因在于法制缺失,打击不力,管理问责机制缺陷。建议从国家层面规范国家考试行业行为,改革国家考试管理机制,整合国家考试管理机构和各类考试资源,健全司法、纪检问责机制,加快国家题库建设,积极培育社会化考试。

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

    DEFF Research Database (Denmark)

    Søndergaard, Eva Gad; Grøne, Bettina Haastrup; Wulff, Christian Nielsen;

    2013-01-01

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

  8. Address Points, Addressing, Published in 2008, Taylor County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Address Points dataset, was produced all or in part from Orthoimagery information as of 2008. It is described as 'Addressing'. Data by this publisher are often...

  9. A systematic review of prevalence, disease characteristics and management of systemic lupus erythematosus in Australia: identifying areas of unmet need.

    Science.gov (United States)

    Nikpour, M; Bridge, J A; Richter, S

    2014-12-01

    Few epidemiological studies of systemic lupus erythematosus (SLE) have been conducted in Australia, and current management practice and levels of unmet need in this country are not well characterised. To perform a systematic literature review to identify Australia-specific information on SLE, particularly areas of unmet need. MEDLINE, EMBASE and the Cochrane Library were searched (1 January 1990 to 29 November 2013). All articles on prevalence, disease characteristics, management and outcomes of SLE in Australia were included. There is limited published information on SLE in Australia. Of 24 articles included, 18 described results from observational studies, three were narrative reviews, one was a clinical update, and two were medical education articles. In remote regions, SLE was reported to be more prevalent in Aboriginal Australians than non-Aboriginal Australians; information in urban populations is lacking. Asian Australians may be more affected by SLE than non-Asian Australians. Pregnancy outcomes may also be adversely affected. Many Australians with SLE may experience high levels of unmet need, including delayed diagnosis, ongoing symptoms, flares, depression/anxiety, sleeping difficulty and decreased quality of life. Published guidance on the SLE management in Australia is limited and dated. Published information on SLE in Australia is limited, but suggests that ethnicity may affect the prevalence and disease characteristics and that many Australians with SLE have unmet needs. Improvements in diagnosis, treatment and management are needed to alleviate these needs. Up-to-date guidance on the management of SLE would benefit healthcare professionals and patients. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

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

    Institute of Scientific and Technical Information of China (English)

    Wu Hailong

    2011-01-01

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

  11. Welfare work addressing immigrants and refugees

    DEFF Research Database (Denmark)

    Øland, Trine

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

  12. Professional health care use and subjective unmet need for social or emotional problems: a cross-sectional survey of the married and divorced population of Flanders

    Directory of Open Access Journals (Sweden)

    Colman Elien

    2012-11-01

    Full Text Available Abstract Background The high mental health care consumption rates of divorced singles may constitute a heavy burden on the public health care system. This raises the question of whether their higher health care use stems from a greater need, or whether there are other factors contributing to these high consumption rates. We examine both health care use and subjective unmet need (perceiving a need for care without seeking it because of social or emotional problems of the divorced singles, the repartnered divorcees, and the married. Moreover, we investigate how health care use and subjective unmet need relate to each other. Methods We conduct several gender specific logistic regressions employing data from the Divorce in Flanders Survey (N men = 2884; N women = 3317. Results Results show that the divorced singles have more contact with professional health care providers (general practitioners, psychiatrists, and psychologists because of social or emotional problems, and more often perceive unmet needs. The higher health care use rates and greater subjective unmet needs can largely be attributed to higher levels of depressive symptoms. Surprisingly, we find that non-frequent health care users more often perceive a subjective unmet need than frequent health care users and those who have not contacted any health care provider. Conclusion The single divorced consult health care providers more often because of social or emotional problems and they also perceive unmet needs more often.

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

    Science.gov (United States)

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

    2016-01-01

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

  14. UNMET NEED OF SEX EDUCATION AMONG ADOLESCENTS IN URBAN SLUM AREA: AN INTERVENTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Tamboli Kshitij S, Avachat Subhada S, Tamboli Suchit S

    2015-07-01

    Full Text Available Context: Adolescents comprise one-fifth of India’s total population. There is widespread ignorance associated with unprotected sex, contraceptives, among young people. As majority adolescents in slum areas have illiterate and ignorant family backgrounds; they are misguided by the myths. Hence providing sex education for them is the need of the hour. Aims: 1 To assess the knowledge and awareness of adolescents in an urban slum area regarding some aspects of reproductive health. 2 To assess the need of sex education among them. 3 To study the impact of sex education on their knowledge Material and Methods: An interventional study was done on 132 adolescents of urban slum area, selected by simple random sampling. Informed consent was obtained from the participants. Data was collected with the help of structured questionnaire prepared by literature search. Response of adolescents was recorded through questionnaires. A sensitization workshop was organized as intervention. The same questionnaire was given to them and the effect of intervention was assessed. Statistical analysis of data was done using percentage, proportion and appropriate tests of significance. Result and Conclusions: Only 31.06% adolescents had discussed the topic of reproductive health with some or other person and out of them friends were the major sources (39.2% of information. Only 38.63% knew the hazards of teenage pregnancy which significantly rose to 89.4% after intervention workshop. The study concludes that the slum adolescents profoundly lack adequate knowledge of sexuality related matters. Even before intervention workshop, unmet need of reproductive health education was 59.1% and 93.93% was the felt need in the post test.

  15. Influence of uncorrected refractive error and unmet refractive error on visual impairment in a Brazilian population.

    Science.gov (United States)

    Ferraz, Fabio H; Corrente, José E; Opromolla, Paula; Schellini, Silvana A

    2014-06-25

    The World Health Organization (WHO) definitions of blindness and visual impairment are widely based on best-corrected visual acuity excluding uncorrected refractive errors (URE) as a visual impairment cause. Recently, URE was included as a cause of visual impairment, thus emphasizing the burden of visual impairment due to refractive error (RE) worldwide is substantially higher. The purpose of the present study is to determine the reversal of visual impairment and blindness in the population correcting RE and possible associations between RE and individual characteristics. A cross-sectional study was conducted in nine counties of the western region of state of São Paulo, using systematic and random sampling of households between March 2004 and July 2005. Individuals aged more than 1 year old were included and were evaluated for demographic data, eye complaints, history, and eye exam, including no corrected visual acuity (NCVA), best corrected vision acuity (BCVA), automatic and manual refractive examination. The definition adopted for URE was applied to individuals with NCVA > 0.15 logMAR and BCVA ≤ 0.15 logMAR after refractive correction and unmet refractive error (UREN), individuals who had visual impairment or blindness (NCVA > 0.5 logMAR) and BCVA ≤ 0.5 logMAR after optical correction. A total of 70.2% of subjects had normal NCVA. URE was detected in 13.8%. Prevalence of 4.6% of optically reversible low vision and 1.8% of blindness reversible by optical correction were found. UREN was detected in 6.5% of individuals, more frequently observed in women over the age of 50 and in higher RE carriers. Visual impairment related to eye diseases is not reversible with spectacles. Using multivariate analysis, associations between URE and UREN with regard to sex, age and RE was observed. RE is an important cause of reversible blindness and low vision in the Brazilian population.

  16. The unmet orthodontic treatment need of adolescents and influencing factors for not seeking orthodontic therapy.

    Science.gov (United States)

    Spalj, Stjepan; Slaj, Martina; Athanasiou, Athanasios E; Govorko, Danijela Kalibović; Slaj, Mladen

    2014-12-01

    The purpose of this study was to estimate unmet orthodontic treatment needs of adolescents in Zagreb, Croatia, compare normative and self-perceived need and investigate factors influencing the reason why untreated subjects with severe malocclusions have not been treated before. One thousand and forty-two non-orthodontically treated subjects in age groups of 12 and 18 years, from sixteen randomly selected public schools in Zagreb, Croatia were examined. The Dental Aesthetic Index, Aesthetic Component of Index of Orthodontic Treatment Need and a questionnaire concerning self-perceived orthodontic treatment need, perception of aesthetics, function, behaviors and socioeconomic status were used. Around one third of untreated adolescent population had an objective need, less than 20 percent had aesthetic need, and self-perceived need was reported in one third of population. Associations and agreements between objective, aesthetic and self-perceived need were weak (r = 0.27-0.48; p 0.05) to 0.32 (p malocclusion were better related in persons with no treatment need or minor need (r = 0.53-0.59) than in those with major need (r = 0.31-0.40). Multiple logistic regression analyses confirmed that objective, aesthetic and self-perceived needs were better related between themselves than to socio-economic status of subjects, function, activities of daily living and oral health-related behaviors. It appears that self-perceived treatment need has low role in predicting objective need, but relation between satisfaction and awareness of malocclusion could be one of basic factors in process of making decision to go for treatment and maybe could serve in predicting patient's compliance.

  17. Family planning services for incarcerated women: models for filling an unmet need.

    Science.gov (United States)

    Sufrin, Carolyn; Baird, Sara; Clarke, Jennifer; Feldman, Elizabeth

    2017-03-13

    Purpose Incarcerated women around the globe are predominantly of reproductive age. Most of these women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release. Yet few of these women are on a regular method of contraception. Providing contraceptive services for women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy implications for expanding services. The paper aims to discuss these issues. Design/methodology/approach The authors describe four model programs in the USA with established contraceptive services on site, highlighting practical steps other facilities can implement. Findings Correctional facilities health administrators, providers, advocates, and legislators should advance policies which should counsel women on family planning and should make a range of contraceptive methods available before release, while remaining sensitive to the potential pressure these women may feel to use birth control in this unique environment. Practical implications Family planning services for incarcerated women benefits individuals, facilities, and the community. Social implications Policies which enable correctional facilities to provide comprehensive family planning to incarcerated women - including reproductive life goals counseling and contraceptive method provision - promote equity in access to critical reproductive health services and also provide broad scale population level benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of women who often have limited access to such services. Originality/value This policy briefing highlights an area of health care in prisons and jails which gets little attention in research and in policy circles: family planning services for incarcerated women. In addition to reviewing the importance of

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

    Science.gov (United States)

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

    2016-01-07

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

  19. Forest Policies Addressing Climate Change in China

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

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

  20. Anonymous-address-resolution model

    Institute of Scientific and Technical Information of China (English)

    Guang-jia SONG; Zhen-zhou JI

    2016-01-01

    Address-resolution protocol (ARP) is an important protocol of data link layers that aims to obtain the corresponding relationship between Internet Protocol (IP) and Media Access Control (MAC) addresses. Traditional ARPs (address-resolution and neighbor-discovery protocols) do not consider the existence of malicious nodes, which reveals destination addresses in the resolution process. Thus, these traditional protocols allow malicious nodes to easily carry out attacks, such as man-in-the-middle attack and denial-of-service attack. To overcome these weaknesses, we propose an anonymous-address-resolution (AS-AR) protocol. AS-AR does not publicize the destination address in the address-resolution process and hides the IP and MAC addresses of the source node. The malicious node cannot obtain the addresses of the destination and the node which initiates the address resolution; thus, it cannot attack. Analyses and experiments show that AS-AR has a higher security level than existing security methods, such as secure-neighbor discovery.

  1. CONTENT-ADDRESSABLE MEMORY SYSTEMS,

    Science.gov (United States)

    The utility of content -addressable memories (CAM’s) within a general purpose computing system is investigated. Word cells within CAM may be...addressed by the character of all or a part of cell contents . Multimembered sets of word cells may be addressed simultaneously. The distributed logical...capabilities of CAM are extended to allow simultaneous transformation of multimembered sets and to allow communication between neighboring word cells. A

  2. Reclaiming unused IPv4 addresses

    CERN Multimedia

    IT Department

    2016-01-01

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

  3. 2015 ASHG Awards and Addresses

    Science.gov (United States)

    2016-01-01

    Each year at the annual meeting of The American Society of Human Genetics (ASHG), addresses are given in honor of The Society and a number of award winners. A summary of each of these is given below. On the following pages, we have printed the presidential address and the addresses for the William Allan Award, the Curt Stern Award, and the Victor A. McKusick Leadership Award. Webcasts of these addresses, as well as those of many other presentations, can be found at http://www.ashg.org.

  4. Review of ICT-based services for identified unmet needs in people with dementia.

    Science.gov (United States)

    Lauriks, S; Reinersmann, A; Van der Roest, H G; Meiland, F J M; Davies, R J; Moelaert, F; Mulvenna, M D; Nugent, C D; Dröes, R M

    2007-10-01

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

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

    Science.gov (United States)

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

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

  6. Ten-Year Quality-of-Life Outcomes of Patients with Schizophrenia and Schizoaffective Disorders: The Relationship with Unmet Needs for Care.

    Science.gov (United States)

    Ritsner, Michael S; Grinshpoon, Alexander

    2015-01-01

    The present study examined the relationship between unmet needs and current as well as long-term quality of life (QOL) of patients with schizophrenia (SZ) and schizoaffective (SA) disorders. Ninety-five stable SZ/SA patients were evaluated using the Quality of Life Enjoyment and Life Satisfaction Questionnaire (Q-LES-Q), the Positive and Negative Syndrome Scale (PANSS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Coping Inventory for Stressful Situations (CISS). At the 10-year evaluation participants also completed the Camberwell Assessment of Need scale. Correlation and multivariate regression analyses were performed. The number of unmet needs negatively correlated with Q-LES-Q domains; however, the predictive value for general quality of life did not reach significant levels controlling for MSPSS and CISS scores. Patterns of individual needs included assistance with psychological distress, daytime activities, welfare benefits, physical health, food, and intimate relationships, and emerged as significant predictors of current general QOL, even after controlling for PANSS, MSPSS, and CISS scores. Patients who had worsened and had dissatisfied courses of general QOL over time expressed many more unmet needs compared to those who were satisfied and had an improved course of QOL. Individual unmet needs concerning daytime activities, psychological distress, psychotic symptoms, information about treatment, company, and money were associated with worsened and dissatisfied general QOL outcomes. Unmet needs of SZ/SA patients show a strong relationship with prior long-term and current quality-of-life outcome. The pattern of individual unmet needs rather than the number of unmet needs had a greater predictive value for current subjective quality of life.

  7. Contraceptive use and unmet need for family planning among HIV positive women on antiretroviral therapy in Kumasi, Ghana.

    Science.gov (United States)

    Laryea, Dennis Odai; Amoako, Yaw Ampem; Spangenberg, Kathryn; Frimpong, Ebenezer; Kyei-Ansong, Judith

    2014-10-11

    A key strategy for minimizing HIV infection rates especially via reduction of Mother- to-Child transmission is by reducing the unmet need for family planning. In Ghana, the integration of family planning services into Antiretroviral Therapy services for persons living with HIV/AIDS has largely been ignored. We set out to measure the prevalence of modern methods of contraception, the unmet need for family planning and to identify factors associated with the use of modern methods of contraception among HIV positive women on anti retroviral therapy. This was a descriptive cross sectional study of HIV positive women in their reproductive ages accessing care at an adult Antiretroviral Therapy Clinic in Kumasi, Ghana. Data was collected using a structured questionnaire. Data analysis was conducted using Epi Info version 7.1.2.0. A total of 230 women were included in the study. Fifty six percent were in the 30-39 year age group. The mean age (SD) was 36.3 (5.4) years. While 53.5% of respondents desired to have children, partner desire for children was reported by 54.6% of respondents with partners. About 74% had received information on contraception from their provider. 42.6% of participants and/or their partners were using a contraception method at the time of study; the male condom (79.6%) being the most commonly used method. The estimated unmet need for contraception was 27.8%. Contraceptive use was strongly associated with partner knowledge of HIV status (AOR = 3.64; 95% CI 1.36-9.72; p = 0.01) and use of a contraceptive method prior to diagnosis of HIV (AOR = 6.1; 2.65-14.23; p Contraceptive Prevalence is high among HIV positive women in Kumasi compared with the general Ghanaian population. Despite this, there still is a high unmet need for family planning in this population. We recommend continuous education on contraceptives use to HIV patients accessing HAART services to further increase contraceptive uptake.

  8. Key outcomes and addressing remaining challenges--perspectives from a final evaluation of the China GAVI project.

    Science.gov (United States)

    Yang, Weizhong; Liang, Xiaofeng; Cui, Fuqiang; Li, Li; Hadler, Stephen C; Hutin, Yvan J; Kane, Mark; Wang, Yu

    2013-12-27

    During the China GAVI project, implemented between 2002 and 2010, more than 25 million children received hepatitis B vaccine with the support of project, and the vaccine proved to be safe and effective. With careful consideration for project savings, China and GAVI continually adjusted the budget, additionally allowing the project to spend operational funds to support demonstration projects to improve timely birth dose (TBD), conduct training of EPI staff, and to monitor the project impact. Results from the final evaluation indicated the achievement of key outcomes. As a result of government co-investment, human resources at county level engaged in hepatitis B vaccination increased from 29 per county on average in 2002 to 66 in 2009. All project counties funded by the GAVI project use auto-disable syringes for hepatitis B vaccination and other vaccines. Surveyed hepatitis B vaccine coverage increased from 71% in 2002 to 93% in 2009 among infants. The HBsAg prevalence declined from 9.67% in 1992 to 0.96% in 2006 among children under 5 years of age. However, several important issues remain: (1) China still accounts for the largest annual number of perinatal HBV infections (estimated 84,121) in the WHO WPR region; (2) China still lacks a clear national policy for safe injection of vaccines; (3) vaccination of high risk adults and protection of health care workers are still not implemented; (4) hepatitis B surveillance needs to be refined to more accurately monitor acute hepatitis B; and (5) a program for treatment of persons with chronic HBV infection is needed. Recommendations for future hepatitis B control include: using the lessons learned from the China GAVI project for future introductions of new vaccines; addressing unmet needs with a second generation hepatitis B program to reach every infant, including screening mothers, and providing HBIG for infants born to HBsAg positive mothers; expanding vaccination to high risk adults; addressing remaining unsafe

  9. Cluster sampling with referral to improve the efficiency of estimating unmet needs among pregnant and postpartum women after disasters.

    Science.gov (United States)

    Horney, Jennifer; Zotti, Marianne E; Williams, Amy; Hsia, Jason

    2012-01-01

    Women of reproductive age, in particular women who are pregnant or fewer than 6 months postpartum, are uniquely vulnerable to the effects of natural disasters, which may create stressors for caregivers, limit access to prenatal/postpartum care, or interrupt contraception. Traditional approaches (e.g., newborn records, community surveys) to survey women of reproductive age about unmet needs may not be practical after disasters. Finding pregnant or postpartum women is especially challenging because fewer than 5% of women of reproductive age are pregnant or postpartum at any time. From 2009 to 2011, we conducted three pilots of a sampling strategy that aimed to increase the proportion of pregnant and postpartum women of reproductive age who were included in postdisaster reproductive health assessments in Johnston County, North Carolina, after tornadoes, Cobb/Douglas Counties, Georgia, after flooding, and Bertie County, North Carolina, after hurricane-related flooding. Using this method, the percentage of pregnant and postpartum women interviewed in each pilot increased from 0.06% to 21%, 8% to 19%, and 9% to 17%, respectively. Two-stage cluster sampling with referral can be used to increase the proportion of pregnant and postpartum women included in a postdisaster assessment. This strategy may be a promising way to assess unmet needs of pregnant and postpartum women in disaster-affected communities. Published by Elsevier Inc.

  10. LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People.

    Science.gov (United States)

    Steele, Leah S; Daley, Andrea; Curling, Deone; Gibson, Margaret F; Green, Datejie C; Williams, Charmaine C; Ross, Lori E

    2017-02-01

    Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender (i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people. This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women. Trans participants were 2.4 times (95% confidence intervals [CI] = 1.6-3.8, p discrimination and social support. We conclude that there are higher rates of unmet need and untreated depression in trans and bisexual participants that are partly explained by differences in social factors, including experiences of discrimination, lower levels of social support, and systemic exclusion from healthcare. Our findings suggest that the mental health system in Ontario is not currently meeting the needs of many sexual and gender minority people.

  11. A Pedagogy to Address Plagiarism.

    Science.gov (United States)

    Whitaker, Elaine E.

    1993-01-01

    Presents strategies and methods by which writing teachers can openly address the potential problem of plagiarism. Details specific methods used by one teacher to train students how to quote and cite materials without plagiarizing. (HB)

  12. Breast cancer: unique communication challenges and strategies to address them.

    Science.gov (United States)

    Parker, Patricia A; Aaron, Joann; Baile, Walter F

    2009-01-01

    Women with breast cancer have become increasingly more involved on a national and local level in advocating for resources to fight cancer. However, in the context of the relationship with their physicians and other cancer caregivers, much remains to be done in providing them with adequate support. In this paper, we highlight the difficulties in communication related to breast cancer and describe strategies and approaches that may be helpful in improving the communication throughout the cancer trajectory. Specifically, breast cancer patients have high unmet information needs relevant to health information and dissatisfaction with the actual information they receive from their providers. These needs seem even more pronounced when patients are older, of lower socio-economic class and from differing cultural backgrounds which may affect their ability to express their desires for information and desire to be involved in decision-making about their treatment. Other communication challenges can be envisioned as occurring at key points across the cancer trajectory: diagnosis disclosure, treatment failure, transition to palliative care, and end of life discussions. These involve techniques as basic as how to establish trust and rapport and determine a patient's information and decision-making preferences and as complex as giving bad news. These strategies are now viewed as essential skills in that they can affect patient distress and quality of life, satisfaction, and malpractice litigation as well as practitioner stress and burnout.

  13. The Spiritual Needs Assessment for Patients (SNAP): development and validation of a comprehensive instrument to assess unmet spiritual needs.

    Science.gov (United States)

    Sharma, Rashmi K; Astrow, Alan B; Texeira, Kenneth; Sulmasy, Daniel P

    2012-07-01

    Unmet spiritual needs have been associated with decreased patient ratings of quality of care, satisfaction, and quality of life. There is a need for a well-validated, psychometrically sound instrument to describe and measure spiritual needs. To develop a valid and reliable instrument to assess patients' spiritual needs. Instrument development was based on a literature review, clinical and pastoral evaluation, and cognitive pretesting (n=15 ambulatory cancer patients). Forty-seven ambulatory cancer patients completed cross-sectional and longitudinal surveys to test instrument validity and reliability. Internal reliability was assessed by Cronbach's α, test-retest reliability by Spearman's correlation coefficients, and construct validity by comparing instrument scores to a previously used single-item spiritual needs question. The Spiritual Needs Assessment for Patients (SNAP) comprises a total of 23 items in three domains: psychosocial (n=5), spiritual (n=13), and religious (n=5). Sixty percent of participants were white, 21% black, 13% Hispanic, and 6% Asian or other. Fifty-eight percent were Catholic, 13% Jewish, 11% Protestant, 2% Buddhist, 2% Muslim, and 2% Hindu. Sixty-eight percent described themselves as spiritual but not religious; 15% reported unmet spiritual needs; 19% wanted help meeting their spiritual needs. Cronbach's α for the total SNAP was 0.95, and for the subscales was psychosocial=0.74, spiritual=0.93, and religious needs=0.86. Test-retest correlation coefficients were total SNAP=0.69, psychosocial needs=0.51, spiritual needs=0.70, and religious needs=0.65. Participants reporting unmet spiritual needs had significantly higher mean scores on the total SNAP (66.3 vs. 49.4, P=0.03) and on the spiritual needs subscale (39.0 vs. 28.3, P=0.02). The results provide preliminary evidence that the SNAP is a valid and reliable instrument for measuring spiritual needs in a diverse patient population. Copyright © 2012 U.S. Cancer Pain Relief Committee

  14. Introduction to IP address management

    CERN Document Server

    Rooney, Tim

    2010-01-01

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

  15. The Effect of Structured Counseling towards Knowledge, Attitude, and Participation of Modern Contraceptive among Unmet Need Couples

    Directory of Open Access Journals (Sweden)

    Herlina Simanjuntak

    2016-06-01

    pasangan usia subur (PUS yang unmet need. Penelitian ini merupakan eksperimen semu dengan rancangan pretest-posttest dengan kelompok kontrol. Penelitian ini dilakukan pada periode Maret – Juni 2015. Pengambilan sampel dilakukan dengan stratified random sampling pada 48 orang untuk kelompok perlakuan (konseling terstruktur dan 48 orang untuk kelompok kontrol (konseling standar. Perbedaan peningkatan pengetahuan dan sikap pada kelompok perlakuan dan kontrol diuji dengan uji Mann-Whitney U, sedangkan pengaruh konseling terstruktur terhadap partisipasi kontrasepsi modern dianalisis dengan uji regresi logistik ganda. Hasil penelitian menunjukkan perbedaan bermakna pada skor pengetahuan dan sikap setelah dilakukan konseling terstruktur antara kelompok perlakuan dan kontrol dengan nilai p < 0,05. Wanita usia subur (WUS yang berada pada kelompok perlakuan akan berpeluang ikutserta menggunakan kontrasepsi modern dengan OR= 6,167 (95% CI= 2,427-15,67. Kesimpulan penelitian ini, konseling yang dilakukan secara terstruktur mampu meningkatkan pengetahuan, sikap dan keikutsertaan kontrasepsi modern pada PUS.

  16. NCI Director Harold Varmus to address National Press Club

    Science.gov (United States)

    The barriers that impede greater and faster progress against cancer include the inherent biological properties of tumors; the difficulties of developing new ways to prevent, diagnose and treat cancers; and economic and social factors that slow the nation’

  17. Presidential address - 1999 Towards a national rangeland policy ...

    African Journals Online (AJOL)

    You may already be aware that the BP Agricultural scholarship has been ... inculcate an ethic of stewardship over every hectare of land in South Africa. ... both in terms of improvements to human living standards and environmental condition.

  18. How the National Estuary Programs Address Environmental Issues

    Science.gov (United States)

    Estuaries face many challenges including, alteration of natural hydrologic flows, aquatic nuisance species, climate change, declines in fish and wildlife populations, habitat loss and degradation, nutrient loads, pathogens, stormwater and toxics.

  19. National History/Transnational Themes: Inaugural Addresses and American Mythology

    DEFF Research Database (Denmark)

    Andersen, Marie

    2004-01-01

    Amerikansk historie, amerikansk mytologi, amerikansk præsidenttaler, indsættelsestaler, civil religion......Amerikansk historie, amerikansk mytologi, amerikansk præsidenttaler, indsættelsestaler, civil religion...

  20. Quality of life and unmet needs in patients with inflammatory arthropathies: results from the multicentre, observational RAPSODIA study.

    Science.gov (United States)

    Giacomelli, Roberto; Gorla, Roberto; Trotta, Francesco; Tirri, Rosella; Grassi, Walter; Bazzichi, Laura; Galeazzi, Mauro; Matucci-Cerinic, Marco; Scarpa, Raffaele; Cantini, Fabrizio; Gerli, Roberto; Lapadula, Giovanni; Sinigaglia, Luigi; Ferraccioli, Gianfranco; Olivieri, Ignazio; Ruscitti, Piero; Sarzi-Puttini, Piercarlo

    2015-05-01

    The observational RAPSODIA (RA, PsA and spondylitis including AS) study was planned to assess, in patients with RA, AS and PsA, their involvement in medical decisions, quality of life and unmet needs 15 years after the introduction of biologic therapies in Italy. Patients completed a questionnaire during their scheduled rheumatology consultation. They rated their satisfaction with disease knowledge on a 5-point scale (1 = not at all satisfied, 5 = totally satisfied). Self-efficacy, defined as judgement of one's own ability to achieve given levels of performance and exercise control over events, was measured using the pain subscale of the Arthritis Self-Efficacy Scale. Patients' global assessments of pain, fatigue and disease activity were recorded on 100 mm visual analogue scales (0 = best status, 100 = worse status). Disease activity status was assessed using standard tools. Health status was measured using the 36-item Short Form Health Survey and the Italian version of the HAQ. Ninety-eight per cent of patients reported that their health care practitioner used understandable terms to explain their condition. Joint issues and general symptoms (e.g. fatigue and malaise) were common. All measures of disease activity and self-efficacy scores were markedly better in patients receiving biologic vs conventional therapy. Biologic therapy recipients were more productive at work. These results confirm that some patients with rheumatic diseases are not satisfied with the level of information they receive about their treatments. Biologic therapy appears to be an important advance, with patients receiving this form of treatment having improved symptoms and productivity. However, patients still report unmet needs. Thus further research, and perhaps new and more effective therapies, along with better education and multidisciplinary collaboration, are required to improve outcomes. © The Author 2014. Published by Oxford University Press on behalf of the British Society for

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

    Directory of Open Access Journals (Sweden)

    Maria Lambri

    2012-01-01

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

  2. Measuring domestic water use: a systematic review of methodologies that measure unmetered water use in low-income settings.

    Science.gov (United States)

    Tamason, Charlotte C; Bessias, Sophia; Villada, Adriana; Tulsiani, Suhella M; Ensink, Jeroen H J; Gurley, Emily S; Mackie Jensen, Peter Kjaer

    2016-11-01

    To present a systematic review of methods for measuring domestic water use in settings where water meters cannot be used. We systematically searched EMBASE, PubMed, Water Intelligence Online, Water Engineering and Development Center, IEEExplore, Scielo, and Science Direct databases for articles that reported methodologies for measuring water use at the household level where water metering infrastructure was absent or incomplete. A narrative review explored similarities and differences between the included studies and provide recommendations for future research in water use. A total of 21 studies were included in the review. Methods ranged from single-day to 14-consecutive-day visits, and water use recall ranged from 12 h to 7 days. Data were collected using questionnaires, observations or both. Many studies only collected information on water that was carried into the household, and some failed to mention whether water was used outside the home. Water use in the selected studies was found to range from two to 113 l per capita per day. No standardised methods for measuring unmetered water use were found, which brings into question the validity and comparability of studies that have measured unmetered water use. In future studies, it will be essential to define all components that make up water use and determine how they will be measured. A pre-study that involves observations and direct measurements during water collection periods (these will have to be determined through questioning) should be used to determine optimal methods for obtaining water use information in a survey. Day-to-day and seasonal variation should be included. A study that investigates water use recall is warranted to further develop standardised methods to measure water use; in the meantime, water use recall should be limited to 24 h or fewer. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2016-01-16

    Identifying relevant measures of women's reproductive health needs is critical to improve women's chances of service utilization. The study aims to systematically review and analyze the adequacy of outcome measures and determinants applied in previous studies for assessing women reproductive health needs across West Africa. Evidence on outcomes and determinants of unmet reproductive health needs among women of childbearing age in diverse multicultural, religious, and ethnic settings in West African countries was systematically reviewed. The review included recent English language publications (from January 2009 - March 2014). Clinical studies particularly on obstetric care services and reproductive services in relation to HIV/AIDS were excluded. We acknowledge the possibility to have excluded non-English publications and yet-to-be-published articles related to the study aim and objectives. Outcomes and determinants were assessed and defined at three main levels; contraceptive use, obstetric care, and antenatal care utilization. Results show increasing unmet need for women's reproductive health needs. Socio-cultural norms and practices resulting in discontinuation of service use, economic constraints, travel distance to access services and low education levels of women were found to be key predictors of service utilization for contraception, antenatal and obstetric care services. Outcome measures were mainly assessed based on service utilization, satisfaction, cost, and quality of services available as core measures across the three levels assessed in this review. Evidence from this review indicates that currently applied measures of women's reproductive health needs might be inadequate in attaining best maternal outcomes since they appear rather broad. More support and research for developing and advancing context-related measures may help to improve women's maternal health.

  4. The unmet demand for walkability: Disparities between preferences and actual choices for residential environments in Toronto and Vancouver.

    Science.gov (United States)

    Frank, Lawrence D; Kershaw, Suzanne E; Chapman, James E; Campbell, Monica; Swinkels, Helena M

    2014-07-11

    Individual preferences for residential location, neighbourhood character and travel options are not always met. The availability and cost of housing and several other factors often require compromise. The primary objectives of this study were to examine neighbourhood preferences, quantify unmet demand for more walkable environments and explore associations between the built environment, travel behaviour and health after controlling for neighbourhood preference. A web-based, visually oriented residential preference survey was conducted with 1,525 adults in the Greater Toronto Area and 1,223 adults in Metro Vancouver aged 25 and older (5.8% and 11.8% of total potential recruits, respectively). Participants were randomly selected from a pre-recruited panel across a range of objectively calculated walkability and income levels at the forward sortation area level. Depending on the neighbourhood design attribute, between 45% and 64% of residents in the cities of Toronto and Vancouver strongly preferred living in walkable settings, compared with between 6% and 15% who strongly preferred auto-oriented places. Of participants who perceived their current neighbourhood as very auto-oriented, between 11% and 20% of City of Toronto participants and 6% and 30% of City of Vancouver participants strongly preferred a very walkable neighbourhood. Residents of highly walkable neighbourhoods reported walking significantly more for utilitarian purposes, taking public transit more frequently and driving fewer kilometres. Strong preferences for walking and transit-supportive neighbourhoods exist in two of Canada's largest metropolitan regions, with considerable unmet demand observed for such environments. The findings provide evidence for policies that enable walkability and inform market analysis, planning and regulatory approaches that better align with the supply and demand of more walkable neighbourhood environments. Providing increased opportunities for active transportation can

  5. Unmet needs of people with severe multiple sclerosis and their carers: qualitative findings for a home-based intervention.

    Directory of Open Access Journals (Sweden)

    Claudia Borreani

    Full Text Available Few data on services for people with severe multiple sclerosis (MS are available. The Palliative Network for Severely Affected Adults with MS in Italy (PeNSAMI developed a home palliative care program for MS patients and carers, preceded by a literature review and qualitative study (here reported.To identify unmet needs of people with severe MS living at home by qualitative research involving key stakeholders, and theorize broad areas of intervention to meet those needs.Data were collected from: at least 10 personal interviews with adults with severe MS (primary/secondary progressive, EDSS≥8.0; three focus group meetings (FGs of carers of people with severe MS; and two FGs of health professionals (HPs. Grounded theory guided the analysis of interview and FG transcripts, from which the areas of intervention were theorized.Between October 2012 and May 2013, 22 MS patients, 30 carers and 18 HPs participated. Forty-eight needs themes were identified, grouped into 14 categories and four domains. Seven, highly interdependent intervention areas were theorized. Patients had difficulties expressing needs; experiences of burden and loneliness were prominent, chiefly in dysfunctional, less affluent families, and among parent carers. Needs differed across Italy with requirements for information and access to services highest in the South. All participants voiced a strong need for qualified personnel and care coordination in day-to-day home care. Personal hygiene emerged as crucial, as did the need for a supportive network and preservation of patient/carer roles within family and community.Unmet needs transcended medical issues and embraced organizational and psychosocial themes, as well as health policies. The high interdependence of the seven intervention areas theorized is in line with the multifaceted approach of palliative care. At variance with typical palliative contexts, coping with disability rather than end-of-life was a major concern of patients

  6. Necessidade de saúde insatisfeita no Brasil: uma investigação sobre a não procura de atendimento Unmet health care needs in Brazil: an investigation about the reasons for not seeking health care

    Directory of Open Access Journals (Sweden)

    Rafael Guerreiro Osorio

    2011-09-01

    Full Text Available Neste trabalho, a necessidade de saúde insatisfeita, definida pelos autores como a situação em que o indivíduo sente necessidade, mas não procura atendimento de saúde, é estudada a partir dos dados do suplemento de saúde das rodadas de 1998, 2003 e 2008 da Pesquisa Nacional por Amostra de Domicílios (Pnad. Constata-se que, de 1998 a 2008, a parcela da população brasileira com necessidade de saúde durante as duas semanas anteriores à pesquisa se manteve em torno de 17%, enquanto a parcela com necessidade de saúde insatisfeita caiu de 3,5% para 2,9%. Também mudou o perfil dos motivos que as pessoas escolhem para justificar não terem procurado atendimento de saúde. A porcentagem dos que alegavam falta de dinheiro se reduziu, embora ainda seja o motivo mais escolhido, aumentando as porcentagens dos que alegam limitações e falhas do sistema de saúde, como o tempo de espera e a falta de profissionais ou serviços. Baixa renda ou escolaridade, residência nas regiões mais pobres do país ou em área rural, ser negro, ser homem, ser adulto, estar ocupado, residir com outras pessoas com necessidade insatisfeita, não realizar consultas médicas há pelo menos um ano e não ter plano de saúde são, dentre outras, características que aumentam a propensão a não satisfazer a necessidade de saúde pela busca de atendimento.Herein, unmet health care needs, defined by the authors as the situation when an individual feels the need but does not seek healthcare, are studied from the data of the health questionnaires of the 1998, 2003 and 2008 rounds of the National Household Sampling Survey (Pnad. From 1998 to 2008, the percentage of the population with healthcare needs during the two weeks prior to the interview did not change, remaining at around 17%, whilst the share with unmet healthcare needs fell from 3.5% to 2.9%. There were also changes in the reasons chosen by the interviewees to justify why they did not seek healthcare. The

  7. 46 CFR 67.321 - Requirement to report change of address of managing owner.

    Science.gov (United States)

    2010-10-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  11. Managing psychological stress in the multiple sclerosis medical visit: Patient perspectives and unmet needs.

    Science.gov (United States)

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

    2016-08-01

    Psychological stress can negatively impact multiple sclerosis. To further understand how stress is addressed in the multiple sclerosis medical visit, 34 people with multiple sclerosis participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological well-being in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in multiple sclerosis. © The Author(s) 2014.

  12. Geocoding Patient Addresses for Biosurveillance

    OpenAIRE

    Olson, Karen L; Kenneth D Mandl

    2002-01-01

    New biosurveillance information systems are being developed to detect clusters of disease using temporal and spatial characteristics. Geographical Information Systems (GIS) can use patient addresses stored in hospital information systems to assign latitude and longitude coordinates, enabling the detection of spatial clusters. However, inaccuracy can be introduced during the geocoding process and this could have a profound adverse effect on detection sensitivity. In an analysis of three years ...

  13. Atomic clusters with addressable complexity

    Science.gov (United States)

    Wales, David J.

    2017-02-01

    A general formulation for constructing addressable atomic clusters is introduced, based on one or more reference structures. By modifying the well depths in a given interatomic potential in favour of nearest-neighbour interactions that are defined in the reference(s), the potential energy landscape can be biased to make a particular permutational isomer the global minimum. The magnitude of the bias changes the resulting potential energy landscape systematically, providing a framework to produce clusters that should self-organise efficiently into the target structure. These features are illustrated for small systems, where all the relevant local minima and transition states can be identified, and for the low-energy regions of the landscape for larger clusters. For a 55-particle cluster, it is possible to design a target structure from a transition state of the original potential and to retain this structure in a doubly addressable landscape. Disconnectivity graphs based on local minima that have no direct connections to a lower minimum provide a helpful way to visualise the larger databases. These minima correspond to the termini of monotonic sequences, which always proceed downhill in terms of potential energy, and we identify them as a class of biminimum. Multiple copies of the target cluster are treated by adding a repulsive term between particles with the same address to maintain distinguishable targets upon aggregation. By tuning the magnitude of this term, it is possible to create assemblies of the target cluster corresponding to a variety of structures, including rings and chains.

  14. Service Use and Unmet Needs in Youth Suicide: A Study of Trajectories

    Science.gov (United States)

    Renaud, Johanne; Séguin, Monique; Lesage, Alain D; Marquette, Claude; Choo, Bettina; Turecki, Gustavo

    2014-01-01

    Objective: While 90% of suicide victims have suffered from mental health disorders, less than one-half are in contact with a mental health professional in the year preceding their death. Service use in the last year of life of young suicide victims and control subjects was studied in Quebec. We wanted to determine what kinds of health care services were needed and if they were actually received by suicide victims. Method: We recruited 67 consecutive suicide victims and 56 matched living control subjects (aged 25 years and younger). We evaluated subjects’ psychopathological profile and determined which services would have been indicated by conducting a needs assessment. We then compared this with what services were actually received. Results: Suicide victims were more likely than living control subjects to have a psychiatric diagnosis. They were most in need of services to address substance use disorder, depression, interpersonal distress, and suicide-related problems. There were significant deficits in the domains of coordination and continuity of care, mental health promotion and training, and governance. Conclusions: Our results show that we need to urgently take action to address these identified deficits to prevent further loss of life in our young people. PMID:25565685

  15. Suicide Prevention Interventions for Sexual & Gender Minority Youth: An Unmet Need.

    Science.gov (United States)

    Marshall, Alexandra

    2016-06-01

    Suicide is currently the second leading cause of death in the U.S. among youth ages 10 to 24. Sexual and gender minority (SGM) youth face heightened risk for suicide and report greater odds of attempting suicide than their heteronormative peers. Contributing factors of experience, which are distinctly different from the experiences of heteronormative youth, place SGM youth at heightened risk for suicide. While interventions aimed at addressing suicide risk factors for all youth are being implemented and many have proven effective in the general population, no evidence-based intervention currently exists to reduce suicide risk within this special population. This perspective article discusses this need and proposes the development of an evidence-based suicide risk reduction intervention tailored to SGM youth. Creating a supportive school climate for SGM youth has been shown to reduce suicide risk and may provide protective effects for all youth while simultaneously meeting the unique needs of SGM youth.

  16. Participation needs of older adults having disabilities and receiving home care: met needs mainly concern daily activities, while unmet needs mostly involve social activities.

    Science.gov (United States)

    Turcotte, Pier-Luc; Larivière, Nadine; Desrosiers, Johanne; Voyer, Philippe; Champoux, Nathalie; Carbonneau, Hélène; Carrier, Annie; Levasseur, Mélanie

    2015-08-01

    Participation is a key determinant of successful aging and enables older adults to stay in their homes and be integrated into the community. Assessing participation needs involves identifying restrictions in the accomplishment of daily and social activities. Although meeting participation needs involves older adults, their caregivers and healthcare providers, little is known about their respective viewpoints. This study thus explored the participation needs of older adults having disabilities as perceived by the older adults themselves, their caregivers and healthcare providers. A qualitative multiple case study consisted of conducting 33 semi-structured interviews in eleven triads, each composed of an older adult, his/her caregiver and a healthcare provider recruited in a Health and Social Services Centre (HSSC) in Québec, Canada. Interview transcripts and reviews of clinical records were analyzed using content analysis and descriptive statistics based on thematic saliency analysis methods. Aged 66 to 88 years, five older adults had physical disabilities, five had mild cognitive impairment and one had psychological problems, leading to moderate to severe functional decline. Caregivers and healthcare providers were mainly women, respectively retired spouses and various professionals with four to 32 years of clinical experience. Participation needs reported by each triad included all domains of participation. Needs related to daily activities, such as personal care, nutrition, and housing, were generally met. Regarding social activities, few needs were met by various resources in the community and were generally limited to personal responsibilities, including making decisions and managing budgets, and some community life activities, such as going shopping. Unmet needs were mainly related to social activities, involving leisure, other community life activities and interpersonal relationships, and some daily activities, including fitness and mobility. This study

  17. Nanoscale content-addressable memory

    Science.gov (United States)

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

    2009-01-01

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

  18. Addressing inequities in healthy eating.

    Science.gov (United States)

    Friel, Sharon; Hattersley, Libby; Ford, Laura; O'Rourke, Kerryn

    2015-09-01

    What, when, where and how much people eat is influenced by a complex mix of factors at societal, community and individual levels. These influences operate both directly through the food system and indirectly through political, economic, social and cultural pathways that cause social stratification and influence the quality of conditions in which people live their lives. These factors are the social determinants of inequities in healthy eating. This paper provides an overview of the current evidence base for addressing these determinants and for the promotion of equity in healthy eating.

  19. Towards an international address standard

    CSIR Research Space (South Africa)

    Coetzee, S

    2008-02-01

    Full Text Available Initiative in Section 5, with a focus on the South African National Accessibility Portal component (referred to as NAP) which forms the basis of our research. We present a NAP presentation technology analysis in Section 6. Section 7... in a better user experience. Standards compliance allows for the separation of concerns: HTML for content, Cascading Style Sheets (CSS) for presentation and JavaScript for dynamic behaviour. Standards compliant documents are also...

  20. Library outreach: addressing Utah's "Digital Divide".

    Science.gov (United States)

    McCloskey, K M

    2000-10-01

    A "Digital Divide" in information and technological literacy exists in Utah between small hospitals and clinics in rural areas and the larger health care institutions in the major urban area of the state. The goals of the outreach program of the Spencer S. Eccles Health Sciences Library at the University of Utah address solutions to this disparity in partnership with the National Network of Libraries of Medicine-- Midcontinental Region, the Utah Department of Health, and the Utah Area Health Education Centers. In a circuit-rider approach, an outreach librarian offers classes and demonstrations throughout the state that teach information-access skills to health professionals. Provision of traditional library services to unaffiliated health professionals is integrated into the library's daily workload as a component of the outreach program. The paper describes the history, methodology, administration, funding, impact, and results of the program.

  1. Advancing efforts to address youth violence involvement.

    Science.gov (United States)

    Weist, M D; Cooley-Quille, M

    2001-06-01

    Discusses the increased public attention on violence-related problems among youth and the concomitant increased diversity in research. Youth violence involvement is a complex construct that includes violence experienced in multiple settings (home, school, neighborhood) and in multiple forms (as victims, witnesses, perpetrators, and through family members, friends, and the media). Potential impacts of such violence involvement are considerable, including increased internalizing and externalizing behaviors among youth and future problems in school adjustment and life-course development. This introductory article reviews key dimensions of youth-related violence, describes an American Psychological Association Task Force (Division 12) developed to advance relevant research, and presents examples of national resources and efforts that attempt to address this critical public health issue.

  2. From unmet clinical need to entrepreneurship: taking your informatics solution to market.

    Science.gov (United States)

    Bowles, Kathryn H; Heil, Eric

    2014-01-01

    This paper will describe the process for taking a decision support solution to market as a start-up business. The nurse inventor and Co-Founder of RightCare Solutions, Inc. will share the steps from answering a clinical question, to registering an invention, creating a business plan and company, obtaining venture funding, and launching a commercial product. We will share positives about the experience such as how to get start-up funds, gaining national exposure and access to an excellent team, disseminating your work broadly, further enhancing the product, and obtaining equity, and financial rewards. We will discuss cons such as losing control, dilution of ownership, and conflict of interest. This paper will encourage nurse informaticians to think differently and learn about the steps in the process from an experienced team.

  3. Unmet health needs identified by Haitian women as priorities for attention: a qualitative study.

    Science.gov (United States)

    Peragallo Urrutia, Rachel; Merisier, Delson; Small, Maria; Urrutia, Eugene; Tinfo, Nicole; Walmer, David K

    2012-06-01

    This 2009 qualitative study investigated Haitian women's most pressing health needs, barriers to meeting those needs and proposed solutions, and how they thought the community and outside organizations should be involved in addressing their needs. The impetus for the study was to get community input into the development of a Family Health Centre in Leogane, Haiti. Individual interviews and focus group discussions were conducted with 52 adult women in six communities surrounding Leogane. The most pressing health needs named by the women were accessible, available and affordable health care, potable water, enough food to eat, improved economy, employment, sanitation and education, including health education. Institutional corruption, lack of infrastructure and social organization, the cost of health care, distance from services and lack of transport as barriers to care were also important themes. The involvement of foreign organizations and local community groups, including grassroots women's groups who would work in the best interests of other women, were identified as the most effective solutions. Organizations seeking to improve women's health care in Haiti should develop services and interventions that prioritize community partnership and leadership, foster partnerships with government, and focus on public health needs.

  4. Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Sandra I McCoy

    Full Text Available BACKGROUND: Prevention of unintended pregnancies among women living with HIV infection is a strategy recommended by the World Health Organization for prevention of mother-to-child transmission of HIV (PMTCT. We assessed pregnancy intentions and contraceptive use among HIV-positive and HIV-negative women with a recent pregnancy in Zimbabwe. METHODS: We analyzed baseline data from the evaluation of Zimbabwe's Accelerated National PMTCT Program. Eligible women were randomly sampled from the catchment areas of 157 health facilities offering PMTCT services in five provinces. Eligible women were ≥16 years old and mothers of infants (alive or deceased born 9 to 18 months prior to the interview. Participants were interviewed about their HIV status, intendedness of the birth, and contraceptive use. RESULTS: Of 8,797 women, the mean age was 26.7 years, 92.8% were married or had a regular sexual partner, and they had an average of 2.7 lifetime births. Overall, 3,090 (35.1% reported that their births were unintended; of these women, 1,477 (47.8% and 1,613 (52.2% were and were not using a contraceptive method prior to learning that they were pregnant, respectively. Twelve percent of women reported that they were HIV-positive at the time of the survey; women who reported that they were HIV-infected were significantly more likely to report that their pregnancy was unintended compared to women who reported that they were HIV-uninfected (44.9% vs. 33.8%, p<0.01. After adjustment for covariates, among women with unintended births, there was no association between self-reported HIV status and lack of contraception use prior to pregnancy. CONCLUSIONS: Unmet need for family planning and contraceptive failure contribute to unintended pregnancies among women in Zimbabwe. Both HIV-infected and HIV-uninfected women reported unintended pregnancies despite intending to avoid or delay pregnancy, highlighting the need for effective contraceptive methods that align with

  5. “Health in the Mirror”: An Unconventional Approach to Unmet Psychological Needs in Oncology

    Directory of Open Access Journals (Sweden)

    Valentina E. Di Mattei

    2017-09-01

    Full Text Available Background: The introduction of aesthetic care programs for cancer patients inside hospitals could help patients cope with the side effects of both disease and treatment. The specific objective of this study is to evaluate whether a complementary and supportive program, called “Health in the Mirror,” has a positive effect on participants by analyzing certain psychological variables.Methods: Eighty-eight female cancer patients were included in this analysis. The support program is composed of three group aesthetic interventions that address both physical and psychological aspects that accompany cancer and its treatment. Patients were asked to complete a battery of tests in order to measure the impact of the program on certain psychological variables including anxiety, depression, body image, self-esteem, and quality of life. Outcome variables were measured at three different time-points: prior to participation, on the last day of the program, and after a 3-month follow-up.Results: Participating in the psychosocial support program “Health in the Mirror” determines an improvement in the psychological variables measured. Results revealed a significant reduction in depressive symptoms, anxiety and body image issues, as well as an improvement in self-esteem levels; this suggests that participating in this program could facilitate better adjustment to disease and treatment.Discussion: This study legitimizes the importance of implementing supportive and complementary therapies together with conventional therapies; the therapeutic approach to cancer cannot be restricted solely to medical care, but it must consider the patient as a whole person with needs that are not only physical or medical, but also psychological, social, and existential.

  6. Unmet Communication and Information Needs for Patients with IBD: Implications for Mobile Health Technology.

    Science.gov (United States)

    Khan, Sameer; Dasrath, Florence; Farghaly, Sara; Otobo, Emamuzo; Riaz, Muhammad Safwan; Rogers, Jason; Castillo, Anabella; Atreja, Ashish

    2016-01-01

    In order to develop an application that addresses the most significant challenges facing IBD patients, this qualitative study explored the major hurdles of living with IBD, the information needs of IBD patients, and how application technology may be used to improve quality of life. 15 IBD patients participated in two focus groups of 120 minutes each. Data collection was achieved by combining focus groups with surveys and direct observation of patients looking at a patient-engaged app (HealthPROMISE) screenshots. The survey elicited information on demographics, health literacy and quality of life through the Short IBD Questionnaire (SIBDQ). The needs of IBD patients center around communication as it relates to both patient information needs and navigating the social impacts of IBD on patients' lives: Communication Challenges regarding Information Needs: Patients cited a doctor-patient communication divide where there is a continued lack of goal setting when discussing treatments and a lack of objectivity in disease control. When objectively compared with the SIBDQ, nearly half of the patients in the focus groups wrongly estimated their IBD control.Communication Challenges regarding Social Impacts of IBD: Patients strongly felt that while IBD disrupts routines, adds significant stress, and contributes to a sense of isolation, the impact of these issues would be significantly alleviated through more conversation and better support.Implication for Mobile Health Solutions: Patients want a tool that improves tracking of symptoms, medication adherence and provides education. Physician feedback to patient input on an application is required for long-term sustainability. IBD patients need mobile health technologies that evaluate disease control and the goals of care. Patients feel an objective assessment of their disease control, goal setting and physician feedback will greatly enhance utilization of all mobile health applications.

  7. Building Footprints - Montana Structures/Addresses Framework

    Data.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Lone Birgitte Skov Jensen

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-09-01

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

  10. Organization for rare diseases India (ORDI) - addressing the challenges and opportunities for the Indian rare diseases' community.

    Science.gov (United States)

    Rajasimha, Harsha Karur; Shirol, Prasannakumar Basayya; Ramamoorthy, Preveen; Hegde, Madhuri; Barde, Sangeeta; Chandru, Vijay; Ravinandan, M E; Ramchandran, Ramani; Haldar, Kasturi; Lin, Jimmy C; Babar, Imran A; Girisha, Katta M; Srinivasan, Sudha; Navaneetham, Duraiswamy; Battu, Rajani; Devarakonda, Rajashree; Kini, Usha; Vijayachandra, Kinnimulki; Verma, Ishwar C

    2014-08-13

    In order to address the unmet needs and create opportunities that benefit patients with rare disease in India, a group of volunteers created a not-for-profit organization named Organization for Rare Diseases India (ORDI; www.ordindia.org). ORDI plans to represent the collective voice and advocate the needs of patients with rare diseases and other stakeholders in India. The ORDI team members come from diverse backgrounds such as genetics, molecular diagnostics, drug development, bioinformatics, communications, information technology, patient advocacy and public service. ORDI builds on the lessons learned from numerous similar organizations in the USA, European Union and disease-specific rare disease foundations in India. In this review, we provide a background on the landscape of rare diseases and the organizations that are active in this area globally and in India. We discuss the unique challenges in tackling rare diseases in India, and highlight the unmet needs of the key stakeholders of rare diseases. Finally, we define the vision, mission, goals and objectives of ORDI, identify the key developments in the health care context in India and welcome community feedback and comments on our approach.

  11. Addressing Patient Sexual Orientation in the Undergraduate Medical Education Curriculum

    Science.gov (United States)

    Tamas, Rebecca L.; Miller, Karen Hughes; Martin, Leslee J.; Greenberg, Ruth B.

    2010-01-01

    Objective: This study aims to estimate the number of hours dedicated to lesbian, gay, bisexual, and transgender content in one medical school's undergraduate curriculum, compare it to the national average, and identify barriers to addressing this content. Methods: Course and clerkship directors were asked to estimate how many hours they spent on…

  12. Actions States and Communities Can Take to Address Cognitive Health

    Centers for Disease Control (CDC) Podcasts

    2014-06-09

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

  13. Addressing neurological disorders with neuromodulation.

    Science.gov (United States)

    Oluigbo, Chima O; Rezai, Ali R

    2011-07-01

    Neurological disorders are becoming increasingly common in developed countries as a result of the aging population. In spite of medications, these disorders can result in progressive loss of function as well as chronic physical, cognitive, and emotional disability that ultimately places enormous emotional and economic on the patient, caretakers, and the society in general. Neuromodulation is emerging as a therapeutic option in these patients. Neuromodulation is a field, which involves implantable devices that allow for the reversible adjustable application of electrical, chemical, or biological agents to the central or peripheral nervous system with the objective of altering its functioning with the objective of achieving a therapeutic or clinically beneficial effect. It is a rapidly evolving field that brings together many different specialties in the fields of medicine, materials science, computer science and technology, biomedical, and neural engineering as well as the surgical or interventional specialties. It has multiple current and emerging indications, and an enormous potential for growth. The main challenges before it are in the need for effective collaboration between engineers, basic scientists, and clinicians to develop innovations that address specific problems resulting in new devices and clinical applications.

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

    OpenAIRE

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

    2016-01-01

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

  15. 75 FR 78998 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Addressing...

    Science.gov (United States)

    2010-12-17

    ... Announcement (FOA) PS11-002; and Addressing TB Control and Lung Health Activities through the Vietnam National Lung Hospital/National TB Program (NLH/ NTP), FOA PS11-004, Initial Review In accordance with Section... Facilities, Laboratories, Prisons And Other Community Settings, FOA PS11-002'' and ``Addressing TB...

  16. 32 CFR 37.1010 - What substantive issues should my award document address?

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false What substantive issues should my award document address? 37.1010 Section 37.1010 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE... Document § 37.1010 What substantive issues should my award document address? You necessarily will...

  17. Addressing concerns and achieving expectations

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-01

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

  18. An address geocoding solution for Chinese cities

    Science.gov (United States)

    Zhang, Xuehu; Ma, Haoming; Li, Qi

    2006-10-01

    We introduce the challenges of address geocoding for Chinese cities and present a potential solution along with a prototype system that deal with these challenges by combining and extending current geocoding solutions developed for United States and Japan. The proposed solution starts by separating city addresses into "standard" addresses which meet a predefined address model and non-standard ones. The standard addresses are stored in a structured relational database in their normalized forms, while a selected portion of the non-standard addresses are stored as aliases to the standard addresses. An in-memory address index is then constructed from the address database and serves as the basis for real-time address matching. Test results were obtained from two trials conducted in the city Beijing. On average 80% matching rate were achieved. Possible improvements to the current design are also discussed.

  19. What is the best care for community-dwelling dependent adults? Sources of care and perception of unmet needs in Spain

    Directory of Open Access Journals (Sweden)

    Rogero-García, Jesús

    2014-08-01

    Full Text Available The objectives of this study in the Spanish context are: (1 to identify what source of care (informal, private or public care achieves the lowest perception of unmet needs amongst dependent adults and (2 to identify which factors are associated with a greater perception of unmet needs within each source of care. This research is based on a sample of 4,766 dependent adults who completed the 2008 Survey on Disability, Personal Autonomy and Dependency Situations (EDAD. Dependent adults who received only paid care were less likely to perceive unmet needs compared to those who received other types of care. Dependents who received public care were more likely to perceive unmet needs. Perception of unmet needs is related to the characteristics of the dependent adults, the primary carers and the caregiving context. The results suggest that policy design must not assume that dependent people prefer family care to other types of care and demonstrate that public care is perceived as unsatisfactory.Los objetivos de este trabajo son: (1 identificar el proveedor de cuidado (informal, privado o público que consigue una menor percepción de necesidades no cubiertas entre los adultos dependientes en España, (2 identificar qué factores se relacionan con una mayor percepción de necesidades no cubiertas en cada situación, atendiendo al proveedor de cuidado. Se analizó una muestra de 4.766 adultos dependientes de la Encuesta sobre Discapacidades, Autonomía personal y situaciones de Dependencia (EDAD 2008. Los adultos dependientes que recibieron únicamente cuidado privado tuvieron menos probabilidades de percibir sus necesidades no cubiertas, en comparación con quienes recibieron cualquier otro tipo de cuidado. Quienes recibieron cuidado solo de servicios sociales tuvieron más probabilidades de percibir sus necesidades como no cubiertas. La percepción de necesidades no cubiertas está relacionada con las características de la persona dependiente, del

  20. Contraceptive use and distribution of high-risk births in Nigeria: a sub-national analysis

    Directory of Open Access Journals (Sweden)

    Akanni Akinyemi

    2015-11-01

    Full Text Available Background: Family planning expansion has been identified as an impetus to harnessing Nigeria's demographic dividend. However, there is a need for data to address pockets of inequality and to better understand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria. Design: The study utilised women's data from the last three Demographic and Health Surveys (2003, 2008, and 2013 in Nigeria. The analysis involved descriptive, bivariate, and multivariate analyses. The multivariate analyses were performed to examine the relationship between high-risk births and contraceptive use. Associations were examined using Poisson regression. Results: Findings showed that respondents in avoidable high-risk birth categories were less likely to use contraceptives compared to those at no risk [rate ratio 0.82, confidence interval: 0.76–0.89, p<0.001]. Education and wealth index consistently predicted significant differences in contraceptive use across the models. Conclusions: The results of this study suggest that women in the high-risk birth categories were significantly less likely to use a modern method of contraception relative to those categorised as having no risk. However, there are huge sub-national variations at regional and state levels in contraceptive prevalence and subsequent high-risk births. These results further strengthen evidence-based justification for increased investments in family planning programmes at the state and regional levels, particularly regions and states with high unmet needs for family planning.

  1. International partnership in lunar missions: Inaugural address

    Indian Academy of Sciences (India)

    Dr A P J Abdul Kalam

    2005-12-01

    I am delighted to participate in the 6th International Conference on Exploration and Utilization of the Moon organized by the Physical Research Laboratory,Ahmedabad.I greet the organizers, eminent planetary exploration and space scientists from India and abroad,academicians,industrialists,engineers,entrepreneurs and distinguished guests.I understand that the International Lunar Conference is a forum to discuss scienti fic results of the ongoing and future space missions related to lunar exploration.This conference will also be utilized to develop understanding on various strategies,initiatives and missions leading to a permanent human presence on our Moon as the future objective.I am happy to note that interactions that took place in the earlier conferences have been bene ficial to participating countries through the intense sharing of scientific knowledge,data and hands-on mission experiences of various space agencies pursuing lunar exploration programmes.I find that nearly 100 scientific papers are being presented in this conference and that the Moon missions being planned and conducted by all the space faring nations of the world are being presented,reviewed and discussed.I note with excitement that many key issues related to space science and Moon missions are being addressed in this conference.These deliberations are important for the world space science community.This will enable you to obtain a comprehensive picture of the goals and policies of all nations striving towards a common vision of space research,being made available for the bene fit of all mankind.Indeed this augurs well for progress towards universal peace and harmony that is a cherished goal of the people of the world as a whole.

  2. 77 FR 48429 - Commission Address Change

    Science.gov (United States)

    2012-08-14

    ... HEALTH REVIEW COMMISSION 29 CFR Parts 2700, 2701, 2702, 2704, 2705, 2706 Commission Address Change AGENCY... to inform the public of the address change. DATES: This final rule will take effect on August 27... because the amendments are of a minor and administrative nature dealing with only a change in address....

  3. Library outreach: addressing Utah's “Digital Divide”

    OpenAIRE

    McCloskey, Kathleen M.

    2000-01-01

    A “Digital Divide” in information and technological literacy exists in Utah between small hospitals and clinics in rural areas and the larger health care institutions in the major urban area of the state. The goals of the outreach program of the Spencer S. Eccles Health Sciences Library at the University of Utah address solutions to this disparity in partnership with the National Network of Libraries of Medicine—Midcontinental Region, the Utah Department of Health, and the Utah Area Health Ed...

  4. Address burnout with a caring, nurturing environment.

    Science.gov (United States)

    2014-06-01

    With their hectic schedules and demanding work responsibilities, emergency physicians are particularly vulnerable to symptoms of burnout. One study showed that more than half of emergency providers reported at least one symptom of burnout when they were asked to fill out a survey tool used to measure burnout--more than any other type of provider. It's a concern because physicians experiencing burnout may be less attentive to their patients, and some ultimately choose to leave medicine because they are no longer satisfied with their work. However, there are steps health systems and administrators can take to help physicians who are struggling, and prevent isolated problems from escalating into larger issues. When a national sample of more than 7,200 physicians agreed to take the Maslach Burnout Inventory, a survey tool used to measure burnout, nearly half (45.8%) reported at least one symptom of burnout, and 65% of the emergency providers reported symptoms of burnout. Burnout is not just fatigue. It involves disappointment in a relationship or relationships, and lack of satisfaction or fulfillment with work, according to experts. Symptoms may include moodiness, irritability, sarcasm, and may result in performance issues as well. Further, there may be physical changes such as weight loss or changes in appetite. To prevent or address burnout, experts advise health systems to nurture a caring, collaborative environment, and to make sure that providers have mentors or resources to reach out to if they are experiencing any work-related problems. They also advise administrators to make sure that burnout is a safe topic of conversation.

  5. Using the unmet obstetric needs indicator to map inequities in life-saving obstetric interventions at the local health care system in Kenya

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Dubourg, Dominique; Makokha, Anselimo;

    2014-01-01

    BackgroundDeveloping countries with high maternal mortality need to invest in indicators that not only provide information about how many women are dying, but also where, and what can be done to prevent these deaths. The unmet Obstetric Needs (UONs) concept provides this information. This concept...... in facilities that provide comprehensive Emergency Obstetric Care (EmOC) services in 2008 and 2009 were collected. The difference between the number of women who experienced life threatening obstetric complications and those who received care was quantified. The main outcome measures in the study were...

  6. Contraceptive Use, Unmet Need for Contraception, and Unintended Pregnancy in a Context of Mexico-U.S. Migration

    Directory of Open Access Journals (Sweden)

    Kathryn Kessler

    2010-10-01

    Full Text Available This study examines the impact of migration on contraceptive use, unmet need for contraception, and unintended pregnancy among migrants from Tlacuitapa, Jalisco, a migrant-sending community in Mexico with a long history of out-migration to the United States. Our analysis found that after controlling for demographic factors, being born in the United States and having lived in the United States for at least one year during youth have a statistically significant positive effect on using medical contraception. We also found that having lived in the United States during youth has a negative influence on unmet need, suggesting that exposure to the United States during these formative years may facilitate access to contraception. In terms of migration and unintended pregnancy, our analysis yielded that being born in the United States and having lived in the United States during youth have a positive effect on unintended pregnancies, suggesting that U.S. experience may in fact be a risk factor for, rather than protective against, unintended pregnancy.Cette étude examine l’impact de l’immigration sur l’utilisation de contraceptifs, le besoin non satisfait de contraception, et les grossesses non désirées chez les migrants de Tlacuitapa, dans l’état de Jalisco, communauté du Mexique ayant une longue tradition d’immigration vers les Etats-Unis. Notre étude a montré, après contrôle des facteurs démographiques, que le fait d’être né aux Etats-Unis et d’avoir vécu dans ce pays pendant au moins un an pendant sa jeunesse avait un effet positif statistiquement significatif sur l’utilisation d’une contraception médicale. Nous avons également démontré que le fait d’avoir vécu aux Etats-Unis pendant sa jeunesse avait une influence négative sur le besoin non satisfait de contraception, laissant entendre que la présence aux Etats-Unis pendant ces années décisives de la vie peut faciliter l’accès à la contraception. En

  7. Nation/non-nation

    DEFF Research Database (Denmark)

    Sonnichsen, André; Gad, Ulrik Pram

    2008-01-01

    Is nationality the only way of organizing political community? Given the ubiquity of the national principle, one might think so. But, in practice, the national principle is constantly challenged by what can be termed non-national identities. This article looks at manners in which such deviating...

  8. Nationalism in Stateless Nations

    DEFF Research Database (Denmark)

    Thomsen, Robert Chr.

    previously independent countries, are excellent examples of this. Building on theories of national identity-formation and nationalism, it traces the development of cultural and political nationalism, and changing images of the national self. With a focus on important fomenting factors and actors...... - intellectuals, political parties and the media - the book combines historical, sociological, political and media studies analyses in an interdisciplinary investigation, providing a comprehensive account of the waxing and waning of nationalism....

  9. Novel Duplicate Address Detection with Hash Function.

    Science.gov (United States)

    Song, GuangJia; Ji, ZhenZhou

    2016-01-01

    Duplicate address detection (DAD) is an important component of the address resolution protocol (ARP) and the neighbor discovery protocol (NDP). DAD determines whether an IP address is in conflict with other nodes. In traditional DAD, the target address to be detected is broadcast through the network, which provides convenience for malicious nodes to attack. A malicious node can send a spoofing reply to prevent the address configuration of a normal node, and thus, a denial-of-service attack is launched. This study proposes a hash method to hide the target address in DAD, which prevents an attack node from launching destination attacks. If the address of a normal node is identical to the detection address, then its hash value should be the same as the "Hash_64" field in the neighboring solicitation message. Consequently, DAD can be successfully completed. This process is called DAD-h. Simulation results indicate that address configuration using DAD-h has a considerably higher success rate when under attack compared with traditional DAD. Comparative analysis shows that DAD-h does not require third-party devices and considerable computing resources; it also provides a lightweight security resolution.

  10. IP Address Management Principles and Practice

    CERN Document Server

    Rooney, Timothy

    2010-01-01

    This book will be the first covering the subject of IP address management (IPAM). The practice of IPAM includes the application of network management disciplines to IP address space and associated network services, namely DHCP (Dynamic Host Configuration Protocol) and DNS (Domain Name System). The consequence of inaccurately configuring DHCP is that end users may not be able to obtain IP addresses to access the network. Without proper DNS configuration, usability of the network will greatly suffer as the name-to-address lookup process may fail. Imagine having to navigate to a website or send a

  11. Addressing the sluggish progress in reducing maternal mortality in India.

    Science.gov (United States)

    Rai, Rajesh Kumar; Tulchinsky, Theodore Herzl

    2015-03-01

    Although some progress has been made in India, achievement of the Fifth Millennium Development Goal (MDG5; ie, 75% reduction in maternal mortality ratio [MMR] from 1990 by 2015) target seems to be unattainable by 2015. Failure of the National Population Policy, 2000, and the National Health Policy, 2002, to reduce the MMR demanded a new direction, leading to the establishment of a National Rural Health Mission in 2005. This commentary addresses both the real achievements and the hurdles faced in India's stagnating progress in maternal health. Promotion of maternal nutrition and health education, with greater attention to emergency obstetrical care at the district subcenter and primary health care center levels, must be prioritized. These changes of focus are vital to make prenatal, delivery, and postnatal care safer with increased resources allotted to adolescents, the poor, and women living in rural areas in order to enhance maternal health and achieve the MDG target.

  12. Caring for women with ovarian cancer in the last year of life: a longitudinal study of caregiver quality of life, distress and unmet needs.

    Science.gov (United States)

    Butow, Phyllis N; Price, Melanie A; Bell, Melanie L; Webb, Penelope M; deFazio, Anna; Friedlander, Michael

    2014-03-01

    Caregiver burden, quality of life (QOL) and unmet needs are poorly understood, particularly at the end of life. We explored these issues in caregivers of women with ovarian cancer. The Australian Ovarian Cancer Study (AOCS) is a prospective population-based study of women newly diagnosed with primary epithelial ovarian cancer. Ninety-nine caregivers of women participating in the AOCS QOL sub-study (88% response rate) rated their QOL (SF-12), psychological distress (HADS), optimism (LOT), social support (Duke) and unmet needs (SCNS-carers), and patients rated their QOL (FACT-O), every three months for two years. This analysis included measurements in the patient's last year of life. Caregivers had significantly lower mental and physical QOL than population norms (pquality of life, predict caregiver quality of life and distress. Caregivers need help with managing emotions about prognosis, balancing their own and the patient's needs, work, and decision-making when there is uncertainty. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. A New Method of Chinese Address Extraction Based on Address Tree Model

    Directory of Open Access Journals (Sweden)

    KANG Mengjun

    2015-01-01

    Full Text Available Address is a spatial location encoding method of individual geographical area. In China, address planning is relatively backward due to the rapid development of the city, resulting in the presence of large number of non-standard address. The space constrain relationship of standard address model is analyzed in this paper and a new method of standard address extraction based on the tree model is proposed, which regards topological relationship as consistent criteria of space constraints. With this method, standard address can be extracted and errors can be excluded from non-standard address. Results indicate that higher math rate can be obtained with this method.

  14. Change of Address Applications filed via the Internet - FY 2016 (53rd week)

    Data.gov (United States)

    Social Security Administration — This dataset provides monthly volumes at the national level from federal fiscal year 2016 onwards for Internet Change of Address. This dataset includes data from the...

  15. NOAA's Coral Reef Conservation Program: 2016 projects to address coral reef conservation issues

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In 2016 the following projects will take place to address aspects of coral reef conservation: Enhancing Management of Pacific ESA-listed Corals with Improved Utility...

  16. 76 FR 38459 - Surety Companies Acceptable on Federal Bonds-Redomestication and Change in Business Address...

    Science.gov (United States)

    2011-06-30

    .... Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety... Carrico, Director, Financial Accounting and Services Division, Financial Management Service. BILLING CODE... Address; National Farmers Union Property and Casualty Company AGENCY: Financial Management Service,...

  17. Image compression using address-vector quantization

    Science.gov (United States)

    Nasrabadi, Nasser M.; Feng, Yushu

    1990-12-01

    A novel vector quantization scheme, the address-vector quantizer (A-VQ), is proposed which exploits the interblock correlation by encoding a group of blocks together using an address-codebook (AC). The AC is a set of address-codevectors (ACVs), each representing a combination of addresses or indices. Each element of the ACV is an address of an entry in the LBG-codebook, representing a vector-quantized block. The AC consists of an active (addressable) region and an inactive (nonaddressable) region. During encoding the ACVs in the AC are reordered adaptively to bring the most probable ACVs into the active region. When encoding an ACV, the active region is checked, and if such an address combination exists, its index is transmitted to the receiver. Otherwise, the address of each block is transmitted individually. The SNR of the images encoded by the A-VQ method is the same as that of a memoryless vector quantizer, but the bit rate is by a factor of approximately two.

  18. A Novel Approach for TNA Address Management

    Institute of Scientific and Technical Information of China (English)

    Xiaodong Wang; Yaohui Jin; Weishen Hu; Shenli Zhu

    2003-01-01

    We present a new scheme to allocate/de- allocate Transport Network Assigned (TNA) address using Link ManagementProtocol (LMP) and to register/resolution these addresses using Lightweight Directory Access Protocol (LDAP) forAutomatically Switched Optical Network (ASON).

  19. State of industry, environment, human resources addressed

    Energy Technology Data Exchange (ETDEWEB)

    Yergin, D.; Brookes, W.; DeArment, R.

    1991-07-01

    The article is based on three addresses to the AMC Coal Convention '91. Yergin examines the impact of the Gulf crisis on the world energy market. Brookes is sceptical about the 'green industry' and calls for better scientific evidence. DeArment addresses the MSAA's Job Safety Analysis program and other health and safety matters.

  20. Forms of Address in Chilean Spanish

    Science.gov (United States)

    Bishop, Kelley; Michnowicz, Jim

    2010-01-01

    The present investigation examines possible social and linguistic factors that influence forms of address used in Chilean Spanish with various interlocutors. A characteristic of the Spanish of Chile is the use of a variety of forms of address for the second person singular, "tu", "vos", and "usted", with corresponding…

  1. Public Address Systems. Specifications - Installation - Operation.

    Science.gov (United States)

    Palmer, Fred M.

    Provisions for public address in new construction of campus buildings (specifications, installations, and operation of public address systems), are discussed in non-technical terms. Consideration is given to microphones, amplifiers, loudspeakers and the placement and operation of various different combinations. (FS)

  2. An overview of the National Survey of SSI Children and Families and related products.

    Science.gov (United States)

    Davies, Paul S; Rupp, Kalman

    The National Survey of SSI Children and Families (NSCF) is the first nationally representative survey since 1978 of noninstitutionalized children and young adults who currently receive or formerly received Supplemental Security Income (SSI). Over 8,500 interviews were completed between July 2001 and June 2002. The primary objective of the NSCF is to provide data to support research and policy evaluation on the current cross section of children (ages 0 to 17) and young adults (ages 18 to 23) receiving SSI. Following that objective, the survey was designed to answer questions such as those presented below. What are the general characteristics of children and young adults receiving SSI and their families? What are the patterns of access to and utilization of health care among children and young adults receiving SSI? What services are utilized by children and young adults receiving SSI? What are the unmet health care and service needs of children and young adults receiving SSI? What costs are associated with caring for a disabled child? What is the impact on the family of having a disabled child? What is the status of young adults with disabilities as they make the transition to adulthood? How well are they prepared for that transition? In addition, the NSCF questionnaire and sample were designed to be comprehensive enough and large enough to address numerous additional policy issues as they emerge. The NSCF fills a gap in the data available to policy analysts by addressing a wide range of topics that cannot be addressed with SSI administrative data and by providing a large sample in contrast to major national survey databases that cover this target population fairly sparsely. A companion article to this overview describes general characteristics of SSI beneficiary children and their families (see Rupp and others 2005/2006, pages 21-48 of this issue). Other topics being examined include disability-related expenditures for SSI children and young adults and labor force

  3. New dialogue for the way forward in maternal health: addressing market inefficiencies.

    Science.gov (United States)

    McCarthy, Katharine; Ramarao, Saumya; Taboada, Hannah

    2015-06-01

    Despite notable progress in Millennium Development Goal (MDG) five, to reduce maternal deaths three-quarters by 2015, deaths due to treatable conditions during pregnancy and childbirth continue to concentrate in the developing world. Expanding access to three effective and low-cost maternal health drugs can reduce preventable maternal deaths, if available to all women. However, current failures in markets for maternal health drugs limit access to lifesaving medicines among those most in need. In effort to stimulate renewed action planning in the post-MDG era, we present three case examples from other global health initiatives to illustrate how market shaping strategies can scale-up access to essential maternal health drugs. Such strategies include: sharing intelligence among suppliers and users to better approximate and address unmet need for maternal health drugs, introducing innovative financial strategies to catalyze otherwise unattractive markets for drug manufacturers, and employing market segmentation to create a viable and sustainable market. By building on lessons learned from other market shaping interventions and capitalizing on opportunities for renewed action planning and partnership, the maternal health field can utilize market dynamics to better ensure sustainable and equitable distribution of essential maternal health drugs to all women, including the most marginalized.

  4. Addressing tuberculosis patients' medical and socio-economic needs: a comprehensive programmatic approach.

    Science.gov (United States)

    Contreras, Carmen C; Millones, Ana K; Santa Cruz, Janeth; Aguilar, Margot; Clendenes, Martin; Toranzo, Miguel; Llaro, Karim; Lecca, Leonid; Becerra, Mercedes C; Yuen, Courtney M

    2017-04-01

    For a cohort of patients with tuberculosis in Carabayllo, Peru, we describe the prevalence of medical comorbidities and socio-economic needs, the efforts required by a comprehensive support programme ('TB Cero') to address them and the success of this programme in linking patients to care. Patients diagnosed with tuberculosis in Carabayllo underwent evaluations for HIV, diabetes, mental health and unmet basic needs. For patients initiating treatment during 14 September, 2015-15 May, 2016, we abstracted data from evaluation forms and a support request system. We calculated the prevalence of medical comorbidities and the need for socio-economic support at the time of tuberculosis diagnosis, as well as the proportion of patients successfully linked to care or support. Of 192 patients, 83 (43%) had at least one medical comorbidity other than tuberculosis. These included eight (4%) patients with HIV, 12 (6%) with diabetes and 62 (32%) deemed at risk for a mental health condition. Of patients who required follow-up for a comorbidity, 100% initiated antiretroviral therapy, 71% attended endocrinology consultations and 66% attended psychology consultations. Of 126 (65%) patients who completed the socio-economic evaluation, 58 (46%) reported already receiving food baskets from the municipality, and 79 (63%) were given additional support, most commonly food vouchers and assistance in accessing health care. Carabayllo tuberculosis patients face many challenges in addition to tuberculosis. A collaborative, comprehensive treatment support programme can achieve high rates of linkage to care for these needs. © 2017 John Wiley & Sons Ltd.

  5. Biological approaches for addressing the grand challenge of providing access to clean drinking water

    OpenAIRE

    Gerba Charles P; Riley Mark R; Elimelech Menachem

    2011-01-01

    Abstract The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of p...

  6. Addressing the Inflammatory Response to Clinically Relevant Polymers by Manipulating the Host Response Using ITIM Domain-Containing Receptors

    Directory of Open Access Journals (Sweden)

    Joshua B. Slee

    2014-09-01

    Full Text Available Tissue contacting surfaces of medical devices initiate a host inflammatory response, characterized by adsorption of blood proteins and inflammatory cells triggering the release of cytokines, reactive oxygen species (ROS and reactive nitrogen species (RNS, in an attempt to clear or isolate the foreign object from the body. This normal host response contributes to device-associated pathophysiology and addressing device biocompatibility remains an unmet need. Although widespread attempts have been made to render the device surfaces unreactive, the establishment of a completely bioinert coating has been untenable and demonstrates the need to develop strategies based upon the molecular mechanisms that define the interaction between host cells and synthetic surfaces. In this review, we discuss a family of transmembrane receptors, known as immunoreceptor tyrosine-based inhibitory motif (ITIM-containing receptors, which show promise as potential targets to address aberrant biocompatibility. These receptors repress the immune response and ensure that the intensity of an immune response is appropriate for the stimuli. Particular emphasis will be placed on the known ITIM-containing receptor, Signal Regulatory Protein Alpha (SIRPα, and its cognate ligand CD47. In addition, this review will discuss the potential of other ITIM-containing proteins as targets for addressing the aberrant biocompatibility of polymeric biomaterials.

  7. Barriers to the Use of Evidence-Supported Programs to Address School Violence

    Science.gov (United States)

    Cawood, Natalie Diane

    2010-01-01

    Researchers have argued that there is a research-practice gap in the delivery of prevention and mental health services in the school setting. This national survey addresses that gap by identifying the barriers confronted by school social workers in implementing evidence-supported programs to address interpersonal violence in the school context. A…

  8. Address forms in Chinese audit opinions

    Institute of Scientific and Technical Information of China (English)

    Ziye; Zhao

    2014-01-01

    Although forms of address are widely used in textual and other types of disclosure,empirical evidence of their effects is rare.China provides a unique setting in which to test the economic consequences of the forms of address used in audit reports.From 2003 to 2011,about 60%of auditors surveyed addressed their clients by their real names in audit opinions,while the others used honorifics.Based on a sample of Chinese audit opinions,I report the following findings.First,the announcement of an audit opinion that uses the client’s real name elicits a greater market response than the announcement of an opinion featuring an honorific form of address.Second,the effects of real-name forms of address are stronger in firms with weak board governance.Third,the association between audit fees and audit risk factors,such as loss-making,is stronger in firms that are addressed by their real names in audit reports.I conclude from these findings that the forms of address used in audit opinions may reveal private information on audit quality.The results of this study are consistent with the power-solidarity effect described by sociolinguists.

  9. Faktor-faktor yang Berhubungan Dengan Unmet Need KB Pasca-Salin IUD post-placenta di Kamar Rawat Pasca-bersalin RSUP DR. M. Djamil periode Januari-Maret 2013

    Directory of Open Access Journals (Sweden)

    Sari Handayani Utami

    2013-09-01

    Full Text Available AbstrakWanita pada periode post-partum memiliki angka unmet need terhadap kontrasepsi, padahal ini waktu yang tepat untuk mulai memakai kontrasepsi. Salah satu kontrasepsi pasca-salin terkini yang mulai disosialisasikan adalah IUD post-placenta. Namun demikian, masih belum banyak wanita pasangan usia subur yang menggunakan alat kontrasepsi ini bahkan mengetahuinya. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan unmet need KB pasca-salin IUD post-placenta. Jenis penelitian survey dengan desain cross sectional study. Waktu pengambilan data dari 12 Januari sampai dengan 12 Maret 2013. Sampel adalah wanita pasangan usia subur yang melahirkan pervaginam dan dipilih secara accidental sampling. Penelitian dilakukan pada 88 orang responden dengan 50 orang bukan akseptor KB IUD post-placenta dan 38 orang akseptor KB IUD Post-placenta. Pengumpulan data dilakukan menggunakan kuesioner melalui wawancara terpimpin. Data dianalisis secara univariat dan bivariat. Hasil penelitian menunjukkan faktor yang memiliki hubungan signifikan dengan unmet need IUD post-placenta adalah faktor pengetahuan (p value = 0,001, sedangkan faktor lain yang tidak memiliki hubungan signifikan adalah faktor pendidikan (p value = 0,222, faktor status ekonomi (p value = 1,000, dan faktor konseling KB (p value = 0,583.Kata kunci: faktor yang berhubungan, unmet need, KB pasca-salin, IUD post-placentaAbstractThe women in post-partum period have unmet need rate to contraception, whereas it’s approriate time to start using contraception. One of recent post-partum contraception method is IUD post-placenta. But, only a few women of fertile age couple use this contraception even has known it. The purpose of this study was to determine the factors associated to unmet need of post-partum contraception IUD post-placenta. This survey study with cross sectional design study. The data was collected from January 12 until March 12 2013. The subject were

  10. Local address and emergency contact details

    CERN Multimedia

    2013-01-01

    The HR Department would like to remind members of the personnel that they are responsible for ensuring that their personal data concerning local address and preferred emergency contact details remains valid and up-to-date.   Both are easily accessible via the links below: Local address: https://edh.cern.ch/Document/Personnel/LocalAddressChange   Emergency contacts: https://edh.cern.ch/Document/Personnel/EC   Please take a few minutes to check your details and modify if necessary. Thank you in advance. HR Department Head Office

  11. VT E911 road address range geocoder

    Data.gov (United States)

    Vermont Center for Geographic Information — VT E911 road address range geocoder. VCGI, in collaboration with the VT E911 Board, has created a suite of geocoding services that can be used to batch geocode...

  12. Address Points, Published in unknown, SWGRC.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Address Points dataset as of unknown. Data by this publisher are often provided in Geographic coordinate system; in a Not Sure projection; The extent of these...

  13. Addressing Transition Issues in Languages Education.

    Science.gov (United States)

    Steigler-Peters, Susi; Moran, Wendy; Piccioli, Maria Teresa; Chesterton, Paul

    2003-01-01

    Focuses on what has been learned from the implementation and evaluation of the Australian Language and Continuity Initiative (LCI) in relation to addressing transition issues in language education. (Author/VWL)

  14. An Efficient Reconfigurable Content Addressable Memory

    Directory of Open Access Journals (Sweden)

    Saswathy Sekharan

    2014-01-01

    Full Text Available This paper introduces an efficient reconfigurable Content Addressable memory (CAMs which is a hardware search engine that are much faster than other algorithmic approaches for search intensive applications. Content Addressable Memories are composed of conventional semiconductor memory (usually SRAM with added comparison circuitry that enables a search operation to complete in a single clock cycle. To understand more about Content Addressable Memory, it helps to contrast it with RAM. A RAM is an integrated circuit that stores data temporarily. In CAM, the user supplies the data and gets back the address.In this paper we introduce a temporary memory called Cache. The cache-CAM (C-CAM saves 80% power over a conventional CAM. Compared with existing software search engines proposed hardware search engine can do multiple searches at a time with more flexibility.

  15. VT E911 ESITE geocoder - address points

    Data.gov (United States)

    Vermont Center for Geographic Information — VT E911 ESITE geocoder - address points. VCGI, in collaboration with the VT E911 Board, has created a suite of geocoding services that can be used to batch geocode...

  16. Chemical Address Tags of Fluorescent Bioimaging Probes

    OpenAIRE

    Shedden, Kerby; Rosania, Gus R.

    2010-01-01

    Chemical address tags can be defined as specific structural features shared by a set of bioimaging probes having a predictable influence on cell-associated visual signals obtained from these probes. Here, using a large image dataset acquired with a high content screening instrument, machine vision and cheminformatics analysis have been applied to reveal chemical address tags. With a combinatorial library of fluorescent molecules, fluorescence signal intensity, spectral, and spatial features c...

  17. 校园网IP地址冲突原因分析及防范——以青海民族大学为例%Campus Network IP Address Conflict Causes Analysis and Prevention --Qinghai University for Nationalities As Example

    Institute of Scientific and Technical Information of China (English)

    马丽君

    2011-01-01

    Through research,analysis of the IP address causes of conflict,on the basis of IP address conflicts should be resolved in the management and technical guard against them,to ensure the safety of the campus network on the LAN IP address conflict operation.%文章通过对局域网中IP地址的冲突问题进行研究,分析了常见的IP地址的冲突原因,在此基础上提出了IP地址冲突的解决应在管理上和技术上加以防范,保证校园网安全运行。

  18. South African address standard and initiatives towards an international address standard

    CSIR Research Space (South Africa)

    Cooper, Antony K

    2008-10-01

    Full Text Available Various countries and international organizations have address standards or are developing them. An address is needed for many more applications than just postal delivery, such as: goods delivery; connecting utilities; opening bank accounts; voting...

  19. South African address standard and initiatives towards an international address standard.

    CSIR Research Space (South Africa)

    Cooper, Anthony K

    2008-09-01

    Full Text Available Various countries and international organizations have address standards or are developing them. An address is needed for many more applications than just postal delivery, such as: goods delivery; connecting utilities; opening bank accounts; voting...

  20. Parcels and Land Ownership, rural addressing does collect address points, Published in unknown, Gibson County Government.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Parcels and Land Ownership dataset as of unknown. It is described as 'rural addressing does collect address points'. The extent of these data is generally Gila...

  1. Address Points, Address points, Published in 2008, Norton County Appraisal Office.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Address Points dataset, was produced all or in part from Orthoimagery information as of 2008. It is described as 'Address points'. Data by this publisher are...

  2. Addressing the financial consequences of cancer: qualitative evaluation of a welfare rights advice service.

    Directory of Open Access Journals (Sweden)

    Suzanne Moffatt

    Full Text Available BACKGROUND: The onset, treatment and trajectory of cancer is associated with financial stress among patients across a range of health and welfare systems and has been identified as a significant unmet need. Welfare rights advice can be delivered effectively in healthcare settings, has the potential to alleviate financial stress, but has not yet been evaluated. We present an evaluation of a welfare rights advice intervention designed to address the financial consequences of cancer. METHODS: Descriptive study of welfare outcomes among 533 male and 641 female cancer patients and carers aged 4-95 (mean 62 years, who accessed the welfare rights advice service in North East England between April 2009 and March 2010; and qualitative interview study of a maximum variation sample of 35 patients and 9 carers. RESULTS: Over two thirds of cancer patients and carers came from areas of high socio-economic deprivation. Welfare benefit claims were successful for 96% of claims made and resulted in a median increase in weekly income of £70.30 ($109.74, €84.44. Thirty-four different types of benefits or grants were awarded. Additional resources were perceived to lessen the impact of lost earnings, help offset costs associated with cancer, reduce stress and anxiety and increase ability to maintain independence and capacity to engage in daily activities, all of which were perceived to impact positively on well-being and quality of life. Key barriers to accessing benefit entitlements were knowledge, system complexity, eligibility concerns and assumptions that health professionals would alert patients to entitlements. CONCLUSIONS: The intervention proved feasible, effectively increased income for cancer patients and was highly valued. Addressing the financial sequelae of cancer can have positive social and psychological consequences that could significantly enhance effective clinical management and suitable services should be routinely available. Further research

  3. States Address Civics with Mandated Task Forces

    Science.gov (United States)

    Delander, Brady

    2014-01-01

    By coincidence or not, Massachusetts, Illinois and Virginia created civic education task forces not long after national test results showed a dismal understanding of the subject matter across all grade levels. Results of the 2010 National Assessment of Educational Progress showed just 25 percent of all testtakers in grades 4, 8 and 12 demonstrated…

  4. Simulation of Polymer Forming PROCESSES—ADDRESSING Industrial Needs

    Science.gov (United States)

    Thibault, F.; DiRaddo, R.

    2011-05-01

    The objective of this paper is to present the development of simulation and design optimization capabilities, for polymer forming processes, in the context of addressing industrial needs. Accomplishments generated from close to twenty years of research in this field, at the National Research Council (NRC), are presented. Polymer forming processes such as extrusion blow moulding, stretch blow moulding and thermoforming have been the focus of the work, yet the research is extendable to similar polymer forming operations such as micro-blow moulding, sheet blow moulding and composites stamping. The research considers material models, process sequence integration and design optimization, derivative processes and 3D finite elements with multi-body contact.

  5. Breast cancer patients treated with chemotherapy reports more unmet supportive care needs in the early treatment phase, than patients treated only with radiotherapy

    DEFF Research Database (Denmark)

    Jensen-Johansen, Mikael Birkelund; Meldgaard, Anette; Henriksen, Jette

    2016-01-01

    Breast Cancer Patients Treated with Chemo-therapy Reports More Unmet Supportive Care Needs in the Early Treatment Phase, than Patients Treated Only with Radio-therapy Jensen-Johansen, Mikael Birkelund, Meldgaard, Anette, Henriksen, Jette, Villadsen, Ingrid VIA University College, Holstebro, Denmark...... treatment period. Eighty-five percent agreed to participate and 100 women filled out the baseline questionnaire. Forty-five women were under treatment with radiation-therapy, forty-nine with chemo-therapy and four women were treated with both radiation- and chemotherapy. Design and methods: As part...... & information-, physical & daily living-, patient care & support-, and sexuality needs. Analysis: The subscales of the SCNS revealed good reliability (Cronbach’s alpha: .79 - .96) and the summated scores were skewed and therefore log-transformed. An independent samples t-test was conducted to compare the need...

  6. GRACEnet: addressing policy needs through coordinated cross-location research

    Science.gov (United States)

    Jawson, Michael D.; Walthall, Charles W.; Shafer, Steven R.; Liebig, Mark; Franzluebbers, Alan J.; Follett, Ronald F.

    2012-01-01

    GRACEnet (Greenhouse gas Reduction through Agricultural Carbon Enhancement network) was conceived to build upon ongoing USDA Agricultural Research Service (ARS) research to improve soil productivity, while addressing the challenges and opportunities of interest in C sequestration from a climate change perspective. The vision for GRACEnet was and remains: Knowledge and information used to implement scientifically based agricultural management practices from the field to national policy scales on C sequestration, greenhouse gas (GHG) emissions, and environmental benefits. The national focus of GRACEnet uses a standardized approach by ARS laboratories and university and land manager (e.g. farmer and rancher) cooperators to assess C sequestration and GHG emission from different crop and grassland systems. Since 2002, GRACEnet has significantly expanded GHG mitigation science and delivered usable information to agricultural research and policy organizations. Recent developments suggest GRACEnet will have international impact by contributing leadership and technical guidance for the Global Research Alliance on Agricultural Greenhouse Gases.

  7. Unmet need for mental health care in schizophrenia: an overview of literature and new data from a first-admission study.

    Science.gov (United States)

    Mojtabai, Ramin; Fochtmann, Laura; Chang, Su-Wei; Kotov, Roman; Craig, Thomas J; Bromet, Evelyn

    2009-07-01

    We present an overview of the literature on the patterns of mental health service use and the unmet need for care in individuals with schizophrenia with a focus on studies in the United States. We also present new data on the longitudinal course of treatments from a study of first-admission patients with schizophrenia. In epidemiological surveys, approximately 40% of the respondents with schizophrenia report that they have not received any mental health treatments in the preceding 6-12 months. Clinical epidemiological studies also find that many patients virtually drop out of treatment after their index contact with services and receive little mental health care in subsequent years. Clinical studies of patients in routine treatment settings indicate that the treatment patterns of these patients often fall short of the benchmarks set by evidence-based practice guidelines, while at least half of these patients continue to experience significant symptoms. The divergence from the guidelines is more pronounced with regard to psychosocial than medication treatments and in outpatient than in inpatient settings. The expansion of managed care has led to further reduction in the use of psychosocial treatments and, in some settings, continuity of care. In conclusion, we found a substantial level of unmet need for care among individuals with schizophrenia both at community level and in treatment settings. More than half of the individuals with this often chronic and disabling condition receive either no treatment or suboptimal treatment. Recovery in this patient population cannot be fully achieved without enhancing access to services and improving the quality of available services. The recent expansion of managed care has made this goal more difficult to achieve.

  8. Can models of self-management support be adapted across cancer types? A comparison of unmet self-management needs for patients with breast or colorectal cancer.

    Science.gov (United States)

    Mansfield, Elise; Mackenzie, Lisa; Carey, Mariko; Peek, Kerry; Shepherd, Jan; Evans, Tiffany-Jane

    2017-09-22

    There is an increased focus on supporting patients with cancer to actively participate in their healthcare, an approach commonly termed 'self-management'. Comparing unmet self-management needs across cancer types may reveal opportunities to adapt effective self-management support strategies from one cancer type to another. Given that breast and colorectal cancers are prevalent, and have high survival rates, we compared these patients' recent need for help with self-management. Data on multiple aspects of self-management were collected from 717 patients with breast cancer and 336 patients with colorectal cancer attending one of 13 Australian medical oncology treatment centres. There was no significant difference between the proportion of patients with breast or colorectal cancer who reported a need for help with at least one aspect of self-management. Patients with breast cancer were significantly more likely to report needing help with exercising more, while patients with colorectal cancer were more likely to report needing help with reducing alcohol consumption. When controlling for treatment centre, patients who were younger, experiencing distress or had not received chemotherapy were more likely to report needing help with at least one aspect of self-management. A substantial minority of patients reported an unmet need for self-management support. This indicates that high-quality intervention research is needed to identify effective self-management support strategies, as well as implementation trials to identify approaches to translating these strategies into practice. Future research should continue to explore whether self-management support strategies could be adapted across cancer types.

  9. Do Gender-Predominant Primary Health Care Organizations Have an Impact on Patient Experience of Care, Use of Services, and Unmet Needs?

    Science.gov (United States)

    Pineault, Raynald; Borgès Da Silva, Roxane; Provost, Sylvie; Fournier, Michel; Prud'homme, Alexandre; Levesque, Jean-Frédéric

    2017-01-01

    Physicians' gender can have an impact on many aspects of patient experience of care. Organization processes through which the influence of gender is exerted have not been fully explored. The aim of this article is to compare primary health care (PHC) organizations in which female or male doctors are predominant regarding organization and patient characteristics, and to assess their influence on experience of care, preventive care delivery, use of services, and unmet needs. In 2010, we conducted surveys of a population stratified sample (N = 9180) and of all PHC organizations (N = 606) in 2 regions of the province of Québec, Canada. Patient and organization variables were entered sequentially into multilevel regression analyses to measure the impact of gender predominance. Female-predominant organizations had younger doctors and nurses with more expanded role; they collaborated more with other PHC practices, used more tools for prevention, and allotted more time to patient visits. However, doctors spent fewer hours a week at the practice in female-predominant organizations. Patients of these organizations reported lower accessibility. Conversely, they reported better comprehensiveness, responsiveness, counseling, and screening, but these effects were mainly attributable to doctors' younger age. Their reporting unmet needs and emergency department attendance tended to decrease when controlling for patient and organization variables other than doctors' age. Except for accessibility, female-predominant PHC organizations are comparable with their male counterparts. Mean age of doctors was an important confounding variable that mitigated differences, whereas other organization variables enhanced them. These findings deserve consideration to better understand and assess the impacts of the growing number of female-predominant PHC organizations on the health care system.

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

    Science.gov (United States)

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

    2016-04-27

    Understanding the perspectives of caregivers of children with developmental disorders living in low-income countries is important to inform intervention programmes. The purpose of this study was to examine the stigma experiences, explanatory models, unmet needs, preferred interventions and coping mechanisms of caregivers of children with developmental disorders in Ethiopia. Participants comprised caregivers (n = 102) of children with developmental disorders attending two child mental health clinics in Addis Ababa. The majority (66.7%; n = 68) had a diagnosis of intellectual disability (ID); 34 children (33.3%) had autism spectrum disorder (ASD) as their primary diagnosis. All caregivers were administered a structured questionnaire via a face-to-face interview, which included an adaptation of the Family Interview Schedule, closed questions about socio-demographic characteristics, explanatory models of illness, type of interventions used or desired and coping strategies, and an open ended question regarding the family's unmet needs. Most caregivers reported experience of stigma: 43.1% worried about being treated differently, 45.1% felt ashamed about their child's condition and 26.7% made an effort to keep their child's condition secret. Stigma did not depend on the type of developmental disorder, the child's age or gender, or on the age or level of education of the caregiver (all p > 0.05). Reported stigma was significantly higher in caregivers who had sought traditional help (p stigma experienced by families caring for a child with a developmental disorder. Designing interventions appropriate for low-income settings that improve awareness about developmental disorders, decrease stigma, improve access to appropriate education and strengthen caregivers' support are needed.

  11. Ergonomics guidelines for designing electronic mail addresses.

    Science.gov (United States)

    Rau, P L; Salvendy, G

    2001-03-15

    The aim was to design a human-centred electronic mail (e-mail) address system based on networking technology and cognitive ergonomics. Based on the background literature and the results of users' survey, a conceptual model is developed for designing e-mail addresses. This model consists of e-mail address components of formats, domain length, meaningfulness, orientation and information type pertaining to recall, information association and categorization. Five hypotheses were proposed to test the conceptual model, and four experiments were conducted with 85 participants to test the hypotheses. The dependent variables were performance time, error rate and degree of satisfaction, and the independent variables were components of the e-mail addresses. The main results indicate that for a recall task, significantly lower total performance time (26.2%) and error rate (75%) were found for the hybrid formats (digits and letters) than for the letter format, and up to four characters was the best single domain length. For an information association task, embedding both geographical and organizational information significantly decreased the response time (10.9%) in comparison with only embedding organizational information. For a categorization task, embedding both geographical information and organizational information significantly decreased response time (40.7%) in comparison with only embedding organizational information. This research demonstrates the importance of human-centred design and provides guidelines in effectively designing e-mail addresses.

  12. Addressing the Issue: Bullying and LGBTQ Youth

    Directory of Open Access Journals (Sweden)

    Kimberly Allen

    2014-09-01

    Full Text Available Each day, thousands of youth experience bullying and as many of 70% of all youth report having experienced bullying, either directly or indirectly (Cantor, 2005. For Gay, Lesbian, Bi-sexual, Transgender and Questioning (LGBTQ youth, the chances of experiencing bullying are much higher than for youth in the general population (Russell, Horn, Kosciw, & Saewyc, 2010. Although many youth serving organizations have begun to address the issue of bullying with bullying prevention programs, there is a deficit of information and a lack of inclusion of prevention efforts that specifically address LGBTQ youth. This article address the role of youth organizations in creating safe and inclusive environments for all youth, with specific attention paid to resources and strategies for inclusive environments for LGBTQ youth.

  13. Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Events: Unmet Needs - Long-Term Recovery After Action Report

    Science.gov (United States)

    2012-08-30

    SCENARIO National Planning Scenario #5: Chemical Attack – Blister Agent Blister agent attack on a packed Coors Field (Downtown Denver). 95 fatalities...large blisters on exposed skin. Lewisite is a blister agent that contains arsenic, a poisonous element. Skin irritation from sulfur mustard...gradually turns into large blisters filled with yellow fluid wherever the agent contacted the skin. Temporary blindness can occur if a victim’s eyes are

  14. Strategies for Addressing Spreadsheet Compliance Challenges

    CERN Document Server

    Weber, Brandon

    2006-01-01

    Most organizations today use spreadsheets in some form or another to support critical business processes. However the financial resources, and developmental rigor dedicated to them are often minor in comparison to other enterprise technology. The increasing focus on achieving regulatory and other forms of compliance over key technology assets has made it clear that organizations must regard spreadsheets as an enterprise resource and account for them when developing an overall compliance strategy. This paper provides the reader with a set of practical strategies for addressing spreadsheet compliance from an organizational perspective. It then presents capabilities offered in the 2007 Microsoft Office System which can be used to help customers address compliance challenges.

  15. Shared address collectives using counter mechanisms

    Science.gov (United States)

    Blocksome, Michael; Dozsa, Gabor; Gooding, Thomas M; Heidelberger, Philip; Kumar, Sameer; Mamidala, Amith R; Miller, Douglas

    2014-02-18

    A shared address space on a compute node stores data received from a network and data to transmit to the network. The shared address space includes an application buffer that can be directly operated upon by a plurality of processes, for instance, running on different cores on the compute node. A shared counter is used for one or more of signaling arrival of the data across the plurality of processes running on the compute node, signaling completion of an operation performed by one or more of the plurality of processes, obtaining reservation slots by one or more of the plurality of processes, or combinations thereof.

  16. Addressing techniques of liquid crystal displays

    CERN Document Server

    Ruckmongathan, Temkar N

    2014-01-01

    Unique reference source that can be used from the beginning to end of a design project to aid choosing an appropriate LCD addressing technique for a given application This book will be aimed at design engineers who are likely to embed LCD drivers and controllers in many systems including systems on chip. Such designers face the challenge of making the right choice of an addressing technique that will serve them with best performance at minimal cost and complexity. Readers will be able to learn about various methods available for driving matrix LCDs and the comparisons at the end of each chap

  17. Transition through Teamwork: Professionals Address Student Access

    Science.gov (United States)

    Bube, Sue Ann; Carrothers, Carol; Johnson, Cinda

    2016-01-01

    Prior to 2013, there was no collaboration around the transition services for deaf and hard of hearing students in Washington State. Washington had numerous agencies providing excellent support, but those agencies were not working together. It was not until January 29, 2013, when pepnet 2 hosted the Building State Capacity to Address Critical…

  18. Rational Rhymes for Addressing Common Childhood Issues

    Science.gov (United States)

    Warren, Jeffrey M.

    2011-01-01

    Music-based interventions are valuable tools counselors can use when working with children. Specific types of music-based interventions, such as songs or rhymes, can be especially pertinent in addressing the thoughts, feelings, and behaviors of children. Rational-emotive behavior therapy (REBT) provides a therapeutic framework that encourages…

  19. Addressing Psychosocial Factors with Library Mentoring

    Science.gov (United States)

    Farrell, Bridget; Alabi, Jaena; Whaley, Pambanisha; Jenda, Claudine

    2017-01-01

    The majority of articles on mentoring in the library and information science field address career development by emphasizing the orientation process for new librarians and building the requisite skills for a specific job. Few articles deal with the psychological and social challenges that many early-career and minority librarians face, which can…

  20. Addressing Issues Related to Technology and Engineering

    Science.gov (United States)

    Technology Teacher, 2008

    2008-01-01

    This article presents an interview with Michael Hacker and David Burghardt, codirectors of Hoftra University's Center for Technological Literacy. Hacker and Burghardt address issues related to technology and engineering. They argue that teachers need to be aware of the problems kids are facing, and how to present these problems in an engaging…

  1. Parallel Memory Addressing Using Coincident Optical Pulses

    Science.gov (United States)

    1989-09-15

    defined for Al and M, respectively, and at each does not have to be the same for every pair of adjacent destination nodeje D, u D2, the number of...system, a register SKIP may be used at each nodej has to skip before reading the messages addressed node to indicate the number of messages to be

  2. Problem Solvers: Solutions--The Inaugural Address

    Science.gov (United States)

    Dause, Emily

    2014-01-01

    Fourth graders in Miss Dause's and Mrs. Hicks's mathematics classes at South Mountain Elementary School in Dillsburg, Pennsylvania, worked with the data from the Inauagural Address problem that was previously published published in the February 2013 issue of "Teaching Children Mathematics". This activity allowed students to showcase…

  3. assessing nutrition intervention programmes that addressed ...

    African Journals Online (AJOL)

    2012-04-02

    Apr 2, 2012 ... address short-term hunger and improve active learning capacity of children in ... evaluation report of 2000 recommended that school feeding should ... were, however, anecdotal accounts of improved school attendance and classroom .... question of what type of food is best suited for the supplementation ...

  4. How Sociology Texts Address Gun Control

    Science.gov (United States)

    Tonso, William R.

    2004-01-01

    William R. Tonso has chosen an issue that he knows something about to examine how sociology textbooks address controversy. Appealing for gun control is fashionable, but it is at odds with a fondness that ordinary Americans have for their firearms--one that is supported by a growing body of research on deterrence to crime. There are two sides to…

  5. Addressing Measurement Issues Related to Bullying Involvement

    Science.gov (United States)

    Casper, Deborah M.; Meter, Diana J.; Card, Noel A.

    2015-01-01

    In this article, we address measurement issues related to select aspects of bullying involvement with the goal of moving psychometrically sound measurement practices toward applied bullying research. We first provide a nontechnical introduction to psychometric considerations in measuring bullying involvement, highlighting the importance of…

  6. Addressing production stops in the food industry

    DEFF Research Database (Denmark)

    Hansen, Zaza Nadja Lee; Herbert, Luke Thomas; Jacobsen, Peter

    2014-01-01

    This paper investigates the challenges in the food industry which causes the production lines to stop, illustrated by a case study of an SME size company in the baked goods sector in Denmark. The paper proposes key elements this sector needs to be aware of to effectively address production stops......, and gives examples of the unique challenges faced by the SME food industry....

  7. Mapping virtual addresses to different physical addresses for value disambiguation for thread memory access requests

    Science.gov (United States)

    Gala, Alan; Ohmacht, Martin

    2014-09-02

    A multiprocessor system includes nodes. Each node includes a data path that includes a core, a TLB, and a first level cache implementing disambiguation. The system also includes at least one second level cache and a main memory. For thread memory access requests, the core uses an address associated with an instruction format of the core. The first level cache uses an address format related to the size of the main memory plus an offset corresponding to hardware thread meta data. The second level cache uses a physical main memory address plus software thread meta data to store the memory access request. The second level cache accesses the main memory using the physical address with neither the offset nor the thread meta data after resolving speculation. In short, this system includes mapping of a virtual address to a different physical addresses for value disambiguation for different threads.

  8. Evaluating health-related quality of life, work ability, and disability in pulmonary arterial hypertension: an unmet need.

    Science.gov (United States)

    Rubenfire, Melvyn; Lippo, Giuseppina; Bodini, Bruno D; Blasi, Francesco; Allegra, Luigi; Bossone, Eduardo

    2009-08-01

    To our knowledge, there are no specific and validated measures of quality of life (QoL) or degree of disability for pulmonary arterial hypertension (PAH). A review of the literature shows that, with the exception of one recently designed specifically for pulmonary hypertension, QoL questionnaires used in PAH studies are generic measures. These are selected because of shared symptoms that do not necessarily correlate well with functional or physiologic measures and have not been validated for applicability in PAH. In this review, we present the available QoL tools for pulmonary artery hypertension and describe the need for more specific instruments that consider the physical and emotional implications of the diseases associated with PAH and the impact of various treatment options. We also discuss the impact of PAH on work ability and the need for provisions to address medical disability status and Social Security benefit status.

  9. Image Coding Based on Address Vector Quantization.

    Science.gov (United States)

    Feng, Yushu

    Image coding is finding increased application in teleconferencing, archiving, and remote sensing. This thesis investigates the potential of Vector Quantization (VQ), a relatively new source coding technique, for compression of monochromatic and color images. Extensions of the Vector Quantization technique to the Address Vector Quantization method have been investigated. In Vector Quantization, the image data to be encoded are first processed to yield a set of vectors. A codeword from the codebook which best matches the input image vector is then selected. Compression is achieved by replacing the image vector with the index of the code-word which produced the best match, the index is sent to the channel. Reconstruction of the image is done by using a table lookup technique, where the label is simply used as an address for a table containing the representative vectors. A code-book of representative vectors (codewords) is generated using an iterative clustering algorithm such as K-means, or the generalized Lloyd algorithm. A review of different Vector Quantization techniques are given in chapter 1. Chapter 2 gives an overview of codebook design methods including the Kohonen neural network to design codebook. During the encoding process, the correlation of the address is considered and Address Vector Quantization is developed for color image and monochrome image coding. Address VQ which includes static and dynamic processes is introduced in chapter 3. In order to overcome the problems in Hierarchical VQ, Multi-layer Address Vector Quantization is proposed in chapter 4. This approach gives the same performance as that of the normal VQ scheme but the bit rate is about 1/2 to 1/3 as that of the normal VQ method. In chapter 5, a Dynamic Finite State VQ based on a probability transition matrix to select the best subcodebook to encode the image is developed. In chapter 6, a new adaptive vector quantization scheme, suitable for color video coding, called "A Self -Organizing

  10. Cancer Information Seeking Among Adult New Zealanders: a National Cross-Sectional Study.

    Science.gov (United States)

    Richards, Rosalina; McNoe, Bronwen; Iosua, Ella; Reeder, Anthony; Egan, Richard; Marsh, Louise; Robertson, Lindsay; Maclennan, Brett; Dawson, Anna; Quigg, Robin; Petersen, Anne-Cathrine

    2016-11-16

    Organisations seeking to establish themselves as leading cancer information sources for the public need to understand patterns and motivators for information seeking. This study describes cancer information seeking among New Zealanders through a national cross-sectional survey conducted in 2014/15 with a population-based sample of adults (18 years and over). Participants were asked if they had sought information about cancer during the past 12 months, the type of information they sought, what prompted them to look for information and ways of getting information they found helpful. Telephone interviews were completed by 1064 participants (588 females, 476 males, 64% response rate). Of these, 33.8% of females and 23.3% of males (total, 29.2%) had searched for information about cancer over the past year. A search was most frequently prompted by a cancer diagnosis of a family member or friend (43.3%), a desire to educate themselves (17.5%), experience of potential symptoms or a positive screening test (9.4%), family history of cancer (8.9%) or the respondent's own cancer diagnosis (7.7%). Across the cancer control spectrum, the information sought was most commonly about treatment and survival (20.2%), symptoms/early detection (17.2%) or risk factors (14.2%), although many were general or non-specific queries (50.0%). The internet was most commonly identified as a helpful source of information (71.7%), followed by health professionals (35.8%), and reading material (e.g. books, pamphlets) (14.7%).This study provides a snapshot of cancer information seeking in New Zealand, providing valuable knowledge to help shape resource delivery to better meet the diverse needs of information seekers and address potential unmet needs, where information seeking is less prevalent.

  11. Addressing Gender Inequities in Collegiate Sport

    Directory of Open Access Journals (Sweden)

    Athena Yiamouyiannis

    2012-05-01

    Full Text Available The purpose of this study was to examine issues related to female representation within the governance structure of the National Collegiate Athletic Association (NCAA. A descriptive statistics approach through the lens of feminism was taken in collecting and analyzing data related to the gender representation of staff leadership positions within the NCAA national office and gender representation within the NCAA Division I, II, and III governance structure. This was coupled with a review of NCAA programming initiatives related to leadership opportunities. Although a number of strategies are being implemented by the NCAA to provide greater access and leadership opportunities for women (e.g., diversity initiatives, Senior Woman Administrator legislation, and guaranteed representation on committees, women continue to be underrepresented within NCAA governance substructures and upper leadership levels within the NCAA national office. In addition, nongender neutral sport governance policies still exist that impede the progress of achieving gender equality.

  12. Directory of National Recreation Organizations.

    Science.gov (United States)

    Exceptional Parent, 1991

    1991-01-01

    Thirty national recreation organizations serving individuals with disabilities are listed, along with addresses and telephone numbers. Sample recreational activities covered include Boy Scouts and Girls Scouts, various wheelchair sports, skiing, golfing, and horticultural therapy. (JDD)

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... VA Open Data VA App Store National Resource Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & ... 800-273-8255 (Press 1) Social Media Complete Directory EMAIL UPDATES Email Address Required Button to subscribe ...

  14. Overview of an address and purpose of the workshop [ISO Workshop on address standards: Considering the issues related to an international address standard

    CSIR Research Space (South Africa)

    Cooper, Antony K

    2008-05-01

    Full Text Available This workshop was conceived with the aim of discussing what an address actually is and exploring the possibility of developing an international address standard across the various domains that use addresses. This paper attempts to provide...

  15. Characterization of addressability by simultaneous randomized benchmarking

    CERN Document Server

    Gambetta, Jay M; Merkel, S T; Johnson, B R; Smolin, John A; Chow, Jerry M; Ryan, Colm A; Rigetti, Chad; Poletto, S; Ohki, Thomas A; Ketchen, Mark B; Steffen, M

    2012-01-01

    The control and handling of errors arising from cross-talk and unwanted interactions in multi-qubit systems is an important issue in quantum information processing architectures. We introduce a benchmarking protocol that provides information about the amount of addressability present in the system and implement it on coupled superconducting qubits. The protocol consists of randomized benchmarking each qubit individually and then simultaneously, and the amount of addressability is related to the difference of the average gate fidelities of those experiments. We present the results on two similar samples with different amounts of cross-talk and unwanted interactions, which agree with predictions based on simple models for the amount of residual coupling.

  16. Improving student learning by addressing misconceptions

    Science.gov (United States)

    Engelmann, Carol A.; Huntoon, Jacqueline E.

    2011-12-01

    Students—and often those who teach them—come to class with preconceptions and misconceptions that hinder their learning. For instance, many K-12 students and teachers believe groundwater exists in the ground in actual rivers or lakes, but in fact, groundwater is found in permeable rock layers called aquifers. Such misconceptions need to be addressed before students can learn scientific concepts correctly. While other science disciplines have been addressing preconceptions and misconceptions for many years, the geoscience community has only recently begun to concentrate on the impact these have on students' learning. Valuable research is being done that illuminates how geologic thinking evolves from the "novice" to "expert" level. The expert is defined as an individual with deep understanding of Earth science concepts. As research progresses, geoscientists are realizing that correcting preconceptions and misconceptions can move teachers and students closer to the "expert" level [Libarkin, 2005].

  17. World Federation of Vascular Societies: presidential address

    DEFF Research Database (Denmark)

    Sillesen, Henrik Hegaard

    2010-01-01

    The presidential address describes briefly the history of the World Federation for Vascular Societies (WFVS) and its objectives. Vascular Surgery today includes interventional procedures (open surgical and endovascular) in addition to risk factor reduction and medical treatment. It is equally imp...... throughout the world. In addition, for introduction of new treatments, training issues and dissemination of science a global organisation like the WFVS is needed.......The presidential address describes briefly the history of the World Federation for Vascular Societies (WFVS) and its objectives. Vascular Surgery today includes interventional procedures (open surgical and endovascular) in addition to risk factor reduction and medical treatment. It is equally....... Similar, in order to be able to train with relevant case mix and numbers, and in order always to have both complex open and endovascular skills on call 24 hours per day, 365 days a year, centralisation into larger units is necessary. The WFVS is important simply looking at the huge demographic differences...

  18. Forms of Address as Discrete Modal Operators

    Directory of Open Access Journals (Sweden)

    Wojciech Paweł Sosnowski

    2016-12-01

    Full Text Available Forms of Address as Discrete Modal Operators The category of expressions of politeness includes, among others, forms of address. Forms of address express honorification. Honorification can be defined as a special type of meaning that consists of information about the social and interpersonal relations between the speaker and the addressee, the speaker and the hearer, and the speaker and the protagonist of the predication. As far as their place in the syntactic structure is concerned, forms of address can either be integrated with the other elements of a predication or not. However, they are always part of a predication’s semantic structure. Moreover, forms of address convey the speaker’s attitude to the meaning of the predicate that they want to convey, which consequently means that forms of address also carry a modal element. Modality can be defined as a situation in which an individual is in a particular mental state, i.e. exhibits some kind of attitude to a situation or a type of situations. Forms of address can be categorised as modal operators conveying imperatives, requests, suppositions, etc. The term "operator" can be used for a unit of language when it changes the semantic structure of the predication. My research on honorification is mainly based on contemporary corpora, both monolingual and multilingual. In the present study, I analyse forms of address which carry imperative and optative meanings.   Formy adresatywne jako dyskretne operatory modalne W obrębie wyrażeń realizujących funkcje grzecznościowe znajduje się grupa form adresatywnych. Są one częścią kategorii honoryfikatywności rozumianej jako szczególny rodzaj znaczenia zawartego w treści wypowiedzi, informację o towarzysko-społecznej relacji między nadawcą a odbiorcą, nadawcą a słuchaczem oraz nadawcą a bohaterem wypowiedzi. Gramatycznie formy adresatywne mogą być zarówno zintegrowane, jak i niezintegrowane syntaktycznie z resztą wypowiedzi, ale

  19. CANE: The Content Addressed Network Environment

    CERN Document Server

    Gardner-Stephen, Paul

    2007-01-01

    The fragmented nature and asymmetry of local and remote file access and network access, combined with the current lack of robust authenticity and privacy, hamstrings the current internet. The collection of disjoint and often ad-hoc technologies currently in use are at least partially responsible for the magnitude and potency of the plagues besetting the information economy, of which spam and email borne virii are canonical examples. The proposed replacement for the internet, Internet Protocol Version 6 (IPv6), does little to tackle these underlying issues, instead concentrating on addressing the technical issues of a decade ago. This paper introduces CANE, a Content Addressed Network Environment, and compares it against current internet and related technologies. Specifically, CANE presents a simple computing environment in which location is abstracted away in favour of identity, and trust is explicitly defined. Identity is cryptographically verified and yet remains pervasively open in nature. It is argued tha...

  20. Addressing food waste reduction in Denmark

    DEFF Research Database (Denmark)

    Halloran, Afton Marina Szasz; Clement, Jesper; Kornum, Niels

    2014-01-01

    and environmental challenge. Using the case of Denmark, this paper analyses causes of food waste, and discusses how different stakeholders address the prevention and reuse of the €1.18. billion of annual edible food waste. Currently, the majority of food waste is still incinerated with energy recovery. However......Global food demand is driven by population and economic growth, and urbanization. One important instrument to meet this increasing demand and to decrease the pressure on food production is to minimize food losses and food waste. Food waste and loss is a major societal, economic, nutritional......, improvements in technology have made it more efficient to utilize food waste for biogas and compost, which improves nutrient cycling through the food system. Major efforts to address food waste in Denmark have mainly been promoted through civil society groups with governmental support, as well as by industry...

  1. Sending and Addressing Messages in Web Services

    OpenAIRE

    Borkowski, Piotr

    2007-01-01

    This thesis provides an overview of Web Services technology. The concept of Web Services and Service Oriented Architecture are explained. The thesis focuses on the mechanisms for transporting and addressing messages in web services, especially SOAP. It presents the development history of SOAP, an overview of the SOAP 1.2 specification, and the differences between SOAP in version 1.1 and 1.2. Further, the thesis presents two web servers for development and deployment of web services using Java...

  2. Design of an addressable memory controller.

    OpenAIRE

    Ham, Byung Woon.

    1987-01-01

    Approved for public release; distribution in unlimited. The main memory is an essential subsystem in a Von Neumann type of stored program machine. Because of the speed gap existence between the processor and the main memor>% there has been a constant need to improve the main memor\\' to achieve a better throughput. One method is to use a CAM(Content Addressable Memorv'). It is known as a \\ery powerful facility for searching a particular item from a data array rather than from...

  3. Addressing spiritual leadership: an organizational model.

    Science.gov (United States)

    Burkhart, Lisa; Solari-Twadell, P Ann; Haas, Sheila

    2008-01-01

    The Joint Commission requires health systems to address spiritual care. Research indicates that spirituality is associated with better physical, psychological, and social health and that culturally diverse populations and individuals at end-of-life often request spiritual care. The authors report the results of a consensus conference of 21 executives representing 10 large faith-based health systems who discussed the input, process, and outcomes of a corporate model for spiritual leadership. Specific initiatives are highlighted.

  4. Matrix-addressable electrochromic display cell

    Science.gov (United States)

    Beni, G.; Schiavone, L. M.

    1981-04-01

    We report an electrochromic display cell with intrinsic matrix addressability. The cell, based on a sputtered iridium oxide film (SIROF) and a tantalum-oxide hysteretic counterelectrode, has electrochromic parameters (i.e., response times, operating voltages, and contrast) similar to those of other SIROF display devices, but in addition, has short-circuit memory and voltage threshold. Memory and threshold are sufficiently large to allow, in principle, multiplexing of electrochromic display panels of large-screen TV pixel size.

  5. Politeness Strategies in American Presidential Inaugural Addresses

    Institute of Scientific and Technical Information of China (English)

    李立文; 朱琳靓

    2008-01-01

    American presidential inaugural address(PIA)a very important variety with worldwide influence and long-lasting significance.Its main task and purpose is to outline the main policies of the new government and win people's support.However.the prerequisite of winning people's sympathy and support lies in people's good relationship with and trust in the government.Therefore almost all the speakers resort to"approached-based" positive politeness strategy quite often which performs this function very well.

  6. Matching Alternative Addresses: a Semantic Web Approach

    Science.gov (United States)

    Ariannamazi, S.; Karimipour, F.; Hakimpour, F.

    2015-12-01

    Rapid development of crowd-sourcing or volunteered geographic information (VGI) provides opportunities for authoritatives that deal with geospatial information. Heterogeneity of multiple data sources and inconsistency of data types is a key characteristics of VGI datasets. The expansion of cities resulted in the growing number of POIs in the OpenStreetMap, a well-known VGI source, which causes the datasets to outdate in short periods of time. These changes made to spatial and aspatial attributes of features such as names and addresses might cause confusion or ambiguity in the processes that require feature's literal information like addressing and geocoding. VGI sources neither will conform specific vocabularies nor will remain in a specific schema for a long period of time. As a result, the integration of VGI sources is crucial and inevitable in order to avoid duplication and the waste of resources. Information integration can be used to match features and qualify different annotation alternatives for disambiguation. This study enhances the search capabilities of geospatial tools with applications able to understand user terminology to pursuit an efficient way for finding desired results. Semantic web is a capable tool for developing technologies that deal with lexical and numerical calculations and estimations. There are a vast amount of literal-spatial data representing the capability of linguistic information in knowledge modeling, but these resources need to be harmonized based on Semantic Web standards. The process of making addresses homogenous generates a helpful tool based on spatial data integration and lexical annotation matching and disambiguating.

  7. Addressing language barriers to healthcare in India.

    Science.gov (United States)

    Narayan, Lalit

    2013-01-01

    In spite of a growing recognition of the importance of doctor-patient communication, the issue of language barriers to healthcare has received very little attention in India. The Indian population speaks over 22 major languages with English used as the lingua franca for biomedicine. Large-scale internal migration has meant that health workers are encountering increasing instances of language discordance within clinical settings. Research done predominantly in the West has shown language discordance to significantly affect access to care, cause problems of comprehension and adherence, and decrease the satisfaction and quality of care. Addressing language barriers to healthcare in India requires a stronger political commitment to providing non-discriminatory health services, especially to vulnerable groups such as illiterate migrant workers. Research will have to address three broad areas: the ways in which language barriers affect health and healthcare, the efficacy of interventions to overcome language barriers, and the costs of language barriers and efforts to overcome them. There is a need to address such barriers in health worker education and clinical practice. Proven strategies such as hiring multilingual healthcare workers, providing language training to health providers, employing in situ translators or using telephone interpretation services will have to be evaluated for their appropriateness to the Indian context. Internet-based initiatives, the proliferation of mobile phones and recent advances in machine translation promise to contribute to the solution. Copyright 2013, NMJI.

  8. Addressing the “Major Unrest” in science

    Science.gov (United States)

    Simarski, Lynn Teo

    “The politics of science and technology has returned with a vengeance—or perhaps it never left,” Mary Good, head of the National Science Board, told a gathering of Washington scientists and policy-makers on March 30. Good addressed a spectrum of U.S. science issues, providing a chance to take the pulse of an important science policy- maker. The 24-member board that she chairs sets policy for the National Science Foundation.Good strongly criticized current attempts in Congress and elsewhere to create one over-arching policy for science, technology, and competitiveness. “We need to get these three areas separated out,” Good said. “They are truly three different subjects.” The issue is part of an on-going debate in Congress over the character of U.S. industrial policy. Congressional committees often ask how a science program under scrutiny will contribute to the nation's ability to compete in the world marketplace. “My cohorts in industry say that the one thing we must have from the universities is quality manpower; that's the first priority,” Good said. Second on the list is to forge links between academia and industry to keep industry's “in-house talent” at the cutting edge.

  9. Partnerships as panacea for addressing global problems?

    NARCIS (Netherlands)

    A. Kolk (Ans)

    2013-01-01

    textabstractThis chapter examines partnerships and their peculiarities, based on recent research from various disciplines, in the context of the large problems faced by (global) society. These problems are very complex, often cross national boundaries, and cannot easily be 'solved' by one single act

  10. Partnerships as panacea for addressing global problems?

    NARCIS (Netherlands)

    A. Kolk (Ans)

    2013-01-01

    textabstractThis chapter examines partnerships and their peculiarities, based on recent research from various disciplines, in the context of the large problems faced by (global) society. These problems are very complex, often cross national boundaries, and cannot easily be 'solved' by one single

  11. Addressing the Challenges in Tonsillectomy Research to Inform Health Care Policy: A Review.

    Science.gov (United States)

    Mandavia, Rishi; Schilder, Anne G M; Dimitriadis, Panagiotis A; Mossialos, Elias

    2017-09-01

    Eighty-five percent of investment in medical research has been wasted, with lack of effect on clinical practice and policy. There is increasing effort to improve the likelihood of research being used to influence clinical practice and policy. Tonsillectomy is one of the most common otorhinolaryngologic surgical procedures, and its frequency, cost, and morbidity create a clear need for evidence-based guidelines and policy. The first systematic review on tonsillectomy was conducted 40 years ago and highlighted the lack of definitive evidence for the procedure. Since that study, the body of evidence has still not been able to sufficiently inform policy. This review provides an overview of the key challenges in research to inform tonsillectomy policy and recommendations to help bridge the evidence-policy gap. The challenges in using research to inform policy can be summarized as 4 main themes: (1) non-policy-focused evidence and lack of available evidence, (2) quality of evidence, (3) communication of research findings, and (4) coordinating time frames. Researchers and decision makers should be aware of the limitations of research designs and conflicts of interest that can undermine policy decisions. Researchers must work with decision makers and patients throughout the research process to identify areas of unmet need and political priority, align research and policy time frames, and disseminate research findings. Incentives for researchers should be reorganized to promote dissemination of findings. It is important to consider why evidence gaps in tonsillectomy research have not been addressed during the past 40 years despite considerable investment in time and resources. These findings and recommendations will help produce research that is more responsive to policy gaps and more likely to result in policy changes.

  12. Preliminary development and psychometric evaluation of an unmet needs measure for adolescents and young adults with cancer: the Cancer Needs Questionnaire - Young People (CNQ-YP

    Directory of Open Access Journals (Sweden)

    Clinton-McHarg Tara

    2012-01-01

    Full Text Available Abstract Background Adolescents and young adult (AYA cancer survivors may have unique physical, psychological and social needs due to their cancer occurring at a critical phase of development. The aim of this study was to develop a psychometrically rigorous measure of unmet need to capture the specific needs of this group. Methods Items were developed following a comprehensive literature review, focus groups with AYAs, and feedback from health care providers, researchers and other professionals. The measure was pilot tested with 32 AYA cancer survivors recruited through a state-based cancer registry to establish face and content validity. A main sample of 139 AYA cancer patients and survivors were recruited through seven treatment centres and invited to complete the questionnaire. To establish test-retest reliability, a sub-sample of 34 participants completed the measure a second time. Exploratory factor analysis was performed and the measure was assessed for internal consistency, discriminative validity, potential responsiveness and acceptability. Results The Cancer Needs Questionnaire - Young People (CNQ-YP has established face and content validity, and acceptability. The final measure has 70 items and six factors: Treatment Environment and Care (33 items; Feelings and Relationships (14 items; Daily Life (12 items; Information and Activities (5 items; Education (3 items; and Work (3 items. All domains achieved Cronbach's alpha values greater than 0.80. Item-to-item test-retest reliability was also high, with all but four items reaching weighted kappa values above 0.60. Conclusions The CNQ-YP is the first multi-dimensional measure of unmet need which has been developed specifically for AYA cancer patients and survivors. The measure displays a strong factor structure, and excellent internal consistency and test-retest reliability. However, the small sample size has implications for the reliability of the statistical analyses undertaken

  13. Medical condition and care of undocumented migrants in ambulatory clinics in Tel Aviv, Israel: assessing unmet needs.

    Science.gov (United States)

    Mor, Zohar; Raveh, Yuval; Lurie, Ido; Leventhal, Alex; Gamzu, Roni; Davidovitch, Nadav; Benari, Orel; Grotto, Itamar

    2017-07-14

    Approximately 150,000 undocumented migrants (UM) who are medically uninsured reside in Israel, including ~50,000 originating from the horn of Africa (MHA). Free medical-care is provided by two walk-in clinics in Tel-Aviv. This study aims to compare the medical complaints of UM from different origins, define their community health needs and assess gaps between medical needs and available services. This cross-sectional study included a random sample of 610 UM aged 18-64 years, who were treated in these community clinics between 2008 and 2011. The study compared UM who had complex medical conditions which necessitated referral to more equipped medical settings with UM having mild/simple medical conditions, who were treated at the clinics. MHA were younger, unemployed and more commonly males compared with UM originating from other countries. MHA also had longer referral-delays and visited the clinics less frequently. UM with complex medical conditions were more commonly females, had chronic diseases and demonstrated longer referral-delays than those who had mild/simple medical conditions. The latter more commonly presented with complained of respiratory, muscular and skeletal discomfort. In multivariate analysis, the variables which predicted complex medical conditions included female gender, chronic illnes and self-referral to the clinics. The ambulatory clinics were capable of responding to mild/simple medical conditions. Yet, the health needs of women and migrants suffering from complex medical conditions and chronic diseases necessitated referrals to secondary/tertiary medical settings, while jeopardizing the continuity of care. The health gaps can be addressed by a more holistic social approach, which includes integration of UM in universal health insurance.

  14. MATCHING ALTERNATIVE ADDRESSES: A SEMANTIC WEB APPROACH

    Directory of Open Access Journals (Sweden)

    S. Ariannamazi

    2015-12-01

    Full Text Available Rapid development of crowd-sourcing or volunteered geographic information (VGI provides opportunities for authoritatives that deal with geospatial information. Heterogeneity of multiple data sources and inconsistency of data types is a key characteristics of VGI datasets. The expansion of cities resulted in the growing number of POIs in the OpenStreetMap, a well-known VGI source, which causes the datasets to outdate in short periods of time. These changes made to spatial and aspatial attributes of features such as names and addresses might cause confusion or ambiguity in the processes that require feature’s literal information like addressing and geocoding. VGI sources neither will conform specific vocabularies nor will remain in a specific schema for a long period of time. As a result, the integration of VGI sources is crucial and inevitable in order to avoid duplication and the waste of resources. Information integration can be used to match features and qualify different annotation alternatives for disambiguation. This study enhances the search capabilities of geospatial tools with applications able to understand user terminology to pursuit an efficient way for finding desired results. Semantic web is a capable tool for developing technologies that deal with lexical and numerical calculations and estimations. There are a vast amount of literal-spatial data representing the capability of linguistic information in knowledge modeling, but these resources need to be harmonized based on Semantic Web standards. The process of making addresses homogenous generates a helpful tool based on spatial data integration and lexical annotation matching and disambiguating.

  15. An assessment of the current treatment landscape for rheumatology patients in Qatar: Recognising unmet needs and moving towards solutions.

    Science.gov (United States)

    Emadi, Samar Al; Hammoudeh, Mohammed; Mounir, Mohamed; Mueller, Ruediger B; Wells, Alvin F; Sarakbi, Housam Aldeen

    2017-04-01

    Objective This study assessed the mode of application (oral, intravenous or subcutaneous (SC)) currently employed in the treatment of rheumatoid arthritis (RA) in patients from Qatar in comparison with patients' individual preferences for the mode of application of their treatment. Methods This study included 294 RA patients visiting three clinics at the main referral hospital in Qatar who were interviewed using a standard questionnaire to determine their preference of mode of application for their disease-modifying antirheumatic drug (DMARD) treatment in relation to their currently employed mode of application. Results The majority of patients were female (76%), and 93% of male patients and 61% of female patients in the study clinics were of a nationality other than Qatari. The highest patient preference recorded was for an oral therapy (69%), compared with injection (23%) and intravenous (8%) therapy. In total, 85% of patients expressed a preference to remain on oral therapy compared with 63% and 58% of intravenous and SC injection patients indicating a preference to remain on their current method of administration. Conclusions This high preference for oral therapies highlights the considerable need for incorporation of new oral targeted synthetic DMARD therapies into clinical practice within the region.

  16. Cervical Cancer Screening and Incidence by Age: Unmet Needs Near and After the Stopping Age for Screening.

    Science.gov (United States)

    White, Mary C; Shoemaker, Meredith L; Benard, Vicki B

    2017-09-01

    Leading professional organizations recommend cervical cancer screening for average-risk women aged 21-65 years. For average-risk women aged >65 years, routine screening may be discontinued if "adequate" screening with negative results is documented. Screening is recommended after age 65 years for women who do not meet adequate prior screening criteria or are at special risk. Authors examined the most recent cervical cancer incidence data from two federal cancer surveillance programs for all women by age and race, corrected for hysterectomy status. The 2013 and 2015 National Health Interview Surveys were analyzed in 2016 to examine the proportion of women aged 41-70 years without a hysterectomy who reported that they never had a Pap test or that their most recent Pap test was >5 years ago (not recently screened). The incidence rate for cervical cancer among older women, corrected for hysterectomy status, did not decline until age ≥85 years. The proportion not recently screened increased with age, from 12.1% for women aged 41-45 years to 18.4% for women aged 61-65 years. Even among women within the recommended age range for routine screening, many are not up to date, and a substantial number of women approach the "stopping" age for cervical cancer screening without an adequate prior screening history. Efforts are needed to reach women who have not been adequately screened, including women aged >65 years, to prevent invasive cervical cancer cases and deaths among older women. Published by Elsevier Inc.

  17. Grid Added Value to Address Malaria

    CERN Document Server

    Breton, V; Hofmann, M

    2008-01-01

    Through this paper, we call for a distributed, internet-based collaboration to address one of the worst plagues of our present world, malaria. The spirit is a non-proprietary peer-production of information-embedding goods. And we propose to use the grid technology to enable such a world wide "open source" like collaboration. The first step towards this vision has been achieved during the summer on the EGEE grid infrastructure where 46 million ligands were docked for a total amount of 80 CPU years in 6 weeks in the quest for new drugs.

  18. A Task Force to Address Bullying.

    Science.gov (United States)

    Keller, Ronald; Budin, Wendy C; Allie, Tammy

    2016-02-01

    Bullying in the workplace can create a dysfunctional environment that is associated with serious physical and psychological harm to the person being bullied. Nurses' experience with bullying has gained considerable attention in recent years, and warrants further discussion. Nurse leaders need to develop and implement effective bullying prevention initiatives that will foster the functioning of a professional and productive staff in a healthy work environment. The aim of this article is to review workplace bullying as experienced by nurses, and describe how nurses at a Magnet-designated academic medical center developed and implemented a bullying task force to address the problem.

  19. ADDRESSING THE RISKS OF GLOBAL PRODUCT DEVELOPMENT

    DEFF Research Database (Denmark)

    Hansen, Zaza Nadja Lee; Ahmed-Kristensen, Saeema

    2011-01-01

    Offshoring various stages in the product development process – from engineering tasks like R&D and design to manufacturing activities - can impact the development process, the product and the organisation. Some of these impacts are positive while some are negative. The negative impacts are related...... to rework, misunderstandings, miscommunication and lower quality. This paper investigates how the organisation can reduce the negative aspects of offshoring by presenting two possible approaches; one which lessens the exposure to situations in which these negative impacts happen and another which addresses...

  20. HEP technologies to address medical imaging challenges

    CERN Document Server

    CERN. Geneva

    2016-01-01

    Developments in detector technologies aimed at solving challenges in present and future CERN experiments, particularly at the LHC, have triggered exceptional advances in the performance of medical imaging devices, allowing for a spectacular progress in in-vivo molecular imaging procedures, which are opening the way for tailored therapies of major diseases. This talk will briefly review the recent history of this prime example of technology transfer from HEP experiments to society, will describe the technical challenges being addressed by some ongoing projects, and will present a few new ideas for further developments and their foreseeable impact.

  1. Panels and Lectures Address China Controversies

    Directory of Open Access Journals (Sweden)

    Video Resources

    2010-04-01

    Full Text Available Editors note: Over the past several months, colleagues have brought to our attention three public panel discussions and lectures that address contemporary controversies in Chinese studies. These discussions have been video-recorded and are available to view on the internet. These presentations may be useful either for scholarly pursuits or may be excerpted for classroom viewing. We wish to thank those who contacted us about these resources, and we encourage readers who know of other such video resources to let us know about them so that we can inform our ASIANetwork colleagues of their existence and availability.

  2. Community Changes Address Common Health Threat

    Centers for Disease Control (CDC) Podcasts

    2013-09-30

    This podcast helps residents living in multiunit housing, like apartments and condos, understand the threat of secondhand smoke. It also helps residents understand what steps they can take to breathe a little easier if involuntarily exposed to secondhand smoke.  Created: 9/30/2013 by Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion.   Date Released: 9/30/2013.

  3. Addressing Human Factors Gaps in Cyber Defense

    Science.gov (United States)

    2016-09-23

    network attack graphs. Paper presented at the IEEE Workshop on Visualization for Computer Security , Minneapolis, MN. Roberts, J.C. (2007). State of...Cyber security is a high-ranking national priority that is only likely to grow as we become more dependent on cyber systems. From a research perspective...Cyber security , cyber operations, human factors 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT: SAR 18. NUMBER OF PAGES 5 19a

  4. Can Assessment of Disease Burden Prior to Changes in Initial COPD Maintenance Treatment Provide Insight into Remaining Unmet Needs? A Retrospective Database Study in UK Primary Care.

    Science.gov (United States)

    Landis, Sarah H; Wurst, Keele; Le, Hoa Van; Bonar, Kerina; Punekar, Yogesh S

    2017-02-01

    This retrospective cohort study aimed to assess treatment patterns over 24 months amongst patients with chronic obstructive pulmonary disease (COPD), initiating a new COPD maintenance treatment, and to understand clinical indicators of treatment change. Patients included in the study initiated a long-acting β2-agonist (LABA), a long-acting muscarinic antagonist (LAMA), or a combination of LABA and an inhaled corticosteroid (ICS/LABA) between January 1, 2009, and November 30, 2013, as recorded in the United Kingdom Clinical Practice Research Datalink (UK CPRD). Treatment modifications (switching or adding maintenance treatments) over 24 months were assessed, and patient characteristics, disease burden, medication and healthcare resource use during the 30 days before treatment modification were evaluated. The cohort comprised 17,258 patients [LABA (8%), LAMA (39%) and ICS/LABA (54%)] with similar age, body mass index and dyspnoea distribution. LABA users were more likely than LAMA users to add a maintenance therapy. Distinct patterns of treatment augmentations were noted, whereby LABA users typically received dual therapy before moving to triple therapy, while LAMA users moved to triple therapy by directly adding an ICS/LABA. Exacerbation events immediately prior to treatment change were not frequently recorded; however, the need for rescue short-acting medication and assessment of dyspnoea in the 30 days prior to the treatment change suggest that dyspnoea is a remaining unmet need driving therapy change.

  5. Achievements, challenges and unmet needs for haemophilia patients with inhibitors: Report from a symposium in Paris, France on 20 November 2014.

    Science.gov (United States)

    Dargaud, Y; Pavlova, A; Lacroix-Desmazes, S; Fischer, K; Soucie, M; Claeyssens, S; Scott, D W; d'Oiron, R; Lavigne-Lissalde, G; Kenet, G; Escuriola Ettingshausen, C; Borel-Derlon, A; Lambert, T; Pasta, G; Négrier, C

    2016-01-01

    Over the past 20 years, there have been many advances in haemophilia treatment that have allowed patients to take greater control of their disease. However, the development of factor VIII (FVIII) inhibitors is the greatest complication of the disease and a challenge in the treatment of haemophilia making management of bleeding episodes difficult and surgical procedures very challenging. A meeting to discuss the unmet needs of haemophilia patients with inhibitors was held in Paris on 20 November 2014. Topics discussed were genetic and non-genetic risk factors for the development of inhibitors, immunological aspects of inhibitor development, FVIII products and inhibitor development, generation and functional properties of engineered antigen-specific T regulatory cells, suppression of immune responses to FVIII, prophylaxis in haemophilia patients with inhibitors, epitope mapping of FVIII inhibitors, current controversies in immune tolerance induction therapy, surgery in haemophilia patients with inhibitors and future perspectives for the treatment of haemophilia patients with inhibitors. A summary of the key points discussed is presented in this paper.

  6. The Role of Local Authorities in Addressing Human Trafficking

    Directory of Open Access Journals (Sweden)

    Kathryn Rossiter

    2009-05-01

    Full Text Available Worldwide, it is estimated that nearly 4 million people fall victim to people traffickers every year. Trafficking is carried out mainly by Organised Criminal Networks and the victims are forced into prostitution, illegal labour, domestic slavery and petty crime. ROSSITER & BENFIELD: The Role of Local Authorities in Addressing Human Trafficking CJLG May 2009 128 On 1 April 2009, the United Kingdom signed up to the Council of Europe Convention on Action against Trafficking in Human Beings.1 The Convention, which has to date been ratified by 20 European countries, is legally binding and aims to promote and protect the rights of victims who have been tricked or forced into leaving their homes, moved to another country, or within their own country, and then exploited. Whilst it is national governments who are signatories to the Council of Europe Convention, local authorities have a key role to play in its successful implementation.

  7. A mental model proposed to address sustainability and terrorism issues.

    Science.gov (United States)

    Schwing, Richard

    2002-06-01

    I have assembled traditional ways to think about human needs and power along with empirical data to support a mental model of human values. The hierarchy of needs from the world of psychology and the hierarchy of power from the world of diplomacy provide a structure for the model. The empirical data collected from several nations over the last three decades support the structure. Furthermore, an examination of specific trends in this data for specific values indicates that it is not impossible to achieve a sustainable world driven by sustainable values. A world that will be defined by its successful movement toward the "triple bottom line," a term articulated by John Elkington, is a world in which economic prosperity, environmental protection, and social equity are aligned. To say that the model allows one to address terrorism is based on the assumption that the lack of social equity or the perception of that lack determines the likelihood of terrorism.

  8. Library outreach: addressing Utah's “Digital Divide”

    Science.gov (United States)

    McCloskey, Kathleen M.

    2000-01-01

    A “Digital Divide” in information and technological literacy exists in Utah between small hospitals and clinics in rural areas and the larger health care institutions in the major urban area of the state. The goals of the outreach program of the Spencer S. Eccles Health Sciences Library at the University of Utah address solutions to this disparity in partnership with the National Network of Libraries of Medicine—Midcontinental Region, the Utah Department of Health, and the Utah Area Health Education Centers. In a circuit-rider approach, an outreach librarian offers classes and demonstrations throughout the state that teach information-access skills to health professionals. Provision of traditional library services to unaffiliated health professionals is integrated into the library's daily workload as a component of the outreach program. The paper describes the history, methodology, administration, funding, impact, and results of the program. PMID:11055305

  9. Addressing firefighter safety around solar PV systems

    Energy Technology Data Exchange (ETDEWEB)

    Harris, B. [Sustainable Energy Technologies, Calgary, AB (Canada)

    2010-11-15

    The article discussed new considerations for installing photovoltaic (PV) systems that address the needs of fire service personnel. The presence of a PV system presents a multitude of dangers for firefighters, including electrical shock, the inhalation of toxic gases from being unable to cut a hole through the roof, falling debris and flying glass, and dead loading on a compromised structure and tripping on conduits. Mapping systems should be modified so that buildings with PV systems are identified for first responders, including firefighters who should learn that solar modules present an electrical hazard during the day but not at night; covering PV modules with foam or salvage covers may not shut the system down to a safe level; it takes a few moments for the power in PV modules to reduce to zero; and PV modules or conduit should never be cut, broke, chopped, or walked upon. The California Department of Forestry and Fire Protection recommends creating pathways and allowing easier access to the roof by setting the modules back from roof edges, creating a structurally sound pathway for firefighters to walk on and space to cut ventilation holes. However, the setback rule makes the economics of solar installation less viable for residential applications. The technological innovations aimed at addressing system safety all focus on limiting firefighter contact with live electrical components to within the extra-low-voltage (ELV) band. Some of the inverters on the market that support ELV system architecture were described. 1 fig.

  10. Integrated optical addressing of an ion qubit

    CERN Document Server

    Mehta, Karan K; McConnell, Robert; Ram, Rajeev J; Sage, Jeremy M; Chiaverini, John

    2015-01-01

    Scalable implementation of the optics required to control trapped atomic ions' quantum states will be required to construct large-scale ion trap quantum information processors. All experiments in ion traps so far have employed approaches cumbersome to scale to even a few tens of qubits, with the majority relying on manipulation of free space beams with bulk optics. Here we demonstrate lithographically defined nanophotonic dielectric waveguides integrated within a linear surface-electrode ion trap chip, and qubit addressing at multiple locations via focusing grating couplers that emit through openings in the trap electrodes to an ion trapped 50 $\\mu$m above the chip. We perform quantum coherent operations using visible light routed in and emitted from silicon nitride waveguides and couplers, on the optical qubit transition in individual $^{88}$Sr$^+$ ions. The addressing beam is focused near the ion position with a 2 $\\mu$m 1/$e^2$-radius along the trap axis, and we measure crosstalk errors between $10^{-2}$ a...

  11. IP address management : augmenting Sandia's capabilities through open source tools.

    Energy Technology Data Exchange (ETDEWEB)

    Nayar, R. Daniel

    2005-08-01

    Internet Protocol (IP) address management is an increasingly growing concern at Sandia National Laboratories (SNL) and the networking community as a whole. The current state of the available IP addresses indicates that they are nearly exhausted. Currently SNL doesn't have the justification to obtain more IP address space from Internet Assigned Numbers Authority (IANA). There must exist a local entity to manage and allocate IP assignments efficiently. Ongoing efforts at Sandia have been in the form of a multifunctional database application notably known as Network Information System (NWIS). NWIS is a database responsible for a multitude of network administrative services including IP address management. This study will explore the feasibility of augmenting NWIS's IP management capabilities utilizing open source tools. Modifications of existing capabilities to better allocate available IP address space are studied.

  12. Importance of national and international registries of inborn errors of metabolism

    Directory of Open Access Journals (Sweden)

    Roberto Giugliani

    2014-07-01

    Full Text Available In the subject of rare diseases, experience and knowledge is limited. With a rare disease registry, longitudinal data can be added to increase information of them and to improve the quality of medical care and the patient outcome. Registries, unlike randomized controlled trials, provide a source of real-time information to develop guidelines for monitoring and to support patient management. Registries are essential to show the real situation of rare diseases and to establish management goals in order to address the unmet needs of the patients.

  13. Addressing violence against women: a call to action.

    Science.gov (United States)

    García-Moreno, Claudia; Zimmerman, Cathy; Morris-Gehring, Alison; Heise, Lori; Amin, Avni; Abrahams, Naeemah; Montoya, Oswaldo; Bhate-Deosthali, Padma; Kilonzo, Nduku; Watts, Charlotte

    2015-04-25

    Violence against women and girls is prevalent worldwide but historically has been overlooked and condoned. Growing international recognition of these violations creates opportunities for elimination, although solutions will not be quick or easy. Governments need to address the political, social, and economic structures that subordinate women, and implement national plans and make budget commitments to invest in actions by multiple sectors to prevent and respond to abuse. Emphasis on prevention is crucial. Community and group interventions involving women and men can shift discriminatory social norms to reduce the risk of violence. Education and empowerment of women are fundamental. Health workers should be trained to identify and support survivors and strategies to address violence should be integrated into services for child health, maternal, sexual, and reproductive health, mental health, HIV, and alcohol or substance abuse. Research to learn how to respond to violence must be strengthened. The elimination of violence against women and girls is central to equitable and sustainable social and economic development and must be prioritised in the agenda for development after 2015.

  14. ADDRESSING THE SPECTRE OF CYBER TERRORISM: A COMPARATIVE PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Fawzia Cassim

    2012-08-01

    Full Text Available This article looks at the definition of cyber terrorism and terrorist use of the Internet. The article evaluates cyber terrorist threats facing countries such as the United States of America, the United Kingdom, India and South Africa. The article also examines measures introduced by the respective governments in these countries to counteract cyber terrorist threats. Finally, the article will propose a way forward to counteract such possible threats in the future.The face of terrorism is changing. The convergence of the physical and virtual worlds has resulted in the creation of a “new threat” called cyber terrorism. Cyber terrorism is one of the recognised cyber crimes. The absence of suitable legal frameworks to address cyber terrorism at national and regional levels, the lack of adequate safeguards, the lack of cyber security strategies and the pre-occupation of countries with internal factors have all contributed to the creation of an environment that can be easily infiltrated by cyber terrorists. The horrific events of 9/11 provided the impetus for many countries to introduce anti-terrorist legislation. The United States of America, United Kingdom, India and South Africa have introduced legislation to address the threat of cyber terrorism.

  15. Address Forms in Chinese and English-Speaking Culture

    Institute of Scientific and Technical Information of China (English)

    王晓茹

    2015-01-01

    Address forms is one of markers of politeness and is an indispensable part of communication. An appropriate address form promotes interpersonal communication smoothly. An address form is polite in one culture, but might be inappropriate in an⁃other culture. The paper contrasts address forms in English and Chinese culture and explores the reasons for their different choice of address terms.

  16. GIS-based geocoding methods for area-based addresses and 3D addresses in urban areas

    OpenAIRE

    Jiyeong Lee

    2009-01-01

    For more than four decades, two address-matching methods, the street-based address geocoding method and address-point-matching method, have been used to identify geographical coordinates from postal addresses. However, street-based address geocoding methods developed for the US addressing system are not universally applicable in developing a single-portal geocoding middleware for worldwide Internet-based geographic information systems applications. Problems also exist with address-point match...

  17. 76 FR 57701 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List

    Science.gov (United States)

    2011-09-16

    ... AGENCY 40 CFR Part 300 National Oil and Hazardous Substances Pollution Contingency Plan; National... rule published on July 29, 2011, (76 FR 45484) is withdrawn as of September 16, 2011. ADDRESSES... Environmental protection, Air pollution control, Chemicals, Hazardous waste, Hazardous...

  18. 76 FR 57662 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List

    Science.gov (United States)

    2011-09-16

    ... AGENCY 40 CFR Part 300 National Oil and Hazardous Substances Pollution Contingency Plan; National... withdrawal of the direct final action (76 FR 45432) is effective as of September 16, 2011. ADDRESSES... Environmental protection, Air pollution control, Chemicals, Hazardous waste, Hazardous...

  19. The potential for entomophagy to address undernutrition.

    Science.gov (United States)

    Nadeau, Luc; Nadeau, Isaac; Franklin, Frank; Dunkel, Florence

    2015-01-01

    The use of insects as food for humans has the potential to substantially reduce undernutrition worldwide. The Food and Agriculture Organization of the United Nations estimates that 805 million people are undernourished, with a total food energy deficit of 67.6 billion kcal/day (84 kcal/day/person). Calculations in this article suggest that this deficit could theoretically be reduced or eliminated through edible insect rearing, utilizing organic side streams as feed, on 15,586 to 92,976 ha.

  20. Adresse inconnue / Address unknown / Suchwiin Bulmyeong

    Directory of Open Access Journals (Sweden)

    Serge Gruzinski

    2005-03-01

    Full Text Available Tous les films asiatiques parlent de métissage, même ceux qui se présentent comme de vastes fresques historiques perdues dans le temps. Les emprunts aux traditions hollywoodiennes et européennes n'ont cessé d'enrichir une cinématographie aussi ancienne que celle du monde occidental. Dans Adresse inconnue (Address unknown le cinéaste coréen Kim Ki-duk explore l'expérience du métissage et le corps du métis à la frontière entre Corée du Nord et Corée du sud. Fils d'un GI américain et noir et d...

  1. Validation of Housing Standards Addressing Accessibility

    DEFF Research Database (Denmark)

    Helle, Tina

    2013-01-01

    The aim was to explore the use of an activity-based approach to determine the validity of a set of housing standards addressing accessibility. This included examination of the frequency and the extent of accessibility problems among older people with physical functional limitations who used...... participant groups were examined. Performing well-known kitchen activities was associated with accessibility problems for all three participant groups, in particular those using a wheelchair. The overall validity of the housing standards examined was poor. Observing older people interacting with realistic...... no mobility device (n = 10) or who used a wheelchair (n = 10) or a rollator (n = 10). The setting was a kitchen designed according to present housing standards. The participants prepared lunch in the kitchen. Accessibility problems were assessed by observation and self-report. Differences between the three...

  2. Professional Culture and Climate: Addressing Unconscious Bias

    Science.gov (United States)

    Knezek, Patricia

    2016-10-01

    Unconscious bias reflects expectations or stereotypes that influence our judgments of others (regardless of our own group). Everyone has unconscious biases. The end result of unconscious bias can be an accumulation of advantage or disadvantage that impacts the long term career success of individuals, depending on which biases they are subject to. In order to foster a professional culture and climate, being aware of these unconscious biases and mitigating against them is a first step. This is particularly important when judgements are needed, such as in cases for recruitment, choice of speakers for conferences, and even reviewing papers submitted for publication. This presentation will cover how unconscious bias manifests itself, what evidence exists to demonstrate it exists, and ways it can be addressed.

  3. Addressing submarine geohazards through scientific drilling

    Science.gov (United States)

    Camerlenghi, A.

    2009-04-01

    Natural submarine geohazards (earthquakes, volcanic eruptions, landslides, volcanic island flank collapses) are geological phenomena originating at or below the seafloor leading to a situation of risk for off-shore and on-shore structures and the coastal population. Addressing submarine geohazards means understanding their spatial and temporal variability, the pre-conditioning factors, their triggers, and the physical processes that control their evolution. Such scientific endeavour is nowadays considered by a large sector of the international scientific community as an obligation in order to contribute to the mitigation of the potentially destructive societal effects of submarine geohazards. The study of submarine geohazards requires a multi-disciplinary scientific approach: geohazards must be studied through their geological record; active processes must be monitored; geohazard evolution must be modelled. Ultimately, the information must be used for the assessment of vulnerability, risk analysis, and development of mitigation strategies. In contrast with the terrestrial environment, the oceanic environment is rather hostile to widespread and fast application of high-resolution remote sensing techniques, accessibility for visual inspection, sampling and installation of monitoring stations. Scientific Drilling through the IODP (including the related pre site-survey investigations, sampling, logging and in situ measurements capability, and as a platform for deployment of long term observatories at the surface and down-hole) can be viewed as the centre of gravity of an international, coordinated, multi-disciplinary scientific approach to address submarine geohazards. The IODP Initial Science Plan expiring in 2013 does not address openly geohazards among the program scientific objectives. Hazards are referred to mainly in relation to earthquakes and initiatives towards the understanding of seismogenesis. Notably, the only drilling initiative presently under way is the

  4. Discurso de paraninfo Guest speaker's address

    Directory of Open Access Journals (Sweden)

    José Carlos Bruni

    2002-01-01

    Full Text Available O presente texto é o discurso de paraninfo pronunciado para os formandos da turma de 2001 da Faculdade de Filosofia e Ciências da Universidade Estadual Paulista, Campus de Marília/SP. Constitui-se em pequena reflexão sobre o momento da formatura, a passagem para a vida profissional e os problemas mais candentes que a vida acadêmica enfrenta hoje no Brasil.This is the text of the guest speaker's address given on the graduation ceremony of the 2001 class at the Faculdade de Filosofia e Ciências da Universidade Estadual Paulista at Marília/São Paulo. It consists in a brief reflection about the moment of graduation, the passage to professional life and the most serious problems of academic life today in Brazil.

  5. Addressing consumerization of IT risks with nudging

    Directory of Open Access Journals (Sweden)

    Iryna Yevseyeva

    2015-01-01

    Full Text Available In this work we address the main issues of Information Technology (IT consumerization that are related to security risks, and vulnerabilities of devices used within Bring Your Own Device (BYOD strategy in particular. We propose a ‘soft’ mitigation strategy for user actions based on nudging, widely applied to health and social behavior influence. In particular, we propose a complementary, less strict, more flexible Information Security policies, based on risk assessment of device vulnerabilities and threats to corporate data and devices, combined with a strategy of influencing security behavior by nudging. We argue that nudging, by taking into account the context of the decision-making environment, and the fact that the employee may be in better position to make a more appropriate decision, may be more suitable than strict policies in situations of uncertainty of security-related decisions. Several examples of nudging are considered for different tested and potential scenarios in security context.

  6. Integrated optical addressing of an ion qubit.

    Science.gov (United States)

    Mehta, Karan K; Bruzewicz, Colin D; McConnell, Robert; Ram, Rajeev J; Sage, Jeremy M; Chiaverini, John

    2016-12-01

    The long coherence times and strong Coulomb interactions afforded by trapped ion qubits have enabled realizations of the necessary primitives for quantum information processing and the highest-fidelity quantum operations in any qubit to date. Although light delivery to each individual ion in a system is essential for general quantum manipulations and readout, experiments so far have employed optical systems that are cumbersome to scale to even a few tens of qubits. Here we demonstrate lithographically defined nanophotonic waveguide devices for light routing and ion addressing that are fully integrated within a surface-electrode ion trap chip. Ion qubits are addressed at multiple locations via focusing grating couplers emitting through openings in the trap electrodes to ions trapped 50 μm above the chip; using this light, we perform quantum coherent operations on the optical qubit transition in individual (88)Sr(+) ions. The grating focuses the beam to a diffraction-limited spot near the ion position with 2 μm 1/e(2) radius along the trap axis, and we measure crosstalk errors between 10(-2) and 4 × 10(-4) at distances 7.5-15 μm from the beam centre. Owing to the scalability of the planar fabrication technique employed, together with the tight focusing and stable alignment afforded by the integration of the optics within the trap chip, this approach presents a path to creating the optical systems required for large-scale trapped-ion quantum information processing.

  7. Integrated optical addressing of an ion qubit

    Science.gov (United States)

    Mehta, Karan K.; Bruzewicz, Colin D.; McConnell, Robert; Ram, Rajeev J.; Sage, Jeremy M.; Chiaverini, John

    2016-12-01

    The long coherence times and strong Coulomb interactions afforded by trapped ion qubits have enabled realizations of the necessary primitives for quantum information processing and the highest-fidelity quantum operations in any qubit to date. Although light delivery to each individual ion in a system is essential for general quantum manipulations and readout, experiments so far have employed optical systems that are cumbersome to scale to even a few tens of qubits. Here we demonstrate lithographically defined nanophotonic waveguide devices for light routing and ion addressing that are fully integrated within a surface-electrode ion trap chip. Ion qubits are addressed at multiple locations via focusing grating couplers emitting through openings in the trap electrodes to ions trapped 50 μm above the chip; using this light, we perform quantum coherent operations on the optical qubit transition in individual 88Sr+ ions. The grating focuses the beam to a diffraction-limited spot near the ion position with 2 μm 1/e2 radius along the trap axis, and we measure crosstalk errors between 10-2 and 4 × 10-4 at distances 7.5-15 μm from the beam centre. Owing to the scalability of the planar fabrication technique employed, together with the tight focusing and stable alignment afforded by the integration of the optics within the trap chip, this approach presents a path to creating the optical systems required for large-scale trapped-ion quantum information processing.

  8. Nationalism in Stateless Nations

    DEFF Research Database (Denmark)

    Thomsen, Robert Chr.

    democracies need not, as argued by theories of 'classic' nationalist movements, strive for full independence. In fact, nationalist movements are adapting to circumstances by becoming autonomist rather than separatist, pragmatic rather than dogmatic, and the book illustrates how Scotland and Newfoundland, both...... - intellectuals, political parties and the media - the book combines historical, sociological, political and media studies analyses in an interdisciplinary investigation, providing a comprehensive account of the waxing and waning of nationalism....

  9. Collaborative socioeconomic tool development to address management and planning needs

    Science.gov (United States)

    Richardson, Leslie A.; Huber, Christopher; Cullinane Thomas, Catherine; Donovan, Elizabeth; Koontz, Lynne M.

    2014-01-01

    Public lands and resources managed by the National Park Service (NPS) and other land management agencies provide a wide range of social and economic benefits to both nearby local communities and society as a whole, ranging from job creation, to access to unique recreational opportunities, to subsistence and tribal uses of the land. Over the years, there has been an increased need to identify and analyze the socioeconomic effects of the public’s use of NPS lands and resources, and the wide range of NPS land management decisions. This need stems from laws such as the National Environmental Policy Act (NEPA), increased litigation and appeals on NPS management decisions, as well as an overall need to demonstrate how parks benefit communities and the American public. To address these needs, the U.S. Geological Survey (USGS) and NPS have an ongoing partnership to collaboratively develop socioeconomic tools to support planning needs and resource management. This article discusses two such tools. The first, Assessing Socioeconomic Planning Needs (ASPN), was developed to help NPS planners and managers identify key social and economic issues that can arise as a result of land management actions. The second tool, the Visitor Spending Effects (VSE) model, provides a specific example of a type of analysis that may be recommended by ASPN. The remainder of this article discusses the development, main features, and plans for future versions and applications of both ASPN and the VSE.

  10. Can Social Identity Theory Addresses the Ethnocentric Tendencies of Consumers?

    Directory of Open Access Journals (Sweden)

    Tamgid Ahmed Chowdhury

    2012-12-01

    Full Text Available This paper investigates two issues of consumer psychology. First part of the paper assesses the applicability of ‘consumer ethnocentric tendencies scale(CETSCALE’ for a developing country Bangladesh to challenge the orthodox belief that consumer ethnocentrism is a phenomenon of developed nations only. With statistically significant results, the study shows that 13 out of 17 items of original CETSCALE are applicable for Bangladesh which validates that CETSCALE can be a research instrument for developing nations. In the second part, based on the modified CETSCALE items, this paperinvestigates the applicability of ‘social identity theory’ in addressing ethnocentric tendencies of different socio-demographic groups of consumers in Bangladesh. Results show that even if all 13 items of modified CETSCALE were supported by the surveyed population as a whole, the opinions on the scale items differ when the consumers are segregated into smaller social identities. And this deviationis due to their ‘in-group’ interests which supports the applicability of the social identity theory in the present context. The methodology is based on 788 samples collected from 22 districts of Bangladesh.

  11. 75 FR 41790 - Address Management Services-Elimination of the Manual Card Option for Address Sequencing Services

    Science.gov (United States)

    2010-07-19

    ... 111 Address Management Services--Elimination of the Manual Card Option for Address Sequencing Services... line of ``Address Management Services comments.'' Faxed comments are not accepted. FOR FURTHER... send address cards to the appropriate Address Management Services district office or to the delivery...

  12. Addressing multimorbidity to improve healthcare and economic sustainability

    Directory of Open Access Journals (Sweden)

    Francesca Colombo

    2016-02-01

    Full Text Available Abstract Patients with multimorbidity are responsible for more than half of all healthcare utilization, challenging the healthcare budgets of all European nations. Although the European Union is showing signs of a fragile economic recovery, achieving sustainable growth will depend on delivering a combination of fiscal responsibility, structural reforms, and improved efficiency. Addressing the challenges of multimorbidity and providing more effective, affordable, and sustainable care, has climbed the political agenda at a global, European, and national level. Current healthcare systems are poorly adapted to cope with the challenges of patients with multimorbidity. Little is known about the epidemiology and natural history of multimorbidity; the evidence base is weak; clinical guidelines are not always relevant to this population; and financing and delivery systems have not evolved to adequately measure and reward quality and performance. Pockets of innovation are, however, beginning to emerge. In Spain, for example, the ongoing economic crisis has forced regional governments to deliver substantial efficiency savings and, with this in mind, integrated care programmes have been introduced across the country for people with chronic disease and multimorbidity. Early results suggest that formalized integrated care for patients with multimorbidity improves their perceptions of care coordination, reduces hospital and emergency admissions and readmissions, and reduces average costs per capita. Such innovations require meaningful investments at a national level – something that is now supported within the framework of the European Union’s Stability and Growth Pact. Journal of Comorbidity 2016;6(1:21–27 An erratum to this article can be found here: http://dx.doi.org/10.15256/joc.2016.6.77

  13. Addressing Earth Science Data Access Challenges through User Experience Research

    Science.gov (United States)

    Hemmings, S. N.; Banks, B.; Kendall, J.; Lee, C. M.; Irwin, D.; Toll, D. L.; Searby, N. D.

    2013-12-01

    The NASA Capacity Building Program (Earth Science Division, Applied Sciences Program) works to enhance end-user capabilities to employ Earth observation and Earth science (EO/ES) data in decision-making. Open data access and user-tailored data delivery strategies are critical elements towards this end. User Experience (UX) and User Interface (UI) research methods can offer important contributions towards addressing data access challenges, particularly at the interface of science application/product development and product transition to end-users. This presentation focuses on developing nation contexts and describes methods, results, and lessons learned from two recent UX/UI efforts conducted in collaboration with NASA: the SERVIRglobal.net redesign project and the U.S. Water Partnership (USWP) Portal development effort. SERVIR, a collaborative venture among NASA, USAID, and global partners, seeks to improve environmental management and climate change response by helping governments and other stakeholders integrate EO and geospatial technologies into decision-making. The USWP, a collaboration among U.S. public and private sectors, harnesses U.S.-based resources and expertise to address water challenges in developing nations. SERVIR's study, conducted from 2010-2012, assessed and tested user needs, preferences, and online experiences to generate a more user-friendly online data portal at SERVIRglobal.net. The portal provides a central access interface to data and products from SERVIR's network of hubs in East Africa, the Hindu Kush Himalayas, and Mesoamerica. The second study, conducted by the USWP Secretariat and funded by the U.S. Department of State, seeks to match U.S.-based water information resources with developing nation stakeholder needs. The USWP study utilizes a multi-pronged approach to identify key design requirements and to understand the existing water data portal landscape. Adopting UX methods allows data distributors to design customized UIs that

  14. Addressing climate challenges in developing countries

    Science.gov (United States)

    Tilmes, Simone; Monaghan, Andrew; Done, James

    2012-04-01

    Advanced Study Program/Early Career Scientist Assembly Workshop on Regional Climate Issues in Developing Countries; Boulder, Colorado, 19-22 October 2011 The Early Career Scientist Assembly (ECSA) and the Advanced Study Program of the National Center for Atmospheric Research (NCAR) invited 35 early-career scientists from nearly 20 countries to attend a 3-day workshop at the NCAR Mesa Laboratory prior to the World Climate Research Programme (WCRP) Open Science Conference in October 2011. The goal of the workshop was to examine a range of regional climate challenges in developing countries. Topics included regional climate modeling, climate impacts, water resources, and air quality. The workshop fostered new ideas and collaborations between early-career scientists from around the world. The discussions underscored the importance of establishing partnerships with scientists located in typically underrepresented countries to understand and account for the local political, economic, and cultural factors on which climate change is superimposed.

  15. Beyond open big data: addressing unreliable research.

    Science.gov (United States)

    Moseley, Edward T; Hsu, Douglas J; Stone, David J; Celi, Leo Anthony

    2014-11-11

    The National Institute of Health invests US $30.9 billion annually in medical research. However, the subsequent impact of this research output on society and the economy is amplified dramatically as a result of the actual medical treatments, biomedical innovations, and various commercial enterprises that emanate from and depend on these findings. It is therefore a great concern to discover that much of published research is unreliable. We propose extending the open data concept to the culture of the scientific research community. By dialing down unproductive features of secrecy and competition, while ramping up cooperation and transparency, we make a case that what is published would then be less susceptible to the sometimes corrupting and confounding pressures to be first or journalistically attractive, which can compromise the more fundamental need to be robustly correct.

  16. Scotland: Nation without Nationalism?

    Directory of Open Access Journals (Sweden)

    Ya. I. Maltsev

    2015-01-01

    Full Text Available In the period before 1990s two concepts were used to describe the Scottish political development: “Nation without nationalism” and “The stateless nation”. After the devolution of 1998 and electoral achievements of SNP neither of these constructions can properly characterize the processes, undergoing in Scotland. The forming of new alignment of political powers in Scotland is not yet finished, but so far its development leads to the emergence of political configuration separated from that of All-British, with regard to extreme weakening of “big” parties in Scotland. 

  17. 32 CFR 37.500 - What must my pre-award business evaluation address?

    Science.gov (United States)

    2010-07-01

    ... DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation § 37.500 What must my pre-award business evaluation address? (a) You must determine the qualification... 32 National Defense 1 2010-07-01 2010-07-01 false What must my pre-award business...

  18. Technical Potential of Solar Energy to Address Energy Poverty and Avoid GHG Emissions in Africa

    Energy Technology Data Exchange (ETDEWEB)

    Cowlin, S. C.; Heimiller, D.; Bilello, D.; Renne, D.

    2008-01-01

    This analysis explores the technical potential of photovoltaics (PV) or concentrating solar power (CSP) to address energy poverty in Africa through a geographic information system (GIS) screening of solar resource data developed by the U.S. Department of Energy's National Renewable Energy Laboratory (NREL).

  19. Addressing uncertainty in atomistic machine learning

    DEFF Research Database (Denmark)

    Peterson, Andrew A.; Christensen, Rune; Khorshidi, Alireza

    2017-01-01

    Machine-learning regression has been demonstrated to precisely emulate the potential energy and forces that are output from more expensive electronic-structure calculations. However, to predict new regions of the potential energy surface, an assessment must be made of the credibility of the predi......Machine-learning regression has been demonstrated to precisely emulate the potential energy and forces that are output from more expensive electronic-structure calculations. However, to predict new regions of the potential energy surface, an assessment must be made of the credibility...... of the predictions. In this perspective, we address the types of errors that might arise in atomistic machine learning, the unique aspects of atomistic simulations that make machine-learning challenging, and highlight how uncertainty analysis can be used to assess the validity of machine-learning predictions. We...... suggest this will allow researchers to more fully use machine learning for the routine acceleration of large, high-accuracy, or extended-time simulations. In our demonstrations, we use a bootstrap ensemble of neural network-based calculators, and show that the width of the ensemble can provide an estimate...

  20. Programming chemistry in DNA-addressable bioreactors.

    Science.gov (United States)

    Fellermann, Harold; Cardelli, Luca

    2014-10-06

    We present a formal calculus, termed the chemtainer calculus, able to capture the complexity of compartmentalized reaction systems such as populations of possibly nested vesicular compartments. Compartments contain molecular cargo as well as surface markers in the form of DNA single strands. These markers serve as compartment addresses and allow for their targeted transport and fusion, thereby enabling reactions of previously separated chemicals. The overall system organization allows for the set-up of programmable chemistry in microfluidic or other automated environments. We introduce a simple sequential programming language whose instructions are motivated by state-of-the-art microfluidic technology. Our approach integrates electronic control, chemical computing and material production in a unified formal framework that is able to mimic the integrated computational and constructive capabilities of the subcellular matrix. We provide a non-deterministic semantics of our programming language that enables us to analytically derive the computational and constructive power of our machinery. This semantics is used to derive the sets of all constructable chemicals and supermolecular structures that emerge from different underlying instruction sets. Because our proofs are constructive, they can be used to automatically infer control programs for the construction of target structures from a limited set of resource molecules. Finally, we present an example of our framework from the area of oligosaccharide synthesis.

  1. Assessing what to address in science communication

    Science.gov (United States)

    Bruine de Bruin, Wändi; Bostrom, Ann

    2013-01-01

    As members of a democratic society, individuals face complex decisions about whether to support climate change mitigation, vaccinations, genetically modified food, nanotechnology, geoengineering, and so on. To inform people’s decisions and public debate, scientific experts at government agencies, nongovernmental organizations, and other organizations aim to provide understandable and scientifically accurate communication materials. Such communications aim to improve people’s understanding of the decision-relevant issues, and if needed, promote behavior change. Unfortunately, existing communications sometimes fail when scientific experts lack information about what people need to know to make more informed decisions or what wording people use to describe relevant concepts. We provide an introduction for scientific experts about how to use mental models research with intended audience members to inform their communication efforts. Specifically, we describe how to conduct interviews to characterize people’s decision-relevant beliefs or mental models of the topic under consideration, identify gaps and misconceptions in their knowledge, and reveal their preferred wording. We also describe methods for designing follow-up surveys with larger samples to examine the prevalence of beliefs as well as the relationships of beliefs with behaviors. Finally, we discuss how findings from these interviews and surveys can be used to design communications that effectively address gaps and misconceptions in people’s mental models in wording that they understand. We present applications to different scientific domains, showing that this approach leads to communications that improve recipients’ understanding and ability to make informed decisions. PMID:23942122

  2. Addressing uncertainty in atomistic machine learning.

    Science.gov (United States)

    Peterson, Andrew A; Christensen, Rune; Khorshidi, Alireza

    2017-05-10

    Machine-learning regression has been demonstrated to precisely emulate the potential energy and forces that are output from more expensive electronic-structure calculations. However, to predict new regions of the potential energy surface, an assessment must be made of the credibility of the predictions. In this perspective, we address the types of errors that might arise in atomistic machine learning, the unique aspects of atomistic simulations that make machine-learning challenging, and highlight how uncertainty analysis can be used to assess the validity of machine-learning predictions. We suggest this will allow researchers to more fully use machine learning for the routine acceleration of large, high-accuracy, or extended-time simulations. In our demonstrations, we use a bootstrap ensemble of neural network-based calculators, and show that the width of the ensemble can provide an estimate of the uncertainty when the width is comparable to that in the training data. Intriguingly, we also show that the uncertainty can be localized to specific atoms in the simulation, which may offer hints for the generation of training data to strategically improve the machine-learned representation.

  3. Addressing social resistance in emerging security technologies

    Science.gov (United States)

    Mitchener-Nissen, Timothy

    2013-01-01

    In their efforts to enhance the safety and security of citizens, governments and law enforcement agencies look to scientists and engineers to produce modern methods for preventing, detecting, and prosecuting criminal activities. Whole body scanners, lie detection technologies, biometrics, etc., are all being developed for incorporation into the criminal justice apparatus.1 Yet despite their purported security benefits these technologies often evoke social resistance. Concerns over privacy, ethics, and function-creep appear repeatedly in analyses of these technologies. It is argued here that scientists and engineers continue to pay insufficient attention to this resistance; acknowledging the presence of these social concerns yet failing to meaningfully address them. In so doing they place at risk the very technologies and techniques they are seeking to develop, for socially controversial security technologies face restrictions and in some cases outright banning. By identifying sources of potential social resistance early in the research and design process, scientists can both engage with the public in meaningful debate and modify their security technologies before deployment so as to minimize social resistance and enhance uptake. PMID:23970863

  4. Addressing Issues for Land Change Science

    Science.gov (United States)

    Braimoh, Ademola; Huang, He Qing

    2009-09-01

    Workshop on Vulnerability and Resilience of Land Systems in Asia; Beijing, China, 15-17 June 2009; There is a growing international community of scholars who work within the interdisciplinary field of land change science, a scientific domain that seeks to understand the dynamics of the land system as a coupled human-environment system. A coupled human-environment system is one in which the social and biophysical subsystems are intertwined so that the system's condition and responses to external forcing are based on the synergy of the two subsystems. Research on land system vulnerability, defined as a function of exposure and sensitivity to natural and anthropogenic perturbations, such as climate variability and sudden changes in macroeconomic conditions and the ability to cope with the impacts of those perturbations, is a fundamental component of land change science. To address issues related to land system vulnerability, the Global Land Project (GLP; http://www.glp-beijing.org.cn/index.php and http://www.glp.hokudai.ac.jp) brought together an interdisciplinary group of researchers with backgrounds ranging from environmental to social sciences. Participants came from both developed and developing countries. The workshop sought to (1) improve knowledge of the causal processes that affect a system's vulnerability and capacity to cope with different perturbations and (2) identify factors that hinder the integration of vulnerability assessment into policies and decision making.

  5. Addressing social resistance in emerging security technologies.

    Science.gov (United States)

    Mitchener-Nissen, Timothy

    2013-01-01

    In their efforts to enhance the safety and security of citizens, governments and law enforcement agencies look to scientists and engineers to produce modern methods for preventing, detecting, and prosecuting criminal activities. Whole body scanners, lie detection technologies, biometrics, etc., are all being developed for incorporation into the criminal justice apparatus. Yet despite their purported security benefits these technologies often evoke social resistance. Concerns over privacy, ethics, and function-creep appear repeatedly in analyses of these technologies. It is argued here that scientists and engineers continue to pay insufficient attention to this resistance; acknowledging the presence of these social concerns yet failing to meaningfully address them. In so doing they place at risk the very technologies and techniques they are seeking to develop, for socially controversial security technologies face restrictions and in some cases outright banning. By identifying sources of potential social resistance early in the research and design process, scientists can both engage with the public in meaningful debate and modify their security technologies before deployment so as to minimize social resistance and enhance uptake.

  6. Address Points - COUNTY_ADDRESS_POINTS_IDHS_IN: Address Points Maintained by County Agencies in Indiana (Indiana Department of Homeland Security, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — COUNTY_ADDRESS_POINTS_IDHS_IN is a point shapefile that contains address points maintained by county agencies in Indiana, provided by personnel of Indiana Department...

  7. Address Points - COUNTY_ADDRESS_POINTS_IDHS_IN: Address Points Maintained by County Agencies in Indiana (Indiana Department of Homeland Security, Point feature class)

    Data.gov (United States)

    NSGIC State | GIS Inventory — COUNTY_ADDRESS_POINTS_IDHS_IN is an ESRI Geodatabase point feature class that contains address points maintained by county agencies in Indiana, provided by personnel...

  8. 76 FR 71037 - Proposed National Toxicology Program (NTP) Review Process for the Report on Carcinogens: Request...

    Science.gov (United States)

    2011-11-16

    ... HUMAN SERVICES Proposed National Toxicology Program (NTP) Review Process for the Report on Carcinogens... Toxicology Program (DNTP), National Institute of Environmental Health Sciences (NIEHS); National Institutes... (see ADDRESSES). Dated: November 8, 2011. John R. Bucher, Associate Director, National...

  9. 77 FR 61418 - National Institute of Nursing Research; Notice of Closed Meeting

    Science.gov (United States)

    2012-10-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Nursing Research; Notice of Closed... of Committee: National Institute of Nursing Research Special Emphasis Panel; Addressing Needs of...: Tamizchelvi Thyagarajan, Ph.D., Scientific Review Officer, National Institute of Nursing Research,...

  10. Unmet mental health care need 10–11 years after the 9/11 terrorist attacks: 2011–2012 results from the World Trade Center Health Registry

    Science.gov (United States)

    2014-01-01

    Background There is little current information about the unmet mental health care need (UMHCN) and reasons for it among those exposed to the World Trade Center (WTC) terrorist attacks. The purpose of this study was to assess the level of UMHCN among symptomatic individuals enrolled in the WTC Health Registry (WTCHR) in 2011–2012, and to analyze the relationship between UMHCN due to attitudinal, cost, and access factors and mental health symptom severity, mental health care utilization, health insurance availability, and social support. Methods The WTCHR is a prospective cohort study of individuals with reported exposure to the 2001 WTC attacks. This study used data from 9,803 adults who completed the 2003–2004 (Wave 1) and 2011–2012 (Wave 3) surveys and had posttraumatic stress disorder (PTSD) or depression in 2011–2012. We estimated logistic regression models relating perceived attitudinal, cost and access barriers to symptom severity, health care utilization, a lack of health insurance, and social support after adjusting for sociodemographic characteristics. Results Slightly more than one-third (34.2%) of study participants reported an UMHCN. Symptom severity was a strong predictor of UMHCN due to attitudinal and perceived cost and access reasons. Attitudinal UMHCN was common among those not using mental health services, particularly those with relatively severe mental health symptoms. Cost-related UMHCN was significantly associated with a lack of health insurance but not service usage. Access-related barriers were significantly more common among those who did not use any mental health services. A higher level of social support served as an important buffer against cost and access UMHCN. Conclusions A significant proportion of individuals exposed to the WTC attacks with depression or PTSD 10 years later reported an UMHCN, and individuals with more severe and disabling conditions, those who lacked health insurance, and those with low levels of social

  11. The benefits of using a mixed methods approach--quantitative with qualitative--to identify client satisfaction and unmet needs in an HIV healthcare centre.

    Science.gov (United States)

    Chow, M Y K; Quine, S; Li, M

    2010-04-01

    Research into patient satisfaction with HIV ambulatory healthcare facilities is limited due to confidentiality restraints, the short history of the condition and the stigma attached. Furthermore, most satisfaction studies of this client group have not used mixed methods (quantitative with qualitative) despite its increasing use since the 1990s in healthcare research. This cross-sectional study demonstrates how a mixed methods approach is beneficial in assessing HIV client satisfaction and in identifying unmet needs in HIV healthcare. Conducted at the largest ambulatory HIV healthcare centre in Australia, this study consisted of two phases conducted sequentially: Phase One, a quantitative self-administered questionnaire survey, provided an overall statistical picture of satisfaction levels. This was followed by Phase Two, qualitative semi-structured face-to-face interviews, which enabled in-depth investigation of the reasons for satisfaction/dissatisfaction. Phase One had 166 respondents, giving a high response rate of 71%, while Phase Two had 22 participants. The study demonstrates the three advantages of using a mixed methods approach. Firstly, it increased the comprehensiveness of overall findings, by showing how qualitative data (Phase Two) provided explanations for statistical data (Phase One). Secondly, it expanded the dimensions of the research topic, as Phase Two enabled investigation of the determinants of satisfaction/dissatisfaction more broadly after assessing the client satisfaction levels in Phase One. Thirdly, it increased the methodological rigour as findings in both phases could be checked for consistency. Thus using a mixed methods approach can greatly enhance our understanding of client satisfaction in HIV/AIDS research.

  12. An exploration into caring for a stroke-survivor in Lima, Peru: Emotional impact, stress factors, coping mechanisms and unmet needs of informal caregivers

    Science.gov (United States)

    Pesantes, M. Amalia; Brandt, Lena R.; Ipince, Alessandra; Miranda, J. Jaime; Diez-Canseco, Francisco

    2017-01-01

    Introduction Understanding local complexities and challenges of stroke-related caregiving are essential to develop appropriate interventions. Our study aimed to characterize the impact of post-stroke care among caregivers in a setting of transitioning economy. Materials and Methods Qualitative study based on in-depth interviews with primary caregivers of stroke survivors in Lima, Peru. Transcribed data was organized into the emotional impact of caregiving, main stress factors and coping mechanisms to deal with the caregiving role, as well as the unmet needs of caregivers. Results We interviewed twelve caregivers, mean age 52.5 years, 8/12 were females, who were either the spouse or child of the stroke survivor. Stroke patients had a median age of 70 years, range 53–85 years. All participants reported having experienced emotional stress and depressive symptoms as a result of caregiving. Although most had family support, reduced social activities and added unanticipated financial burdens increased caregiver’s stress. None of the caregivers had received training in post-stroke care tasks after the patient’s discharge and only a few had received some psychological support, yet almost all expressed the need to see a professional to improve their mental health. Keeping a positive attitude towards their relative’s physical post-stroke condition was a key coping mechanism. Conclusions In the absence of structured institutional responses, family members endure with the provision of care for stroke survivors, a task escorted by major emotional, financial, and social strains. This burden could be prevented or curtailed if caregivers were to be targeted by interventions providing psychological and financial support, together with basic training on post-stroke care.

  13. Biological approaches for addressing the grand challenge of providing access to clean drinking water.

    Science.gov (United States)

    Riley, Mark R; Gerba, Charles P; Elimelech, Menachem

    2011-03-31

    The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms.

  14. Biological approaches for addressing the grand challenge of providing access to clean drinking water

    Science.gov (United States)

    2011-01-01

    The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms. PMID:21453515

  15. Biological approaches for addressing the grand challenge of providing access to clean drinking water

    Directory of Open Access Journals (Sweden)

    Gerba Charles P

    2011-03-01

    Full Text Available Abstract The U.S. National Academy of Engineering (NAE recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF. Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms.

  16. Programmatic methods for addressing contaminated volume uncertainties.

    Energy Technology Data Exchange (ETDEWEB)

    DURHAM, L.A.; JOHNSON, R.L.; RIEMAN, C.R.; SPECTOR, H.L.; Environmental Science Division; U.S. ARMY CORPS OF ENGINEERS BUFFALO DISTRICT

    2007-01-01

    Accurate estimates of the volumes of contaminated soils or sediments are critical to effective program planning and to successfully designing and implementing remedial actions. Unfortunately, data available to support the preremedial design are often sparse and insufficient for accurately estimating contaminated soil volumes, resulting in significant uncertainty associated with these volume estimates. The uncertainty in the soil volume estimates significantly contributes to the uncertainty in the overall project cost estimates, especially since excavation and off-site disposal are the primary cost items in soil remedial action projects. The Army Corps of Engineers Buffalo District's experience has been that historical contaminated soil volume estimates developed under the Formerly Utilized Sites Remedial Action Program (FUSRAP) often underestimated the actual volume of subsurface contaminated soils requiring excavation during the course of a remedial activity. In response, the Buffalo District has adopted a variety of programmatic methods for addressing contaminated volume uncertainties. These include developing final status survey protocols prior to remedial design, explicitly estimating the uncertainty associated with volume estimates, investing in predesign data collection to reduce volume uncertainties, and incorporating dynamic work strategies and real-time analytics in predesign characterization and remediation activities. This paper describes some of these experiences in greater detail, drawing from the knowledge gained at Ashland1, Ashland2, Linde, and Rattlesnake Creek. In the case of Rattlesnake Creek, these approaches provided the Buffalo District with an accurate predesign contaminated volume estimate and resulted in one of the first successful FUSRAP fixed-price remediation contracts for the Buffalo District.

  17. Computational strategies to address chromatin structure problems

    Science.gov (United States)

    Perišić, Ognjen; Schlick, Tamar

    2016-06-01

    While the genetic information is contained in double helical DNA, gene expression is a complex multilevel process that involves various functional units, from nucleosomes to fully formed chromatin fibers accompanied by a host of various chromatin binding enzymes. The chromatin fiber is a polymer composed of histone protein complexes upon which DNA wraps, like yarn upon many spools. The nature of chromatin structure has been an open question since the beginning of modern molecular biology. Many experiments have shown that the chromatin fiber is a highly dynamic entity with pronounced structural diversity that includes properties of idealized zig-zag and solenoid models, as well as other motifs. This diversity can produce a high packing ratio and thus inhibit access to a majority of the wound DNA. Despite much research, chromatin’s dynamic structure has not yet been fully described. Long stretches of chromatin fibers exhibit puzzling dynamic behavior that requires interpretation in the light of gene expression patterns in various tissue and organisms. The properties of chromatin fiber can be investigated with experimental techniques, like in vitro biochemistry, in vivo imagining, and high-throughput chromosome capture technology. Those techniques provide useful insights into the fiber’s structure and dynamics, but they are limited in resolution and scope, especially regarding compact fibers and chromosomes in the cellular milieu. Complementary but specialized modeling techniques are needed to handle large floppy polymers such as the chromatin fiber. In this review, we discuss current approaches in the chromatin structure field with an emphasis on modeling, such as molecular dynamics and coarse-grained computational approaches. Combinations of these computational techniques complement experiments and address many relevant biological problems, as we will illustrate with special focus on epigenetic modulation of chromatin structure.

  18. Final Report on Internet Addressable Lightswitch

    Energy Technology Data Exchange (ETDEWEB)

    Rubinstein, Francis; Pettler, Peter

    2001-08-27

    This report describes the work performed to develop and test a new switching system and communications network that is useful for economically switching lighting circuits in existing commercial buildings. The first section of the report provides the general background of the IBECS (Integrated Building Environmental Communications System) research and development work as well as the context for the development of the new switching system. The research and development effort that went into producing the first proof-of-concept (the IBECS Addressable Power Switch or APS) and the physical prototype of that concept is detailed in the second section. In the third section of the report, we detail the refined Powerline Carrier Based IBECS Title 24 Wall Switch system that evolved from the APS prototype. The refined system provided a path for installing IBECS switching technology in existing buildings that may not be already wired for light level switching control. The final section of the report describes the performance of the IBECS Title 24 Switch system as applied to a small demonstration in two offices at LBNL's Building 90. We learned that the new Powerline Carrier control systems (A-10 technology) that have evolved from the early X-10 systems have solved most of the noise problems that dogged the successful application of X-10 technologies in commercial buildings. We found that the new A-10 powerline carrier control technology can be reliable and effective for switching lighting circuits even in electrically noisy office environments like LBNL. Thus we successfully completed the task objectives by designing, building and demonstrating a new switching system that can provide multiple levels of light which can be triggered either from specially designed wall switches or from a digital communications network. By applying commercially available powerline carrier based technologies that communicate over the in-place lighting wiring system, this type of control can be

  19. Public health approach to address maternal mortality.

    Science.gov (United States)

    Rai, Sanjay K; Anand, K; Misra, Puneet; Kant, Shashi; Upadhyay, Ravi Prakash

    2012-01-01

    Reducing maternal mortality is one of the major challenges to health systems worldwide, more so in developing countries that account for nearly 99% of these maternal deaths. Lack of a standard method for reporting of maternal death poses a major hurdle in making global comparisons. Currently much of the focus is on documenting the "number" of maternal deaths and delineating the "medical causes" behind these deaths. There is a need to acknowledge the social correlates of maternal deaths as well. Investigating and in-depth understanding of each maternal death can provide indications on practical ways of addressing the problem. Death of a mother has serious implications for the child as well as other family members and to prevent the same, a comprehensive approach is required. This could include providing essential maternal care, early management of complications and good quality intrapartum care through the involvement of skilled birth attendants. Ensuring the availability, affordability, and accessibility of quality maternal health services, including emergency obstetric care (EmOC) would prove pivotal in reducing the maternal deaths. To increase perceived seriousness of the community regarding maternal health, a well-structured awareness campaign is needed with importance be given to avoid adolescent pregnancy as well. Initiatives like Janani Surakhsha Yojna (JSY) that have the potential to improve maternal health needs to be strengthened. Quality assessments should form an essential part of all services that are directed toward improving maternal health. Further, emphasis needs to be given on research by involving multiple allied partners, with the aim to develop a prioritized, coordinated, and innovative research agenda for women's health.

  20. Public health approach to address maternal mortality

    Directory of Open Access Journals (Sweden)

    Sanjay K Rai

    2012-01-01

    Full Text Available Reducing maternal mortality is one of the major challenges to health systems worldwide, more so in developing countries that account for nearly 99% of these maternal deaths. Lack of a standard method for reporting of maternal death poses a major hurdle in making global comparisons. Currently much of the focus is on documenting the "number" of maternal deaths and delineating the "medical causes" behind these deaths. There is a need to acknowledge the social correlates of maternal deaths as well. Investigating and in-depth understanding of each maternal death can provide indications on practical ways of addressing the problem. Death of a mother has serious implications for the child as well as other family members and to prevent the same, a comprehensive approach is required. This could include providing essential maternal care, early management of complications and good quality intrapartum care through the involvement of skilled birth attendants. Ensuring the availability, affordability, and accessibility of quality maternal health services, including emergency obstetric care (EmOC would prove pivotal in reducing the maternal deaths. To increase perceived seriousness of the community regarding maternal health, a well-structured awareness campaign is needed with importance be given to avoid adolescent pregnancy as well. Initiatives like Janani Surakhsha Yojna (JSY that have the potential to improve maternal health needs to be strengthened. Quality assessments should form an essential part of all services that are directed toward improving maternal health. Further, emphasis needs to be given on research by involving multiple allied partners, with the aim to develop a prioritized, coordinated, and innovative research agenda for women′s health.

  1. 21 CFR 1321.01 - DEA mailing addresses.

    Science.gov (United States)

    2010-04-01

    ... Addresses Code of Federal Regulations Section—Topic DEA Mailing address DEA Administrator 1308.43(b... 21 Food and Drugs 9 2010-04-01 2010-04-01 false DEA mailing addresses. 1321.01 Section 1321.01 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE DEA MAILING ADDRESSES § 1321.01...

  2. Addressing Disease-Related Malnutrition in Healthcare

    Science.gov (United States)

    Correia, Maria Isabel; Hegazi, Refaat A.; Diaz-Pizarro Graf, José Ignacio; Gomez-Morales, Gabriel; Fuentes Gutiérrez, Catalina; Goldin, Maria Fernanda; Navas, Angela; Pinzón Espitia, Olga Lucia; Tavares, Gilmária Millere

    2015-01-01

    Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms—increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients’ clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.’s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use. PMID:25883116

  3. Analytical Approaches to Address Homeland Security Issues

    Energy Technology Data Exchange (ETDEWEB)

    Holter, Gregory M.; Young, Jonathan

    2003-11-01

    Homeland security concerns arising since September 11, 2001, have captured national attention and sparked a number of responses at all levels of government. As events have unfolded and the nature of the situation has become better understood within the United States, the need for effective planning and response has resulted in the identification of significant analytical challenges. These challenges relate to a number of different needs, including the following: (1) estimating the probability and the potential impact of various threats, (2) identifying the need for and effectiveness of specific counter-measures, and (3) assessing the combined results of interacting activities and events. Analytical approaches traditionally used for safety engineering and risk analysis, coupled with analytical approaches borrowed from other systems analysis disciplines, can be usefully adapted to help meet these challenges. This paper identifies and discusses several illustrative examples of the analytical challenges currently being faced with respect to homeland security. Linkages are then examined between these specific challenges and traditional analytical approaches from a variety of disciplines, including safety engineering and risk analysis. Since effective cooperation among responsible agencies and organizations has been identified as an issue of concern and is essential to achieve an effective homeland security strategy and response capability, issues relating to multiple interacting activities are specifically highlighted.

  4. Addressing concerns related to geologic hazards at the site of the proposed Transuranic Waste Facility , TA-63, Los Alamos National Laboratory: focus on the current Los Alamos Seismic Network earthquake catalog, proximity of identified seismic events to the proposed facility , and evaluation of prev

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, Peter M. [Los Alamos National Laboratory; Schultz-Fellenz, Emily S. [Los Alamos National Laboratory; Kelley, Richard E. [Los Alamos National Laboratory

    2012-04-02

    This technical paper presents the most recent and updated catalog of earthquakes measured by the Los Alamos Seismic Network at and around Los Alamos National Laboratory (LANL), with specific focus on the site of the proposed transuranic waste facility (TWF) at Technical Area 63 (TA-63). Any questions about the data presented herein, or about the Los Alamos Seismic Network, should be directed to the authors of this technical paper. LANL and the Los Alamos townsite sit atop the Pajarito Plateau, which is bounded on its western edge by the Pajarito fault system, a 35-mile-long system locally comprised of the down-to-the-east Pajarito fault (the master fault) and subsidiary down-to-the-west Rendija Canyon, Guaje Mountain, and Sawyer Canyon faults (Figure 1). This fault system forms the local active western margin of the Rio Grande rift near Los Alamos, and is potentially seismogenic (e.g., Gardner et al., 2001; Reneau et al., 2002; Lewis et al., 2009). The proposed TWF area at TA-63 is situated on an unnamed mesa in the north-central part of LANL between Twomile Canyon to the south, Ten Site Canyon to the north, and the headwaters of Canada del Buey to the east (Figure 2). The local bedrock is the Quaternary Bandelier Tuff, formed in two eruptive pulses from nearby Valles caldera, the eastern edge of which is located approximately 6.5 miles west-northwest of the technical area. The older member (Otowi Member) of the Bandelier Tuff has been dated at 1.61 Ma (Izett and Obradovich 1994). The younger member (Tshirege Member) of the Bandelier Tuff has been dated at 1.256 Ma (age from Phillips et al. 2007) and is widely exposed as the mesa-forming unit around Los Alamos. Several discrete cooling units comprise the Tshirege Member. Commonly accepted stratigraphic nomenclature for the Tshirege Member is described in detail by Broxton and Reneau (1995), Gardner et al. (2001), and Lewis et al. (2009). The Tshirege Member cooling unit exposed at the surface at TA-63 is Qbt3

  5. Addressing contrasting cognitive models in scientific collaboration

    Science.gov (United States)

    Diviacco, P.

    2012-04-01

    If the social aspects of scientific communities and their internal dynamics is starting to be recognized and acknowledged in the everyday lives of scientists, it is rather difficult for them to find tools that could support their activities consistently with this perspective. Issues span from gathering researchers to mutual awareness, from information sharing to building meaning, with the last one being particularly critical in research fields as the geo-sciences, that deal with the reconstruction of unique, often non-reproducible, and contingent processes. Reasoning here is, in fact, mainly abductive, allowing multiple and concurrent explanations for the same phenomenon to coexist. Scientists bias one hypothesis over another not only on strictly logical but also on sociological motivations. Following a vision, scientists tend to evolve and isolate themselves from other scientists creating communities characterized by different cognitive models, so that after some time these become incompatible and scientists stop understanding each other. We address these problems as a communication issue so that the classic distinction into three levels (syntactic, semantic and pragmatic) can be used. At the syntactic level, we highlight non-technical obstacles that condition interoperability and data availability and transparency. At the semantic level, possible incompatibilities of cognitive models are particularly evident, so that using ontologies, cross-domain reconciliation should be applied. This is a very difficult task to perform since the projection of knowledge by scientists, in the designated community, is political and thus can create a lot of tension. The strategy we propose to overcome these issues pertains to pragmatics, in the sense that it is intended to acknowledge the cultural and personal factors each partner brings into the collaboration and is based on the idea that meaning should remain a flexible and contingent representation of possibly divergent views

  6. Evaluating Judicial Performance and Addressing Gender Bias

    Directory of Open Access Journals (Sweden)

    Angela Melville

    2014-12-01

    Full Text Available Elek and Rottman argue that judicial evaluation is often biased against women and minority judges. The need to address bias is important, however often the desire for diversity seems so self-evident as to belie deeper analysis. This paper examines the two main rationales for gender equality on the bench. First, female judges are often considered necessary in order to bring a gendered perspective to judging, however it is argued that this rationale is flawed. Second, an alternative rationale based on equality and legitimacy is offered which avoids gender essentialism. While debates typically focus on these two rationales, a third rationale embraces both difference and equality/legitimacy. The presence of female judges has an important symbolic value which destabilises existing fraternal legal norms. Finally, increasing the number of female judges may not necessarily change judging, and this paper also analyses how the transformative potential offered by judicial diversity can work in practice. Elek y Rottman defienden que la evaluación judicial suele estar sesgada en contra de las mujeres y los jueces pertenecientes a minorías. La necesidad de abordar el sesgo es importante, sin embargo a menudo el deseo de diversidad parece tan evidente como para contradecir un análisis más profundo. Este artículo examina los dos motivos principales para la igualdad de género en el banquillo. En primer lugar, las mujeres jueces a menudo se consideran necesarias para aportar una perspectiva de género al hecho de juzgar, sin embargo, se defiende que este razonamiento es erróneo. En segundo lugar, se ofrece una alternativa lógica basada en la igualdad y la legitimidad que evita el esencialismo de género. Mientras que los debates suelen centrarse en estas dos razones, una tercera justificación abarca tanto la diferencia como la igualdad/legitimidad. La presencia de mujeres en la judicatura tiene un importante valor simbólico que desestabiliza las normas

  7. Multi Sensor Approach to Address Sustainable Development

    Science.gov (United States)

    Habib, Shahid

    2007-01-01

    The main objectives of Earth Science research are many folds: to understand how does this planet operates, can we model her operation and eventually develop the capability to predict such changes. However, the underlying goals of this work are to eventually serve the humanity in providing societal benefits. This requires continuous, and detailed observations from many sources in situ, airborne and space. By and large, the space observations are the way to comprehend the global phenomena across continental boundaries and provide credible boundary conditions for the mesoscale studies. This requires a multiple sensors, look angles and measurements over the same spot in accurately solving many problems that may be related to air quality, multi hazard disasters, public health, hydrology and more. Therefore, there are many ways to address these issues and develop joint implementation, data sharing and operating strategies for the benefit of the world community. This is because for large geographical areas or regions and a diverse population, some sound observations, scientific facts and analytical models must support the decision making. This is crucial for the sustainability of vital resources of the world and at the same time to protect the inhabitants, endangered species and the ecology. Needless to say, there is no single sensor, which can answer all such questions effectively. Due to multi sensor approach, it puts a tremendous burden on any single implementing entity in terms of information, knowledge, budget, technology readiness and computational power. And, more importantly, the health of planet Earth and its ability to sustain life is not governed by a single country, but in reality, is everyone's business on this planet. Therefore, with this notion, it is becoming an impractical problem by any single organization/country to bear this colossal responsibility. So far, each developed country within their means has proceeded along satisfactorily in implementing

  8. Addressing the Old Water Paradox using tritium

    Science.gov (United States)

    Cartwright, Ian; Morgenstern, Uwe

    2017-04-01

    , including intermediate stores such as soil water, interflow, and water in the regolith, a multi-tracer approach is required to apportion the contribution of water from these stores during high flow events. Most of the major ions and EC were not useful in determining the changing water stores and the variation in stable isotopes was minor. Tritium provides the opportunity to directly assess how the average residence time of water varies across the flow event and through this address some aspects of the old water paradox.

  9. Multi Sensor Approach to Address Sustainable Development

    Science.gov (United States)

    Habib, Shahid

    2007-01-01

    The main objectives of Earth Science research are many folds: to understand how does this planet operates, can we model her operation and eventually develop the capability to predict such changes. However, the underlying goals of this work are to eventually serve the humanity in providing societal benefits. This requires continuous, and detailed observations from many sources in situ, airborne and space. By and large, the space observations are the way to comprehend the global phenomena across continental boundaries and provide credible boundary conditions for the mesoscale studies. This requires a multiple sensors, look angles and measurements over the same spot in accurately solving many problems that may be related to air quality, multi hazard disasters, public health, hydrology and more. Therefore, there are many ways to address these issues and develop joint implementation, data sharing and operating strategies for the benefit of the world community. This is because for large geographical areas or regions and a diverse population, some sound observations, scientific facts and analytical models must support the decision making. This is crucial for the sustainability of vital resources of the world and at the same time to protect the inhabitants, endangered species and the ecology. Needless to say, there is no single sensor, which can answer all such questions effectively. Due to multi sensor approach, it puts a tremendous burden on any single implementing entity in terms of information, knowledge, budget, technology readiness and computational power. And, more importantly, the health of planet Earth and its ability to sustain life is not governed by a single country, but in reality, is everyone's business on this planet. Therefore, with this notion, it is becoming an impractical problem by any single organization/country to bear this colossal responsibility. So far, each developed country within their means has proceeded along satisfactorily in implementing

  10. Addressing Tobacco in Managed Care: Results of the 2002 Survey

    Directory of Open Access Journals (Sweden)

    Carol McPhillips-Tangum

    2004-10-01

    Full Text Available Introduction In the United States, tobacco use is the leading preventable cause of death and disease. The health and cost consequences of tobacco dependence have made treatment and prevention of tobacco use a key priority among multiple stakeholders, including health plans, insurers, providers, employers, and policymakers. In 2002, the third survey of tobacco control practices and policies in health plans was conducted by America’s Health Insurance Plans’ technical assistance office as part of the Addressing Tobacco in Managed Care (ATMC program. Methods The ATMC survey was conducted in the spring of 2002 via mail, e-mail, and fax. A 19-item survey instrument was developed and pilot-tested. Of the 19 items, 12 were the same as in previous years, four were modified to collect more detailed data on areas of key interest, and three were added to gain information about strategies to promote smoking cessation. The sample for the survey was drawn from the 687 plans listed in the national directory of member and nonmember health plans in America's Health Insurance Plans. Results Of the 246 plans in the sample, 152 plans (62% representing more than 43.5 million health maintenance organization members completed the survey. Results show that health plans are using evidence-based programs and clinical guidelines to address tobacco use. Compared to ATMC survey data collected in 1997 and 2000, the 2002 ATMC survey results indicate that more health plans are providing full coverage for first-line pharmacotherapies and telephone counseling for smoking cessation. Plans have also shown improvement in their ability to identify at least some members who smoke. Similarly, a greater percentage of plans are employing strategies to address smoking cessation during the postpartum period to prevent smoking relapse and during pediatric visits to reduce or eliminate children’s exposure to environmental tobacco smoke. Conclusion The results of the 2002 ATMC survey

  11. Research on the Mo del of a Lightweight Resource Addressing

    Institute of Scientific and Technical Information of China (English)

    LUO Bingqing; SUN Zhixin

    2015-01-01

    This paper discussed the characteristics of addressing from the perspective of Internet address-ing mechanism. An Internet of things (IOT) resource ad-dressing iteration model was defined. In the model, a di-rect addressing mode for active nodes and an indirect addressing mode for passive codes were proposed, which meet the requirement for multiple encoding mode. A uni-fied IOT resource lightweight addressing scheme based on IPv6 has been proposed to implement the two addressing modes. The scheme utilized the virtual domain to solve the problem of the heterogeneous encoding. The paper imple-mented the addressing process from the Internet host to the sensor node based on IPv6 over low-power wireless personal area networks (6LoWPAN) protocol. The experi-ment results show that the scheme is performed to realize communication between wireless sensor networks and IPv6 networks.

  12. A knowledge-based agent prototype for Chinese address geocoding

    Science.gov (United States)

    Wei, Ran; Zhang, Xuehu; Ding, Linfang; Ma, Haoming; Li, Qi

    2009-10-01

    Chinese address geocoding is a difficult problem to deal with due to intrinsic complexities in Chinese address systems and a lack of standards in address assignments and usages. In order to improve existing address geocoding algorithm, a spatial knowledge-based agent prototype aimed at validating address geocoding results is built to determine the spatial accuracies as well as matching confidence. A portion of human's knowledge of judging the spatial closeness of two addresses is represented via first order logic and the corresponding algorithms are implemented with the Prolog language. Preliminary tests conducted using addresses matching result in Beijing area showed that the prototype can successfully assess the spatial closeness between the matching address and the query address with 97% accuracy.

  13. Complications - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications - national data. This data set includes national-level data the hip/knee complication measure, and the Agency for Healthcare Research and Quality...

  14. HCAHPS - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...

  15. Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment measures – national data. This data set includes national-level data for the payment measures associated with an episode of care for heart attack, heart...

  16. Addressing an Uncertain Future Using Scenario Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Siddiqui, Afzal S.; Marnay, Chris

    2006-12-15

    nature, such as the Energy Information Administration's (EIA's) National Energy Modeling System (NEMS). NEMS is the source of the influential Annual Energy Outlook whose business-as-usual (BAU) case, the Reference Case, forms the baseline for most of the U.S. energy policy discussion. NEMS is an optimizing model because: 1. it iterates to an equilibrium among modules representing the supply, demand, and energy conversion subsectors; and 2. several subsectoral models are individually solved using linear programs (LP). Consequently, it is deeply rooted in the recent past and any effort to simulate the consequences of a major regime shift as depicted in Figure 1 must come by applying an exogenously specified scenario. And, more generally, simulating futures that lie outside of our recent historic experience, even if they do not include regime switches suggest some form of scenario approach. At the same time, the statistical validity of scenarios that deviate significantly outside the ranges of historic inputs should be questioned.

  17. Addressing Parenting Disputes Between Estranged Parents Through Community Mediation

    Directory of Open Access Journals (Sweden)

    Madhawa Palihapitiya

    2014-07-01

    Full Text Available Mediation provides a means of resolving disputes that promises to reduce litigation while avoiding further damage to party relationships. The present study addressed the question whether parents engaged in parenting disputes generated by divorce or separation received the promised benefits of mediation when services were delivered by means of community mediation, which combined the dual features of free services and volunteer mediators. Reported outcomes such as agreements, party satisfaction, relationship changes, and court involvement, as well as the connection between these outcomes and party factors of custodial status and income level, were examined, and several encouraging trends emerged. Results indicated that an economically diverse group of disputing parents were provided access to mediation services delivered under community mediation. Moreover, the prospect of avoiding litigation motivated a majority of parents to participate in community mediation. The positive outcomes reported by most parents, irrespective of income level and custodial status, included agreement and process satisfaction rates consistent with national trends, the development of parenting plans, and for a sizable minority of parents, reduced court involvement and improved between-parent interactions. However, non-custodial parents tended to be significantly more positive about mediation’s helpfulness with parenting issues than were custodial parents.

  18. Biodiversity data provision and decision-making - addressing the challenges

    Directory of Open Access Journals (Sweden)

    Katherine Despot-Belmonte

    2017-02-01

    Full Text Available Essential Biodiversity Variables (EBVs are measurements required for study, reporting, and management of biodiversity change. They are being developed to support consistency, from the collection to the reporting of biodiversity data at the national, regional and global scales. However, "EBV stakeholders" need to strike a balance between 'doing innovative research' and 'having positive impact' on biodiversity management decisions. This paper reports on a workshop entitled Identifying joint pathways to address the challenges of biodiversity data provision and decision-making and presents the main workshop’s output, a “researcher’s brief” entitled Guiding principles for promoting the application of EBVs for current and future needs of decision-makers. These guiding principles are: Speak with a common voice; Clearly define what is an EBV and how it relates to indicators; Engage beyond the research world; Be realistic about what can be done now and later; Define criteria for good EBVs; Use EBV as a clearing house; Convey the limitations of EBVs; Clarify what impact EBVs should have; Be salient, credible, legitimate, iterative; Don't put an EBV skin on everything you do; Don't create too many EBVs; and Don't reduce EBVs to building blocks of indicators. This brief is of relevance to the wider GEO BON (Group on Earth Observation Biodoversity Observation Network community, and in particular those scientists/researchers interested in the application of EBVs.

  19. Social entrepreneurship in religious congregations' efforts to address health needs.

    Science.gov (United States)

    Werber, Laura; Mendel, Peter J; Derose, Kathryn Pitkin

    2014-01-01

    Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Multiple case studies. Los Angeles County, California. Purposive sample of 14 congregations representing diverse races/ethnicities (African-American, Latino, and white) and faith traditions (Jewish and various Christian). Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n = 57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed by using a qualitative, code-based approach. Congregations' health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations' health initiatives, providing a safe, confidential environment and leveraging resources from-and for-faith-based and secular organizations in their community networks. Congregations also served as "incubators" for members to engage in social entrepreneurship. Although the small scale of congregations' health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations' position in their communities permit them to network in productive ways.

  20. Social Entrepreneurship in Religious Congregations’ Efforts to Address Health Needs

    Science.gov (United States)

    Werber, Laura; Mendel, Peter J.; Derose, Kathryn Pitkin

    2013-01-01

    Purpose Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Design Multiple case studies. Setting Los Angeles County, California. Participants Purposive sample of 14 congregations representing diverse races-ethnicities (African American, Latino, and white) and faith traditions (Jewish and various Christian). Method Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n=57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed using a qualitative, code-based approach. Results Congregations’ health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations’ health initiatives, providing a safe, confidential environment and leveraging resources from – and for – faith-based and secular organizations in their community networks. Congregations also served as “incubators” for members to engage in social entrepreneurship. Conclusion Although the small scale of congregations’ health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations’ position in their communities permit them to network in productive ways. PMID:23875986