WorldWideScience

Sample records for expanded access program

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

    Science.gov (United States)

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

    2015-10-01

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

  2. Expanding Access and Opportunity: The Washington State Achievers Program

    Science.gov (United States)

    Ramsey, Jennifer; Gorgol, Laura

    2010-01-01

    In 2001, the Bill & Melinda Gates Foundation launched a 10-year, multi-million dollar initiative, the Washington State Achievers Program (WSA), to increase opportunities for low-income students to attend postsecondary institutions in Washington State. The Bill & Melinda Gates Foundation granted funds to the College Success Foundation…

  3. Expanding access to gerontological education via distance learning: the Management of Aging Services Masters Program at UMass Boston.

    Science.gov (United States)

    Nadash, Pamela; Miller, Edward Alan; Porell, Frank W; Birchander, Ellen; Glickman, Lillian; Burr, Jeffrey A

    2014-01-01

    This article describes the online Management of Aging Services Masters Program at the University of Massachusetts Boston and reports on a recent Program review. The Program has experienced rapid growth, evolving from seven matriculating students in 2003 to 108 in 2012. It has graduated 125 students and boasts a 78% completion rate. The authors describe the Program and report on faculty and student perceptions of performance. The Program demonstrates sound pedagogical practice for online education, incorporating techniques to foster community and encourage students and faculty interaction. Distance learning holds considerable promise for expanding access to gerontological education to reach future aging services professionals.

  4. Cabazitaxel for metastatic castration-resistant prostate cancer: safety data from the Spanish expanded access program.

    Science.gov (United States)

    Castellano, Daniel; Antón Aparicio, Luis M; Esteban, Emilio; Sánchez-Hernández, Alfredo; Germà, Jose Ramón; Batista, Norberto; Maroto, Pablo; Pérez-Valderrama, Begoña; Luque, Raquel; Méndez-Vidal, María José

    2014-09-01

    Based on the TROPIC study results, cabazitaxel was approved for the management of metastatic castration-resistant prostate cancer (mCRPC) progressing on or after docetaxel. This multi-centre program provided early access to cabazitaxel to patients with mCRPC before its commercialization. Safety data from 153 Spanish patients receiving cabazitaxel 25 mg/m(2) i.v. Q3W, plus oral prednisone/prednisolone 10 mg daily, are reported. Median age of patients was 70 years (26.8% ≥ 75 years), 94.1 and 26.8% had bone and visceral metastasis, respectively. Most had an Eastern Cooperative Oncology Group ≤ 1 (88.9%) and had received a median of 8.0 cycles of last docetaxel treatment. The median of cabazitaxel cycles and cumulative dose were 6.0 (Interquartile range [IQR]: 4.0; 8.0) and 148.9 (IQR: 98.2; 201.4) mg/m(2), respectively. Adverse events (AEs) possibly related to cabazitaxel occurred in 143 (93.5%) patients. The most frequent grade ≥ 3 AEs were neutropenia (n = 25, 16.3%) and asthenia (n = 17, 11.1%). Febrile neutropenia and grade ≥ 3 diarrhea occurred in 5.2% of the patients each. There were five (3.3%) possibly treatment-related deaths, mainly infection-related. G-CSFs were used in 114 (74.5%) patients, generally as prophylaxis (n = 107; 69.9%). Grade ≥ 3 peripheral neuropathy and nail disorders were uncommon. Cabazitaxel administration, in a real-world setting, is tolerated by Spanish patients with mCRPC, and the AEs are manageable.

  5. Expanding Access and Opportunity: The Impact of the Gates Millennium Scholars Program

    Science.gov (United States)

    Ramsey, Jennifer

    2010-01-01

    In 1999, the Bill & Melinda Gates Foundation began an innovative scholarship program that provides full financial support to low-income minority students across the United States. The Gates Millennium Scholars (GMS) program has already awarded more than 10,000 scholarships to exceptional students, with the ultimate goal of funding at least…

  6. EFFECTS: an expanded access program of everolimus for patients with subependymal giant cell astrocytoma associated with tuberous sclerosis complex.

    Science.gov (United States)

    Fogarasi, Andras; De Waele, Liesbeth; Bartalini, Gabriella; Jozwiak, Sergiusz; Laforgia, Nicola; Verhelst, Helene; Petrak, Borivoj; Pedespan, Jean-Michel; Witt, Olaf; Castellana, Ramon; Crippa, Stefania; Gislimberti, Gabriella; Gyorsok, Zsuzsanna

    2016-08-08

    Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, has been shown to be effective and safe in the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC). The Everolimus For Fast Expanded aCcess in TSC SEGA (EFFECTS) study was designed to provide everolimus access to patients with SEGA associated with TSC and to mainly assess the safety and also efficacy of everolimus in a real-world setting. EFFECTS was a phase 3b, open-label, noncomparative, multicenter, expanded access study. Eligible patients were ≥ 3 years of age, with a definite diagnosis of TSC, and with at least one SEGA lesion identified by MRI or CT scan. Patients received once daily everolimus (dose adjusted to attain a trough level of 5-15 ng/mL). Safety evaluation was the primary objective and included collection of adverse events (AEs) and serious AEs, with their severity and relationship to everolimus. Efficacy evaluation, which was the secondary objective, was based on the best overall response as per medical judgment. Of the 120 patients enrolled, 100 (83.3%) completed the study. Median age of patients was 11 years (range, 1-47). Median daily dose of everolimus was 5.82 mg (range, 2.0-11.8). Median duration of exposure was 56.5 weeks (range, 0.3-130). The overall incidence of AEs was 74.2%. Aphthous stomatitis (18 [15.0%]), pyrexia (18 [15.0%]), bronchitis (11 [9.2%]), and stomatitis (10 [8.3%]) were the most common AEs reported. Overall, 25 patients had grade 3 AEs; most frequent was stomatitis (4 [3.3%]). Grade 4 AEs were reported in three (2.5%) patients. A total of 62 (51.7%) patients had suspected drug-related AEs, of which 15 (12.5%) were of grade 3 or 4. In eight (6.7%) patients, AEs led to drug discontinuation. With regard to efficacy, 81 (67.5%) patients had a partial response, 35 (29.2%) had a stable disease, and one (0.8%) had progressive disease. The response was unknown in three (2.5%) patients. This study confirms the

  7. Health workers' and managers' perceptions of the integrated community case management program for childhood illness in Malawi: the importance of expanding access to child health services.

    Science.gov (United States)

    Callaghan-Koru, Jennifer A; Hyder, Adnan A; George, Asha; Gilroy, Kate E; Nsona, Humphreys; Mtimuni, Angella; Bryce, Jennifer

    2012-11-01

    Community case management (CCM) is a promising task-shifting strategy for expanding treatment of childhood illness that is increasingly adopted by low-income countries. Its success depends in part on how the strategy is perceived by those responsible for its implementation. This study uses qualitative methods to explore health workers' and managers' perceptions about CCM provided by health surveillance assistants (HSAs) during the program's first year in Malawi. Managers and HSAs agreed that CCM contributed beneficially by expanding access to the underserved and reducing caseloads at health facilities. Managers differed among themselves in their endorsements of CCM, most offered constrained endorsement, and a few had stronger justifications for CCM. In addition, HSAs uniformly wanted continued expansion of their clinical role, while managers preferred to view CCM as a limited mandate. The HSAs also reported motivating factors and frustrations related to system constraints and community pressures related to CCM. The impact of CCM on motivation and workload of HSAs is noted and deserves further attention.

  8. Pharmacy staff characteristics associated with support for pharmacy-based HIV-testing in pharmacies participating in the New York State Expanded Access Syringe Exchange Program

    Science.gov (United States)

    Amesty, Silvia; Blaney, Shannon; Crawford, Natalie D.; Rivera, Alexis V.; Fuller, Crystal

    2013-01-01

    Objective To determine support of in-pharmacy HIV-testing among pharmacy staff and the individual-level characteristics associated with in-pharmacy HIV testing support. Design Descriptive, nonexperimental, cross-sectional study. Setting New York City (NYC) during January 2008 to March 2009. Intervention 131 pharmacies registered in the Expanded Syringe Access Program (ESAP) completed a survey. Participants 480 pharmacy staff, including pharmacists, owners/managers, and technicians/clerks. Main outcome measures Support of in-pharmacy HIV testing. Results Support of in-pharmacy HIV testing is high among pharmacy staff (79.4%). Pharmacy staff that supported in-pharmacy vaccinations were significantly more likely to support in-pharmacy HIV testing. Pharmacy staff that think that selling syringes to IDUs causes the community to be littered with dirty syringes were significantly less likely to support in-pharmacy HIV testing. Conclusion Support for in-pharmacy HIV testing is high among our sample of ESAP pharmacy staff actively involved in non-prescription syringe sales. These findings suggest that active ESAP pharmacy staff may be amenable to providing HIV counseling and testing to injection drug users and warrants further investigation. PMID:22825227

  9. Professional Access 2013 programming

    CERN Document Server

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

    2013-01-01

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

  10. Particle physicists want to expand open access

    CERN Multimedia

    Kaiser, Jocelyn

    2006-01-01

    "Particle physicists have come up with a novel way to promote free, immediate access to journal articles. Led by CERN, the gian lab near Geneva, Switzerland, they want to raise at least $6 million a year to begin buying open access to all published papers in their field." (1 page)

  11. Particle physicists want to expand open access

    CERN Multimedia

    Kaiser, Jocelyn

    2006-01-01

    "Particle physicists have come up with a novel way to promote free, immediate access to journal articles. Led by CERN, the giant lab near Geneva, Switzerland, thay want to raise at lesat $6 million a year to begin buying open access to all published papers in their field." (1/2 page)

  12. Expanding Rural Access to Renewable Energy

    DEFF Research Database (Denmark)

    Sovacool, Benjamin

    2013-01-01

    The Energy Services Delivery Project (ESDP) in Sri Lanka was an exemplary renewable energy access programme. Consisting of a Credit Component, a Wind Farm Component and a Capacity Building Component, the $53.8 million ESDP successfully installed 21,000 off-grid Solar Home Systems (SHS), 31...... megawatts (MW) of grid-connected mini-hydro capacity, 574 kilowatts (kW) of off-grid village hydroelectric systems serving 2,897 households, and a 3MW grid-connected wind farm from 1997 to 2002. By the end of 2004, two years after the ESDP’s close, the Sri Lankan renewable energy industry boasted more than...

  13. The Competitive Edge: Expanded Access Drives Vendors.

    Science.gov (United States)

    Pepin, Theresa; And Others

    1997-01-01

    This report analyzes data gathered from 29 automated library system vendors who responded to a 1996 survey. The survey also requested their perceptions of Java (an object-oriented programming language) and network computers, and issues and trends to be considered by library administrators. Contact information about the vendors is provided. (Four…

  14. Expanding Access to Insurance by the Poor : Policy, Regulation and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Expanding Access to Insurance by the Poor : Policy, Regulation and Supervision of Micro Insurance. This project aims to facilitate poor people's access to insurance products and services as a means of addressing their vulnerability to risk. It will do so by carrying out case studies in five countries. Potential candidates ...

  15. How Often Are Drugs Made Available Under the Food and Drug Administration's Expanded Access Process Approved?

    Science.gov (United States)

    McKee, Amy E; Markon, André O; Chan-Tack, Kirk M; Lurie, Peter

    2017-10-01

    In this review of individual patient expanded-access requests to the Center for Drug Evaluation and Research for the period Fiscal Year 2010 to Fiscal Year 2014, we evaluated the number of applications received and the number allowed to proceed. We also evaluated whether drugs and certain biologics obtained under expanded access went on to be approved by the Food and Drug Administration. Finally, we considered concerns that adverse events occurring during expanded access might place sponsors at risk for legal liability. Overall, 98% of individual patient expanded-access requests were allowed to proceed. During the study period, among drugs without a previous approval for any indication or dosage form, 24% of unique drugs (ie, multiple applications for access to the same drug were considered to relate to 1 unique drug), and 20% of expanded-access applications received marketing approval by 1 year after initial submission; 43% and 33%, respectively, were approved by 5 years after initial submission. A search of 3 legal databases and a database of news articles did not appear to identify any product liability cases arising from the use of a product in expanded access. Our analyses seek to give physicians and patients a realistic perspective on the likelihood of a drug's approval as well as certain information regarding the product liability risks for commercial sponsors when providing expanded access to investigational drugs. The US Food and Drug Administration (FDA)'s expanded-access program maintains a careful balance between authorizing patient access to potentially beneficial drugs and protecting them from drugs that may have unknown risks. At the same time, the agency wishes to maintain the integrity of the clinical trials process, ultimately the best way to get safe and effective drugs to patients. © 2017, The American College of Clinical Pharmacology.

  16. Response to "Expanding Access to Learning with Mobile Digital Devices"

    Science.gov (United States)

    Vanek, Jen

    2017-01-01

    In his article "Expanding Access to Learning with Mobile Digital Devices" (EJ1150752), Jeff Carter recommended a balanced perspective when measuring the potential of mobile learning to redefine teaching and learning for adults with basic skills needs. In response to Carter's article, the author makes some recommendations that she thinks…

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-15

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

  18. Rubella Seroprevalence Before Expanded Vaccination Program

    Directory of Open Access Journals (Sweden)

    Kenan Sener

    2007-10-01

    Full Text Available Altough rubella is usually a mild childhood disease, but when it occurs early in pregnancy are severe. In this study, seroprevalence of rubella antibodies have been invastegated in various age groups especially chilbearing age’s women before Expanded Vaccination Programme. IgM and IgG antibodies against rubella were tested by ELISA kits. Seropositivity of rubella IgG was 89,5% in chlidbearing age’s women. In Turkey, the vaccine has been on the market since 1989 but rubella vaccination is currently included in the national immunization programme. Hence, our results are important for comparison of the seroprevalence rates after national vaccination program. [TAF Prev Med Bull. 2007; 6(5: 371-374

  19. Rubella Seroprevalence Before Expanded Vaccination Program

    Directory of Open Access Journals (Sweden)

    Kenan Sener

    2007-10-01

    Full Text Available Altough rubella is usually a mild childhood disease, but when it occurs early in pregnancy are severe. In this study, seroprevalence of rubella antibodies have been invastegated in various age groups especially chilbearing age’s women before Expanded Vaccination Programme. IgM and IgG antibodies against rubella were tested by ELISA kits. Seropositivity of rubella IgG was 89,5% in chlidbearing age’s women. In Turkey, the vaccine has been on the market since 1989 but rubella vaccination is currently included in the national immunization programme. Hence, our results are important for comparison of the seroprevalence rates after national vaccination program. [TAF Prev Med Bull 2007; 6(5.000: 371-374

  20. AVLIS industrial access program

    Energy Technology Data Exchange (ETDEWEB)

    1984-11-15

    This document deals with the procurements planned for the construction of an Atomic Vapor Laser Isotope Separation (AVLIS) production plant. Several large-scale AVLIS facilities have already been built and tested; a full-scale engineering demonstration facility is currently under construction. The experience gained from these projects provides the procurement basis for the production plant construction and operation. In this document, the status of the AVLIS process procurement is presented from two viewpoints. The AVLIS Production Plant Work Breakdown Structure is referenced at the level of the items to be procured. The availability of suppliers for the items at this level is discussed. In addition, the work that will result from the AVLIS enrichment plant project is broken down by general procurement categories (construction, mechanical equipment, etc.) and the current AVLIS suppliers are listed according to these categories. A large number of companies in all categories are currently providing AVLIS equipment for the Full-Scale Demonstration Facility in Livermore, California. These companies form an existing and expanding supplier network for the AVLIS program. Finally, this document examines the relationship between the AVLIS construction project/operational facility and established commercial suppliers. The goal is to utilize existing industrial capability to meet the needs of the project in a competitive procurement situation. As a result, costs and procurement risks are both reduced because the products provided come from within the AVLIS suppliers' experience base. At the same time, suppliers can benefit by the potential to participate in AVLIS technology spin-off markets. 35 figures.

  1. Expanded Access Programme: looking for a common definition.

    Science.gov (United States)

    Iudicello, Antonella; Alberghini, Lucia; Benini, Giulia; Mosconi, Paola

    2016-01-12

    Therapeutic use of an unauthorised drug (or of an authorised drug for an unauthorised indication) for patients with a life-threating disease is permitted outside a clinical trial as an Expanded Access Programme (EAP).The regulations regarding EAPs is not the same all over the world. For example, the recommendation of the European Medicines Agency (EMA) in EU countries also includes within EAPs patients who have been treated in a clinical trial and who wish to continue the treatment. Nevertheless, the patients treated in a clinical trial could have the option of continuing treatment for an extended period in an Open-label Extension study, aimed to generate long-term data on efficacy, safety, tolerability and administration.The aims of this paper - based on the difficulties and incoherence encountered by an Italian Ethic Committee (EC) during the authorisation process of EAPs - are: understanding the origin of this misclassification by analysing differences and similarities among USA, European and Italian regulations concerning EAPs; and showing difficulties in classifying international study protocols as a consequence of the lack of harmonisation of definitions.We performed a critical review of the current USA, European and Italian regulations and we analysed some practical cases by retrieving protocols from Clinicaltrials.gov and the Italian Clinical Trials Registry (OsSC) containing in the title the keywords 'Expanded Access Programme', "'Expanded Access', 'Open-label Extension study' or 'Early Access'.We observed that the Food and Drug Administration ( FDA) definition of EAP is very clear while the EMA definition is similar to that of an Open-label Extension study. This lack of a clear definition generates misclassification and it is possible to find an EAP with an efficacy or safety endpoint; or an EAP managed as a clinical trial; or an EAP classified in Clinical Trials Registries as a phase II, III or IV clinical trial.The internationalisation of the studies

  2. An open-label safety study of first-line bevacizumab in combination with standard chemotherapy in Chinese patients with metastatic colorectal cancer treated in an expanded access program in Taiwan.

    Science.gov (United States)

    Lee, Kuan-Der; Chen, Hong-Hwa; Wang, Hwei-Ming; Tsao, Chao-Jung; Hsu, Tzu-Chi; Chiu, Chang-Fang; Su, Wu-Chou; Wang, Jeng-Yi

    2013-01-01

    An increased risk of serious adverse effects related to bevacizumab has been observed in many Western studies for metastatic colorectal cancer. To evaluate the safety of bevacizumab in Chinese patients, a safety study was conducted in Taiwan. Bevacizumab was provided by the Expanded Access Program in combination with first-line chemotherapy per investigator's choice. The primary objective is the safety profile, particularly the targeted adverse events such as proteinuria, bowel perforation, hypertension, wound healing complication, thromboembolism and bleeding. The second objectives include time to disease progression and overall survival time. Patients with major surgical procedure performed within the 28 days of bevacizumab were excluded from this study. Forty patients were eligible for intent-to-treat analysis. The overall rate of objective response and disease control was 55.2 and 81.6%. The median time to disease progression and overall survival were 11.9 and 22.9 months. The actuarial 2-year survival was 46.6%. Regarding toxicity, 7 subjects (17.5%) had serious adverse effects related to study treatment. None of the patients in this cohort had arterial thrombotic events and bowel perforation. Bevacizumab demonstrates a similar activity and safety profile in Chinese patients. Life-threatening bowel complications were avoided in this study by excluding patients with major surgery within the first 28 days. Copyright © 2013 S. Karger AG, Basel.

  3. Expanding Access with Satellite-Enabled Distance Education

    Directory of Open Access Journals (Sweden)

    Qi Wang

    2006-12-01

    Full Text Available Education and training became increasingly critical for citizens of every nation during the last century, and that paradigm will be no less true, throughout the 21st Century. As the world progresses fully into an information society, access to information and to a knowledge-based work force is a precondition for any country to remain competitive. Education, and increasingly distant education (DE, plays a vital role in turning human resources into knowledge workers. Information and communications technologies (ICT have provided new ways to educate and to disseminate information that is crucial for creating these competitive, knowledge-based work forces. Modern DE, enabled by ICT-based networks and the Internet tools, offers great advantages that are leveling the global playing field, in terms of providing access and opportunities for specialized training and education. Using satellite technology in DE may be imperative to developing countries, where the majority of their populations are scattered in rural and remote areas. Where the traditional brick and mortar classrooms cannot easily reach, satellite-powered DE systems can. Through literature review and rational analysis, this paper examines how satellite-assisted DE systems expand education access.

  4. Expanding Access to Care: Scope of Practice Laws.

    Science.gov (United States)

    Hoke, Kathleen; Hexem, Sarah

    2017-03-01

    Allied health professionals play an integral role in providing safe, affordable care to communities in need. Laws that define the permissible scope of practice for these professionals may take full advantage of these providers and may unnecessarily restrict safe and effective care. Nurse practitioners in many states may provide care independent of a physician; research reveals that this care is safe, affordable and accessible. Yet hurdles exist that prevent communities from securing the full benefit of NPs in independent practice. The scope of independent practice for allied dental providers varies greatly across the country, often including stringent supervision requirements. Emerging approaches to allowing allied dental providers to practice independently in certain settings or with dentist supervision via telemedicine and creating the intermediate provider, the dental therapist, may increase access to safe, affordable dental care. Research on the impact of laws that allow broader independent practice by NPs to ferret out the hurdles to full implementation of the spirit of such laws is needed. That research could support expanded independent scope for allied dental providers and other allied health care providers.

  5. Going "social" to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded access.

    Science.gov (United States)

    Mackey, Tim K; Schoenfeld, Virginia J

    2016-02-02

    Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes

  6. Traditions of the Sun, One Model for Expanding Audience Access

    Science.gov (United States)

    Hawkins, I.; Paglierani, R.

    2006-12-01

    The Internet is a powerful tool with which to expand audience access, bringing students, teachers and the public to places and resources they might not otherwise visit or make use of. We will present Traditions of the Sun, an experiential Web site that invites exploration of the world's ancient observatories with special emphasis on Chaco Culture National Historic Park in the Four Corners region of the US and several sites in the Yucatan Peninsula in Mexico. Traditions of the Sun includes resources in English and Spanish along with a unique trilingual on-line book, "Traditions of the Sun, A Photographic Journal," containing explanatory text in Yucatec Maya as well. Traditions of the Sun offers rich opportunities for virtual visits to ancient sites used for solar observing while learning about current NASA research on the Sun and indigenous solar practices within a larger historical and cultural context. The site contains hundreds of photographs, historic images and rich multimedia to help tell the story of the Sun-Earth Connection. Visitors to the site can zoom in on the great Mayan cities of Chichen Itza, Uxmal, Dzibilchaltun, and Mayapan to learn about Mayan astronomy, history, culture, and science. They can also visit Chaco Canyon to watch sunrise over Pueblo Bonito on the summer solstice, take a virtual reality tour of the great kiva at Casa Rinconada or see panoramic vistas from Fajada Butte, an area which, for preservation purposes, is restricted to the public. Traditions of the Sun provides one model of how exploration and discovery can come to life for both formal and informal audiences via the Internet. Traditions of the Sun is a collaborative project between NASA's Sun-Earth Connection Education Forum, the National Park Service, Instituto National de Antropologia e Historia, Universidad Nacional Autonoma de Mexico, and Ideum.

  7. Expanding health access in the more vulnerable region in the state of São Paulo, Brazil: is this a reflection of the Mais Médicos (More Doctors) Program?

    Science.gov (United States)

    Silva, Bruna Pontes da; Stockmann, Denise; Lúcio, Donavan de Souza; Henna, Elaine; Rocha, Maria Carolina Pereira da; Junqueira, Fábio Miranda

    2016-09-01

    The Mais Médicos (More Doctors) Program seeks to broaden access to health by providing medical professionals, investments in health units and multi-professional integration geared to the Family Health Strategy. Vale do Ribeira includes 25 cities and is among the most vulnerable regions in São Paulo. It has been allocated 41 physicians from the Program. This study is to evaluate access to health, comparing health indicators before and after the Program. We collected data from DATASUS, SIAB, and the Ministry of Health. There was a marked increase in the number of appointments for infants under one year of age, adults, the elderly, STD/HIV patients and group patient care. There was a decrease in appointments outside the catchment area, as well as hospital admissions for other causes, mothers exclusively breastfeeding their infants up to four months. We concluded that after deployment of the Program, there was an increase in health access and health promotion focused on an area that presents an enormous challenge for Primary Health Care (PHC). It would seem that, since this is a high vulnerability area with a large area for care, hospital admissions for PHC care-sensitive conditions, as well as referrals for secondary services, did not decrease.

  8. 2010 Impacts: The Expanded Food and Nutrition Education Program (EFNEP)

    Science.gov (United States)

    National Institute of Food and Agriculture, 2011

    2011-01-01

    Since 1969, the Expanded Food and Nutrition Education Program (EFNEP) has improved the diets and food-related behaviors of program participants. Each year EFNEP enrolls more than half a million new program participants. In 2010, EFNEP reached 137,814 adults and 463,530 youth directly and nearly 400,000 family members indirectly. This paper…

  9. Trials and Triumphs of Expanded Extension Programs.

    Science.gov (United States)

    Leavengood, Scott; Love, Bob

    1998-01-01

    Oregon extension faced challenges in presenting programs in the wood products industry. Several traditional tactics, revised to suit a new audience, have proved successful: personal coaching, building partnerships, and providing a high level of service. Newer methods, such as database marketing and distance learning, are also proving to be…

  10. Code-Expanded Random Access for Machine-Type Communications

    DEFF Research Database (Denmark)

    Kiilerich Pratas, Nuno; Thomsen, Henning; Stefanovic, Cedomir

    2012-01-01

    Abstract—The random access methods used for support of machine-type communications (MTC) in current cellular standards are derivatives of traditional framed slotted ALOHA and therefore do not support high user loads efficiently. Motivated by the random access method employed in LTE, we propose...

  11. Education Abroad for Students with Disabilities: Expanding Access

    Science.gov (United States)

    Soneson, Heidi M.; Fisher, Shelly

    2011-01-01

    Education abroad is a rapidly expanding opportunity for undergraduate students in the United States. Concurrent with this growth in total numbers is a growth in the diversity of participants. Students with different ethnic backgrounds, academic majors, age, socioeconomic status, and disabilities are increasingly seeking opportunities overseas. In…

  12. Expanding Educational Access in Eastern Turkey: A New Initiative

    Science.gov (United States)

    O'Dwyer, John; Aksit, Necmi; Sands, Margaret

    2010-01-01

    The Eastern Anatolian project extends opportunity and access to quality education. The study examines the selection and learning systems adopted within the framework of gender equity, family background and higher order skills. Performance data on a range of selection measures and the initial programme are analysed. Results show that selection was…

  13. Mobility and conflict: persistent challenges in expanding access to ...

    African Journals Online (AJOL)

    This study explores into mobility patterns and prevalence of conflict as determinants of access to and retention in education. The assessment has been carried out in two educationally underprivileged pastoralist districts of south Omo. Ethnographic visits, key informants interview and focus group discussion were the major ...

  14. Geodetic Data Via Web Services: Standardizing Access, Expanding Accessibility, and Promoting Discovery

    Science.gov (United States)

    Zietlow, D. W.; Molnar, C.; Meertens, C. M.; Phillips, D. A.; Bartel, B. A.; Ertz, D. J.

    2016-12-01

    UNAVCO, a university-governed consortium that enables geodetic research and education, is developing and implementing new web services to standardize and enhance access to geodetic data for an ever-growing community of users. This simple and easy to use tool gives both experienced and novice users access to all data and products archived at UNAVCO through a uniform interface regardless of data type and structure. UNAVCO data product types include GPS station position time series, velocity estimates and metadata, as well as meteorological time series, and borehole geophysical data and metadata including strain, seismic, and tilt time series. Users access data through a request URL or through the Swagger user interface (UI). The Swagger UI allows users to easily learn about the web services and provides users the ability to test the web services in their web browser. Swagger UI also provides documentation of the web services' URLs and query parameters. With this documentation users can see the valid query parameters for each web service to assist in documentation for both the developers and the users.Output from the web services is currently in a standard comma-separated (CSV) format that can then be used in other processing and/or visualization programs. The web services are being standardized so that all CSV formats will follow the GeoCSV specification. Other formats will be available such as GeoJSON and time series xml since not all data are well represented by the CSV format. The UNAVCO web services are written using Python along with the Flask microframework. This allows quick development and the ability to easily implement new services. Future services are being planned to allow users to access metadata from any station with data available directly or indirectly from the UNAVCO website. In collaboration with the UNAVCO Student Internship Program (USIP), we developed a short video demonstrating how to use the web services tool to assist new users and the broader

  15. The Expanded Food and Nutrition Education Program (EFNEP)

    Science.gov (United States)

    National Institute of Food and Agriculture, 2010

    2010-01-01

    Obesity, poor health, and limited physical activity are major health concerns. The Expanded Food and Nutrition Education Program (EFNEP) improves the health and well-being of limited resource families and youth. Additionally, EFNEP leads to public savings. Research shows that better health is associated with reduced health care costs, less…

  16. Expanding Access and Opportunity: The Washington State Achievers Scholarship

    Science.gov (United States)

    O'Brien, Colleen

    2011-01-01

    In 2001, the Bill & Melinda Gates Foundation launched the multi-year, multi-million dollar Washington State Achievers Scholarship program. Concerned about disparities in college participation for low-income students in the state of Washington versus their wealthier peers, the Gates Foundation partnered with the College Success Foundation…

  17. 77 FR 29473 - Market Access Program

    Science.gov (United States)

    2012-05-17

    ... Access Program; Final Rule #0;#0;Federal Register / Vol. 77 , No. 96 / Thursday, May 17, 2012 / Rules and... Market Access Program AGENCY: Foreign Agricultural Service and Commodity Credit Corporation, USDA. ACTION... Access Program (MAP) by updating and merging the application requirements and the activity plan...

  18. Health and Federal Budgetary Effects of Increasing Access to Antiretroviral Medications for HIV by Expanding Medicaid

    Science.gov (United States)

    Kahn, James G.; Haile, Brain; Kates, Jennifer; Chang, Sophia

    2001-01-01

    Objectives. This study modeled the health and federal fiscal effects of expanding Medicaid for HIV-infected people to improve access to highly active antiretroviral therapy. Methods. A disease state model of the US HIV epidemic, with and without Medicaid expansion, was used. Eligibility required a CD4 cell count less than 500/mm3 or viral load greater than 10 000, absent or inadequate medication insurance, and annual income less than $10 000. Two benefits were modeled, “full” and “limited” (medications, outpatient care). Federal spending for Medicaid, Medicare, AIDS Drug Assistance Program, Supplemental Security Income, and Social Security Disability Insurance were assessed. Results. An estimated 38 000 individuals would enroll in a Medicaid HIV expansion. Over 5 years, expansion would prevent an estimated 13 000 AIDS diagnoses and 2600 deaths and add 5816 years of life. Net federal costs for all programs are $739 million (full benefits) and $480 million (limited benefits); for Medicaid alone, the costs are $1.43 and $1.17 billion, respectively. Results were sensitive to awareness of serostatus, highly active antiretroviral therapy cost, and participation rate. Strategies for federal cost neutrality include Medicaid HIV drug price reductions as low as 9% and private insurance buy-ins. Conclusions. Expansion of the Medicaid eligibility to increase access to antiretroviral therapy would have substantial health benefits at affordable costs. PMID:11527783

  19. Health and federal budgetary effects of increasing access to antiretroviral medications for HIV by expanding Medicaid.

    Science.gov (United States)

    Kahn, J G; Haile, B; Kates, J; Chang, S

    2001-09-01

    OBJECTIVES. This study modeled the health and federal fiscal effects of expanding Medicaid for HIV-infected people to improve access to highly active antiretroviral therapy. A disease state model of the US HIV epidemic, with and without Medicaid expansion, was used. Eligibility required a CD4 cell count less than 500/mm3 or viral load greater than 10,000, absent or inadequate medication insurance, and annual income less than $10,000. Two benefits were modeled, "full" and "limited" (medications, outpatient care). Federal spending for Medicaid, Medicare, AIDS Drug Assistance Program, Supplemental Security Income, and Social Security Disability Insurance were assessed. An estimated 38,000 individuals would enroll in a Medicaid HIV expansion. Over 5 years, expansion would prevent an estimated 13,000 AIDS diagnoses and 2600 deaths and add 5,816 years of life. Net federal costs for all programs are $739 million (full benefits) and $480 million (limited benefits); for Medicaid alone, the costs are $1.43 and $1.17 billion, respectively. Results were sensitive to awareness of serostatus, highly active antiretroviral therapy cost, and participation rate. Strategies for federal cost neutrality include Medicaid HIV drug price reductions as low as 9% and private insurance buy-ins. Expansion of the Medicaid eligibility to increase access to antiretroviral therapy would have substantial health benefits at affordable costs.

  20. Expanding access to published research: open access and self-archiving.

    Science.gov (United States)

    Mower, Allyson; Youngkin, Mary E

    2008-03-01

    Academic libraries traditionally provide access to the life science journal literature for their respective institutions by purchasing annual subscriptions to journals. However, with skyrocketing subscription prices and decreased or flattened library budgets, fewer journals are being purchased. This trend results in diminished access to the literature for members of that institution. Open access and self-archiving are possible solutions to this crisis.

  1. Expanding Access to Quality Pre-K Is Sound Public Policy

    Science.gov (United States)

    Barnett, W. Steven

    2013-01-01

    In 2013, preschool education received more attention in the media and public policy circles than it has for some time, in part because of a series of high-profile proposals to expand access to quality pre-K. The scientific basis for these proposed expansions of quality pre-K is impressive. This paper brings to bear the full weight of the evidence…

  2. 77 FR 41885 - Market Access Program

    Science.gov (United States)

    2012-07-17

    ... Corporation 7 CFR Part 1485 Market Access Program AGENCY: Foreign Agricultural Service and Commodity Credit... Trade Programs, Program Operations Division; or by phone: (202) 720- 4327; or by fax: (202) 720-9361; or... submitted later than 3 months after the end of a MAP Participant's program year. At any given time, total...

  3. Charter Halibut Limited Access Program

    Data.gov (United States)

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

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

    Data.gov (United States)

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

  5. Policies to Spur Energy Access. Executive Summary; Volume 1, Engaging the Private Sector in Expanding Access to Electricity; Volume 2, Case Studies to Public-Private Models to Finance Decentralized Electricity Access

    Energy Technology Data Exchange (ETDEWEB)

    Walters, Terri [National Renewable Energy Lab. (NREL), Golden, CO (United States); Rai, Neha [International Institute for Environment and Development (IIED), London (England); Esterly, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cox, Sadie [National Renewable Energy Lab. (NREL), Golden, CO (United States); Reber, Tim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Muzammil, Maliha [Univ. of Oxford (United Kingdom); Mahmood, Tasfiq [International Center for Climate Change and Development, Baridhara (Bangladesh); Kaur, Nanki [International Institute for Environment and Development (IIED), London (England); Tesfaye, Lidya [Echnoserve Consulting (Ethiopia); Mamuye, Simret [Echnoserve Consulting (Ethiopia); Knuckles, James [Univ. of London (England). Cass Business School; Morris, Ellen [Columbia Univ., New York, NY (United States); de Been, Merijn [Delft Univ. of Technology (Netherlands); Steinbach, Dave [International Institute for Environment and Development (IIED), London (England); Acharya, Sunil [Digo Bikas Inst. (Nepal); Chhetri, Raju Pandit [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bhushal, Ramesh [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-09-01

    Government policy is one of the most important factors in engaging the private sector in providing universal access to electricity. In particular, the private sector is well positioned to provide decentralized electricity products and services. While policy uncertainty and regulatory barriers can keep enterprises and investors from engaging in the market, targeted policies can create opportunities to leverage private investment and skills to expand electricity access. However, creating a sustainable market requires policies beyond traditional electricity regulation. The report reviews the range of policy issues that impact the development and expansion of a market for decentralized electricity services from establishing an enabling policy environment to catalyzing finance, building human capacity, and integrating energy access with development programs. The case studies in this report show that robust policy frameworks--addressing a wide range of market issues--can lead to rapid transformation in energy access. The report highlights examples of these policies in action Bangladesh, Ethiopia, Mali, Mexico, and Nepal.

  6. Politics of prevention: expanding prevention benefits in the Medicare program.

    Science.gov (United States)

    Foote, Susan Bartlett; Blewett, Lynn A

    2003-01-01

    It is critical that public health advocates understand the structure of the Medicare program and the impact of the political process on Medicare's benefit set. This article provides an overview of the design of Medicare and its explicit exclusion of prevention benefits in the original legislation. We then provide a history of subsequent legislation authorizing coverage of specific prevention benefits over the last twenty years. We critique the current process in light of innovation in preventive services and the influence of politics in the decision-making. We conclude with a discussion of policy options to improve access to an appropriate range of evidence-based preventive services in Medicare within the context of new technology innovation and rising health care costs.

  7. Using social impact borrowing to expand preschool through third grade programs in urban public schools.

    Science.gov (United States)

    Temple, Judy A; Reynolds, Arthur J

    Budget constraints and difficulty raising taxes limit school districts from expanding education programming even when research shows that additional expenditures would generate economic benefits that are greater than costs. Recently, coalitions of private investors, philanthropists, education practitioners, and government finance analysts have emerged to create opportunities to expand education services that promise high rates of social net benefits without raising taxes or reducing other expenditures. These collaborators have a strong interest in obtaining careful estimates of educational program effectiveness. We describe the use of social-impact borrowing to increase access to the Child-Parent Center preschool-through-third-grade intervention for at-risk students in the Chicago Public School District. The partners include the city, school district, investors, nonprofit organizations, and a university. The key to the feasibility of social-impact borrowing is the ability to document that early intervention can reduce the need for later special-education services. With the help of private investors and nonprofit organizations, it is possible for public school districts to finance services with funds from private sources and use future cost savings to repay this debt. We discuss how social-impact borrowing is being used in Chicago and in Salt Lake County as the nation's first two instances of using pay-for-performance social-impact borrowing to support early education.

  8. Apprenticeship Programs Expand with Help of Community Colleges

    Science.gov (United States)

    Gonzalez, Jennifer

    2011-01-01

    The apprenticeship system, long considered an educational relic by some educators and policy makers, is gaining new attention as a model for improving job skills and meeting national college-completion goals. A number of states and community and technical colleges are working to strengthen and expand apprenticeship opportunities. They offer…

  9. Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access

    Science.gov (United States)

    2015-01-01

    Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid

  10. Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

    Science.gov (United States)

    Rusk, Andria; Goodman, Catherine; Naanyu, Violet; Koech, Beatrice; Obala, Andrew; O'Meara, Wendy Prudhomme

    2013-01-01

    Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance.

  11. Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

    Directory of Open Access Journals (Sweden)

    Andria Rusk

    2013-01-01

    Full Text Available Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs, a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance.

  12. Access to Ophthalmologists in States Where Optometrists Have Expanded Scope of Practice.

    Science.gov (United States)

    Stein, Joshua D; Kapoor, Kapil G; Tootoo, Joshua L; Li, Ruiyang; Wagner, Alan; Andrews, Chris; Miranda, Marie Lynn

    2018-01-01

    As the United States considers how to best structure its health care services, specialty care availability is receiving increased focus. This study assesses whether patients lack reasonable access to ophthalmologists in states where optometrists have been granted expanded scope of practice. To determine the estimated travel time (ETT) to the nearest ophthalmologist office for persons residing in states that have expanded scope of practice for optometrists, and to quantify ETT to the nearest ophthalmologist for Medicare beneficiaries who received surgical care from optometrists in those states between 2008 and 2014. This study used data from the 2010 US census, a 2016 American Academy of Ophthalmology member database, and a data set of claims data for a random sample of 20% of beneficiaries enrolled in Medicare nationwide from 2008 to 2014 (n=14 063 725). Combining these sources with geographic information systems analysis, the ETT to the nearest ophthalmologist office was calculated for every resident of Kentucky, Oklahoma, and New Mexico. This study also assessed ETT to the nearest ophthalmologist for Medicare beneficiaries in those states who had received surgery from an optometrist from 2008 to 2014. Data analyses were conducted from July 2016 to July 2017. The proportion of residents of Kentucky, Oklahoma, and New Mexico who live within an ETT of 10, 30, 45, 60, or 90 minutes of the nearest ophthalmologist office. The study included 4 339 367 Kentucky residents, 3 751 351 Oklahoma residents, and 2 059 179 New Mexico residents. Of these, 5 140 547 (50.6%) were female. Racial/ethnic composition included 7 154 847 people (70.5%) who were white, 640 608 (6.3%) who were black, and 1 418 246 (14.0%) who were Hispanic. The mean (SD) age was 37.8 (22.8) years. More than 75% of residents in the 3 states lived within an ETT of 30 minutes to the nearest ophthalmology office, and 94% to 99% of residents lived within an ETT of 60 minutes to the

  13. Expanding Access and Usage of NASA Near Real-Time Imagery and Data

    Science.gov (United States)

    Cechini, M.; Murphy, K. J.; Boller, R. A.; Schmaltz, J. E.; Thompson, C. K.; Huang, T.; McGann, J. M.; Ilavajhala, S.; Alarcon, C.; Roberts, J. T.

    2013-12-01

    In late 2009, the Land Atmosphere Near-real-time Capability for EOS (LANCE) was created to greatly expand the range of near real-time data products from a variety of Earth Observing System (EOS) instruments. Since that time, NASA's Earth Observing System Data and Information System (EOSDIS) developed the Global Imagery Browse Services (GIBS) to provide highly responsive, scalable, and expandable imagery services that distribute near real-time imagery in an intuitive and geo-referenced format. The GIBS imagery services provide access through standards-based protocols such as the Open Geospatial Consortium (OGC) Web Map Tile Service (WMTS) and standard mapping file formats such as the Keyhole Markup Language (KML). Leveraging these standard mechanisms opens NASA near real-time imagery to a broad landscape of mapping libraries supporting mobile applications. By easily integrating with mobile application development libraries, GIBS makes it possible for NASA imagery to become a reliable and valuable source for end-user applications. Recently, EOSDIS has taken steps to integrate near real-time metadata products into the EOS ClearingHOuse (ECHO) metadata repository. Registration of near real-time metadata allows for near real-time data discovery through ECHO clients. In kind with the near real-time data processing requirements, the ECHO ingest model allows for low-latency metadata insertion and updates. Combining with the ECHO repository, the fast visual access of GIBS imagery can now be linked directly back to the source data file(s). Through the use of discovery standards such as OpenSearch, desktop and mobile applications can connect users to more than just an image. As data services, such as OGC Web Coverage Service, become more prevalent within the EOSDIS system, applications may even be able to connect users from imagery to data values. In addition, the full resolution GIBS imagery provides visual context to other GIS data and tools. The NASA near real-time imagery

  14. Expanding Dress Code Requirements in the Doctor of Pharmacy Program

    National Research Council Canada - National Science Library

    Cynthia A Naughton

    2017-01-01

    "1 We initiated this article to address both the potential advantages and disadvantages to implementing a dress code to facilitate a discussion surrounding this topic and to assist programs that might...

  15. HIV testing practices of South African township MSM in the era of expanded access to ART.

    Science.gov (United States)

    Sandfort, Theo G M; Knox, Justin; Collier, Kate L; Lane, Tim; Reddy, Vasu

    2015-03-01

    While men who have sex with men (MSM) in Africa are at high risk for HIV infection, few of those already infected know their status. Effectively promoting frequent HIV testing-of increasing importance with the expanding accessibility of antiretroviral treatment-requires an understanding of the testing practices in this population. To understand men's HIV testing practices, including their behavior, experiences, and perceptions, we conducted in-depth interviews with 81 black South African MSM (ages 20-39), purposively recruited from four townships. Many men in the sample had tested for HIV. While ever having tested seemed to facilitate repeat testing, men still expressed a high level of discomfort with testing. It was common to test after having engaged in risky behavior, thus increasing anxiety about testing that was already present. Fear that they might test HIV positive caused some men to avoid testing until they were clearly sick, and others to avoid testing completely. HIV testing may increase in this population if it becomes a routine practice, instead of being driven by anxiety-inducing incidents. Mobilization through social support might facilitate frequent testing while education about current treatment options is needed.

  16. Expanding the Enzyme Universe: Accessing Non-Natural Reactions by Mechanism-Guided Directed Evolution

    Science.gov (United States)

    Renata, Hans; Wang, Z. Jane

    2015-01-01

    High selectivities and exquisite control over reaction outcomes entice chemists to use biocatalysts in organic synthesis. However, many useful reactions are not accessible because they are not in nature’s known repertoire. We will use this review to outline an evolutionary approach to engineering enzymes to catalyze reactions not found in nature. We begin with examples of how nature has discovered new catalytic functions and how such evolutionary progressions have been recapitulated in the laboratory starting from extant enzymes. We then examine non-native enzyme activities that have been discovered and exploited for chemical synthesis, emphasizing reactions that do not have natural counterparts. The new functions have mechanistic parallels to the native reaction mechanisms that often manifest as catalytic promiscuity and the ability to convert from one function to the other with minimal mutation. We present examples of how non-natural activities have been improved by directed evolution, mimicking the process used by nature to create new catalysts. Examples of new enzyme functions include epoxide opening reactions with non-natural nucleophiles catalyzed by a laboratory-evolved halohydrin dehalogenase, cyclopropanation and other carbene transfer reactions catalyzed by cytochrome P450 variants, and non-natural modes of cyclization by a modified terpene synthase. Lastly, we describe discoveries of non-native catalytic functions that may provide future opportunities for expanding the enzyme universe. PMID:25649694

  17. Expanding Dress Code Requirements in the Doctor of Pharmacy Program.

    Science.gov (United States)

    Naughton, Cynthia A; Schweiger, Teresa A; Angelo, Lauren B; Lea Bonner, C; Dhing, Conrad W; Farley, Joel F

    2016-06-25

    Although the use of a professional dress code is standard practice across colleges and schools of pharmacy during introductory and advanced pharmacy practice experiences, requiring professional attire is not applied consistently during the didactic portion of students' education. There are arguments for and against the adoption of a professional dress code throughout the entire doctor of pharmacy program, including the classroom setting. Given uncertainty regarding the potential benefits and challenges that may arise from adopting a professional dress code in the didactic portion of a student pharmacist's education, it is perhaps not surprising that programs adopt disparate policies regarding its use. This exploration was conducted as part of a series of debates held in conjunction with the American Association of Colleges of Pharmacy's (AACP) Academic Leadership Fellows Program (ALFP) and was presented at the 2015 AACP Interim Meeting on February 7, 2015.

  18. Confronting the "Acid Test": Educators' Perspectives on Expanding Access to Advanced Placement at a Diverse Florida High School

    Science.gov (United States)

    Rowland, M. Lance; Shircliffe, Barbara J.

    2016-01-01

    This study examines educators' perspectives on accountability mandates designed to expand access to the College Board's Advanced Placement (AP) classes to traditionally underserved students at a diverse suburban high school in Florida, Palm Crest High School. Consistent with Elmore (1979), district and site-based administrators focused on the…

  19. 78 FR 27115 - Draft Guidance for Industry on Expanded Access to Investigational Drugs for Treatment Use...

    Science.gov (United States)

    2013-05-09

    ... access under each of the three access categories, the types and content of access submissions, IRB review... appropriate ethical oversight. This draft guidance is being issued consistent with FDA's good guidance... docket at http://www.regulations.gov . IV. Electronic Access Persons with access to the Internet may...

  20. Expanding Public Outreach: The Solar System Ambassadors Program

    Science.gov (United States)

    Ferrari, K. A.

    2000-12-01

    The Solar System Ambassadors Program is a public outreach program designed to work with motivated volunteers across the nation. Those volunteers organize and conduct public events that communicate exciting discoveries and plans in Solar System research, exploration and technology through non-traditional forums, e.g. community service clubs, libraries, museums, planetariums, ``star parties," mall displays, etc. In 2001, 200 Ambassadors from almost all 50 states bring the excitement of space to the public. Ambassadors are space enthusiasts, K-12 in-service educators, retirees, community college teachers, and other members of the general public interested in providing greater service and inspiration to the community at large. Last year, Ambassadors conducted approximately 600 events that directly reached more than one-half million people in communities across the United States. The Solar System Ambassadors Program is sponsored by the Jet Propulsion Laboratory (JPL) in Pasadena, California, an operating division of the California Institute of Technology (Caltech) and a lead research and development center for the National Aeronautics and Space Administration (NASA). Participating JPL projects include Cassini, Galileo, STARDUST, Outer Planets mission, Solar Probe, Genesis, Ulysses, Voyager, Mars missions, Discovery missions NEAR-Shoemaker and Deep Impact, and the Deep Space Network. Each Ambassador participates in on-line (web-based) training sessions that provide interaction with NASA scientists, engineers and project team members. As such, each Ambassador's experience with the space program becomes personalized. Training sessions provide Ambassadors with general background on each mission and educate concerning specific mission milestones, such as launches, planetary flybys, first image returns, arrivals, and ongoing key discoveries. Additionally, projects provide videos, slide sets, booklets, pamphlets, posters, postcards, lithographs, on-line materials, resource

  1. Expanding rural access to mental health care through online postgraduate nurse practitioner education.

    Science.gov (United States)

    Kverno, Karan; Kozeniewski, Kate

    2016-12-01

    Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services. ©2016 American Association of Nurse Practitioners.

  2. Interservice Physician Assistant Program: Educators for an Expanding Profession.

    Science.gov (United States)

    Brock, Douglas M; Orrahood, Scott A; Cooper, Christopher K; Alvitre, John J; Tozier, William

    2017-10-01

    The number of physician assistant (PA) programs has increased exponentially across the past decade, and the demand for PAs will likely remain strong through 2025. Because of this rapid growth, both new and established PA programs face significant challenges in recruiting experienced educators. We describe the value of using PAs trained through the Interservice Physician Assistant Program (IPAP) as civilian PA educators. The literature on IPAP and its graduates proved too limited to conduct a formal systematic review. We searched the PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for works speaking to the value that IPAP-trained PAs may bring to civilian PA training. Those findings were supplemented with informal conversations with IPAP-trained PAs currently employed in the military and those working in civilian PA education. Themes were identified supporting the potential value of IPAP-trained PAs in civilian training. Military PAs work within hierarchical organizations and may transition easily to academic settings. They leave military service not only as highly trained and proficient primary care providers but also as experienced educators. Military PAs must demonstrate professionalism across their entire military careers. They serve as leaders and work in teams, but they are also experienced in negotiating up chains of command. They are trained in and apply the latest innovations in health care delivery and have provided care with a degree of autonomy uncommon in civilian PA practice. The PAs trained through IPAP leave the service with skills and experiences valuable to civilian PA training. Employing these PAs in civilian education honors their service contributions while addressing emerging PA educator workforce demands.

  3. LATTICEEASY A Program for Lattice Simulations of Scalar Fields in an Expanding Universe

    CERN Document Server

    Felder, G; Tkachev, Igor; Felder, Gary

    2008-01-01

    We describe a C++ program that we have written and made available for calculating the evolution of interacting scalar fields in an expanding universe. The program is particularly useful for the study of reheating and thermalization after inflation. The program and its full documentation are available on the Web at http://physics.stanford.edu/gfelder/latticeeasy. In this paper we provide a brief overview of what the program does and what it is useful for.

  4. Strategies To Expand a Pen Pal Program from Simple Letters into a Full Intergenerational Experience.

    Science.gov (United States)

    Kiernan, Holly Way; Mosher-Ashley, Pearl M.

    2002-01-01

    The Senior Pen Pal Program began as an exchange of letters between first graders and older adults. Structured group visits between the classroom and the senior center, a holiday concert, and assigned readings about aging expanded the reach of the intergenerational program. (SK)

  5. Augmentation of Virtual Space Physics Observatory Services to Expand Data Access Capabilities Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aquilent, Inc. proposes to support the effort of Virtual Space Physics Observatory (VSPO) by developing services to expand the VSPO search capabilities, developing...

  6. An Accessible User Interface for Geoscience and Programming

    Science.gov (United States)

    Sevre, E. O.; Lee, S.

    2012-12-01

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

  7. 76 FR 66089 - Access Authorization Program for Nuclear Power Plants

    Science.gov (United States)

    2011-10-25

    ... COMMISSION Access Authorization Program for Nuclear Power Plants AGENCY: Nuclear Regulatory Commission... revision to Regulatory Guide 5.66, ``Access Authorization Program for Nuclear Power Plants.'' This guide... Authorization Requirements for Nuclear Power Plants,'' and 10 CFR part 26, ``Fitness for Duty Programs.'' The RG...

  8. Feasibility and safety of endoscopic transesophageal access and closure using a Maryland dissector and a self-expanding metal stent.

    Science.gov (United States)

    von Renteln, Daniel; Vassiliou, Melina C; Caca, Karel; Schmidt, Arthur; Rothstein, Richard I

    2011-07-01

    Secure access and reliable closure is paramount in the setting of transesophageal mediastinal endoscopic surgery. The purpose of this study was to develop a secure transesophageal access technique and to evaluate the feasibility, safety, and efficacy of a novel covered, self-expanding, retractable stent for closure of 15-mm esophageal defects. Fifteen-millimeter esophagotomies were created in 18 domestic pigs using needle knife puncture and balloon dilatation or a blunt dissection technique. Six animals were randomly assigned to open surgical repair and six animals to endoscopic closure using a self-expanding, covered, nitinol stent (Danis SX-ELLA stent, ELLA-CS) in a nonsurvival setting. Pressurized leak tests were performed on all closures. Six animals underwent transesophageal endoscopic mediastinal interventions and survived for 17 days. Stents were extracted at day 10. Nonsurvival experiments revealed two bleeding complications associated with the needle-knife access technique, while blunt-dissection mediastinal access was not associated with any complications. Leak test results were not different for stent compared to surgical closures. All survival animals were found to have complete closure and adequate healing of the esophagotomies. No leakage or infectious complication occurred. Blunt dissection achieves safe access into the mediastinum. Stent closure achieves similar leak test results compared to surgical closure and results in adequate sealing and wound healing of 15-mm esophageal defects.

  9. Managing Profound Suffering at the End-of-Life: Should expanding access to continuous deep sedation be the priority?

    Directory of Open Access Journals (Sweden)

    Kirby, Jeffrey

    2015-01-01

    Full Text Available This paper argues that in addressing and managing profound suffering at the end-of-life, the priority should not be the legalization of physician-assisted suicide or voluntary active euthanasia in jurisdictions where these practices are not currently available. Rather, concerted efforts should be made by society and the healthcare provider community to expand patient access to proportionate distress-relieving sedation and continuous deep sedation.

  10. 77 FR 6113 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2012-02-07

    ... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The... description, access to emergency programming, and access to user interfaces, menus, and programming guides...

  11. Welfare Reform Implementing DOT's Access to Jobs Program

    National Research Council Canada - National Science Library

    1998-01-01

    Since the Transportation Equity Act for the 21st Century authorized the Access to Jobs program in June 1998, the Department of Transportation has made several important decisions about the program's...

  12. Participant and Household Characteristics Associated With Graduation From the Expanded Food and Nutrition Education Program.

    Science.gov (United States)

    Cooper, Brittany Rhoades; Barale, Karen; Funaiole, Angie; Power, Thomas G; Combe, Angela

    2016-01-01

    To examine empirically participant and household characteristics associated with Expanded Food and Nutrition Education Program (EFNEP) graduation and to determine whether they differ across 2 counties. Survey of EFNEP participants from 2011 to 2012. Expanded Food and Nutrition Education Program sites serving limited-resource families in 1 rural and 1 urban/suburban county in Washington State. Expanded Food and Nutrition Education Program participants (urban/suburban: n = 647; rural: n = 569). Expanded Food and Nutrition Education Program completion/graduation. Multivariate logistic regression was used to examine associations of participant (ethnicity, race, age, education, pregnancy status, and nutrition knowledge/behavior at baseline) and household (number of people in the house, place of residence, and public assistance services) characteristics with EFNEP graduation. Associations were moderated by county. For the urban/suburban county, participants living with more people (after controlling for the total number of adults) were more likely to graduate. For the rural county, participants living with fewer total adults (after controlling for the total number in the house) and those with better food safety practices at baseline were more likely to graduate. This study aids in understanding which participants are more or less likely to complete EFNEP successfully, and therefore can inform strategies aimed at increasing graduation rates. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  13. Expanding Access to the Intrauterine Device in Public Health Facilities in Ethiopia: A Mixed-Methods Study.

    Science.gov (United States)

    Tilahun, Yewondwossen; Mehta, Sarah; Zerihun, Habtamu; Lew, Candace; Brooks, Mohamad I; Nigatu, Tariku; Hagos, Kidest Lulu; Asnake, Mengistu; Tasissa, Adeba; Ali, Seid; Desalegn, Ketsela; Adane, Girmay

    2016-03-01

    In Ethiopia, modern contraceptive prevalence among currently married women nearly tripled over the last decade, but the method mix remains skewed toward short-acting methods. Since 2011, the Integrated Family Health Program (IFHP+), jointly implemented by Pathfinder International and John Snow Inc., has supported the Federal Ministry of Health to introduce intrauterine devices (IUDs) in more than 800 health centers across 4 regions to improve access to a wider range of methods. Between March and August 2014, Pathfinder conducted a mixed-methods study in 40 purposively selected health centers to assess shifts in the contraceptive method mix following introduction of IUDs using data from family planning registers; determine the characteristics of IUD users through a cross-sectional survey of 2,943 family planning clients who accepted the IUD; explore reasons for method discontinuation among 165 clients seeking IUD removal services; and identify facilitators and barriers to IUD use through focus group discussions (N = 115 clients) and key informant interviews (N = 36 providers, facility heads, and health office heads). Introduction of IUDs into the 40 health centers participating in the study was correlated with a statistically significant increase in the contribution of all long-acting reversible contraceptives (LARCs)-both IUDs and implants-to the method mix, from 6.9% in 2011 to 20.5% in 2014 (Pmethod was acceptable to a broad cross-section of women. Of the 2,943 women who sought IUDs during the 6-month study period, 18.0% were new contraceptive users (i.e., those using a contraceptive method for the first time ever), 44.7% reported no educational attainment, 62.5% were from rural areas, and 59.3% were younger than 30 years old, with almost 3 in 10 (27.7%) under the age of 25. The most commonly cited reason for seeking IUD removal services was a desire to become pregnant (43% of women). Qualitative data indicated that while acceptability of the method is

  14. Expanded adult day program as a transition option from hospital to home.

    Science.gov (United States)

    Jones, Katherine R; Tullai-McGuinness, Susan; Dolansky, Mary; Farag, Amany; Krivanek, Mary Jo; Matthews, Laura

    2011-02-01

    This article describes a pilot program for provision of postacute care (PAC) in an established adult day program. Demographic, clinical, utilization, and satisfaction data were abstracted retrospectively from program records; postdischarge readmission and emergency department visit data were obtained from the electronic health record. Comparative data were obtained from the health records of patients who were offered but declined the adult day program. Between 2005 and 2008, 78 patients requiring PAC were approached by the RN coordinator; 33 selected the adult day program, and 45 selected alternative destinations. The majority of patients had a neurological diagnosis, most commonly stroke. Participants and their family caregivers were highly satisfied with the program. The 30-day readmission rate for adult day program participants was significantly lower than that for nonparticipants. An expanded adult day program may represent a viable Transitional Care Model for selected patients and a feasible alternative to skilled nursing facility and home health care for PAC.

  15. Increasing access and support for emergency management higher education programs.

    Science.gov (United States)

    Cwiak, Carol L

    2014-01-01

    The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.

  16. Expanding Access to NCAR's Digital Assets: Towards a Unified Scientific Data Management System

    Science.gov (United States)

    Stott, D.

    2016-12-01

    In 2014 the National Center for Atmospheric Research (NCAR) Directorate created the Data Stewardship Engineering Team (DSET) to plan and implement the strategic vision of an integrated front door for data discovery and access across the organization, including all laboratories, the library, and UCAR Community Programs. The DSET is focused on improving the quality of users' experiences in finding and using NCAR's digital assets. This effort also supports new policies included in federal mandates, NSF requirements, and journal publication rules. An initial survey with 97 respondents identified 68 persons responsible for more than 3 petabytes of data. An inventory, using the Data Asset Framework produced by the UK Digital Curation Centre as a starting point, identified asset types that included files and metadata, publications, images, and software (visualization, analysis, model codes). User story sessions with representatives from each lab identified and ranked desired features for a unified Scientific Data Management System (SDMS). A process beginning with an organization-wide assessment of metadata by the HDF Group and followed by meetings with labs to identify key documentation concepts, culminated in the development of an NCAR metadata dialect that leverages the DataCite and ISO 19115 standards. The tasks ahead are to build out an SDMS and populate it with rich standardized metadata. Software packages have been prototyped and currently are being tested and reviewed by DSET members. Key challenges for the DSET include technical and non-technical issues. First, the status quo with regard to how assets are managed varies widely across the organization. There are differences in file format standards, technologies, and discipline-specific vocabularies. Metadata diversity is another real challenge. The types of metadata, the standards used, and the capacity to create new metadata varies across the organization. Significant effort is required to develop tools to create

  17. 76 FR 56091 - Expansion of 911 Access; Telecommunications Loan Program

    Science.gov (United States)

    2011-09-12

    ... Service 7 CFR Part 1735 RIN 0572-AC24 Expansion of 911 Access; Telecommunications Loan Program AGENCY... access and integrated emergency communications systems in rural areas for the Telecommunications Loan... Villano, Assistant Administrator, Telecommunications Program, USDA--Rural Utilities Service, 1400...

  18. Dietary Changes by Expanded Food and Nutrition Education Program (EFNEP) Graduates Are Independent of Program Delivery Method.

    Science.gov (United States)

    Luccia, Barbara H. D.; Kunkel, Mary E.; Cason, Katherine L.

    2003-01-01

    Expanded Food and Nutrition Education Program graduates (n=1,141) who received either individual (21.3%), group (76.2%), or combined (2.5%) instruction were assessed. Independent of method, participants significantly improved the number of servings consumed from grains, vegetables, dairy, and meat and meat alternatives; total calories consumed;…

  19. An Analysis of Naval Officer Accession Programs

    National Research Council Canada - National Science Library

    Lehner, William D

    2008-01-01

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

  20. Private Higher Education in Jamaica: Expanding Access in Pursuit of Vision 2030

    Science.gov (United States)

    Coates, Chad Orlando

    2012-01-01

    The purpose of this study was to gain insight on why private higher education institutions have flourished as key providers of higher education in Jamaica, how these institutions facilitate access to higher education, and to what extent private higher education institutions contribute to the achievement of Jamaica's national higher education…

  1. Parental Intentions to Enroll Children in a Voluntary Expanded Newborn Screening Program

    Science.gov (United States)

    Paquin, Ryan S.; Peay, Holly L.; Gehtland, Lisa M.; Lewis, Megan A.; Bailey, Donald B.

    2016-01-01

    Background and Objectives Nearly all babies in the United States are tested at birth for rare, serious, and treatable disorders through mandatory state newborn screening (NBS). Recently, there have been calls for an expanded, voluntary model to facilitate early diagnosis and treatment of a wider range of disorders. We applied the reasoned action framework to examine parental intentions to participate in voluntary expanded screening. Methods We recruited a national cohort of recent and expectant parents living in the U.S. who completed a self-administered online survey (N = 1,001). Using a mixed-level fractional factorial experiment, we studied parental participation intentions and preferences for timing of consent, cost, consent format, and testing options. Results We conducted a hierarchical regression analysis assessing parental intentions to participate in voluntary expanded NBS. Attitudes, perceived normative influence, and perceived behavioral control explained substantial variance in intention, with perceived normative influence emerging as the strongest predictor. We found no evidence that the manipulated program features altered mean levels of intention, but timing of parental permission, cost, and permission format moderated the relative importance of reasoned action constructs on intention. Conclusion Program design features may impact the psychological mechanisms underlying parental decision making for voluntary expanded screening. These results have important implications for parent education, outreach, and informed parental permission procedures. PMID:27526258

  2. Formative assessment in the development of an obesity prevention component for the Expanded Food and Nutrition Education Program in Texas

    Science.gov (United States)

    This study conducted formative research (surveys, focus groups); to assess the nutrition education needs of clients in the Texas Expanded Food and Nutrition Education Program prior to curriculum revision. Current participants in the Expanded Food and Nutrition Education Program from 3 Texas cities (...

  3. Code-expanded radio access protocol for machine-to-machine communications

    DEFF Research Database (Denmark)

    Thomsen, Henning; Kiilerich Pratas, Nuno; Stefanovic, Cedomir

    2013-01-01

    The random access methods used for support of machine-to-machine, also referred to as Machine-Type Communications, in current cellular standards are derivatives of traditional framed slotted ALOHA and therefore do not support high user loads efficiently. We propose an approach that is motivated...... subframes and orthogonal preambles, the amount of available contention resources is drastically increased, enabling the massive support of Machine-Type Communication users that is beyond the reach of current systems....

  4. 77 FR 66052 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... challenging exclusive contracts involving cable-affiliated programming; and amendments to its rules to ensure that buying groups utilized by small and medium-sized multichannel video programming distributors..., identified by MB Docket No. 12-68, by any of the following methods: Federal Communications Commission's Web...

  5. 77 FR 66025 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... programming beyond its October 5, 2012 expiration date. Instead of this prohibition, the Commission will address exclusive contracts involving satellite-delivered, cable-affiliated programming on a case-by-case...). Summary of the Report and Order and Order on Reconsideration I. Introduction 1. In this Report and Order...

  6. TU-C-HORIZONS-01: The Expanding Horizons Travel Grant Program: ePosters and Discussion

    Energy Technology Data Exchange (ETDEWEB)

    Siewerdsen, J [Johns Hopkins University, Baltimore, MD (United States); Jeraj, R [University of Wisconsin, Madison, WI (United States)

    2016-06-15

    The Expanding Horizons travel grant program provides opportunity for students and trainees to broaden the scope of scientific meetings they attend and gain insight from research outside traditional domains of medical physics. Through participation in such conferences, early-career researchers are introduced to new topics with relevance to medical physics research as a means to expand the scientific horizons of our discipline. This year, 21 Expanding Horizons travel grants were awarded, granting travel to 17 conferences, including: Radiomics, the World Molecular Imaging Society (WMIS), the 3D Printing Conference and Expo, the GPU Technology Conference, the SIAM Imaging Science Conference, the Human Brain Mapping Conference, the OSA Conference on Clinical and Translational Biophotonics, the Society for Neuroscience, the AACR Conference on Tumor Microenvironment, and the Conference on Knowledge Discovery and Data Mining. The Expanding Horizons electronic poster session gives a venue for AAPM conference attendees to meet and discuss with awardees, learn the hot topics and emerging research areas presented at these conferences, and understand the relevance to future medical physics research.

  7. Technological Innovation and Cooperation for Foreign Information Access Program

    Science.gov (United States)

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

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

  8. Expanding your Horizons: a Program for Engaging Middle School Girls in Science and Mathematics

    Science.gov (United States)

    Jahnke, Tamera S.; Level, Allison V.

    Gender equity in science, mathematics, and technology is an issue that has generated the creation of a number of programs. Young women need to be aware that there are a variety of careers in science, mathematics, and technology that they can actively pursue. This article highlights one example of a successful middle school science program in Southwest Missouri. Expanding Your Horizons in Science, Mathematics, and Technology (EYH) integrates keynote speakers, role model mentoring sessions, and small group experiments into a hands-on learning environment. Initial survey results of parents and teachers show support for the conference and indicate that the program helps motivate students to consider careers in science, mathematics, and technology. In addition to the goal of increasing awareness for these young people, there is a need for increased scientific literacy of the general public and an increased application of science to "real world" circumstances. This program addresses these issues.

  9. Service-Learning in the Financial Planning Curriculum: Expanding Access to the Community

    Science.gov (United States)

    Annis, Paul M.; Palmer, Lance; Goetz, Joseph

    2010-01-01

    Service-learning projects are a cornerstone of student experiential learning. Such programs have proven to be mutually beneficial to communities and students within a variety of family and consumer sciences courses. However, there is a paucity of literature addressing service-learning efforts within the field of financial planning. There is an…

  10. Expanding access to non-traditional vaccines: A perspective from Indonesia

    NARCIS (Netherlands)

    Suwantika, Auliya A.; Postma, Maarten J.

    2014-01-01

    In addition to the use of traditional vaccines in the National Immunization Program, the introduction: of additional vaccines in Indonesia appears to be important to further reduce rates of childhood mortality. However, it typically takes at least two decades for additional vaccines to be introduced

  11. Expanding access to non-traditional vaccines : a perspective from Indonesia

    NARCIS (Netherlands)

    Suwantika, Auliya A; Postma, Maarten J

    2014-01-01

    In addition to the use of traditional vaccines in the National Immunization Program, the introduction: of additional vaccines in Indonesia appears to be important to further reduce rates of childhood mortality. However, it typically takes at least two decades for additional vaccines to be introduced

  12. Expanding the enzyme universe: accessing non-natural reactions by mechanism-guided directed evolution.

    Science.gov (United States)

    Renata, Hans; Wang, Z Jane; Arnold, Frances H

    2015-03-09

    High selectivity and exquisite control over the outcome of reactions entice chemists to use biocatalysts in organic synthesis. However, many useful reactions are not accessible because they are not in nature's known repertoire. In this Review, we outline an evolutionary approach to engineering enzymes to catalyze reactions not found in nature. We begin with examples of how nature has discovered new catalytic functions and how such evolutionary progression has been recapitulated in the laboratory starting from extant enzymes. We then examine non-native enzyme activities that have been exploited for chemical synthesis, with an emphasis on reactions that do not have natural counterparts. Non-natural activities can be improved by directed evolution, thus mimicking the process used by nature to create new catalysts. Finally, we describe the discovery of non-native catalytic functions that may provide future opportunities for the expansion of the enzyme universe. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Embedded Systems Programming: Accessing Databases from Esterel

    Directory of Open Access Journals (Sweden)

    2009-03-01

    Full Text Available A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel’s synchrony hypothesis, or remotely along several of Esterel’s execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel’s facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs’ utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot’s controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse’s floor layout into account, both of which are stored in a MySQL database.

  14. Embedded Systems Programming: Accessing Databases from Esterel

    Directory of Open Access Journals (Sweden)

    White David

    2008-01-01

    Full Text Available Abstract A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel's synchrony hypothesis, or remotely along several of Esterel's execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel's facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs' utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot's controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse's floor layout into account, both of which are stored in a MySQL database.

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

    KAUST Repository

    Belli, Roberto

    2015-05-01

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

  16. 42 CFR 431.818 - Access to records: MEQC program.

    Science.gov (United States)

    2010-10-01

    ... Control Medicaid Eligibility Quality Control (meqc) Program § 431.818 Access to records: MEQC program. (a) The agency, upon written request, must mail to the HHS staff all records, including complete local... State has an alternate method of submitting these records that is approved by CMS or has received, on an...

  17. 5 CFR 723.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... would result in a fundamental alteration in the nature of a program or activity or in undue financial... such alteration or burdens. The decision that compliance would result in such alteration or burdens...

  18. 22 CFR 530.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 530.150(a) would result in such alteration or burdens. The decision that compliance would result in...

  19. 25 CFR 720.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 720.150(a) would result in such alteration or burdens. The decision that compliance would result in...

  20. 45 CFR 1153.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 1153.150(a) would result in such alteration or burdens. The decision that compliance would result in...

  1. 36 CFR 1208.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-07-01

    ... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...

  2. 5 CFR 2416.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2416.150(a) would result in such alteration or...

  3. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...

  4. 5 CFR 1207.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 1207.150(a) would result in such alteration or...

  5. 1 CFR 500.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 500.150(a) would result in such alteration or burdens. The decision that compliance would result in...

  6. 14 CFR 1251.550 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...

  7. 46 CFR 507.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 507.150(a) would result in such alteration or burdens. The decision that compliance would result in...

  8. 49 CFR 1014.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 1014.150(a) would result in such alteration or burdens. The decision that compliance would result in...

  9. 22 CFR 144.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 144.150(a) would result in such alteration or burdens. The decision that compliance would result in...

  10. 78 FR 77074 - Accessibility of User Interfaces, and Video Programming Guides and Menus; Accessible Emergency...

    Science.gov (United States)

    2013-12-20

    ... COMMISSION 47 CFR Part 79 Accessibility of User Interfaces, and Video Programming Guides and Menus... authority for requiring MVPDs to ensure that video programming guides and menus that ] provide channel and... the instructions for submitting comments. Federal Communications Commission's Web site: http...

  11. 76 FR 57989 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-09-19

    ... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The..., and the delivery of video description, access to emergency programming, and the interoperability and...

  12. 76 FR 2686 - Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and...

    Science.gov (United States)

    2011-01-14

    ... COMMISSION Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and... Programming and Emergency Access Advisory Committee (``Committee'' or ``VPEAAC'') of the Federal... name to the Video Programming Accessibility Advisory Committee (``VPAAC''). The Commission further...

  13. Encouraging Reflexivity in a Residency Leadership Development Program: Expanding Outside the Competency Approach.

    Science.gov (United States)

    Clapp, Justin T; Gordon, Emily K B; Baranov, Dimitry Y; Trey, Beulah; Tilin, Felice J; Fleisher, Lee A

    2018-02-01

    While leadership development is increasingly a goal of academic medicine, it is typically framed as competency acquisition, which can limit its focus to a circumscribed set of social behaviors. This orientation may also reinforce the cultural characteristics of academic medicine that can make effective leadership difficult, rather than training leaders capable of examining and changing this culture. Expanding leadership development so it promotes social reflexivity presents a way to bolster some of the weaknesses of the competency paradigm. In 2013-2016, the University of Penn sylvania's Department of Anesthesiology and Critical Care (DACC) carried out a leadership development program for residents, which included seminars focused on developing particular leadership skills and annual capstone sessions facilitating discussion between residents and attending physicians about topics chosen by residents. The capstone sessions proved to be most impactful, serving as forums for open conversation about how these groups interact when engaged in social behaviors such as giving/receiving feedback, offering support after an adverse event, and teaching/learning in the clinic. The success of the capstone sessions led to a 2016 DACC-wide initiative to facilitate transparency among all professional roles (faculty, residents, nurse anesthetists, administrative staff) and encourage widespread reflexive examination about how the manner in which these groups interact encourages or impedes leadership and teamwork. Further work is necessary to describe how leadership program formats can be diversified to better encourage reflexivity. There is also a need to develop mechanisms for assessing outcomes of leadership programs that expand outside the competency-based system.

  14. Expanding the Impact of Photogrammetric Topography Through Improved Data Archiving and Access

    Science.gov (United States)

    Crosby, C. J.; Arrowsmith, R.; Nandigam, V.

    2016-12-01

    Centimeter to decimeter-scale 2.5 to 3D sampling of the Earth surface topography coupled with the potential for photorealistic coloring of point clouds and texture mapping of meshes enables a wide range of science applications. Not only is the configuration and state of the surface as imaged valuable, but repeat surveys enable quantification of topographic change (erosion, deposition, and displacement) caused by various geologic processes. We are in an era of ubiquitous point clouds which come from both active sources such as laser scanners and radar as well as passive scene reconstruction via structure from motion (SfM) photogrammetry. With the decreasing costs of high-resolution topography (HRT) data collection, via methods such as SfM, the number of researchers collecting these data is increasing. These "long-tail" topographic data are of modest size but great value, and challenges exist to making them widely discoverable, shared, annotated, cited, managed and archived. Presently, there are no central repositories or services to support storage and curation of these datasets. The NSF funded OpenTopography (OT) employs cyberinfrastructure including large-scale data management, high-performance computing, and service-oriented architectures, to provide efficient online access to large HRT (mostly lidar) datasets, metadata, and processing tools. With over 200 datasets and 12,000 registered users, OT is well positioned to provide curation for community collected photogrammetric topographic data. OT is developing a "Community DataSpace", a service built on a low cost storage cloud (e.g. AWS S3) to make it easy for researchers to upload, curate, annotate and distribute their datasets. The system's ingestion workflow will extract metadata from data uploaded; validate it; assign a digital object identifier (DOI); and create a searchable catalog entry, before publishing via the OT portal. The OT Community DataSpace will enable wider discovery and utilization of these HRT

  15. Expanding the live kidney donor pool: ethical considerations regarding altruistic donors, paired and pooled programs.

    Science.gov (United States)

    Patel, Shaneel Rajendra; Chadha, Priyanka; Papalois, Vassilios

    2011-06-01

    In renal transplant, there is a well-known deficiency in organ supply relative to demand. Live donation provides superior results when compared with deceased donation including a better rate of graft success and fewer immunologic complications. This deficiency in organs leads to significant morbidity and mortality rates. Alternative avenues have been extensively explored that may expand the live donor pool. They include altruistic donation as well as paired and pooled exchange programs. Altruistic donation is a truly selfless act from a donor unknown to the recipient. Kidney paired donation involves 2 incompatible donor-recipient pairs swapping donors to produce compatibility. Pooled donation involves at least 2 pairs, and can take the form of domino chains in which altruistic input sets up a chain of transplants, in which each recipient's incompatible donor makes a donation for the next recipient. Despite application of these various methods, there lie extensive ethical issues surrounding them. Misconceptions frequently occur; for instance, the perceived benefit that donating an organ to a loved one is greater for a related donor than for an altruistic one. Additionally, it is frequently believed that immunologic incompatibility offers coerced donors liberation from surgery, and that overcoming these barriers by introducing exchange programs provides vulnerable donors less protection. This article explores these and other complex ethical issues surrounding the various methods of expanding the donor pool. The authors offer opinions that challenge the ethical issues and attempt to overcome those views that hinder progress in the field.

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

    Science.gov (United States)

    Khan, Aziz; Mathelier, Anthony

    2017-12-15

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

  17. Expanding access to pain care for frail, older people in primary care: a cross-sectional study.

    Science.gov (United States)

    Muntinga, M E; Jansen, A P D; Schellevis, F G; Nijpels, G

    2016-01-01

    Although untreated pain has a negative impact on quality of life and health outcomes, research has shown that older people do not always have access to adequate pain care. Practice nurse-led, comprehensive geriatric assessments (CGAs) may increase access to tailored pain care for frail, older people who live at home. To explore this, we investigated whether new pain cases were identified by practice nurses during CGAs administered as part of an intervention with the Geriatric Care Model, a comprehensive care model based on the Chronic Care Model, and whether the intervention led to tailored pain action plans in care plans of frail, older people. We used cross-sectional data from the older Adults: Care in Transition (ACT) study, a 2-year clinical trial carried out in two regions of the Netherlands. Practice nurses proactively visited older people at home and administered an in-home CGA that included an assessment of pain. Pain care-related agreements and actions (pain action plans) based on CGA results were described in a tailored care plan. We analyzed care plans of 781 older people who received a first-time CGA by a practice nurse for the presence of pain, pain location and cause, new pain cases, and pain action plans. We used descriptive statistics to analyze our data. We found that 315 (40.3 %) older people experienced any type of pain. Practice nurses identified 20 (10.6 %) new pain cases, and 188 (59.7 %) older people with pain formulated at least one therapeutic or non-therapeutic pain action plan together with a practice nurse. More than half of the older people whose pain had already been identified by a primary care physician wanted a pain action plan. Most pain action plans consisted of actions or agreements related to continuity of care. Practice nurses in primary care can contribute to expanding older people's access to tailored pain care. Future researchers should continue to direct their focus at ways to overcome the barriers that restrict older

  18. Formal analysis of name accessing in programming languages

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Carol Lynn [Iowa State Univ., Ames, IA (United States)

    1975-10-01

    One of the main purposes of a programming language is to provide a framework within which a user can convey the specification of a task to an information processing system. A model is proposed in which name accessing conventions can be analyzed and compared.

  19. 24 CFR 9.149 - Program accessibility: discrimination prohibited.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Program accessibility: discrimination prohibited. 9.149 Section 9.149 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF DISABILITY IN...

  20. 45 CFR 1181.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... FOUNDATION ON THE ARTS AND THE HUMANITIES INSTITUTE OF MUSEUM AND LIBRARY SERVICES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INSTITUTE OF MUSEUM AND... services to accessible buildings, assignment of aides to beneficiaries, home visits, delivery of services...

  1. 24 CFR 1003.507 - Public access to program records.

    Science.gov (United States)

    2010-04-01

    ... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANTS FOR INDIAN TRIBES AND ALASKA NATIVE VILLAGES Grant... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Public access to program records...

  2. 22 CFR 711.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 711.150(a) would result in such alteration or...

  3. 45 CFR 2104.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 2104.150(a) would result in such alteration or burdens. The decision that...

  4. 17 CFR 149.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 149.150(a) would result in such alteration or burdens. The decision that...

  5. 34 CFR 1200.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-07-01

    ... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 1200.150(a) would result in such alteration or...

  6. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...

  7. 45 CFR 2301.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 2301.150(a) would result in such alteration or...

  8. 5 CFR 1636.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 1636.150(a) would result in such alteration or...

  9. 18 CFR 1313.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... (a)(3), alternative methods of achieving program accessibility include— (i) Using audio-visual...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 1313.150(a) would result in such alteration or burdens. The decision that...

  10. Experience in production of (68)Ga-DOTA-NOC for clinical use under an Expanded Access IND.

    Science.gov (United States)

    Green, Mark A; Mathias, Carla J; Fletcher, James W

    2016-10-01

    [(68)Ga]Ga-DOTA-NOC was produced under an Expanded Access IND for 174 clinical PET/CT studies to evaluate patients with neuroendocrine tumors. Production employed either the TiO2-based Eckert & Ziegler (EZAG) (68)Ge/(68)Ga-generator (with fractionated elution), or the SiO2-based ITG (68)Ge/(68)Ga-generator. In both cases, [(68)Ga]Ga-DOTA-NOC was reliably produced, without pre-synthesis purification of the(68)Ga generator eluate, using readily-implemented manual synthesis procedures. [(68)Ga]Ga-DOTA-NOC radiochemical purity averaged 99.2±0.4%. Administered (68)Ga dose averaged 181±22 MBq, and administered peptide mass averaged 43.2±5.2µg (n=47) and 23.9±5.7µg (n=127), respectively, using the EZAG and ITG generators. At dose expiration, (68)Ge breakthrough in the final product averaged 2.7×10(-7)% and 5.4×10(-5%) using the EZAG and ITG generators, respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. [Waiting lists in public systems: from expanding supply to timely access? Reflections on Spain's National Health System].

    Science.gov (United States)

    Conill, Eleonor Minho; Giovanella, Lígia; de Almeida, Patty Fidelis

    2011-06-01

    The paper discusses the issue of waiting times based on a study of Spain's National Health System (Sistema Nacional de Salud, SNS), focusing on the national context, management issues and local practices. Observation visits and interviews with health personnel and managers conducted in the metropolitan areas of the Autonomous Communities of Madrid, Andalusia, Catalonia and Basque Country were complemented by secondary data and a review of the literature. There is unanimity as to the positive results of the SNS, but cutting waiting times seems to be one key aspect requiring improvement. Two directions were identified for complementary measures: guaranteed maximum waiting times in the macro-social sphere associated with local measures to increase service integration and primary care resolution rates. The peculiarities of the Spanish decentralisation process and the existence of economic, political and health profession corporate interests were mentioned as factors hampering waiting list regulation, transparency and management. A comprehensive approach to this issue shows the need to shift discussion from waiting list monitoring and/or expanded supply to guaranteed timely access. That is the quality differential that primary care-oriented systems must bring to public health systems.

  12. On Common Constitutional Ground: How Georgia's Scholarship Tax Credits Mirror Other State Programs and Expand Educational Opportunity

    Science.gov (United States)

    Carpenter, Dick M., II.; Erickson, Angela C.

    2016-01-01

    In 2008, Georgia launched a tax-credit scholarship program to expand educational opportunities for the state's pre-K through 12th-grade students by providing them scholarships to attend private schools. Georgia's scholarship tax credit program will help over 13,000 children get the best education for their needs at secular and religious private…

  13. Demonstrating Impact through Replicable Analysis: Implications of an Evaluation of Arkansas's Expanded Food and Nutrition Education Program

    Science.gov (United States)

    Phelps, Josh; Brite-Lane, Allison; Crook, Tina; Hakkak, Reza; Fuller, Serena

    2017-01-01

    The evaluation described in this article focused on the effectiveness of Arkansas's Extension-based Expanded Food and Nutrition Education Program (EFNEP) but demonstrates an analytic approach that may be useful across Extension programs. We analyzed data from 1,810 Arkansas EFNEP participants' entry and exit Behavior Checklists to assess…

  14. Final results of the European Advanced Renal Cell Carcinoma Sorafenib (EU-ARCCS) expanded-access study: a large open-label study in diverse community settings

    NARCIS (Netherlands)

    Beck, J.; Procopio, G.; Bajetta, E.; Keilholz, U.; Negrier, S.; Szczylik, C.; Bokemeyer, C.; Bracarda, S.; Richel, D. J.; Staehler, M.; Strauss, U. P.; Mersmann, S.; Burock, K.; Escudier, B.

    2011-01-01

    The European Advanced Renal Cell Carcinoma Sorafenib (EU-ARCCS) expanded-access study provided sorafenib to advanced renal cell carcinoma (RCC) patients in whom previous systemic therapy had failed. The study assessed the safety and use of sorafenib for the treatment of advanced RCC in a large

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

    Directory of Open Access Journals (Sweden)

    Rosarin Sruamsiri

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

  16. 76 FR 19356 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-04-07

    ... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The meeting will address the provision of closed captioning of Internet programming previously captioned on...

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

    Directory of Open Access Journals (Sweden)

    Roque da Silva Araújo

    Full Text Available ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (she stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample, diabetic (44% and dyslipidemic patients (31%.

  18. Sustained attention in mice: expanding the translational utility of the SAT by incorporating the Michigan Controlled Access Response Port (MICARP).

    Science.gov (United States)

    St Peters, Megan; Cherian, Ajeesh Koshy; Bradshaw, Marc; Sarter, Martin

    2011-12-01

    Advances in mouse genetic technology have spurred increasing interest in the development of cognitive tasks for mice. Here, we describe and discuss the modifications necessary to adapt a task for the assessment of sustained attention performance for use in mice, including for taxing the top-down control of such performance. The validity of the Sustained Attention Task (SAT), including the distractor version (dSAT), has previously been demonstrated in rats and humans. This task requires moveable or retractable operanda; insertion of operanda into the operant chambers cues animals to respond to a prior signal or non-signal event, reporting either a hit or a miss, or a correct rejection or false alarm, respectively. Retractable levers did not support sufficiently high and stable levels of performance in mice. Given the widespread use of static nose-poke devices for testing operant performance in mice, we therefore designed and fabricated a retractable nose-poke device. As this device extends into chambers, a hole for nose-poking is slowly opened and closed again as the device retracts (termed the "Michigan Controlled Access Response Port", MICARP). Results describe the effects of variation of signal duration and event rate, trial outcome and trial type probability, effects of mice deprivation levels, and the reliability of SAT and dSAT performance. Mice perform the SAT and dSAT at levels comparable to those observed in rats. This task will be of assistance in expanding the translational usefulness of the SAT and dSAT. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Everolimus safety and efficacy for renal angiomyolipomas associated with tuberous sclerosis complex: a Spanish expanded access trial.

    Science.gov (United States)

    Robles, Nicolás Roberto; Peces, Ramón; Gómez-Ferrer, Álvaro; Villacampa, Felipe; Álvarez-Ossorio, Jose Luis; Pérez-Segura, Pedro; Morote, Juan; Herrera-Imbroda, Bernardo; Nieto, Javier; Carballido, Joaquín; Anido, Urbano; Valero, Marian; Meseguer, Cristina; Torra, Roser

    2016-09-26

    Renal angiomyolipomas (AML) are usual manifestations of tuberous sclerosis complex (TSC) that may cause aneurism-related haemorrhages and renal impairment. Everolimus has emerged as an alternative to surgery/embolization. We provide further insight into everolimus safety and efficacy for TSC-related AML. This was a Spanish expanded access trial including patients aged ≥18 years with TSC-related AML. They received 10 mg everolimus once daily until AML progression, unacceptable toxicity, death/withdrawal, commercialisation for TSC-related AML, or 1 year after first patient enrolment. The primary outcome was dose-limiting safety according to grade 3/4 adverse events, serious adverse events, or adverse events leading to treatment modification. Secondary outcomes included overall safety and efficacy. Nineteen patients were enrolled and received everolimus for a median of 6.6 (5.3-10.9) months. Eleven (57.9 %) remained on 10 mg/day throughout the study and eight (42.1 %) required treatment modifications due to adverse events; none permanently discontinued treatment. Adverse events were overall grade 1/2 and most frequently included aphthous stomatitis/mucosal inflammation, hypercholesterolaemia/hypertriglyceridaemia, urinary tract infection, hypertension, dermatitis acneiform, and insomnia. Four (21.1 %) patients experienced grade 3 adverse events, none was grade 4, and only one (5.3 %) was serious (pneumonia). AML volume was reduced ≥30 % in 11 (57.9 %) patients and ≥50 % in 9 (47.4 %); none progressed. Right and left kidney sizes decreased in 16 and 14 patients, respectively. These findings support the benefit of everolimus for renal AML due to a manageable safety profile accompanied by reduced AML and kidney volumes. EudraCT number 2012-005397-63 ; date of registration 22 Nov 2012.

  20. An accessible interface for programming an assistive robot

    Directory of Open Access Journals (Sweden)

    Juan G Victores

    2014-09-01

    Full Text Available In this paper, we present an accessible interface in the context of our work on bringing advanced robotics closer to everyday domestic users. This interface allows inexperienced users to be capable of programming an assistive robotic arm to perform a specific desired task in a household environment. The programming process is performed through the developed Web Browsable interface, within which a Task Creator Wizard plays an essential role. The robot's open architecture enables flexible multi-modal interaction. In addition to the touch buttons provided by the Web Browsable interface when presented on a touch screen, voice commands and the use of the Wii RemoteTM controller for intuitive robotic movement have also been enabled. The Web Browsable interface has been designed to provide high accessibility while taking aesthetic details into account, in order to prevent distraction caused by boredom of the user.

  1. 77 FR 6479 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2012-02-08

    ... Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final rule... carriage of video programming vendors by multichannel video programming distributors (program carriage... and Order, Leased Commercial Access; Development of Competition and Diversity in Video Programming...

  2. A very large diversity space of synthetically accessible compounds for use with drug design programs

    Science.gov (United States)

    Nikitin, Sergey; Zaitseva, Natalia; Demina, Olga; Solovieva, Vera; Mazin, Evgeny; Mikhalev, Sergey; Smolov, Maxim; Rubinov, Anatoly; Vlasov, Peter; Lepikhin, Dmitry; Khachko, Denis; Fokin, Valery; Queen, Cary; Zosimov, Viktor

    2005-01-01

    We have constructed a very large virtual diversity space containing more than 1013 chemical compounds. The diversity space is built from about 400 combinatorial libraries, which have been expanded by choosing sizeable collections of suitable R-groups that can be attached to each link point of their scaffolds. These R-group collections have been created by selecting reagents that have drug-like properties from catalogs of available chemicals. As members of known combinatorial libraries, the compounds in the diversity space are in general synthetically accessible and useful as potential drug leads. Hence, the diversity space can be used as a vast source of compounds by a de novo drug design program. For example, we have used such a program to generate inhibitors of HIV integrase enzyme that exhibited activity in the micromolar range.

  3. Integrating Vitamin A Supplementation at 6 months into the Expanded Program of Immunization in Sierra Leone.

    Science.gov (United States)

    Hodges, Mary H; Sesay, Fatmata F; Kamara, Habib I; Nyorkor, Emmanuel D; Bah, Mariama; Koroma, Aminata S; Kandeh, Joseph N; Ouédraogo, Rasmata; Wolfe, Adam C; Katcher, Heather I; Blankenship, Jessica L; Baker, Shawn K

    2015-09-01

    Since 2004, twice-yearly mass vitamin A supplementation (VAS) has equitably reached over 85% of children 6-59 months old in Sierra Leone. However infants who turn 6 months after the event may wait until they are 11 months old to receive their first dose. The effectiveness of integrating VAS at 6 months into the Expanded Program of Immunization (EPI) in a revised child health card was studied. Health facilities matched according to staff cadre and work load were assigned to provide either a 'mini package' of VAS and infant and young child feeding (IYCF), a 'full package' of VAS, IYCF and family planning (FP), or 'child health card' only. 400 neonates were enrolled into each group, caregivers given the new child health card and followed until they were 12 months old. More infants in the full: 74.5% and mini: 71.7% group received VAS between 6 and 7 months of age compared with the new CH card only group: 60.2% (p = 0.002, p 60% coverage for infants between 6 and 7 months of age. Provision of FP and/or IYCF further improved coverage. Funding was provided by the Canadian Department of Foreign Affairs, Trade and Development who had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

  4. Expand the Modeling Capabilities of DOE's EnergyPlus Building Energy Simulation Program

    Energy Technology Data Exchange (ETDEWEB)

    Don Shirey

    2008-02-28

    EnergyPlus{trademark} is a new generation computer software analysis tool that has been developed, tested, and commercialized to support DOE's Building Technologies (BT) Program in terms of whole-building, component, and systems R&D (http://www.energyplus.gov). It is also being used to support evaluation and decision making of zero energy building (ZEB) energy efficiency and supply technologies during new building design and existing building retrofits. Version 1.0 of EnergyPlus was released in April 2001, followed by semiannual updated versions over the ensuing seven-year period. This report summarizes work performed by the University of Central Florida's Florida Solar Energy Center (UCF/FSEC) to expand the modeling capabilities of EnergyPlus. The project tasks involved implementing, testing, and documenting the following new features or enhancement of existing features: (1) A model for packaged terminal heat pumps; (2) A model for gas engine-driven heat pumps with waste heat recovery; (3) Proper modeling of window screens; (4) Integrating and streamlining EnergyPlus air flow modeling capabilities; (5) Comfort-based controls for cooling and heating systems; and (6) An improved model for microturbine power generation with heat recovery. UCF/FSEC located existing mathematical models or generated new model for these features and incorporated them into EnergyPlus. The existing or new models were (re)written using Fortran 90/95 programming language and were integrated within EnergyPlus in accordance with the EnergyPlus Programming Standard and Module Developer's Guide. Each model/feature was thoroughly tested and identified errors were repaired. Upon completion of each model implementation, the existing EnergyPlus documentation (e.g., Input Output Reference and Engineering Document) was updated with information describing the new or enhanced feature. Reference data sets were generated for several of the features to aid program users in selecting proper

  5. Family and Consumer Sciences Focus on the Human Dimension: The Expanded Food and Nutrition Education Program Example

    Science.gov (United States)

    Cason, Katherine L.; Chipman, Helen; Forstadt, Leslie A.; Rasco, Mattie R.; Sellers, Debra M.; Stephenson, Laura; York, De'Shoin A.

    2017-01-01

    The history of family and consumer sciences (FCS) and the Expanded Food and Nutrition Education Program (EFNEP) is discussed with an emphasis on the critical importance of the human dimension. EFNEP's focus on people, education for change, accountability, strategic partnerships, and public value are highlighted as an example and model for…

  6. Creating Healthful Home Food Environments: Results of a Study with Participants in the Expanded Food and Nutrition Education Program

    Science.gov (United States)

    Cullen, Karen Weber; Smalling, Agueda Lara; Thompson, Debbe; Watson, Kathleen B.; Reed, Debra; Konzelmann, Karen

    2009-01-01

    Objective: To evaluate a modified curriculum for the 6-session Texas Expanded Food and Nutrition Education Program (EFNEP) promoting healthful home food environments and parenting skills related to obesity prevention. Design: Two-group randomized control trial; intervention versus usual EFNEP curriculum. Setting: Texas EFNEP classes. Participants:…

  7. Creating healthful home food environments: Results of a study with participants in the Expanded Food and Nutrition Education Program

    Science.gov (United States)

    Our objective was to evaluate a modified curriculum for the 6-session Texas Expanded Food and Nutrition Education Program (EFNEP), promoting healthful home food environments and parenting skills related to obesity prevention. We used a two-group randomized control trial: intervention versus usual EF...

  8. Doing more for less: identifying opportunities to expand public sector access to safe abortion in South Africa through budget impact analysis.

    Science.gov (United States)

    Lince-Deroche, Naomi; Harries, Jane; Constant, Deborah; Morroni, Chelsea; Pleaner, Melanie; Fetters, Tamara; Grossman, Daniel; Blanchard, Kelly; Sinanovic, Edina

    2017-08-03

    To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i.e. the method mix), and (4) expansion plus changing the method mix. The public sector performed an estimated 20% of the expected total number of abortions in 2016/17; 26% and 54% of all abortions were performed illegally or in the private sector respectively. Costs were lowest in scenarios where method mix shifting occurred. Holding the proportion of abortions performed in the public-sector constant, shifting to more cost-effective service provision (more first-trimester services with more medication abortion and using the combined regimen for medical induction in the second trimester) could result in savings of $28.1 million in the public health service over the 10-year period. Expanding public sector provision through elimination of unsafe abortions would require an additional $192.5 million. South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided. More research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions. South Africa can provide more safe abortions for less money in the public sector through shifting to more first-trimester methods, including more medication abortion, and shifting to a combined mifepristone plus misoprostol regimen for second trimester medical induction. Expanding access in addition to method mix changes would require additional funds. Copyright

  9. Expanding The INSPIRED COPD Outreach ProgramTM to the emergency department: a feasibility assessment

    Directory of Open Access Journals (Sweden)

    Gillis D

    2017-05-01

    Full Text Available Darcy Gillis,1 Jillian Demmons,1 Graeme Rocker1,2 1Division of Respirology, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Nova Scotia Health Authority, Halifax, NS, Canada; 2Division of Respirology, Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada Background: The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%–80% reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD who avoid hospital admission.Methods: Patients were eligible for the INSPIRED-ED study if >40 years of age, diagnosed with AECOPD and discharged from the ED, willing to be referred, community dwelling with at least one of: previous use of the ED services, admission to Intermediate Care Unit/Intensive Care Unit, or admission to hospital with AECOPD in the past year. We set feasibility objectives for referral rates, completion of action plans, advance care planning participation, and reduction in ED visit frequency.Results: Referral rates were 0.5/week. Among eligible patients (n=174 33 (19% were referred of whom 15 (M=4, F=11 enrolled in INSPIRED-ED. Mean (SD age was 68 (7 years, post-bronchdilator FEV1 44.2 (15.5 % predicted, and Medical Research Council (MRC dyspnea score 3.8 (0.41. We met feasibility objectives for action plan and advance care planning completion. Frequency of subsequent ED visits fell by 54%. Mean (SD Care Transition Measure (CTM-3 improved from 8.6 (2.0 to 11.3 (1.3, P=0.0004, and of 14 patients responding 12 (86% found the program very helpful. An additional 34

  10. Expanded syringe exchange programs and reduced HIV infection among new injection drug users in Tallinn, Estonia

    Science.gov (United States)

    2011-01-01

    Background Estonia has experienced an HIV epidemic among intravenous drug users (IDUs) with the highest per capita HIV prevalence in Eastern Europe. We assessed the effects of expanded syringe exchange programs (SEP) in the capital city, Tallinn, which has an estimated 10,000 IDUs. Methods SEP implementation was monitored with data from the Estonian National Institute for Health Development. Respondent driven sampling (RDS) interview surveys with HIV testing were conducted in Tallinn in 2005, 2007 and 2009 (involving 350, 350 and 327 IDUs respectively). HIV incidence among new injectors (those injecting for 80%), and young adults (mean ages 24 to 27 years). The proportion of new injectors decreased significantly over the years (from 21% in 2005 to 12% in 2009, p = 0.005). HIV prevalence among all respondents stabilized at slightly over 50% (54% in 2005, 55% in 2007, 51% in 2009), and decreased among new injectors (34% in 2005, 16% in 2009, p = 0.046). Estimated HIV incidence among new injectors decreased significantly from 18/100 person-years in 2005 and 21/100 person-years in 2007 to 9/100 person-years in 2009 (p = 0.026). Conclusions In Estonia, a transitional country, a decrease in the HIV prevalence among new injectors and in the numbers of people initiating injection drug use coincided with implementation of large-scale SEPs. Further reductions in HIV transmission among IDUs are still required. Provision of 70 or more syringes per IDU per year may be needed before significant reductions in HIV incidence occur. PMID:21718469

  11. 76 FR 60651 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2011-09-29

    ... Access; Development of Competition and Diversity in Video Programming Distribution and Carriage; Revision... Video Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final... carriage of video programming vendors by multichannel video programming distributors (``MVPDs''), known as...

  12. Safety of enzalutamide in patients with metastatic castration‐resistant prostate cancer previously treated with docetaxel: Expanded access in North America

    Science.gov (United States)

    Shore, Neal D.; Saad, Fred; Chi, Kim N.; Olsson, Carl A.; Emmenegger, Urban; Scholz, Mark; Berry, William; Mukherjee, Som D.; Winquist, Eric; Haas, Naomi B.; Foley, Margaret A.; Dmuchowski, Carl; Perabo, Frank; Hirmand, Mohammad; Hasabou, Nahla; Rathkopf, Dana

    2015-01-01

    BACKGROUND The open‐label, single‐arm enzalutamide expanded access program (EAP) in the United States and Canada evaluated the safety of enzalutamide in patients with metastatic castration‐resistant prostate cancer (mCRPC) who had previously received docetaxel. METHODS Patients (n = 507) received enzalutamide 160 mg/day until disease progression, intolerable adverse events (AEs), or commercial availability occurred. AEs and other safety variables were assessed on day 1, weeks 4 and 12, and every 12 weeks thereafter. Data following transition to commercial drug were not collected. RESULTS Median age was 71 years (range 43–97); 426 patients (83.9%) had a baseline ECOG score of ≤1. In addition to docetaxel, the majority of patients had received prior prostate cancer treatments such as abiraterone (76.1%) or cabazitaxel (28.6%). Median study treatment duration was 2.6 months (range 0.03–9.07). The most frequently reported reasons for discontinuation were commercial availability of enzalutamide (46.7%) and progressive disease (33.7%). A total of 88.2% of patients experienced AEs; 45.4% experienced AEs with a maximum grade of 1 or 2. Fatigue (39.1%), nausea (22.7%), and anorexia (14.8%) were the most commonly reported AEs. Seizure was reported in four patients (0.8%). The most commonly reported event leading to death was progression of metastatic prostate cancer (7.7%). CONCLUSION In this heavily pretreated EAP population with progressive mCRPC, enzalutamide was well tolerated and the safety profile was consistent with that of the AFFIRM trial. Prostate 75: 836–844, 2015. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc. PMID:25683285

  13. Accessibility Landscapes of Supplemental Nutrition Assistance Program-Authorized Stores.

    Science.gov (United States)

    Racine, Elizabeth F; Delmelle, Eric; Major, Elizabeth; Solomon, Corliss A

    2018-01-20

    The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Participants receive electronic benefits that are redeemable at a variety of food stores. Previous research notes that low-income neighborhoods often lack supermarkets with high-quality, affordable food. The first aim of this study was to explore the number and spatial distribution of SNAP stores by type and to assess how SNAP benefit redemption is linked to store type in North Carolina in 2015. The second aim was to compare the demographics of populations living in areas with a high concentration of SNAP participants vs areas with a lower concentration of SNAP participants. The third aim was to test for disparities in the availability of and access to SNAP-authorized stores in areas with high vs low concentration of SNAP participants stratified by rural/urban status. US Department of Agriculture and US Census data were used to explore the spatial distribution of SNAP stores at the census block group level utilizing a Geographic Information System. The 9,556 North Carolina SNAP stores in 2015 categorized into full-variety and limited-variety stores. Proximity to limited-variety SNAP food stores and full-variety SNAP food stores within access range (1 mile in urban areas and 10 miles in rural areas). Wilcoxon rank sum and χ 2 tests are used to compare the distance to and concentration of SNAP stores by rurality and SNAP participant concentration at census block group scale. Among the SNAP stores in North Carolina, 83% are limited-variety stores and 17% are full-variety stores. There are disparities in the demographics of individuals living in census block groups with a high proportion of SNAP participants compared to census block groups with a lower proportion of SNAP participants. More households in higher SNAP participant census block groups were non-white, did not have a car, and had children compared to census block groups with lower SNAP

  14. Expanding Antimicrobial Stewardship to Urgent Care Centers Through a Pharmacist-Led Culture Follow-up Program.

    Science.gov (United States)

    Dumkow, Lisa E; Beuschel, Thomas S; Brandt, Kasey L

    2017-09-01

    Urgent care centers represent a high-volume outpatient setting where antibiotics are prescribed frequently but resources for antimicrobial stewardship may be scarce. In 2015, our pharmacist-led Emergency Department (ED) culture follow-up program was expanded to include two urgent care (UC) sites within the same health system. The UC program is conducted by ED and infectious diseases clinical pharmacists as well as PGY1 pharmacy residents using a collaborative practice agreement (CPA). The purpose of this study was to describe the pharmacist-led UC culture follow-up program and its impact on pharmacist workload. This retrospective, descriptive study included all patients discharged to home from UC with a positive culture from any site resulting between 1 January and 31 December 2016. Data collected included the culture type, presence of intervention, and proportion of interventions made under the CPA. Additionally, pharmacist workload was reported as the number of call attempts made, new prescriptions written, and median time to complete follow-up per patient. Data were reported using descriptive statistics. A total of 1461 positive cultures were reviewed for antibiotic appropriateness as part of the UC culture follow-up program, with 320 (22%) requiring follow-up intervention. Culture types most commonly requiring intervention were urine cultures (25%) and sexually transmitted diseases (25%). A median of 15 min was spent per intervention, with a median of one call (range 1-6 calls) needed to reach each patient. Less than half of patients required a new antimicrobial prescription at follow-up. A pharmacist-led culture follow-up program conducted using a CPA was able to be expanded to UC sites within the same health system using existing clinical pharmacy staff along with PGY1 pharmacy residents. Service expansion resulted in minimal increase in pharmacist workload. Adding UC culture follow-up services to an existing ED program can allow health systems to expand

  15. To expand coverage, or increase frequency: Quantifying the tradeoffs between equity and efficiency facing cervical cancer screening programs in low-resource settings.

    Science.gov (United States)

    Campos, Nicole G; Tsu, Vivien; Jeronimo, Jose; Mvundura, Mercy; Lee, Kyueun; Kim, Jane J

    2017-03-15

    Cervical cancer is a leading cause of cancer death worldwide, with 85% of the disease burden residing in less developed regions. To inform evidence-based decision-making as cervical cancer screening programs are planned, implemented, and scaled in low- and middle-income countries, we used cost and test performance data from the START-UP demonstration project in Uganda and a microsimulation model of HPV infection and cervical carcinogenesis to quantify the health benefits, distributional equity, cost-effectiveness, and financial impact of either (1) improving access to cervical cancer screening or (2) increasing the number of lifetime screening opportunities for women who already have access. We found that when baseline screening coverage was low (i.e., 30%), expanding coverage of screening once in a lifetime to 50% can yield comparable reductions in cancer risk to screening two or three times in a lifetime at 30% coverage, lead to greater reductions in health disparities, and cost 150 international dollars (I$) per year of life saved (YLS). At higher baseline screening coverage levels (i.e., 70%), screening three times in a lifetime yielded greater health benefits than expanding screening once in a lifetime to 90% coverage, and would have a cost-effectiveness ratio (I$590 per YLS) below Uganda's per capita GDP. Given very low baseline coverage at present, we conclude that a policy focus on increasing access for previously unscreened women appears to be more compatible with improving both equity and efficiency than a focus on increasing frequency for a small subset of women. © 2016 UICC.

  16. Newborn access and care in a health attention program

    Directory of Open Access Journals (Sweden)

    Poliana Remundini de Lima

    2016-03-01

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

  17. Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

    Science.gov (United States)

    Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

    2011-01-01

    In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.

  18. 77 FR 47440 - Office of the Assistant Secretary for Office of Disability Employment Program Accessible...

    Science.gov (United States)

    2012-08-08

    ... information technology professionals and developers. Conducting trainings/webinars on issues related to accessible technology in the workplace, including use of emerging technologies to facilitate employment and... of the Assistant Secretary for Office of Disability Employment Program Accessible Technology Action...

  19. 77 FR 51948 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property...

    Science.gov (United States)

    2012-08-28

    ... Federal Aviation Administration 14 CFR Chapter 1 Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property; Correction AGENCY: Federal Aviation Administration (FAA... paragraph in the Proposed Policy Regarding Access to Airports From Residential Property that was published...

  20. Cost-effectiveness of Access to Critical Cerebral Emergency Support Services (ACCESS): a neuro-emergent telemedicine consultation program.

    Science.gov (United States)

    Whetten, Justin; van der Goes, David N; Tran, Huy; Moffett, Maurice; Semper, Colin; Yonas, Howard

    2018-01-19

    Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective. A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not. The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3 h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952-$4,438) per patient and increase QALYs by 0.20 (0.14-0.22). This increase in QALYs equates to ∼73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model. The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).

  1. Development and delivery of a pharmacist training program to increase naloxone access in Kentucky.

    Science.gov (United States)

    Palmer, Emma; Hart, Steve; Freeman, Patricia R

    To describe the development and delivery of a comprehensive training program for Kentucky pharmacists to enable dispensation of naloxone per protocol. In May 2015, the Kentucky Board of Pharmacy (KBP) promulgated regulations outlining the requirements for pharmacists to initiate the dispensing of naloxone under a physician-approved protocol. The Advancing Pharmacy Practice in Kentucky Coalition, a partnership between Kentucky's Colleges of Pharmacy, KBP, and state and local pharmacists associations, developed and offered educational programming to fulfill this regulation. Pharmacists who completed the 90-minute program could apply to KBP for registration as a naloxone-certified pharmacist. The program consists of a 90-minute session covering naloxone access, opioid overdoses, the pharmacology and use of naloxone, protocol development, patient identification, and resources. Sessions were offered live and via webinar. Sessions have also been incorporated into the pharmacy curriculum at the 2 colleges of pharmacy in Kentucky. Between June 28, 2015, and June 1, 2016, a total of 1254 pharmacists and 348 student pharmacists completed training. Of those, 646 (52%) have applied to KBP and received naloxone-certified status. The program was well received, with 87% of learners ranking the usefulness of the information presented as excellent. Learners cited screening tips, protocol information, patient screening information, and education resources as information they will implement in their practice. The swift deployment of training to a wide variety of pharmacy professionals has resulted in a substantial number of naloxone-certified pharmacists across Kentucky. Through a coordinated training initiative involving all major pharmacy stakeholders, we reached many individuals rapidly, documenting the value of this approach for future training endeavors. This educational initiative may enhance pharmacy practice across Kentucky and the nation by expanding and educating on the

  2. Expanding the Web of Meaning: Thought and Emotion in an Intergenerational Reading and Writing Program

    Science.gov (United States)

    Dipardo, Anne; Schnack, Pat

    2004-01-01

    This study explores informants' experiences in a reading/writing program that paired eighth-grade language arts students with elderly volunteers. Twenty-three pairs were followed over an academic year as they read books in common, corresponded in response journals, and met in person at program social events. Through analysis of interviews, their…

  3. Expanding Pathways: A Summer Bridge Program for Community College STEM Students

    Science.gov (United States)

    Lenaburg, Lubella; Aguirre, Ofelia; Goodchild, Fiona; Kuhn, Jens-Uwe

    2012-01-01

    This paper addresses the transition of community college students to degree programs in science, technology, engineering, and mathematics (STEM). The paper presents the results of an evaluation of a two-week residential summer bridge program that recruited community college students from a wide range of academic, ethnic, and socioeconomic…

  4. Challenges in Expanding Access to Dialysis in South Africa-Expensive Modalities, Cost Constraints and Human Rights.

    Science.gov (United States)

    Etheredge, Harriet; Fabian, June

    2017-07-31

    South Africa is a country with two distinct health sectors, which are both characterised by inequalities. Within this context, patients with end stage renal disease face unique and sometimes impenetrable barriers to accessing dialysis. There are a number of reasons for this situation. These include: the South African government's endorsement of discordant, unequal policies, which disadvantage the most vulnerable; a lack of robust national guidelines; and divisive rationing practices, which are ad hoc and place the burden of responsibility for rationing dialysis on the clinician. In this paper, we trace the socio-economic mechanisms of how we have come to be in this situation, and overlay this with a detailed examination of South African legislation. Finally, we make comprehensive practical recommendations for rectifying the situation, which include engagement with key stakeholders, public-private partnerships, and more equitable funding mechanisms.

  5. Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights

    Directory of Open Access Journals (Sweden)

    Harriet Etheredge

    2017-07-01

    Full Text Available South Africa is a country with two distinct health sectors, which are both characterised by inequalities. Within this context, patients with end stage renal disease face unique and sometimes impenetrable barriers to accessing dialysis. There are a number of reasons for this situation. These include: the South African government’s endorsement of discordant, unequal policies, which disadvantage the most vulnerable; a lack of robust national guidelines; and divisive rationing practices, which are ad hoc and place the burden of responsibility for rationing dialysis on the clinician. In this paper, we trace the socio-economic mechanisms of how we have come to be in this situation, and overlay this with a detailed examination of South African legislation. Finally, we make comprehensive practical recommendations for rectifying the situation, which include engagement with key stakeholders, public–private partnerships, and more equitable funding mechanisms.

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

    Science.gov (United States)

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

    2016-10-10

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

  7. International Education Programs: Access to the World and Its Languages

    Science.gov (United States)

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

    The International Education Programs Service (IEPS) administers 14 education programs. These programs are complementary in nature and designed to benefit a variety of audiences through training programs, research, start-up or enhancement projects, and fellowships. This paper provides brief descriptions of these programs.

  8. Expanding our conceptualization of program implementation: lessons from the genealogy of a school-based nutrition program.

    Science.gov (United States)

    Bisset, Sherri; Potvin, Louise

    2007-10-01

    This work presents a theoretical framework in which health promotion and health education program implementation can be conceived as an open dynamic system. By tracing the evolution of an elementary school-based nutrition program from its conception to its recent form, we construct a program genealogy. Data were derived from two interviews and three historical documents from which historical events were identified and reconstructed in the form of a tree analogy. Data analysis ensued using concepts from the actor-network theory about social innovation. These concepts identified social and technical program attributes and situated them within a process which evolved over time, thus permitting the program's genealogy to appear. The genealogy was found to be influenced by the ways in which the involved actors interpreted the issue of food security, namely, as a professional issue, with a nutrition education response and as a social issue, with a community-building response. The interaction between the interests of the actors and the technical components of the program resulted in three temporal program iterations. The results highlight the important role played by the involved actors during program implementation and suggest the need to take these interests into consideration during all phases of program planning.

  9. 47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

    ... provide accommodations requiring the assistance of other persons (e.g., American Sign Language interpreters, communication access realtime translation (CART) providers, transcribers, captioners, and readers...

  10. Federal Policies and Programs to Expand Employment Services Among Individuals with Serious Mental Illnesses.

    Science.gov (United States)

    Karakus, Mustafa; Riley, Jarnee; Goldman, Howard

    2017-05-01

    Previous studies suggest that providing employment services to individuals with serious mental illnesses can help them obtain competitive, real-world employment. However, these services are still not easily accessible to this population. This paper provides a brief summary of recent federal initiatives that may influence widespread implementation of employment services. While there is an increasing recognition of the need to remove barriers and provide supported employment services to individuals with mental illnesses, a wide-spread coordination across Federal polices, financing and regulatory changes are necessary to promote measurable and lasting effects on the broad availability of employment services among this population.

  11. Building a French for Business and Technology Program Abroad: Giving Students an Edge in an Expanding Global Job Market

    OpenAIRE

    Lemarchand, Lionel J.

    2010-01-01

    The reality of globalization has made international programs more significant than ever before. Students from all over the world are accessing an increasingly competitive world market. Understanding other cultures in the social sense and in the business culture sense is crucial not only for their own benefits but also for their careers. This article describes how to develop an “Abroad Business and Technology Program” and presents the principal components that can insure its success. It also s...

  12. Expanding Horizons: A Pilot Mentoring Program Linking College/Graduate Students and Teens With ASD.

    Science.gov (United States)

    Curtin, Carol; Humphrey, Kristin; Vronsky, Kaela; Mattern, Kathryn; Nicastro, Susan; Perrin, Ellen C

    2016-02-01

    A small pilot program of 9 youth 13 to 18 years old with high-functioning autism spectrum disorder (ASD) or Asperger's syndrome assessed the feasibility, acceptability, and potential efficacy of an individualized mentoring program. Youth met weekly for 6 months with trained young adult mentors at a local boys and girls club. Participants reported improvements in self-esteem, social anxiety, and quality of life. Participants, parents, mentors, and staff reported that the program improved participants' social connectedness. Although the pilot study was small, it provides preliminary data that mentoring for youth with ASD has promise for increasing self-esteem, social skills, and quality of life. © The Author(s) 2015.

  13. Impact of expanded access to combination antiretroviral therapy in pregnancy: results from a cohort study in Ukraine.

    Science.gov (United States)

    Bailey, Heather; Townsend, Claire L; Semenenko, Igor; Malyuta, Ruslan; Cortina-Borja, Mario; Thorne, Claire

    2013-07-01

    To investigate the scale-up of antenatal combination antiretroviral therapy (cART) in Ukraine since this became part of the national policy for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV). Data on 3535 HIV-positive pregnant women who were enrolled into the Ukraine European Collaborative Study in 2008-2010 were analysed. Factors associated with receipt of zidovudine monotherapy (AZTm) - rather than cART - and rates of mother-to-child transmission (MTCT) of HIV were investigated. cART coverage increased significantly, from 22% of deliveries in 2008 to 61% of those in 2010. After adjusting for possible confounders, initiation of antenatal AZTm - rather than cART - was associated with cohabiting (versus being married; adjusted prevalence ratio, aPR: 1.09; 95% confidence interval, CI: 1.02-1.16), at least two previous live births (versus none; aPR: 1.22; 95% CI: 1.11-1.35) and a diagnosis of HIV infection during the first or second trimester (versus before pregnancy; aPR: 1.11; 95% CI: 1.03-1.20). The overall MTCT rate was 4.1% (95% CI: 3.4-4.9); 42% (49/116) of the transmissions were from the 8% (n = 238) of women without antenatal ART. Compared with AZTm, cART was associated with a 70% greater reduction in the risk of MTCT (adjusted odds ratio: 0.30; 95% CI: 0.16-0.56). Between 2008 and 2010, access to antenatal cART improved substantially in Ukraine, but implementation of the World Health Organization's Option-B policy was slow. For MTCT to be eliminated in Ukraine, improvements in the retention of women in HIV care and further roll-out of Option B are urgently needed.

  14. 76 FR 37779 - Rural Broadband Access Loans and Loan Guarantees Program

    Science.gov (United States)

    2011-06-28

    ... Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees Program AGENCY: Rural Utilities... for the Rural Broadband Access Loans and Loan Guarantees Program for fiscal year (FY) 2011. A Notice..., 2011, at 76 FR 13797, prior to the passage of a final appropriations bill identifying a definite...

  15. Should the vaccine injury compensation program be expanded to cover adults?

    OpenAIRE

    Lloyd-Puryear, M. A.; Ball, L K; Benor, D

    1998-01-01

    In 1996, the National Vaccine Advisory Committee (NVAC) asked for a review of the pros and cons of including adult influenza and pneumococcal vaccines in the Vaccine Injury Compensation Program (VICP). The authors, as staff to the subcommittees charged with undertaking this assessment, looked at the following questions: (a) Would inclusion in VICP of these two vaccines, used primarily for adults, increase adult vaccination levels? (b) Is this Federal involvement warranted based on the liabili...

  16. Urgent need to strengthen and expand screening and other cancer control programs in the CARICOM Caribbean.

    Science.gov (United States)

    Franklin, Renee A; Simeon, Donald T

    2017-11-01

    With high mortality in breast, cervical, prostate, and colorectal cancers in Caribbean Community (CARICOM) countries, we examined cancer control initiatives including screening as well as the implementation of relevant international and regional mandates. Secondary data were used to examine cancer control initiatives, which included the presence of national policies, programs, and screening services as well as the implementation of international and regional mandates. To identify the data, an on-line search was conducted using Google/Google Scholar. Data were available for 14 of the 15 full members of CARICOM. Although only six countries had distinct cancer control policies, strategies or action plans, all 14 had key elements of cancer control programs. Screening services were available in the 14 countries for cervical, in 12 countries for breast and in 11 for colorectal cancer. However, only four countries had screening policies. In addition, screening guidelines were available for cervical cancer in nine countries, in one country for breast and in none for colorectal cancer. Selected tobacco control policies were present in the 14 countries and immunization policies for human papillomavirus (HPV) in 13. Treatment services included chemotherapy in 10 countries and radiotherapy in six. Nine countries had palliative care services for patients with advanced disease. The countries were at different stages of implementation/compliance with international and regional mandates and frameworks. There is an urgent need to develop and implement comprehensive and customized cancer control policies addressing screening programs, treatment and palliative care.

  17. Has mifepristone medical abortion expanded abortion access in New Mexico? A survey of OB-GYN and Family Medicine physicians.

    Science.gov (United States)

    Espey, Eve; Leeman, Larry; Ogburn, Tony; Skipper, Betty; Eyman, Candace; North, Mariah

    2011-08-01

    The FDA approval of mifepristone in 2000 broadened the available options for abortion. The aim of this study was to evaluate whether physicians in New Mexico have integrated the use of mifepristone into their practice. We performed a mail-out survey of New Mexico Obstetrician Gynecologists (Ob-Gyn) and Family Medicine (FM) physicians in 2001 and 2008. Questions addressed integration of abortion services, attitudes towards providing abortion in different scenarios and barriers to offering abortion services. The response rates were 59% for the 2001 survey and 54% in 2008. In 2001 and 2008, 11% and 15% (p=.26) of physicians, respectively, provided any abortion - medical or surgical. Similarly, in 2001 and 2008, 5% and 10% (p=.07) provided medical abortion. Commonly cited barriers to provision of abortion in both years were beliefs against abortion and lack of training. The number of physicians offering any abortion or medical abortion in New Mexico has not changed since the FDA approval of mifepristone. Residency training programs in FM and in Ob-gyn should include training in medical abortion. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Calendar Year 2007 Program Benefits for U.S. EPA Energy Star Labeled Products: Expanded Methodology

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Marla; Homan, Gregory; Lai, Judy; Brown, Richard

    2009-09-24

    This report provides a top-level summary of national savings achieved by the Energy Star voluntary product labeling program. To best quantify and analyze savings for all products, we developed a bottom-up product-based model. Each Energy Star product type is characterized by product-specific inputs that result in a product savings estimate. Our results show that through 2007, U.S. EPA Energy Star labeled products saved 5.5 Quads of primary energy and avoided 100 MtC of emissions. Although Energy Star-labeled products encompass over forty product types, only five of those product types accounted for 65percent of all Energy Star carbon reductions achieved to date, including (listed in order of savings magnitude)monitors, printers, residential light fixtures, televisions, and furnaces. The forecast shows that U.S. EPA?s program is expected to save 12.2 Quads of primary energy and avoid 215 MtC of emissions over the period of 2008?2015.

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

    Science.gov (United States)

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

    2016-08-01

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

  20. Four-year treatment outcomes of adult patients enrolled in Mozambique's rapidly expanding antiretroviral therapy program.

    Directory of Open Access Journals (Sweden)

    Andrew F Auld

    Full Text Available BACKGROUND: In Mozambique during 2004-2007 numbers of adult patients (≥15 years old enrolled on antiretroviral therapy (ART increased about 16-fold, from 60 kg, WHO stage IV (AHR 1.7; 95% CI, 1.3-2.4, reference group WHO stage I/II, lack of co-trimoxazole prescription (AHR 1.4; 95% CI, 1.0-1.8, and later calendar year of ART initiation (AHR 1.5; 95% CI, 1.2-1.8. Rates of immunologic treatment failure and regimen-switch were 14.0 and 0.6 events per 100-patient years, respectively. CONCLUSIONS: ART initiation at earlier disease stages and scale-up of co-trimoxazole among ART patients could improve outcomes. Research to determine reasons for low regimen-switch rates and increasing rates of attrition during program expansion is needed.

  1. Assessing program efficiency: a time and motion study of the Mental Health Emergency Care - Rural Access Program in NSW Australia

    National Research Council Canada - National Science Library

    Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell

    2014-01-01

    The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia...

  2. Should the vaccine injury compensation program be expanded to cover adults?

    Science.gov (United States)

    Lloyd-Puryear, M A; Ball, L K; Benor, D

    1998-01-01

    In 1996, the National Vaccine Advisory Committee (NVAC) asked for a review of the pros and cons of including adult influenza and pneumococcal vaccines in the Vaccine Injury Compensation Program (VICP). The authors, as staff to the subcommittees charged with undertaking this assessment, looked at the following questions: (a) Would inclusion in VICP of these two vaccines, used primarily for adults, increase adult vaccination levels? (b) Is this Federal involvement warranted based on the liability burden for these vaccines? (c) Does the risk of adverse events following vaccinations warrant inclusion of these vaccines? (d) Is there a consensus among stakeholders favoring their inclusion? To address these questions, the authors reviewed information on adult vaccines, including data on l lawsuits filed and reports of injuries, and sought input from interested groups. They found no evidence that the use of influenza and pneumococcal vaccines would increase if they were included in VICP. They found a low liability burden for these vaccines, that serious adverse events were rare, and that no consensus existed among stakeholders. After considering the staff report, NVAC chose, in 1996, not to advise the Department of Health and Human Services to include adult vaccines in VICP.

  3. Access and Quality of HIV-Related Point-of-Care Diagnostic Testing in Global Health Programs.

    Science.gov (United States)

    Fonjungo, Peter N; Boeras, Debrah I; Zeh, Clement; Alexander, Heather; Parekh, Bharat S; Nkengasong, John N

    2016-02-01

    Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  4. Social Media as a Supplement to Face-to-Face Education: The Perspectives of Expanded Food and Nutrition Education Program Paraprofessionals and Graduates

    Science.gov (United States)

    Elmer, Sarah R.; Harrison, Judy A.; da Silva, Vanessa R.

    2016-01-01

    Using social media is an inexpensive, innovative approach to supplementing direct education provided by the Expanded Food and Nutrition Education Program (EFNEP). Focus group research was conducted with EFNEP paraprofessionals (n = 33) and participants (n = 39) to inform the development of a social media presence for the program. Although…

  5. Rapid access palliative radiation therapy programs: an efficient model of care.

    Science.gov (United States)

    Dennis, Kristopher; Linden, Kelly; Balboni, Tracy; Chow, Edward

    2015-01-01

    Palliating symptoms of advanced and metastatic cancers are one of the most common indications for radiation therapy (RT), and the demand for palliative RT is increasing. Dedicated rapid access palliative RT programs improve access to care, and can deliver RT in a more efficient and evidence-based manner than standard RT programs. In this narrative review, we discuss the role of palliative RT in comprehensive cancer care, and challenges that have faced patients trying to access it. We describe how rapid access programs developed to address these challenges and provide an overview of dedicated programs worldwide. Finally, we show how these programs can serve as models for multidisciplinary care and education, and sources of exciting research opportunities in clinical care and advanced technologies.

  6. Unsupervised phenotyping of Severe Asthma Research Program participants using expanded lung data.

    Science.gov (United States)

    Wu, Wei; Bleecker, Eugene; Moore, Wendy; Busse, William W; Castro, Mario; Chung, Kian Fan; Calhoun, William J; Erzurum, Serpil; Gaston, Benjamin; Israel, Elliot; Curran-Everett, Douglas; Wenzel, Sally E

    2014-05-01

    Previous studies have identified asthma phenotypes based on small numbers of clinical, physiologic, or inflammatory characteristics. However, no studies have used a wide range of variables using machine learning approaches. We sought to identify subphenotypes of asthma by using blood, bronchoscopic, exhaled nitric oxide, and clinical data from the Severe Asthma Research Program with unsupervised clustering and then characterize them by using supervised learning approaches. Unsupervised clustering approaches were applied to 112 clinical, physiologic, and inflammatory variables from 378 subjects. Variable selection and supervised learning techniques were used to select relevant and nonredundant variables and address their predictive values, as well as the predictive value of the full variable set. Ten variable clusters and 6 subject clusters were identified, which differed and overlapped with previous clusters. Patients with traditionally defined severe asthma were distributed through subject clusters 3 to 6. Cluster 4 identified patients with early-onset allergic asthma with low lung function and eosinophilic inflammation. Patients with later-onset, mostly severe asthma with nasal polyps and eosinophilia characterized cluster 5. Cluster 6 asthmatic patients manifested persistent inflammation in blood and bronchoalveolar lavage fluid and exacerbations despite high systemic corticosteroid use and side effects. Age of asthma onset, quality of life, symptoms, medications, and health care use were some of the 51 nonredundant variables distinguishing subject clusters. These 51 variables classified test cases with 88% accuracy compared with 93% accuracy with all 112 variables. The unsupervised machine learning approaches used here provide unique insights into disease, confirming other approaches while revealing novel additional phenotypes. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  7. 47 CFR 76.1003 - Program access proceedings.

    Science.gov (United States)

    2010-10-01

    ... multichannel video programming distributor that uses the same distribution technology as the competitor... authority to fashion appropriate sanctions for violations of its protective orders, including but not...

  8. Safety and efficacy of sunitinib in patients from Latin America: subanalysis of an expanded access trial in metastatic renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Barrios CH

    2016-09-01

    Full Text Available Carlos H Barrios,1 Daniel Herchenhorn,2 Matías Chacón,3 Paula Cabrera-Galeana,4 Peter Sajben,5 Ke Zhang6 1Department of Medicine, PUCRS School of Medicine, Porto Alegre, 2Division of Clinical Oncology, Instituto Nacional do Câncer, Rio de Janeiro, Brazil; 3Clinical Oncology, Alexander Fleming Institute, Buenos Aires, Argentina; 4Department of Medical Oncology, Instituto Nacional de Cancerología, México, Centro Oncológico Issemym Edomex, México; 5Pfizer Oncology, New York, NY, 6Pfizer Oncology, La Jolla, CA, USA Background: Sunitinib is an approved treatment for metastatic renal cell carcinoma (mRCC. The safety profile and efficacy of sunitinib were confirmed in a global expanded access trial (ClinicalTrials.gov identifier: NCT00130897. This report presents a subanalysis of the final trial data from patients in Latin America.Methods: Treatment-naïve or previously treated mRCC patients aged ≥18 years received oral sunitinib at a starting dose of 50 mg/day on a 4-weeks-on/2-weeks-off schedule. Treatment continued until disease progression, unacceptable toxicity, or withdrawal of consent. Safety was assessed regularly, and tumor measurements were scheduled per local practice (using Response Evaluation Criteria in Solid Tumors.Results: In total, 348 patients from Latin America received sunitinib. Overall, 75% of patients had two or more sites of metastatic disease, 28% were aged ≥65 years, 14% had an Eastern Cooperative Oncology Group performance status ≥2, 9% had brain metastases, 9% had no prior nephrectomy, and 5% had non-clear cell RCC. Median treatment duration was 8 months, and median follow-up was 15.1 months. In total, 326 patients (94% discontinued treatment, primarily due to death (41% or lack of efficacy (22%. Most treatment-related adverse events were of mild to moderate severity (grade 1/2. Mucosal inflammation (reported in 54% of patients, diarrhea (53%, and asthenia (41% were the most common any-grade treatment

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

    Science.gov (United States)

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

    2017-12-01

    There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, paccess to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Accessibility benchmarks: interpretive programs and services in north central California

    Science.gov (United States)

    Laura J. McLachlin; Emilyn A. Sheffield; Donald A. Penland; Charles W. Nelson

    1995-01-01

    The Heritage Corridors Project was a unique partnership between the California Department of Parks and Recreation, the California State University, and the Across California Conservancy. The purpose of the project was to develop a map of selected northern California outdoor recreation and heritage sites. Data about facility accessibility improvements (restrooms, clear...

  11. 47 CFR 76.1507 - Competitive access to satellite cable programming.

    Science.gov (United States)

    2010-10-01

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

  12. Increasing access to dental care for medicaid preschool children: the Access to Baby and Child Dentistry (ABCD) program.

    Science.gov (United States)

    Grembowski, D; Milgrom, P M

    2000-01-01

    OBJECTIVE: Washington State's Access to Baby and Child Dent stry (ABCD) Program, first implemented in Spokane County in 1995, offers extended dental benefits to participating Medicaid-enrolled children and higher fees for certified providers. This study aimed to determine the program's effect on children's dental utilization and dental fear, and on parent satisfaction and knowledge. METHODS: The study used a posttest-only comparison group design. Trained interviewers conducted telephone interviews with 465 parents of chi dren ages 13 to 36 months (49% ABCD, 51% Medicaid-enrolled children not in ABCD). One year later, 282 of 465 parents completed a follow-up survey. Utilization and expenditures were calculated from Medicaid claims. RESULTS: Forty-three percent of children in the ABCD Program visited a dentist in the follow-up year, compared with 12% of Medicaid-enrolled children not in the ABCD Program. An ABCD child was 5.3 times as likely to have had at least one dental visit as a child not in the program. ABCD children were 4 to 13 times as likely to have used specific dental services. Parents of ABCD children were more likely to report having ever tried to make a dental appointment, less likely to report that their children were fearful of the dentist, and were more satisfied, compared to parents of non-ABCD children. CONCLUSION: The authors conclude that the ABCD Program was effective in increasing access for preschool children enrolled in Medicaid, reducing dental fear, and increasing parent satisfaction. PMID:11236017

  13. Safety and efficacy of sunitinib in patients from Latin America: subanalysis of an expanded access trial in metastatic renal cell carcinoma.

    Science.gov (United States)

    Barrios, Carlos H; Herchenhorn, Daniel; Chacón, Matías; Cabrera-Galeana, Paula; Sajben, Peter; Zhang, Ke

    2016-01-01

    Sunitinib is an approved treatment for metastatic renal cell carcinoma (mRCC). The safety profile and efficacy of sunitinib were confirmed in a global expanded access trial (ClinicalTrials.gov identifier: NCT00130897). This report presents a subanalysis of the final trial data from patients in Latin America. Treatment-naïve or previously treated mRCC patients aged ≥18 years received oral sunitinib at a starting dose of 50 mg/day on a 4-weeks-on/2-weeks-off schedule. Treatment continued until disease progression, unacceptable toxicity, or withdrawal of consent. Safety was assessed regularly, and tumor measurements were scheduled per local practice (using Response Evaluation Criteria in Solid Tumors). In total, 348 patients from Latin America received sunitinib. Overall, 75% of patients had two or more sites of metastatic disease, 28% were aged ≥65 years, 14% had an Eastern Cooperative Oncology Group performance status ≥2, 9% had brain metastases, 9% had no prior nephrectomy, and 5% had non-clear cell RCC. Median treatment duration was 8 months, and median follow-up was 15.1 months. In total, 326 patients (94%) discontinued treatment, primarily due to death (41%) or lack of efficacy (22%). Most treatment-related adverse events were of mild to moderate severity (grade 1/2). Mucosal inflammation (reported in 54% of patients), diarrhea (53%), and asthenia (41%) were the most common any-grade treatment-related adverse events. Asthenia (12%), neutropenia (10%), and fatigue and thrombocytopenia (both 9%) were the most common grade 3/4 treatment-related adverse events. In total, 311 patients were included for tumor response, of whom eight (3%) had a complete response and 46 (15%) a partial response, yielding an objective response rate of 17%. Median duration of response, progression-free survival, and overall survival were 26.7, 12.1, and 16.9 months, respectively. The efficacy and safety profile of sunitinib in patients with mRCC from Latin America was comparable to

  14. 22 CFR 1600.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ....150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP... action that it can demonstrate would result in a fundamental alteration in the nature of a program or...

  15. Mexico's "Telesecundaria" Program and Equitable Access to Resources

    Science.gov (United States)

    Craig, Dana; Etcheverry, Jose; Ferris, Stefan

    2016-01-01

    This Note provides an analysis of Mexico's "Telesecundaria" program within the context of Mexico's new education reform framework offering a succinct background of the project, as well as key policy lessons that can be useful for other jurisdictions interested in the development of distance education programs. This Note uses a literature…

  16. Expanding access to off-grid rural electrification in Africa: An analysis of community-based micro-grids in Kenya

    Science.gov (United States)

    Kirubi, Charles Gathu

    lead to elite capture. Experiences from different micro-grid settings illustrate the manner in which a coincidence of interest between the elites and the rest of members and access to external support can create incentives and mechanisms to enable community-wide access to scarce services, hence mitigating elite capture. Moreover, access to external support was found to increase the likelihood of participation for the relatively poor households. The policy-relevant message from this research is two-fold. In rural areas with suitable sites for micro-hydro power, the potential for community micro-grids appear considerable to the extent that this option would seem to represent "the road not taken" as far as policies and initiatives aimed at expanding RE are concerned in Kenya and other African countries with comparable settings. However, local participatory initiatives not complimented by external technical assistance run a considerable risk of locking rural households into relatively more costly and poor-quality services. By taking advantage of existing and/or building a dense network of local organizations, including micro-finance agencies, the government and development partners can make available to local communities the necessary support---financial, technical or regulatory---essential for efficient design of micro-grids in addition to facilitating equitable distribution of electricity benefits.

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

    Directory of Open Access Journals (Sweden)

    Nancy Wise

    2011-06-01

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

  18. Evaluating the Effectiveness of Navy Medical Corps Accession Programs

    Science.gov (United States)

    2012-03-01

    GAO General Accounting Office GME Graduate Medical Education GMO General Medical Officer GPA Grade Point Average xiv HPLRP Health...uniformed services as they transform themselves to meet new challenges, the departments concerned must offer, in addition to challenging and rewarding...9 Title 37 U.S.C. § 1008, “Presidential recommendations concerning adjustments and changes in pay and allowances,” last accessed November

  19. 77 FR 24301 - Revision of the Commission's Program Access Rules

    Science.gov (United States)

    2012-04-23

    ..., movie studio, and other businesses with some of Comcast's cable programming and online content... number of cable subscribers and homes passed by a single MSO in particular markets (accomplished via...

  20. 75 FR 39135 - Voluntary Public Access and Habitat Incentive Program

    Science.gov (United States)

    2010-07-08

    ..., fishing, wildlife observation, photography, and environmental education and interpretation. Eligibility... hunting, fishing, wildlife-observation, photography, environmental education and interpretation, or other... Environmental Programs Division (CEPD), U.S. Department of Agriculture (USDA) FSA CEPD, STOP 0513, 1400...

  1. 78 FR 42419 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2013-07-16

    ... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Final... through-the-fence access to a federally-obligated airport from an adjacent or nearby property, when that...

  2. 77 FR 44515 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2012-07-30

    ... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... policy, based on Federal law, concerning through-the-fence access to a federally obligated airport from...

  3. 76 FR 15028 - Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential...

    Science.gov (United States)

    2011-03-18

    ... Federal Aviation Administration Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Interim policy... clarifying FAA policy concerning through-the-fence access to a federally-obligated airport from an adjacent...

  4. 75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

    Science.gov (United States)

    2010-01-15

    ... Administration (FTA), DOT. ACTION: Notice of Availability of Fiscal Year 2009 Funds: Solicitation of Grant...) announces the availability of funds in Fiscal Year (FY) 2009 for the Over-the-Road Bus (OTRB) Accessibility... OTRB Accessibility Program makes funds available to private operators of over-the-road buses to finance...

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

    Science.gov (United States)

    McClellan, Sean R; Snowden, Lonnie

    2015-01-01

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

  6. Storage and processing of mineral deposits using Access, Delphi and Topol programs

    Energy Technology Data Exchange (ETDEWEB)

    Kolomaznik, I. (HGF VSB-TU Ostrava, Ostrava-Poruba (Czech Republic))

    1999-01-01

    The program system has been developed to store and process data. The Rockware system can be used for graphic outputs and some special operations and calculations. This system allows graphic outputs based on text files which contain graphic instructions. A modern database program Microsoft Access 97 is used for data storage, whereas the Borland compiler Delphi 3 serves as the programming medium, and the Topol program of the Help Service Mapping Company is used for graphic outputs. 3 figs.

  7. Storage and processing of mineral deposits using Access, Delphi and Topol programs

    Energy Technology Data Exchange (ETDEWEB)

    Kolomaznik, I. [HGF VSB-TU Ostrava, Ostrava-Poruba (Czech Republic)

    1999-11-01

    The program system has been developed to store and process data. The Rockware system can be used for graphic outputs and some special operations and calculations. This system allows graphic outputs based on text files which contain graphic instructions. A modern database program Microsoft Access 97 is used for data storage, whereas the Borland compiler Delphi 3 serves as the programming medium, and the Topol program of the Help Service Mapping Company is used for graphic outputs. 3 figs.

  8. Evaluating a Human Rights-Based Advocacy Approach to Expanding Access to Pain Medicines and Palliative Care: Global Advocacy and Case Studies from India, Kenya, and Ukraine.

    Science.gov (United States)

    Lohman, Diederik; Amon, Joseph J

    2015-12-10

    Palliative care has been defined as care that is person-centered and attentive to physical symptoms and psychological, social, and existential distress in patients with severe or life-threatening illness. The identification of access to palliative care and pain treatment as a human rights issue first emerged among palliative care advocates, physicians, and lawyers in the 1990s, with a basis in the right to health and the right to be free from cruel, inhuman, and degrading treatment. Using a case study approach, we evaluate the results of a human rights-based advocacy approach on access to pain medicine and palliative care in India, Kenya, and Ukraine. In each country, human rights advocacy helped raise awareness of the issue, identify structural barriers to care, define government obligations, and contribute to the reform of laws, policies, and practices impeding the availability of palliative care services. In addition, advocacy efforts stimulated civil society engagement and high-level political leadership that fostered the implementation of human rights-based palliative care programs. Globally, access to palliative care was increasingly recognized by human rights bodies and within global health and drug policy organizations as a government obligation central to the right to health. Copyright © 2015 Lohman, Amon. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  9. An economic evaluation of the use of Japanese encephalitis vaccine in the expanded program of immunization of Guizhou province, China.

    Science.gov (United States)

    Yin, Zundong; Beeler Asay, Garrett R; Zhang, Li; Li, Yixing; Zuo, Shuyan; Hutin, Yvan J; Ning, Guijun; Sandhu, Hardeep S; Cairns, Lisa; Luo, Huiming

    2012-08-10

    Historically, China's Japanese encephalitis vaccination program was a mix of household purchase of vaccine and government provision of vaccine in some endemic provinces. In 2006, Guizhou, a highly endemic province in South West China, integrated JE vaccine into the provincial Expanded Program on Immunization (EPI); later, in 2007 China fully integrated 28 provinces into the national EPI, including Guizhou, allowing for vaccine and syringe costs to be paid at the national level. We conducted a retrospective economic analysis of JE integration into EPI in Guizhou province. We modeled two theoretical cohorts of 100,000 persons for 65 years; one using JE live-attenuated vaccine in EPI (first dose: 95% coverage and 94.5% efficacy; second dose: 85% coverage and 98% efficacy) and one not. We assumed 60% sensitivity of surveillance for reported JE rates, 25% case fatality, 30% chronic disability and 3% discounting. We reviewed acute care medical records and interviewed a sample of survivors to estimate direct and indirect costs of illness. We reviewed the EPI offices expenditures in 2009 to estimate the average Guizhou program cost per vaccine dose. Use of JE vaccine in EPI for 100,000 persons would cost 434,898 US$ each year (46% of total cost due to vaccine) and prevent 406 JE cases, 102 deaths, and 122 chronic disabilities (4554 DALYs). If we ignore future cost savings and only use EPI program cost, the program would cost 95.5 US$/DALY, less than China Gross Domestic Product per capita in 2009 (3741 US$). From a cost-benefit perspective taking into account future savings, use of JE vaccine in EPI for a 100,000-person cohort would lead to savings of 1,591,975 US$ for the health system and 11,570,989 US$ from the societal perspective. In Guizhou, China, use of JE vaccine in EPI is a cost effective investment. Furthermore, it would lead to savings for the health system and society. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Latino Males and College Preparation Programs: Examples of Increased Access

    Science.gov (United States)

    Sanchez, Sheila M.; Huerta, Adrian H.; Venegas, Kristan M.

    2012-01-01

    This study highlights the narratives of five Latino males from three different postsecondary institutions--a community college, a four-year public state college, and a large private research university--and the impact of their participation in college preparation programs. The data is drawn from a study in which the impact of college preparation…

  11. 22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-04-01

    .... 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP... unusable by handicapped persons, be denied the benefits of, be excluded from participation in, or otherwise...

  12. Access, Equity, and Opportunity. Women in Machining: A Model Program.

    Science.gov (United States)

    Warner, Heather

    The Women in Machining (WIM) program is a Machine Action Project (MAP) initiative that was developed in response to a local skilled metalworking labor shortage, despite a virtual absence of women and people of color from area shops. The project identified post-war stereotypes and other barriers that must be addressed if women are to have an equal…

  13. 41 CFR 51-10.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-07-01

    ... audio-visual materials and devices to depict those portions of an historic property that cannot... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 51-10.150(a) would result in such alteration or...

  14. 22 CFR 1005.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...

  15. 29 CFR 2205.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-07-01

    ... audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2205.150(a) would result in such alteration or...

  16. 29 CFR 2706.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-07-01

    ... audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2706.150(a) would result in such alteration or...

  17. 29 CFR 4907.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-07-01

    ... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...

  18. 12 CFR 794.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...

  19. 10 CFR 4.550 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ...— (i) Using audio-visual materials and devices to depict those portions of an historic property that... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... alteration or burdens. The decision that compliance would result in such alteration or burdens must be made...

  20. 1 CFR 457.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...

  1. 38 CFR 15.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-07-01

    ...) Using audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 15.150(a) would result in such alteration or burdens...

  2. Timing and delay in children vaccination; evaluation of expanded program of immunization in outskirt of Iranian cities.

    Science.gov (United States)

    Rejali, Mehri; Mohammadbeigi, Abolfazl; Mokhtari, Mohsen; Zahraei, Seyed Mohsen; Eshrati, Babak

    2015-01-01

    Most studies evaluated the vaccine coverage, but the time of vaccination is important as coverage. This study was conducted to evaluate the Expanded Program of Immunization (EPI) in outskirt of Iranian cities regarding to incidence of delay vaccination among children less than 4 years. This cross sectional descriptive study was conducted among children 24-47 months old, living in the suburbs of five metropolises of Iran. Totally, 3610 eligible children selected with proportioned cluster sampling method and data of vaccination card extracted after interview with child parents. Delayed incidence rate reported and predictive factors assessed by Chi square test and Multivariate logistic regression. Overall, 56.6% to 93.2% vaccines were administered out of time. Delayed vaccination incidence with more than one-week delay varies from 5.5% to 74.9% for polio at birth and MMR2 at 18 month, respectively. Mother's educational level and birth order were the most important predictors of delayed vaccination. Incidence of delayed vaccination was enlarged by increasing birth order and decreased in lower educated mothers. Incidence rate of delayed vaccination is more than expectation. Regarding to high coverage vaccines in Iran, heath officers and health policy makers should attempt for on-time vaccination beside of high immunization coverage especially in slum areas with more concentrated immigrants due to low literature and crowded families.

  3. 75 FR 20034 - Over-the-Road Bus Accessibility Program Grants: Corrections

    Science.gov (United States)

    2010-04-16

    ... Office (Appendix A) or Blenda Younger, Office of Program Management, (202) 366-2053. Corrections On page... the Special Warranty for the Over-the-Road Bus Accessibility Program that is most current as of the... thereto. Any U.S. DOL Special Warranty that may be provided and any documents cited therein are...

  4. 77 FR 25529 - Over-the-Road Bus Accessibility Program Grants

    Science.gov (United States)

    2012-04-30

    ... Transit Administration (FTA), DOT. ACTION: Notice of Availability of Fiscal Year 2012 Funds: Solicitation... availability of funds in Fiscal Year (FY) 2012 for the Over-the-Road Bus Accessibility (OTRB) Program... OTRB program makes funds available to private operators of over-the-road buses to finance the...

  5. 16 CFR 6.152 - Program accessibility: Electronic and information technology.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Program accessibility: Electronic and information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL TRADE...

  6. The impact of goal attainment on behavioral and mediating variables among low income women participating in an Expanded Food and Nutrition Education Program intervention study

    Science.gov (United States)

    This study examined the relationships between participant goal attainment, and changes in mediating variables, and food choice outcomes from a modified curriculum for the Texas Expanded Food and Nutrition Education Program (EFNEP), promoting healthy home food environments and parenting skills relate...

  7. Associative programming language and virtual associative access manager

    Science.gov (United States)

    Price, C.

    1978-01-01

    APL provides convenient associative data manipulation functions in a high level language. Six statements were added to PL/1 via a preprocessor: CREATE, INSERT, FIND, FOR EACH, REMOVE, and DELETE. They allow complete control of all data base operations. During execution, data base management programs perform the functions required to support the APL language. VAAM is the data base management system designed to support the APL language. APL/VAAM is used by CADANCE, an interactive graphic computer system. VAAM is designed to support heavily referenced files. Virtual memory files, which utilize the paging mechanism of the operating system, are used. VAAM supports a full network data structure. The two basic blocks in a VAAM file are entities and sets. Entities are the basic information element and correspond to PL/1 based structures defined by the user. Sets contain the relationship information and are implemented as arrays.

  8. Enabling Web-Based GIS Tools for Internet and Mobile Devices To Improve and Expand NASA Data Accessibility and Analysis Functionality for the Renewable Energy and Agricultural Applications

    Science.gov (United States)

    Ross, A.; Stackhouse, P. W.; Tisdale, B.; Tisdale, M.; Chandler, W.; Hoell, J. M., Jr.; Kusterer, J.

    2014-12-01

    The NASA Langley Research Center Science Directorate and Atmospheric Science Data Center have initiated a pilot program to utilize Geographic Information System (GIS) tools that enable, generate and store climatological averages using spatial queries and calculations in a spatial database resulting in greater accessibility of data for government agencies, industry and private sector individuals. The major objectives of this effort include the 1) Processing and reformulation of current data to be consistent with ESRI and openGIS tools, 2) Develop functions to improve capability and analysis that produce "on-the-fly" data products, extending these past the single location to regional and global scales. 3) Update the current web sites to enable both web-based and mobile application displays for optimization on mobile platforms, 4) Interact with user communities in government and industry to test formats and usage of optimization, and 5) develop a series of metrics that allow for monitoring of progressive performance. Significant project results will include the the development of Open Geospatial Consortium (OGC) compliant web services (WMS, WCS, WFS, WPS) that serve renewable energy and agricultural application products to users using GIS software and tools. Each data product and OGC service will be registered within ECHO, the Common Metadata Repository, the Geospatial Platform, and Data.gov to ensure the data are easily discoverable and provide data users with enhanced access to SSE data, parameters, services, and applications. This effort supports cross agency, cross organization, and interoperability of SSE data products and services by collaborating with DOI, NRCan, NREL, NCAR, and HOMER for requirements vetting and test bed users before making available to the wider public.

  9. Intellectual Property Rights vs. Public Access Rights: Ethical Aspects of the DeCSS Decryption Program

    Science.gov (United States)

    Vaagan, Robert; Koehler, Wallace

    2005-01-01

    Introduction: In 1999-2000, a Norwegian youth cracked a DVD-access code and published a decryption program on the Internet. He was sued by the US DVD Copy Control Association (DVD-CCA) and the Norwegian Motion Picture Association (MAP), allies of the US Motion Picture Association of America (MPAA), arrested by Norwegian police and charged with…

  10. 78 FR 2449 - Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions

    Science.gov (United States)

    2013-01-11

    ... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Notice of Funding Opportunity. SUMMARY: The National Credit...

  11. 76 FR 21325 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2011-04-15

    ... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... assistance for generic or brand promotion activities. For generic activities, funding priority is given to... government agencies can participate directly in the brand program. The MAP generally operates on a...

  12. 75 FR 26194 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2010-05-11

    ... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... marketing and promotion activities. MAP participants may receive assistance for generic or brand promotion... brand program. The MAP generally operates on a reimbursement basis. III. Eligibility Information 1...

  13. 78 FR 31530 - Applications for New Awards; Child Care Access Means Parents in School Program

    Science.gov (United States)

    2013-05-24

    ... preschool through grade 12, or a student enrolled in postsecondary education or training who has a parent or... Doc No: 2013-12491] DEPARTMENT OF EDUCATION Applications for New Awards; Child Care Access Means Parents in School Program AGENCY: Office of Postsecondary Education, Department of Education. ACTION...

  14. 76 FR 13797 - Rural Broadband Access Loans and Loan Guarantees Program

    Science.gov (United States)

    2011-03-14

    ... (download plus upload speeds) for both fixed and mobile broadband service and the broadband lending speed will be a minimum bandwidth of 5 megabits per second for both fixed and mobile service to the customer...; ] DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees Program...

  15. 75 FR 6790 - Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and...

    Science.gov (United States)

    2010-02-10

    ... Customer Information and Customer Notice AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION... of Proposal: Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and Customer Notice. OMB Number: 1550-0110. Form Numbers: N/A. Regulation requirement: 12 CFR Part...

  16. 50 CFR 648.60 - Sea scallop area access program requirements.

    Science.gov (United States)

    2010-10-01

    ... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program....83(a)(1), and the additional restrictions for Atlantic cod, haddock, and yellowtail flounder... (d)(4). (A) Atlantic cod. Such vessel may bring onboard and possess only up to 100 lb (45.4 kg) of...

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

    NARCIS (Netherlands)

    Ooms, L.; Veenhof, C.

    2014-01-01

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

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

    National Research Council Canada - National Science Library

    Snowden, Lonnie R; McClellan, Sean R

    2013-01-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-01

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

  20. Expanding subjectivities

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda; Soldz, Stephen

    2012-01-01

    A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool to understa...

  1. Expander Codes

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 10; Issue 1. Expander Codes - The Sipser–Spielman Construction. Priti Shankar. General Article Volume 10 ... Author Affiliations. Priti Shankar1. Department of Computer Science and Automation, Indian Institute of Science Bangalore 560 012, India.

  2. 75 FR 9691 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-03-03

    ... competition is an increase in employment in the video programming sector of the economy. The relationship... on Commission precedent in which the Commission has considered certain Regional Sports Networks.... Conversely, when programming is non- replicable and valuable to consumers, such as regional sports...

  3. Exploring Situational Factors Shaping Access in a Laptop Program for Socially Disadvantaged Children in India: A Case Study

    Science.gov (United States)

    Padmanabhan, Poornima; Wise, Alyssa Friend

    2012-01-01

    Low-cost laptop programs attempt to address gaps in access to computers in developing countries. However, the translation of computing access from intention to actuality is mediated by many situational factors. This research presents a case study of how access to a set of laptops donated to a school for socially disadvantaged children in India was…

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

    Science.gov (United States)

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

    2018-01-10

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

  5. The Military Accessions Vital to National Interest Program: What It Is and How It Can Be Made Relevant

    Science.gov (United States)

    2011-05-19

    Army’s New Non-Citizen Recruting Program,” online http://www.scribd.com/doc/12866758/Margaret-Stock. Last accessed in February 2011. 89 Stock... Recruting Program.” Online at http://www.scribd.com/doc/12866758/Margaret-Stock. Last accessed in February 2011. United States Army, Field Manual 3-24

  6. Biochemical screening of 504,049 newborns in Denmark, the Faroe Islands and Greenland - Experience and development of a routine program for expanded newborn screening

    DEFF Research Database (Denmark)

    Lund, Allan Meldgaard; Hougaard, David Michael; Simonsen, Henrik

    2012-01-01

    :4942 (mothers excluded) or 1:4421 (mothers included). The false positive rate was 0.038% and positive predictive value 37%. Overall specificity was 99.99%. All patients with true positive results were followed in The Center for Inherited Metabolic Disorders in Copenhagen, and the mean follow-up period was 45......Expanded newborn screening for selected inborn errors of metabolism (IEM) in Denmark, the Faroe Islands and Greenland was introduced in 2002. We now present clinical, biochemical, and statistical results of expanded screening (excluding PKU) of 504,049 newborns during nine years as well...... argue that newborn screening for these disorders should be standard of care, though unresolved issues remain, e.g. about newborns with a potential for remaining asymptomatic throughout life. Well organized logistics of the screening program from screening laboratory to centralized, clinical management...

  7. Partition expanders

    Czech Academy of Sciences Publication Activity Database

    Gavinsky, Dmitry; Pudlák, Pavel

    2017-01-01

    Roč. 60, č. 3 (2017), s. 378-395 ISSN 1432-4350 R&D Projects: GA ČR GBP202/12/G061 Institutional support: RVO:67985840 Keywords : expanders * pseudorandomness * communication complexity Subject RIV: BA - General Mathematics Impact factor: 0.645, year: 2016 http://link.springer.com/article/10.1007%2Fs00224-016-9738-5

  8. The Impact of Nutrition Education on Dietary Behavior and Iron Status in Participants of the Supplemental Food Program for Women, Infants and Children, and the Expanded Food and Nutrition Education Program

    OpenAIRE

    Christensen, Nedra K.

    1993-01-01

    This study was conducted to determine the impact of nutrition edu cation on participants of the Supplemental Food Program for Women, Infants and Children (WIC) and the Expanded Food and Nutrition Education Program (EFNEP). The specific objectives were to: 1) determine the impact of participation in EFNEP on iron status as assessed by hematocrit (hct) and ferritin levels; 2) determine the effect of nutrition knowledge on hct and ferritin values; and 3) determine the effect dietary behavior has...

  9. Web-based public health geographic information systems for resources-constrained environment using scalable vector graphics technology: a proof of concept applied to the expanded program on immunization data

    Directory of Open Access Journals (Sweden)

    Kamadjeu Raoul

    2006-06-01

    Full Text Available Abstract Background Geographic Information Systems (GIS are powerful communication tools for public health. However, using GIS requires considerable skill and, for this reason, is sometimes limited to experts. Web-based GIS has emerged as a solution to allow a wider audience to have access to geospatial information. Unfortunately the cost of implementing proprietary solutions may be a limiting factor in the adoption of a public health GIS in a resource-constrained environment. Scalable Vector Graphics (SVG is used to define vector-based graphics for the internet using XML (eXtensible Markup Language; it is an open, platform-independent standard maintained by the World Wide Web Consortium (W3C since 2003. In this paper, we summarize our methodology and demonstrate the potential of this free and open standard to contribute to the dissemination of Expanded Program on Immunization (EPI information by providing interactive maps to a wider audience through the Internet. Results We used SVG to develop a database driven web-based GIS applied to EPI data from three countries of WHO AFRO (World Health Organization – African Region. The system generates interactive district-level country immunization coverage maps and graphs. The approach we describe can be expanded to cover other public health GIS demanding activities, including the design of disease atlases in a resources-constrained environment. Conclusion Our system contributes to accumulating evidence demonstrating the potential of SVG technology to develop web-based public health GIS in resources-constrained settings.

  10. Expandable LED array interconnect

    Science.gov (United States)

    Yuan, Thomas Cheng-Hsin; Keller, Bernd

    2011-03-01

    A light emitting device that can function as an array element in an expandable array of such devices. The light emitting device comprises a substrate that has a top surface and a plurality of edges. Input and output terminals are mounted to the top surface of the substrate. Both terminals comprise a plurality of contact pads disposed proximate to the edges of the substrate, allowing for easy access to both terminals from multiple edges of the substrate. A lighting element is mounted to the top surface of the substrate. The lighting element is connected between the input and output terminals. The contact pads provide multiple access points to the terminals which allow for greater flexibility in design when the devices are used as array elements in an expandable array.

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

    Directory of Open Access Journals (Sweden)

    Robert Vaagan

    2005-01-01

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

  12. Performance Evaluation of Remote Memory Access (RMA) Programming on Shared Memory Parallel Computers

    Science.gov (United States)

    Jin, Hao-Qiang; Jost, Gabriele; Biegel, Bryan A. (Technical Monitor)

    2002-01-01

    The purpose of this study is to evaluate the feasibility of remote memory access (RMA) programming on shared memory parallel computers. We discuss different RMA based implementations of selected CFD application benchmark kernels and compare them to corresponding message passing based codes. For the message-passing implementation we use MPI point-to-point and global communication routines. For the RMA based approach we consider two different libraries supporting this programming model. One is a shared memory parallelization library (SMPlib) developed at NASA Ames, the other is the MPI-2 extensions to the MPI Standard. We give timing comparisons for the different implementation strategies and discuss the performance.

  13. Supporting the whole student: Inclusive program design for making undergraduate research experiences accessible

    Science.gov (United States)

    Haacker-Santos, R.; Allen, L.; Batchelor, R. L.

    2013-12-01

    As undergraduate research experiences have become an unofficial pre-requisite to enter graduate school programs in the sciences, we have to make sure that these experiences are inclusive and accessible to all students. Program managers who make a conscious effort to recruit students from traditionally under-represented groups, including veterans, non-traditional students or students with disabilities, are often unaware of the financial and program implications these students require, and discover that their current program design might inadvertently exclude or not fully support these students. The SOARS Program, an undergraduate-to-graduate bridge program in the atmospheric sciences, has supported this group of students for over 15 years. We have found that we needed to adjust some program elements and secure extra funding sources to holistically support our students in their research experience, however, the program and the students have reaped tremendous benefits. Involving non-traditional students or veterans in our program has raised the maturity level and problem solving skills of the group, and having students with disabilities participate has been a vehicle for broadening perspective and diverse knowledge into the field of study, e.g. researching weather and climate beyond what you can 'see'. This presentation will highlight some of the findings from the SOARS program experience, and will share practices for recruitment and holistic support to ensure student success. We will share resources and tips on inclusive program design, including working with students with family commitments or physical disabilities, and will report on the enormous program benefits and peer learning these students have brought to the student cohorts and research labs they are working in.

  14. Building Partner Capacity: DOD Should Improve Its Reporting to Congress on Challenges to Expanding Ministry of Defense Advisors Program

    Science.gov (United States)

    2015-02-11

    Ministry of Defense Advisors ( MODA ) program more slowly than planned. It had 2 advisors in the field in Kosovo and Montenegro for most of fiscal year...approval process and with advisor recruitment and training. DOD has met most but not all legislative requirements for the MODA program. As required by...of each Global MODA deployment, which could help Congress assess the value of the program in relation to other capacity-building efforts (see figure

  15. Dance for Health: An Intergenerational Program to Increase Access to Physical Activity.

    Science.gov (United States)

    Schroeder, Krista; Ratcliffe, Sarah J; Perez, Adriana; Earley, David; Bowman, Cory; Lipman, Terri H

    The purpose of this study was to evaluate Dance for Health, an intergenerational program to increase access to physical activity in an underserved, high risk urban community. Dance for Health was developed using community-based participatory research methods and evaluated using an observational study design. The program entailed two hour line dancing sessions delivered by trained dance instructors in the neighborhood recreation center. The weekly sessions were delivered for one month in the spring and one month in the fall from 2012-2016. Nurse practitioner students mentored local high school students to assess outcomes: achievement of target heart rate, Borg Rating of Perceived Exertion, number of pedometer steps during dance session, Physical Activity Enjoyment Scale, and adiposity. Analytic methods included descriptive statistics and mixed effects models. From 2012-2016, 521 participants ranging from 2-79 years attended Dance for Health. Approximately 50% of children and 80% of adults achieved target heart rate. Achievement of target heart rate was not related to perceived exertion, though it was related to pedometer steps in adults. All participants rated the program highly for enjoyment. There was no change in adiposity. Dance for Health demonstrated high levels of community engagement and enjoyment. It led to adequate levels of exertion, particularly for adults. Our evaluation can inform program refinement and future intergenerational physical activity programs. Dance is an enjoyable, culturally appropriate, low cost method for increasing access to physical activity for children and families. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. An Innovative Method of Measuring Changes in Access to Healthful Foods in School Lunch Programs: Findings from a Pilot Evaluation.

    Directory of Open Access Journals (Sweden)

    Allison P Hawkes

    Full Text Available A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings.School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS and "Higher Fat and more added Sugar" (HFS based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings.In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001. The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant.This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts improved access to healthful food/drink by changing the contents of reimbursable school lunches. The evaluation method discussed here can generate information that districts can use in helping sustain and expand their efforts to create healthier environments for children and adults. Although federal regulations now cover all food and beverages served during the school day, there are still opportunities to improve and measure changes in food served in other settings such as child care centers, youth correction facilities, or in schools not participating in the National School Lunch Program.

  17. 24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

    Science.gov (United States)

    2010-04-01

    ... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily... in a PDP multifamily housing project shall, to the maximum extent feasible, be made to be readily...

  18. Expanding cities

    DEFF Research Database (Denmark)

    Møller-Jensen, Lasse

    upon qualitative interviews with residents as well as road network data and travel speed data collected with GPS to offer a combination of local testimony with GIS-based modelling of overall accessibility. It is argued that the use of digital network analysis enables planners to obtain a better......A number of cities in Africa experience very rapid spatial growth without the benefit of a systematic process of planning and implementation of planning decisions. This process has challenged the road and transport system, created high levels of congestion, and hampered mobility and accessibility...... knowledge of the spatial patterns of urban accessibility, while the analysis of mobility practices of residents enables a better understanding of the constraints people experience related to their livelihood strategies. Finally, the paper addresses how local residents engage in providing and improving...

  19. Preventive services program: a model engaging volunteers to expand community-based oral health services for children.

    Science.gov (United States)

    Hoffman, Ann M; Branson, Bonnie G; Keselyak, Nancy T; Simmer-Beck, Melanie

    2014-04-01

    This paper describes the Preventive Services Program (PSP), a community based oral health program model which engages volunteers to provide preventive services and education for underserved children in Missouri. In 2006, the Missouri Department of Health and Senior Services created a program for children designed to use a systems approach for population-based prevention of oral disease. Currently, 5 part-time dental hygienists serve as Oral Health Program Consultants to work with the citizens of a community to engage dentists, dental hygienists, parents and other interested stakeholders in the activities of the program. Dental volunteers evaluate oral health and disease in the community's children and facilitate referrals for dental care. Other volunteers apply fluoride varnish and provide educational services to the children. In 2006, 273 volunteer dentists and dental hygienists and 415 community volunteers provided oral screenings, oral health education, 2 fluoride varnish applications and referral for unmet dental care for 8,529 children. In 2011, 775 volunteer dentists and dental hygienists and 1,837 other community volunteers provided by PSP services to nearly 65,000 children. It has been demonstrated that when the local citizens take responsibility for their own needs that a sustainable and evidence-based program like PSP is possible. Guidelines which provide criteria for matching models with the specific community characteristics need to be generated. Furthermore, a national review of successful program models would be helpful to those endeavoring to implement community oral health program.

  20. Expanding versus non expanding universe

    CERN Document Server

    Alfonso-Faus, Antonio

    2012-01-01

    In cosmology the number of scientists using the framework of an expanding universe is very high. This model, the big-bang, is now overwhelmingly present in almost all aspects of society. It is the main stream cosmology of today. A small number of scientists are researching on the possibility of a non-expanding universe. The existence of these two groups, one very large and the other very small, is a good proof of the use of the scientific method: it does not drive to an absolute certainty. All models have to be permanently validated, falsified. Ockham's razor, a powerful philosophical tool, will probably change the amount of scientists working in each of these groups. We present here a model where a big-bang is unnecessary. It ends, in a finite time, in a second INFLATION, or a disaggregation to infinity. We also discuss the possibilities of a non-expanding universe model. Only a few references will be cited, mainly concerned with our own work in the past, thus purposely avoiding citing the many thousands of ...

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

    OpenAIRE

    Lynch, Sarah; Hayes, Sharon; Napolitano, Melissa; Hufnagel, Katrina

    2016-01-01

    Background More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown. Objective The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment. Methods The 10 public universities with the largest student bodies with a mean (SD) undergraduate...

  2. The influence of Community Access to Child Health (CATCH) program on community pediatrics.

    Science.gov (United States)

    Soares, Neelkamal S; Hobson, Wendy L; Ruch-Ross, Holly; Finneran, Maureen; Varrasso, Denia A; Keller, David

    2014-01-01

    The CATCH (Community Access to Child Health) Program, which supports pediatricians who engage with the community to improve child health, increase access to health care, and promote advocacy through small seed grants, was last evaluated in 1998. The objective was to describe the characteristics of CATCH grant recipients and projects and assess the community impact of funded projects. Prospective data was collected from CATCH applications (grantee characteristics, topic area and target population for projects funded from 2006-2012) and post-project 2-year follow-up survey (project outcomes, sustainability, and impact for projects funded from 2008 through 2010). From 2006 through 2012, the CATCH Program awarded 401 projects to grantees working mostly in general pediatrics. Eighty-five percent of projects targeted children covered by Medicaid, 33% targeted uninsured children, and 75% involved a Latino population. Main topic areas addressed were nutrition, access to health care, and medical home. Sixty-nine percent of grantees from 2008 to 2010 responded to the follow-up survey. Ninety percent reported completing their projects, and 86% of those projects continued to exist in some form. Grantees reported the development of community partnerships (77%) and enhanced recognition of child health issues in the community (73%) as the most frequent changes due to the projects. The CATCH Program funds community-based projects led by pediatricians that address the medical home and access to care. A majority of these projects and community partnerships are sustained beyond their original CATCH funding and, in many cases, are leveraged into additional financial or other community support.

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

    Science.gov (United States)

    Petrakis, P. L.

    1993-01-01

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

  4. Expanding a community's justice response to sex crimes through advocacy, prosecutorial, and public health collaboration: introducing the RESTORE program.

    Science.gov (United States)

    Koss, Mary P; Bachar, Karen J; Hopkins, C Quince; Carlson, Carolyn

    2004-12-01

    Problems in criminal justice system response to date-acquaintance rape and nonpenetration sexual offenses include (a) they are markers of a sexual offending career, yet are viewed as minor; (b) perpetrators are not held accountable in ways that reduce reoffense; and (c) criminal justice response disappoints and traumatizes victims. To address these problems, a collaboration of victim services, prosecutors, legal scholars, and public health professionals are implementing and evaluating RESTORE, a victim-driven, community-based restorative justice program for selected sex crimes. RESTORE prepares survivors, responsible persons (offenders), and both parties' families and friends for face-to-face dialogue to identify the harm and develop a redress plan. The program then monitors the offender's compliance for 12 months. The article summarizes empirical data on problems in criminal justice response, defines restorative justice models, and examines outcome. Then the RESTORE program processes and goals are described. The article highlights community collaboration in building and sustaining this program.

  5. Expanding the Lessons Learned Program to Include Corps Support Command Commanders and Theater Army Area Command Commanders

    Science.gov (United States)

    1989-03-10

    INTRODUCTION The Oral History Program’s purpose is to supplement oFficial histories , to isolate successful command, leadership and managerial...of -the program is to capture the experience of senior leaders in the areas of command, leadership , and management . The individual is interviewed...used to gain insight into command and management techniques and to further research in military history . In June of 1984, the Chief of Staff, General

  6. Using Technology to Expand and Enhance Applied Behavioral Analysis Programs for Children with Autism in Military Families

    Science.gov (United States)

    2014-07-01

    C. T. (2007). Predictors of depressive symptoms in primary caregivers of young children with or at risk for developmental delay. Journal of...Applied Behavioral Analysis Programs for Children with Autism in Military Families PRINCIPAL INVESTIGATOR: Wayne Fisher, Ph.D... Autism in Military Families 5b. GRANT NUMBER W81XWH-11-1-0444 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Wayne W. Fisher

  7. Expanding occupational sun safety to an outdoor recreation industry: a translational study of the Go Sun Smart program.

    Science.gov (United States)

    Andersen, Peter A; Buller, David B; Walkosz, Barbara J; Scott, Michael D; Kane, Ilima L; Cutter, Gary R; Dignan, Mark B; Liu, Xia

    2012-03-01

    A successful occupational sun-protection program was translated to 67 ski areas where the effectiveness of two dissemination strategies was assessed. An industry professional association distributed materials to the resorts. Half of the resorts received the basic dissemination strategy (BDS) in which the materials were simply distributed to the resorts. In a randomized trial, the BDS was compared with an enhanced dissemination strategy (EDS) that added interpersonal contact with managers. Employees (n=2,228) at worksites that received the EDS had elevated program exposure (74.0% at EDS vs. 57.5% at BDS recalled a message). Exposure increased at two levels of program use: from less than four (55% exposed) to four to eight (68%) and to nine or more (82%) program items in use. More employees exposed to messages engaged in sun-safety behaviors than those unexposed. At worksites using nine or more items (versus 4-8 or <4), employees engaged in additional sun-safety behaviors. Program effects were strongly mediated by increased self-efficacy. Partnerships with industry associations facilitate dissemination of evidence-based programs. Dissemination methods are needed to maximize implementation and exposure to reduce health risk behaviors.

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

    OpenAIRE

    Emily Saurman; David Lyle; Sue Kirby; Russell Roberts

    2014-01-01

    The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time ...

  9. Expanded Dengue.

    Science.gov (United States)

    Kadam, D B; Salvi, Sonali; Chandanwale, Ajay

    2016-07-01

    The World Health Organization (WHO) has coined the term expanded dengue to describe cases which do not fall into either dengue shock syndrome or dengue hemorrhagic fever. This has incorporated several atypical findings of dengue. Dengue virus has not been enlisted as a common etiological agent in several conditions like encephalitis, Guillain Barre syndrome. Moreover it is a great mimic of co-existing epidemics like Malaria, Chikungunya and Zika virus disease, which are also mosquito-borne diseases. The atypical manifestations noted in dengue can be mutisystemic and multifacetal. In clinical practice, the occurrence of atypical presentation should prompt us to investigate for dengue. Knowledge of expanded dengue helps to clinch the diagnosis of dengue early, especially during ongoing epidemics, avoiding further battery of investigations. Dengue has proved to be the epidemic with the ability to recur and has a diverse array of presentation as seen in large series from India, Srilanka, Indonesia and Taiwan. WHO has given the case definition of dengue fever in their comprehensive guidelines. Accordingly, a probable case is defined as acute febrile illness with two or more of any findings viz. headache, retro-orbital pain, myalgia, arthralgia, rash, hemorrhagic manifestations, leucopenia and supportive serology. There have been cases of patients admitted with fever, altered mentation with or without neck stiffness and pyramidal tract signs. Some had seizures or status epilepticus as presentation. When they were tested for serology, dengue was positive. After ruling out other causes, dengue remained the only culprit. We have come across varied presentations of dengue fever in clinical practice and the present article throws light on atypical manifestations of dengue. © Journal of the Association of Physicians of India 2011.

  10. 'Expanding your mind': the process of constructing gender-equitable masculinities in young Nicaraguan men participating in reproductive health or gender training programs.

    Science.gov (United States)

    Torres, Virgilio Mariano Salazar; Goicolea, Isabel; Edin, Kerstin; Ohman, Ann

    2012-01-01

    Traditional forms of masculinity strongly influence men's and women's wellbeing. This study has two aims: (i) to explore notions of various forms of masculinities in young Nicaraguan men participating in programs addressing sexual health, reproductive health, and/or gender equality and (ii) to find out how these young men perceive their involvement in actions aimed at reducing violence against women (VAW). A qualitative grounded theory study. Data were collected through six focus groups and two in-depth interviews with altogether 62 young men. Our analysis showed that the informants experienced a process of change, labeled 'Expanding your mind', in which we identified four interrelated subcategories: The apprentice, The responsible/respectful man, The proactive peer educator, and 'The feminist man'. The process showed how an increased awareness of gender inequities facilitated the emergence of values (respect and responsibility) and behavior (thoughtful action) that contributed to increase the informant's critical thinking and agency at individual, social, and political levels. The process was influenced by individual and external factors. Multiple progressive masculinities can emerge from programs challenging patriarchy in this Latin American setting. The masculinities identified in this study show a range of attitudes and behaviors; however, all lean toward more equitable gender relations. The results suggest that learning about sexual and reproductive health does not directly imply developing more gender-equitable attitudes and behaviors or a greater willingness to prevent VAW. It is paramount that interventions to challenge machismo in this setting continue and are expanded to reach more young men.

  11. Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland.

    Science.gov (United States)

    Rowland, Sandi; Leider, Jonathon P; Davidson, Clare; Brady, Joanne; Knudson, Alana

    2016-12-01

    To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed.

  12. Using Technology to Expand and Enhance Applied Behavioral Analysis Programs for Children with Autism in Military Families

    Science.gov (United States)

    2012-07-01

    Virtual Care Predelivery” 2. Shipping options: a. Carriers . b. Insurance. c. Costs. 37 7.1 Pre-Installation...d. On the GoToMeeting program control panel, make sure that the microphone is not “Muted.” e. If you’re using an external microphone or headphones

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

    Science.gov (United States)

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

    2016-01-01

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

  14. After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda

    National Research Council Canada - National Science Library

    Muldoon, Katherine A; Muzaaya, Godfrey; Betancourt, Theresa S; Ajok, Mirriam; Akello, Monica; Petruf, Zaira; Nguyen, Paul; Baines, Erin K; Shannon, Kate

    2014-01-01

    .... Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status...

  15. Expanding the Navy’s Managers Internal Control Program’s (MICP) Capability to Prepare for External Financial Audits

    Science.gov (United States)

    2015-06-01

    the Department is well managed. In 2013, The Committee of Sponsoring Organizations of the Treadway Commission ( COSO ) added 17 principles to the five...analyzing the content of the MICP against the COSO and GAO publications, this thesis developed templates to supplement the MICP in order to bring the...Commission’s ( COSO ) 17 Principles, Office of Financial Operations (FMO), Managers’ Internal Control Program, Managers’ Internal Control Manual. 15. NUMBER OF

  16. Reconfiguring REU programs to build links between institutions is an efficiient way of expanding student participation in research.

    Science.gov (United States)

    Halpern, J. B.

    2016-12-01

    There is good evidence that STEM career recruiting would be bettered by a shift in REU programs from an individual student focus to building institutional links with faculty participation. This would improve recruiting, duration and the scientific productivity of the REU system. Student commitment would benefit from a more sophisticated and productive project that this would enable as would research groups and mentors at all institutions. Such programs build long lasting links between the institutions and individual faculty. For teaching institutions, scientifically centered collaborations bring faculty and students into the research culture. Faculty who teach at such institutions will maintain their research skills as well as their links to the field and gain respect both internally and externally. Visibility of the collaboration at the non-research centered institution will attract other students into the area. An on-going collaboration offers benefits to the research institution as well. First, recruitment becomes less hit and miss because the partners have observed and taught their students. Second partners will provide appropriate training and context before the summer starts for new students. Third, the availability of partners to help mentoring the students during the summer and into the academic year makes it easier for graduate students, post-docs and the research university faculty as well. Fourth, a good collaboration builds respect and understanding on all sides, which, since many in the research group will go on to teach at teaching centered institutions is important. Building respect for transfer students from Community Colleges and smaller teaching institutions among the research faculty is another benefit. I will describe programs that I have designed an led that successfully implement these ideas.

  17. Expanding the generation and use of economic and financial data to improve HIV program planning and efficiency: a global perspective.

    Science.gov (United States)

    Holmes, Charles B; Atun, Rifat; Avila, Carlos; Blandford, John M

    2011-08-01

    Cost information is needed at multiple levels of health care systems to inform the public health response to HIV. To date, most attention has been paid to identifying the cost drivers of providing antiretroviral treatment, and these data have driven interventions that have been successful in reducing drug and human resource costs. The need for further cost information, especially for less well-studied areas such as HIV prevention, is particularly acute given global budget constraints and ongoing efforts to extract the greatest possible value from money spent on the response. Cost information can be collected from multiple perspectives and levels of the health care system (site, program, and national levels), and it is critical to choose the appropriate methodology in order to generate the appropriate information for decision-making. Organizations such as United States President's Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and other organizations are working together to bridge the divide between the fields of economics and HIV program implementation by accelerating the collection of cost data and building further local demand and capacity for their use.

  18. Remote Memory Access: A Case for Portable, Efficient and Library Independent Parallel Programming

    Directory of Open Access Journals (Sweden)

    Alexandros V. Gerbessiotis

    2004-01-01

    Full Text Available In this work we make a strong case for remote memory access (RMA as the effective way to program a parallel computer by proposing a framework that supports RMA in a library independent, simple and intuitive way. If one uses our approach the parallel code one writes will run transparently under MPI-2 enabled libraries but also bulk-synchronous parallel libraries. The advantage of using RMA is code simplicity, reduced programming complexity, and increased efficiency. We support the latter claims by implementing under this framework a collection of benchmark programs consisting of a communication and synchronization performance assessment program, a dense matrix multiplication algorithm, and two variants of a parallel radix-sort algorithm and examine their performance on a LINUX-based PC cluster under three different RMA enabled libraries: LAM MPI, BSPlib, and PUB. We conclude that implementations of such parallel algorithms using RMA communication primitives lead to code that is as efficient as the message-passing equivalent code and in the case of radix-sort substantially more efficient. In addition our work can be used as a comparative study of the relevant capabilities of the three libraries.

  19. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders.

    Science.gov (United States)

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-08-11

    . Introducing a new, more affordable LNG IUS product could help expand choice for women in Kenya and increase use of long-acting reversible contraception. Further evaluation is needed to identify the full costs required for introduction-including the cost of demand creation-as well as research among potential and actual LNG IUS users, their partners, and health care providers to help inform scale-up of the method. © Rademacher et al.

  20. Human Immunodeficiency Virus Reverse Transcriptase and Protease Sequence Database: an expanded data model integrating natural language text and sequence analysis programs.

    Science.gov (United States)

    Kantor, R; Machekano, R; Gonzales, M J; Dupnik, K; Schapiro, J M; Shafer, R W

    2001-01-01

    The HIV Reverse Transcriptase and Protease Sequence Database is an on-line relational database that catalogs evolutionary and drug-related sequence variation in the human immunodeficiency virus (HIV) reverse transcriptase (RT) and protease enzymes, the molecular targets of anti-HIV therapy (http://hivdb.stanford.edu). The database contains a compilation of nearly all published HIV RT and protease sequences, including submissions from International Collaboration databases and sequences published in journal articles. Sequences are linked to data about the source of the sequence sample and the antiretroviral drug treatment history of the individual from whom the isolate was obtained. During the past year 3500 sequences have been added and the data model has been expanded to include drug susceptibility data on sequenced isolates. Database content has also been integrated with didactic text and the output of two sequence analysis programs.

  1. Yakima Tributary Access and Habitat Program, 2002-2003 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Myra, D.; Ready, C.

    2003-12-01

    The Yakima Tributary Access and Habitat Program (YTAHP) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and to improve habitat in areas where access is restored. This program intends to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/or habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). The objectives of YTAHP are listed below and also include subtasks detailed in the report: (1) Conduct Early Action Projects; (2) Review Strategic Plan; (3) Restore Access, including stream inventory, prioritization, implementation; and (4) Provide opportunities to improve habitat and conserve resources. The BPA YTAHP funding supported activities of the program which are described in this report. These activities are primarily related to objective 1 (conduct early action projects) and parts of objectives 2-4. The work supported by YTAHP funding will support a series of scheduled projects and be

  2. Geothermal Program Review X: proceedings. Geothermal Energy and the Utility Market -- the Opportunities and Challenges for Expanding Geothermal Energy in a Competitive Supply Market

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    Each year the Geothermal Division of the US Department of Energy conducts an in-depth review of its entire geothermal R&D program. The conference serves several purposes: a status report on current R&D activities, an assessment of progress and problems, a review of management issues, and a technology transfer opportunity between DOE and the US geothermal city. This year`s conference, Program Review X, was held in San Francisco on March 24--26, 1992. The theme of the review, ``Geothermal Energy and the Utility Market -- The Opportunities and Challenges for Expanding Geothermal Energy in a Competitive Supply Market,`` focused on the needs of the electric utility sector. Geothermal energy, with its power capacity potential of 10 GWe by the year 2010, can provide reliable, enviromentally clean electricity which can help offset the projected increase in demand. Program Review X consisted of seven sessions including an opening session with presentations by Mr. Vikram Budhraja, Vice President of System Planning and Operations, Southern California Edison Company, and Mr. Richard Jaros, President and Chief Operating Officer, California Energy Company. The six technical sessions included presentations by the relevant field researchers covering DOE-sponsored R&D in hydrothermal, hot dry rock, and geopressured energy. Individual projects are processed separately for the data bases.

  3. Urate levels predict survival in amyotrophic lateral sclerosis: Analysis of the expanded Pooled Resource Open-Access ALS clinical trials database.

    Science.gov (United States)

    Paganoni, Sabrina; Nicholson, Katharine; Chan, James; Shui, Amy; Schoenfeld, David; Sherman, Alexander; Berry, James; Cudkowicz, Merit; Atassi, Nazem

    2017-08-31

    Urate has been identified as a predictor of amyotrophic lateral sclerosis (ALS) survival in some but not all studies. Here we leverage the recent expansion of the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) database to study the association between urate levels and ALS survival. Pooled data of 1,736 ALS participants from the PRO-ACT database were analyzed. Cox proportional hazards regression models were used to evaluate associations between urate levels at trial entry and survival. After adjustment for potential confounders (i.e., creatinine and body mass index), there was an 11% reduction in risk of reaching a survival endpoint during the study with each 1-mg/dL increase in uric acid levels (adjusted hazard ratio 0.89, 95% confidence interval 0.82-0.97, P ALS and confirms the utility of the PRO-ACT database as a powerful resource for ALS epidemiological research. Muscle Nerve 2017. © 2017 Wiley Periodicals, Inc.

  4. How much does it cost to get a dose of vaccine to the service delivery location? Empirical evidence from Vietnam's Expanded Program on Immunization.

    Science.gov (United States)

    Mvundura, Mercy; Kien, Vu Duy; Nga, Nguyen Tuyet; Robertson, Joanie; Cuong, Nguyen Van; Tung, Ho Thanh; Hong, Duong Thi; Levin, Carol

    2014-02-07

    Few studies document the costs of operating vaccine supply chains, but decision-makers need this information to inform cost projections for investments to accommodate new vaccine introduction. This paper presents empirical estimates of vaccine supply chain costs for Vietnam's Expanded Program on Immunization (EPI) for routine vaccines at each level of the supply chain, before and after the introduction of the pentavalent vaccine. We used micro-costing methods to collect resource-use data associated with storage and transportation of vaccines and immunization supplies at the national store, the four regional stores, and a sample of provinces, districts, and commune health centers. We collected stock ledger data on the total number of doses of vaccines handled by each facility during the assessment year. Total supply chain costs were estimated at approximately US$65,000 at the national store and an average of US$39,000 per region, US$5800 per province, US$2200 per district, and US$300 per commune health center. Across all levels, cold chain equipment capital costs and labor were the largest drivers of costs. The cost per dose delivered was estimated at US$0.19 before the introduction of pentavalent and US$0.24 cents after introduction. At commune health centers, supply chain costs were 104% of the value of vaccines before introduction of pentavalent vaccine and 24% after introduction, mainly due to the higher price per dose of the pentavalent vaccine. The aggregated costs at the last tier of the health system can be substantial because of the large number of facilities. Even in countries with high-functioning systems, empirical evidence on current costs from all levels of the system can help estimate resource requirements for expanding and strengthening resources to meet future immunization program needs. Other low- and middle-income countries can benefit from similar studies, in view of new vaccine introductions that will put strains on existing systems. Copyright

  5. Expanding your mind’: the process of constructing gender-equitable masculinities in young Nicaraguan men participating in reproductive health or gender training programs

    Science.gov (United States)

    Torres, Virgilio Mariano Salazar; Goicolea, Isabel; Edin, Kerstin; Öhman, Ann

    2012-01-01

    Background Traditional forms of masculinity strongly influence men's and women's wellbeing. Objective This study has two aims: (i) to explore notions of various forms of masculinities in young Nicaraguan men participating in programs addressing sexual health, reproductive health, and/or gender equality and (ii) to find out how these young men perceive their involvement in actions aimed at reducing violence against women (VAW). Design A qualitative grounded theory study. Data were collected through six focus groups and two in-depth interviews with altogether 62 young men. Results Our analysis showed that the informants experienced a process of change, labeled ‘Expanding your mind’, in which we identified four interrelated subcategories: The apprentice, The responsible/respectful man, The proactive peer educator, and ‘The feminist man’. The process showed how an increased awareness of gender inequities facilitated the emergence of values (respect and responsibility) and behavior (thoughtful action) that contributed to increase the informant's critical thinking and agency at individual, social, and political levels. The process was influenced by individual and external factors. Conclusions Multiple progressive masculinities can emerge from programs challenging patriarchy in this Latin American setting. The masculinities identified in this study show a range of attitudes and behaviors; however, all lean toward more equitable gender relations. The results suggest that learning about sexual and reproductive health does not directly imply developing more gender-equitable attitudes and behaviors or a greater willingness to prevent VAW. It is paramount that interventions to challenge machismo in this setting continue and are expanded to reach more young men. PMID:22870066

  6. Expanding your mind’: the process of constructing gender-equitable masculinities in young Nicaraguan men participating in reproductive health or gender training programs

    Directory of Open Access Journals (Sweden)

    Virgilio Mariano Salazar Torres

    2012-08-01

    Full Text Available Background: Traditional forms of masculinity strongly influence men's and women's wellbeing. Objective: This study has two aims: (i to explore notions of various forms of masculinities in young Nicaraguan men participating in programs addressing sexual health, reproductive health, and/or gender equality and (ii to find out how these young men perceive their involvement in actions aimed at reducing violence against women (VAW. Design: A qualitative grounded theory study. Data were collected through six focus groups and two in-depth interviews with altogether 62 young men. Results: Our analysis showed that the informants experienced a process of change, labeled ‘Expanding your mind’, in which we identified four interrelated subcategories: The apprentice, The responsible/respectful man, The proactive peer educator, and ‘The feminist man’. The process showed how an increased awareness of gender inequities facilitated the emergence of values (respect and responsibility and behavior (thoughtful action that contributed to increase the informant's critical thinking and agency at individual, social, and political levels. The process was influenced by individual and external factors. Conclusions: Multiple progressive masculinities can emerge from programs challenging patriarchy in this Latin American setting. The masculinities identified in this study show a range of attitudes and behaviors; however, all lean toward more equitable gender relations. The results suggest that learning about sexual and reproductive health does not directly imply developing more gender-equitable attitudes and behaviors or a greater willingness to prevent VAW. It is paramount that interventions to challenge machismo in this setting continue and are expanded to reach more young men.

  7. The expanded program on immunization service delivery in the Dschang health district, west region of Cameroon: a cross sectional survey

    Directory of Open Access Journals (Sweden)

    Walter Ebile Akoh

    2016-08-01

    Full Text Available Abstract Background Vaccination is the most effective intervention strategy, and the provision of vaccination at fixed posts and outreach posts is a backbone of a sustainable vaccination system in developing countries. Access to immunization services is still limited in Cameroon. Several health districts in the west region have recorded new epidemic outbreaks, including the occurrence of a wild polio virus epidemic outbreak in 2013. The aim of this study was to assess immunization service delivery in one of the largest health districts in the west region of Cameroon; the Dschang Health district. Methods It was a cross sectional study conducted in 2013, in 42 health facilities covering 18 health areas in the Dschang Health District. Data were collected with questionnaires administered to health personnel face to face and an observation grid was used to assess resources and tools. Data were entered and analyzed in Epi Info. Results A total of 42 health facilities were assessed and 77 health personnel were interviewed. Overall, 29 (69.0 % health facilities organized one vaccination session monthly, 2 (4.8 % organized an outreach within the last 3 months prior to the study, 15 (35.7 % did not have a vaccination micro plan, 24 (32.9 % health personnel had not been supervised for at least the last 6 months prior to the study, 7 (16.7 % health facilities did not have a functional refrigerator, 1 (2.4 % did not have a vaccine carrier, 23 (54.8 % did not have a means of transport (vehicle or motorcycle and 12 (28.6 % did not have an EPI guideline. The knowledge of health personnel on vaccine and cold chain management, and on diseases of the EPI under epidemiological surveillance was found to be limited. Conclusion The frequency and strategic provision of immunization services in the Dschang Health district is inadequate. Resource availability for an adequate provision of immunization services is insufficient. The knowledge of health personnel

  8. Community College First-Year Experience Programs: Examining Student Access, Experience, and Success from the Student Perspective

    Science.gov (United States)

    Acevedo-Gil, Nancy; Zerquera, Desiree D.

    2016-01-01

    This chapter examines community college first-year experience programs using critical race theory and ecological theory. The study draws on diverse students' experiences with access, support, and long-term success within community colleges to assess how these programs foster student success, as told through the voices of student participants.

  9. 76 FR 26927 - National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the Access to...

    Science.gov (United States)

    2011-05-10

    ... Service 7 CFR Part 205 National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the... National Organic Program (NOP) to amend the provision on ruminant slaughter stock under the NOP regulations... ruminant slaughter stock requirements as codified by the final rule on access to pasture published on...

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

    Science.gov (United States)

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

    2016-01-01

    Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health-funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants' career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. © 2016 C. Margherio et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  11. "PrepCom" ends with U.S. vow to expand pop programs; House panels act on UNFPA.

    Science.gov (United States)

    1993-05-28

    Delegates to Prepcom II have just completed the new World Population Plan of Action (WPP), which provides goals and a structural outline for action. The WPP will be presented at the International Conference on Population and Development in Cairo in September, 1994. Prepcom will meet again in April, 1994 in New York. The Conference chair, Dr. Fred Sai of Ghana, remarked that there was unprecedented agreement, even on abortion. Debate on the new plan centered on the US delegation's objection to the inclusion of a new chapter on "The Family" which might be construed to imply that there is one notion of family type. US concern was also directed to the omission of "environment" from many chapter headings. The stalemate was broken when the chairman agreed to present the entire outline to the plenary as the "chairman's summary." Substantive chapters were to be devoted to the following: the interrelationships between population, sustained economic growth, and sustainable development; gender equality and empowerment of women; population growth and structure; the family, its role and composition; reproductive rights, reproductive health, and family planning, health and mortality; and population distribution, urbanization, and internal migration. The US delegation representative remarked that there was an expressed appreciation for the complex links among population, environment, consumption, migration, and development. These issues need to be considered from the standpoint of people, especially women, who are affected the most. There was a promise to increase the effort to broaden US support for reproductive health, family planning, and population programs in its foreign assistance budget. In the deliberations about the State Department authorization bill to restore funding for the UN Family Planning Association (UNFPA), a motion carried to withhold $13.8 million from the $50 million authorized for UNFPA in each of fiscal years 1994 and 1995, unless President Clinton

  12. The effect of a healthy school tuck shop program on the access of students to healthy foods

    OpenAIRE

    Kim, Kirang; Hong, Seo Ah; Yun, Sung Ha; Ryou, Hyun Joo; Lee, Sang Sun; Kim, Mi Kyung

    2012-01-01

    The objective of this study was to evaluate the effect of a healthy school tuck shop program, developed as a way of creating a healthy and nutritional school environment, on students' access to healthy foods. Five middle schools and four high schools (775 students) participated in the healthy school tuck shop program, and nine schools (1,282 students) were selected as the control group. The intervention program included restriction of unhealthy foods sold in tuck shops, provision of various f...

  13. Goal-Programming-Driven Genetic Algorithm Model for Wireless Access Point Deployment Optimization

    Directory of Open Access Journals (Sweden)

    Chen-Shu Wang

    2012-01-01

    Full Text Available Appropriate wireless access point deployment (APD is essential for ensuring seamless user communication. Optimal APD enables good telecommunication quality, balanced capacity loading, and optimal deployment costs. APD is a typical NP-complex problem because improving wireless networking infrastructure has multiple objectives (MOs. This paper proposes a method that integrates a goal-programming-driven model (PM and a genetic algorithm (GA to resolve the MO-APD problem. The PM identifies the target deployment subject of four constraints: budget, coverage, capacity, and interference. The PM also calculates dynamic capacity requirements to replicate real wireless communication. Three experiments validate the feasibility of the PM. The results demonstrate the utility and stability of the proposed method. Decision makers can easily refer to the PM-identified target deployment before allocating APs.

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

    Science.gov (United States)

    McClellan, Sean R.

    2013-01-01

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

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

    Science.gov (United States)

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

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

  16. Access to Archived Astronaut Data for Human Research Program Researchers: Update on Progress and Process Improvements

    Science.gov (United States)

    Lee, L. R.; Montague, K. A.; Charvat, J. M.; Wear, M. L.; Thomas, D. M.; Van Baalen, M.

    2016-01-01

    Since the 2010 NASA directive to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for astronaut medical data has increased greatly. LSAH and LSDA personnel are working with Human Research Program on many fronts to improve data access and decrease lead time for release of data. Some examples include the following: Feasibility reviews for NASA Research Announcement (NRA) data mining proposals; Improved communication, support for researchers, and process improvements for retrospective Institutional Review Board (IRB) protocols; Supplemental data sharing for flight investigators versus purely retrospective studies; Work with the Multilateral Human Research Panel for Exploration (MHRPE) to develop acceptable data sharing and crew consent processes and to organize inter-agency data coordinators to facilitate requests for international crewmember data. Current metrics on data requests crew consenting will be presented, along with limitations on contacting crew to obtain consent. Categories of medical monitoring data available for request will be presented as well as flow diagrams detailing data request processing and approval steps.

  17. Equitable Access for Secondary English Learner Students: Course Taking as Evidence of EL Program Effectiveness

    Science.gov (United States)

    Callahan, Rebecca M.; Shifrer, Dara

    2016-01-01

    Purpose EL education policy has long directed schools to address English learner (EL) students’ linguistic and academic development, and must do so without furthering inequity or segregation (Lau, 1974; Castañeda, 1981). The recent ESSA (2015) reauthorization expresses a renewed focus on evidence of equity, effectiveness, and opportunity to learn. We propose that high school course taking patterns provide evidence of program effectiveness and equity in access. Research Design Using data from the nationally representative Educational Longitudinal Study of 2002 (ELS: 2002), we employ multinomial regression models to predict students’ likelihood of completing two types of high school coursework (basic graduation, college preparatory) by their linguistic status. Findings Despite considerable linguistic, sociodemographic, and academic controls, marked disparities in high school course taking patterns remain, with EL students experiencing significantly less academic exposure. Implications for Policy and Practice Building on McKenzie and Scheurich’s (2004) notion of an equity trap and evidence of a long-standing EL opportunity gap, we suggest that school leaders might use our findings and their own course taking patterns to prompt discussions about the causes and consequences of local EL placement processes. Such discussions have the potential to raise awareness about how educators and school leaders approach educational equity and access, key elements central to the spirit of EL education policy. PMID:27429476

  18. Endoscopy training in primary care: innovative training program to increase access to endoscopy in primary care.

    Science.gov (United States)

    Walker, Tarik; Deutchman, Mark; Ingram, Beth; Walker, Ely; Westfall, John M

    2012-03-01

    Colorectal cancer (CRC) is a significant source of morbidity and mortality in the United States. Colonoscopy can be an extension of the care provided by a family physician to help substantially reduce CRC morbidity and mortality. Family physicians trained in colonoscopy can provide access to care in rural and medically underserved areas. The Department of Family Medicine and the Colorado Area Health Education Center (AHEC) developed the Endoscopy Training for Primary Care (ETPC) program to teach primary care physicians to perform colonoscopy. The program included online didactic education, a formal endoscopy simulator experience, and proctoring by a current endoscopist. Participants completed a baseline and follow-up survey assessing CRC screening knowledge and the effectiveness of the endoscopy training for ongoing screening activities. To date, 94 practitioners and health professional students have participated in the study. Ninety-one (97%) completed the online didactic portion of the training. Sixty-five participants (77%) were physicians or medical students, and the majority (64%) was in the field of family medicine. The year 4 (2011) follow-up cohort was comprised of 62% respondents working in an urban background and 26% in rural communities. Many participants remain in a queue for proctoring by a trained endoscopist. Several participants are successfully performing a significant number of colonoscopies. ETPC program showed success in recruiting a large number of physicians and students to participate in training. The program enhanced perceptions about the value of colon cancer screening and providing screening endoscopy in primary care practice. Providing sites for simulation training throughout Colorado provided opportunity for providers in rural regions to participate. As a result of this training, thousands of patients underwent testing to prevent colon cancer. Future research relating to colonoscopy training by family physicians should focus on quality

  19. Yakima Tributary Access and Habitat Program : Action Plan Final Report 2002.

    Energy Technology Data Exchange (ETDEWEB)

    Myra, David (South Central Washington Resource Conservation and Development Council, Ellensburg, WA); Ready, Carol A. (Kittitas County Water Purveyors, Ellensburg, WA)

    2003-04-01

    This report covers activities conducted by the Yakima Tributary Access and Habitat Program under Bonneville Power Administration (BPA) grant project No. 2002-025-00 for fiscal year 2002. The Yakima Tributary Access and Habitat Program (YTAHP, Program) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and improve habitat in areas where access is restored. Specifically, this program is designed to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/or habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). Achievements of YTAHP with BPA Action Plan funding during FY 2002 were to: (1) Establish contracts with RC&D and YTAHP participants. (2) Determine contract mechanism for MWH engineering services. (3) Provide engineering designs and services for 11 early action projects, including inverted siphons, pump and gravity diversion screening, diversion metering, rock weirs for improved fish passage

  20. Advanced Expander Test Bed Program

    Science.gov (United States)

    1991-04-01

    Aoceptance Tests 2. Design Methodology Review a. Cononent Acceptance Tm w/ Spares 3. Preliminary DeignReview 9. Engine Asembly and Acceptance Teets 4. Critical...of the disk and the bearing of both primary and secondary turbines, has been revised to accommodate brush seals for reduced leakage. Primary disk

  1. Early Successes in an Open Access, Provincially Funded Hepatitis C Treatment Program in Prince Edward Island.

    Science.gov (United States)

    Smyth, Daniel; Francheville, Jordan W; Rankin, Robin; Beck, Jeremy; Hoare, Connie; Materniak, Stefanie; German, Greg; Barrett, Lisa; Bunimov-Wall, Natalie

    2017-01-01

    The availability of curative hepatitis C therapies has created an opportunity to improve delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. Using a community based prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: 1) Treatment effectiveness using intention-to-treat analysis; and 2) Patient treatment experience assessed using demographics, adverse events, and medication adherence. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.

  2. The impact of goal attainment on behavioral and mediating variables among low income women participating in an Expanded Food and Nutrition Education Program intervention study.

    Science.gov (United States)

    Cullen, Karen Weber; Thompson, Deborah I; Scott, Amanda R; Lara-Smalling, Agueda; Watson, Kathleen B; Konzelmann, Karen

    2010-10-01

    This study examined the relationships between participant goal attainment and changes in mediating variables and food choice outcomes from a modified curriculum for the Texas Expanded Food and Nutrition Education Program (EFNEP) promoting healthy home food environments and parenting skills related to obesity prevention. EFNEP participants in 54 intervention classes received a goal sheet after each of 6 classes. Participants recorded goal attainment and returned at the next class, Diet and mediating variables were measured at baseline, immediate post, and 4 months later. Mixed model regression analysis over time assessed whether goal attainment was associated with the outcomes at post or follow-up, controlling for baseline assessment. Participants who reported attaining more goals reported greater self-efficacy for planning/encouraging fruit and vegetable consumption and making fruit and vegetables available, menu planning skills, improvement in the food preparation practices and higher home availability for regular vegetables. At post, those who reported attaining more fiber, vegetable, and water goals reported consuming more of these items. Goal attainment was related to some changes in food choice and mediating variables in an at risk population. Further research into the use and efficacy of goal setting and attainment in this population is warranted.

  3. After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda.

    Science.gov (United States)

    Muldoon, Katherine A; Muzaaya, Godfrey; Betancourt, Theresa S; Ajok, Mirriam; Akello, Monica; Petruf, Zaira; Nguyen, Paul; Baines, Erin K; Shannon, Kate

    2014-01-01

    Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated. This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as 'reintegrated' if they reported ≥1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre. A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated. From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988-2010 for an average length of one year, the median age of abduction was 13 years (IQR:11-14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed ≥1 reintegration program were not significantly different from

  4. Accessibility in Teaching Assistant Training: A Critical Review of Programming from Ontario's Teaching and Learning Centres

    Science.gov (United States)

    Vander Kloet, Marie

    2015-01-01

    It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and…

  5. Novel Humanitarian Aid Program: The Glivec International Patient Assistance Program-Lessons Learned From Providing Access to Breakthrough Targeted Oncology Treatment in Low- and Middle-Income Countries.

    Science.gov (United States)

    Garcia-Gonzalez, Pat; Boultbee, Paula; Epstein, David

    2015-10-01

    Imatinib was the first targeted therapy approved for the treatment of cancer. With its approval, it was immediately clear to Novartis that this breakthrough therapy would require an innovative approach to worldwide access, with special consideration of low- and middle-income countries. Lack of government reimbursement, universal health care, or health insurance coverage, few trained specialty physicians or diagnostic services, and poor health care infrastructure were, and continue to be, contributing barriers to access to treatment in low- and middle-income countries. The Glivec International Patient Assistance Program (GIPAP) is an international drug donation program established by Novartis Pharma AG and implemented in partnership with The Max Foundation, a nonprofit, nongovernmental organization. GIPAP was established in 2001, essentially in parallel with the first approval of imatinib for chronic myeloid leukemia. Since 2001, GIPAP has made imatinib accessible to all medically and financially eligible patients within 80 countries on an ongoing basis as long as their physicians prescribe it and no other means of access exists. To date, more than 49,000 patients have benefited from GIPAP, and 2.3 million monthly doses of imatinib have been approved through the program. GIPAP represents an innovative drug donation model that has set the standard for access programs for other targeted or innovative therapies. The purpose of this article is to describe the structure of GIPAP, as well as important lessons that have contributed to the success of the program. This article may assist other companies with the development of successful and far-reaching patient assistance programs in the future.

  6. Collaboration and Perspectives on Identity Management and Access from two Geoscience Cyberinfrastructure Programs

    Science.gov (United States)

    Ramamurthy, M. K.

    2016-12-01

    Increasingly, the conduct of science requires close international collaborations to share data, information, knowledge, expertise, and other resources. This is particularly true in the geosciences where the highly connected nature of the Earth system and the need to understand global environmental processes have heightened the importance of scientific partnerships. As geoscience studies become a team effort involving networked scientists and data providers, it is crucial that there is open and reliable access to earth system data of all types, software, tools, models, and other assets. That environment demands close attention to security-related matters, including the creation of trustworthy cyberinfrastructure to facilitate the efficient use of available resources and support the conduct of science. Unidata and EarthCube, both of which are NSF-funded and community-driven programs, recognize the importance of collaborations and the value of networked communities. Unidata, a cornerstone cyberinfrastructure facility for the geosciences, includes users in nearly 180 countries. The EarthCube initiative is aimed at transforming the conduct of geosciences research by creating a well-connected and facile environment for sharing data and in an open, transparent, and inclusive manner and to accelerate our ability to understand and predict the Earth system. We will present the Unidata and EarthCube community perspectives on the approaches to balancing an environment that promotes open and collaborative eScience with the needs for security and communication, including what works, what is needed, the challenges, and opportunities to advance science.

  7. Factors influencing implementation of easily accessible sporting programs: perceptions of national sports federation and local sports clubs.

    NARCIS (Netherlands)

    Ooms, L.; Veenhof, C.

    2014-01-01

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

  8. Teacher Adaptations to a Core Reading Program: Increasing Access to Curriculum for Elementary Students in Urban Classrooms

    Science.gov (United States)

    Maniates, Helen

    2017-01-01

    This article examines how three urban elementary school teachers adapted pedagogical strategies from a school district--adopted core reading program to increase their students' access to the curriculum. Using teacher interviews and classroom observations to construct a descriptive case study of teacher adaptation, analysis reveals that the…

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

    Science.gov (United States)

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

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

  10. Problem-Based Learning in a Programming Context-Planning and Executing a Pilot Survey on Database Access in a Programming Language

    Science.gov (United States)

    Bellström, Peter; Kilbrink, Nina

    In this chapter we describe a pilot survey on applying problem-based learning (PBL) in an undergraduate programming course. During the course the students have applied PBL as a complement to traditional teaching and learning techniques. The PBL problem in this survey combines both knowledge about programming and knowledge about databases. We argue that to handle programming the students have to learn programming according to the deep approach to learning in order to be able to apply their knowledge in new programming situations and contexts. The result from this pilot survey indicates from both a tutor and a student perspective that PBL could be one method to reach a deeper understanding on how to access databases in a programming language.

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

    Science.gov (United States)

    Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell

    2014-01-01

    The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas. PMID:25089774

  12. Minimization of hepatitis B infection among children in Jiangsu, China, 12years after integration of hepatitis B vaccine into the expanded program on immunization.

    Science.gov (United States)

    Lin, Xiaoqian; Yang, Jishi; Lu, Huixia; Zhou, Yulin; Zhou, Guiping; Wu, Huiyi; Xu, Chenyu; Wu, Qiaozhen; Liu, Jingli; Chen, Shanshan; Yang, Muyi; Gu, Guangyu; Hu, Yali; Zhou, Yi-Hua

    2016-12-12

    China has integrated hepatitis B vaccine into the Expanded Program on Immunization since 2002. We aimed to survey the seroprevalence of and immunity to hepatitis B virus (HBV) in children born from 2002 to 2014 in Jiangsu, China. Totally 3442 children (M:F=2072:1370) at the age of 7months to 12years (5.5±3.6), from five cities and rural areas across Jiangsu province, were enrolled. Blood samples were measured for HBV markers by ELISA and quantitative microparticle enzyme immunoassay. HBV DNA was tested by real-time PCR and S region was amplified by nested PCR. Twelve (0.35%) children were positive for hepatitis B surface antigen (HBsAg) and 34 (0.99%) were HBsAg negative and positive for antibody against hepatitis B core antigen (anti-HBc). Totally 2542 (73.85%) children had anti-HBs levels ⩾10mIU/ml and 535 (15.54%) with 2-9.9mIU/ml. All 12 HBsAg-positive children had detectable HBV DNA with a mean level of 6.1±1.7logIU/ml (3.3-8.1logIU/ml); 8 were genotype C and 4 were genotype B. No mutation was detected in the a determinant of HBsAg. HBV DNA was not detected in all the 34 children with positive anti-HBc and negative HBsAg. HBsAg prevalence among children in Jiangsu born after the introduction of universal vaccination against hepatitis B has significantly decreased. No mutation of S gene is associated with vaccine failure in the cohort of children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. CDHC, a possible change agent promoting access to care.

    Science.gov (United States)

    Cumby, Dunn H; Beatty, Marsha W; Sevier, Sydney T

    2011-07-01

    Access to oral health care has been a topic of concern among dental and community health professionals in the United States for some time. The American Dental Association is piloting a new program aimed at expanding the current dental health workforce and alleviating some of the problems associated with access to care. This paper explores the potential benefits of the community dental health coordinator program while examining some of the lessons learned in its initial implementation in Oklahoma.

  14. 77 FR 77117 - Proposed Revision 0 on Access Authorization-Operational Program

    Science.gov (United States)

    2012-12-31

    ... System (ADAMS): You may access publicly available documents online in the NRC Library at http://www.nrc...), that integrates the performance requirements contained within 10 CFR 73.56, ``Personnel Access Authorization Requirements for Nuclear Power Plants,'' and the criminal history checks of 10 CFR 73.57...

  15. Integrating a Writing-Across-Curriculum Program into a Self-Access Learning Center

    Science.gov (United States)

    Hsu, Jeng-yih

    2007-01-01

    In recent years, several writing centers have been set up in colleges and universities of Taiwan. Almost at the same time, many self-access learning centers are being designed and built on campuses all over the island. Whether these two institutes function jointly or independently, dissatisfaction arises. In order to run the self-access learning…

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

    Science.gov (United States)

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

    2017-10-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  18. The effect of an educational program for vascular access care on nurses’ knowledge at dialysis centers in Khartoum State, Sudan

    Directory of Open Access Journals (Sweden)

    Kalthoum Ibrahim Yousif

    2017-01-01

    Full Text Available End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses’ knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group. Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82. Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses’ knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001. The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.

  19. The effect of an educational program for vascular access care on nurses' knowledge at dialysis centers in Khartoum State, Sudan.

    Science.gov (United States)

    Yousif, Kalthoum Ibrahim; Abu-Aisha, Hasan; Abboud, Omar Ibrahim

    2017-01-01

    End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group). Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI) clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82). Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses' knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001). The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.

  20. Project Integration Architecture (PIA) and Computational Analysis Programming Interface (CAPRI) for Accessing Geometry Data from CAD Files

    Science.gov (United States)

    Benyo, Theresa L.

    2002-01-01

    Integration of a supersonic inlet simulation with a computer aided design (CAD) system is demonstrated. The integration is performed using the Project Integration Architecture (PIA). PIA provides a common environment for wrapping many types of applications. Accessing geometry data from CAD files is accomplished by incorporating appropriate function calls from the Computational Analysis Programming Interface (CAPRI). CAPRI is a CAD vendor neutral programming interface that aids in acquiring geometry data directly from CAD files. The benefits of wrapping a supersonic inlet simulation into PIA using CAPRI are; direct access of geometry data, accurate capture of geometry data, automatic conversion of data units, CAD vendor neutral operation, and on-line interactive history capture. This paper describes the PIA and the CAPRI wrapper and details the supersonic inlet simulation demonstration.

  1. Economic impact of the introduction of machine perfusion preservation in a kidney transplantation program in the expanded donor era: cost-effectiveness assessment.

    Science.gov (United States)

    Gómez, V; Galeano, C; Diez, V; Bueno, C; Díaz, F; Burgos, F J

    2012-11-01

    Kidney transplantations (KT) from expanded criteria donors (ECD) show a higher rate of delayed graft function (DGF) that increases postoperative costs because of the prolonged hospital stay as well as the needs for dialysis and additional diagnostic procedures. Hypothermic machine perfusion (MP) might be superior to cold storage (CS) to reduce the relative risks of DGF and primary nonfunction (PNF) as well as to increase 1-year graft survival. The aim of the study was to determine the relative cost-effectiveness of two different storage methods: MP versus CS. A probabilistic decision tree was developed to compare MP and CS as graft preservation methods. The structure of the model was populated by review of the literature and outcomes of KT from ECD in our center. The model estimated budget impact and incremental cost-effectiveness ratio in terms of DGF and PNF cases. The cost comparison of methods for KT preservation included: hospitalization and intermediate care unit stay; post-KT dialysis; graft removal; immunosuppressive regimen; treatment of acute rejection episodes; as well as costs of preservation solutions and pulsatile preservation device or storage containers. Resource consumption for CS stratified by graft function varied from $8,159 for immediate graft function (IGF) recipients to $10,865 for DGF recipients to $25,933 for PNF recipients. Meanwhile, resource consumption for MP varied from $9,522 for IGF to $12,228 for DGF to $27,297 for PNF recipients. The main components of resource consumption were hospitalization stay (41.5%-53.9%); graft explantation (20.2%), and the need for dialysis (16.0%). The budget impact per patient for the introduction of MP was $505. However, the incremental cost-effectiveness ratio was $3,369 for each DGF- or PNF- saved case. The introduction of the MP preservation technology in a KT program form ECD is cost-effective in terms of savings for DGF and PNF cases. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Enhancing Accessibility and Engagement in Evidence-Based Parenting Programs to Reduce Maltreatment: Conversations With Vulnerable Parents.

    Science.gov (United States)

    Love, Susan M; Sanders, Matthew R; Metzler, Carol W; Prinz, Ronald J; Kast, Elizabeth Z

    2013-01-01

    11 focus groups (N = 160) of high-risk parents in Los Angeles County were asked to assess the value of social media to deliver an evidence-based parenting program, Triple P-Positive Parenting Program, to reduce child maltreatment. For feasibility, (N = 238) parents were surveyed regarding their internet use. Parents responded enthusiastically to the online program, and expressed the importance of a sense of community and learning through the experiences of others. 78% of the young, high-poverty, minority parents used the internet. An online evidence-based parenting program delivered in social media could enhance accessibility and engagement of high-risk parents - a powerful tool to reduce child maltreatment.

  3. 34 CFR Appendix A to Subpart C of... - Grants for Access and Persistence Program (GAP) State Grant Allotment Case Study

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Grants for Access and Persistence Program (GAP) State Grant Allotment Case Study A Appendix A to Subpart C of Part 692 Education Regulations of the Offices of...) State Grant Allotment Case Study ER29OC09.010 ER29OC09.011 ER29OC09.012 ER29OC09.013 ER29OC09.014...

  4. 75 FR 57829 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2010-09-22

    ... for an association, business, labor union, etc.). You may review DOT's complete Privacy Act Statement..., Preserving Rights and Powers, to prohibit new residential through-the-fence access. In that Notice, there was...

  5. Memory Access Behavior Analysis of NUMA-Based Shared Memory Programs

    Directory of Open Access Journals (Sweden)

    Jie Tao

    2002-01-01

    Full Text Available Shared memory applications running transparently on top of NUMA architectures often face severe performance problems due to bad data locality and excessive remote memory accesses. Optimizations with respect to data locality are therefore necessary, but require a fundamental understanding of an application's memory access behavior. The information necessary for this cannot be obtained using simple code instrumentation due to the implicit nature of the communication handled by the NUMA hardware, the large amount of traffic produced at runtime, and the fine access granularity in shared memory codes. In this paper an approach to overcome these problems and thereby to enable an easy and efficient optimization process is presented. Based on a low-level hardware monitoring facility in coordination with a comprehensive visualization tool, it enables the generation of memory access histograms capable of showing all memory accesses across the complete address space of an application's working set. This information can be used to identify access hot spots, to understand the dynamic behavior of shared memory applications, and to optimize applications using an application specific data layout resulting in significant performance improvements.

  6. Galveston Head Start Captive Reared Sea Turtle Program 1979 to 2016 (NCEI Accession 0157625)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This is a compilation of several data sets related to the Galveston Texas Seaturtle Headstart program. Most notable is the Kemp's ridley headstart program...

  7. Exposing medical students to expanding populations

    Directory of Open Access Journals (Sweden)

    Lindenthal JJ

    2015-03-01

    Full Text Available JJ Lindenthal,1,2 JA DeLisa,3 GF Heinrich,4 WS Calderón Gerstein,5 1Department of Psychiatry, Institute for the Public Understanding of Health and Medicine, 2Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA; 3Department of Orthopedics and Rehabilitation, University of New Mexico Health Science Center, Albuquerque, NM, USA; 4Department of Preventive Medicine and Community Health, New Jersey Medical School, Rutgers University, Newark, NJ, USA; 5Hospital Nacional Ramiro Prialé, EsSalud, Huancayo, Peru Abstract: Physicians are required to advocate for and counsel patients based on the best science and the interests of the individual while avoiding discrimination, ensuring equal access to health and mental services. Nonetheless, the communication gap between physician and patients has long been observed. To this end, the Institute for the Public Understanding of Health and Medicine of the Rutgers University New Jersey Medical School has expanded its efforts. This report describes two new programs: a legacy lecture series for medical students and an international “experience”, in Huancayo, Peru, for medical students and faculty. The MiniMed outreach program, now in its ninth year and first described in this journal in 2012, was designed to empower the powerless to communicate more effectively with clinicians, thus improving both the effectiveness of the physician–patient relationship and health care outcomes. The approach of the two new programs and their effects on patients, particularly the underserved, and medical students and faculty, are outlined in the following article. Keywords: MiniMed program, equal access, underserved populations, Newark Renaissance House, Kintock Group, role modeling 

  8. The visible embryo project: embedded program objects for knowledge access, creation and management through the World Wide Web.

    Science.gov (United States)

    Doyle, M D; Ang, C S; Martin, D C; Noe, A

    1996-01-01

    We have designed a prototype knowledge management online environment for the biomedical sciences which integrates access to online representations of the scientific literature, bibliographic databases, high-performance visualization technologies, large-scale scientific databases, and tools for authoring new-generation scientific publications. This system will provide widespread access to its resources by using the World Wide Web for its underlying architecture. This system expands upon our Weblet Interactive Remote Visualization (IRV) server technology to produce a set of dedicated Internet "visualization servers" which provide interactive control of real-time visualizations from the Visible Embryo Project database from within Web pages viewed with our WebRouser software package. This system will be used to develop a set of prototype applications for both online education of medical students in developmental anatomy and for an interactive patient education system for expectant parents. We recognize that knowledge represented by these national resource databases is not static, therefore it is essential to include tools for both the creation of new "compound documents" which incorporate embedded objects, as well as for managing the peer-review of scholarly publications, in order to ensure the integrity of new knowledge as it is added to these databases in the future. We have therefore begun to design integrated tools for our system which facilitate both the creation of and the validation of new generations of scientific knowledge.

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

    Science.gov (United States)

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

    2012-10-01

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

  10. Evaluation of Florida physicians' knowledge and attitudes toward accessing the state prescription drug monitoring program as a prescribing tool.

    Science.gov (United States)

    Gershman, Jennifer A; Gershman, Jason A; Fass, Andrea D; Popovici, Ioana

    2014-12-01

    The purpose of this study is to assess Florida physicians' attitudes and knowledge toward accessing the state's prescription drug monitoring program (PDMP). Five thousand medical doctors and osteopathic physicians licensed in Florida were randomly selected for a voluntary and anonymous 15-question self-administered survey approved by the Institutional Review Board. Surveys were distributed through U.S. postal service mail. Likert-scale questions were used to assess prior knowledge (1 = none to 5 = excellent) and attitudes toward accessing the PDMP (1 = strongly disagree to 5 = strongly agree). The study yielded a response rate of 7.8%, 71.5% of whom agreed or strongly agreed that the PDMP is a useful tool. Among participants that have access and answered the PDMP usefulness question, 94.8% agree or strongly agree that it is a useful tool. There were 63 out of 64 physicians (98.4%) who conducted 25 or more searches who agreed or strongly agreed that the PDMP is a useful tool for monitoring patients' controlled substance histories. There were 72.5% of participants with access that answered the "doctor shopping" question who agreed that "doctor shopping" will decrease. Among the 64 most frequent PDMP users, 69.4% agreed or strongly agreed that they have prescribed fewer controlled substances after accessing the PDMP. The study revealed that a majority of participants believe that the PDMP is a useful tool for monitoring patients' controlled substance histories. More continuing education programs should be provided to Florida physicians to enhance their knowledge regarding PDMPs. Wiley Periodicals, Inc.

  11. Achievements of the Australian Access to Allied Psychological Services (ATAPS) program: summarising (almost) a decade of key evaluation data.

    Science.gov (United States)

    Bassilios, Bridget; Nicholas, Angela; Reifels, Lennart; King, Kylie; Fletcher, Justine; Machlin, Anna; Ftanou, Maria; Blashki, Grant; Burgess, Philip; Pirkis, Jane

    2016-01-01

    Introduced in July 2001, Australian Access to Allied Psychological Services (ATAPS) was the inaugural national policy initiative to provide community access to government-funded psychological services in primary care. Our aim was to examine the achievements of ATAPS in relation to its stated objectives using a set of indicators that largely drew on data from a minimum data set that we designed for the evaluation of ATAPS. We used de-identified professional-, consumer- and session-level data from the minimum dataset, and secondary analyses of our quantitative and qualitative data collected for a series of specific evaluation studies. Available data covered the period from 1 July 2003 to 31 December 2012. Approximately 350,000 referrals were made to the ATAPS program over the 9.5 year analysis period, 79 % of which resulted in services. Over 1.4 million sessions were offered. Overall, 29 % of consumers were male, 4 % children, and 3 % Aboriginal people; 54 % of consumers had depression and 41 % an anxiety disorder; at least 60 % were on low incomes; and around 50 % resided outside of major cities. The most common interventions delivered were cognitive and behavioural therapies. Selected outcome measures indicated improvement in mental health symptoms. Access to Allied Psychological Services achieved its objectives within a decade of operation. The program delivered evidence-based services to a substantial number of consumers who were disadvantaged and historically would not have accessed services. Importantly, where data were available, there were indications that ATAPS achieved positive clinical outcomes for consumers. This suggests that ATAPS carved an important niche by successfully addressing unmet need of hard-to-reach consumers and through means that were not available via other programs. It will be interesting to see the effects from July 2016 of the reform of ATAPS, which will see ATAPS subsumed under psychological services commissioned by regional

  12. Gaining Access or Losing Ground? Socioeconomically Disadvantaged Students in Undergraduate Engineering, 1994-2003

    Science.gov (United States)

    Lundy-Wagner, Valerie C.; Veenstra, Cindy P.; Orr, Marisa K.; Ramirez, Nichole M.; Ohland, Matthew W.; Long, Russell A.

    2014-01-01

    Expanding access to engineering for underrepresented groups has by and large focused on ethnicity/race and gender, with little understanding of socioeconomic disadvantages. In this study, we use economic, human, and cultural capital theories to frame and then describe access to undergraduate engineering degree programs and bachelor's degrees.…

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

    Science.gov (United States)

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

    2014-01-01

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

  14. 77 FR 24169 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2012-04-23

    ... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... Notice of Funds Availability. DATES: All applications must be received by 5 p.m. Eastern Daylight Time... overseas marketing and promotion activities. MAP participants may receive assistance for generic or brand...

  15. 78 FR 23893 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2013-04-23

    ... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... publish a notice in the Federal Register rescinding this Notice of Funds Availability. DATES: All... marketing and promotion activities. MAP Participants may receive assistance for generic or brand promotion...

  16. A Free Program for Using and Teaching an Accessible Electronic Wayfinding Device

    Science.gov (United States)

    Greenberg, Maya Delgado; Kuns, Jerry

    2012-01-01

    Accessible Global Positioning Systems (GPS) are changing the way many people with visual impairments (that is, those who are blind or have low vision) travel. GPS provides real-time orientation information so that a traveler with a visual impairment can make informed decisions about path of travel and destination. Orientation and mobility (O&M)…

  17. 75 FR 19464 - Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and...

    Science.gov (United States)

    2010-04-14

    ... Customer Information and Customer Notice AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION... for Unauthorized Access to Customer Information and Customer Notice. OMB Number: 1550-0110. Form...) Ensure the security and confidentiality of customer records and information; (2) protect against any...

  18. 77 FR 5027 - Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to...

    Science.gov (United States)

    2012-02-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... data more accessible and user-friendly. FOR FURTHER INFORMATION CONTACT: Daniel W. Sigelman, Office of... INFORMATION: FDA is announcing the availability of a report entitled ``Food and Drug Administration...

  19. 78 FR 77209 - Accessibility of User Interfaces, and Video Programming Guides and Menus

    Science.gov (United States)

    2013-12-20

    ...-party device (e.g., a laptop, tablet, smart phone) or if additional services are required to make use of... computers without conditional access capability, mobile devices (such as tablets and smartphones) that do... televisions--a function that digital tuning adapters (``DTAs'') and similar devices perform today. These...

  20. What Expands in an Expanding Universe?

    Directory of Open Access Journals (Sweden)

    JOSÉ A. DE FREITAS PACHECO

    2015-12-01

    Full Text Available ABSTRACT In the present investigation, the possible effects of the expansion of the Universe on systems bonded either by gravitational or electromagnetic forces, are reconsidered. It will be shown that the acceleration (positive or negative of the expanding background, is the determinant factor affecting planetary orbits and atomic sizes. In the presently accepted cosmology (ΛCDM all bonded systems are expanding at a decreasing rate that tends to be zero as the universe enters in a de Sitter phase. It is worth mentioning that the estimated expansion rates are rather small and they can be neglected for all practical purposes.

  1. What Expands in an Expanding Universe?

    Science.gov (United States)

    Pacheco, José A De Freitas

    2015-01-01

    In the present investigation, the possible effects of the expansion of the Universe on systems bonded either by gravitational or electromagnetic forces, are reconsidered. It will be shown that the acceleration (positive or negative) of the expanding background, is the determinant factor affecting planetary orbits and atomic sizes. In the presently accepted cosmology (ΛCDM) all bonded systems are expanding at a decreasing rate that tends to be zero as the universe enters in a de Sitter phase. It is worth mentioning that the estimated expansion rates are rather small and they can be neglected for all practical purposes.

  2. 77 FR 71865 - Over-the-Road Bus Accessibility Grant Program

    Science.gov (United States)

    2012-12-04

    ..., Office of Program Management, 202-366-3800, for general information about the OTRB Program. Contact... FTA's Transportation Electronic Awards Management System (TEAM) for the projects identified in Tables... under the Special Warranty Provisions of the Department of Labor Guidelines ``Section 5333(b), Federal...

  3. Increasing Access to an ASD Imitation Intervention via a Telehealth Parent Training Program

    Science.gov (United States)

    Wainer, Allison L.; Ingersoll, Brooke R.

    2015-01-01

    Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…

  4. Balancing the One-to-One Equation: Equity and Access in Three Laptop Programs

    Science.gov (United States)

    Warschauer, Mark; Zheng, Binbin; Niiya, Melissa; Cotten, Shelia; Farkas, George

    2014-01-01

    Seeking to improve teaching and learning and to narrow gaps between students of high and low socioeconomic status, many school districts in the United States are implementing one-to-one laptop programs. In this comparative case study, we examine one-to-one laptop programs in Colorado, California, and Alabama, all of which deployed low-cost netbook…

  5. Supplement Analysis for the Watershed Management Program EIS (DOE/EIS-0265/SA-102) - Yakima Tributary Access and Habitat Program – Ellensburg Water Company/ Cooke Creek Diversion Project

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Shannon C. [Bonneville Power Administration (BPA), Portland, OR (United States)

    2003-01-17

    The Bonneville Power Administration (BPA) is proposing to fund a canal-stream crossing and fish screen improvement project on Cooke Creek in Kittitas County, Washington. The project proposes to place the Ellensburg Water Company’s (EWC) main canal into a siphon passing underneath Cooke Creek, to build a fish screen on the EWC diversion on Cooke Creek, and to restore the Cooke Creek channel to a more natural state. The goal of this project is to improve fish habitat conditions in the Yakima River Basin and to protect ESA listed Mid-Columbia steelhead and bull trout. This project is part of the Yakima Tributary Access and Habitat Program, which works with landowners, water purveyors, and municipalities to restore fish passage to Yakima River tributaries that historically supported salmonids and to improve habitat in areas where access is restored.

  6. Complementary primary mental health programs for young people in Australia: Access to Allied Psychological Services (ATAPS) and headspace.

    Science.gov (United States)

    Bassilios, Bridget; Telford, Nicolas; Rickwood, Debra; Spittal, Matthew J; Pirkis, Jane

    2017-01-01

    Access to Allied Psychological Services (ATAPS) was introduced in 2001 by the Australian Government to provide evidence-based psychological interventions for people with high prevalence disorders. headspace, Australia's National Youth Mental Health Foundation, was established in 2006 to promote and facilitate improvements in the mental health, social wellbeing and economic participation of young people aged 12-25 years. Both programs provided free or low cost psychological services. This paper aims to describe the uptake of psychological services by people aged 12-25 years via ATAPS and headspace, the characteristics of these clients, the types of services received and preliminary client outcomes achieved. Data from 1 July 2009 to 30 June 2012 were sourced from the respective national web-based minimum datasets used for routine data collection in ATAPS and headspace. In total, 20,156 and 17,337 young people accessed two or more psychological services via ATAPS and headspace, respectively, in the 3-year analysis period. There were notable differences between the clients of, and the services delivered by, the programs. ATAPS clients were less likely to be male (31 vs 39%) and to reside in major cities (51 vs 62%) than headspace clients; ATAPS clients were also older (18-21 vs 15-17 years modal age group). There was some variation in the number and types of psychological sessions that young people received via the programs but the majority received at least one session of cognitive behavioural therapy. Based on limited available outcome data, both programs appear to have produced improvements in clients' mental health; specifically, psychological distress as assessed by the Kessler-10 (K-10) was reduced. ATAPS and headspace have delivered free or low-cost psychological services to 12-25 year olds with somewhat different characteristics. Both programs have had promising effects on mental health. ATAPS and headspace have operated in a complementary fashion to fill a

  7. Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program.

    Science.gov (United States)

    Rangel Gomez, Maria Gudelia; Tonda, Josana; Zapata, G Rogelio; Flynn, Michael; Gany, Francesca; Lara, Juanita; Shapiro, Ilan; Rosales, Cecilia Ballesteros

    2017-01-01

    While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud -Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.

  8. EntrezAJAX: direct web browser access to the Entrez Programming Utilities.

    Science.gov (United States)

    Loman, Nicholas J; Pallen, Mark J

    2010-06-21

    Web applications for biology and medicine often need to integrate data from Entrez services provided by the National Center for Biotechnology Information. However, direct access to Entrez from a web browser is not possible due to 'same-origin' security restrictions. The use of "Asynchronous JavaScript and XML" (AJAX) to create rich, interactive web applications is now commonplace. The ability to access Entrez via AJAX would be advantageous in the creation of integrated biomedical web resources. We describe EntrezAJAX, which provides access to Entrez eUtils and is able to circumvent same-origin browser restrictions. EntrezAJAX is easily implemented by JavaScript developers and provides identical functionality as Entrez eUtils as well as enhanced functionality to ease development. We provide easy-to-understand developer examples written in JavaScript to illustrate potential uses of this service. For the purposes of speed, reliability and scalability, EntrezAJAX has been deployed on Google App Engine, a freely available cloud service. The EntrezAJAX webpage is located at http://entrezajax.appspot.com/

  9. EntrezAJAX: direct web browser access to the Entrez Programming Utilities

    Directory of Open Access Journals (Sweden)

    Pallen Mark J

    2010-06-01

    Full Text Available Abstract Web applications for biology and medicine often need to integrate data from Entrez services provided by the National Center for Biotechnology Information. However, direct access to Entrez from a web browser is not possible due to 'same-origin' security restrictions. The use of "Asynchronous JavaScript and XML" (AJAX to create rich, interactive web applications is now commonplace. The ability to access Entrez via AJAX would be advantageous in the creation of integrated biomedical web resources. We describe EntrezAJAX, which provides access to Entrez eUtils and is able to circumvent same-origin browser restrictions. EntrezAJAX is easily implemented by JavaScript developers and provides identical functionality as Entrez eUtils as well as enhanced functionality to ease development. We provide easy-to-understand developer examples written in JavaScript to illustrate potential uses of this service. For the purposes of speed, reliability and scalability, EntrezAJAX has been deployed on Google App Engine, a freely available cloud service. The EntrezAJAX webpage is located at http://entrezajax.appspot.com/

  10. 76 FR 21741 - Twenty-First Century Communications and Video Programming Accessibility Act; Announcement of Town...

    Science.gov (United States)

    2011-04-18

    ... Governmental Affairs Bureau, 202-418-2498 (voice), 202-418-1169 (TTY), or [email protected] (e-mail); or... gaps in video programming through the provision of video description on television and closed...

  11. NODC Standard Format NOS Coastal Wave Program (F182) Data (1979-1983) (NODC Accession 0014203)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data type was designed for analyzed wave data originating from the National Ocean Service (NOS) Coastal Wave Program. The data are organized into 3 record...

  12. Access to Adequate Healthcare for Hmong Women: A Patient Navigation Program to Increase Pap Test Screening

    Directory of Open Access Journals (Sweden)

    Moon S. Chen, Jr

    2010-01-01

    Full Text Available This paper describes the development and implementation of a Hmong Cervical Cancer Intervention Program utilizing a patient navigation model to raise cervical cancer awareness for Hmong women through educational workshops and to assist Hmong women in obtaining a Pap test. Out of 402 women who participated in a baseline survey, the Patient Navigation Program was able to enroll 109 participants who had not had a Pap test in the past 3 years and had never had a Pap test. Through utilization of outreach, an awareness campaign and patient navigation support, at least 38 percent of 109 participants obtained a Pap test. Overall, 21 workshops and 43 outreach activities were conducted by the Hmong Women’s Heritage Association, leading to 63 percent of those enrolled in the Patient Navigation Program who could be contacted to obtain a Pap test.

  13. Layouts of Expander Graphs

    OpenAIRE

    Dujmović, Vida; Sidiropoulos, Anastasios; Wood, David R.

    2015-01-01

    Bourgain and Yehudayoff recently constructed $O(1)$-monotone bipartite expanders. By combining this result with a generalisation of the unraveling method of Kannan, we construct 3-monotone bipartite expanders, which is best possible. We then show that the same graphs admit 3-page book embeddings, 2-queue layouts, 4-track layouts, and have simple thickness 2. All these results are best possible.

  14. Access to "Jiggasha program: a family planning communication approach" and its exposure to the selected background characteristics.

    Science.gov (United States)

    Hossain, M W; Khan, H T; Begum, A

    1999-06-01

    This paper studies the effectiveness of "Jiggasha," an innovative communication approach for the promotion of family planning in Dhaka, Bangladesh. Data from the 1996 Jiggasha follow-up survey were used, which gathered information by interviewing a network sample of 1862 married women and a subsample of 608 men. The study used the sample constituted by women respondents and included data on socioeconomic and demographic characteristics of the respondents and their knowledge, attitude and practice relating to contraceptives. Findings showed that Jiggasha respondents have more access to radio than television. All respondents reported having a radio in their homes and they emphasized the importance of broadcasting more family planning messages via both electronic media. Only 16% of the women in the study setting were exposed to group meetings. Of the respondents reporting participation in group meetings, 38.25% joined in a Jiggasha meeting, 23.15% in a Grameen Bank group meeting, and 4.70% in a Bangladesh Rural Advancement Committee group meeting. Logistic regression analysis indicated more access to Jiggashas among women over 30 years of age than among the younger age groups. Religion and education levels of respondents have significant impact on access to Jiggashas. Husbands' approval plays an important role among the Jiggasha respondents in using family planning method. This study provides important information for policy-makers to make family planning program a success.

  15. National study of changes in community access to school physical activity facilities: the school health policies and programs study.

    Science.gov (United States)

    Evenson, Kelly R; Wen, Fang; Lee, Sarah M; Heinrich, Katie M; Eyler, Amy

    2010-03-01

    A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation's public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006. In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006). No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym. These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation's public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1979-06-01

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

  17. 77 FR 5295 - Over-the-Road Bus Accessibility Program Announcement of Project Selections

    Science.gov (United States)

    2012-02-02

    ... Regional Office for grant-specific issues; or Blenda Younger, Office of Program Management, 202-366-4345... FTA's Transportation Electronic Awards Management System (TEAM) for the projects identified in Tables... under the Special Warranty Provisions of the Department of Labor Guidelines ``Section 5333(b), Federal...

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

    Science.gov (United States)

    2017-03-01

    maximize workplace efficiency. As a result of targeting these high-quality applicants and creating more efficient leadership training programs, these...organization, which is known for exceptionally high safety standards and performance, small inefficiencies in the areas of teamwork and leadership ...recruiting needs. We found that the Navy is inadequately assessing applicant skills and attributes through its primary use of cognitive testing

  19. Farmers' Market Use Patterns Among Supplemental Nutrition Assistance Program Recipients With High Access to Farmers' Markets.

    Science.gov (United States)

    Freedman, Darcy A; Flocke, Susan; Shon, En-Jung; Matlack, Kristen; Trapl, Erika; Ohri-Vachaspati, Punam; Osborne, Amanda; Borawski, Elaine

    2017-05-01

    Evaluate farmers' market (FM) use patterns among Supplemental Nutrition Assistance Program (SNAP) recipients. Cross-sectional survey administered June to August, 2015. Cleveland and East Cleveland, OH. A total of 304 SNAP recipients with children. Participants lived within 1 mile of 1 of 17 FMs. Most were African American (82.6%) and female (88.1%), and had received SNAP for ≥5 years (65.8%). Patterns of FM shopping, awareness of FM near home and of healthy food incentive program, use of SNAP to buy fruits and vegetables and to buy other foods at FMs, receipt of healthy food incentive program. Two-stage cluster analysis to identify segments with similar FM use patterns. Bivariate statistics including chi-square and ANOVA to evaluate main outcomes, with significance at P ≤ .05. A total of 42% reported FM use in the past year. Current FM shoppers (n = 129) were segmented into 4 clusters: single market, public market, multiple market, and high frequency. Clusters differed significantly in awareness of FM near home and the incentive program, use of SNAP to buy fruit and vegetables at FMs, and receipt of incentive. Findings highlight distinct types of FM use and had implications for tailoring outreach to maximize first time and repeat use of FMs among SNAP recipients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Programmatic Knowledge Management: Technology, Literacy, and Access in 21st-Century Writing Programs

    Science.gov (United States)

    York, Eric James

    2015-01-01

    Growing out of research in Technical Communication, Composition Studies, and Writing Program Administration, the articles in this dissertation explicitly seek to address changes in the practices and products of writing and writing studies wrought by the so-called "digital revolution" in communication technology, which has been ongoing in…

  1. 45 CFR 1706.151 - Program accessibility: New construction and alterations.

    Science.gov (United States)

    2010-10-01

    ..., requirements, and standards of the Architectural Barriers Act (42 U.S.C. 4151-4157), as established in 41 CFR...) NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE...

  2. 75 FR 70831 - Medicare and Medicaid Programs: Changes to the Hospital and Critical Access Hospital Conditions...

    Science.gov (United States)

    2010-11-19

    .... An article published in 2004 in the Journal of the American Medical Association (Berwick, D.M. and... environment'' as they ``engender trust in families, creating a better working relationship between hospital... technical assistance programs (such as Medicare Learning Network at http://www.cms.gov/MLNGenInfo/ ) to make...

  3. Evaluation of the Expanded and Enhanced Model System-Wide K-9 Drug/Alcohol Abuse Prevention Training Program for Counselors, Social Workers, and Nurses, 1991-92.

    Science.gov (United States)

    Weich, Leah; Philip, Radhika

    The objective of this program, which was created in response to the emergency situation in New York City's Community School District 3, was to train all guidance counselors, social workers, and nurses in the district to develop the skills to deliver substance abuse prevention counseling and support services. Program sponsored training was to be…

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

    Directory of Open Access Journals (Sweden)

    Weiner Bryan J

    2008-12-01

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

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

    Science.gov (United States)

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

    2017-03-24

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

  6. News from the Library: Facilitating access to a program for radiation shielding - the Library can help

    CERN Multimedia

    CERN Library

    2013-01-01

    MicroShield® is a comprehensive photon/gamma ray shielding and dose assessment programme. It is widely used for designing shields, estimating source strength from radiation measurements, minimising exposure to people, and teaching shielding principles.   Integrated tools allow the graphing of results, material and source file creation, source inference with decay (dose-to-Bq calculations accounting for decay and daughter buildup), the projection of exposure rate versus time as a result of decay, access to material and nuclide data, and decay heat calculations. The latest version is able to export results using Microsoft Office (formatted and colour-coded for readability). Sixteen geometries accommodate offset dose points and as many as ten standard shields plus source self-shielding and cylinder cladding are available. The library data (radionuclides, attenuation, build-up and dose conversion) reflect standard data from ICRP 38 and 107* as well as ANSI/ANS standards and RSICC publicat...

  7. Dialysis vascular access management by interventional nephrology programs at University Medical Centers in the United States.

    Science.gov (United States)

    Vachharajani, Tushar J; Moossavi, Shahriar; Salman, Loay; Wu, Steven; Dwyer, Amy C; Ross, Jamie; Dukkipati, Ramanath; Maya, Ivan D; Yevzlin, Alexander S; Agarwal, Anil; Abreo, Kenneth D; Work, Jack; Asif, Arif

    2011-01-01

    The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political "turf" issues." Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrology program. This has largely been accomplished by consolidating available resources and collaborating with other specialties irrespective of the size of the dialysis population. The collaboration with other specialties also offers an opportunity to perform advanced procedures, such as application of excimer laser and endovascular ultrasound. As more UMCs establish interventional nephrology programs, opportunities for developing standardized training centers will improve, resulting in better quality and availability of nephrology-related procedures, and providing an impetus for research activities. © 2011 Wiley Periodicals, Inc.

  8. Improving Access to Maternity Care for Women with Opioid Use Disorders: Colocation of Midwifery Services at an Addiction Treatment Program.

    Science.gov (United States)

    Goodman, Daisy

    2015-01-01

    Perinatal drug and alcohol use is associated with serious medical and psychiatric morbidity for pregnant and postpartum women and their newborns. Participation in prenatal care has been shown to improve outcomes, even in the absence of treatment for substance use disorders. Unfortunately, women with substance use disorders often do not receive adequate prenatal care. Barriers to accessing care for pregnant women with substance use disorders include medical and psychiatric comorbidities, transportation, caring for existing children, housing and food insecurity, and overall lack of resources. In a health care system where care is delivered by each discipline separately, lack of communication between providers causes poorly coordinated services and missed opportunities. The integration of mental health and substance use treatment services in medical settings is a goal of health care reform. However, this approach has not been widely promoted in the context of maternity care. The Dartmouth-Hitchcock Medical Center Perinatal Addiction Treatment Program provides an integrated model of care for pregnant and postpartum women with substance use disorders, including the colocation of midwifery services in the context of a dedicated addiction treatment program. A structured approach to screening and intervention for drug and alcohol use in the outpatient prenatal clinic facilitates referral to treatment at the appropriate level. Providing midwifery care within the context of a substance use treatment program improves access to prenatal care, continuity of care throughout pregnancy and the postpartum, and availability of family planning services. The evolution of this innovative approach is described. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

  9. The American Geological Institute Minority Participation Program (MPP): Thirty Years of Improving Access to Opportunities in the Geosciences Through Undergraduate and Graduate Scholarships for Underrepresented Minorities

    Science.gov (United States)

    Callahan, C. N.; Byerly, G. R.; Smith, M. J.

    2001-05-01

    Since 1971, the American Geological Institute (AGI) Minority Participation Program (MPP) has supported scholarships for underrepresented minorities in the geosciences at the undergraduate and graduate levels. Some of our MPP scholars have gone on to hugely successful careers in the geosciences. MPP scholars include corporate leaders, university professors, a NASA scientist-astronaut and a National Science Foundation (NSF) CAREER awardee. Yet as ethnic minorities continue to be underrepresented in the geosciences, AGI plans to expand its efforts beyond its traditional undergraduate and graduate scholarships to include diversity programs for secondary school geoscience teacher internships, undergraduate research travel support, and doctoral research fellowships. AGI promotes its MPP efforts primarily through its web pages, which are very successful in attracting visitors; through its publications, especially Geotimes; and through its Corporate Associates and Member Societies. Funding for the MPP has come from multiple sources over the past 30 years. Industry, non-profit organizations, and individuals have been the primary source of funding for graduate scholarships. The NSF has regularly funded the undergraduate scholarships. AGI Corporate Associates have contributed to both scholarship programs. The MPP Advisory Committee selects scholarship recipients based upon student academic performance, financial need, and potential for success as a geoscience professional. AGI currently has 29 MPP scholars, including 11 undergraduate and 18 graduate students. Undergraduate scholarships range from \\1000 to \\5000, with an average award of approximately \\2500. Graduate scholarships range from \\500 to \\4000, with an average award of approximately \\1300. In addition to financial assistance, every MPP scholar is assigned a professional geoscientist as a mentor. The mentor is responsible for regular personal contacts with MPP scholars, and with writing evaluation reports that

  10. Integration of vitamin A supplementation with the expanded program on immunization does not affect seroconversion to oral poliovirus vaccine in infants.

    NARCIS (Netherlands)

    R.D. Semba; M. Muhilal; N.E. Mohgaddam (Nasrin); Z. Munasir; A. Akib; D. Permaesih; M.S. Muherdiyantiningsih; A.D.M.E. Osterhaus (Albert)

    1999-01-01

    textabstractChildhood immunization programs may provide infrastructure for delivering vitamin A supplements to infants in developing countries. The effect of giving vitamin A, an immune enhancer, on antibody responses to trivalent oral poliovirus vaccine (TOPV) is unknown. A

  11. "Diamond in the Rough": The Impact of a Remedial Program on College Access and Opportunity for Black Males at an Historically Black Institution

    Science.gov (United States)

    Palmer, Robert T.; Davis, Ryan J.

    2012-01-01

    Researchers, policymakers, and administrations have shown great concern over the efficacy of college remediation, which has prompted some states to eliminate remedial programs from public 4-year institutions. However, research suggests that eliminating these programs may have unintended consequences on college access and opportunity for…

  12. Access and Diversity in the Running Start Program: A Comparison of Washington's Running Start Program to Other State Level Dual Enrollment Programs Hosted on a College Campus

    Science.gov (United States)

    Smith, Karl

    2014-01-01

    Since 1990, high school students in Washington have had the choice of earning college credit through the Running Start program. Running start is a dual enrollment and dual credit program that allows eleventh and twelfth grade high school students to take college courses at any of Washington's 34 community and technical colleges, Central Washington…

  13. Environmental Assessment Expanded Ponnequin Wind Energy Project Weld County, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    N/A

    1999-03-02

    The U.S.Department of Energy (DOE) has considered a proposal from the State of Colorado, Office of Energy Conservation (OEC), for funding construction of the Expanded Ponnequin Wind Project in Weld County, Colorado. OEC plans to enter into a contracting arrangement with Public Service Company of Colorado (PSCO) for the completion of these activities. PSCo, along with its subcontractors and business partners, are jointly developing the Expanded Ponnequin Wind Project. DOE completed an environmental assessment of the original proposed project in August 1997. Since then, the geographic scope and the design of the project changed, necessitating additional review of the project under the National Environmental Policy Act. The project now calls for the possible construction of up to 48 wind turbines on State and private lands. PSCo and its partners have initiated construction of the project on private land in Weld County, Colorado. A substation, access road and some wind turbines have been installed. However, to date, DOE has not provided any funding for these activities. DOE, through its Commercialization Ventures Program, has solicited applications for financial assistance from state energy offices, in a teaming arrangement with private-sector organizations, for projects that will accelerate the commercialization of emerging renewable energy technologies. The Commercialization Ventures Program was established by the Renewable Energy and Energy Efficiency Technology Competitiveness Act of 1989 (P.L. 101-218) as amended by the Energy Policy Act of 1992 (P.L. 102-486). The Program seeks to assist entry into the marketplace of newly emerging renewable energy technologies, or of innovative applications of existing technologies. In short, an emerging renewable energy technology is one which has already proven viable but which has had little or no operational experience. The Program is managed by the Department of Energy, Office of Energy Efficiency and Renewable Energy. The

  14. Expanding Thurston maps

    CERN Document Server

    Bonk, Mario

    2017-01-01

    This monograph is devoted to the study of the dynamics of expanding Thurston maps under iteration. A Thurston map is a branched covering map on a two-dimensional topological sphere such that each critical point of the map has a finite orbit under iteration. It is called expanding if, roughly speaking, preimages of a fine open cover of the underlying sphere under iterates of the map become finer and finer as the order of the iterate increases. Every expanding Thurston map gives rise to a fractal space, called its visual sphere. Many dynamical properties of the map are encoded in the geometry of this visual sphere. For example, an expanding Thurston map is topologically conjugate to a rational map if and only if its visual sphere is quasisymmetrically equivalent to the Riemann sphere. This relation between dynamics and fractal geometry is the main focus for the investigations in this work.

  15. Excluding Orphan Drugs from the 340B Drug Discount Program: the Impact on 18 Critical Access Hospitals

    Directory of Open Access Journals (Sweden)

    Madeline Carpinelli Wallack

    2012-01-01

    Full Text Available Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs for all drugs except those designated as “orphan.” Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs. Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals’ current cost. Results: The 18 CAHs’ purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings. Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.

  16. Measuring Access to Family Planning: Conceptual Frameworks and DHS Data.

    Science.gov (United States)

    Choi, Yoonjoung; Fabic, Madeleine Short; Adetunji, Jacob

    2016-06-01

    Expanding access to family planning (FP) is a driving aim of global and national FP efforts. The definition and measurement of access, however, remain nebulous, largely due to complexity. This article aims to bring clarity to the measurement of FP access. First, we synthesize key access elements for measurement by reviewing three well-known frameworks. We then assess the extent to which the Demographic and Health Surveys (DHS)-a widely used data source for FP programs and research-has information to measure these elements. We finally examine barriers to access by element, using the latest DHS data from four countries in sub-Saharan Africa. We discuss opportunities and limitations in the measurement of access, the importance of careful interpretation of data from population-based surveys, and recommendations for collecting and using data to better measure access. © 2016 The Population Council, Inc.

  17. Real-world cabazitaxel safety: the Italian early-access program in metastatic castration-resistant prostate cancer.

    Science.gov (United States)

    Bracarda, Sergio; Gernone, Angela; Gasparro, Donatello; Marchetti, Paolo; Ronzoni, Monica; Bortolus, Roberto; Fratino, Lucia; Basso, Umberto; Mazzanti, Roberto; Messina, Caterina; Tucci, Marcello; Boccardo, Francesco; Cartenì, Giacomo; Pinto, Carmine; Fornarini, Giuseppe; Mattioli, Rodolfo; Procopio, Giuseppe; Chiuri, Vincenzo; Scotto, Tiziana; Dondi, Davide; Di Lorenzo, Giuseppe

    2014-05-01

    Cabazitaxel is a novel taxane that is approved for use in metastatic castration-resistant prostate cancer based on the Phase III TROPIC study, which showed improved overall survival with cabazitaxel/prednisone versus mitoxantrone/prednisone. A global early-access program was initiated in order to provide early access to cabazitaxel in docetaxel-pretreated patients and to obtain real-world data. We report interim safety results from an Italian prospective, single-arm, multicenter, open-label trial of 218 patients receiving cabazitaxel 25 mg/m2 every 3 weeks plus prednisolone 10 mg/day, until disease progression, unacceptable toxicity, investigator's decision or death. Patients completing treatment received a median of six cabazitaxel cycles. The most common grade 3/4 adverse events were neutropenia (33.9%), leukopenia (15.6%), anemia (6%) and asthenia (6%). No peripheral neuropathy or nail disorders were observed. These results confirm that cabazitaxel has a manageable safety profile in daily clinical practice and support its use in patients with prostate cancer who progress during or after a docetaxel-based therapy.

  18. Effects of the State Children's Health Insurance Program on access to dental care and use of dental services.

    Science.gov (United States)

    Wang, Hua; Norton, Edward C; Rozier, R Gary

    2007-08-01

    To provide national estimates of implementation effects of the State Children's Health Insurance Program (SCHIP) on dental care access and use for low-income children. The 1997-2002 National Health Interview Survey. The study design is based on variation in the timing of SCHIP implementation across states and among children observed before and after implementation. Two analyses were conducted. The first estimated the total effect of SCHIP implementation on unmet need for dental care due to cost in the past year and dental services use for low-income children (family income below state SCHIP eligibility thresholds) using county and time fixed effects models. The second analysis estimated differences in dental care access and use among low-income children with SCHIP or Medicaid coverage and their uninsured counterparts, using instrumental variables methods to control for selection bias. Both analyses controlled for child and family characteristics. When SCHIP had been implemented for more than 1 year, the probability of unmet dental care needs for low-income children was lowered by 4 percentage points. Compared with their uninsured counterparts, those who had SCHIP or Medicaid coverage were less likely to report unmet dental need by 8 percentage points (standard error: 2.3), and more likely to have visited a dentist within 6 or 12 months by 17 (standard error: 3.7) and 23 (standard error: 3.6) percentage points, respectively. SCHIP program type had no differential effects. Consistent results from two analytical approaches provide evidence that SCHIP implementation significantly reduced financial barriers for dental care for low-income children in the U.S. Low-income children enrolled in SCHIP or Medicaid had substantially increased use of dental care than the uninsured.

  19. Expanding Options. A Model to Attract Secondary Students into Nontraditional Vocational Programs. For Emphasis in: Building Trades, Electronics, Health Services, Machine Shop, Welding.

    Science.gov (United States)

    Good, James D.; DeVore, Mary Ann

    This model has been designed for use by Missouri secondary schools in attracting females and males into nontraditional occupational programs. The research-based strategies are intended for implementation in the following areas: attracting females into building trades, electronics, machine shop, and welding; and males into secondary health…

  20. OPTImal CArdiac REhabilitation (OPTICARE) following Acute Coronary Syndromes: Rationale and design of a randomised, controlled trial to investigate the benefits of expanded educational and behavioural intervention programs.

    Science.gov (United States)

    Sunamura, M; Ter Hoeve, N; van den Berg-Emons, H J G; Haverkamp, M; Redekop, K; Geleijnse, M L; Stam, H J; Boersma, E; van Domburg, R T

    2013-07-01

    The majority of cardiac rehabilitation (CR) referrals consist of patients who have survived an acute coronary syndrome (ACS). Although major changes have been implemented in ACS treatment since the 1980s, which highly influenced mortality and morbidity, CR programs have barely changed and only few data are available on the optimal CR format in these patients. We postulated that standard CR programs followed by relatively brief maintenance programs and booster sessions, including behavioural techniques and focusing on incorporating lifestyle changes into daily life, can improve long-term adherence to lifestyle modifications. These strategies might result in improved (cardiac) mortality and morbidity in a cost-effective fashion. In the OPTImal CArdiac REhabilitation (OPTICARE) trial we will assess the effects of two advanced and extended CR programs that are designed to stimulate permanent adaption of a heart-healthy lifestyle, compared with current standard CR, in ACS patients. We will study the effects in terms of cardiac risk profile, levels of daily physical activity, quality of life and health care consumption.

  1. Overview of the Geothermal Energy Program Review X: Geothermal Energy and the Utility Market - The Opportunities and Challenges for Expanding Geothermal Energy in a Competitive Supply Market

    Energy Technology Data Exchange (ETDEWEB)

    Mock, John E.; Budraja, Vikram; Jaros, Richard; Yamaguchi, Tsutomu; Hinrichs, Thomas C.

    1992-01-01

    This overview at the Geothermal Program Review X: Geothermal Energy and the Utility Market consisted of five presentations: ''Technology Advancements to Support Growth in Geothermal Power Sales in a Dynamic Utility Market'' by John E. Mock; ''Geothermal Energy Market in Southern California: Past, Present and Future'' by Vikram Budraja; ''Taking the High Ground: Geothermal's Place in the Revolving Energy Market'' by Richard Jaros; ''Recent Developments in Japan's Hot Dry Rock Program'' by Tsutomu Yamaguchi; and ''Options in the Eleventh Year for Interim Standard Offer Number Four Contracts'' by Thomas C. Hinrichs.

  2. Medicare Access and CHIP Reauthorization Act: What do Geriatrics Healthcare Professionals Need to Know About the Quality Payment Program?

    Science.gov (United States)

    Unroe, Kathleen T; Hollmann, Peter A; Goldstein, Alanna C; Malone, Michael L

    2017-04-01

    Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA. CMS received extensive input from stakeholders including the American Geriatrics Society. Under the Quality Payment Program, CMS streamlined multiple Medicare value-based payment programs into a new Merit-based Incentive Payment System (MIPS). CMS also outlined how it will provide incentives for participation in Advanced Alternative Payment Models (called APMs). Although Medicare payments to geriatrics health professionals will not be based on the new MIPS formula until 2019, those payments will be based upon performance during a 90-day period in 2017. This article defines geriatrics health professionals as clinicians who care for a predominantly older adult population and who are eligible to bill under the Medicare Physician Fee Schedule. Given the current paucity of eligible APMs, this article will focus on MIPS while providing a brief overview of APMs. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  3. 50 nm AlxOy resistive random access memory array program bit error reduction and high temperature operation

    Science.gov (United States)

    Ning, Sheyang; Ogura Iwasaki, Tomoko; Takeuchi, Ken

    2014-01-01

    In order to decrease program bit error rate (BER) of array-level operation in AlxOy resistive random access memory (ReRAM), program BERs are compared by using 4 × 4 basic set and reset with verify methods on multiple 1024-bit-pages in 50 nm, mega-bit class ReRAM arrays. Further, by using an optimized reset method, 8.5% total BER reduction is obtained after 104 write cycles due to avoiding under-reset or weak reset and ameliorating over-reset caused wear-out. Then, under-set and over-set are analyzed by tuning the set word line voltage (VWL) of ±0.1 V. Moderate set current shows the best total BER. Finally, 2000 write cycles are applied at 125 and 25 °C, respectively. Reset BER increases 28.5% at 125 °C whereas set BER has little difference, by using the optimized reset method. By applying write cycles over a 25 to 125 to 25 °C temperature variation, immediate reset BER change can be found after the temperature transition.

  4. Silicon microfabricated beam expander

    Energy Technology Data Exchange (ETDEWEB)

    Othman, A., E-mail: aliman@ppinang.uitm.edu.my; Ibrahim, M. N.; Hamzah, I. H.; Sulaiman, A. A. [Faculty of Electrical Engineering, Universiti Teknologi MARA Malaysia, 40450, Shah Alam, Selangor (Malaysia); Ain, M. F. [School of Electrical and Electronic Engineering, Engineering Campus, Universiti Sains Malaysia, Seri Ampangan, 14300,Nibong Tebal, Pulau Pinang (Malaysia)

    2015-03-30

    The feasibility design and development methods of silicon microfabricated beam expander are described. Silicon bulk micromachining fabrication technology is used in producing features of the structure. A high-precision complex 3-D shape of the expander can be formed by exploiting the predictable anisotropic wet etching characteristics of single-crystal silicon in aqueous Potassium-Hydroxide (KOH) solution. The beam-expander consist of two elements, a micromachined silicon reflector chamber and micro-Fresnel zone plate. The micro-Fresnel element is patterned using lithographic methods. The reflector chamber element has a depth of 40 µm, a diameter of 15 mm and gold-coated surfaces. The impact on the depth, diameter of the chamber and absorption for improved performance are discussed.

  5. TRIPLE ACTION PALATE EXPANDER

    Directory of Open Access Journals (Sweden)

    Svetlana Yordanova

    2011-09-01

    Full Text Available Malocclusion correction essentially involves expansion of the maxilla, protrusion of anterior teeth and opening the bite. Expansion is often the stage preceding the treatment with fixed appliances. The elevation of the occlusion using accomplished with different devices (bite planes -fixed or removable, composite material on the occlusall surface of molars carries the risk of breaking or debonding them.The present article proposes an expanding appliance with triple action as a therapeutic means of choice in an orthodontic treatment with fixed appliances. The expander can simultaneously be used to protrude upper teeth, to expand the upper jaw and disarticulate the occlusion. It can be easily fabricated in clinical conditions, causes no discomfort and does not hamper oral hygiene because it can be removed and cleaned.

  6. Expandable gastroretentive dosage forms.

    Science.gov (United States)

    Klausner, Eytan A; Lavy, Eran; Friedman, Michael; Hoffman, Amnon

    2003-06-24

    Expandable gastroretentive dosage forms (GRDFs) have been designed for the past 3 decades. They were originally created for possible veterinary use, but later the design was modified for enhanced drug therapy in humans. These GRDFs are easily swallowed and reach a significantly larger size in the stomach due to swelling or unfolding processes that prolong their gastric retention time (GRT). After drug release, their dimensions are minimized with subsequent evacuation from the stomach. Gastroretentivity is enhanced by the combination of substantial dimensions with high rigidity of the dosage form to withstand the peristalsis and mechanical contractility of the stomach. Positive results were obtained in preclinical and clinical studies evaluating GRT of expandable GRDFs. Narrow absorption window drugs compounded in such systems have improved in vivo absorption properties. These findings are an important step towards the implementation of expandable GRDFs in the clinical setting. The current review deals with expandable GRDFs reported in articles and patents, and describes the physiological basis of their design. Using the dog as a preclinical screening model prior to human studies, relevant imaging techniques and pharmacokinetic-pharmacodynamic aspects of such delivery systems are also discussed.

  7. AstroCom NYC: Expanding the Partnership

    Science.gov (United States)

    Paglione, Timothy; Ford, Saavik; Agueros, Marcel A.; Mac Low, Mordecai-Mark; Robbins, Dennis

    2015-01-01

    AstroCom NYC is an undergraduate mentoring program designed to improve urban minority student access to opportunities in astrophysical research by greatly enhancing partnerships between research astronomers in New York City (City University of New York - an MSI, American Museum of Natural History, and Columbia). AstroCom NYC provides centralized, personalized mentoring as well as financial and academic support, to CUNY undergraduates throughout their studies, plus the resources and opportunities to further CUNY faculty research with students. The goal is that students' residency at AMNH helps them build a sense of belonging in the field, and readies and inspires them for graduate study. AstroCom NYC provides a rigorous Methods of Scientific Research course developed specifically to this purpose, a laptop, research and career mentors, outreach activities, scholarships and stipends, Metrocards, and regular assessment for maximum effectiveness. Stipends in part alleviate the burdens at home typical for CUNY students so they may concentrate on their academic success. AMNH serves as the central hub for our faculty and students, who are otherwise dispersed among all five boroughs of the City. For our second cohort, we dramatically improved the application and screening process, implemented a number of tools to evaluate their potential for grad school, and began growing a network of potential hosts for summer internships around NY State and the US. We review these implementations and outcomes, as well as plans for Year 3, when we expect many of our current students to compete for external summer REUs, and after greatly expanding the program reach through a NASA community college initiative.

  8. The IRIS Education and Outreach Program: Providing access to data and equipment for educational and public use

    Science.gov (United States)

    Taber, J.; Toigo, M.; Bravo, T. K.; Hubenthal, M.; McQuillan, P. J.; Welti, R.

    2009-12-01

    The IRIS Education and Outreach Program has been an integral part of IRIS for the past 10 years and during that time has worked to advance awareness and understanding of seismology and earth science while inspiring careers in geophysics. The focus on seismology and the use of seismic data has allowed the IRIS E&O program to develop and disseminate a unique suite of products and services for a wide range of audiences. One result of that effort has been increased access to the IRIS Data Management System by non-specialist audiences and simplified use of location and waveform data. The Seismic Monitor was one of the first Web-based tools for observing near-real-time seismicity. It continues to be the most popular IRIS web page, and thus it presents aspects of seismology to a very wide audience. For individuals interested in more detailed ground motion information, waveforms can be easily viewed using the Rapid Earthquake Viewer, developed by the University of South Carolina in collaboration with IRIS E&O. The Seismographs in Schools program gives schools the opportunity to apply for a low-cost educational seismograph and to receive training for its use in the classroom. To provide better service to the community, a new Seismographs in Schools website was developed in the past year with enhanced functions to help teachers improve their teaching of seismology. The site encourages schools to make use of seismic data and communicate with other educational seismology users throughout the world. Users can view near-real-time displays of other participating schools, upload and download data, and use the “find a teacher” tool to contact nearby schools that also may be operating seismographs. In order to promote and maintain program participation and communication, the site features a discussion forum to encourage and support the growing global community of educational seismograph users. Any data that is submitted to the Seismographs in Schools Website is also accessible

  9. The expanding role of civil society in the global HIV/AIDS response: what has the President's Emergency Program For AIDS Relief's role been?

    Science.gov (United States)

    Coutinho, Alex; Roxo, Uchechi; Epino, Henry; Muganzi, Alex; Dorward, Emily; Pick, Billy

    2012-08-15

    Civil society has been part of the HIV/AIDS response from the very beginning of the epidemic, often becoming engaged before national governments. Traditional roles of civil society--advocacy, activism, serving as government watchdog, and acting as community caretaker--have been critical to the response. In addition, civil society organizations (CSOs) play an integral part in providing world-class HIV prevention and treatment services and helping to ensure continuity of care. The President's Emergency Program for AIDS Relief (PEPFAR) has significantly increased the global scale-up of combination antiretroviral therapy reaching for more than 5 million people in developing countries, as well as implementation of effective evidence-based combination prevention approaches. PEPFAR databases in 5 countries and annual reports from a centrally managed initiative were mined and analyzed to determine the numbers and types of CSOs funded by PEPFAR over a 5-year period (2006-2011). Data are also presented from Uganda showing the overall resource growth in CSO working for HIV. Case studies document the evolution of 3 indigenous CSOs that increased the capacity to implement activities with PEPFAR funding. A legacy of PEPFAR has been the growth of civil society to address social and health issues as well as recognition by governments that partnerships with beneficiaries and civil society result in better outcomes. Scale-up of the global response could not have happened without the involvement of civil society and people living with HIV. This game changing partnership to jointly tackle the problems that countries face may well be the greatest benefit emerging from the HIV epidemic.

  10. Grazing incidence beam expander

    Energy Technology Data Exchange (ETDEWEB)

    Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  11. Expanding the HAWC Observatory

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Johanna [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-08-17

    The High Altitude Water Cherenkov Gamma-Ray Observatory is expanding its current array of 300 water tanks to include 350 outrigger tanks to increase sensitivity to gamma rays above 10 TeV. This involves creating and testing hardware with which to build the new tanks, including photomultiplier tubes, high voltage supply units, and flash analog to digital converters. My responsibilities this summer included preparing, testing and calibrating that equipment.

  12. Backpack Programs and the Crisis Narrative of Child Hunger-A Critical Review of the Rationale, Targeting, and Potential Benefits and Harms of an Expanding but Untested Model of Practice.

    Science.gov (United States)

    Fram, Maryah S; Frongillo, Edward A

    2018-01-01

    In recent years, school-based food backpack programs (BPPs) have come into national prominence as a response to a perceived crisis of child hunger in America. Distributing bags of free food directly to schoolchildren for their own personal consumption each weekend, BPPs bring together private donors, faith communities, and public schools around an intuitively appealing project: children are hungry, and so we give them food. Perhaps because of their intuitive appeal, BPPs have expanded rapidly, without rigorous evaluation to determine their impacts on children, families, and schools. This Perspective aims to open up thinking about BPPs, first articulating the implicit conceptual model that undergirds BPPs, drawing on documentation offered by major program providers and on our own experience working with several schools implementing BPPs, to provide a window into what BPPs do and how and why they do it. We focus in particular on how the crisis narrative of child hunger has shaped the BPP model and on the related interplay between public sympathy and the neoliberal climate in which structural solutions to family poverty are eschewed. We then assess the BPP model in light of existing knowledge, concluding that BPPs fit poorly with the needs of the majority of children living in food-insecure households in the United States and consequently put children at risk of negative consequences associated with worry, shame, stigma, and disruptions to family functioning. Finally, we provide recommendations for practice and research, emphasizing the importance of 1) responding to children's actual needs throughout program implementation, 2) avoiding unnecessary risks by effective targeting of services to only those children who need them, and 3) rigorously evaluating program outcomes and unintended consequences to determine whether, even for the small number of US children who experience hunger, the benefits of the BPP model outweigh its psychosocial costs. © 2018 American

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

    Science.gov (United States)

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

    2017-12-01

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

  14. Feasibility of Using a Community-Supported Agriculture Program to Increase Access to and Intake of Vegetables among Federally Qualified Health Center Patients.

    Science.gov (United States)

    Izumi, Betty T; Higgins, Cesar E; Baron, Andrea; Ness, Sylvia J; Allan, Bryan; Barth, Elizabeth T; Smith, Teresa M; Pranian, Katy; Frank, Brian

    2017-11-21

    This study explored the feasibility of using a 23-week subsidized community-supported agriculture program to increase access to and intake of vegetables among Federally Qualified Health Center patients. Outcomes were measured using pre-post intervention surveys (n = 9). Process data were collected in post-intervention surveys and focus groups (n = 15). Most participants (77%) indicated that the program improved their health and all (100%) reported that they were eating a greater variety of vegetables because of their participation in the program. Three themes emerged from the focus groups: increased access to fresh and/or organic vegetables, improved diet quality, and the importance of social support during the program. Linking subsided community-supported agriculture programs with Federally Qualified Health Centers has the potential to increase access to and intake of vegetables among low-income patients. However, further research is needed with a larger sample size and a more robust study design. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  15. Provisional Admission Practices: Blending Access and Support to Facilitate Student Success

    Science.gov (United States)

    Nichols, Andrew Howard; Clinedinst, Melissa

    2013-01-01

    This report examines provisional admission as an initiative that can expand four-year college access and success for students from economically disadvantaged backgrounds. Provisional admission policies and programs enable students to enroll at an institution under specific conditions. Students are often required to meet certain academic…

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

    Science.gov (United States)

    Squitieri, Lee; Chung, Kevin C

    2017-07-01

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

  17. Accessibility in Teaching Assistant Training: A Critical Review of Programming from Ontario’s Teaching and Learning Centres

    OpenAIRE

    Marie Vander Kloet

    2015-01-01

    It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and other materials provided by Ontario’s teaching and learning centres, this paper seeks to do two things. First, it provides a critical overview of t...

  18. Preventive Ethics Through Expanding Education.

    Science.gov (United States)

    Ho, Anita; MacDonald, Lisa Mei-Hwa; Unger, David

    2016-03-01

    Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers' schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects.

  19. The expanding universe

    CERN Document Server

    Lew, Kristi

    2011-01-01

    People have always been fascinated with the stars above and the universe that contains them. Over the years, astronomers have developed numerous theories to explain how the universe began, how it works, and what its ultimate fate will be. But all of the scientists' questions are far from answered. The Expanding Universe goes beyond the creation of the universe to explain how scientists think the universe works, grows, and changes, including what great thinkers Isaac Newton and Albert Einstein had to say about its fate. Readers will also learn about how researchers are slowly shedding light on

  20. Expanding Your Horizon 2015

    CERN Multimedia

    Kaltenhauser, Kristin

    2015-01-01

    Expanding your horizons is a bi-annual “Science Day” for girls aged 11 to 14, held at the University of Geneva on 14 November. The girls had the opportunity to take part in hands-on workshops held by local professional women in the field of science, mathematics, engineering and technology. For the fourth time, CERN was part of this event, offering three workshops as well as a booth at the Discovery Fair, including Higgnite, an interactive visualization of the Higgs Field.

  1.  Daclatasvir plus asunaprevir dual therapy for chronic HCV genotype 1b infection: results of Turkish early access program.

    Science.gov (United States)

    Köklü, Seyfettin; Köksal, Iftihar; Akarca, Ulus Salih; Balkan, Ayhan; Güner, Rahmet; Demirezen, Aylin; Sahin, Memduh; Akhan, Sila; Ozaras, Reşat; Idilman, Ramazan

     Background. Daclatasvir and asunaprevir dual therapy is approved for the treatment of HCV genotype 1b infection in several countries. To evaluate the efficacy and safety of daclatasvir and asunaprevir dual therapy in Turkish patients. Sixty-one patients with HCV genotype 1b were enrolled in the Turkish early access program. Most of the patients were in difficult-to-treat category. Patients were visited at each 4 week throughout the follow-up period. Laboratory findings and adverse events were recorded at each visit. Fifty-seven of 61 enrolled patients completed 24 weeks of treatment. Two patients died as a result of underlying diseases at 12-14th weeks of treatment. Two patients stopped the treatment early as a consequence of virological breakthrough, and 2 patients had viral relapse at the post-treatment follow-up. Overall SVR12 rates were 90% (55/61) and 93.2% (55/59) according to intention-to-treat (ITT) and per protocol (PP) analysis respectively. In ITT analysis, SVR12 was achieved by 93% (13/14) in relapsers, 80% (12/15) in interferon-ineligible patients and 91% (20/22) in previous nonresponder patients. SVR12 rates were 86.5% and 91.4% in patients with cirrhosis according to ITT and PP analysis respectively. SVR12 was 95.8% in non-cirrhosis group in both analysis. Patients with previous protease inhibitor experience had an SVR12 of 87.5%. Common adverse events developed in 28.8% of patients. There were no treatment related severe adverse event or grade-4 laboratory abnormality. Daclatasvir and asunaprevir dual therapy is found to be effective and safe in difficult-to-treat Turkish patients with HCV genotype 1b infection.

  2. Access 2010 Programmer's Reference

    CERN Document Server

    Hennig, Teresa; Griffith, Geoffrey L

    2010-01-01

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

  3. Rural people who inject drugs: A cross-sectional survey addressing the dimensions of access to secondary needle and syringe program outlets.

    Science.gov (United States)

    Fisher, Karin; Smith, Tony; Nairn, Karen; Anderson, Donna

    2017-04-01

    To better understand issues related to access to injecting equipment for people who inject drugs (PWID) in a rural area of New South Wales (NSW), Australia. Cross-sectional face-to-face survey using convenience and snowball sampling. Six regional and rural population centres in Northern NSW, within the Hunter New England Local Health District. The sample included 190 PWID who had accessed a needle and syringe program outlet within 4 weeks of the survey. Data include demographic information, preferred location for accessing injecting equipment, reasons for that preference, whether they obtained enough equipment, travelling distance to an NSP and self-reported hepatitis C virus status. Sixty percent self-identified as Aboriginal people. The median age of respondents was 32 years and 60% were men. A significantly larger proportion (P equipment at a community health facility (62.6%), as opposed to other secondary outlets, where they gained enough equipment (67.4%). Just over 80% said they were tested for HCV in the past year, with about 37% told they had tested positive. There are complex dimensions affecting how rural PWID access secondary NSP outlets. Although access is similarly limited as other rural health services because of the nature of injecting drug use and sensitivities existing in rural communities, there is potential for application of unique access models, such as, promoting secondary distribution networks. © 2016 National Rural Health Alliance Inc.

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

    Science.gov (United States)

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

    2012-06-01

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

  5. Expanding Media Reach

    Centers for Disease Control (CDC) Podcasts

    2007-11-01

    In this podcast, two nurses serving a Chinese American community show how they have used local ethnic media to communicate health messages.  Created: 11/1/2007 by National Diabetes Education Program (NDEP), a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health.   Date Released: 11/11/2007.

  6. Enhancing Ocean Research Data Access

    Science.gov (United States)

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

    2014-05-01

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

  7. Expanding hollow metal rings

    Science.gov (United States)

    Peacock, Harold B [Evans, GA; Imrich, Kenneth J [Grovetown, GA

    2009-03-17

    A sealing device that may expand more planar dimensions due to internal thermal expansion of a filler material. The sealing material is of a composition such that when desired environment temperatures and internal actuating pressures are reached, the sealing materials undergoes a permanent deformation. For metallic compounds, this permanent deformation occurs when the material enters the plastic deformation phase. Polymers, and other materials, may be using a sealing mechanism depending on the temperatures and corrosivity of the use. Internal pressures are generated by either rapid thermal expansion or material phase change and may include either liquid or solid to gas phase change, or in the gaseous state with significant pressure generation in accordance with the gas laws. Sealing material thickness and material composition may be used to selectively control geometric expansion of the seal such that expansion is limited to a specific facing and or geometric plane.

  8. Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program.

    Science.gov (United States)

    Pearson, Amber L; Kvizhinadze, Giorgi; Wilson, Nick; Smith, Megan; Canfell, Karen; Blakely, Tony

    2014-06-26

    Similar to many developed countries, vaccination against human papillomavirus (HPV) is provided only to girls in New Zealand and coverage is relatively low (47% in school-aged girls for dose 3). Some jurisdictions have already extended HPV vaccination to school-aged boys. Thus, exploration of the cost-utility of adding boys' vaccination is relevant. We modeled the incremental health gain and costs for extending the current girls-only program to boys, intensifying the current girls-only program to achieve 73% coverage, and extension of the intensive program to boys. A Markov macro-simulation model, which accounted for herd immunity, was developed for an annual cohort of 12-year-olds in 2011 and included the future health states of: cervical cancer, pre-cancer (CIN I to III), genital warts, and three other HPV-related cancers. In each state, health sector costs, including additional health costs from extra life, and quality-adjusted life-years (QALYs) were accumulated. The model included New Zealand data on cancer incidence and survival, and other cause mortality (all by sex, age, ethnicity and deprivation). At an assumed local willingness-to-pay threshold of US$29,600, vaccination of 12-year-old boys to achieve the current coverage for girls would not be cost-effective, at US$61,400/QALY gained (95% UI $29,700 to $112,000; OECD purchasing power parities) compared to the current girls-only program, with an assumed vaccine cost of US$59 (NZ$113). This was dominated though by the intensified girls-only program; US$17,400/QALY gained (95% UI: dominant to $46,100). Adding boys to this intensified program was also not cost-effective; US$128,000/QALY gained, 95% UI: $61,900 to $247,000).Vaccination of boys was not found to be cost-effective, even for additional scenarios with very low vaccine or program administration costs - only when combined vaccine and administration costs were NZ$125 or lower per dose was vaccination of boys cost-effective. These results suggest that

  9. Accessibility of standardized information of a national colorectal cancer screening program for low health literate screening invitees: A mixed method study.

    Science.gov (United States)

    Fransen, Mirjam P; Dekker, Evelien; Timmermans, Daniëlle R M; Uiters, Ellen; Essink-Bot, Marie-Louise

    2017-02-01

    To explore the accessibility of standardized printed information materials of the national Dutch colorectal cancer screening program among low health literate screening invitees and to assess the effect of the information on their knowledge about colorectal cancer and the screening program. Linguistic tools were used to analyze the text and design characteristics. The accessibility, comprehensibility and relevance of the information materials were explored in interviews and in observations (n=25). The effect of the information on knowledge was assessed in an online survey (n=127). The materials employed a simple text and design. However, respondents expressed problems with the amount of information, and the difference between screening and diagnostic follow-up. Knowledge significantly increased in 10 out of 16 items after reading the information but remained low for colorectal cancer risk, sensitivity of testing, and the voluntariness of colorectal cancer screening. Despite intelligible linguistic and design characteristics, screening invitees with low health literacy had problems in accessing, comprehending and applying standard information materials on colorectal cancer screening, and lacked essential knowledge for informed decision-making about participation. To enable equal access to informed decision-making, information strategies need to be adjusted to the skills of low health literate screening invitees. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Expanding Underrepresented Minority Participation: America's Science and Technology Talent at the Crossroads

    Science.gov (United States)

    Hrabowski, F. A.

    2011-12-01

    This talk will focus on the recent National Academies Report, Expanding Underrepresented Minority Participation: America's Science and Technology Talent at the Crossroads. The report (1) suggests stronger coordination among national agencies in developing policies and incentives for broadening participation and (2) focuses on the key roles of different types of educational institutions, from K-12 through higher education. The talk will focus on those issues most important for minority success in STEM, including academic preparation, access and motivation, academic and financial support, and social integration. Finally, Dr. Hrabowski will draw upon his experience in developing the Meyerhoff Scholars Program for talented minority students at his university.

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

    Science.gov (United States)

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

    2017-11-09

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

  12. Expanding Pharmacists' Scope of Practice to Include Immunization in Nova Scotia

    Directory of Open Access Journals (Sweden)

    Beth O'Reilly

    2017-07-01

    Full Text Available On 10 December 2010 An Act to Amend Chapter 36 of the Acts of 2001, the Pharmacy Act (Bill 7 received Royal Assent in Nova Scotia, including an amendment that enabled an expanded scope of pharmacy practice. Expanding pharmacists' scope of practice came about from recommendations by various federal and provincial government bodies as an attempt to improve accessibility to health care and decrease costs. In 2013, pharmacists in Nova Scotia began administering the influenza vaccine as part of the publicly funded program in attempts to improve vaccine coverage rates. Preliminary evaluation in Nova Scotia has shown an increase in influenza vaccination coverage. Although pharmacist administration of influenza vaccination may improve vaccination coverage and reduce demand on physician time, there may be tension created among the professions, which needs to be addressed and managed.

  13. Improving and expanding NGO programmes.

    Science.gov (United States)

    Mukhopadhyay, A

    1993-06-01

    India has massive problems and is in need of improving and expanding non governmental organization (NGO) programs by broadening the scope of NGO activities, identifying successful NGO activities, and by moving closer to the community to participate in their activities. The problems and experience in the last few decades indicate that with expansion bureaucratization takes place. The institution begins to depend on donors and follows donor-driven agendas. As more money is given by the government, many more so called GONGO or Government-NGO projects materialize. Another problem is that the government almost always approaches the NGOs for the implementation of a project, and there is complete lack of cooperation at the planning stage. The government is considering a loan from the World Bank and UNICEF to launch a mother and child health program, but there has not been any discussion with the dozens of people who have worked on issues concerning mother and child health issues for many years. There is a need to be more demanding of the government about the various programs that are implemented for the government. Very few NGO health and family welfare projects are run by ordinary nurses or ordinary Ayurvedic doctors under ordinary conditions. Since successful NGO work has to be extended to other parts of the country, they will have to be run by ordinary people with very ordinary resources. Over the years, the NGO community has become preoccupied with its own agenda. Today, despite very sophisticated equipment and infrastructure, they are not able to reach the 60,000-70,000 workers and employees. Some of the ideas with respect to the strengthens and weaknesses of community participation have to be shared. NGOs should include all the existing non governmental organizations throughout the country, and have a dialogue with other nongovernmental bodies such as trade unions. The challenge is to adjust the current agenda, prevailing style, and present way of operating and move

  14. Factors associated with access to HIV care services in eastern Uganda: the Kumi home based HIV counseling and testing program experience.

    Science.gov (United States)

    Lubogo, David; Ddamulira, John Bosco; Tweheyo, Raymond; Wamani, Henry

    2015-11-03

    The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. Approximately 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4-1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000-81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The aim of this study therefore, was to explore the factors associated with access to HIV care services among HIV seropositive clients identified by a home based HIV counseling and testing program in Kumi district, eastern Uganda. In a cross sectional study conducted in February 2009, we explored predictor variables: socio-demographics, health facility and community factors related to access to HIV care and treatment. The main outcome measure was reported receipt of cotrimoxazole for prophylaxis. The majority [81.1 % (284/350)] of respondents received cotrimoxazole prophylaxis (indicating access to HIV care). The main factors associated with access to HIV care include; age 25-34 years (AOR = 5.1, 95 % CI: 1.5-17.1), male sex (AOR = 2.3, 95 % CI: 1.2-4.4), urban residence (AOR = 2.5, CI: 1.1-5.9) and lack of family support (AOR = 0.5, CI: 0.2-0.9). There was relatively high access to HIV care and treatment services at health facilities for HIV positive clients referred from the Kumi home based HIV counseling and testing program. The factors associated with access to HIV care services include; age group, sex, residence and having a supportive family. Stakeholders involved in providing HIV care and treatment services in similar settings should therefore consider these socio-demographic variables as they formulate interventions to improve access to HIV care services.

  15. Access to modern contraception.

    Science.gov (United States)

    Welsh, Michael J; Stanback, John; Shelton, James

    2006-06-01

    Access to modern contraception has become a recognized human right, improving the health and well-being of women, families and societies worldwide. However, contraceptive access remains uneven. Irregular contraceptive supply, limited numbers of service delivery points and specific geographic, economic, informational, psychosocial and administrative barriers (including medical barriers) undermine access in many settings. Widening the range of providers enabled to offer contraception can improve contraceptive access, particularly where resources are most scarce. International efforts to remove medical barriers include the World Health Organization's Medical Eligibility Criteria. Based on the best available evidence, these criteria provide guidance for weighing the risks and benefits of contraceptive choice among women with specific clinical conditions. Clinical job aids can also improve access. More research is needed to further elucidate the pathways for expanding contraceptive access. Further progress in removing medical barriers will depend on systems for improving provider education and promoting evidence-based contraceptive service delivery.

  16. Expander chunked codes

    Science.gov (United States)

    Tang, Bin; Yang, Shenghao; Ye, Baoliu; Yin, Yitong; Lu, Sanglu

    2015-12-01

    Chunked codes are efficient random linear network coding (RLNC) schemes with low computational cost, where the input packets are encoded into small chunks (i.e., subsets of the coded packets). During the network transmission, RLNC is performed within each chunk. In this paper, we first introduce a simple transfer matrix model to characterize the transmission of chunks and derive some basic properties of the model to facilitate the performance analysis. We then focus on the design of overlapped chunked codes, a class of chunked codes whose chunks are non-disjoint subsets of input packets, which are of special interest since they can be encoded with negligible computational cost and in a causal fashion. We propose expander chunked (EC) codes, the first class of overlapped chunked codes that have an analyzable performance, where the construction of the chunks makes use of regular graphs. Numerical and simulation results show that in some practical settings, EC codes can achieve rates within 91 to 97 % of the optimum and outperform the state-of-the-art overlapped chunked codes significantly.

  17. Android Access Control Extension

    Directory of Open Access Journals (Sweden)

    Anton Baláž

    2015-12-01

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

  18. Impact of an easy-access telephonic interpreter program in the acute care setting: an evaluation of a quality improvement intervention.

    Science.gov (United States)

    Tuot, Delphine S; Lopez, Monica; Miller, Cecily; Karliner, Leah S

    2012-02-01

    Language barriers render interaction with the health care system difficult and lead to health disparities for patients with limited English proficiency (LEP). Despite a long-standing legal obligation for large health care organizations in the United States to try to provide free language access services for patients with LEP, professional interpretation is not always widely accessible, and even when it is, its use is often suboptimal. A dual-handset phone with 24-hour access to professional telephonic interpretation was placed at the bedside of all patients admitted to the general medicine floor of a tertiary care academic hospital. Nurses and physicians were surveyed before and after the easy-access interpretation program's implementation. Distribution of pre- and postimplementation surveys to 127 and 122 nurses, respectively, yielded a total of 163 completed surveys (overall participation rate, 65%). Distribution of surveys to 96 and 78 physicians, respectively, yielded 116 completed surveys (overall participation rate, 67%). After implementation, use of professional telephonic interpreters for communication with LEP patients increased fourfold, without a decrease in use of professional in-person interpreters. There were significant increases in professional interpreter use during brief communications with high error potential, including medication administration (odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.1-3.2) and pre-rounding (OR = 3.4, 95% CI 1.2-9.8). Increasing ease of access to dual-handset interpreter telephones promotes use of professional interpreters in the acute care setting. Future hospital policy should focus on further integrating language services into the hospital environment, accompanied by an educational program to assist in shifting professional norms toward use of professional interpreters.

  19. 大學經濟弱勢學生入學及就學扶助政策分析與建議 Expanding Access to and Participation in Higher Education for Low-SES Students: Policy Analysis and Suggestions

    Directory of Open Access Journals (Sweden)

    鄭英耀 Ying-Yao Cheng

    2015-12-01

    enacted numerous assistance strategies for the admission and retention of low-SES students, gaps still exist between these measures and the actual problems and considerations of students. For instance, low-SES students may choose schools that academically undermatch their performance, have little understanding of the admission process, or lack assistance in preparing admission applications. Thus, some policies may require revision to address the needs of such students. According to the strategies of developed country governments and top universities and evidences from empirical studies, this paper proposes numerous suggestions for improving low-SES students’ university admission and retention rates, including promoting widening participation programs, simplifying the admission application process, and constructing a single platform website integrating all information on application and assistance relevant to low-SES students. With these suggestions, the authors hope to reinforce the concept of campus diversity and assist low-SES students improve their current situation.

  20. Derandomization, Hashing and Expanders

    DEFF Research Database (Denmark)

    Ruzic, Milan

    that independent and unbiased random bits are accessible. However, truly random bits are scarce in reality. In practice, pseudorandom generators are used in place of random numbers; usually, even the seed of the generator does not come from a source of true random- ness. While things mostly work well in practice...... of work in this direction. There has been a lot of work in designing general tools for simulating randomness and making deterministic versions of randomized algorithms, with some loss in time and space performance. These methods are not tied to particular algorithms, but work on large classes of problems....... The central question in this area of computational complexity is \\P=BPP?". Instead of derandomizing whole complexity classes, one may work on derandomizing concrete problems. This approach trades generality for possibility of having much better performance bounds. There are a few common techniques...

  1. The Artful Universe Expanded

    Science.gov (United States)

    Barrow, John D.

    2005-07-01

    Our love of art, writes John Barrow, is the end product of millions of years of evolution. How we react to a beautiful painting or symphony draws upon instincts laid down long before humans existed. Now, in this enhanced edition of the highly popular The Artful Universe , Barrow further explores the close ties between our aesthetic appreciation and the basic nature of the Universe. Barrow argues that the laws of the Universe have imprinted themselves upon our thoughts and actions in subtle and unexpected ways. Why do we like certain types of art or music? What games and puzzles do we find challenging? Why do so many myths and legends have common elements? In this eclectic and entertaining survey, Barrow answers these questions and more as he explains how the landscape of the Universe has influenced the development of philosophy and mythology, and how millions of years of evolutionary history have fashioned our attraction to certain patterns of sound and color. Barrow casts the story of human creativity and thought in a fascinating light, considering such diverse topics as our instinct for language, the origins and uses of color in nature, why we divide time into intervals as we do, the sources of our appreciation of landscape painting, and whether computer-generated fractal art is really art. Drawing on a wide variety of examples, from the theological questions raised by St. Augustine and C.S. Lewis to the relationship between the pure math of Pythagoras and the music of the Beatles, The Artful Universe Expanded covers new ground and enters a wide-ranging debate about the meaning and significance of the links between art and science.

  2. Providing researchers with online access to NHLBI biospecimen collections: The results of the first six years of the NHLBI BioLINCC program.

    Science.gov (United States)

    Giffen, Carol A; Wagner, Elizabeth L; Adams, John T; Hitchcock, Denise M; Welniak, Lisbeth A; Brennan, Sean P; Carroll, Leslie E

    2017-01-01

    The National Heart, Lung, and Blood Institute (NHLBI), within the United States' National Institutes of Health (NIH), established the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) in 2008 to develop the infrastructure needed to link the contents of the NHLBI Biorepository and the NHLBI Data Repository, and to promote the utilization of these scientific resources by the broader research community. Program utilization metrics were developed to measure the impact of BioLINCC on Biorepository access by researchers, including visibility, program efficiency, user characteristics, scientific impact, and research types. Input data elements were defined and are continually populated as requests move through the process of initiation through fulfillment and publication. This paper reviews the elements of the tracking metrics which were developed for BioLINCC and reports the results for the first six on-line years of the program.

  3. Accessibility in Teaching Assistant Training: A Critical Review of Programming from Ontario’s Teaching and Learning Centres

    Directory of Open Access Journals (Sweden)

    Marie Vander Kloet

    2015-06-01

    Full Text Available It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and other materials provided by Ontario’s teaching and learning centres, this paper seeks to do two things. First, it provides a critical overview of the types of training currently available at Ontario universities for teaching assistants on accessibility and teaching. This review will outline initiatives directed towards compliance with Accessibility for Ontarians with Disabilities Act (AODA requirements, those focused on education and advocacy (as well as areas of overlap and broader equity training which encompasses accessibility. Second, this paper, considering the content of the reviewed material and informed by critical disability studies, offers up an articulation of future directions for research, writing, advocacy, and training on teaching assistant development on accessible teaching. Il est de plus en plus accepté que l’éducation universitaire doit être accessible aux personnes handicapées. Certes, la responsabilité de rendre l’université accessible est partagée par tous et pourtant, la mesure dans laquelle celle-ci est devenue totalement accessible est sans nul doute suspecte. Après avoir entrepris des analyses qualitatives et discursives de sites web, de textes en ligne et d’autres documents fournis par des centres d’enseignement et d’apprentissage de l’Ontario, on cherche dans cet article à accomplir deux choses. Tout d’abord, l’article présente un aperçu critique des types de formation disponibles à l’heure actuelle dans les universités de l’Ontario à l’intention des enseignants auxiliaires sur l’accessibilité et l’enseignement. Cet examen va d

  4. Enhancing Accessibility and Engagement in Evidence-Based Parenting Programs to Reduce Maltreatment: Conversations With Vulnerable Parents

    OpenAIRE

    Love, Susan M.; Sanders, Matthew R.; Metzler, Carol W.; Prinz, Ronald J.; Kast, Elizabeth Z.

    2013-01-01

    11 focus groups (N = 160) of high-risk parents in Los Angeles County were asked to assess the value of social media to deliver an evidence-based parenting program, Triple P—Positive Parenting Program, to reduce child maltreatment. For feasibility, (N = 238) parents were surveyed regarding their internet use. Parents responded enthusiastically to the online program, and expressed the importance of a sense of community and learning through the experiences of others. 78% of the young, high-pover...

  5. Can an internet-based program for the prevention and early intervention in eating disorders facilitate access to conventional professional healthcare?

    Science.gov (United States)

    Moessner, Markus; Minarik, Carla; Özer, Fikret; Bauer, Stephanie

    2016-10-01

    The majorities of individual suffering from eating disorders do not seek or receive adequate professional treatment. Internet-based approaches promise to facilitate access to conventional healthcare by providing an easy-access, low-threshold contact. The current study investigated whether an Internet-based program for the prevention and early intervention for eating disorders (ProYouth) may contribute to the actual and intended uptake of professional care. Characteristics of individuals who seek help are explored as well as barriers to help-seeking. The sample included 453 ProYouth participants who were surveyed three months after registration. Actual help-seeking behavior, intended help-seeking, potential help-seeking, and barriers to help-seeking were assessed. Within three months of participation, 43 individuals (9.5%) took up treatment, 32 (7.8%) intended to start treatment, and 163 (43.1%) of the remaining reported that they would seek professional help in case of need (potential help-seeking). Approximately 50% of (potential) help-seekers stated that participation in ProYouth has changed their attitude towards help-seeking. Mental health literacy and shame/stigma were the most frequently mentioned barriers. This is the first study indicating that an online program for prevention and early intervention may serve as facilitator in accessing conventional healthcare.

  6. Romania's accession process into the European Union: discourses at policy-, program-, and project-levels in the justice sector

    NARCIS (Netherlands)

    D. Rem (Dana); D.R. Gasper (Des)

    2008-01-01

    textabstractSpecial arrangements were made by the European Union for decision-making on the possible accession of Romania and Bulgaria. A regime of extra procedures was added to the arrangements used for the Eastern European countries which joined the Union in 2004. This paper examines how the

  7. Multiple access to sterile syringes for injection drug users: vending machines, needle exchange programs and legal pharmacy sales in Marseille, France.

    Science.gov (United States)

    Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y

    2001-03-01

    In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel

  8. Teaching Students to Write across a Border: A Writing Curriculum for Inner-City College Access Programs

    Science.gov (United States)

    Dobbs, Jennifer Kwon

    2012-01-01

    This article explores the development of the Summer Tools, Information, Motivation, and Education (SummerTIME) Writing Program, the only program of its kind in Los Angeles that conducts self-assessment. The author describes the geographical and political boundaries separating inner-city Los Angeles high school graduates from higher education,…

  9. The Southern Rural Access Program and Alabama's Rural Health Leaders Pipeline: a partnership to develop needed minority health care professionals.

    Science.gov (United States)

    Rackley, Benjamin P; Wheat, John R; Moore, Cynthia E; Garner, Robert G; Harrell, Barbara W

    2003-01-01

    Rural Health Leaders Pipeline programs are intended to increase the number of youth interested in and pursuing health professions in rural communities. This paper presents 2 complementary approaches to Rural Health Leaders Pipeline programs. Two different organizations in Alabama recruit students from 18 specified counties. One organization is a rural, community-based program with college freshmen and upperclassmen from rural communities. Students shadow health professionals for 6 weeks, attend classes, visit medical schools, complete and present health projects, and receive support from online tutors. The second organization is a university-based program that supplements an existing 11th grade-medical school rural medicine pipeline with 10 minority students from rural communities who have graduated from high school and plan to enter college as premedical students in the following academic year. Students participate in classes, tutorials, seminars, and other activities. Students earn college credits during the 7-week program, maintain contact with program staff during the school year, and by performance and interest can continue in this pipeline program for a total of 4 consecutive summers, culminating in application to medical school. Each organization provides stipends for students. Early experiences have been positive, although Rural Health Leaders Pipeline programs are expensive and require long-term commitments.

  10. Mobility, Accessibility, and Travel Impacts of Transportation Programs for the Elderly and Handicapped. Working Paper: 5050-4-6.

    Science.gov (United States)

    Kirby, Ronald F.; McGillivray, Robert G.

    Special transportation assistance is currently provided for elderly and handicapped persons in the United States through a variety of programs at the federal, state, and local levels of government. The programs are concerned with improving the mobility of the client groups served, thereby making various activities and locations in urban areas more…

  11. End-user searching: impetus for an expanding information management and technology role for the hospital librarian.

    Science.gov (United States)

    Klein, M S; Ross, F

    1997-07-01

    Using the results of the 1993 Medical Library Association (MLA) Hospital Libraries Section survey of hospital-based end-user search services, this article describes how end-user search services can become an impetus for an expanded information management and technology role for the hospital librarian. An end-user services implementation plan is presented that focuses on software, hardware, finances, policies, staff allocations and responsibilities, educational program design, and program evaluation. Possibilities for extending end-user search services into information technology and informatics, specialized end-user search systems, and Internet access are described. Future opportunities are identified for expanding the hospital librarian's role in the face of changing health care management, advances in information technology, and increasing end-user expectations.

  12. Expanding Access to Insurance by the Poor : Policy, Regulation and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Boosting climate resilience for Colombian coffee growers. IDRC, Tim Hortons, and Cenicafé joining forces in a new partnership. Their goal is to reduce the vulnerability of Colombia's smallholder coffee growers to the climate-related challenges posing a... View moreBoosting climate resilience for Colombian coffee growers.

  13. Alternative Mechanisms for Expanding Access to Justice in Latin ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The approach will include a baseline study that will develop an inventory of initiatives and a theoretical framework to capture the main schools of thought and practice. Researchers will also participate in multidisciplinary, country-based case studies, and produce synthesis and policy papers for public officials in the region.

  14. Open data research: expanding the concept of free access

    OpenAIRE

    Sayão, Luis Fernando; SALES, Luana Farias

    2014-01-01

    The development of a new generation of experiments, sensors, instruments and simulation software causes the contemporary scientific research produce and use an extraordinary amount of data. This fact characterizes the emerging concept of e-Science, which offers a set of technological tools for collecting and analyzing research data and enables new approaches, applications, innovations and services are offered by modern science. However, for the data to be preserved they must undergo digital c...

  15. Expanding access to the management of HIV/ AIDS through ...

    African Journals Online (AJOL)

    Most of them referred to the mass media as their primary source of information. There is an urgent need for pro-active planning to prepare physicians in private practice for increasing demands in the management of HIV/AIDS in Nigeria. Organising a nation-wide training programme that would lead to ongoing accreditation ...

  16. Expanding Access through Technology: "The Drexel Virtual Symposium"

    Science.gov (United States)

    Clothey, Rebecca A.

    2010-01-01

    Distance learning, open source courseware, e-books, wikis, and many other innovative technologies have impacted the education fields by connecting any topic in any discipline to any learner in any place. Drexel University's School of Education capitalized on these possibilities earlier this year by hosting its second annual live and online Virtual…

  17. Mobility and conflict: Persistent challenges in expanding access to ...

    African Journals Online (AJOL)

    Alemayehu Debebe

    threat. Parents become anxious about safety of their children. The question of well- being remains a top priority than thinking of the instructional tasks among the teaching personnel. School supplies may cease to exist due to disruption in transport service. This study was carried out to examine the patterns of mobility and.

  18. Expanding access to rheumatology care: the rheumatology general practice toolbox.

    LENUS (Irish Health Repository)

    Conway, R

    2015-02-01

    Management guidelines for many rheumatic diseases are published in specialty rheumatology literature but rarely in general medical journals. Musculoskeletal disorders comprise 14% of all consultations in primary care. Formal post-graduate training in rheumatology is limited or absent for many primary care practitioners. Primary care practitioners can be trained to effectively treat complex diseases and have expressed a preference for interactive educational courses. The Rheumatology General Practice (GP) Toolbox is an intensive one day course designed to offer up to date information to primary care practitioners on the latest diagnostic and treatment guidelines for seven common rheumatic diseases. The course structure involves a short lecture on each topic and workshops on arthrocentesis, joint injection and DXA interpretation. Participants evaluated their knowledge and educational experience before, during and after the course. Thirty-two primary care practitioners attended, who had a median of 13 (IQR 6.5, 20) years experience in their specialty. The median number of educational symposia attended in the previous 5 years was 10 (IQR-5, 22.5), with a median of 0 (IQR 0, 1) in rheumatology. All respondents agreed that the course format was appropriate. Numerical improvements were demonstrated in participant\\'s confidence in diagnosing and managing all seven common rheumatologic conditions, with statistically significant improvements (p < 0.05) in 11 of the 14 aspects assessed. The Rheumatology Toolbox is an effective educational method for disseminating current knowledge in rheumatology to primary care physicians and improved participant\\'s self-assessed competence in diagnosis and management of common rheumatic diseases.

  19. The Expanding Universe: Dark Energy

    Energy Technology Data Exchange (ETDEWEB)

    Lincoln, Don [Fermilab; Nord, Brian [Fermilab

    2014-09-01

    In 1998, observations of distant supernovae led physicists that not only was the universe expanding, but the expansion was speeding up. In this article, we describe the evidence for an expanding universe and describe what physicists and cosmologists have learned in the intervening years. The target audience for this article is high school physics teachers and college physics professors at teaching institutions.

  20. Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

    Science.gov (United States)

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

    2013-09-01

    Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

  1. Coded Random Access

    DEFF Research Database (Denmark)

    Paolini, Enrico; Stefanovic, Cedomir; Liva, Gianluigi

    2015-01-01

    , in which the structure of the access protocol can be mapped to a structure of an erasure-correcting code defined on graph. This opens the possibility to use coding theory and tools for designing efficient random access protocols, offering markedly better performance than ALOHA. Several instances of coded......The rise of machine-to-machine communications has rekindled the interest in random access protocols as a support for a massive number of uncoordinatedly transmitting devices. The legacy ALOHA approach is developed under a collision model, where slots containing collided packets are considered...... as waste. However, if the common receiver (e.g., base station) is capable to store the collision slots and use them in a transmission recovery process based on successive interference cancellation, the design space for access protocols is radically expanded. We present the paradigm of coded random access...

  2. Sediment toxicity data from the NOAA National Status and Trends Program, March 1991 to July 1996 (NODC Accession 9800146)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — As part of its bioeffects assessment program. NOAA has begun a series of surveys of the toxicity and other biological effects of toxicants in selected bays and...

  3. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) from 07 June 1999 to 16 September 1999 (NODC Accession 0000513)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of Coral Reef Assessment and Monitoring Program (CRAMP) surveys taken in 1999 and include quantitative estimates of substrate type, rugosity,...

  4. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    Science.gov (United States)

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.

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

    Science.gov (United States)

    Watts, Sarah E; Andrews, Gavin

    2014-08-01

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

  6. Youth access to tobacco: the effects of age, gender, vending machine locks, and "it's the law" programs.

    Science.gov (United States)

    DiFranza, J R; Savageau, J A; Aisquith, B F

    1996-02-01

    This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in It's the Law programs. In communities with no requirements for lockout devices, illegal sales were far more likely from vending machines than from over-the-counter sources (odds ratio [OR] = 5.9, 95% confidence interval [CI] = 3.3, 10.3). Locks on vending machines made them equivalent to over-the-counter sources in terms of illegal sales to youths. Vendors participating in It's the Law programs were as likely to make illegal sales as nonparticipants (OR = 0.87, 95% CI = 0.57, 1.35). Girls and youths 16 years of age and older were more successful at purchasing tobacco. The It's the Law programs are ineffective in preventing illegal sales. While locks made vending machines equivalent to over-the-counter sources in their compliance with the law, they are not a substitute for law enforcement.

  7. AccessAbility @ Cleveland Public Library.

    Science.gov (United States)

    Mates, Barbara T.

    2003-01-01

    Describes several programs that were developed by staff at the Cleveland (Ohio) Public Library to be accessible to users with disabilities. Highlights include a Braille reading program; sensory garden; poetry club; book club based on talking books; wheelchair athletics; touching museum artifacts; and a mobile library for users who could not visit…

  8. Counseling on Access to Lethal Means (CALM): An Evaluation of a Suicide Prevention Means Restriction Training Program for Mental Health Providers.

    Science.gov (United States)

    Sale, Elizabeth; Hendricks, Michelle; Weil, Virginia; Miller, Collin; Perkins, Scott; McCudden, Suzanne

    2017-11-28

    This paper evaluates the effectiveness of the Counseling on Access to Lethal Means (CALM) suicide prevention program. CALM trains mental health providers how to counsel suicidal individuals and those who support them on mean restriction during times of crisis. Pre/post/3-month follow-up assessments measured knowledge of lethal means, confidence and comfort in discussing means restriction (self-efficacy), and future intentions to counsel clients on means restriction. Change in the number of clients receiving lethal means counseling was also assessed. All constructs increased significantly at posttest. Confidence and counseling intentions were sustained at follow-up and significantly more clients received means counseling in the 3 months following the CALM training. Knowledge and comfort levels decreased at follow-up but not to pre-training levels. CALM is effective at increasing mental health professionals' comfort, knowledge, and frequency of talking about means restriction with clients. an effective means restriction training program. A template to assess clients for suicidality and lethal means access and booster sessions are recommended to further sustain effects.

  9. 76 FR 4193 - Equal Access to Housing in HUD Programs-Regardless of Sexual Orientation or Gender Identity

    Science.gov (United States)

    2011-01-24

    ... enactments are a source of further evidence of housing discrimination ] based on sexual orientation or gender...., Laws Prohibiting Discrimination Based on Sexual Orientation and Gender Identity (Institute of Real... exclusion or discrimination on the basis of sexual orientation or gender identity in HUD programs. Such...

  10. Community Adaptation of Youth Accessing Residential Programs or a Home-Based Alternative: Contact with the Law and Delinquent Activities

    Science.gov (United States)

    Cameron, Gary; Frensch, Karen; Preyde, Michele; Quosai, Trudy Smit

    2011-01-01

    This article presents the findings from a longitudinal investigation of the prevalence of negative contact with the law for a sample of youth 12-18 months after graduating from residential and intensive children's mental health programming. Results of this study suggest serious community adaptation difficulties face many youth graduating from…

  11. CSU Standard for the CLSI Expanded Title Record.

    Science.gov (United States)

    Anderson, Karen; And Others

    The revised system specifications described in this document were adopted by the 19 California State University and College (CSUC) libraries for a second test version of the CLSI "Expanded Title Record" public access online catalog at California State University at Chico. Should this pilot demonstration of the data format prove…

  12. Proposed 'grant-and-access' program with price caps could stimulate development of drugs for very rare diseases.

    Science.gov (United States)

    Valverde, Ana M; Reed, Shelby D; Schulman, Kevin A

    2012-11-01

    The 1983 Orphan Drug Act created incentives for the development of orphan drugs. Despite its successes, including a substantial increase in new drugs, approved orphan drugs still treat fewer than 5 percent of registered rare diseases. In addition, concerns have arisen about the high prices of many of these therapies, which can cost hundreds of thousands of dollars per patient each year. In this article, we propose a new "grant-and-access pathway," in which drug developers could opt to compete for federal grants to subsidize the costs of clinical testing. In return for the grant funding, companies would no longer claim orphan drug tax credits and would agree to price caps for marketed products based on the duration and costs associated with drug development, expected market size, and target rate of return. We identify scenarios in which such a policy could provide a net benefit to society.

  13. The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

    Science.gov (United States)

    Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

    2012-09-01

    Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

  14. Strategies of Building a Stronger Sense of Community for Sustainable Neighborhoods: Comparing Neighborhood Accessibility with Community Empowerment Programs

    Directory of Open Access Journals (Sweden)

    Te-I Albert Tsai

    2014-05-01

    Full Text Available New Urbanist development in the U.S. aims at enhancing a sense of community and seeks to return to the design of early transitional neighborhoods which have pedestrian-oriented environments with retail shops and services within walking distances of housing. Meanwhile, 6000 of Taiwan’s community associations have been running community empowerment programs supported by the Council for Cultural Affairs that have helped many neighborhoods to rebuild so-called community cohesion. This research attempts to evaluate whether neighborhoods with facilities near housing and shorter travel distances within a neighborhood would promote stronger social interactions and form a better community attachment than neighborhoods that have various opportunities for residents to participate in either formal or informal social gatherings. After interviewing and surveying residents from 19 neighborhoods in Taipei’s Beitou District, and correlating the psychological sense of community with inner neighborhood’s daily travel distances and numbers of participatory activities held by community organizations under empowerment programs together with frequencies of regular individual visits and casual meetings, statistical evidence yielded that placing public facilities near residential locations is more effective than providing various programs for elevating a sense of community.

  15. An Open-Source Sandbox for Increasing the Accessibility of Functional Programming to the Bioinformatics and Scientific Communities.

    Science.gov (United States)

    Fenwick, Matthew; Sesanker, Colbert; Schiller, Martin R; Ellis, Heidi Jc; Hinman, M Lee; Vyas, Jay; Gryk, Michael R

    2012-01-01

    Scientists are continually faced with the need to express complex mathematical notions in code. The renaissance of functional languages such as LISP and Haskell is often credited to their ability to implement complex data operations and mathematical constructs in an expressive and natural idiom. The slow adoption of functional computing in the scientific community does not, however, reflect the congeniality of these fields. Unfortunately, the learning curve for adoption of functional programming techniques is steeper than that for more traditional languages in the scientific community, such as Python and Java, and this is partially due to the relative sparseness of available learning resources. To fill this gap, we demonstrate and provide applied, scientifically substantial examples of functional programming, We present a multi-language source-code repository for software integration and algorithm development, which generally focuses on the fields of machine learning, data processing, bioinformatics. We encourage scientists who are interested in learning the basics of functional programming to adopt, reuse, and learn from these examples. The source code is available at: https://github.com/CONNJUR/CONNJUR-Sandbox (see also http://www.connjur.org).

  16. Commercial sector can improve access.

    Science.gov (United States)

    Finger, W R

    1998-01-01

    This article discusses the improved accessibility to family planning (FP) services made possible by expanding services among private physicians and through social marketing in developing countries. Encouraging private sector (PS) FP is a way to ease the caseload of public FP facilities and creating the potential for attracting more lower-income clients. Few developing countries have a "viable commercial market" for contraceptives. Commercial success depends upon a secure supply of FP supplies, well-trained providers, and consumer demand. Consumers want affordable, high-quality, and convenient services. Governments must ensure that regulations do not hamper PS programs. Public and private programs should not compete in ways that are counterproductive. The commercial sector includes private physicians, clinics, pharmacies, or hospitals without public subsidies. Public funding might be used to encourage PS distribution, especially condoms and messages about HIV and sexually transmitted disease prevention. Messages may target specific audiences and promote an appealing logo and packaging. SOMARC in Turkey promotes a network of commercial health care facilities that offer high quality FP at affordable prices. The model includes provider training, quality of care monitoring, marketing, a hotline, posted prices, and prices set by consumer affordability surveys. This model is being tried in both Nepal and the Philippines. Commercial marketing has been successful in Latin America, North Africa, and the Middle East. Commercial expansion and survival is dependent upon the satisfaction of consumer preferences for convenience, greater access, better confidentiality, and quality. Examples from Zimbabwe and Romania are used to show strategies for training private providers. Private providers will become involved, for instance, by offering targeted training programs.

  17. ITAINNOVA AIDA-2020 Transnational Access

    CERN Multimedia

    ITAINNOVA, Zaragoza, Spain

    2017-01-01

    The AIDA-2020 Transnational Access program offers access to 10 European facilities, including the Electromagnetic Compatibility Laboratory (EMClab) at Instituto Tecnológico de Aragón (ITAINNOVA) in Spain.

  18. UCLouvain AIDA-2020 Transnational Access

    CERN Multimedia

    Universite catholique de Louvain, Belgium

    2016-01-01

    The AIDA-2020 Transnational Access program offers access to 10 European facilities, including the Centre de Recherche du Cyclotron (CRC) at the Universite catholique de Louvain (UCLouvain) in Belgium.

  19. ACCESS Pointing Control System

    Science.gov (United States)

    Brugarolas, Paul; Alexander, James; Trauger, John; Moody, Dwight; Egerman, Robert; Vallone, Phillip; Elias, Jason; Hejal, Reem; Camelo, Vanessa; Bronowicki, Allen; hide

    2010-01-01

    ACCESS (Actively-Corrected Coronograph for Exoplanet System Studies) was one of four medium-class exoplanet concepts selected for the NASA Astrophysics Strategic Mission Concept Study (ASMCS) program in 2008/2009. The ACCESS study evaluated four major coronograph concepts under a common space observatory. This paper describes the high precision pointing control system (PCS) baselined for this observatory.

  20. Accessing the Microform Publication.

    Science.gov (United States)

    Schindler, Stan

    1985-01-01

    Characterizes types of indexing programs used by Research Publications, Inc. and describes provision of access to four major projects: "The Official Washington Post Index" (provides access to newspaper and microfilm edition); "The Eighteenth Century"; "The Declassified Documents Reference System" (ongoing fiche…

  1. Open All Night: Using the Internet To Improve Access to Archives: A Case Study of the New York State Archives and Records Administration.

    Science.gov (United States)

    Ruller, Thomas J.

    1997-01-01

    Archives can use the Internet to enhance access to information about holdings, programs, and services; improve efficiency of traditional reference services; and expand use without an increased burden on existing resources. Reviews the experiences of the New York State Archives and Records Administration which operates Internet services using…

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-19

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

  3. Program Specificity for Ptf1a in Pancreas versus Neural Tube Development Correlates with Distinct Collaborating Cofactors and Chromatin Accessibility

    Science.gov (United States)

    Meredith, David M.; Borromeo, Mark D.; Deering, Tye G.; Casey, Bradford H.; Savage, Trisha K.; Mayer, Paul R.; Hoang, Chinh; Tung, Kuang-Chi; Kumar, Manonmani; Shen, Chengcheng; Swift, Galvin H.

    2013-01-01

    The lineage-specific basic helix-loop-helix transcription factor Ptf1a is a critical driver for development of both the pancreas and nervous system. How one transcription factor controls diverse programs of gene expression is a fundamental question in developmental biology. To uncover molecular strategies for the program-specific functions of Ptf1a, we identified bound genomic regions in vivo during development of both tissues. Most regions bound by Ptf1a are specific to each tissue, lie near genes needed for proper formation of each tissue, and coincide with regions of open chromatin. The specificity of Ptf1a binding is encoded in the DNA surrounding the Ptf1a-bound sites, because these regions are sufficient to direct tissue-restricted reporter expression in transgenic mice. Fox and Sox factors were identified as potential lineage-specific modifiers of Ptf1a binding, since binding motifs for these factors are enriched in Ptf1a-bound regions in pancreas and neural tube, respectively. Of the Fox factors expressed during pancreatic development, Foxa2 plays a major role. Indeed, Ptf1a and Foxa2 colocalize in embryonic pancreatic chromatin and can act synergistically in cell transfection assays. Together, these findings indicate that lineage-specific chromatin landscapes likely constrain the DNA binding of Ptf1a, and they identify Fox and Sox gene families as part of this process. PMID:23754747

  4. Strengthening and expanding the capacity of health worker education in Zambia.

    Science.gov (United States)

    Michelo, Charles; Zulu, Joseph Mumba; Simuyemba, Moses; Andrews, Benjamin; Katubulushi, Max; Chi, Benjamin; Njelesani, Evariste; Vwalika, Bellington; Bowa, Kasonde; Maimbolwa, Margaret; Chipeta, James; Goma, Fastone; Nzala, Selestine; Banda, Sekelani; Mudenda, John; Ahmed, Yusuf; Hachambwa, Lotti; Wilson, Craig; Vermund, Sten; Mulla, Yakub

    2017-01-01

    Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia. Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach. The MEPI program triggered the development of new postgraduate programs thereby increasing student enrollment. This was achieved by leveraging of existing and new partnerships with other universities and differentiating the old Master in Public Health into specialized curriculum. Furthermore, the MEPI program improved the capacity and quality of training by facilitating installation and integration of new technology such as the eGranary digital library, E-learning methods and clinical skills laboratory into the Schools. This technology enabled easy access to relevant data or information, quicker turn around of experiments and enhanced data recording, display and analysis features for experiments. The program also facilitated transforming of the academic environment into a more conducive work place through strengthening the Staff Development program and support towards research activities. These activities stimulated work motivation and interest in research by faculty. Meanwhile, these processes were inhibited by the inability to upload all courses on to Moodle as well as inadequate operating procedures and feedback mechanisms for the Moodle. Expansion and improvement in training processes for health care workers requires targeted investment within medical institutions and strengthening local and international partnerships.

  5. Expanding the Game Design Space

    DEFF Research Database (Denmark)

    Larsen, Lasse Juel; Majgaard, Gunver

    2016-01-01

    . It encapsulates the entire development process from the first ideas to the final game with emphasis on game design thinking. Our model of expanded game design space consists of four separate – yet interconnected – layers in the process of game development. The first layer addresses the importance of framing...... as a guideline for evaluating game design thinking and for measuring solutions made in the development process. To strengthen our model of expanded design space, we will present examples from our game design courses.......This article considers game design research in educational settings. Its focus is on how undergraduate students – particularly engineering students – learn computer game design. From observations conducted during our game design courses we have developed a model of expanded game design space...

  6. Utilizing Public Access Data and Open Source Statistical Programs to Teach Climate Science to Interdisciplinary Undergraduate Students

    Science.gov (United States)

    Collins, L.

    2014-12-01

    Students in the Environmental Studies major at the University of Southern California fulfill their curriculum requirements by taking a broad range of courses in the social and natural sciences. Climate change is often taught in 1-2 lectures in these courses with limited examination of this complex topic. Several upper division elective courses focus on the science, policy, and social impacts of climate change. In an upper division course focused on the scientific tools used to determine paleoclimate and predict future climate, I have developed a project where students download, manipulate, and analyze data from the National Climatic Data Center. Students are required to download 100 or more years of daily temperature records and use the statistical program R to analyze that data, calculating daily, monthly, and yearly temperature averages along with changes in the number of extreme hot or cold days (≥90˚F and ≤30˚F, respectively). In parallel, they examine population growth, city expansion, and changes in transportation looking for correlations between the social data and trends observed in the temperature data. Students examine trends over time to determine correlations to urban heat island effect. This project exposes students to "real" data, giving them the tools necessary to critically analyze scientific studies without being experts in the field. Utilizing the existing, public, online databases provides almost unlimited, free data. Open source statistical programs provide a cost-free platform for examining the data although some in-class time is required to help students navigate initial data importation and analysis. Results presented will highlight data compiled over three years of course projects.

  7. Effect of the health extension program and other accessibility factors on care-seeking behaviors for common childhood illnesses in rural Ethiopia.

    Science.gov (United States)

    Ashenafi, Addis; Karim, Ali Mehryar; Ameha, Agazi; Erbo, Amano; Getachew, Nebiyu; Betemariam, Wuleta

    2014-10-01

    In January 2011, Health Extension Workers (HEWs) of Ethiopia's Health Extension Program (HEP) began providing pneumonia case management for children less than five years of age through the integrated Community Case Management (iCCM) strategy. To report the effect of HEP, following the introduction of iCCM, and other accessibility factors on care-seeking behaviors for common childhood illnesses (acute respiratory infection [ARI], diarrhea, and fever). Three possible care-seeking outcomes for childhood illnesses were considered: not seeking appropriate care, seeking care from HEP sources, or seeking care from other appropriate sources. The baseline care-seeking outcomes from the Ethiopian Demographic and Health Survey, 2011, were compared with the care-seeking outcomes in a follow-up iCCM survey in December 2012. The effects of the HEP intensity and other factors on care-seeking outcomes were estimated using regression analyses. Appropriate care-seeking for children with acute respiratory infection, ARI, diarrhea, or fever increased two-fold, from 19% at baseline to 38% at follow-up, mainly due to an increase in seeking care for common child- hood illnesses from HEWs. Higher intensity of the HEP and other accessibility factors were associated with higher care-seeking for childhood illnesses from HEP sources. Incorporating iCCM within the HEP service package significantly improved the appropriate care-seeking behaviors for childhood illnesses in rural Ethiopia.

  8. Data Portal for the Library of Integrated Network-based Cellular Signatures (LINCS) program: integrated access to diverse large-scale cellular perturbation response data.

    Science.gov (United States)

    Koleti, Amar; Terryn, Raymond; Stathias, Vasileios; Chung, Caty; Cooper, Daniel J; Turner, John P; Vidovic, Dušica; Forlin, Michele; Kelley, Tanya T; D'Urso, Alessandro; Allen, Bryce K; Torre, Denis; Jagodnik, Kathleen M; Wang, Lily; Jenkins, Sherry L; Mader, Christopher; Niu, Wen; Fazel, Mehdi; Mahi, Naim; Pilarczyk, Marcin; Clark, Nicholas; Shamsaei, Behrouz; Meller, Jarek; Vasiliauskas, Juozas; Reichard, John; Medvedovic, Mario; Ma'ayan, Avi; Pillai, Ajay; Schürer, Stephan C

    2017-11-13

    The Library of Integrated Network-based Cellular Signatures (LINCS) program is a national consortium funded by the NIH to generate a diverse and extensive reference library of cell-based perturbation-response signatures, along with novel data analytics tools to improve our understanding of human diseases at the systems level. In contrast to other large-scale data generation efforts, LINCS Data and Signature Generation Centers (DSGCs) employ a wide range of assay technologies cataloging diverse cellular responses. Integration of, and unified access to LINCS data has therefore been particularly challenging. The Big Data to Knowledge (BD2K) LINCS Data Coordination and Integration Center (DCIC) has developed data standards specifications, data processing pipelines, and a suite of end-user software tools to integrate and annotate LINCS-generated data, to make LINCS signatures searchable and usable for different types of users. Here, we describe the LINCS Data Portal (LDP) (http://lincsportal.ccs.miami.edu/), a unified web interface to access datasets generated by the LINCS DSGCs, and its underlying database, LINCS Data Registry (LDR). LINCS data served on the LDP contains extensive metadata and curated annotations. We highlight the features of the LDP user interface that is designed to enable search, browsing, exploration, download and analysis of LINCS data and related curated content. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  9. Uganda's new national laboratory sample transport system: a successful model for improving access to diagnostic services for Early Infant HIV Diagnosis and other programs.

    Directory of Open Access Journals (Sweden)

    Charles Kiyaga

    Full Text Available INTRODUCTION: Uganda scaled-up Early HIV Infant Diagnosis (EID when simplified methods for testing of infants using dried blood spots (DBS were adopted in 2006 and sample transport and management was therefore made feasible in rural settings. Before this time only 35% of the facilities that were providing EID services were reached through the national postal courier system, Posta Uganda. The transportation of samples during this scale-up, therefore, quickly became a challenge and varied from facility to facility as different methods were used to transport the samples. This study evaluates a novel specimen transport network system for EID testing. METHODS: A retrospective study was done in mid-2012 on 19 pilot hubs serving 616 health facilities in Uganda. The effect on sample-result turnaround time (TAT and the cost of DBS sample transport on 876 sample-results was analyzed. RESULTS: The HUB network system provided increased access to EID services ranging from 36% to 51%, drastically reduced transportation costs by 62%, reduced turn-around times by 46.9% and by a further 46.2% through introduction of SMS printers. CONCLUSIONS: The HUB model provides a functional, reliable and efficient national referral network against which other health system strengthening initiatives can be built to increase access to critical diagnostic and treatment monitoring services, improve the quality of laboratory and diagnostic services, with reduced turn-around times and improved quality of prevention and treatment programs thereby reducing long-term costs.

  10. Uganda's new national laboratory sample transport system: a successful model for improving access to diagnostic services for Early Infant HIV Diagnosis and other programs.

    Science.gov (United States)

    Kiyaga, Charles; Sendagire, Hakim; Joseph, Eleanor; McConnell, Ian; Grosz, Jeff; Narayan, Vijay; Esiru, Godfrey; Elyanu, Peter; Akol, Zainab; Kirungi, Wilford; Musinguzi, Joshua; Opio, Alex

    2013-01-01

    Uganda scaled-up Early HIV Infant Diagnosis (EID) when simplified methods for testing of infants using dried blood spots (DBS) were adopted in 2006 and sample transport and management was therefore made feasible in rural settings. Before this time only 35% of the facilities that were providing EID services were reached through the national postal courier system, Posta Uganda. The transportation of samples during this scale-up, therefore, quickly became a challenge and varied from facility to facility as different methods were used to transport the samples. This study evaluates a novel specimen transport network system for EID testing. A retrospective study was done in mid-2012 on 19 pilot hubs serving 616 health facilities in Uganda. The effect on sample-result turnaround time (TAT) and the cost of DBS sample transport on 876 sample-results was analyzed. The HUB network system provided increased access to EID services ranging from 36% to 51%, drastically reduced transportation costs by 62%, reduced turn-around times by 46.9% and by a further 46.2% through introduction of SMS printers. The HUB model provides a functional, reliable and efficient national referral network against which other health system strengthening initiatives can be built to increase access to critical diagnostic and treatment monitoring services, improve the quality of laboratory and diagnostic services, with reduced turn-around times and improved quality of prevention and treatment programs thereby reducing long-term costs.

  11. Flow boiling in expanding microchannels

    CERN Document Server

    Alam, Tamanna

    2017-01-01

    This Brief presents an up to date summary of details of the flow boiling heat transfer, pressure drop and instability characteristics; two phase flow patterns of expanding microchannels. Results obtained from the different expanding microscale geometries are presented for comparison and addition to that, comparison with literatures is also performed. Finally, parametric studies are performed and presented in the brief. The findings from this study could help in understanding the complex microscale flow boiling behavior and aid in the design and implementation of reliable compact heat sinks for practical applications.

  12. Expanding nail or expanding femur? An adverse event with the expandable intramedullary nail.

    Science.gov (United States)

    Gangopadhyay, Soham; Riley, Nicholas D; Sivaji, Chellappan K

    2010-01-01

    The expandable intramedullary nail is self-locking and has the advantage of reducing operating time and exposure to ionizing radiation. The nail is recommended for simple diaphyseal fractures involving the middle third of long bones, where the nail can bypass the fracture site by at least 5 cm. We encountered a unique complication with the expandable nail in a simple transverse shaft fracture at the junction of the middle and distal third of the left femur in an otherwise healthy 57-year-old man. The fracture was reduced and a 12-mm expandable nail was inserted. Following full expansion, intraoperative radiographs were obtained prior to closure. After six postoperative weeks, it was noted that the nail expanded the femoral canal, converting a simple fracture to a distally progressing comminuted fracture with a butterfly fragment. A review of the intraoperative radiographs showed slight widening of the medullary canal at the level of the fracture. As the alignment was satisfactory and callus was present, no further surgical intervention was considered. The patient was advised not to bear weight and was provided with a locked knee brace in extension to wear for six weeks. Radiographs at 12 weeks demonstrated good progress of healing with adequate callus and the patient was permitted to bear weight as tolerated and commence knee flexion. The fracture united satisfactorily at four months. This adverse experience emphasizes that caution should be exercised when expanding the nail, with close observation of the medullary canal diameter during the later stages of expansion.

  13. Counting the Cost: A Report on APC-Supported Open Access Publishing in a Research Library

    OpenAIRE

    Newton, Mark P.; Cunningham, Eva T.; O'Connell, Kerri

    2014-01-01

    BACKGROUND At one-hundred twenty-two articles published, the open access journal Tremor and Other Hyperkinetic Movements (Tremor) is growing its readership and expanding its influence among patients, clinicians, researchers, and the general public interested in issues of non-Parkinsonian tremor disorders. Among the characteristics that set the journal apart from similar publications, Tremor is published in partnership with the library-based publications program at Columbia University’s Center...

  14. The Expanded Owens Valley Solar Array

    Science.gov (United States)

    Gary, Dale E.; Hurford, G. J.; Nita, G. M.; White, S. M.; Tun, S. D.; Fleishman, G. D.; McTiernan, J. M.

    2011-05-01

    The Expanded Owens Valley Solar Array (EOVSA) is now under construction near Big Pine, CA as a solar-dedicated microwave imaging array operating in the frequency range 1-18 GHz. The solar science to be addressed focuses on the 3D structure of the solar corona (magnetic field, temperature and density), on the sudden release of energy and subsequent particle acceleration, transport and heating, and on space weather phenomena. The project will support the scientific community by providing open data access and software tools for analysis of the data, to exploit synergies with on-going solar research in other wavelengths. The New Jersey Institute of Technology (NJIT) is expanding OVSA from its previous complement of 7 antennas to a total of 15 by adding 8 new antennas, and will reinvest in the existing infrastructure by replacing the existing control systems, signal transmission, and signal processing with modern, far more capable and reliable systems based on new technology developed for the Frequency Agile Solar Radiotelescope (FASR). The project will be completed in time to provide solar-dedicated observations during the upcoming solar maximum in 2013 and beyond. We provide an update on current status and our preparations for exploiting the data through modeling and data analysis tools. This research is supported by NSF grants AST-0908344, and AGS-0961867 and NASA grant NNX10AF27G to New Jersey Institute of Technology.

  15. Clinical trial on the effects of a free-access acidified milk replacer feeding program on the health and growth of dairy replacement heifers and veal calves.

    Science.gov (United States)

    Todd, C G; Leslie, K E; Millman, S T; Bielmann, V; Anderson, N G; Sargeant, J M; DeVries, T J

    2017-01-01

    The objectives of this study were to evaluate the effects of free-access acidified milk replacer feeding on the pre- and postweaning health of dairy and veal calves. Individually housed calves were systematically assigned at birth to 1 of 2 feeding programs: free-access feeding (ad libitum) of acidified milk replacer (ACD, n=249) or traditional restricted feeding (3L fed twice daily) of milk replacer (RES, n=249). Calves were fed milk replacer containing 24% crude protein and 18% fat. Acidified milk replacer was prepared to a target pH between 4.0 and 4.5 using formic acid. Calves were weaned off milk replacer at approximately 6wk of age. Weaning occurred over 5d, and during this weaning period, ACD calves had access to milk replacer for 12h/d and RES calves were offered only one feeding of milk replacer (3 L) daily. Calves were monitored daily for signs of disease. Fecal consistency scores were assigned each week from birth until weaning. A subset of calves was systematically selected for fecal sampling at 3 time points between 7 and 27d of age. Fecal samples were analyzed for enterotoxigenic Escherichia coli F5, Cryptosporidium parvum, rotavirus, and coronavirus. Hip width, hip height, body length, heart girth, and body weight were measured at birth and weaning. Postweaning body weight measurements were collected from the heifers at approximately 8mo of age. Postweaning body weight and carcass grading information was collected from the veal calves at slaughter once a live weight between 300 and 350kg had been achieved. The odds of ACD calves being treated for a preweaning disease event tended to be lower than that of the RES calves (1.2 vs. 5.2%, respectively). Preweaning mortality, postweaning disease treatment, and postweaning mortality did not differ between feeding treatments. The ACD feeding treatment supported greater preweaning average daily gain (0.59 vs. 0.43kg/d) and structural growth than RES feeding. Postweaning average daily gain and carcass

  16. Designing the Expanded Programme on Immunisation (EPI) as a service: Prioritising patients over administrative logic

    DEFF Research Database (Denmark)

    McKnight, J.; Holt, D. B.

    2014-01-01

    Expanded Programme on Immunisation (EPI) vaccination rates remain well below herd immunity in regions of many countries despite huge international resources devoted to both financing and access. We draw upon service marketing theory, organisational sociology, development anthropology and cultural...

  17. EFFECT OF INCORPORATING EXPANDED POLYSTYRENE ...

    African Journals Online (AJOL)

    2012-11-03

    Nov 3, 2012 ... Abstract. Incorporating expanded polystyrene granules in concrete matrix can produce lightweight polystyrene aggregate concrete of various densities. Workability which is an important property of concrete, affects the rate of placement and the degree of compaction of concrete. Inadequate compaction.

  18. Expanding the eukaryotic genetic code

    Science.gov (United States)

    Chin, Jason W.; Cropp, T. Ashton; Anderson, J. Christopher; Schultz, Peter G.

    2013-01-22

    This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

  19. Expanding the eukaryotic genetic code

    Energy Technology Data Exchange (ETDEWEB)

    Chin, Jason W.; Cropp, T. Ashton; Anderson, J. Christopher; Schultz, Peter G.

    2017-02-28

    This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

  20. U.S. physicians' views on financing options to expand health insurance coverage: a national survey.

    Science.gov (United States)

    McCormick, Danny; Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H; Himmelstein, David U

    2009-04-01

    Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. To assess physician views on financing options for expanding health care coverage and on access to health care. Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians.

  1. A spatial analysis to study access to emergency obstetric transport services under the public private "Janani Express Yojana" program in two districts of Madhya Pradesh, India.

    Science.gov (United States)

    Sabde, Yogesh; De Costa, Ayesha; Diwan, Vishal

    2014-07-22

    The government in Madhya Pradesh (MP), India in 2006, launched "Janani Express Yojana" (JE), a decentralized, 24X7, free emergency transport service for all pregnant women under a public-private partnership. JE supports India's large conditional cash transfer program, the "Janani Suraksha Yojana" (JSY) in the province and transports on average 60,000 parturients to hospital every month. The model is a relatively low cost one that potentially could be adopted in other parts of India and South Asia. This paper describes the uptake, time taken and geographic equity in access to the service to transport women to a facility in two districts of MP. This was a facility based cross sectional study. We interviewed parturients (n = 468) who delivered during a five day study period at facilities with >10 deliveries/month (n = 61) in two study districts. The women were asked details of transportation used to arrive at the facility, time taken and their residential addresses. These details were plotted onto a Geographic Information System (GIS) to estimate travelled distances and identify statistically significant clusters of mothers (hot spots) reporting delays >2 hours. JE vehicles were well dispersed across the districts and used by 236 (50.03%) mothers of which 111(47.03%) took >2 hours to reach a facility. Inability of JE vehicle to reach a mother in time was the main reason for delays. There was no correlation between the duration of delay and distance travelled. Maps of the travel paths and travel duration of the women are presented. The study identified hot spots of mothers with delays >2 hours and explored the possible reasons for longer delays. The JE service was accessible in all parts of the districts. Relatively high utilization rates of JE indicate that it ably supported JSY program to draw more women for institutional deliveries. However, half of the JE users experienced long (>2 hour) delays. The delayed mothers clustered in difficult terrains of the districts

  2. The awareness of patients with non - muscle invasive bladder cancer regarding the importance of smoking cessation and their access to smoking cessation programs.

    Science.gov (United States)

    Yuruk, Emrah; Tuken, Murat; Colakerol, Aykut; Serefoglu, Ege Can

    2017-01-01

    Smoking is the most important risk factor for bladder cancer and smoking cessation is associated with reduced risk of tumor recurrence and progression. The aim of this study is to assess the awareness of non-muscle invasive bladder cancer (NMIBC) patients regarding the importance of smoking cessation, determine their access to smoking cessation programs and the effects of smoking cessation on recurrence rates of NMIBC. NMIBC patients who were followed with cystoscopy were included in the study. Their demographic properties were recorded, along with their smoking habits, awareness regarding the effects of smoking on bladder cancer and previous attempts for smoking cessation. Moreover, the patients were asked whether they applied for a smoking cessation program. Recurrence of bladder cancer during the follow-up period was also noted. A total of 187 patients were included in the study. The mean age was 64.68±12.05 (range: 15-90) and the male to female ratio was 167/20. At the time of diagnosis, 114 patients (61.0%) were active smokers, 35 patients (18.7%) were ex-smokers and 38 patients (20.3%) had never smoked before. After the diagnosis, 83.3% of the actively smoking patients were advised to quit smoking and 57.9% of them quit smoking. At the time of the study, 46.52% of the NMIBC patients were aware of the link between smoking and bladder cancer, whereas only 4.1% of the smoking patients were referred to smoking cessation programs. After a mean follow-up of 32.28±11.42 months, 84 patients (44.91%) had recurrence; however, current smoking status or awareness of the causative role of smoking on NMIBC did not affect the recurrence. In our study group, the majority of the NMIBC patients were not aware of the association between smoking and bladder cancer. Although most of the physicians advised patients to quit smoking, a significant amount of the patients were still active smokers during follow-up. Only a small proportion of patients were referred to smoking

  3. Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

    Science.gov (United States)

    Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

    2017-04-21

    Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN

  4. Expanding the uses of AHRQ's prevention quality indicators: validity from the clinician perspective.

    Science.gov (United States)

    Davies, Sheryl; McDonald, Kathryn M; Schmidt, Eric; Schultz, Ellen; Geppert, Jeffrey; Romano, Patrick S

    2011-08-01

    The Agency for Healthcare Research and Quality's prevention quality indicators (PQIs) are used as a metric of area-level access to quality care. Recently, interest has expanded to using the measures at the level of payer or large physician groups, including public reporting or pay-for-performance programs. However, the validity of these expanded applications is unknown. We conducted a novel panel process to establish face validity of the 12 PQIs at 3 denominator levels: geographic area, payer, and large physician groups; and 3 uses: quality improvement, comparative reporting, and pay for performance. Sixty-four clinician panelists were split into Delphi and Nominal Groups. We aimed to capitalize on the reliability of the Delphi method and information sharing in the Nominal group method by applying these techniques simultaneously. We examined panelists' perceived usefulness of the indicators for specific uses using median scores and agreement within and between groups. Panelists showed stronger support of the usefulness of chronic disease indicators at the payer and large physician group levels than for acute disease indicators. Panelists fully supported the usefulness of 2 indicators for comparative reporting (asthma, congestive heart failure) and no indicators for pay-for-performance applications. Panelists expressed serious concerns about the usefulness of all new applications of 3 indicators (angina, perforated appendix, dehydration). Panelists rated age, current comorbidities, earlier hospitalization, and socioeconomic status as the most important risk-adjustment factors. Clinicians supported some expanded uses of the PQIs, but generally expressed reservations. Attention to denominator definitions and risk adjustment are essential for expanded use.

  5. Environmental assessment, expanded Ponnequin wind energy project, Weld County, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The US Department of Energy (DOE) has considered a proposal from the State of Colorado, Office of Energy Conservation (OEC), for funding construction of the Expanded Ponnequin Wind Project in Weld County, Colorado. OEC plans to enter into a contracting arrangement with Public Service Company of Colorado (PSCo) for the completion of these activities. PSCo, along with its subcontractors and business partners, are jointly developing the Expanded Ponnequin Wind Project. The purpose of this Final Environmental Assessment (EA) is to provide DOE and the public with information on potential environmental impacts associated with the Expanded Ponnequin Wind Energy Project. This EA, and public comments received on it, were used in DOE`s deliberations on whether to release funding for the expanded project under the Commercialization Ventures Program.

  6. Positive influence of the revised Special Supplemental Nutrition Program for Women, Infants, and Children food packages on access to healthy foods.

    Science.gov (United States)

    Andreyeva, Tatiana; Luedicke, Joerg; Middleton, Ann E; Long, Michael W; Schwartz, Marlene B

    2012-06-01

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has important potential for preventing diet-related disease in low-income children. WIC food packages were recently revised to offer foods that better reflect dietary recommendations for Americans. This article reports on how implementation of the new healthier WIC food packages affected access of low-income populations to healthy foods (eg, whole grains, fruit and vegetables, and lower-fat milk). A pre-post store inventory was completed using a standardized instrument to assess availability, variety, quality and prices of WIC-approved foods (65 food items). Stores were assessed before (spring 2009) and shortly after the new WIC package implementation (spring 2010). All convenience stores and nonchain grocery stores located in five towns of Connecticut (N=252), including 33 WIC-authorized stores and 219 non-WIC stores. The healthy food supply score was constructed to summarize postrevision changes in availability, variety, prices of healthy foods, and produce quality. The effect of the WIC food package revisions was measured by differential changes in the scores for stores authorized to accept WIC benefits and stores not participating in WIC, including differences by neighborhood income. Multivariate multilevel regression models were estimated. The 2009 introduction of the revised WIC food packages has significantly improved availability and variety of healthy foods in WIC-authorized and (to a smaller degree) non-WIC convenience and grocery stores. The increase in the composite score of healthy food supply varied from 16% in WIC convenience and grocery stores in higher-income neighborhoods to 39% in lower-income areas. Improved availability and variety of whole-grain products were responsible for most of the increase in the composite score of healthy food supply. Designed as cost-neutral changes, the WIC food package revisions have improved access to healthy foods for WIC participants

  7. Cabazitaxel in patients with metastatic castration-resistant prostate cancer: safety and quality of life data from the Australian early access program.

    Science.gov (United States)

    Parente, Phillip; Ng, Siobhan; Parnis, Francis; Guminski, Alex; Gurney, Howard

    2017-12-01

    Cabazitaxel is a next generation taxane that has been shown to improve overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC) whose disease progressed during or after docetaxel-based therapy. A worldwide early access program (EAP) study was established to provide access to cabazitaxel ahead of commercial availability and to evaluate its safety and tolerability. The Australian EAP included patient-reported outcomes to evaluate the impact of cabazitaxel on quality of life (QoL). The final safety and QoL results from the Australian EAP for cabazitaxel are reported. Australian patients with mCRPC previously treated with a docetaxel-containing regimen received cabazitaxel (25 mg/m2 ) every 3 weeks plus prednisone/prednisolone (10 mg daily) until disease progression, death, unacceptable toxicity, physician's decision or patient's refusal of further treatment. QoL data was collected using the AQoL-8D questionnaire. 104 patients from 18 Australian sites (median age at baseline, 70) enrolled in the EAP and completed at least one AQoL-8D questionnaire. Patients received a median of 6 cycles of cabazitaxel. 67 patients (64.4%) experienced grade ≥3 treatment-emergent adverse events (TEAEs); the most frequent TEAEs were neutropenia, febrile neutropenia, diarrhoea, and vomiting. QoL scores remained stable with increasing treatment cycles. The results suggest that the safety profile cabazitaxel is manageable in the Australian clinical practice setting and that QoL is maintained with little or no detrimental effect of cabazitaxel in patients continuing on treatment without disease progression. © 2017 John Wiley & Sons Australia, Ltd.

  8. Expanding the Game Design Space

    DEFF Research Database (Denmark)

    Larsen, Lasse Juel; Majgaard, Gunver

    2016-01-01

    layer establishes correspondence between formal elements of computer games and the structure of problem-based creativity. It addresses how game design challenges should be formulated and how creative solutions can be measured. The fourth and final layer demonstrates how clear framing can act......This article considers game design research in educational settings. Its focus is on how undergraduate students – particularly engineering students – learn computer game design. From observations conducted during our game design courses we have developed a model of expanded game design space....... It encapsulates the entire development process from the first ideas to the final game with emphasis on game design thinking. Our model of expanded game design space consists of four separate – yet interconnected – layers in the process of game development. The first layer addresses the importance of framing...

  9. Quantifying Carbon and distributional benefits of solar home system programs in Bangladesh

    OpenAIRE

    Wang, Limin; Bandyopadhyay, Sushenjit; Cosgrove-Davies, Mac; Samad, Hussain

    2011-01-01

    Scaling-up adoption of renewable energy technology, such as solar home systems, to expand electricity access in developing countries can accelerate the transition to low-carbon economic development. Using a purposely collected national household survey, this study quantifies the carbon and distributional benefits of solar home system programs in Bangladesh. Three key findings are generated...

  10. Wireless Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Wireless Access. Wireless connect to the Base station. Easy and Convenient access. Costlier as compared to the wired technology. Reliability challenges. We see it as a complementary technology to the DSL.

  11. Increasing Access to Mental Health Care With Breathe, an Internet-Based Program for Anxious Adolescents: Study Protocol for a Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Newton, Amanda S; Wozney, Lori; Bagnell, Alexa; Fitzpatrick, Eleanor; Curtis, Sarah; Jabbour, Mona; Johnson, David; Rosychuk, Rhonda J; Young, Michael; Ohinmaa, Arto; Joyce, Anthony; McGrath, Patrick

    2016-01-29

    There is a demand to make first-line treatments, including cognitive behavioural therapy (CBT) for adolescent anxiety disorders, more widely available. Internet-based CBT is proposed to circumvent access and availability barriers and reduce health care system costs. Recent reviews suggest more evidence is needed to establish the treatment effects of Internet-based CBT in children and adolescents and to determine related economic impacts. This pilot trial aims to collect the necessary data to inform the planning of a full-scale RCT to test the effectiveness of the Internet-based CBT program Breathe (Being Real, Easing Anxiety: Tools Helping Electronically). We are conducting a 27-month, 2-arm parallel-group, pilot randomized controlled trial (RCT). Outcomes will inform the planning of a full-scale RCT aimed to test the effectiveness of Internet-based CBT with a population of adolescents with moderate to mild anxiety problems. In the pilot RCT we will: (1) define a minimal clinically important difference (MCID) for the primary outcome measure (total anxiety score using the Multidimensional Anxiety Scale for Children); (2) determine a sample size for the full-scale RCT; (3) estimate recruitment and retention rates; (4) measure intervention acceptability to inform critical intervention changes; (5) determine the use of co-interventions; and (6) conduct a cost-consequence analysis to inform a cost-effectiveness analysis in the full-scale RCT. Adolescents aged 13-17 years seeking care for an anxiety complaint from a participating emergency department, mobile or school-based crisis team, or primary care clinic are being screened for interest and eligibility. Enrolled adolescents are being randomly allocated to either 8 weeks of Internet-based CBT with limited telephone and e-mail support, or a control group with access to a static webpage listing anxiety resources. Adolescents are randomly assigned using a computer generated allocation sequence. Data are being collected

  12. Open access

    NARCIS (Netherlands)

    Valkenburg, P.M.

    2015-01-01

    Open access week Van 19 tot en met 25 oktober 2015 vond wereldwijd de Open Access Week plaats. Tijdens deze week werden er over de hele wereld evenementen georganiseerd waar open access een rol speelt. Ook in Nederland zijn er diverse symposia, workshops en debatten georganiseerd zoals het debat in

  13. Free access to hypertension and diabetes medicines among the elderly: a reality yet to be constructed.

    Science.gov (United States)

    Paniz, Vera Maria Vieira; Fassa, Anaclaudia Gastal; Facchini, Luiz Augusto; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; da Silveira, Denise Silva; Rodrigues, Maria Aparecida; Domingues, Marlos Rodrigues; Bertoldi, Andréa Dâmaso

    2010-06-01

    The study evaluated free access to hypertension and diabetes medicines and the reasons reported for lack of access. The sample included 4,003 elderly people living in Primary Care Unit coverage areas from 41 Southern and Northeastern Brazilian cities. Free access was higher in the Northeast (62.4%). The strategy of the Family Health Program (Programa Saúde da Família - PSF) was more effective in providing access than the traditional model, with higher results in the Northeast (61.2%) than in the South (39.6%). Around 20% of medicines included in the Hypertension and Diabetes Program and 26% of those included in the National Essential Medicines List (RENAME) were paid out of pocket. In the Northeast, 25% of insulin and 32% of oral antidiabetics were paid out of pocket. Unavailability in the public sector and a lack of money determined the lack of access. Although the PSF, Hypertension and Diabetes Program and RENAME expanded free access, supplies were insufficient. A greater connection between programs and a clear definition of responsibilities can improve medicine acquisition process, increasing the effectiveness of pharmaceutical assistance.

  14. Staged repair of giant exomphalos major using tissue expanders

    Directory of Open Access Journals (Sweden)

    R.S. Shah

    2016-10-01

    Full Text Available Giant exomphalos, also called hepato-omphalocele, is a major exodus of abdominal viscera. Due to the large discrepancy between abdominal domain and the volume of extra abdominal organs, these defects present a significant challenge to pediatric surgeons. A 10 month old boy with antenatally diagnosed exomphalos major had a giant exomphalos 15 × 15 × 10 cm in size. Investigations revealed significant visceroabdominal disproportion, in view of which staged repair of the exomphalos was planned. An intraperitoneal silicon tissue expander was inserted for this child in the infra-umbilical abdominal cavity with the flat surface in the recto-vesical pouch through pfannenstiel incision & gradually inflated. Subsequently, subcutaneous expanders were placed in both flanks using minimal access technique to get adequate healthy skin cover prior to final ventral hernia repair. At eight years of age, the patient underwent exploratory laparotomy with ventral hernia repair with meshplasty using dual surface mesh & had an excellent and prompt recovery. There are numerous surgical techniques for giant omphalocele closure, which fall into the categories of staged, and delayed closure. Uniqueness of this case is combined use of both intraperitoneal and subcutaneous tissue expansion with the aid of minimal access technique in placement of subcutaneous expanders. The combined use of both intra-abdominal & subcutaneous expanders has not yet been reported in children.

  15. Strategies for expanding health insurance coverage in vulnerable populations

    OpenAIRE

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-01-01

    Background Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. Objectives To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), pa...

  16. DEMONSTRATION OF PACKAGING MATERIALS ALTERNATIVES TO EXPANDED POLYSTYRENE

    Science.gov (United States)

    This report represents the second demonstration of cleaner technologies to support the goals of the 33/50 Program under the EPA Cooperative Agreement No. CR-821848. The report presents assessment results of alternative packaging materials which could potentially replace expanded...

  17. Expanding Learning Opportunities for High School Students with Distance Learning

    Science.gov (United States)

    Beese, Jane

    2014-01-01

    The purpose of the Synchronous Interactive Video Conference Distance Learning pilot program was to use emerging technologies to expand learning opportunities for students at an urban public high school. Through grant funding, students were able to enroll in Advanced Placement and foreign language courses through an online learning provider. Using…

  18. Expanding the Spanish Classroom: The "Art" in Liberal Arts

    Science.gov (United States)

    Díaz, Erin M.

    2016-01-01

    Supplementing the foreign language curriculum with the incorporation of art museum visits has benefits for students, faculty, the campus art gallery, and the institution. Such a collaborative program serves to expand the classroom and complement instruction by providing learners with a new space to engage in authentic practice in the target…

  19. Gemini Observatory Takes its Local Communities on an Expanding Journey

    Science.gov (United States)

    Harvey, Janice; Michaud, Peter

    2012-08-01

    Currently in its 7th year (2011) Hawaii's annual Journey through the Universe (JttU) program is a flagship Gemini Observatory public education/outreach initiative involving a broad cross-section of the local Hawai'i Island astronomical community, the public, educators, businesses, local government officials, and thousands of local students. This paper describes the program, its history, planning, implementation, as well as the program's objectives and philosophy. The success of this program is documented here, as measured by continuous and expanding engagement of educators, the community, and the public, along with formal evaluation feedback and selected informal verbal testimony. The program's success also serves as justification for the planned adaptation of a version of the program in Chile in 2011 (adapted for Chilean educational and cultural differences). Finally, lessons learned are shared which have refined the program for Gemini's host communities but can also apply to any institution wishing to initiate a similar program.

  20. A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder.

    Science.gov (United States)

    Oswald, Tasha M; Winder-Patel, Breanna; Ruder, Steven; Xing, Guibo; Stahmer, Aubyn; Solomon, Marjorie

    2017-12-12

    The purpose of this pilot randomized controlled trial was to investigate the acceptability and efficacy of the Acquiring Career, Coping, Executive control, Social Skills (ACCESS) Program, a group intervention tailored for young adults with autism spectrum disorder (ASD) to enhance critical skills and beliefs that promote adult functioning, including social and adaptive skills, self-determination skills, and coping self-efficacy. Forty-four adults with ASD (ages 18-38; 13 females) and their caregivers were randomly assigned to treatment or waitlist control. Compared to controls, adults in treatment significantly improved in adaptive and self-determination skills, per caregiver report, and self-reported greater belief in their ability to access social support to cope with stressors. Results provide evidence for the acceptability and efficacy of the ACCESS Program.