Results-based financing for equitable access to maternal and child ...

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

The project will also look at the impact of results-based financing on health providers' motivation and teamwork, local leadership, community management committees of health facilities, access to and use of health ... L'importance des services de garde d'enfants pour améliorer les possibilités économiques des femmes.

An exploration of equitable science teaching practices for students with learning disabilities

Science.gov (United States)

Morales, Marlene

In this study, a mixed methods approach was used to gather descriptive exploratory information regarding the teaching of science to middle grades students with learning disabilities within a general education classroom. The purpose of this study was to examine teachers' beliefs and their practices concerning providing equitable opportunities for students with learning disabilities in a general education science classroom. Equitable science teaching practices take into account each student's differences and uses those differences to inform instructional decisions and tailor teaching practices based on the student's individualized learning needs. Students with learning disabilities are similar to their non-disabled peers; however, they need some differentiation in instruction to perform to their highest potential achievement levels (Finson, Ormsbee, & Jensen, 2011). In the quantitative phase, the purpose of the study was to identify patterns in the beliefs of middle grades science teachers about the inclusion of students with learning disabilities in the general education classroom. In the qualitative phase, the purpose of the study was to present examples of instruction in the classrooms of science education reform-oriented middle grades science teachers. The quantitative phase of the study collected data from 274 sixth through eighth grade teachers in the State of Florida during the 2007--2008 school year using The Teaching Science to Students with Learning Disabilities Inventory. Overall, the quantitative findings revealed that middle grades science teachers held positive beliefs about the inclusion of students with learning disabilities in the general education science classroom. The qualitative phase collected data from multiple sources (interviews, classroom observations, and artifacts) to develop two case studies of reform-oriented middle grades science teachers who were expected to provide equitable science teaching practices. Based on their responses to The

Undermining Racism and a Whiteness Ideology: White Principals Living a Commitment to Equitable and Excellent Schools

Science.gov (United States)

Theoharis, George; Haddix, Marcelle

2011-01-01

This article reports on six White urban principals who came to administration with a commitment to create more equitable and excellent schools for students from marginalized communities. These leaders made strides in raising student achievement, creating a climate of belonging for students, staff, and families, and increasing access to learning…

Open Access to Scientific Literature: An Assessment of Awareness Support and Usage among Academic Librarians at Historically Black Colleges and Universities

Science.gov (United States)

Evans, Marsha Ann Johnson

2012-01-01

Open Access (OA) to scholarly communications is a critical component in providing equitable admission to scholarly information and a key vehicle toward the achievement of global access to research in the knowledge building process. A standard and universally accepted process for guaranteeing OA permits complimentary access to knowledge, research…

Assessing equitable access to urban green space: the role of engineered water infrastructure.

Science.gov (United States)

Wendel, Heather E Wright; Downs, Joni A; Mihelcic, James R

2011-08-15

Urban green space and water features provide numerous social, environmental, and economic benefits, yet disparities often exist in their distribution and accessibility. This study examines the link between issues of environmental justice and urban water management to evaluate potential improvements in green space and surface water access through the revitalization of existing engineered water infrastructures, namely stormwater ponds. First, relative access to green space and water features were compared for residents of Tampa, Florida, and an inner-city community of Tampa (East Tampa). Although disparities were not found in overall accessibility between Tampa and East Tampa, inequalities were apparent when quality, diversity, and size of green spaces were considered. East Tampa residents had significantly less access to larger, more desirable spaces and water features. Second, this research explored approaches for improving accessibility to green space and natural water using three integrated stormwater management development scenarios. These scenarios highlighted the ability of enhanced water infrastructures to increase access equality at a variety of spatial scales. Ultimately, the "greening" of gray urban water infrastructures is advocated as a way to address environmental justice issues while also reconnecting residents with issues of urban water management.

How Should Organizations Promote Equitable Distribution of Benefits from Technological Innovation in Health Care?

Science.gov (United States)

Nambisan, Satish; Nambisan, Priya

2017-11-01

Technological innovations typically benefit those who have good access to and an understanding of the underlying technologies. As such, technology-centered health care innovations are likely to preferentially benefit users of privileged socioeconomic backgrounds. Which policies and strategies should health care organizations adopt to promote equitable distribution of the benefits from technological innovations? In this essay, we draw on two important concepts-co-creation (the joint creation of value by multiple parties such as a company and its customers) and digitalization (the application of new digital technologies and the ensuing changes in sociotechnical structures and relationships)-and propose a set of policies and strategies that health care organizations could adopt to ensure that benefits from technological innovations are more equitably distributed among all target populations, including resource-poor communities and individuals. © 2017 American Medical Association. All Rights Reserved.

Designing equitable antiretroviral allocation strategies in resource-constrained countries.

Directory of Open Access Journals (Sweden)

David P Wilson

2005-02-01

Full Text Available Recently, a global commitment has been made to expand access to antiretrovirals (ARVs in the developing world. However, in many resource-constrained countries the number of individuals infected with HIV in need of treatment will far exceed the supply of ARVs, and only a limited number of health-care facilities (HCFs will be available for ARV distribution. Deciding how to allocate the limited supply of ARVs among HCFs will be extremely difficult. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria.Here we use operations research techniques, and we show how to determine the optimal strategy for allocating ARVs among HCFs in order to satisfy the equitable criterion that each individual infected with HIV has an equal chance of receiving ARVs. We present a novel spatial mathematical model that includes heterogeneity in treatment accessibility. We show how to use our theoretical framework, in conjunction with an equity objective function, to determine an optimal equitable allocation strategy (OEAS for ARVs in resource-constrained regions. Our equity objective function enables us to apply the egalitarian principle of equity with respect to access to health care. We use data from the detailed ARV rollout plan designed by the government of South Africa to determine an OEAS for the province of KwaZulu-Natal. We determine the OEAS for KwaZulu-Natal, and we then compare this OEAS with two other ARV allocation strategies: (i allocating ARVs only to Durban (the largest urban city in KwaZulu-Natal province and (ii allocating ARVs equally to all available HCFs. In addition, we compare the OEAS to the current allocation plan of the South African government (which is based upon allocating ARVs to 17 HCFs. We show that our OEAS significantly improves equity in treatment accessibility in comparison with these three ARV allocation strategies. We also quantify how the size of the

Is health care financing in Uganda equitable?

Science.gov (United States)

Zikusooka, C M; Kyomuhang, R; Orem, J N; Tumwine, M

2009-10-01

Health care financing provides the resources and economic incentives for operating health systems and is a key determinant of health system performance. Equitable financing is based on: financial protection, progressive financing and cross-subsidies. This paper describes Uganda's health care financing landscape and documents the key equity issues associated with the current financing mechanisms. We extensively reviewed government documents and relevant literature and conducted key informant interviews, with the aim of assessing whether Uganda's health care financing mechanisms exhibited the key principles of fair financing. Uganda's health sector remains significantly under-funded, mainly relying on private sources of financing, especially out-of-pocket spending. At 9.6 % of total government expenditure, public spending on health is far below the Abuja target of 15% that GoU committed to. Prepayments form a small proportion of funding for Uganda's health sector. There is limited cross-subsidisation and high fragmentation within and between health financing mechanisms, mainly due to high reliance on out-of-pocket payments and limited prepayment mechanisms. Without compulsory health insurance and low coverage of private health insurance, Uganda has limited pooling of resources, and hence minimal cross-subsidisation. Although tax revenue is equitable, the remaining financing mechanisms for Uganda are inequitable due to their regressive nature, their lack of financial protection and limited cross-subsidisation. Overall, Uganda's current health financing is inequitable and fragmented. The government should take explicit action to promote equitable health care financing by establishing pre-payment schemes, enhancing cross-subsidisation mechanisms and through appropriate integration of financing mechanisms.

Equitable Coloring of Graphs. Recent Theoretical Results and New Practical Algorithms

Directory of Open Access Journals (Sweden)

Furmańczyk Hanna

2016-09-01

Full Text Available In many applications in sequencing and scheduling it is desirable to have an underlaying graph as equitably colored as possible. In this paper we survey recent theoretical results concerning conditions for equitable colorability of some graphs and recent theoretical results concerning the complexity of equitable coloring problem. Next, since the general coloring problem is strongly NP-hard, we report on practical experiments with some efficient polynomial-time algorithms for approximate equitable coloring of general graphs.

Shared Housing Arrangements in Germany—An Equitable Alternative to Long Term Care Services beyond Homes and Institutions?

Directory of Open Access Journals (Sweden)

Lorraine Frisina Doetter

2018-02-01

Full Text Available Given the saliency of socio-demographic pressures, the highly restrictive definition of “need for care” characterizing the German long-term care system at its foundations in 1994 has since been subject to various expansionary reforms. This has translated into greater interest in innovative care models that provide more choice and flexibility to beneficiaries. One such model is ‘shared housing arrangements’ (“ambulant betreute Wohngemeinschaften”, where a small group of people rent private rooms, while sharing a common space, domestic support, and nursing care. Using interview and secondary data, this study examines the potential for such arrangements to provide an equitable alternative to care that is accessible to a larger population of beneficiaries than presently seen in Germany.

Equitable science education in urban middle schools: Do reform efforts make a difference?

Science.gov (United States)

Hewson, Peter W.; Butler Kahle, Jane; Scantlebury, Kathryn; Davies, Darleen

2001-12-01

A central commitment of current reforms in science education is that all students, regardless of culture, gender, race, and/ or socioeconomic status, are capable of understanding and doing science. The study Bridging the Gap: Equity in Systemic Reform assessed equity in systemic reform using a nested research design that drew on both qualitative and quantitative methodologies. As part of the study, case studies were conducted in two urban middle schools in large Ohio cities. The purpose of the case studies was to identify factors affecting equity in urban science education reform. Data were analyzed using Kahle's (1998) equity metric. That model allowed us to assess progress toward equity using a range of research-based indicators grouped into three categories critical for equitable education: access to, retention in, and achievement in quality science education. In addition, a fourth category was defined for systemic indicators of equity. Analyses indicated that the culture and climate of the case study schools differentially affected their progress toward equitable reform in science education.

Learning from doing the EquitAble project: Content, context, process, and impact of a multi-country research project on vulnerable populations in Africa

Directory of Open Access Journals (Sweden)

Mac MacLachlan

2014-10-01

Objectives: This article reports on the content, context, process and impact of project EquitAble, funded by the European Commission Seventh Research Framework Programme, which brought together researchers from Ireland, Norway, South Africa, Namibia, Sudan and Malawi. Method: After the 4-year project ended in February 2013, all members of the consortium were asked to anonymously complete a bespoke questionnaire designed by the coordinating team. The purpose of the questionnaire was to capture the views of those who collaborated on the research project in relation to issues of content, context, process and impact of the EquitAble project. Results: Our results indicated some of the successes and challenges encountered by our consortium. Conclusion: We identified contextual and process learning points, factors often not discussed in papers, which typically focus on the reporting of the ‘content’ of results.

Implementation of accessible tourism concept at museums in Jakarta

Science.gov (United States)

Wiastuti, R. D.; Adiati, M. P.; Lestari, N. S.

2018-03-01

Accessibility, sustainability and equitable participation by all makeup what is known as Tourism for All. Tourism product must be designed for all people despite the age, gender and ability as one of the requirements to comply the accessible tourism concept. Museum as one of the elements of tourism chain must adhere to accessible tourism concept thus able to be enjoyed for everyone regardless of one’s abilities. The aim of this study is to identify the implementation of accessible tourism concept at the museum in Jakarta and to provide practical accessibility- improvement measures for the museum in Jakarta towards accessible tourism concept. This research is qualitative- explorative research. Jakarta Tourism Board website was used as the main reference to obtain which museum that was selected. Primary data collect from direct field observations and interview. The results outline museum implementation of accessible tourism that classified into five criteria; information, transport, common requirements, universal design, and accessibility. The implication of this study provides recommendations to enhance museums’ accessibility performance expected to be in line with accessible tourism concept.

Equitable availability of social facilities

CSIR Research Space (South Africa)

Green, Cheri A

2008-11-01

Full Text Available and promote development. Part of the prerequisite of basic services is the provision of social facilities, for example primary health care, parks, sports fields and community halls. The CSIR research investigates the sufficient and equitable availability...

Equitable Financial Evaluation Method for Public-Private Partnership Projects

Institute of Scientific and Technical Information of China (English)

KE Yongjian; LIU Xinping; WANG Shouqing

2008-01-01

The feasibility study of a public-private partnership (PPP) project is regarded as one of the critical factors for successful implementation,but unfortunately the common financial evaluation methods currently used only represent the benefits of the private sector.There is,therefore,an urgent need to develop an equitable financial evaluation method for PPP projects.This paper presents a comprehensive literature review that examines international practices.An equitable financial evaluation method was then developed taking into account the inherent characteristics of PPP projects using six separate indicators and Monte Carlo simulations.The result for a bridge project in Romania shows that the method combines the viewpoints of all the relevant stakeholders to achieve an equitable financial evaluation of PPP projects.

Case studies of natural resource access in Jharkhand, India

DEFF Research Database (Denmark)

Sareen, Siddharth

This policy brief illustrates that decentralisation can only effectively support residents’ access to natural resources if it both resolves policy overlaps at multiple levels to bring about inclusive and equitable access and aligns policies with ground realities for specific natural resources....

Universal access, cost recovery, and payment services

OpenAIRE

Sujit Chakravorti; Jeffery W. Gunther; Robert R. Moore

2005-01-01

We suggest a subtle, yet far- reaching, tension in the objectives specified by the Monetary Control Act of 1980 (MCA) for the Federal Reserve’s role in providing retail payment services, such as check processing. Specifically, we argue that the requirement of an overall cost-revenue match, coupled with the goal of ensuring equitable access on a universal basis, partially shifted the burden of cost recovery from high-cost to low-cost service points during the MCA’s early years, thereby allowin...

The Contribution of Equitation Science to Minimising Horse-Related Risks to Humans

Directory of Open Access Journals (Sweden)

Melissa Starling

2016-02-01

Full Text Available Equitation science is an evidence-based approach to horse training and riding that focuses on a thorough understanding of both equine ethology and learning theory. This combination leads to more effective horse training, but also plays a role in keeping horse riders and trainers safe around horses. Equitation science underpins ethical equitation, and recognises the limits of the horse’s cognitive and physical abilities. Equitation is an ancient practice that has benefited from a rich tradition that sees it flourishing in contemporary sporting pursuits. Despite its history, horse-riding is an activity for which neither horses nor humans evolved, and it brings with it significant risks to the safety of both species. This review outlines the reasons horses may behave in ways that endanger humans and how training choices can exacerbate this. It then discusses the recently introduced 10 Principles of Equitation Science and explains how following these principles can minimise horse-related risk to humans and enhance horse welfare.

Human Rights and the Political Economy of Universal Health Care: Designing Equitable Financing.

Science.gov (United States)

Rudiger, Anja

2016-12-01

Health system financing is a critical factor in securing universal health care and achieving equity in access and payment. The human rights framework offers valuable guidance for designing a financing strategy that meets these goals. This article presents a rights-based approach to health care financing developed by the human right to health care movement in the United States. Grounded in a human rights analysis of private, market-based health insurance, advocates make the case for public financing through progressive taxation. Financing mechanisms are measured against the twin goals of guaranteeing access to care and advancing economic equity. The added focus on the redistributive potential of health care financing recasts health reform as an economic policy intervention that can help fulfill broader economic and social rights obligations. Based on a review of recent universal health care reform efforts in the state of Vermont, this article reports on a rights-based public financing plan and model, which includes a new business tax directed against wage disparities. The modeling results suggest that a health system financed through equitable taxation could produce significant redistributive effects, thus increasing economic equity while generating sufficient funds to provide comprehensive health care as a universal public good.

Adverse or acceptable: negotiating access to a post-apartheid health care contract.

Science.gov (United States)

Harris, Bronwyn; Eyles, John; Penn-Kekana, Loveday; Thomas, Liz; Goudge, Jane

2014-05-15

As in many fragile and post-conflict countries, South Africa's social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering - negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Although South Africa's right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Building health in fragile and post-conflict societies requires

A method to evaluate equitable accessibility : Combining ethical theories and accessibility-based approaches

NARCIS (Netherlands)

Lucas, K.; Van Wee, G.P.; Maat, C.

2015-01-01

In this paper, we present the case that traditional transport appraisal methods do not sufficiently capture the social dimensions of mobility and accessibility. However, understanding this is highly relevant for policymakers to understand the impacts of their transport decisions. These dimensions

20 CFR 222.57 - When an equitably adopted child is dependent.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false When an equitably adopted child is dependent. 222.57 Section 222.57 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Child Support and Dependency § 222.57 When an equitably adopted child is...

Promoting equitable global health research: a policy analysis of the Canadian funding landscape.

Science.gov (United States)

Plamondon, Katrina; Walters, Dylan; Campbell, Sandy; Hatfield, Jennifer

2017-08-29

Recognising radical shifts in the global health research (GHR) environment, participants in a 2013 deliberative dialogue called for careful consideration of equity-centred principles that should inform Canadian funding polices. This study examined the existing funding structures and policies of Canadian and international funders to inform the future design of a responsive GHR funding landscape. We used a three-pronged analytical framework to review the ideas, interests and institutions implicated in publically accessible documents relevant to GHR funding. These data included published literature and organisational documents (e.g. strategic plans, progress reports, granting policies) from Canadian and other comparator funders. We then used a deliberative approach to develop recommendations with the research team, advisors, industry informants and low- and middle-income country (LMIC) partners. In Canada, major GHR funders invest an estimated CA$90 M per annum; however, the post-2008 re-organization of funding structures and policies resulted in an uncoordinated and inefficient Canadian strategy. Australia, Denmark, the European Union, Norway, Sweden, the United Kingdom and the United States of America invest proportionately more in GHR than Canada. Each of these countries has a national strategic plan for global health, some of which have dedicated benchmarks for GHR funding and policy to allow funds to be held by partners outside of Canada. Key constraints to equitable GHR funding included (1) funding policies that restrict financial and cost burden aspects of partnering for GHR in LMICs; and (2) challenges associated with the development of effective governance mechanisms. There were, however, some Canadian innovations in funding research that demonstrated both unconventional and equitable approaches to supporting GHR in Canada and abroad. Among the most promising were found in the International Development Research Centre and the (no longer active) Global Health

Browsing for the Best Internet Access Provider?

Science.gov (United States)

Weil, Marty

1996-01-01

Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

Community Science: creating equitable partnerships for the advancement of scientific knowledge for action.

Science.gov (United States)

Lewis, E. S.; Gehrke, G. E.

2017-12-01

In a historical moment where the legitimacy of science is being questioned, it is essential to make science more accessible to the public. Active participation increases the legitimacy of projects within communities (Sidaway 2009). Creating collaborations in research strengthens not only the work by adding new dimensions, but also the social capital of communities through increased knowledge, connections, and decision making power. In this talk, Lewis will discuss how engagement at different stages of the scientific process is possible, and how researchers can actively develop opportunities that are open and inviting. Genuine co-production in research pushes scientists to work in new ways, and with people from different backgrounds, expertise, and lived experiences. This approach requires a flexible and dynamic balance of learning, sharing, and creating for all parties involved to ensure more meaningful and equitable participation. For example, in community science such as that by Public Lab, the community is at the center of scientific exploration. The research is place-based and is grounded in the desired outcomes of community members. Researchers are able to see themselves as active participants in this work alongside community members. Participating in active listening, developing plans together, and using a shared language built through learning can be helpful tools in all co-production processes. Generating knowledge is powerful. Through genuine collaboration and co-creation, science becomes more relevant. When community members are equitable stakeholders in the scientific process, they are better able to engage and advocate for the changes they want to see in their communities. Through this talk, session attendees will learn about practices that promote equitable participation in science, and hear examples of how the community science process engages people in both the knowledge production, and in the application of science.

Effective vaccine safety systems in all countries: a challenge for more equitable access to immunization.

Science.gov (United States)

Amarasinghe, Ananda; Black, Steve; Bonhoeffer, Jan; Carvalho, Sandra M Deotti; Dodoo, Alexander; Eskola, Juhani; Larson, Heidi; Shin, Sunheang; Olsson, Sten; Balakrishnan, Madhava Ram; Bellah, Ahmed; Lambach, Philipp; Maure, Christine; Wood, David; Zuber, Patrick; Akanmori, Bartholomew; Bravo, Pamela; Pombo, María; Langar, Houda; Pfeifer, Dina; Guichard, Stéphane; Diorditsa, Sergey; Hossain, Md Shafiqul; Sato, Yoshikuni

2013-04-18

Serious vaccine-associated adverse events are rare. To further minimize their occurrence and to provide adequate care to those affected, careful monitoring of immunization programs and case management is required. Unfounded vaccine safety concerns have the potential of seriously derailing effective immunization activities. To address these issues, vaccine pharmacovigilance systems have been developed in many industrialized countries. As new vaccine products become available to prevent new diseases in various parts of the world, the demand for effective pharmacovigilance systems in low- and middle-income countries (LMIC) is increasing. To help establish such systems in all countries, WHO developed the Global Vaccine Safety Blueprint in 2011. This strategic plan is based on an in-depth analysis of the vaccine safety landscape that involved many stakeholders. This analysis reviewed existing systems and international vaccine safety activities and assessed the financial resources required to operate them. The Blueprint sets three main strategic goals to optimize the safety of vaccines through effective use of pharmacovigilance principles and methods: to ensure minimal vaccine safety capacity in all countries; to provide enhanced capacity for specific circumstances; and to establish a global support network to assist national authorities with capacity building and crisis management. In early 2012, the Global Vaccine Safety Initiative (GVSI) was launched to bring together and explore synergies among on-going vaccine safety activities. The Global Vaccine Action Plan has identified the Blueprint as its vaccine safety strategy. There is an enormous opportunity to raise awareness for vaccine safety in LMIC and to garner support from a large number of stakeholders for the GVSI between now and 2020. Synergies and resource mobilization opportunities presented by the Decade of Vaccines can enhance monitoring and response to vaccine safety issues, thereby leading to more equitable

Towards equitable access to medicines for the rural poor: analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan.

Science.gov (United States)

Waning, Brenda; Maddix, Jason; Tripodis, Yorghos; Laing, Richard; Leufkens, Hubert Gm; Gokhale, Manjusha

2009-12-14

A rural pharmacy initiative (RPI) designed to increase access to medicines in rural Kyrgyzstan created a network of 12 pharmacies using a revolving drug fund mechanism in 12 villages where no pharmacies previously existed. The objective of this study was to determine if the establishment of the RPI resulted in the unforeseen benefit of triggering medicine price competition in pre-existing (non-RPI) private pharmacies located in the region. We conducted descriptive and multivariate analyses on medicine insurance claims data from Kyrgyzstan's Mandatory Health Insurance Fund for the Jumgal District of Naryn Province from October 2003 to December 2007. We compared average quarterly medicine prices in competitor pharmacies before and after the introduction of the rural pharmacy initiative in October 2004 to determine the RPI impact on price competition. Descriptive analyses suggest competitors reacted to RPI prices for 21 of 30 (70%) medicines. Competitor medicine prices from the quarter before RPI introduction to the end of the study period decreased for 17 of 30 (57%) medicines, increased for 4 of 30 (13%) medicines, and remained unchanged for 9 of 30 (30%) medicines. Among the 9 competitor medicines with unchanged prices, five initially decreased in price but later reverted back to baseline prices. Multivariate analyses on 19 medicines that met sample size criteria confirm these findings. Fourteen of these 19 (74%) competitor medicines changed significantly in price from the quarter before RPI introduction to the quarter after RPI introduction, with 9 of 19 (47%) decreasing in price and 5 of 19 (26%) increasing in price. The RPI served as a market driver, spurring competition in medicine prices in competitor pharmacies, even when they were located in different villages. Initiatives designed to increase equitable access to medicines in rural regions of developing and transitional countries should consider the potential to leverage medicine price competition as a means

Towards equitable access to medicines for the rural poor: analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan

Directory of Open Access Journals (Sweden)

Leufkens Hubert GM

2009-12-01

Full Text Available Abstract Background A rural pharmacy initiative (RPI designed to increase access to medicines in rural Kyrgyzstan created a network of 12 pharmacies using a revolving drug fund mechanism in 12 villages where no pharmacies previously existed. The objective of this study was to determine if the establishment of the RPI resulted in the unforeseen benefit of triggering medicine price competition in pre-existing (non-RPI private pharmacies located in the region. Methods We conducted descriptive and multivariate analyses on medicine insurance claims data from Kyrgyzstan's Mandatory Health Insurance Fund for the Jumgal District of Naryn Province from October 2003 to December 2007. We compared average quarterly medicine prices in competitor pharmacies before and after the introduction of the rural pharmacy initiative in October 2004 to determine the RPI impact on price competition. Results Descriptive analyses suggest competitors reacted to RPI prices for 21 of 30 (70% medicines. Competitor medicine prices from the quarter before RPI introduction to the end of the study period decreased for 17 of 30 (57% medicines, increased for 4 of 30 (13% medicines, and remained unchanged for 9 of 30 (30% medicines. Among the 9 competitor medicines with unchanged prices, five initially decreased in price but later reverted back to baseline prices. Multivariate analyses on 19 medicines that met sample size criteria confirm these findings. Fourteen of these 19 (74% competitor medicines changed significantly in price from the quarter before RPI introduction to the quarter after RPI introduction, with 9 of 19 (47% decreasing in price and 5 of 19 (26% increasing in price. Conclusions The RPI served as a market driver, spurring competition in medicine prices in competitor pharmacies, even when they were located in different villages. Initiatives designed to increase equitable access to medicines in rural regions of developing and transitional countries should consider the

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

Directory of Open Access Journals (Sweden)

Elsje Scheffler

2015-06-01

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

30 CFR 285.540 - How will MMS equitably distribute revenues to States?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How will MMS equitably distribute revenues to... Financial Assurance Requirements Revenue Sharing with States § 285.540 How will MMS equitably distribute revenues to States? (a) The MMS will distribute among the eligible coastal States 27 percent of the...

Neighborhood disparities in access to healthy foods and their effects on environmental justice

Science.gov (United States)

Environmental justice is concerned with an equitable distribution of environmental burdens. These burdens comprise immediate health hazards as well as subtle inequities, such as limited access to healthy foods. We reviewed the literature on neighborhood disparities in access to fast-food outlets and...

Access to finance from different finance provider types

NARCIS (Netherlands)

Wulandari, Eliana; Meuwissen, Miranda P.M.; Karmana, Maman H.; Oude Lansink, Alfons G.J.M.

2017-01-01

Analysing farmer knowledge of the requirements of finance providers can provide valuable insights to policy makers about ways to improve farmers’ access to finance. This study compares farmer knowledge of the requirements to obtain finance with the actual requirements set by different finance

Sharing the Planet. Population - Consumption - Species. Science and Ethics for a Sustainable and Equitable World

Energy Technology Data Exchange (ETDEWEB)

Van der Zwaan, B.; Petersen, A. (eds.)

2003-11-01

The world is going through the profound changes of a demographic transition. Population growth is best taken care of when women and men are able to choose freely and responsibly their number of children. The most important aspects are the availability of reliable and safe means and the access women have to knowledge, resources and decision power. General education is a prerequisite. (Groningen Manifesto, statement no. 7). The current international, political, economic and financial order still primarily reflects the claims of international trade. There is a lack of public awareness as to the inescapable limits of the planet's resources and we hardly seem to be moving towards a sustainable and equitable world. The contributors to this volume provide an up-to-date and forceful exposition of this problematique. In the aftermath of the World Summit on Sustainable Development held in Johannesburg, they suggest topical ways to alter the world's course. The keys to reaching a sustainable world, in which the planet is equitably shared among humans and other species, are to consider the impact of our collective actions at longer timescales and to deal head-on with the interconnected issues of population pressure, consumption volume and species loss. The volume displays a multidisciplinary and multicultural approach involving both scientific and ethical arguments. It is of interest to a wide audience of scholars and concerned citizens. With contributions by: Ernst Ulrich von Weizsaecker, Friedrich Schmidt-Bleek, Johan van Klinken, Anne Ehrlich, Sergey Kapitza, Roefie Hueting, Jan van Hooff, Lucas Reijnders, Arthur Petersen, Bob van der Zwaan, Vandana Shiva, Radha Holla, Koo van der Wal, Bas de Gaay Fortman, Atiq Rahman and Jane Goodall.

A Human Rights Approach to Localising The MDGs Through Gender-Equitable Local Development

Directory of Open Access Journals (Sweden)

Ron McGill

2009-11-01

Full Text Available Until now, the United Nations Capital Development Fund’s (UNCDF Gender Equitable Local Development (GELD programme has not been presented within an explicit human rights framework. This is strange given that the human rights based approach to development (HRBAD aims to ensure that all human beings can live their lives fully and with dignity. HRBAD is fundamentally about the healthy and full development of individuals and communities. In addition, one of human rights’ central concerns is that people have equal access to the benefits of society. Initiatives to realize human rights therefore give priority to the most marginalized - the poorest - in a society. It is those individuals who have most difficulty in securing the basics that are essential to living their lives with dignity. Women in all communities are disproportionately represented among the poor. Thus, human rights have gender equity as a central focus. Put another way, we are dealing with the feminization of poverty. We are dealing with the concept of equal access (to development. In short, we are dealing with those who need (and deserve greater priority in access to infrastructure and supporting services in order to reach a point of equality.

Equitable resourcing of primary health care in remote communities in Australia's Northern Territory: a pilot study.

Science.gov (United States)

Wakerman, John; Sparrow, Lisa; Thomas, Susan L; Humphreys, John S; Jones, Mike

2017-06-29

Improved Primary Health Care (PHC) utilisation is central to reducing the unacceptable morbidity and mortality rates characterising populations living in remote communities. Despite poorer health, significant inequity characterises the funding of PHC services in Australia's most remote areas. This pilot study sought to ascertain what funding is required to ensure equitable access to sustainable, high quality primary health care irrespective of geographical remoteness of communities. High performing remote Primary Health Care (PHC) services were selected using improvement measures from the Australian Primary Care Collaboratives Program and validated by health experts. Eleven PHC services provided data relating to the types of services provided, level of service utilisation, human resources, operating and capital expenses. A further four services that provide visiting PHC to remote communities provided information on the level and cost of these services. Demographic data for service catchment areas (including estimated resident population, age, Indigenous status, English spoken at home and workforce participation) were obtained from the Australian Bureau of Statistics 2011 census. Formal statistical inference (p-values) were derived in the linear regression via the nonparametric bootstrap. A direct linear relationship was observed between the total cost of resident PHC services and population, while cost per capita decreased with increasing population. Services in smaller communities had a higher number of nursing staff per 1000 residents and provided more consultations per capita than those in larger communities. The number of days of visiting services received by a community each year also increased with population. A linear regression with bootstrapped statistical inference predicted a significant regression equation where the cost of resident services per annum is equal to $1,251,893.92 + ($1698.83 x population) and the cost of resident and visiting services is

Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services.

Science.gov (United States)

Newman, Lareen; Biedrzycki, Kate; Baum, Fran

2012-05-01

To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information. Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories. Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills. The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities.

Assessing equitable care for indigenous and afrodescendant women in Latin America

Directory of Open Access Journals (Sweden)

Arachu Castro

2015-08-01

Full Text Available OBJECTIVE: To identify and understand the barriers to equitable care within health care settings that women of ethnic minorities encounter in Latin America and to examine possible strategies for mitigating the issues. METHODS: This was a comprehensive review of the literature from 2000-2015 available from the online databases PubMed, Google Scholar, EBSCOhost, and SciELO in Spanish, English, and Portuguese, using a keyword search that included the Region and country names. RESULTS: Health provider discrimination against Indigenous and Afrodescendant women is a primary barrier to quality health care access in Latin America. Discrimination is driven by biases against ethnic minority populations, women, and the poor in general. Discriminatory practices can manifest as patient-blaming, purposeful neglect, verbal or physical abuse, disregard for traditional beliefs, and the non-use of Indigenous languages for patient communication. These obstacles prevent delivery of appropriate and timely clinical care, and also produce fear of shame, abuse, or ineffective treatment, which, in addition to financial barriers, deter women from seeking care. CONCLUSIONS: To ensure optimal health outcomes among Indigenous and Afrodescendant women in Latin America, the issue of discrimination in health care settings needs to be understood and addressed as a key driver of inequitable health outcomes. Strategies that target provider behavior alone have limited impact because they do not address women's needs and the context of socioeconomic inequality in which intra-hospital relations are built.

ACCESS TO PUBLIC OPEN SPACE: IS DISTRIBUTION EQUITABLE ACROSS DIFFERENT SOCIO-ECONOMIC AREAS

Directory of Open Access Journals (Sweden)

Mohammad Javad Koohsari

2011-12-01

Full Text Available During the past decade, the role of the built environment on physical activity has been well investigated by public health, transportation and urban design scholars and it has been shown that different aspects of the built environment can influence physical activity Public open spaces (POS like parks have many health benefits and they can be important settings and destinations for having physical activity. Inequality in access to POS which may influence the amount of physical activity can be a reason for lower physical activity among deprived neighbourhoods. This paper aims to examine whether objective access to public open spaces (POS like parks is equally across the different socio-economic status (SES areas in the City of Melbourne. Objective access to POS was measured in network distance using geographic information systems (GIS and area SES was obtained using the SEIFA (Socio-Economic Indexes for Areas index. The results showed there was a significant difference in access to POS according to the SES areas. There was a significant negative correlation between the access to POS and the SES areas in which lower SES areas had poorer access to POS in comparison with the higher ones.

Traditional Knowledge in the Time of Neo-Liberalism: Access and Benefit-Sharing Regimes in India and Bhutan

Directory of Open Access Journals (Sweden)

Indrani Barpujari

2017-03-01

Full Text Available In a neoliberal world, traditional knowledge (TK of biodiversity possessed by Indigenous and Local Communities (ILCs in the global South has become a valuable "commodity" or "bio-resource," necessitating the setting up of harmonized ground rules (international and national in the form of an access and benefitsharing regime to facilitate its exchange in the world market. Despite criticisms that a regime with a neo-liberal orientation is antithetical to the normative ethos of ILCs, it could also offer a chance for developing countries and ILCs to generate revenue for socioeconomic development—to which they are gradually becoming open, but only under fair and equitable terms. Based on this context, this article proposes to look into the legal and policy frameworks and institutional regimes governing access and benefit sharing of TK associated with biological resources in two countries of South Asia: India and Bhutan. The article seeks to examine how such regimes are reconciling the imperatives of a neo-liberal economy with providing a just and equitable framework for ILCs and TK holders, which is truly participatory and not top-down.

Metadata and Providing Access to e-Books

Science.gov (United States)

Vasileiou, Magdalini; Rowley, Jennifer; Hartley, Richard

2013-01-01

In the very near future, students are likely to expect their universities to provide seamless access to e-books through online library catalogues and virtual learning environments. A paradigm change in terms of the format of books, and especially textbooks, which could have far-reaching impact, is on the horizon. Based on interviews with a number…

Transmission access raises unresolved economic issues

International Nuclear Information System (INIS)

Happ, H.H.

1994-01-01

The electric utility industry is in the process of gradual change from a fully regulated industry to one of partial deregulation. Instead of relying on regulation to achieve a fair and equitable price to the consumer for electric energy, the reliance is placed more and more on market forces, through competition, to provide wholesale energy at the best market price. Clearly, open transmission access is required to create a viable competitive wholesale market for new generation resources. This article describes four unresolved, or at least partially unresolved, issues associated with transmission access for wholesale wheeling. Wheeling has been defined as the use of a utility's transmission facilities to transmit power for other buyers and sellers. At least three parties are involved in a wheeling transaction: a seller, a buyer, and one or more wheeling utilities that transmit the power from the seller to the buyer. This article considers wholesale or bulk wheeling only, and does not consider retail wheeling. The four unresolved economic issues described in this article pertain to transmission access: Actual cost of providing transmission services, Methodology or methodologies used in evaluating the cost of wheeling, Contract path versus the actual power flows of the wheel, Issues associated with the formation of transmission regions

Acceptable care? Illness constructions, healthworlds, and accessible chronic treatment in South Africa.

Science.gov (United States)

Fried, Jana; Harris, Bronwyn; Eyles, John; Moshabela, Mosa

2015-05-01

Achieving equitable access to health care is an important policy goal, with access influenced by affordability, availability, and acceptability of specific services. We explore patient narratives from a 5-year program of research on health care access to examine relationships between social constructions of illness and the acceptability of health services in the context of tuberculosis treatment and antiretroviral therapy in South Africa. Acceptability of services seems particularly important to the meanings patients attach to illness and care, whereas-conversely-these constructions appear to influence what constitutes acceptability and hence affect access to care. We highlight the underestimated role of individually, socially, and politically constructed healthworlds; traditional and biomedical beliefs; and social support networks. Suggested policy implications for improving acceptability and hence overall health care access include abandoning patronizing approaches to care and refocusing from treating "disease" to responding to "illness" by acknowledging and incorporating patients' healthworlds in patient-provider interactions. © The Author(s) 2015.

Improving high quality, equitable maternal health services in Malawi ...

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

Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

“Assessment as Discourse”: A Pre-Service Physics Teacher’s Evolving Capacity to Support an Equitable Pedagogy

Directory of Open Access Journals (Sweden)

Edward G. Lyon

2013-07-01

Full Text Available One way to view ‘equitable pedagogy’ is through an opportunity to learn (OTL lens, meaning that regardless of race, class, or culture, a student has access to rigorous and meaningful content, as well as appropriate resources and instruction necessary to learn and demonstrate understanding of that content. Assessment holds a unique position in the classroom in that it can both uncover whether inequitable conditions exist (i.e., performance gaps, denied OTL and provide an OTL by mediating communication between teacher and students regarding learning progress and what is important to learn. Nevertheless, individuals entering teacher education programs often hold deficit views toward marginalized students, such as Language Minorities (LMs, believe that assessment strictly serves to evaluate learning, and do not do consider how language and culture influence student thinking–views supplanting assessment’s role at supporting an equitable pedagogy for LMs. Through surveys, interviews, program artifacts, and classroom observation, I report on a case study of one pre-service physics teacher, Dean, to depict how his expertise at assessing science did evolve throughout his yearlong teacher education program in terms of (a becoming more knowledgeable of the role of language and (b developing a belief in incorporating ‘discourse’ while assessing science. Within the case study, I analyze one particular episode from Dean’s teaching practicum to highlight remaining challenges for pre-service teachers to integrate science and language in classroom assessment—namely, interpreting students’ use of language along with their understanding of core science ideas. The findings underscore the need for connecting language and equity issues to content-area assessment in teacher preparation.

A Methodology for Equitable Performance Assessment and Presentation of Wave Energy Converters Based on Sea Trials

DEFF Research Database (Denmark)

Kofoed, Jens Peter; Pecher, Arthur; Margheritini, Lucia

2013-01-01

This paper provides a methodology for the analysis and presentation of data obtained from sea trials of wave energy converters (WEC). The equitable aspect of this methodology lies in its wide application, as any WEC at any scale or stage of development can be considered as long as the tests are p...... parameters influence the performance of the WEC can also be investigated using this methodology.......This paper provides a methodology for the analysis and presentation of data obtained from sea trials of wave energy converters (WEC). The equitable aspect of this methodology lies in its wide application, as any WEC at any scale or stage of development can be considered as long as the tests...... leads to testing campaigns that are not as extensive as desired. Therefore, the performance analysis should be robust enough to allow for not fully complete sea trials and sub optimal performance data. In other words, this methodology is focused at retrieving the maximum amount of useful information out...

Would it provide Free Education?

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Would it provide Free Education? Would it provide Free Education? Would it provide Compulsory Education? Would it guarantee education of equitable quality? Would it prevent discrimination? Would it stop schools that promote inequality & discrimination? NO! NO!

Equity of access to elective surgery: reflections from NZ clinicians.

Science.gov (United States)

McLeod, Deborah; Dew, Kevin; Morgan, Sonya; Dowell, Anthony; Cumming, Jackie; Cormack, Donna; McKinlay, Eileen; Love, Tom

2004-10-01

To explore factors potentially influencing equitable access to elective surgery in New Zealand by describing clinicians' perceptions of equity and the factors they consider when prioritising patients for elective surgery. A qualitative study in selected New Zealand localities. A purposive sample of 49 general practitioners, specialists and registrars were interviewed. Data were analysed thematically. General practitioners described unequal opportunities for patients to access primary and secondary care and, in particular, private sector elective surgery. They felt that socio-economically disadvantaged patients were less able to advocate for themselves and were more vulnerable to being lost to the elective surgical booking system as well as being less able to access private care. Both GPs and secondary care clinicians described situations where they would personally advocate for individual patients to improve their access. Advocacy was related to clinicians' perceptions of the 'value' that patients would receive from the surgery and patients' needs for public sector funding. The structure of the health system contributes to inequities in access to elective care in New Zealand. Subjective decision making by clinicians has the potential to advantage or disadvantage patients through the weighting clinicians place on socio-demographic factors when making rationing decisions. Review of the potential structural barriers to equitable access, further public debate and guidance for clinicians on the relative importance of socio-demographic factors in deciding access to rationed services are required for allocation of services to be fair.

Providing the Public with Online Access to Large Bibliographic Data Bases.

Science.gov (United States)

Firschein, Oscar; Summit, Roger K.

DIALOG, an interactive, computer-based information retrieval language, consists of a series of computer programs designed to make use of direct access memory devices in order to provide the user with a rapid means of identifying records within a specific memory bank. Using the system, a library user can be provided access to sixteen distinct and…

Rural providers' access to online resources: a randomized controlled trial

Science.gov (United States)

Hall, Laura J.; McElfresh, Karen R.; Warner, Teddy D.; Stromberg, Tiffany L.; Trost, Jaren; Jelinek, Devin A.

2016-01-01

Objective The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state. Methods In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen's d statistic to compare pre- and post-study effects sizes. Results Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen's d increase of +1.50 compared to AccessMedicine users' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen's d. Conclusion Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine. PMID:26807050

Human capital flight challenges within an equitable health system.

Science.gov (United States)

Udonwa, N E

2007-01-01

The issue of human capital flight has been discussed at different forums with a consensus opinion that it has its merits and demerits to equitable health system. Most often one nation becomes a substantial net exporter of talent, leaving the provider nation at risk of depleting its natural supply of talent. This paper looks into the historical perspective of human capital flight or "brain drain", and its burden. It attempts to elucidate the various causes and suggested solutions. The paper's objective is to educate colleagues on the conceptual and contextual imperatives of the issue. Using a convenient sample of key informants who were medical colleagues in Nigeria relevant information was sourced from these colleagues, documents from the postgraduate medical college of Nigeria and the internet on maters relating to human capital flight and brain drain. Every year, thousands of qualified doctors, and other professionals leave Nigeria tempted by significantly higher wages, brighter prospects for employment and education, stability, food security. It appears that the potential exposure to different working conditions, resources and professional environments can be of advantage to the country, should Nigeria be able to recall these professionals. It also appears that necessary economic reforms that make staying at home rewarding, that is--good leadership, and policy planning that seriously looks into rural development, among other issues, are keys ingredients to reversing the trend in order to ensure a more equitable health system.

Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.

Science.gov (United States)

Jung, Hye-Young; Gichoya, Judy Wawira; Vest, Joshua R

2017-02-01

An increasing number of technologies allow providers to access the results of imaging studies. This study examined differences in access of radiology images compared with text-only reports through a health information exchange system by health care professionals. The study sample included 157,256 historical sessions from a health information exchange system that enabled 1,670 physicians and non-physicians to access text-based reports and imaging over the period 2013 to 2014. The primary outcome was an indicator of access of an imaging study instead of access of a text-only report. Multilevel mixed-effects regression models were used to estimate the association between provider and session characteristics and access of images compared with text-only reports. Compared with primary care physicians, specialists had an 18% higher probability of accessing actual images instead of text-only reports (β = 0.18; P < .001). Compared with primary care practice settings, the probability of accessing images was 4% higher for specialty care practices (P < .05) and 8% lower for emergency departments (P < .05). Radiologists, orthopedists, and neurologists accounted for 79% of all the sessions with actual images accessed. Orthopedists, radiologists, surgeons, and pulmonary disease specialists accessed imaging more often than text-based reports only. Consideration for differences in the need to access images compared with text-only reports based on the type of provider and setting of care are needed to maximize the benefits of image sharing for patient care. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

ICTs for Equal Access to Human Resources in Health in ...

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

Making use of information and communication technology (ICT) to ensure equitable access to health services in developing countries is becoming more and more feasible. Since the conference, Bridges to African Development via the Internet (Bamako, 2000), several ICT initiatives have appeared in Mali, such as the ...

The role of higher education in equitable human development

Science.gov (United States)

Peercy, Chavanne; Svenson, Nanette

2016-04-01

As developing countries continue to battle poverty despite strong economic growth, understanding the relationship between equity and human development becomes increasingly important. In this context, equity is not equivalent to equality for any specific outcome such as health status, education or income. It is an objective ideal whereby people's achievements are increasingly dependent upon personal effort, choice and initiative rather than predetermined characteristics such as race, gender and socioeconomic background. As such, equity becomes an issue of moral equality based on the belief that people should be treated as equals, with equal access to life chances. This ideal pursues equal access to public services, infrastructure and rights for all citizens, including the right to education. While evidence suggests that education builds healthier, richer, more equitable societies, research on this has focused predominantly on primary and secondary schooling. The authors of this paper begin with an extensive review of existing research and relevant literature. In the second part of their article, they then report on their own study which furthers the discussion by exploring connections between tertiary education and development using equity as a reflection of human development - a holistic extension of economic development. After extracting relevant data from a number of available world reports by the United Nations, the World Bank and other organisations, they carried out a cross-national statistical analysis designed to examine the relationship between tertiary enrolment levels and a composite equity variable. Their results indicate a strong association between higher post-secondary education levels and higher levels of social equity.

Sci-Hub provides access to nearly all scholarly literature.

Science.gov (United States)

Himmelstein, Daniel S; Romero, Ariel Rodriguez; Levernier, Jacob G; Munro, Thomas Anthony; McLaughlin, Stephen Reid; Greshake Tzovaras, Bastian; Greene, Casey S

2018-03-01

The website Sci-Hub enables users to download PDF versions of scholarly articles, including many articles that are paywalled at their journal's site. Sci-Hub has grown rapidly since its creation in 2011, but the extent of its coverage has been unclear. Here we report that, as of March 2017, Sci-Hub's database contains 68.9% of the 81.6 million scholarly articles registered with Crossref and 85.1% of articles published in toll access journals. We find that coverage varies by discipline and publisher, and that Sci-Hub preferentially covers popular, paywalled content. For toll access articles, we find that Sci-Hub provides greater coverage than the University of Pennsylvania, a major research university in the United States. Green open access to toll access articles via licit services, on the other hand, remains quite limited. Our interactive browser at https://greenelab.github.io/scihub allows users to explore these findings in more detail. For the first time, nearly all scholarly literature is available gratis to anyone with an Internet connection, suggesting the toll access business model may become unsustainable. © 2018, Himmelstein et al.

Providing Access and Visualization to Global Cloud Properties from GEO Satellites

Science.gov (United States)

Chee, T.; Nguyen, L.; Minnis, P.; Spangenberg, D.; Palikonda, R.; Ayers, J. K.

2015-12-01

Providing public access to cloud macro and microphysical properties is a key concern for the NASA Langley Research Center Cloud and Radiation Group. This work describes a tool and method that allows end users to easily browse and access cloud information that is otherwise difficult to acquire and manipulate. The core of the tool is an application-programming interface that is made available to the public. One goal of the tool is to provide a demonstration to end users so that they can use the dynamically generated imagery as an input into their own work flows for both image generation and cloud product requisition. This project builds upon NASA Langley Cloud and Radiation Group's experience with making real-time and historical satellite cloud product imagery accessible and easily searchable. As we see the increasing use of virtual supply chains that provide additional value at each link there is value in making satellite derived cloud product information available through a simple access method as well as allowing users to browse and view that imagery as they need rather than in a manner most convenient for the data provider. Using the Open Geospatial Consortium's Web Processing Service as our access method, we describe a system that uses a hybrid local and cloud based parallel processing system that can return both satellite imagery and cloud product imagery as well as the binary data used to generate them in multiple formats. The images and cloud products are sourced from multiple satellites and also "merged" datasets created by temporally and spatially matching satellite sensors. Finally, the tool and API allow users to access information that spans the time ranges that our group has information available. In the case of satellite imagery, the temporal range can span the entire lifetime of the sensor.

20 CFR 222.34 - Relationship resulting from equitable adoption.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Relationship resulting from equitable adoption. 222.34 Section 222.34 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.34 Relationship resulting from...

Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach

OpenAIRE

Agyepong, Irene A; Aryeetey, Geneieve C; Nonvignon, Justice; Asenso-Boadi, Francis; Dzikunu, Helen; Antwi, Edward; Ankrah, Daniel; Adjei-Acquah, Charles; Esena, Reuben; Aikins, Moses; Arhinful, Daniel K

2014-01-01

Background Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured ...

Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level.

Science.gov (United States)

O'Connell, Thomas S; Bedford, K Juliet A; Thiede, Michael; McIntyre, Di

2015-06-09

A key element of the global drive to universal health coverage is ensuring access to needed health services for everyone, and to pursue this goal in an equitable way. This requires concerted efforts to reduce disparities in access through understanding and acting on barriers facing communities with the lowest utilisation levels. Financial barriers dominate the empirical literature on health service access. Unless the full range of access barriers are investigated, efforts to promote equitable access to health care are unlikely to succeed. This paper therefore focuses on exploring the nature and extent of non-financial access barriers. We draw upon two structured literature reviews on barriers to access and utilization of maternal, newborn and child health services in Ghana, Bangladesh, Vietnam and Rwanda. One review analyses access barriers identified in published literature using qualitative research methods; the other in published literature using quantitative analysis of household survey data. We then synthesised the key qualitative and quantitative findings through a conjoint iterative analysis. Five dominant themes on non-financial access barriers were identified: ethnicity; religion; physical accessibility; decision-making, gender and autonomy; and knowledge, information and education. The analysis highlighted that non-financial factors pose considerable barriers to access, many of which relate to the acceptability dimension of access and are challenging to address. Another key finding is that quantitative research methods, while yielding important findings, are inadequate for understanding non-financial access barriers in sufficient detail to develop effective responses. Qualitative research is critical in filling this gap. The analysis also indicates that the nature of non-financial access barriers vary considerably, not only between countries but also between different communities within individual countries. To adequately understand access barriers as a

JNC's experience of complementary accesses provided by the additional protocol

International Nuclear Information System (INIS)

Miura, Yasushi

2001-01-01

JNC (Japan Nuclear Cycle Development Institute) examined problems on implementation of the Additional Protocol to Japan/IAEA Safeguards Agreement with the Government of Japan and International Atomic Energy Agency through trials performed at Oarai Engineering Center before it entered into force. On December 16th 1999, the Additional Protocol entered into force, and in last January JNC provided the first JNC site information to STA. Then our Government provided it of all Japan to IAEA in last June. Also in this January, we sent the additional information changed from old one to MEXT (Ministry of Education, Culture, Sports, Science and Technology). The first Complementary Access of not only JNC but also Japan was implemented on JNC Ningyo-Toge Environmental Engineering Center on the end of last November. Since then, we have had over 10 times experience of Complementary Accesses for about one year especially on Tokai works and Ningyo-Toge. JNC's experience of Complementary Accesses will be introduced. (author)

“Fair” community benefits and equitable land governance | IDRC ...

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

“Fair” community benefits and equitable land governance ... In several regions, women are resisting displacement and making claims to land through ... Cambridge, UK, in collaboration with the Community Legal Education Center, Cambodia; ... Birth registration is the basis for advancing gender equality and children's rights.

An interdisciplinary model for mapping the Normative diffusion of fair and equitable benefit-sharing

OpenAIRE

Parks, Louisa; Morgera, Elisa

2015-01-01

Fair and equitable benefit-sharing is emerging in various areas of international environmental law (biodiversity, oceans, climate change, water, food and agriculture), as well as in international processes on human rights and corporate accountability. Benefit-sharing seeks to fairly and equitably allocate economic as well as socio-cultural and environmental advantages arising from the conservation and sustainable use of natural resources, or from their regulation, among different stakeholders...

planning for gender equitable services delivery in a decentralised ...

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

Sarah Ssali

Services Delivery in Uganda. – Services offered. – Participation. – Decision making process. – Actors. – Issues. • Post-Conflict Situations in Uganda. – Challenges from Conflict. – Decentralisation in Post conflict settings. – Planning for gender equitable services delivery. • Recommendations (Policy). • Research Gaps ...

48 CFR 52.250-5 - SAFETY Act-Equitable Adjustment.

Science.gov (United States)

2010-10-01

... Act—Equitable Adjustment (FEB 2009) (a) Definitions. As used in this clause— Act of terrorism means... the DHS has determined to be a Qualified Anti-Terrorism Technology (QATT). Qualified Anti-Terrorism... preventing, detecting, identifying, or deterring acts of terrorism or limiting the harm such acts might...

Barriers to Maori sole mothers’ primary health care access

Directory of Open Access Journals (Sweden)

Lee R

2013-12-01

Full Text Available INTRODUCTION: International research consistently shows that sole mothers experience poorer health and suboptimal health care access. New Zealand studies on sole mothers' health report similar findings. The aim of this exploratory research was to better understand the experiences of Maori sole mothers' access to health services, particularly primary health care, for personal health needs. METHODS: This qualitative study employed a general inductive design informed by a Kaupapa Maori approach, providing guidance on appropriate cultural protocols for recruiting and engaging Maori participants. Distributing written information and snowballing techniques were used to purposively recruit seven Maori sole mothers. Data collection involved semi-structured interviews which were digitally recorded and transcribed verbatim. Data were analysed using general inductive thematic analysis to identify commonalities and patterns in participants' experiences. FINDINGS: The dominant themes that emerged captured and described participants' experiences in accessing health care. The major barrier to access reported was cost. Compounding cost, transport difficulties and location or scheduling of services were additional barriers to health service accessibility. Child-related issues also posed a barrier, including prioritising children's needs and childcare over personal health needs. CONCLUSION: The findings illuminate Maori sole mothers' experiences of accessing health care and the complex socioeconomic inequalities affecting access options and uptake of services. Further investigation of barriers to access is needed. The study has implications for addressing barriers to access at policy, funding and practice levels to improve health outcomes and equitable health care access for Maori sole mothers.

Improving Information Access through Technology: A Plan for Louisiana's Public Libraries.

Science.gov (United States)

Jaques, Thomas F.

Strengthening technology in Louisiana's public libraries will support equitable and convenient access to electronic information resources for all citizens at library sites, in homes, and in business. The plan presented in this document is intended to enhance and expand technology in the state's public libraries. After discussion of the crucial…

Are Ontario Teachers Paid More Equitably? Do Local Variables Matter?

Directory of Open Access Journals (Sweden)

Xiaobin Li

2010-05-01

Full Text Available This study investigated whether Ontario’s education funding reform of 1998 made teacher salaries more equitable. It also examined whether selected local variables had the same influence on teacher salaries in 2001-02 as they did in 1995-96 before the reform. Average teacher salaries before the reform in 1995-96 and after the reform in 2001-02 among school boards and among census divisions were compared to see whether the variation in teacher salaries increased or decreased. A partial correlation analysis was conducted to examine the influence on teacher salaries from local variables, which were derived from a literature review. This study finds that (a teachers are paid more equitably today than before the reform, and (b local variables no longer really matter, as a result of the changed provincial funding formula.

On the Adjacent Strong Equitable Edge Coloring of Pn ∨ Pn, Pn ∨ Cn and Cn ∨ Cn

OpenAIRE

Liu Jun; Zhao Chuan Cheng; Yao Shu Xia; Guo Ren Zhi; Yue Qiu Ju

2016-01-01

A proper edge coloring of graph G is called equitable adjacent strong edge coloring if colored sets from every two adjacent vertices incident edge are different,and the number of edges in any two color classes differ by at most one,which the required minimum number of colors is called the adjacent strong equitable edge chromatic number. In this paper, we discuss the adjacent strong equitable edge coloring of join-graphs about Pn ∨ Pn, Pn ∨ Cn and Cn ∨ Cn.

IMPEDIMENTS TO WOMEN’S EQUITABLE EMPLOYMENT: GLOBAL SCENARIO

OpenAIRE

Farida Faisal

2011-01-01

The ambivalent record of progress on issues of gender equality is reflective of the impediments to women’s equitable employment. This paper presents facts on global gender inequality in general, while specifically focusing on gender discrimination in the labour market and formal organisations. The Gender Mainstreaming strategy is presented as a viable option to overcome the obstacles restricting women from attaining their productive potential.

Land access and livelihoods in post-conflict Timor-Leste: no magic bullets

Directory of Open Access Journals (Sweden)

Simon P.J. Batterbury

2015-09-01

Full Text Available In Timor-Leste, customary institutions contribute to sustainable and equitable rural development and the establishment of improved access to and management of land, water and other natural resources. Drawing on multi-sited empirical research, we argue that the recognition and valorization of custom and common property management is a prerequisite for sustainable and equitable land tenure reform in Timor-Leste. In a four-community study of the relationship between land access and the practice of rural livelihoods in eastern and western districts of Timor-Leste, where customary management systems are dominant, we found different types of traditional dispute resolution, with deep roots in traditional forms of land management and with varying levels of conflict. The article shows how customary land tenure systems have already managed to create viable moral economies. Interviewees expressed a desire for the government to formalize its recognition and support for customary systems and to provide them with basic livelihood support and services. This was more important than instituting private landholding or state appropriation of community lands, which is perceived to be the focus of national draft land laws and an internationally supported project. We suggest ways in which diverse customary institutions can co-exist and work with state institutions to build collective political legitimacy in the rural hinterlands, within the context of upgrading the quality of rural life, promoting social and ecological harmony, and conflict management.

Providing safe drinking water to 1.2 billion unserved people

Energy Technology Data Exchange (ETDEWEB)

Gadgil, Ashok J.; Derby, Elisabeth A.

2003-06-01

Despite substantial advances in the past 100 years in public health, technology and medicine, 20% of the world population, mostly comprised of the poor population segments in developing countries (DCs), still does not have access to safe drinking water. To reach the United Nations (UN) Millennium Goal of halving the number of people without access to safe water by 2015, the global community will need to provide an additional one billion urban residents and 600 million rural residents with safe water within the next twelve years. This paper examines current water treatment measures and implementation methods for delivery of safe drinking water, and offers suggestions for making progress towards the goal of providing a timely and equitable solution for safe water provision. For water treatment, based on the serious limitations of boiling water and chlorination, we suggest an approach based on filtration coupled with ultraviolet (UV) disinfection, combined with public education. Additionally, owing to the capacity limitations for non-governmental organizations (NGOs) to take on this task primarily on their own, we suggest a strategy based on financially sustainable models that include the private sector as well as NGOs.

The deadlock principle as a ground for the just and equitable ...

African Journals Online (AJOL)

The deadlock principle as a ground for the just and equitable winding up of a solvent company: Thunder Cats Investments 92 (Pty) Ltd v Nkonjane Economic Prospecting Investment (Pty) Ltd 2014 5 SA 1 (SCA)

Human capital flight challenges within an Equitable Health System ...

African Journals Online (AJOL)

Human capital flight challenges within an Equitable Health System. N E Udonwa. Abstract. No Abstract Nigerian Journal of Medicine Vol. 16 (4) 2007: pp. 307-311. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/njm.v16i4.37327 · AJOL African ...

Examining the Relationship between Creativity and Equitable Thinking in Schools

Science.gov (United States)

Luria, Sarah R.; Kaufman, James C.

2017-01-01

This paper reviews the relationship between creativity and equitable thinking and the individual differences in personality, demographic, and experiential factors that influence both concepts as they affect each other. Given the nationwide push to increase equity in public schools, interventions beyond teaching about equity are becoming…

Creating Healthier, More Equitable Communities By Improving Governance And Policy.

Science.gov (United States)

Dubowitz, Tamara; Orleans, Tracy; Nelson, Christopher; May, Linnea Warren; Sloan, Jennifer C; Chandra, Anita

2016-11-01

How can healthier, more equitable communities be created? This is a key question for public health. Even though progress has been made in understanding the impact of social, physical, and policy factors on population health, there is much room for improvement. With this in mind, the Robert Wood Johnson Foundation made creating healthier, more equitable communities the third of four Action Areas in its Culture of Health Action Framework. This Action Area focuses on the interplay of three drivers-the physical environment, social and economic conditions, and policy and governance-in influencing health equity. In this article we review some of the policy and governance challenges confronting decisionmakers as they seek to create healthy communities on a broad scale. We use these challenges as a framework for understanding where the most critical gaps still exist, where the links could be exploited more effectively, and where there are opportunities for further research and policy development. Project HOPE—The People-to-People Health Foundation, Inc.

Task-sharing or public finance for the expansion of surgical access in rural Ethiopia: an extended cost-effectiveness analysis.

Science.gov (United States)

Shrime, Mark G; Verguet, Stéphane; Johansson, Kjell Arne; Desalegn, Dawit; Jamison, Dean T; Kruk, Margaret E

2016-07-01

Despite a high burden of surgical disease, access to surgical services in low- and middle-income countries is often limited. In line with the World Health Organization's current focus on universal health coverage and equitable access to care, we examined how policies to expand access to surgery in rural Ethiopia would impact health, impoverishment and equity. An extended cost-effectiveness analysis was performed. Deterministic and stochastic models of surgery in rural Ethiopia were constructed, utilizing pooled estimates of costs and probabilities from national surveys and published literature. Model calibration and validation were performed against published estimates, with sensitivity analyses on model assumptions to check for robustness. Outcomes of interest were the number of deaths averted, the number of cases of poverty averted and the number of cases of catastrophic expenditure averted for each policy, divided across wealth quintiles. Health benefits, financial risk protection and equity appear to be in tension in the expansion of access to surgical care in rural Ethiopia. Health benefits from each of the examined policies accrued primarily to the poor. However, without travel vouchers, many policies also induced impoverishment in the poor while providing financial risk protection to the rich, calling into question the equitable distribution of benefits by these policies. Adding travel vouchers removed the impoverishing effects of a policy but decreased the health benefit that could be bought per dollar spent. These results were robust to sensitivity analyses. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Use of Tablet Computers to Improve Access to Education in a Remote Location

Science.gov (United States)

Ally, Mohamed; Balaji, V.; Abdelbaki, Anwar; Cheng, Ricky

2017-01-01

A research project was carried out in using mobile learning to increase access to education. This project is contributing to the achievement of Goal 4 of the Sustainable Development Goals (SDGs), which is to "Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all". The mobile learning project…

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…

How to ensure equitable access to eye health for children with disabilities

Directory of Open Access Journals (Sweden)

Hannah Kuper

2016-07-01

Full Text Available All children need access to good quality eye care, and this must include children with disabilities. Childhood disability is very common. The World Health Organization (WHO estimates that there are at least 93 million children with disabilities worldwide, which equates to one in twenty children.1 Childhood disability is particularly common in low- and middle-income countries.

Legitimate expectations as an element of the fair and equitable standard of treatment of foreign investments in arbitral practice

Directory of Open Access Journals (Sweden)

Đundić Petar

2014-01-01

Full Text Available Fair and equitable standard of treatment of foreign investments represents an integral part of all modern international agreements on protection and encouragement of foreign investments. The key element of its contents, according to arbitral practice, is an obligation of the host state to provide the investor with the treatment in accordance with basic expectations that he or she had at the time of the investment with regard to economical and legal conditions in the host state. The paper analyzes the most important awards of arbitral tribunals dealing with legitimate expectations of the investor as a part of the fair and equitable treatment standard. A considerable attention is dedicated to identifying the behavior of the host state capable of creating legitimate expectation which enjoy legal protection as well as to detecting the requirements for the development of reasonable expectations.

Assessing Sustainable Behavior and its Correlates: A Measure of Pro-Ecological, Frugal, Altruistic and Equitable Actions

Directory of Open Access Journals (Sweden)

Blanca Fraijo-Sing

2013-02-01

Full Text Available Measures of sustainable behavior (SB usually include the self-report of activities aimed at the conservation of the natural environment. The sustainability notion explicitly incorporates both the satisfaction of human needs and the need of conserving the natural environment. Yet, the assessment of sustainable behaviors rarely considers the protection of the social environment as situation to investigate. In this paper, we propose the use of an instrument assessing SB, which includes the report of pro-ecological and frugal actions in addition to altruistic and equitable behaviors. The responses provided by 807 Mexican undergraduates to a questionnaire investigating those four instances of SB were processed within a structural equation model. Emotional (indignation due to environmental destruction, affinity towards diversity, happiness and rational (intention to act factors assumedly linked to sustainable behavior were also investigated. Significant interrelations among pro-ecological, frugal, altruistic and equitable behaviors resulted, suggesting the presence of a higher-order-factor that we identified as SB. This factor, in turn, significantly correlated with the rest of the investigated pro-environmental factors.

Providing Access to Library Automation Systems for Students with Disabilities.

Science.gov (United States)

California Community Colleges, Sacramento. High-Tech Center for the Disabled.

This document provides information on the integration of assistive computer technologies and library automation systems at California Community Colleges in order to ensure access for students with disabilities. Topics covered include planning, upgrading, purchasing, implementing and using these technologies with library systems. As information…

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

Directory of Open Access Journals (Sweden)

Freda Mold

2015-12-01

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

Internet Access Practices and Employee Attitudes toward Internet Usage Policy Implementation in Selected Philippines Financial Institutions

Directory of Open Access Journals (Sweden)

Maria Sagrario R. Simbulan

2004-06-01

Full Text Available This study explores the employees’ concept of appropriate use of Internet facilities as well as their perception of the rights and liabilities, both of the individual and of the organization, associated with the grant of Internet access privileges in the workplace. It further examines how employees perceive their organization’s monitoring of employees online activities and the use of an Internet Usage Policy, whether these are seen as monitoring and control mechanisms or as ways to ensure that Internet access facilities are shared equitably and used responsibly. While the issue of the impact of Internet access on employee productivity will not directly be tackled, the study will provide insights into the frequency and type of usage of Internet facilities in the workplace. Considering the sizeable investment that an organization makes to provide Internet facilities, determining how employees use these facilities to achieve the goals of the organization is, in the very least, interesting and for most organizations concerned with their survival in difficult times, critically important.

Access to water provides economic relief through enhanced relationships in Kenya.

Science.gov (United States)

Zolnikov, Tara Rava; Blodgett-Salafia, Elizabeth

2017-03-01

Sub-Saharan Africa is comprised of low- and middle-income countries subject to the residual effects of chronic poverty. Poverty contributes to health disparities and social inequities. Public health strategies and solutions seek to remedy the effects of poverty. Providing access to quality water is one priority public health project that alleviates adverse health effects, but may have additional outcomes. Previous research has not thoroughly reviewed the economic relief and relationship changes from implemented water interventions. A qualitative phenomenological approach used 52 semi-structured interviews to understand relationship experiences among primary water gatherers and their families after implemented water interventions in a community. This study took place throughout the historically semi-arid eastern region in Kitui, Kenya, where community members have been beneficiaries of various water interventions. Prior to the water intervention, relationships were strained because of economic hardships. Households experienced economic difficulties in paying for children's school fees, buying bricks for housing structures, having water for house gardens, trees for shade in the compound, crops and providing water for their animals. After receiving access to water, relationships improved, because families were able to discuss and address economic challenges. Additional financial revenue was gained and used to pay for water to make bricks to sell or use on housing structures, expand on house gardens and agricultural crops, build new businesses, purchase water for animals, and construct local water spouts near the household. Access to water improved relationships, which encouraged economic growth. This information provides a critical component in understanding the interconnected nature between access to water, poverty and family relationships. Ultimately, this research suggests an increased need for access to quality water worldwide to improve both economic situations

Bring Your Own Device - Providing Reliable Model of Data Access

Directory of Open Access Journals (Sweden)

Stąpór Paweł

2016-10-01

Full Text Available The article presents a model of Bring Your Own Device (BYOD as a model network, which provides the user reliable access to network resources. BYOD is a model dynamically developing, which can be applied in many areas. Research network has been launched in order to carry out the test, in which as a service of BYOD model Work Folders service was used. This service allows the user to synchronize files between the device and the server. An access to the network is completed through the wireless communication by the 802.11n standard. Obtained results are shown and analyzed in this article.

Adolescents' Sexual Wellbeing in Southwestern Uganda: A Cross-Sectional Assessment of Body Image, Self-Esteem and Gender Equitable Norms.

Science.gov (United States)

Kemigisha, Elizabeth; Nyakato, Viola N; Bruce, Katharine; Ndaruhutse Ruzaaza, Gad; Mlahagwa, Wendo; Ninsiima, Anna B; Coene, Gily; Leye, Els; Michielsen, Kristien

2018-02-22

Measures of sexual wellbeing and positive aspects of sexuality in the World Health Organization definition for sexual health are rarely studied and remain poorly understood, especially among adolescents in Sub-Saharan Africa. The objective of this study was to assess sexual wellbeing in its broad sense-i.e., body image, self-esteem, and gender equitable norms-and associated factors in young adolescents in Uganda. A cross-sectional survey of adolescents ages 10-14 years in schools was carried out between June and July 2016. Among 1096 adolescents analyzed, the median age was 12 (Inter-Quartile Range (IQR): 11, 13) and 58% were female. Self-esteem and body image scores were high with median 24 (IQR: 22, 26, possible range: 7-28) and median 22 (IQR: 19, 24, possible range: 5-25) respectively. Gender equitable norms mean score was 28.1 (SD 5.2: possible range 11-44). We noted high scores for self-esteem and body image but moderate scores on gender equitable norms. Girls had higher scores compared to boys for all outcomes. A higher age and being sexually active were associated with lower scores on gender equitable norms. Gender equitable norms scores decreased with increasing age of adolescents. Comprehensive and timely sexuality education programs focusing on gender differences and norms are recommended.

Species dominance and equitability: patterns in Cenozoic foraminifera of eastern North America

Science.gov (United States)

Gibson, T.G.; Hill, E.E.

1992-01-01

Species dominance in benthonic foraminifera, represented by percent of the assemblage composed of the single most abundant species, shows little change in observed range of values from shallow into deep-marine waters in 1005 samples from the Gulf of Mexico, Atlantic, and Arctic margins of North America. This finding contrasts with the model that species dominance is highest in shallow-marine environments and decreases offshore into deeper marine waters. Equitability, the relation of all species abundances within an assemblage, also shows little change between the values found in shallow-marine assemblages and those found in assemblages from deeper water environments. Equitability and dominance values found in 421 assemblages from Palaeocene, Eocene, Miocene, and Pleistocene strata of the Atlantic and E Gulf of Mexico coastal plains are similar to the modern values. -from Authors

Finding pathways to more equitable and meaningful public-scientist partnerships

Science.gov (United States)

Daniela Soleri; Jonathan W. Long; Monica D. Ramirez-Andreotta; Ruth Eitemiller; Rajul Pandyaǁ

2016-01-01

For many, citizen science is exciting because of the possibility for more diverse, equitable partnerships in scientific research with outcomes considered meaningful and useful by all, including public participants. This was the focus of a symposium we organized at the 2015 conference of the Citizen Science Association. Here we synthesize points made by symposium...

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

Science.gov (United States)

Long, Genia; Mortimer, Richard; Sanzenbacher, Geoffrey

2014-12-01

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

Voluntary program promotes equitable and expedited remediation of contaminated properties

Energy Technology Data Exchange (ETDEWEB)

Wolfenden, A.K.; Cambridge, M. [California Environmental Protection Agency, Sacramento, CA (United States). Dept. of Toxic Substances Control

1995-12-31

In California, the California Environmental Protection Agency (Cal/EPA) has developed a more equitable and expedited approach for the redevelopment of sites contaminated with hazardous substances. Senate Bill 923 enacted in 1994, established the Expedited Remedial Action Program (ERAP) under Chapter 6.85 of the California Health and Safety Code. This bill responds to a nationwide demand to reform Superfund laws and promote the restoration of blighted and contaminated parcels--often referred to as Brownfields. The program was designed as an alternative to CERCLA, which has come under criticism for being inefficient, unfair and restricting opportunities for effective cleanups. Cal/EPA`s Department of Toxic Substances Control will implement this pilot program. This pilot program, which will eventually comprise 30 sites, provides incentives for voluntary remediation by addressing key economic issues associated with the remediation and redevelopment of contaminated properties.

Mental Health, Access, and Equity in Higher Education

Directory of Open Access Journals (Sweden)

Jennifer Martin

2010-03-01

Full Text Available This paper tackles the difficult and often not openly discussed This paper tackles the difficult and often not openly discussed topic of access and equity in higher education for people with mental health difficulties. Recent legislative and policy developments in mental health, disability, anti-discrimination and education mean that all students who disclose a mental health condition can expect fair and equitable treatment. However the findings of an exploratory study at an Australian university reveal that just under two thirds of the 54 students who reported mental health difficulties did not disclose this to staff due to fears of discrimination at university and in future employment. Students who did disclose felt supported when staff displayed a respectful attitude and provided appropriate advice and useful strategies for them to remain engaged in university studies when experiencing mental health difficulties.

Evaluation Report on Defense Contract Audit Agency Audits of Requests for Equitable Adjustment

National Research Council Canada - National Science Library

1997-01-01

Contractors may submit requests for equitable adjustment (REAs) of costs or prices as proposals under the Federal Acquisition Regulation governing contract modifications or as claims under the Contract Disputes Act...

Adolescents’ Sexual Wellbeing in Southwestern Uganda: A Cross-Sectional Assessment of Body Image, Self-Esteem and Gender Equitable Norms

Science.gov (United States)

Kemigisha, Elizabeth; Nyakato, Viola N.; Bruce, Katharine; Ndaruhutse Ruzaaza, Gad; Mlahagwa, Wendo; Ninsiima, Anna B.; Coene, Gily; Leye, Els; Michielsen, Kristien

2018-01-01

Measures of sexual wellbeing and positive aspects of sexuality in the World Health Organization definition for sexual health are rarely studied and remain poorly understood, especially among adolescents in Sub-Saharan Africa. The objective of this study was to assess sexual wellbeing in its broad sense—i.e., body image, self-esteem, and gender equitable norms—and associated factors in young adolescents in Uganda. A cross-sectional survey of adolescents ages 10–14 years in schools was carried out between June and July 2016. Among 1096 adolescents analyzed, the median age was 12 (Inter-Quartile Range (IQR): 11, 13) and 58% were female. Self-esteem and body image scores were high with median 24 (IQR: 22, 26, possible range: 7–28) and median 22 (IQR: 19, 24, possible range: 5–25) respectively. Gender equitable norms mean score was 28.1 (SD 5.2: possible range 11–44). We noted high scores for self-esteem and body image but moderate scores on gender equitable norms. Girls had higher scores compared to boys for all outcomes. A higher age and being sexually active were associated with lower scores on gender equitable norms. Gender equitable norms scores decreased with increasing age of adolescents. Comprehensive and timely sexuality education programs focusing on gender differences and norms are recommended. PMID:29470388

Providing Data Access for Interdisciplinary Research

Science.gov (United States)

Hooper, R. P.; Couch, A.

2012-12-01

Developing an interdisciplinary understanding of human and environmental interactions with water requires access to a variety of data kinds collected by various organizations. The CUAHSI Hydrologic Information System (HIS) is a standards-based, services-oriented architecture designed for time-series data. Such data represents an important type of data in water studies. Through the efforts of HIS, a standard transmission language, WaterML2, has been adopted by the Open Geospatial Consortium and is under consideration by the World Meteorologic Organization as an international standards. Web services have also been developed to retrieve data and metadata. HIS is completed with a metadata catalog, hosted by San Diego Supercomputing Center, which indexes more than 20 million time series provided from over 90 different services. This catalog is supported through a hierarchically organized controlled vocabulary that is open for community input and mediation. Data publishers include federal agencies, universities, state agencies, and non-profit organizations such as watershed associations. Accessing data from such a broad spectrum of sources through a uniform service standard promises to truly transform the way in which hydrologic research is done. CUAHSI HIS is a large-scale prototype at this time, but a proposal is under consideration by the National Science Foundation to operationalize HIS through a data facility, tentatively called the CUAHSI Water Data Center. Establishing HIS is an important step to enable research into human-environment interactions with water, but it is only one step. Other data structures will need to be made accessible and interoperable to support this research. Some data—such as two-dimensional GIS coverages—already have widely used standards for transmission and sharing. The US Federal government has long operated a clearinghouse for federal geographic data that is now being augmented with other services such as ArcGIS OnLine. Other data

An exploration of multilevel modeling for estimating access to drinking-water and sanitation.

Science.gov (United States)

Wolf, Jennyfer; Bonjour, Sophie; Prüss-Ustün, Annette

2013-03-01

Monitoring progress towards the targets for access to safe drinking-water and sanitation under the Millennium Development Goals (MDG) requires reliable estimates and indicators. We analyzed trends and reviewed current indicators used for those targets. We developed continuous time series for 1990 to 2015 for access to improved drinking-water sources and improved sanitation facilities by country using multilevel modeling (MLM). We show that MLM is a reliable and transparent tool with many advantages over alternative approaches to estimate access to facilities. Using current indicators, the MDG target for water would be met, but the target for sanitation missed considerably. The number of people without access to such services is still increasing in certain regions. Striking differences persist between urban and rural areas. Consideration of water quality and different classification of shared sanitation facilities would, however, alter estimates considerably. To achieve improved monitoring we propose: (1) considering the use of MLM as an alternative for estimating access to safe drinking-water and sanitation; (2) completing regular assessments of water quality and supporting the development of national regulatory frameworks as part of capacity development; (3) evaluating health impacts of shared sanitation; (4) using a more equitable presentation of countries' performances in providing improved services.

34 CFR 364.37 - What access to records must be provided?

Science.gov (United States)

2010-07-01

... SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING SERVICES... Requirements? § 364.37 What access to records must be provided? For the purpose of conducting audits, examinations, and compliance reviews, the State plan must include satisfactory assurances that all recipients...

Does the edge effect impact on the measure of spatial accessibility to healthcare providers?

Science.gov (United States)

Gao, Fei; Kihal, Wahida; Le Meur, Nolwenn; Souris, Marc; Deguen, Séverine

2017-12-11

Spatial accessibility indices are increasingly applied when investigating inequalities in health. Although most studies are making mentions of potential errors caused by the edge effect, many acknowledge having neglected to consider this concern by establishing spatial analyses within a finite region, settling for hypothesizing that accessibility to facilities will be under-reported. Our study seeks to assess the effect of edge on the accuracy of defining healthcare provider access by comparing healthcare provider accessibility accounting or not for the edge effect, in a real-world application. This study was carried out in the department of Nord, France. The statistical unit we use is the French census block known as 'IRIS' (Ilot Regroupé pour l'Information Statistique), defined by the National Institute of Statistics and Economic Studies. The geographical accessibility indicator used is the "Index of Spatial Accessibility" (ISA), based on the E2SFCA algorithm. We calculated ISA for the pregnant women population by selecting three types of healthcare providers: general practitioners, gynecologists and midwives. We compared ISA variation when accounting or not edge effect in urban and rural zones. The GIS method was then employed to determine global and local autocorrelation. Lastly, we compared the relationship between socioeconomic distress index and ISA, when accounting or not for the edge effect, to fully evaluate its impact. The results revealed that on average ISA when offer and demand beyond the boundary were included is slightly below ISA when not accounting for the edge effect, and we found that the IRIS value was more likely to deteriorate than improve. Moreover, edge effect impact can vary widely by health provider type. There is greater variability within the rural IRIS group than within the urban IRIS group. We found a positive correlation between socioeconomic distress variables and composite ISA. Spatial analysis results (such as Moran's spatial

Geographic Accessibility - Providing government servies in an spatially equitable manner: Perspectives for Fire Station location

CSIR Research Space (South Africa)

Green, Cheri A

2012-10-01

Full Text Available - - 30928 Inanda C - Low 78 311 2 760 30928 Inanda D - Rural 26 317 8 960 25542 Newlands/Sea Cow lake B - Moderate 3 469 500 25542 Newlands/Sea Cow lake C - Low 59 481 1 780 25542 Newlands/Sea Cow lake D - Rural 1 918 220 25542 Newlands/Sea Cow lake E...

Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal.

Science.gov (United States)

He, Wen-Jun; Lai, Ying-Si; Karmacharya, Biraj M; Dai, Bo-Feng; Hao, Yuan-Tao; Xu, Dong Roman

2018-04-02

Per United Nations' Sustainable Development Goals, Nepal is aspiring to achieve universal and equitable access to safe and affordable drinking water and provide access to adequate and equitable sanitation for all by 2030. For these goals to be accomplished, it is important to understand the country's geographical heterogeneity and inequality of access to its drinking-water supply and sanitation (WSS) so that resource allocation and disease control can be optimized. We aimed 1) to estimate spatial heterogeneity of access to improved WSS among the overall Nepalese population at a high resolution; 2) to explore inequality within and between relevant Nepalese administrative levels; and 3) to identify the specific administrative areas in greatest need of policy attention. We extracted cluster-sample data on the use of the water supply and sanitation that included 10,826 surveyed households from the 2011 Nepal Demographic and Health Survey, then used a Gaussian kernel density estimation with adaptive bandwidths to estimate the distribution of access to improved WSS conditions over a grid at 1 × 1 km. The Gini coefficient was calculated for the measurement of inequality in the distribution of improved WSS; the Theil L measure and Theil T index were applied to account for the decomposition of inequality. 57% of Nepalese had access to improved sanitation (range: 18.1% in Mahottari to 100% in Kathmandu) and 92% to drinking-water (range: 41.7% in Doti to 100% in Bara). The most unequal districts in Gini coefficient among improved sanitation were Saptari, Sindhuli, Banke, Bajura and Achham (range: 0.276 to 0.316); and Sankhuwasabha, Arghakhanchi, Gulmi, Bhojpur, Kathmandu (range: 0.110 to 0.137) among improved drinking-water. Both the Theil L and Theil T showed that within-province inequality was substantially greater than between-province inequality; while within-district inequality was less than between-district inequality. The inequality of several districts was

The changing face of government information providing access in the twenty-first century

CERN Document Server

Kumar, Suhasini L

2006-01-01

Learn what innovative changes lie in the future of government information The Changing Face of Government Information comprehensively examines the way government documents' librarians acquire, provide access, and provide reference services in the new electronic environment. Noted experts discuss the impact electronic materials have had on the Government Printing Office (GPO), the reference services within the Federal Depository Library Program (FDLP), and the new opportunities in the transition from paper-based information policy to an electronic e-government. This source reveals the latest changes in the field of government documents librarianship and the knowledge and expertise needed to teach users how to access what they need from this enormous wealth of government information. Major changes have taken place in the way government information is created, disseminated, accessed, and preserved. The Changing Face of Government Information explains in detail the tremendous change taking place in libraries and ...

"The care is the best you can give at the time": Health care professionals' experiences in providing gender affirming care in South Africa.

Directory of Open Access Journals (Sweden)

Sarah Spencer

Full Text Available While the provision of gender affirming care for transgender people in South Africa is considered legal, ethical, and medically sound, and is-theoretically-available in both the South African private and public health sectors, access remains severely limited and unequal within the country. As there are no national policies or guidelines, little is known about how individual health care professionals providing gender affirming care make clinical decisions about eligibility and treatment options.Based on an initial policy review and service mapping, this study employed semi-structured interviews with a snowball sample of twelve health care providers, representing most providers currently providing gender affirming care in South Africa. Data were analysed thematically using NVivo, and are reported following COREQ guidelines.Our findings suggest that, whilst a small minority of health care providers offer gender affirming care, this is almost exclusively on their own initiative and is usually unsupported by wider structures and institutions. The ad hoc, discretionary nature of services means that access to care is dependent on whether a transgender person is fortunate enough to access a sympathetic and knowledgeable health care provider.Accordingly, national, state-sanctioned guidelines for gender affirming care are necessary to increase access, homogenise quality of care, and contribute to equitable provision of gender affirming care in the public and private health systems.

Wellbeing in the Welfare State: level not higher, distribution not more equitable

NARCIS (Netherlands)

R. Veenhoven (Ruut)

2000-01-01

textabstract'Wellbeing' and 'welfare' are often bracketed together, in particular wellbeing and state-welfare. The level of wellbeing is believed to be higher in welfare states, and its distribution more equitable. This theory is tested in a comparative study of 40 nations 1980-1990. The size of

What Type of Knowledge Provides Valid Housing Standards Addressing Accessibility?

DEFF Research Database (Denmark)

Helle, Tina; Brandt, Åse; Iwarsson, Susanne

evaluations of task-surface heights in elderly people’s homes. Applied Ergonomics, 31, 109-119. Kohlbacher, F. (2006). The use of qualitative content analysis in case study research. Forum: Qualitative social research sozialforschung (FQS), Open Journal Systems, vol 7, No1. Kozey, J.W. & Das, B. (2004...... accessibility aspects such as either reach, seat height or space requirements • Targeted primarily industrial workstation design and only wheelchair/scooter users • Addressed positions (standing/seated) and sex difference with respect to reach • Was generated in lab-like environments, using methods...... of the validity of housing standards. Therefore, it is reasonable to question what type of knowledge that provides the most valid standards addressing accessibility and explore the consequences of using an alternative approach. The idea was thus to examine the validity of a set of housing standards using a so...

Secret Shoppers Find Access To Providers And Network Accuracy Lacking For Those In Marketplace And Commercial Plans.

Science.gov (United States)

Haeder, Simon F; Weimer, David L; Mukamel, Dana B

2016-07-01

The adequacy of provider networks for plans sold through insurance Marketplaces established under the Affordable Care Act has received much scrutiny recently. Various studies have established that networks are generally narrow. To learn more about network adequacy and access to care, we investigated two questions. First, no matter the nominal size of a network, can patients gain access to primary care services from providers of their choice in a timely manner? Second, how does access compare to plans sold outside insurance Marketplaces? We conducted a "secret shopper" survey of 743 primary care providers from five of California's nineteen insurance Marketplace pricing regions in the summer of 2015. Our findings indicate that obtaining access to primary care providers was generally equally challenging both inside and outside insurance Marketplaces. In less than 30 percent of cases were consumers able to schedule an appointment with an initially selected physician provider. Information about provider networks was often inaccurate. Problems accessing services for patients with acute conditions were particularly troubling. Effectively addressing issues of network adequacy requires more accurate provider information. Project HOPE—The People-to-People Health Foundation, Inc.

Perceived barriers in accessing dental care among patients attending dental institute using decision-making trial and evaluation laboratory method

Directory of Open Access Journals (Sweden)

Ravneet Malhi

2015-01-01

Full Text Available Introduction: Utilization of dental service is a concept of expressing the extent of interaction between the service provider and the people for whom it is indented. However, one of the major issues in social welfare is the equitable provision of these services to the population. Aim: To determine the perceived barriers affecting access to the dental services in the dental institute. Materials and Methods: A cross-sectional survey was conducted in the dental institute during the month of February in the year 2014 using decision-making trial and evaluation laboratory (DEMATEL method. The study sample included the 364 subjects. The required data were collected using a specially designed and pretested questionnaire. The data were analyzed using SPSS 18.0 (SPSS Inc., Chicago, IL, USA and MATLAB 7.6.0. The mean, standard deviations were used to describe the data, and inferential statistics included one-way ANOVA and DEMATEL. Results: The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access dental services. Based on subjects′ responses to the questions, the cost (54.75% agreed or strongly agreed was identified as the most important factor affecting the access to dental health care followed by dentist-patient relationship (48.57%, inconvenience (36.55%, fear (23.70%, and organization (14.02%. The difference was found to be statistically significant (P = 0.0001. When the hierarchy of the affecting and affected factors was calculated, based on the factor analysis by using DEMATEL method, the cost (R−J = 0.16 and organization (R−J = 1.15, were certain affecting determinant which influenced the access to dental services and inconvenience. Conclusion: The major barriers to oral health care utilization among our patients were cost, fear, and organization. Policymakers, administrators, and insurance organizations have a major role. Hence, the policies should be fair and

The potential of PVs in developing countries: maintaining an equitable society in the face of fossil fuel depletion

OpenAIRE

Byrd, Hugh

2010-01-01

The availability of an adequate electrical supply to the whole population is essential for the wellbeing and equity of a society. However, for those countries that are largely dependent on fossil fuels for generating electricity, peak oil and gas threaten energy security and the ability to provide an uninterrupted supply of electricity on an equitable basis. This paper will review future energy demand and supply in Malaysia and implications for its electricity supply. It will demonstrate ...

“The care is the best you can give at the time”: Health care professionals’ experiences in providing gender affirming care in South Africa

Science.gov (United States)

Spencer, Sarah; Meer, Talia

2017-01-01

Background While the provision of gender affirming care for transgender people in South Africa is considered legal, ethical, and medically sound, and is—theoretically—available in both the South African private and public health sectors, access remains severely limited and unequal within the country. As there are no national policies or guidelines, little is known about how individual health care professionals providing gender affirming care make clinical decisions about eligibility and treatment options. Method Based on an initial policy review and service mapping, this study employed semi-structured interviews with a snowball sample of twelve health care providers, representing most providers currently providing gender affirming care in South Africa. Data were analysed thematically using NVivo, and are reported following COREQ guidelines. Results Our findings suggest that, whilst a small minority of health care providers offer gender affirming care, this is almost exclusively on their own initiative and is usually unsupported by wider structures and institutions. The ad hoc, discretionary nature of services means that access to care is dependent on whether a transgender person is fortunate enough to access a sympathetic and knowledgeable health care provider. Conclusion Accordingly, national, state-sanctioned guidelines for gender affirming care are necessary to increase access, homogenise quality of care, and contribute to equitable provision of gender affirming care in the public and private health systems. PMID:28704458

Evaluating accessibility to Bangkok Metro Systems using multi-dimensional criteria across user groups

Directory of Open Access Journals (Sweden)

Duangporn Prasertsubpakij

2012-07-01

Full Text Available Metro systems act as fast and efficient transport systems for many modern metropolises; however, enhancing higher usage of such systems often conflicts with providing suitable accessibility options. The traditional approach of metro accessibility studies seems to be an ineffective measure to gage sustainable access in which the equal rights of all users are taken into account. Bangkok Metropolitan Region (BMR transportation has increasingly relied on the role of two mass rapid transport systems publicly called “BTS Skytrain” and “MRT Subway”, due to limited availability of land and massive road congestion; however, access to such transit arguably treats some vulnerable groups, especially women, the elderly and disabled people unfairly. This study constructs a multi-dimensional assessment of accessibility considerations to scrutinize how user groups access metro services based on BMR empirical case. 600 individual passengers at various stations were asked to rate the questionnaire that simultaneously considers accessibility aspects of spatial, feeder connectivity, temporal, comfort/safety, psychosocial and other dimensions. It was interestingly found by user disaggregated accessibility model that the lower the accessibility perceptions—related uncomfortable and unsafe environment conditions, the greater the equitable access to services, as illustrated by MRT — Hua Lumphong and MRT — Petchaburi stations. The study suggests that, to balance the access priorities of groups on services, policy actions should emphasize acceptably safe access for individuals, cost efficient feeder services connecting the metro lines, socioeconomic influences and time allocation. Insightful discussions on integrated approach balancing different dimensions of accessibility and recommendations would contribute to accessibility-based knowledge and potential propensity to use the public transits towards transport sustainability.

Health care access and quality for persons with disability: Patient and provider recommendations.

Science.gov (United States)

McClintock, Heather F; Kurichi, Jibby E; Barg, Frances K; Krueger, Alice; Colletti, Patrice M; Wearing, Krizia A; Bogner, Hillary R

2018-07-01

Significant disparities in health care access and quality persist between persons with disabilities (PWD) and persons without disabilities (PWOD). Little research has examined recommendations of patients and providers to improve health care for PWD. We sought to explore patient and health care provider recommendations to improve health care access and quality for PWD through focus groups in the physical world in a community center and in the virtual world in an online community. In all, 17 PWD, 4 PWOD, and 6 health care providers participated in 1 of 5 focus groups. Focus groups were conducted in the virtual world in Second Life ® with Virtual Ability, an online community, and in the physical world at Agape Community Center in Milwaukee, WI. Focus group data were analyzed using a grounded theory methodology. Themes that emerged in focus groups among PWD and PWOD as well as health care providers to improve health care access and quality for PWD were: promoting advocacy, increasing awareness and knowledge, improving communication, addressing assumptions, as well as modifying and creating policy. Many participants discussed political empowerment and engagement as central to health care reform. Both PWD and PWOD as well as health care providers identified common themes potentially important for improving health care for PWD. Patient and health care provider recommendations highlight a need for modification of current paradigms, practices, and approaches to improve the quality of health care provision for PWD. Participants emphasized the need for greater advocacy and political engagement. Copyright © 2018 Elsevier Inc. All rights reserved.

"A More Equitable Society": The Politics of Global Fairness in Paralympic Sport.

Science.gov (United States)

Swartz, Leslie; Bantjes, Jason; Rall, Divan; Ferreira, Suzanne; Blauwet, Cheri; Derman, Wayne

2016-01-01

The Paralympic Movement explicitly sets out to create a more equitable society and promote participation for all and fairness in disability sport. This is primarily achieved through the use of a range of interventions with less attention given to how economic factors may hinder access and achievement in Paralympic sport. We investigated how country-level economic variables influence the level of participation and achievement in the 2015 International Paralympic Committee (IPC) Athletics Championships held in Doha. We used multiple regression analysis to show how levels of participation and achievement in the Championships were significantly determined by economic factors independent of population size. Our data show that in spite of the ideals of inclusion and fairness within the Paralympic Movement and the considerable effort expended on the use of technologies to achieve this, economic factors continue to exert a statistically significant influence on both the level of participation and achievement of Paralympic athletes. LMICs participate at lower levels and achieve fewer medals when compared to HICs. These differences are particularly marked in events that have a high cost of participation. Our findings raise questions regarding the use of current technologies and the level to which they are able to truly disrupt the politics of global inequality in sport.

South Africa’s protracted struggle for equal distribution and equitable access – still not there

Science.gov (United States)

2014-01-01

The purpose of this contribution is to analyse and explain the South African HRH case, its historical evolution, and post-apartheid reform initiatives aimed at addressing deficiencies and shortfalls. HRH in South Africa not only mirrors the nature and diversity of challenges globally, but also the strategies pursued by countries to address these challenges. Although South Africa has strongly developed health professions, large numbers of professional and mid-level workers, and also well-established training institutions, it is experiencing serious workforce shortages and access constraints. This results from the unequal distribution of health workers between the well-resourced private sector over the poorly-resourced public sector, as well as from distributional disparities between urban and rural areas. During colonial and apartheid times, disparities were aggravated by policies of racial segregation and exclusion, remnants of which are today still visible in health-professional backlogs, unequal provincial HRH distribution, and differential access to health services for specific race and class groups. Since 1994, South Africa’s transition to democracy deeply transformed the health system, health professions and HRH establishments. The introduction of free-health policies, the district health system and the prioritisation of PHC ensured more equal distribution of the workforce, as well as greater access to services for deprived groups. However, the HIV/AIDS epidemic brought about huge demands for care and massive patient loads in the public-sector. The emigration of health professionals to developed countries and to the private sector also undermines the strength and effectiveness of the public health sector. For the poor, access to care thus remains constrained and in perpetual shortfall. The post-1994 government has introduced several HRH-specific strategies to recruit, distribute, motivate and retain health professionals to strengthen the public sector and to

The Development of a More Equitable Method of Billing for Online Services.

Science.gov (United States)

Kenton, David

1984-01-01

The National Library of Medicine has discarded connect hour-only billing for a more equitable system, which distributes user costs by type and intensity of work performed and data delivered. User data (cost comparisons, interpolated input/output count per connect hours, connect hours per year) were analyzed and further improvements are planned.…

Barriers to accessing ATLS provider course for junior doctors at a ...

African Journals Online (AJOL)

Barriers to accessing ATLS provider course for junior doctors at a major university hospital in South Africa. ... South African Journal of Surgery ... Subgroup analysis comparing the reasons for PGY1s vs PGY2s demonstrated that not being able to secure a place on course was more common among PGY2s [19% vs 33%, ...

Virtual Library: Providing Accessible Online Resources.

Science.gov (United States)

Kelly, Rob

2001-01-01

Describes e-global library, a virtual library based on the Jones International University's library that organizes Internet resources to make them more accessible to students at all skill levels. Highlights include online tutorials; research guides; financial aid and career development information; and possible partnerships with other digital…

The unethical focus on access: a study of medical ethics and the waiting-time guarantee.

Science.gov (United States)

Karlberg, H I; Brinkmo, B-M

2009-03-01

All civilized societies favour ethical principles of equity. In healthcare, these principles generally focus on needs for medical care. Methods for establishing priorities among such needs are instrumental in this process. In this study, we analysed whether rules on access to healthcare, waiting-time guarantees, conflict with ethical principles of distributive justice. We interviewed directors, managers and other decision-makers of various healthcare providers of hospitals, primary care organizations and purchasing offices. We also conducted focus group interviews with professionals from a number of distinct medical areas. Our informants and their co-workers were reasonably familiar with the ethical platforms for priority-setting established by the Swedish parliament, giving the sickest patients complete priority. However, to satisfy the waiting-time guarantees, the informants often had to make priority decisions contrary to the ethical principles by favouring access before needs to keep waiting times within certain limits. The common opinion was that the waiting-time guarantee leads to crowding-out effects, overruling the ethical principles based on needs. For more than a decade, the interpretation in Sweden of the equitable principle based on medical needs has been distorted through political decisions, leading to healthcare providers giving priority to access rather than needs for care.

Providing Social Enterprises with Better Access to Public Procurement : The Development of Supportive Legal Frameworks

NARCIS (Netherlands)

Argyrou, A.

2017-01-01

This article discusses the issue of social enterprises gaining access to public procurement processes and contracts at the EU and national level. It primarily examines the opportunities for social enterprises to access public procurement contracts provided for in the Public Procurement Directive

Poor Access for African Researchers to African Emergency Care Publications: A Cross-sectional Study.

Science.gov (United States)

Bruijns, Stevan R; Maesela, Mmapeladi; Sinha, Suniti; Banner, Megan

2017-10-01

Based on relative population size and burden of disease, emergency care publication outputs from low- and middle-income regions are disproportionately lower than those of high-income regions. Ironically, outputs from regions with higher publication rates are often less relevant in the African context. As a result, the dissemination of and access to local research is essential to local researchers, but the cost of this access (actual and cost-wise) remains unknown. The aim of this study was to describe access to African emergency care publications in terms of publisher-based access (open access or subscription) and alternate access (self-archived or author provided), as well as the cost of access. We conducted a retrospective, cross-sectional study using all emergency medicine publications included in Scopus between 2011 and 2015. A sequential search strategy described access to each article, and we calculated mean article charges against the purchasing power parity index (used to describe out-of-pocket expense). We included 666 publications from 49 journals, of which 395 (59.3%) were open access. For subscription-based articles, 106 (39.1%) were self-archived, 60 (22.1%) were author-provided, and 105 (38.8%) were inaccessible. Mean article access cost was $36.44, and mean processing charge was $2,319.34. Using the purchasing power parity index it was calculated that equivalent out-of-pocket expenditure for South African, Ghanaian and Tanzanian authors would respectively be $15.77, $10.44 and $13.04 for access, and $1,004.02, $664.36 and $830.27 for processing. Based on this, the corrected cost of a single-unit article access or process charge for South African, Ghanaian and Tanzanian authors, respectively, was 2.3, 3.5 and 2.8 times higher than the standard rate. One in six African emergency care publications are inaccessible outside institutional library subscriptions; additionally, the cost of access to publications in low- and middle-income countries appears

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.

Improving access to medicines in low and middle income countries: corporate responsibilities in context.

Science.gov (United States)

Leisinger, Klaus Michael; Garabedian, Laura Faden; Wagner, Anita Katharina

2012-12-01

More than two billion people in low- and middle-income countries (LMIC) lack adequate access to essential medicines. In this paper, we make strong public health, human rights and economic arguments for improving access to medicines in LMIC and discuss the different roles and responsibilities of key stakeholders, including national governments, the international community, and non-governmental organizations (NGOs). We then establish a framework of pharmaceutical firms' corporate responsibilities - the "must," the "ought to," and the "can" dimensions - and make recommendations for actionable business strategies for improving access to medicines. We discuss controversial topics, such as pharmaceutical profits and patents, with the goal of building consensus around facts and working towards a solution. We conclude that partnerships and collaboration among multiple stakeholders are urgently needed to improve equitable access to medicines in LMIC.

Noticing Children's Participation: Insights into Teacher Positionality toward Equitable Mathematics Pedagogy

Science.gov (United States)

Wager, Anita A.

2014-01-01

This article describes how teachers in a professional development course responded to what they noticed about children's participation in elementary mathematics classrooms and how what they noticed was connected to the teachers' positionality toward equitable mathematics pedagogy. Findings suggest that a lens of participation supported…

Are Ontario Teachers Paid More Equitably? Do Local Variables Matter?

OpenAIRE

Xiaobin Li

2010-01-01

This study investigated whether Ontario’s education funding reform of 1998 made teacher salaries more equitable. It also examined whether selected local variables had the same influence on teacher salaries in 2001-02 as they did in 1995-96 before the reform. Average teacher salaries before the reform in 1995-96 and after the reform in 2001-02 among school boards and among census divisions were compared to see whether the variation in teacher salaries increased or decreased. A partial co...

Is the high-risk strategy to prevent cardiovascular disease equitable?

DEFF Research Database (Denmark)

Wallach Kildemoes, Helle; Diderichsen, Finn; Krasnik, Allan

2012-01-01

ABSTRACT: BACKGROUND: Statins are increasingly prescribed to prevent cardiovascular disease (CVD) in asymptomatic individuals. Yet, it is unknown whether those at higher CVD risk - i.e. individuals in lower socio-economic position (SEP) - are adequately reached by this high-risk strategy. Aim......: To examine whether the Danish implementation of the strategy to prevent cardiovascular disease (CVD) by initiating statin (HMG-CoA reductase inhibitor) therapy in high-risk individuals is equitable across socioeconomic groups. METHODS: Design: Cohort study. Setting and participants: Applying individual...

Access to essential medicines in Pakistan: policy and health systems research concerns.

Directory of Open Access Journals (Sweden)

Shehla Zaidi

Full Text Available INTRODUCTION: Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i gaps related to access to essential medicine in Pakistan; and ii prioritization of emerging policy and research concerns. METHODS: An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. FINDINGS: A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. CONCLUSION: Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda.

Do Your School Policies Provide Equal Access to Computers? Are You Sure?

Science.gov (United States)

DuBois, Phyllis A.; Schubert, Jane G.

1986-01-01

Outlines how school policies can unintentionally perpetuate gender discrimination in student computer use and access. Describes four areas of administrative policies that can cause inequities and provides ways for administrators to counteract these policies. Includes discussion of a program to balance computer use, and an abstract of an article…

“A More Equitable Society”: The Politics of Global Fairness in Paralympic Sport

Science.gov (United States)

Bantjes, Jason; Rall, Divan; Ferreira, Suzanne; Blauwet, Cheri; Derman, Wayne

2016-01-01

The Paralympic Movement explicitly sets out to create a more equitable society and promote participation for all and fairness in disability sport. This is primarily achieved through the use of a range of interventions with less attention given to how economic factors may hinder access and achievement in Paralympic sport. We investigated how country-level economic variables influence the level of participation and achievement in the 2015 International Paralympic Committee (IPC) Athletics Championships held in Doha. We used multiple regression analysis to show how levels of participation and achievement in the Championships were significantly determined by economic factors independent of population size. Our data show that in spite of the ideals of inclusion and fairness within the Paralympic Movement and the considerable effort expended on the use of technologies to achieve this, economic factors continue to exert a statistically significant influence on both the level of participation and achievement of Paralympic athletes. LMICs participate at lower levels and achieve fewer medals when compared to HICs. These differences are particularly marked in events that have a high cost of participation. Our findings raise questions regarding the use of current technologies and the level to which they are able to truly disrupt the politics of global inequality in sport. PMID:27941981

12 CFR 614.4590 - Equitable treatment of OFIs and Farm Credit System associations.

Science.gov (United States)

2010-01-01

... differences in credit risk and administrative costs to the Farm Credit Bank or agricultural credit bank. (c... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Equitable treatment of OFIs and Farm Credit System associations. 614.4590 Section 614.4590 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT...

Access to finance from different finance provider types: Farmer knowledge of the requirements

OpenAIRE

Wulandari, Eliana; Meuwissen, Miranda P. M.; Karmana, Maman H.; Oude Lansink, Alfons G. J. M.

2017-01-01

Analysing farmer knowledge of the requirements of finance providers can provide valuable insights to policy makers about ways to improve farmers' access to finance. This study compares farmer knowledge of the requirements to obtain finance with the actual requirements set by different finance provider types, and investigates the relation between demographic and socioeconomic factors and farmer knowledge of finance requirements. We use a structured questionnaire to collect data from a sample o...

"I just answer 'yes' to everything they say": access to health care for deaf people in Worcester, South Africa and the politics of exclusion.

Science.gov (United States)

Kritzinger, Janis; Schneider, Marguerite; Swartz, Leslie; Braathen, Stine Hellum

2014-03-01

To explore whether there are other factors besides communication difficulties that hamper access to health care services for deaf patients. Qualitative methodology using semi-structured interviews with 16 deaf participants from the National Institute for the Deaf in Worcester and 3 Key informants from the Worcester area, South Africa. Communication difficulties were found to be a prominent barrier in accessing health care services. In addition to this interpersonal factors including lack of independent thought, overprotectedness, non-questioning attitude, and lack of familial communication interact with communication difficulties in a way that further hampers access to health care services. These interpersonal factors play a unique role in how open and accepting health services feel to deaf patients. Health care services need to take cognizance of the fact that providing sign language interpreters in the health care setting will not necessarily make access more equitable for deaf patients, as they have additional barriers besides communication to overcome before successfully accessing health care services. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Providing Internet Access to the Ohio Career Information System for All Residents: A Feasibility Study.

Science.gov (United States)

Lewis, Morgan V.

Expanded Internet access to the Ohio Career Information System (OCIS) would provide adults in Ohio who need to or wish to make career changes with the best available information about occupations, education and training programs, and financial aid. In order to determine the feasibility of improving access without cost to users, an advisory group,…

Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study.

Science.gov (United States)

Cottrell, Michelle A; Hill, Anne J; O'Leary, Shaun P; Raymer, Maree E; Russell, Trevor G

2017-12-01

The Neurosurgical & Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service (N/OPSC&MDS) originated as a complementary, non-surgical pathway for patients referred to public neurosurgical and orthopaedic specialist services. Patient access to the N/OPSC&MDS could potentially be improved with the implementation of telerehabilitation as an additional method of service delivery. To evaluate service provider's views on (1) current barriers to patients' accessing N/OPSC & MD services, and (2) the implementation of telerehabilitation within the N/OPSC&MDS. Qualitative descriptive study design. Healthcare providers (n = 26) were recruited from six N/OPSC&MD services located throughout Queensland, Australia. Semi-structured interviews were conducted to explore service providers' views with respect to existing barriers to patients accessing the N/OPSC&MDS, and if telerehabilitation could be feasibly adopted to address current barriers. Template analysis resulted in six themes: (1) barriers to some patients' accessing current N/OPSC&MD services are complex & multifaceted; (2) telerehabilitation could improve patient access to appropriate management for their musculoskeletal condition; (3) telerehabilitation may have limitations when compared to face-to-face healthcare; (4) the delivery of telerehabilitation needs to be flexible; (5) perceived barriers, and (6) facilitators to the successful implementation of telerehabilitation within the N/OPSC&MDS. This study represents a critical step in determining the readiness of service providers for the implementation of telerehabilitation within the N/OPSC&MDS. Although cautious, service providers are overall accepting of the implementation of telerehabilitation, acknowledging that it could eliminate several current barriers, subsequently achieving more equitable access to the service. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Online medical books: their availability and an assessment of how health sciences libraries provide access on their public Websites.

Science.gov (United States)

MacCall, Steven L

2006-01-01

The objective of this study was to determine the number and topical range of available online medical books and to assess how health sciences libraries were providing access to these resources on their public Websites. The collection-based evaluative technique of list checking was used to assess the number and topical range of online medical books of the six largest publishers. Publisher inventory lists were downloaded over a two-day period (May 16-17, 2004). Titles were counted and compared with the 2003 Brandon/Hill list. A sample of health sciences libraries was subsequently derived by consulting the 2004 "Top Medical Schools-Research" in U.S. News & World Report. Bibliographic and bibliothecal access methods were evaluated based on an inspection of the publicly available Websites of the sample libraries. Of 318 currently published online medical books, 151 (47%) were Brandon/Hill titles covering 42 of 59 Brandon/Hill topics (71%). These 151 titles represented 22% (N = 672) of the Brandon/Hill list, which further broke down as 52 minimal core, 41 initial purchase, and 58 other recommended Brandon/Hill titles. These numbers represented 50%, 28%, and 12%, respectively, of all Brandon/Hill titles corresponding to those categories. In terms of bibliographic access, 20 of 21 of sampled libraries created catalog records for their online medical books, 1 of which also provided analytical access at the chapter level, and none provided access at the chapter section level. Of the 21 libraries, 19 had library Website search engines that provided title-level access and 4 provided access at the chapter level and none that at the chapter section level. For bibliothecal access, 19 of 21 libraries provided title-level access to medical books, 8 of which provided classified and alphabetic arrangements, 1 provided a classified arrangement only, and 10 provided an alphabetic arrangement only. No library provided a bibliothecal arrangement for medical book chapters or chapter

Free Access to Point of Care Resource Results in Increased Use and Satisfaction by Rural Healthcare Providers

Directory of Open Access Journals (Sweden)

Lindsay Alcock

2016-12-01

Full Text Available A Review of: Eldredge, J. D., Hall, L. J., McElfresh, K. R., Warner, T. D., Stromberg, T. L., Trost, J. T., & Jelinek, D. A. (2016. Rural providers’ access to online resources: A randomized controlled trial. Journal of the Medical Library Association, 104(1, 33-41. http://dx.doi.org/10.3163/1536-5050.104.1.005 Objective – To determine whether free access to the point of care (PoC resource Dynamed or the electronic book collection AccessMedicine was more useful to rural health care providers in answering clinical questions in terms of usage and satisfaction. Design – Randomized controlled trial. Setting – Rural New Mexico. Subjects – Twenty-eight health care providers (physicians, nurses, physician assistants, and pharmacists with no reported access to PoC resources, (specifically Dynamed and AccessMedicine or electronic textbook collections prior to enrollment.

Employee Attitude to Management Style : case: International equitable association Nigeria Limited.

OpenAIRE

Osondu, Marshall

2012-01-01

The aim of the study is to reveal employees’ attitudes to management style in International equitable association Limited, Aba, Nigeria (IEA). IEA is a soap and detergent manufacturing company. The company uses modern management styles to drive employee performance. This study set out to investigate employee attitudes to the various management styles in use at IEA. The study used a framework which shows that employee attitude is driven by the employee’s awareness, the employee’s application o...

34 CFR 200.65 - Determining equitable participation of teachers and families of participating private school...

Science.gov (United States)

2010-07-01

...) From applicable funds reserved for parent involvement and professional development under § 200.77, an... equitable basis in professional development and parent involvement activities, respectively. (2) The amount... LEA must conduct professional development and parent involvement activities for the teachers and...

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

Science.gov (United States)

Gamble, Brandon E.; Lambros, Katina M.

2014-01-01

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

Technology solutions to support supervisory activities and also to provide information access to the society

Science.gov (United States)

Paladini, D.; Mello, A. B.

2016-07-01

Inmetro's data about the conformity of certificated products, process and services are, usually, displayed at fragmented databases of difficult access for several reasons, for instance, the lack of computational solutions which allow this kind of access to its users. A discussion about some of the technological solutions to support supervisory activities by the appropriate regulatory bodies and also to provide information access to society in general is herein presented, along with a theoretical explanation of the pros and cons of such technologies to the conclusion that a mobile platform seems to be the best tool for the requirements of Inmetro.

Changing access to mental health care and social support when people living with HIV/AIDS become service providers.

Science.gov (United States)

Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie

2015-01-01

As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance

Accessibility and spatial distribution of general practice services in an Australian city by levels of social disadvantage.

Science.gov (United States)

Hyndman, J C; Holman, C D

2001-12-01

The accessibility and spatial distribution of health services provided by the main source of primary medical care in Australia--the general practice surgery--was investigated by level of social disadvantage of local catchment areas. All 459 general practice surgeries in Perth, an Australian city of 1.2 million residents, were surveyed with a 94% response. Amount of service provision was measured using weekly doctor-hours, available from consulting rooms during opening hours, and associated nurse-hours of service. Access factors were defined as the distance to the nearest surgery, provision of Sunday and evening services, ease of making a same day appointment, bulk-billing, and whether the surgery offered a choice of gender of doctor. There were relatively more surgeries in disadvantaged areas and doctor-hours of service provision were also greater (41.0 h/1,000 most disadvantaged vs. 37.9 h/1000 least disadvantaged). Bulk-billing care, at no direct cost to the patient, was more likely to be provided in most disadvantaged areas compared with least disadvantaged areas (61 vs. 38%). However, populations living in the most disadvantaged areas were less likely to be able to see the local GP at short notice (91 vs. 95%), to have access to a local female GP (56 vs. 62%) or a local service in the evenings (42 vs. 51%). While the overall picture of accessibility was favourable, there was considerable variation in the type of services provided to different socioeconomic groups. Health care planners should investigate the reasons for these differences and advise Government to ensure that access factors affecting publicly funded services are equitably distributed.

Keeping Kids Moving: How Equitable Transportation Policy Can Prevent Childhood Obesity--What It Is

Science.gov (United States)

Robert Wood Johnson Foundation, 2012

2012-01-01

The nation faces an obesity crisis, especially among low-income children and children of color. Today, nearly one-third of children and adolescents are overweight or obese, and physical inactivity is a leading cause of this epidemic. Equitable transportation policy that fosters healthy, opportunity-rich communities has a critical role to play in…

Building equitable health systems in Latin America | IDRC ...

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

The region's segmented health systems make it difficult to provide equal access to ... to reorganize healthcare systems in Argentina, Brazil, Paraguay, and Uruguay. ... Involving urban communities in controlling dengue fever in Latin America.

How equitable is vocational rehabilitation in Sweden? A review of evidence on the implementation of a national policy framework.

Science.gov (United States)

Burstrom, Bo; Nylen, Lotta; Clayton, Stephen; Whitehead, Margaret

2011-01-01

Under the national framework law in Sweden, all eligible people should have equal chances of receiving vocational rehabilitation. We aimed to review the evidence on (1) whether access to vocational rehabilitation is equitable in practice and (2) whether the outcomes vary for different groups in the population. Systematic review of studies in Sweden that reported diagnostic or socio-demographic characteristics of people offered or taking up rehabilitation programmes and outcomes of such programmes for different diagnostic and socio-demographic groups. Searches of 11 relevant electronic databases, 15 organisational websites, citation searching and contact with experts in the field, for the period 1990-2009. A total of 11 studies were included in the final review, six of which addressed review question (1) and seven addressed review question (2). All the six observational studies of access reported biased selection into vocational rehabilitation: greater likelihood for men, younger people, those with longer-term sick leave, those with lower income, employed rather than unemployed people and those with musculoskeletal and mental disorders or alcohol abuse. Having had a rehabilitation investigation also increased the likelihood of receiving vocational rehabilitation. Differential outcome of rehabilitation was reported in seven studies: outcomes were better for men, younger people, employed individuals, those with shorter sick leave and those with higher income. Selection into vocational rehabilitation was perceived as important for successful outcomes, but success also depended on the state of the local labour market. There is evidence of socio-demographic differences in access to and outcomes of vocational rehabilitation in Sweden, even though the national framework law is meant to apply to everyone. Few studies have deliberately measured differential access or outcomes, and there is a need for this kind of equity analysis of population-wide policies. Studies

The Deadlock Principle as a Ground for the Just and Equitable Winding Up of a Solvent Company: Thunder Cats Investments 92 (Pty Ltd v Nkonjane Economic Prospecting Investment (Pty Ltd 2014 5 SA 1 (SCA

Directory of Open Access Journals (Sweden)

Tumo Charles Maloka

2016-05-01

Full Text Available The question addressed by the Supreme Court of Appeal in Thunder Cats Investment 92 (Pty Ltd v Nkonjane Economic Prospecting & Investments (Pty Ltd 2014 5 SA 1 (SCA (hereafter the "Thunder Cats" provides much-needed guidance on the deadlock principle as well as the breadth and scope of the "just and equitable ground for winding up in terms of s 81(1(d(iii of the Companies Act 71 of 2008. The facts, the issues and the contextual authority of Thunder Cats also bring to fore the lacuna in the just and equitable winding up provisions of the current Companies Act which lacuna has so far received no judicial or academic consideration. This Note contends the fact that the just and equitable winding up provisions do not countenance any deviation from the statutory prescriptions once the factual grounds for just and equitable winding up have been established is not in consonance with the spirit, purport and objects of Companies Act, and, in particular those of Chapter Six of the Act which have introduced the innovative business rescue scheme into South African corporate law landscape. The facts, the issues and the contextual authority of Thunder Cats will be reviewed at length in the ensuing discussion.

Barriers to accessing termination of pregnancy in a remote and rural setting: a qualitative study.

Science.gov (United States)

Heller, R; Purcell, C; Mackay, L; Caird, L; Cameron, S T

2016-09-01

To explore the experiences of women from a remote and rural setting who had a termination of pregnancy (TOP), in relation to any barriers they may have experienced trying to access TOP. Qualitative interview study. Scottish Highlands and Western Isles. Women who had undergone TOP in the Scottish Highlands National Health Service between October 2014 and May 2015. Sixteen semi-structured, audio-recorded telephone interviews were conducted by a researcher with women who had consented to be interviewed at their initial assessment. Six stages of thematic analysis were followed to explore themes in and across participant accounts. Themes derived from interview transcripts. Four themes emerged relating to barriers to access and experience: (1) the impact of travel for TOP, (2) temporal factors unique to this population and how they affected women, (3) the attitude of health professionals, notably general practitioners, as a result of local culture, and (4) stigma surrounding TOP and the expectation that abortion will be traumatising. Women in remote and rural areas experience barriers to accessing TOP. Prompt referrals, more providers of TOP and tackling stigma associated with TOP could make delivery of this service more equitable and improve women's journey through TOP. Women in remote and rural areas of Scotland face multiple barriers to accessing termination of pregnancy. © 2016 Royal College of Obstetricians and Gynaecologists.

Providing India with Internet access anywhere there is electricity - and Canada with commercial opportunity

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-07-01

Access to high-speed Internet service is booming all over the world but the cost of optic cable installation and other related broadband delivery technology is still too high for many developing countries to afford. A Canada-India R & D group is working on a broadband technology delivered over the power line in order to provide internet access wherever there is electricity. Moreover, the application of such a technology in rural India could also improve the distribution and management of India's national electrical grid, as the risk of electricity theft can be monitored by power assumption tracking. Since the required infrastructure is already in place across the country, this project could be deployed rapidly and in a cost-efficient manner, providing thousands of potential opportunities for rural dwellers as well as for Indian and international companies.

Access to finance from different finance provider types: Farmer knowledge of the requirements.

Science.gov (United States)

Wulandari, Eliana; Meuwissen, Miranda P M; Karmana, Maman H; Oude Lansink, Alfons G J M

2017-01-01

Analysing farmer knowledge of the requirements of finance providers can provide valuable insights to policy makers about ways to improve farmers' access to finance. This study compares farmer knowledge of the requirements to obtain finance with the actual requirements set by different finance provider types, and investigates the relation between demographic and socioeconomic factors and farmer knowledge of finance requirements. We use a structured questionnaire to collect data from a sample of finance providers and farmers in Java Island, Indonesia. We find that the most important requirements to acquire finance vary among different finance provider types. We also find that farmers generally have little knowledge of the requirements, which are important to each type of finance provider. Awareness campaigns are needed to increase farmer knowledge of the diversity of requirements among the finance provider types.

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

International Nuclear Information System (INIS)

Rehman, I.H.; Kar, Abhishek; Banerjee, Manjushree; Kumar, Preeth; Shardul, Martand; Mohanty, Jeevan; Hossain, Ijaz

2012-01-01

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

The Encyclopedia of Life v2: Providing Global Access to Knowledge About Life on Earth

Science.gov (United States)

2014-01-01

Abstract The Encyclopedia of Life (EOL, http://eol.org) aims to provide unprecedented global access to a broad range of information about life on Earth. It currently contains 3.5 million distinct pages for taxa and provides content for 1.3 million of those pages. The content is primarily contributed by EOL content partners (providers) that have a more limited geographic, taxonomic or topical scope. EOL aggregates these data and automatically integrates them based on associated scientific names and other classification information. EOL also provides interfaces for curation and direct content addition. All materials in EOL are either in the public domain or licensed under a Creative Commons license. In addition to the web interface, EOL is also accessible through an Application Programming Interface. In this paper, we review recent developments added for Version 2 of the web site and subsequent releases through Version 2.2, which have made EOL more engaging, personal, accessible and internationalizable. We outline the core features and technical architecture of the system. We summarize milestones achieved so far by EOL to present results of the current system implementation and establish benchmarks upon which to judge future improvements. We have shown that it is possible to successfully integrate large amounts of descriptive biodiversity data from diverse sources into a robust, standards-based, dynamic, and scalable infrastructure. Increasing global participation and the emergence of EOL-powered applications demonstrate that EOL is becoming a significant resource for anyone interested in biological diversity. PMID:24891832

Accessibility and equity of health and social care services: exploring the views and experiences of Bangladeshi carers in South Wales, UK.

Science.gov (United States)

Merrell, Joy; Kinsella, Faye; Murphy, Fiona; Philpin, Sue; Ali, Amina

2006-05-01

There is a paucity of information regarding the extent and nature of caring provided by minority ethnic communities. The proportion of older people from these communities will dramatically increase in the next 20 years, which will be accompanied by increasing health and social care needs and an increased demand for carers. A qualitative, exploratory study was conducted to identify the health and social care needs of informal carers, who were caring for a dependent adult from a Bangladeshi community in South Wales, UK. This paper focuses on Bangladeshi carers' access to formal support services provided by the statutory, private and voluntary sectors to assist them with their caring responsibilities. The findings are based on data collected using face-to-face, focused interviews with 20 Bangladeshi carers. Purposive and snowball sampling were used to recruit the sample. The data were analysed using thematic content analysis. The dimensions of accessibility and equity of quality of care were drawn upon to aid understanding of the findings. Bangladeshi carers faced a number of barriers in accessing health and social service provision, which impeded uptake of these services. Additionally, there was evidence of inequity in service provision. Recommendations for improving the accessibility of health and social care services are proposed, which may assist in promoting more equitable services for carers from the Bangladeshi community.

[Gender inequity in the access to health care in Chile].

Science.gov (United States)

Vega, Jeanette; Bedregal, Paula; Jadue, Liliana; Delgado, Iris

2003-06-01

In the last two decades, Chile has experienced advances in economical development and global health indicators. However, gender inequities persist in particular related to access to health services and financing of health insurance. To examine gender inequities in the access to health care in Chile. An analysis of data obtained from a serial national survey applied to assess social policies (CASEN) carried out by the Ministry of Planning. During the survey 45,379 and 48,107 dwellings were interviewed in 1994 and in 1998, respectively. Women use health services 1.5 times more often, their salaries are 30% lower in all socioeconomic strata. Besides, in the private health sector, women pay higher insurance premiums than men. Men of less than two years of age have 2.5 times more preventive consultations than girls. This difference, although of lesser magnitude, is also observed in people over 60 years. Women of high income quintiles and users of private health insurance have a better access to preventive consultations but not to specialized care. An improvement in equitable access of women to health care and financing is recommended. Also, monitoring systems to survey these indicators for women should improve their efficiency.

Monitoring fever treatment behaviour and equitable access to effective medicines in the context of initiatives to improve ACT access: baseline results and implications for programming in six African countries

Directory of Open Access Journals (Sweden)

Littrell Megan

2011-10-01

Full Text Available Abstract Background Access to artemisinin-based combination therapy (ACT remains limited in high malaria-burden countries, and there are concerns that the poorest people are particularly disadvantaged. This paper presents new evidence on household treatment-seeking behaviour in six African countries. These data provide a baseline for monitoring interventions to increase ACT coverage, such as the Affordable Medicines Facility for malaria (AMFm. Methods Nationally representative household surveys were conducted in Benin, the Democratic Republic of Congo (DRC, Madagascar, Nigeria, Uganda and Zambia between 2008 and 2010. Caregivers responded to questions about management of recent fevers in children under five. Treatment indicators were tabulated across countries, and differences in case management provided by the public versus private sector were examined using chi-square tests. Logistic regression was used to test for association between socioeconomic status and 1 malaria blood testing, and 2 ACT treatment. Results Fever treatment with an ACT is low in Benin (10%, the DRC (5%, Madagascar (3% and Nigeria (5%, but higher in Uganda (21% and Zambia (21%. The wealthiest children are significantly more likely to receive ACT compared to the poorest children in Benin (OR = 2.68, 95% CI = 1.12-6.42; the DRC (OR = 2.18, 95% CI = 1.12-4.24; Madagascar (OR = 5.37, 95% CI = 1.58-18.24; and Nigeria (OR = 6.59, 95% CI = 2.73-15.89. Most caregivers seek treatment outside of the home, and private sector outlets are commonly the sole external source of treatment (except in Zambia. However, children treated in the public sector are significantly more likely to receive ACT treatment than those treated in the private sector (except in Madagascar. Nonetheless, levels of testing and ACT treatment in the public sector are low. Few caregivers name the national first-line drug as most effective for treating malaria in Madagascar (2%, the DRC (2%, Nigeria (4% and Benin (10

Barriers to free antiretroviral treatment access for female sex workers in Chennai, India.

Science.gov (United States)

Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Kurian, Abraham K; Dubrow, Robert

2009-11-01

India's National AIDS Control Organization (NACO) provides free first-line antiretroviral treatment (ART) at government centers for people living with HIV. To assist in developing policies and programs to ensure equity in ART access, we explored barriers to ART access among female sex workers (FSWs) living with HIV in Chennai. Between August and November 2007, we conducted three focus group discussions and two key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family/social, health care system/programmatic, and individual levels. Major barriers included fear of adverse consequences of disclosure of HIV status due to stigma and discrimination associated with HIV and sex work, lack of family support, negative experiences with health care providers, lack of adequate counseling services at government centers and by outreach workers employed by nongovernmental organizations (NGOs), perceived biased treatment of FSWs who are not referred by NGOs, lack of adequate knowledge about ART, and fatalism. Barriers can be addressed by: creating effective measures to reduce stigma associated with HIV/AIDS and sex work at the familial, societal, and health care system levels; incorporating information about ART into targeted interventions among FSWs; training counselors at government hospitals and NGO outreach workers on treatment issues; improving infrastructure and staffing levels at government centers to allow adequate time and privacy for counseling; and implementing government mass media campaigns on ART availability. Finally, it is crucial that NACO begin monitoring ART coverage of FSWs and other marginalized populations to ensure equitable ART access.

Access to health care for undocumented migrant children and pregnant women: the paradox between values and attitudes of health care professionals.

Science.gov (United States)

Ruiz-Casares, Mónica; Rousseau, Cécile; Laurin-Lamothe, Audrey; Rummens, Joanna Anneke; Zelkowitz, Phyllis; Crépeau, François; Steinmetz, Nicolas

2013-02-01

Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.

Safety accessibility and sustainability: The importance of micro-scale outcomes to an equitable design of transport systems

Directory of Open Access Journals (Sweden)

N. Tyler

2017-07-01

Full Text Available This paper discusses the potential conflicts that can arise when trying to design a transport system to be sustainable, safe and accessible. The paper considers first the overarching vision that drives such an aim and how that determines choices for design and implementation of such schemes. Using the example of a shared space project, Exhibition Road in London, to illustrate how these issues come to arise and how research could help to resolve them, the paper then considers how science is able to support better design and implementation. This raises questions for scientific methods that could support better consideration of such issues, learning from the small-samples analysis of transport safety research to be amplified to include the detailed research that drives accessible design.

Organizational Analysis and Career Projections Based on a Level-of-Responsibility/Equitable Payment Model. Technical Report.

Science.gov (United States)

Laner, Stephen; And Others

Following an explanation of the Level of Responsibility/Equitable Pay Function, its applicability is demonstrated to the analysis and to the design and redesign of organizational hierarchies. It is shown how certain common dysfuntional anomalies can be avoided by structuring an organization along the principles outlined. A technique is then…

Access to medicines and hepatitis C in Africa: can tiered pricing and voluntary licencing assure universal access, health equity and fairness?

Science.gov (United States)

Assefa, Yibeltal; Hill, Peter S; Ulikpan, Anar; Williams, Owain D

2017-09-13

The recent introduction of Direct Acting Antivirals (DAAs) for treating Hepatitis C Virus (HCV) can significantly assist in the world reaching the international target of elimination by 2030. Yet, the challenge facing many individuals and countries today lies with their ability to access these treatments due to their relatively high prices. Gilead Sciences applies differential pricing and licensing strategies arguing that this provides fairer and more equitable access to these life-saving medicines. This paper analyses the implications of Gilead's tiered pricing and voluntary licencing strategy for access to the DAAs. We examined seven countries in Africa (Egypt, Ethiopia, Nigeria, Democratic Republic of Congo, Cameroon, Rwanda and South Africa) to assess their financial capacity to provide DAAs for the treatment of HCV under present voluntary licensing and tiered-pricing arrangements. These countries have been selected to explore the experience of countries with a range of different burdens of HCV and shared eligibility for supply by licensed generic producers or from discounted Gilead prices. The cost of 12-weeks of generic DAA varies from $684 per patient treated in Egypt to $750 per patient treated in other countries. These countries can also procure the same DAA for 12-weeks of treatment from the originator, Gilead, at a cost of $1200 per patient. The current prices of DAAs (both from generic and originator manufacturers) are much more than the median annual income per capita and the annual health budget of most of these countries. If governments alone were to bear the costs of universal treatment coverage, then the required additional health expenditure from present rates would range from a 4% increase in South Africa to a staggering 403% in Cameroon. The current arrangements for increasing access to DAAs, towards elimination of HCV, are facing challenges that would require increases in expenditure that are either too burdensome to governments or potentially

Geographic Accessibility Of Food Outlets Not Associated With Body Mass Index Change Among Veterans, 2009-14.

Science.gov (United States)

Zenk, Shannon N; Tarlov, Elizabeth; Wing, Coady; Matthews, Stephen A; Jones, Kelly; Tong, Hao; Powell, Lisa M

2017-08-01

In recent years, various levels of government in the United States have adopted or discussed subsidies, tax breaks, zoning laws, and other public policies that promote geographic access to healthy food. However, there is little evidence from large-scale longitudinal or quasi-experimental research to suggest that the local mix of food outlets actually affects body mass index (BMI). We used a longitudinal design to examine whether the proximity of food outlets, by type, was associated with BMI changes between 2009 and 2014 among 1.7 million veterans in 382 metropolitan areas. We found no evidence that either absolute or relative geographic accessibility of supermarkets, fast-food restaurants, or mass merchandisers was associated with changes in an individual's BMI over time. While policies that alter only geographic access to food outlets may promote equitable access to healthy food and improve nutrition, our findings suggest they will do little to combat obesity in adults. Project HOPE—The People-to-People Health Foundation, Inc.

A Jeffersonian Vision of Nurturing Talent and Creativity: Toward a More Equitable and Productive Gifted Education

Science.gov (United States)

Dai, David Yun

2015-01-01

This article attempts to address the question of how to make gifted education more equitable and productive by shifting priorities to talent development for all rather than confining itself to the "gifted." I first present an overview of political and ethical considerations in selecting a few for talent or creativity development. I then…

Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil

Directory of Open Access Journals (Sweden)

Davide Rasella

2016-02-01

Full Text Available Background: The importance of the social determinants of health (SDH and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC in Brazil and other developing countries. Objective: To evaluate a set of proposed indicators of SDH and barriers to the access and utilization of healthcare – proposed by the SDH unit of the World Health Organization – with respect to their relevance in tracking progress in moving toward equitable population health and UHC in Brazil. Design: This study had a mixed methodology, combining a quantitative analysis of secondary data from governmental sources with a qualitative study comprising two focus group discussions and six key informant interviews. The set of indicators tested covered a broad range of dimensions classified by three different domains: environment quality; accountability and inclusion; and livelihood and skills. Indicators were stratified according to income quintiles, urbanization, race, and geographical region. Results: Overall, the indicators were adequate for tracking progress in terms of the SDH, equity, gender, and human rights in Brazil. Stratifications showed inequalities. The qualitative analysis revealed that many of the indicators were well known and already used by policymakers and health sector managers, whereas others were considered less useful in the Brazilian context. Conclusions: Monitoring and evaluation practices have been developed in Brazil, and the set of indicators assessed in this study could further improve these practices, especially from a health equity perspective. Socioeconomic inequalities have been reduced in Brazil in the last decade, but there is still much work to be done in relation to addressing the SDH.

Christianity and Community development in Igboland, 1960-2000

African Journals Online (AJOL)

FEN

would enhance equitable transport development in Lagos Island were proffered. ... Introduction. It is essential to appreciate that the purpose of transport is to provide accessibility, or the ability to take a journey for a specific purpose. Transport ... 1998) and accessibility and occurrence of public facilities in Lagos Island,.

Maternal and Child Health | IDRC - International Development ...

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

Despite progress in the past two decades, nearly 800 women die every day due ... their rights and to access the services they require to protect themselves from ... Challenges to providing equitable and accessible health services are further exacerbated in fragile settings. ... Achieve real gender equality for adolescent health.

Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border.

Science.gov (United States)

Servin, Argentina E; Muñoz, Fátima A; Zúñiga, María Luisa

2014-01-01

Latinos living with HIV residing in the US-Mexico border region frequently seek care on both sides of the border. Given this fact, a border health perspective to understanding barriers to care is imperative to improve patient health outcomes. This qualitative study describes and compares experiences and perceptions of Mexican and US HIV care providers regarding barriers to HIV care access for Latino patients living in the US-Mexico border region. In 2010, we conducted in-depth qualitative interviews with HIV care providers in Tijuana (n = 10) and San Diego (n = 9). We identified important similarities and differences between Mexican and US healthcare provider perspectives on HIV care access and barriers to service utilisation. Similarities included the fact that HIV-positive Latino patients struggle with access to ART medication, mental health illness, substance abuse and HIV-related stigma. Differences included Mexican provider perceptions of medication shortages and US providers feeling that insurance gaps influenced medication access. Differences and similarities have important implications for cross-border efforts to coordinate health services for patients who seek care in both countries.

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.

Providing Access to Census-based Interaction Data in the UK: That's WICID!

Directory of Open Access Journals (Sweden)

John Stillwell

2006-08-01

Full Text Available The Census Interaction Data Service (CIDS is funded by the Economic and Social Research Council in the UK to provide access for social science researchers and students to the detailed migration and journey-to-work statistics that are collected by the national statistical agencies. These interaction data sets are known collectively as the Special Migration Statistics (SMS and the Special Workplace Statistics (SWS. This paper outlines how problems of user access to these data have been tackled through the development of a web-based system known as WICID (Web-based Interface to Census Interaction Data. The paper illustrates various interface features including some of the query building facilities that enable users to extract counts of flows of particular groups of individuals between selected origin and destination areas. New tools are outlined for assisting area selection using digital maps of census geographies, for planning output and for adding value to the data through analysis. Mapping of flows of migrants between London boroughs and the rest of the UK demonstrates the value of the data. The paper begins with a summary of the data sets that are contained within the system and an outline of the system architecture.

Strategy for Promoting the Equitable Development of Basic Education in Underdeveloped Counties as Seen from Cili County

Science.gov (United States)

Shihua, Peng; Rihui, Tan

2009-01-01

Employing statistical analysis, this study has made a preliminary exploration of promoting the equitable development of basic education in underdeveloped counties through the case study of Cili county. The unequally developed basic education in the county has been made clear, the reasons for the inequitable education have been analyzed, and,…

Investigations in the Science of Sports.

Science.gov (United States)

Hammrich, Penny L.; Fadigan, Kathleen

2003-01-01

Describes the Sisters in Sport Science (SISS) program which provides equitable access for girls to science and mathematics through sports. Includes a sample SISS activity that integrates track and physical sciences. (YDS)

College Students’ Preferences for Health Care Providers when Accessing Sexual Health Resources

Science.gov (United States)

Garcia, Carolyn M.; Lechner, Kate E.; Frerich, Ellen A.; Lust, Katherine A.; Eisenberg, Marla E.

2017-01-01

Objective Many emerging adults (18–25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students’ perceptions of health care providers, specifically in the context of accessing sexual health resources. Design and Sample Students (N=52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. Results Inductive qualitative analysis yielded six themes summarizing students’ perceptions of provider characteristics, health care resources, the role of their peers, and students’ suggestions for strengthening health care services. Importantly, students consider a variety of staff—and their student peers—to be resources for sexual health information and services. Conclusions Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Post-secondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers’ characteristics and interpersonal skills. PMID:25159532

College students' preferences for health care providers when accessing sexual health resources.

Science.gov (United States)

Garcia, Carolyn M; Lechner, Kate E; Frerich, Ellen A; Lust, Katherine A; Eisenberg, Marla E

2014-01-01

Many emerging adults (18-25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students' perceptions of health care providers, specifically in the context of accessing sexual health resources. Students (N = 52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. Open-ended one-to-one interview questions. Inductive qualitative analysis yielded six themes summarizing students' perceptions of provider characteristics, health care resources, the role of their peers, and students' suggestions for strengthening health care services. Importantly, students consider a variety of staff-and their student peers-to be resources for sexual health information and services. Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Postsecondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers' characteristics and interpersonal skills. © 2014 Wiley Periodicals, Inc.

Geographic Disparities in Access to Agencies Providing Income-Related Social Services.

Science.gov (United States)

Bauer, Scott R; Monuteaux, Michael C; Fleegler, Eric W

2015-10-01

Geographic location is an important factor in understanding disparities in access to health-care and social services. The objective of this cross-sectional study is to evaluate disparities in the geographic distribution of income-related social service agencies relative to populations in need within Boston. Agency locations were obtained from a comprehensive database of social services in Boston. Geographic information systems mapped the spatial relationship of the agencies to the population using point density estimation and was compared to census population data. A multivariate logistic regression was conducted to evaluate factors associated with categories of income-related agency density. Median agency density within census block groups ranged from 0 to 8 agencies per square mile per 100 population below the federal poverty level (FPL). Thirty percent (n = 31,810) of persons living below the FPL have no access to income-related social services within 0.5 miles, and 77 % of persons living below FPL (n = 83,022) have access to 2 or fewer agencies. 27.0 % of Blacks, 30.1 % of Hispanics, and 41.0 % of non-Hispanic Whites with incomes below FPL have zero access. In conclusion, some neighborhoods in Boston with a high concentration of low-income populations have limited access to income-related social service agencies.

Integration of mental health resources in a primary care setting leads to increased provider satisfaction and patient access.

Science.gov (United States)

Vickers, Kristin S; Ridgeway, Jennifer L; Hathaway, Julie C; Egginton, Jason S; Kaderlik, Angela B; Katzelnick, David J

2013-01-01

This evaluation assessed the opinions and experiences of primary care providers and their support staff before and after implementation of expanded on-site mental health services and related system changes in a primary care clinic. Individual semistructured interviews, which contained a combination of open-ended questions and rating scales, were used to elicit opinions about mental health services before on-site system and resource changes occurred and repeated following changes that were intended to improve access to on-site mental health care. In the first set of interviews, prior to expanding mental health services, primary care providers and support staff were generally dissatisfied with the availability and scheduling of on-site mental health care. Patients were often referred outside the primary care clinic for mental health treatment, to the detriment of communication and coordinated care. Follow-up interviews conducted after expansion of mental health services, scheduling refinements and other system changes revealed improved provider satisfaction in treatment access and coordination of care. Providers appreciated immediate and on-site social worker availability to triage mental health needs and help access care, and on-site treatment was viewed as important for remaining informed about patient care the primary care providers are not delivering directly. Expanding integrated mental health services resulted in increased staff and provider satisfaction. Our evaluation identified key components of satisfaction, including on-site collaboration and assistance triaging patient needs. The sustainability of integrated models of care requires additional study. © 2013.

Doing Better: Illuminating a Framework of Equitable Science Pedagogy through a Cross- Case Analysis of Urban High School Science Teachers

Science.gov (United States)

Sheth, Manali J.

Students of color are routinely asked to participate in science education that is less intellectually rich and self-affirming. Additionally, teachers have trouble embarking on professional growth related to issues of equity and diversity in science. The purpose of this dissertation research is to develop a multi-dimensional framework for equitable science pedagogy (ESP) through analyzing the efforts and struggles of high school science teachers. This study is grounded in a conceptual framework derived from scholarship in science education, multicultural education, critical science studies, and teacher learning. The following questions guide this research: 1) What visions and enactments emerge in teachers' practices towards equitable science pedagogy? 2) How are teachers' practice decisions towards ESP influenced by their personal theories of race/culture, science, and learning and sociocultural contexts? 3) Why are there consistencies and variances across teachers' practices? This study employs a qualitative multiple case study design with ethnographic data collection to explore the practices of three urban high school science teachers who were identified as being committed to nurturing the science learning of students of color. Data include over 120 hours of classroom observation, 60 hours of teacher interviews, and 500 teacher- and student-generated artifacts. Data analysis included coding teachers' practices using theory- and participant generated codes, construction of themes based on emergent patterns, and cross-case analysis. The affordances and limitations of the participants' pedagogical approaches inform the following framework for equitable science pedagogy: 1) Seeing race and culture and sharing responsibility for learning form foundational dimensions. Practices from the other three dimensions--- nurturing students' identities, re-centering students' epistemologies, and critiquing structural inequities---emerge from the foundation. As emergent practices

Providing comprehensive and consistent access to astronomical observatory archive data: the NASA archive model

Science.gov (United States)

McGlynn, Thomas; Fabbiano, Giuseppina; Accomazzi, Alberto; Smale, Alan; White, Richard L.; Donaldson, Thomas; Aloisi, Alessandra; Dower, Theresa; Mazzerella, Joseph M.; Ebert, Rick; Pevunova, Olga; Imel, David; Berriman, Graham B.; Teplitz, Harry I.; Groom, Steve L.; Desai, Vandana R.; Landry, Walter

2016-07-01

Since the turn of the millennium a constant concern of astronomical archives have begun providing data to the public through standardized protocols unifying data from disparate physical sources and wavebands across the electromagnetic spectrum into an astronomical virtual observatory (VO). In October 2014, NASA began support for the NASA Astronomical Virtual Observatories (NAVO) program to coordinate the efforts of NASA astronomy archives in providing data to users through implementation of protocols agreed within the International Virtual Observatory Alliance (IVOA). A major goal of the NAVO collaboration has been to step back from a piecemeal implementation of IVOA standards and define what the appropriate presence for the US and NASA astronomy archives in the VO should be. This includes evaluating what optional capabilities in the standards need to be supported, the specific versions of standards that should be used, and returning feedback to the IVOA, to support modifications as needed. We discuss a standard archive model developed by the NAVO for data archive presence in the virtual observatory built upon a consistent framework of standards defined by the IVOA. Our standard model provides for discovery of resources through the VO registries, access to observation and object data, downloads of image and spectral data and general access to archival datasets. It defines specific protocol versions, minimum capabilities, and all dependencies. The model will evolve as the capabilities of the virtual observatory and needs of the community change.

The fight against the greenhouse effect. Equity and efficiency; La lutte contre l'effet de serre. Equite et efficacite

Energy Technology Data Exchange (ETDEWEB)

Vallee, A. [Paris-12 Univ., 94 - Creteil (France)

2003-07-01

The author discusses the definition of an equitable division rule of the global effort of greenhouse gases emissions decrease, the research of the economic efficiency, the flexibility mechanisms and the emissions trading. (A.L.B.)

ACCESS REFORM DALAM KERANGKA REFORMA AGRARIA UNTUK MEWUJUDKAN KEADILAN SOSIAL

Directory of Open Access Journals (Sweden)

Ferry Irawan Febriansyah

2016-05-01

Full Text Available In essence, the purpose of the implementation of agrarian reformis to improve the welfare of the poor peasants. Agrarian reformis not only understood as a policy for there distribution of land, but also as abroader process such as access to natural resources, financial/capital, technology, goods and labor markets, and also the distribution of political power. Equitable distribution of land tenureinrural areas as a result of agrarian reform will result in an increase in the welfare of the villagers who are generally small farmers or farm laborers. Agrarian reform plays an important role in the fight against ruralpoverty. The main target of the agrarian reformis the creation of social justice that is characterized by the presence of agrarian justice.

A mobile school-based HCT service - is it youth friendly?

Science.gov (United States)

Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert

2016-12-01

Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. Providing HCT in the school setting may make HCT more accessible for

A mobile school-based HCT service – is it youth friendly?

Directory of Open Access Journals (Sweden)

Estelle Lawrence

2016-01-01

Full Text Available Background: Despite an increase in HIV Counselling and Testing (HCT, few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. Methods: The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. Key Results: The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. Conclusion: Providing HCT

School Librarian, Teacher Collaborator, and Independent Learner: A Symbiosis for Equitable Education in an Alternative High School

Science.gov (United States)

Jaaskelainen, Kristal; Deneen, Musetta

2018-01-01

As the future arrives faster and faster one must ask continually, what do kids actually need from their formal education today and tomorrow? Continuous innovation of method and strategy must be integral to the practice of all teaching professionals. Equitable educators must take a look at the learners in front of them, when and where they stand,…

Access to New Zealand Sign Language interpreters and quality of life for the deaf: a pilot study.

Science.gov (United States)

Henning, Marcus A; Krägeloh, Christian U; Sameshima, Shizue; Shepherd, Daniel; Shepherd, Gregory; Billington, Rex

2011-01-01

This paper aims to: (1) explore usage and accessibility of sign language interpreters, (2) appraise the levels of quality of life (QOL) of deaf adults residing in New Zealand, and (3) consider the impact of access to and usage of sign language interpreters on QOL. Sixty-eight deaf adults living in New Zealand participated in this study. Two questionnaires were employed: a 12-item instrument about access and use of New Zealand sign language interpreters and the abbreviated version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF). The results showed that 39% of this sample felt that they were unable to adequately access interpreting services. Moreover, this group scored significantly lower than a comparable hearing sample on all four WHOQOL-BREF domains. Finally, the findings revealed that access to good quality interpreters were associated with access to health services, transport issues, engagement in leisure activities, gaining more information, mobility and living in a healthy environment. These findings have consequences for policy makers and agencies interested in ensuring that there is an equitable distribution of essential services for all groups within New Zealand which inevitably has an impact on the health of the individual.

Equity in access to health care in a rural population in Malaysia: A cross-sectional study.

Science.gov (United States)

Lim, Ka Keat; Sivasampu, Sheamini; Mahmud, Fatihah

2017-04-01

To examine the extent of equity in access to health care, their determinants and reasons of unmet need of a rural population in Malaysia. Exploratory cross-sectional survey administered by trained interviewers among participants of a health screening program. A rural plantation estate in the West Coast of Peninsular Malaysia. One hundred and thirty out of 142 adults above 18 years old who attended the program. Percentages of respondents reporting realised access and unmet need to health care, determinants of both access indicators and reasons for unmet need. Realised access associated with need but not predisposing or enabling factors and unmet need not associated with any variables were considered equitable. A total of 88 (67.7%) respondents had visited a doctor (realised access) in the past 6 months and 24.8% (n = 31) experienced unmet need in the past 12 months. Using logistic regression, realised access was associated with presence of chronic disease (OR 6.97, P  RM 2000 per month) (OR 51.27, P population, the latter associated with education level, subjective health status and income. Despite not being generalisable, the findings highlight the need for a national level study on equity in access before the country reforms its health system. © 2016 National Rural Health Alliance Inc.

A review of promoting access to medicines in China - problems and recommendations.

Science.gov (United States)

Sun, Jing; Hu, Cecile Jia; Stuntz, Mark; Hogerzeil, Hans; Liu, Yuanli

2018-02-20

Despite recent reforms, distorting funding mechanisms and over-prescribing still maintain severe financial barriers to medicines access in China. Complicated and interrelated problems in the pharmaceutical sector require a common framework to be resolved as fragmented solutions do not work. We present a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and propose policy recommendations for promoting universal access to medicines in China. Drawing on multiple sources of information, including a review of published literatures and official national data, field investigations in six provinces and interviews with key opinion leaders, this paper presents a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and proposes policy recommendations for promoting universal access to medicines in China. Public expenditure on medicines has been strictly controlled since the national healthcare reforms of 2009. Yet total pharmaceutical expenditure (TPE) and total health expenditure growth rates continuously outpaced the growth of gross domestic product (GDP). With 2.4% of GDP, TPE now exceeds that of most high income countries. The distorted provider and consumer incentives in the Chinese health system have not fundamentally changed. Price-setting and reimbursement mechanisms do not promote cost-effective use of medicines. Inappropriate price controls and perverse financial incentives are the un-resolved root causes of preference of originator brands for some major diseases and shortages of low-cost and low-consumption medicines. In addition, access to expensive life-saving medicines is yet systematically addressed. The complicated and interdependent problems interact in a way that leads to significant system problems in China, which create dual challenges that both the developing country and the developed countries are facing. To further promote access to medicines, China should speed up

A review of promoting access to medicines in China - problems and recommendations

Directory of Open Access Journals (Sweden)

Jing Sun

2018-02-01

Full Text Available Abstract Background Despite recent reforms, distorting funding mechanisms and over-prescribing still maintain severe financial barriers to medicines access in China. Complicated and interrelated problems in the pharmaceutical sector require a common framework to be resolved as fragmented solutions do not work. We present a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and propose policy recommendations for promoting universal access to medicines in China. Methods Drawing on multiple sources of information, including a review of published literatures and official national data, field investigations in six provinces and interviews with key opinion leaders, this paper presents a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and proposes policy recommendations for promoting universal access to medicines in China. Results Public expenditure on medicines has been strictly controlled since the national healthcare reforms of 2009. Yet total pharmaceutical expenditure (TPE and total health expenditure growth rates continuously outpaced the growth of gross domestic product (GDP. With 2.4% of GDP, TPE now exceeds that of most high income countries. The distorted provider and consumer incentives in the Chinese health system have not fundamentally changed. Price-setting and reimbursement mechanisms do not promote cost-effective use of medicines. Inappropriate price controls and perverse financial incentives are the un-resolved root causes of preference of originator brands for some major diseases and shortages of low-cost and low-consumption medicines. In addition, access to expensive life-saving medicines is yet systematically addressed. Conclusions The complicated and interdependent problems interact in a way that leads to significant system problems in China, which create dual challenges that both the developing country and the developed countries are

Understanding the Complex Dimensions of the Digital Divide: Lessons Learned in the Alaskan Arctic

Science.gov (United States)

Subramony, Deepak Prem

2007-01-01

An ethnographic case study of Inupiat Eskimo in the Alaskan Arctic has provided insights into the complex nature of the sociological issues surrounding equitable access to technology tools and skills, which are referred to as the digital divide. These people can overcome the digital divide if they get the basic ready access to hardware and…

Finding the Pareto Optimal Equitable Allocation of Homogeneous Divisible Goods Among Three Players

Directory of Open Access Journals (Sweden)

Marco Dall'Aglio

2017-01-01

Full Text Available We consider the allocation of a finite number of homogeneous divisible items among three players. Under the assumption that each player assigns a positive value to every item, we develop a simple algorithm that returns a Pareto optimal and equitable allocation. This is based on the tight relationship between two geometric objects of fair division: The Individual Pieces Set (IPS and the Radon-Nykodim Set (RNS. The algorithm can be considered as an extension of the Adjusted Winner procedure by Brams and Taylor to the three-player case, without the guarantee of envy-freeness. (original abstract

The U.S. Culture Collection Network Responding to the Requirements of the Nagoya Protocol on Access and Benefit Sharing

Directory of Open Access Journals (Sweden)

Kevin McCluskey

2017-08-01

Full Text Available The U.S. Culture Collection Network held a meeting to share information about how culture collections are responding to the requirements of the recently enacted Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from their Utilization to the Convention on Biological Diversity (CBD. The meeting included representatives of many culture collections and other biological collections, the U.S. Department of State, U.S. Department of Agriculture, Secretariat of the CBD, interested scientific societies, and collection groups, including Scientific Collections International and the Global Genome Biodiversity Network. The participants learned about the policies of the United States and other countries regarding access to genetic resources, the definition of genetic resources, and the status of historical materials and genetic sequence information. Key topics included what constitutes access and how the CBD Access and Benefit-Sharing Clearing-House can help guide researchers through the process of obtaining Prior Informed Consent on Mutually Agreed Terms. U.S. scientists and their international collaborators are required to follow the regulations of other countries when working with microbes originally isolated outside the United States, and the local regulations required by the Nagoya Protocol vary by the country of origin of the genetic resource. Managers of diverse living collections in the United States described their holdings and their efforts to provide access to genetic resources. This meeting laid the foundation for cooperation in establishing a set of standard operating procedures for U.S. and international culture collections in response to the Nagoya Protocol.

Inequities in coverage of preventive child health interventions: the rural drinking water supply program and the universal immunization program in Rajasthan, India.

Science.gov (United States)

Mohan, Pavitra

2005-02-01

I assessed whether the Rural Drinking Water Supply Program (RDWSP) and the Universal Immunization Program (UIP) have achieved equitable coverage in Rajasthan, India, and explored program characteristics that affect equitable coverage of preventive health interventions. A total of 2460 children presenting at 12 primary health facilities in one district of Rajasthan were enrolled and classified into economic quartiles based on possession of assets. Immunization coverage and prime source of drinking water were compared across quartiles. A higher access to piped water by wealthier families (P< .001) was compensated by higher access to hand pumps by poorer families (P<.001), resulting in equal access to a safe source (P=.9). Immunization coverage was inequitable, favoring the wealthier children (P<.001). The RDWSP has achieved equitable coverage, while UIP coverage remains highly inequitable. Programs can make coverage more equitable by formulating explicit objectives to ensure physical access to all, promoting the intervention's demand by the poor, and enhancing the support and monitoring of frontline workers who deliver these interventions.

An oncofetal glycosaminoglycan modification provides therapeutic access to Cisplatin-resistant bladder cancer

DEFF Research Database (Denmark)

Seiler, Roland; Oo, Htoo Zarni; Tortora, Davide

2017-01-01

the malaria parasite Plasmodium falciparum, we can target these sugar chains, and our results showed a significant antitumor effect in cisplatin-resistant bladder cancer. This novel treatment paradigm provides therapeutic access to bladder cancers not responding to cisplatin.......BACKGROUND: Although cisplatin-based neoadjuvant chemotherapy (NAC) improves survival of unselected patients with muscle-invasive bladder cancer (MIBC), only a minority responds to therapy and chemoresistance remains a major challenge in this disease setting. OBJECTIVE: To investigate the clinical...... significance of oncofetal chondroitin sulfate (ofCS) glycosaminoglycan chains in cisplatin-resistant MIBC and to evaluate these as targets for second-line therapy. DESIGN, SETTING, AND PARTICIPANTS: An ofCS-binding recombinant VAR2CSA protein derived from the malaria parasite Plasmodium falciparum (rVAR2...

Private health insurance and access to healthcare.

Science.gov (United States)

Duggal, Ravi

2011-01-01

The health insurance business in India has seen a growth of over 25% per annum in the last few years with the expansion of the private health insurance sector. The premium incomes of health insurance have crossed the Rs 8,000 crore mark with the share of private companies increasing to over 41%. This is despite the fact that from the perspective of patients, health insurance is not a good deal, especially when they need it most. This raises a number of ethical issues regarding how the health insurance business runs and how medical practice adjusts to it for profiteering. This article uses the personal experience of the author to argue that health insurance in an unregulated environment can only lead to unethical practices, further victimising the patient. Further, publicly financed healthcare which operates in an environment regulating both public and private healthcare provisioning is the only way to assure access to ethical and equitable healthcare to people.

Designing a system for patients controlling providers' access to their electronic health records: organizational and technical challenges.

Science.gov (United States)

Leventhal, Jeremy C; Cummins, Jonathan A; Schwartz, Peter H; Martin, Douglas K; Tierney, William M

2015-01-01

Electronic health records (EHRs) are proliferating, and financial incentives encourage their use. Applying Fair Information Practice principles to EHRs necessitates balancing patients' rights to control their personal information with providers' data needs to deliver safe, high-quality care. We describe the technical and organizational challenges faced in capturing patients' preferences for patient-controlled EHR access and applying those preferences to an existing EHR. We established an online system for capturing patients' preferences for who could view their EHRs (listing all participating clinic providers individually and categorically-physicians, nurses, other staff) and what data to redact (none, all, or by specific categories of sensitive data or patient age). We then modified existing data-viewing software serving a state-wide health information exchange and a large urban health system and its primary care clinics to allow patients' preferences to guide data displays to providers. Patients could allow or restrict data displays to all clinicians and staff in a demonstration primary care clinic, categories of providers (physicians, nurses, others), or individual providers. They could also restrict access to all EHR data or any or all of five categories of sensitive data (mental and reproductive health, sexually transmitted diseases, HIV/AIDS, and substance abuse) and for specific patient ages. The EHR viewer displayed data via reports, data flowsheets, and coded and free text data displayed by Google-like searches. Unless patients recorded restrictions, by default all requested data were displayed to all providers. Data patients wanted restricted were not displayed, with no indication they were redacted. Technical barriers prevented redacting restricted information in free textnotes. The program allowed providers to hit a "Break the Glass" button to override patients' restrictions, recording the date, time, and next screen viewed. Establishing patient

Providing information and guidance on water and soil management

Energy Technology Data Exchange (ETDEWEB)

Den Haan, K. [CONCAWE, Brussels (Belgium)

2013-04-01

When CONCAWE was formed in 1963, the conservation of Europe's water resources was one of the main drivers, following the commitment made by the industry at the 6th World Petroleum Congress. Water remains an essential resource that has, over the years, come progressively higher on the international agenda because of its intimate relationship with both human health and ecosystem development. In the 50 years of CONCAWE's existence, water quality in Europe has improved steadily and the contribution of the refining sector to this improvement cannot be ignored. Today, almost 50% of Europe's surface and groundwater bodies are classed as being of at least 'good' status (as defined in the Water Framework Directive) and, for those that do not meet this standard, the impact of the refining sector has been shown to be minimal. Nevertheless there is growing pressure on water resources in terms of chemical and ecological quality, of the quantity used or consumed, and of equitable access to good quality water.

Water Demand Management Policy Brief No

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

Bob Stanley

Fair share: Water Demand Management can help provide fair access to water for the poor. Water Policy. Brief no.2 ... management (WDM) can help spread water more equitably, providing a measure of opportunity, security and ... improving health and quality of life for families. WDM measures can improve the efficiency of.

Single-centre experience with Renal PatientView, a web-based system that provides patients with access to their laboratory results.

Science.gov (United States)

Woywodt, Alexander; Vythelingum, Kervina; Rayner, Scott; Anderton, John; Ahmed, Aimun

2014-10-01

Renal PatientView (RPV) is a novel, web-based system in the UK that provides patients with access to their laboratory results, in conjunction with patient information. To study how renal patients within our centre access and use RPV. We sent out questionnaires in December 2011 to all 651 RPV users under our care. We collected information on aspects such as the frequency and timing of RPV usage, the parameters viewed by users, and the impact of RPV on their care. A total of 295 (45 %) questionnaires were returned. The predominant users of RPV were transplant patients (42 %) followed by pre-dialysis chronic kidney disease patients (37 %). Forty-two percent of RPV users accessed their results after their clinic appointments, 38 % prior to visiting the clinic. The majority of patients (76 %) had used the system to discuss treatment with their renal physician, while 20 % of patients gave permission to other members of their family to use RPV to monitor results on their behalf. Most users (78 %) reported accessing RPV on average 1-5 times/month. Most patients used RPV to monitor their kidney function, 81 % to check creatinine levels, 57 % to check potassium results. Ninety-two percent of patients found RPV easy to use and 93 % felt that overall the system helps them in taking care of their condition; 53 % of patients reported high satisfaction with RPV. Our results provide interesting insight into use of a system that gives patients web-based access to laboratory results. The fact that 20 % of patients delegate access to relatives also warrants further study. We propose that online access to laboratory results should be offered to all renal patients, although clinicians need to be mindful of the 'digital divide', i.e. part of the population that is not amenable to IT-based strategies for patient empowerment.

Equitable access: Remote and rural communities 'transport needs'

OpenAIRE

White, Peter

2011-01-01

Transport in rural and remote regions receives considerable attention in research, but this is often focussed on specific means of resolving problems in those regions - for example, the role of demand-responsive bus services, or scope for attracting users to rail services. The aim of this paper is to take a broader view, firstly in defining what constitute rural and remote regions, and secondly in considering a wide range of public transport options available. Experience in Britain will be ta...

Guidelines to Mainstream Gender in Transport Projects

OpenAIRE

Luz Caballero

2008-01-01

The consideration of gender in transport is essential to ensure that transport is equitable, affordable, and provides access to resources and opportunities required for development. This note aims to provide guidance for mainstreaming gender into transport projects. It provides examples of how to do this, in relation to the various transport modes used in development operations by the Wor...

Inequitable access to substance abuse treatment services in Cape Town, South Africa

Directory of Open Access Journals (Sweden)

Louw Johann

2010-11-01

Full Text Available Abstract Background Despite high levels of substance use disorders in Cape Town, substance abuse treatment utilization is low among people from disadvantaged communities in Cape Town, South Africa. To improve substance abuse treatment utilization, it is important to identify any potential barriers to treatment initiation so that interventions to reduce these barriers can be implemented. To date, substance abuse research has not examined the factors associated with substance abuse treatment utilization within developing countries. Using the Behavioural Model of Health Services Utilization as an analytic framework, this study aimed to redress this gap by examining whether access to substance abuse treatment is equitable and the profile of variables associated with treatment utilization for people from poor communities in Cape Town, South Africa. Methods This study used a case-control design to compare 434 individuals with substance use disorders from disadvantaged communities who had accessed treatment with 555 controls who had not accessed treatment on a range of predisposing, treatment need and enabling/restricting variables thought to be associated with treatment utilization. A hierarchical logistic regression was conducted to assess the unique contribution that the need for treatment, predisposing and enabling/restricting variable blocks made on substance abuse treatment utilization. Results Findings revealed that non-need enabling/restricting variables accounted for almost equal proportions of the variance in service utilization as the need for treatment variables. These enabling/restricting variables also attenuated the influence of the treatment need and predisposing variables domains on chances of treatment utilization. Several enabling/restricting variables emerged as powerful partial predictors of utilization including competing financial priorities, geographic access barriers and awareness of treatment services. Perceived severity of

Bridging the digital divide: mobile access to personal health records among patients with diabetes.

Science.gov (United States)

Graetz, Ilana; Huang, Jie; Brand, Richard J; Hsu, John; Yamin, Cyrus K; Reed, Mary E

2018-01-01

Some patients lack regular computer access and experience a digital divide that causes them to miss internet-based health innovations. The diffusion of smartphones has increased internet access across the socioeconomic spectrum, and increasing the channels through which patients can access their personal health records (PHRs) could help bridge the divide in PHR use. We examined PHR use through a computer-based Web browser or mobile device. Cross-sectional historical cohort analysis. Among adult patients in the diabetes registry of an integrated healthcare delivery system, we studied the devices used to access their PHR during 2016. Among 267,208 patients with diabetes, 68.1% used the PHR in 2016; 60.6% of all log-ins were via computer and 39.4% were via mobile device. Overall, 63.9% used it from both a computer and mobile device, 29.6% used only a computer, and 6.5% used only a mobile device. After adjustment, patients who were black, Hispanic, or Asian; lived in lower socioeconomic status (SES) neighborhoods; or had lower engagement were all significantly more likely to use the PHR only from a mobile device (P digital divide in computer use, disproportionately reaching racial/ethnic minorities and lower SES patients. Nonetheless, even with a mobile-optimized and app-accessible PHR, differences in PHR use by race/ethnicity and SES remain. Continued efforts are needed to increase equitable access to PHRs among patients with chronic conditions.

Provider perceptions of stigma and discrimination experienced by adolescents and young adults with pHiV while accessing sexual and reproductive health care.

Science.gov (United States)

Fair, Cynthia D; Berk, Meredith

2018-02-01

Historically, children with perinatally-acquired HIV (PHIV) were viewed as the "innocent victims" as their HIV infection was not acquired through sexual/drug related means. Today, adolescents with PHIV are surviving into young adulthood and are engaging in developmentally expected behaviors such as establishing intimate, sexual relationships. Like other youth, those living with PHIV often need to access sexual and reproductive health (SRH) services. Previous research has documented stigma and discrimination experienced by adult women living with HIV as they try to access SRH care. However, little is known about the experiences of stigma and discrimination encountered by the maturing adolescents and young adults (AYA) with PHIV when accessing services. HIV health care providers (HHCPs) who frequently care for this population are in a unique position to learn about and understand the stigma and discrimination experienced by their patients in formal service settings. HHCPs (n = 57, 28 medical and 29 social service providers) were recruited using snowball sampling, and completed an online survey based on patient-shared experiences of stigma and discrimination when accessing SRH-related health care and social services. Thirty-eight percent (22/57) of providers reported that their patients with PHIV had shared encounters of stigma or discrimination when accessing SRH services. Coded open-ended provider comments indicated that AYA patients experienced challenges with providers who were unfamiliar with PHIV and expressed surprise that someone with PHIV was still alive. Analyses also revealed prejudicial attitudes towards women with HIV. Patients reported being counseled to terminate their pregnancy and lectured about their "poor choices." As AYA with PHIV transition out of pediatric and adolescent care, it is important for providers to simultaneously help them navigate care in other health settings, as well as educate adult health care providers about possible

Free versus subsidised healthcare: options for fee exemptions, access to care for vulnerable groups and effects on the health system in Burkina Faso.

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Yaogo, Maurice

2017-07-12

The many forms of healthcare fee exemptions implemented in Burkina Faso since the 2000s have varied between total exemption (free) and cost subsidisation. This article examines both options, their contextual variations and the ways in which they affect access to healthcare for vulnerable people as well as the operation of the health system. This research is part of an interdisciplinary regional program on the elimination of user fees for health services in West Africa (Burkina Faso, Mali and Niger). A conceptual framework and a chronological review of policy interventions are used as references to summarise the results of the three qualitative studies presented. Historical reference points are used to describe the emergence of healthcare fee exemption policies in Burkina Faso and the events that influenced their adoption. The joint analysis of opinions on options for fee exemption focuses on the different types of repercussions on access to healthcare and the operation of the health system. In conjunction with the twists and turns of the gradual development of a national health policy and in response to international recommendations, healthcare fee exemptions have evolved since colonisation. The limitations of the changes introduced with cost recovery and the barriers to healthcare access for the poorest people led to the adoption of the current sectorial fee exemptions. The results provide information on the reasons for the changes that have occurred over time. The nuanced perspectives of different categories of people surveyed about fee exemption options show that, beyond the perceived effects on healthcare access and the health system, the issue is one of more equitable governance. In principle, the fee exemption measures are intended to provide improved healthcare access for vulnerable groups. In practice, the negative effects on the operation of the health system advocate for reforms to harmonise the changes to multifaceted fee exemptions and the actual needs

‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

Science.gov (United States)

2013-01-01

Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of

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

Science.gov (United States)

Lechuga, Vicente M.

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

42 CFR 433.127 - Termination of FFP for failure to provide access to claims processing and information retrieval...

Science.gov (United States)

2010-10-01

... claims processing and information retrieval systems. 433.127 Section 433.127 Public Health CENTERS FOR... PROGRAMS STATE FISCAL ADMINISTRATION Mechanized Claims Processing and Information Retrieval Systems § 433.127 Termination of FFP for failure to provide access to claims processing and information retrieval...

The climate4impact platform: Providing, tailoring and facilitating climate model data access

Science.gov (United States)

Pagé, Christian; Pagani, Andrea; Plieger, Maarten; Som de Cerff, Wim; Mihajlovski, Andrej; de Vreede, Ernst; Spinuso, Alessandro; Hutjes, Ronald; de Jong, Fokke; Bärring, Lars; Vega, Manuel; Cofiño, Antonio; d'Anca, Alessandro; Fiore, Sandro; Kolax, Michael

2017-04-01

One of the main objectives of climate4impact is to provide standardized web services and tools that are reusable in other portals. These services include web processing services, web coverage services and web mapping services (WPS, WCS and WMS). Tailored portals can be targeted to specific communities and/or countries/regions while making use of those services. Easier access to climate data is very important for the climate change impact communities. To fulfill this objective, the climate4impact (http://climate4impact.eu/) web portal and services has been developed, targeting climate change impact modellers, impact and adaptation consultants, as well as other experts using climate change data. It provides to users harmonized access to climate model data through tailored services. It features static and dynamic documentation, Use Cases and best practice examples, an advanced search interface, an integrated authentication and authorization system with the Earth System Grid Federation (ESGF), a visualization interface with ADAGUC web mapping tools. In the latest version, statistical downscaling services, provided by the Santander Meteorology Group Downscaling Portal, were integrated. An innovative interface to integrate statistical downscaling services will be released in the upcoming version. The latter will be a big step in bridging the gap between climate scientists and the climate change impact communities. The climate4impact portal builds on the infrastructure of an international distributed database that has been set to disseminate the results from the global climate model results of the Coupled Model Intercomparison project Phase 5 (CMIP5). This database, the ESGF, is an international collaboration that develops, deploys and maintains software infrastructure for the management, dissemination, and analysis of climate model data. The European FP7 project IS-ENES, Infrastructure for the European Network for Earth System modelling, supports the European

A Case of Equitable Maritime Delimitation: Nicaragua and Colombia in the Western Caribbean Sea

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Paul S. Reichler

2013-06-01

Full Text Available The unanimous judgment the International Court of Justice in November 2012 which resolved the boundary dispute between Nicaragua and Colombia in the western Caribbean Sea has generated considerable attention and commentary. Almost all of it has been highly favorable, with the sole exception of the reaction by Colombia, which purported to “reject” the Court’s Judgment and commenced procedures to withdraw its acceptance of ICJ jurisdiction in regard to future cases. This article demonstrates that the Court’s Judgment reflects the application of well-established legal principles of maritime boundary delimitation, and results in an equitable solution that is balanced and fair to both Parties. By analyzing the unique geographical circumstances of this case and discussing the methodologies and reasoning the Court employed in these circumstances to delimit the disputed maritime area, the article demonstrates that the delimitation line established by the Court was a creative solution to a difficult and complex geographic situation, which at the same time is firmly rooted in and consistent with well-established jurisprudence. As a result, the maritime boundary that the Court fixed between Nicaragua and Colombia allows the coasts of both States to generate maritime entitlements in a reasonable and mutually balanced way. Not only is the Court’s Judgment equitable to both Parties; it is also legally binding on them. There is no basis for either State to “reject” it, and no justification for refusing to entrust future cases to the Court, which remains an indispensable forum for the peaceful resolution of disputes between States according to the rule of law.

: health is my capital: a qualitative study of access to healthcare by Chinese migrants in Singapore.

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Tam, Wai Jia; Goh, Wei Leong; Chua, Jeffrey; Legido-Quigley, Helena

2017-06-15

Since the 1970s, Singapore has turned into one of the major receiving countries of foreign workers in Southeast Asia. Over the years, challenges surrounding access to healthcare by Chinese migrant workers have surfaced globally. This study aims to explore the experiences of Chinese migrants accessing primary and secondary/tertiary healthcare in Singapore, and the opportunities for overcoming these barriers. We conducted 25 in-depth interviews of 20 Chinese migrants and five staff from HealthServe, a non-governmental organization serving Chinese migrants in Singapore from October 2015 to January 2016. Interviews were transcribed and analysed inductively adopting thematic analysis. Chinese migrants in Singapore who were interviewed are mainly middle-aged breadwinners with multiple dependents. Their concept of health is encapsulated in a Chinese proverb ", meaning "health is my capital". Health is defined by them as a personal asset, needed to provide for their families. From their health-seeking behaviors, six pathways were identified, highlighting different routes chosen and resulting outcomes depending on whether their illness was perceived as major or minor, and if they sought help from the private or public sector private or public sector. Key barriers were identified relating to vulnerabilities during the migration process, during their illness, when consulting with healthcare providers, and during repatriation. A transactional doctor-patient culture in China contrasts with the trust migrants place in Singaporean's public health system, perceived as equitable and personable. However, challenges remain for injured migrants who sought help from the private sector and those with chronic diseases. Policy recommendations to increase patient autonomy enabling choice of healthcare provider and provide for non-work related illnesses are suggested. Partnerships between migrant advocacy organizations and various stakeholders such as hospitals, government agencies and

Environmental Flows in Water Resources Policies, Plans, and Projects - Part 1: Findings and Recommendations and Part 2: Case Studies

OpenAIRE

World Bank

2010-01-01

Environmental flows are central to equitable distribution of and access to water and services provided by aquatic ecosystems. They refer to the quality, quantity, and timing of water flows required maintaining the components, functions, processes and resilience of aquatic ecosystems that provide goods and services to people. They are fundamental for sustainable water resources development, ...

Towards Equitable and Sustainable Urban Space: Introduction to Special Issue on “Urban Land and Sustainable Development”

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Yehua Dennis Wei

2016-08-01

Full Text Available The unprecedented wave of global urbanization has exerted increased pressure on urban land and made land-use sustainability an urgent concern. This Special Issue examines patterns, structures, and dynamics of urban land use from the economic, social, and, to a lesser extent, environmental standpoints, in light of the goal of equitable and sustainable development. This introduction discusses the background and design of the Special Issue and highlights the contribution of the selected papers.

Nurse practitioner perceptions of barriers and facilitators in providing health care for deaf American Sign Language users: A qualitative socio-ecological approach.

Science.gov (United States)

Pendergrass, Kathy M; Nemeth, Lynne; Newman, Susan D; Jenkins, Carolyn M; Jones, Elaine G

2017-06-01

Nurse practitioners (NPs), as well as all healthcare clinicians, have a legal and ethical responsibility to provide health care for deaf American Sign Language (ASL) users equal to that of other patients, including effective communication, autonomy, and confidentiality. However, very little is known about the feasibility to provide equitable health care. The purpose of this study was to examine NP perceptions of barriers and facilitators in providing health care for deaf ASL users. Semistructured interviews in a qualitative design using a socio-ecological model (SEM). Barriers were identified at all levels of the SEM. NPs preferred interpreters to facilitate the visit, but were unaware of their role in assuring effective communication is achieved. A professional sign language interpreter was considered a last resort when all other means of communication failed. Gesturing, note-writing, lip-reading, and use of a familial interpreter were all considered facilitators. Interventions are needed at all levels of the SEM. Resources are needed to provide awareness of deaf communication issues and legal requirements for caring for deaf signers for practicing and student NPs. Protocols need to be developed and present in all healthcare facilities for hiring interpreters as well as quick access to contact information for these interpreters. ©2017 American Association of Nurse Practitioners.

JISC Open Access Briefing Paper

OpenAIRE

Swan, Alma

2005-01-01

What Open Access is. What Open Access is not. How is Open Access provided? Open Access archives or repositories. Open Access journals. Why should authors provide Open Access to their work? Further information and resources

Patient and provider determinants for receipt of three dimensions of respectful maternity care in Kigoma Region, Tanzania-April-July, 2016.

Science.gov (United States)

Dynes, M M; Twentyman, E; Kelly, L; Maro, G; Msuya, A A; Dominico, S; Chaote, P; Rusibamayila, R; Serbanescu, F

2018-03-05

provider information in the analysis of RMC. Strategies that address provider-level determinants of RMC (such as equitable pay, work environment, access to mentoring platforms) may improve RMC and subsequently address uptake of facility delivery.

Ethnicity, Inequality, and Higher Education in Malaysia.

Science.gov (United States)

Selvaratnam, Viswanathan

1988-01-01

Traces the development since 1957 of Malaysian education policies aimed at providing equitable access to higher education. Suggests that these policies have increased representation of the Malay underclass in tertiary institutions and the professions, but have had little effect on intraethnic class inequalities. 46 references. (SV)

Women's Access and Provider Practices for the Case Management of Malaria during Pregnancy: A Systematic Review and Meta-Analysis

NARCIS (Netherlands)

Hill, Jenny; D'Mello-Guyett, Lauren; Hoyt, Jenna; van Eijk, Anna M.; ter Kuile, Feiko O.; Webster, Jayne

2014-01-01

Background: WHO recommends prompt diagnosis and quinine plus clindamycin for treatment of uncomplicated malaria in the first trimester and artemisinin-based combination therapies in subsequent trimesters. We undertook a systematic review of women's access to and healthcare provider adherence to WHO

Carework and caring: A path to gender equitable practices among men in South Africa?

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Jewkes Rachel

2011-05-01

Full Text Available Abstract Background The purpose of this study was to examine the relationship between men who engage in carework and commitment to gender equity. The context of the study was that gender inequitable masculinities create vulnerability for men and women to HIV and other health concerns. Interventions are being developed to work with masculinity and to 'change men'. Researchers now face a challenge of identifying change in men, especially in domains of their lives beyond relations with women. Engagement in carework is one suggested indicator of more gender equitable practice. Methods A qualitative approach was used. 20 men in three South African locations (Durban, Pretoria/Johannesburg, Mthatha who were identified as engaging in carework were interviewed. The men came from different backgrounds and varied in terms of age, race and socio-economic status. A semi-structured approach was used in the interviews. Results Men were engaged in different forms of carework and their motivations to be involved differed. Some men did carework out of necessity. Poverty, associated with illness in the family and a lack of resources propelled some men into carework. Other men saw carework as part of a commitment to making a better world. 'Care' interpreted as a functional activity was not enough to either create or signify support for gender equity. Only when care had an emotional resonance did it relate to gender equity commitment. Conclusions Engagement in carework precipitated a process of identity and value transformation in some men suggesting that support for carework still deserves to be a goal of interventions to 'change men'. Changing the gender of carework contributes to a more equitable gender division of labour and challenges gender stereotypes. Interventions that promote caring also advance gender equity.

Providing open-access online materials and hands-on sessions for GIS exercises

Science.gov (United States)

Oguchi, T.; Yamauchi, H.; Hayakawa, Y. S.

2017-12-01

Researchers of GIS (Geographical Information Systems/Sciences) in Japan have collaborated to provide materials for GIS lecture classes in universities for the last 20 years. The major outcomes include 1) a GIS core curriculum, 2) a GIS "body of knowledge" explaining the details of the curriculum, 3) a series of PowerPoint presentations, and 4) a comprehensive GIS textbook. However, materials for GIS exercises at university classes using GIS software have been limited in Japan. Therefore, we launched a project to provide such materials which will be available online and accessible by anybody. The materials cover broad basic aspects of GIS including geoscientific applications such as terrain analysis using digital elevation models. The materials utilize public-domain and open-source software packages such as QGIS and GRASS. The data used are also freely available ones such as those from the Geospatial Information Authority of Japan. The use of the GitHub platform to distribute the materials allow easier online interactions by both material producers and users. Selected sets of the materials have been utilized for hands-on activities including both official university classes and public instructions. We have been updating the materials based on the opinions of people who took the hands-on courses for better GIS education. The current materials are in Japanese, but we plan to translate some of them into English.

Putting Making into High School Computer Science Classrooms: Promoting Equity in Teaching and Learning with Electronic Textiles in "Exploring Computer Science"

Science.gov (United States)

Fields, Deborah Ann; Kafai, Yasmin; Nakajima, Tomoko; Goode, Joanna; Margolis, Jane

2018-01-01

Recent discussions of making have focused on developing out-of-school makerspaces and activities to provide more equitable and enriching learning opportunities for youth. Yet school classrooms present a unique opportunity to help broaden access, diversify representation, and deepen participation in making. In turning to classrooms, we want to…

Contrasting Disclosure Practices and Experiences of School Support for Australian Adolescents with Cancer, Cystic Fibrosis and Anorexia Nervosa: Parent Perspectives

Science.gov (United States)

Bowtell, Evelyn Cecile; Aroni, Rosalie; Green, Julie; Sawyer, Susan M.

2018-01-01

Schools in Australia are required to promote equitable access to education and provide support services to students with chronic health conditions (CHCs). This qualitative study was conducted to explore stakeholders' experiences and perceptions regarding school-based support. In-depth interviews were conducted with 38 parents of upper secondary…

Efficient and equitable spatial allocation of renewable power plants at the country scale

Science.gov (United States)

Drechsler, Martin; Egerer, Jonas; Lange, Martin; Masurowski, Frank; Meyerhoff, Jürgen; Oehlmann, Malte

2017-09-01

Globally, the production of renewable energy is undergoing rapid growth. One of the most pressing issues is the appropriate allocation of renewable power plants, as the question of where to produce renewable electricity is highly controversial. Here we explore this issue through analysis of the efficient and equitable spatial allocation of wind turbines and photovoltaic power plants in Germany. We combine multiple methods, including legal analysis, economic and energy modelling, monetary valuation and numerical optimization. We find that minimum distances between renewable power plants and human settlements should be as small as is legally possible. Even small reductions in efficiency lead to large increases in equity. By considering electricity grid expansion costs, we find a more even allocation of power plants across the country than is the case when grid expansion costs are neglected.

Unifying Water Data Sources: How the CUAHSI Water Data Center is Enabling and Improving Access to a Growing Catalog of over 100 Data Providers

Science.gov (United States)

Pollak, J.; Berry, K.; Couch, A.; Arrigo, J.; Hooper, R. P.

2013-12-01

Scientific data about water are collected and distributed by numerous sources which can differ tremendously in scale. As competition for water resources increases, increasing access to and understanding of information about water will be critical. The mission of the new CUAHSI Water Data Center (WDC) is to provide those researchers who collect data a medium to publish their datasets and give those wanting to discover data the proper tools to efficiently find the data that they seek. These tools include standards-based data publication, data discovery tools based upon faceted and telescoping search, and a data analysis tool HydroDesktop that downloads and unifies data in standardized formats. The CUAHSI Hydrologic Information System (HIS) is a community developed and open source system for sharing water data. As a federated, web service oriented system it enables data publication for a diverse user population including scientific investigators (Research Coordination Networks, Critical Zone Observatories), government agencies (USGS, NASA, EPA), and citizen scientists (watershed associations). HydroDesktop is an end user application for data consumption in this system that the WDC supports. This application can be used for finding, downloading, and analyzing data from the HIS. It provides a GIS interface that allows users to incorporate spatial data that are not accessible via HIS, simple analysis tools to facilitate graphing and visualization, tools to export data to common file types, and provides an extensible architecture that developers can build upon. HydroDesktop, however, is just one example of a data access client for HIS. The web service oriented architecture enables data access by an unlimited number of clients provided they can consume the web services used in HIS. One such example developed at the WDC is the 'Faceted Search Client', which capitalizes upon exploratory search concepts to improve accuracy and precision during search. We highlight such

Influence of socio-demographic factors on distances travelled to access HIV services: enhanced surveillance of HIV patients in north west England

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Tocque Karen

2009-03-01

Full Text Available Abstract Background Patient choice and access to health care is compromised by many barriers including travel distance. Individuals with the human immunodeficiency virus (HIV can seek free specialist care in Britain, without a referral, providing flexible access to care services. Willingness to travel beyond local services for preferred care has funding and service implications. Data from an enhanced HIV surveillance system were used to explore geodemographic and clinical factors associated with accessing treatment services. Methods We extracted data on the location, type and frequency of care services utilized by HIV positive persons (n = 3983 accessing treatment in north west England between January 1st 2005 and June 30th 2006. Individuals were allocated a deprivation score and grouped by urban/rural residence, and distance to care services was calculated. Analysis identified independent predictors of distance travelled (general linear modelling and, for those bypassing their nearest clinic, the probability of accessing a specialist service (logistic regression, SPSS ver 14. Inter-relationships between variables and distance travelled were visualised using detrended correspondence analysis (PC-ORD ver 4.1. Results HIV infected persons travelled an average of 4.8 km (95% confidence intervals (CI 4.6–4.9 per trip and had on average 6 visits (95% CI 5.9–6.2 annually for care. Longer trips were made by males (4.8 km vs 4.5 km, white people (6.2 km, the young (>15 years, 6.8 km and elderly (60+ years, 6.3 km, those on multiple therapy (5.3 km vs 4.0 km, and the more affluent living in rural areas (16.1 km, P Conclusion Distance travelled, and type of HIV services used, were associated with socioeconomic status, even after accounting for ethnicity, route of infection and age. Thus despite offering an 'equitable' service, travel costs may advantage those with higher income.

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

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Mina Anjomshoa

2013-12-01

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

Mitsunobu mischief: Neighbor-directed histidine N(π)–alkylation provides access to peptides containing selectively functionalized imidazolium heterocycles

Science.gov (United States)

Qian, Wen-Jian

2015-01-01

There are few methodologies that yield peptides containing His residues with selective N(π), N(π)-bis-alkylated imidazole rings. We have found that, under certain conditions, on-resin Mitsunobu coupling of alcohols with peptides having a N(π)-alkylated His residue results in selective and high-yield alkylation of the imidazole N(π) nitrogen. The reaction requires the presence of a proximal phosphoric, carboxylic or sulfonic acid, and proceeds through an apparent intramolecular mechanism involving Mitsunobu intermediates. These transformations have particular application to phosphopeptides, where “charge masking” of one phosphoryl anionic charge by the cationic histidine imidazolium ion is now possible. This chemistry opens selective access to peptides containing differentially functionalized imidazolium heterocycles, which provide access to new classes of peptides and peptide mimetics. PMID:25739367

Vascular Access in Children

International Nuclear Information System (INIS)

Krishnamurthy, Ganesh; Keller, Marc S.

2011-01-01

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

Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

Science.gov (United States)

Otero-Garcia, Laura; Goicolea, Isabel; Gea-Sánchez, Montserrat; Sanz-Barbero, Belen

2013-01-01

Background There is insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ) of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy terminations, and the

Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives' perspectives.

Science.gov (United States)

Otero-Garcia, Laura; Goicolea, Isabel; Gea-Sánchez, Montserrat; Sanz-Barbero, Belen

2013-11-08

There insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ) of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives' perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy terminations, and the delay in the first prenatal visit, as discerned by

Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

Directory of Open Access Journals (Sweden)

Laura Otero-Garcia

2013-11-01

Full Text Available Background: There insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives: The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design: A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results: Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions: Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy

17 CFR 270.18f-2 - Fair and equitable treatment for holders of each class or series of stock of series investment...

Science.gov (United States)

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Fair and equitable treatment for holders of each class or series of stock of series investment companies. 270.18f-2 Section 270.18f... or series of stock of series investment companies. (a) For purposes of this § 270.18f-2 a series...

Carbon emissions and an equitable emission reduction criterion

International Nuclear Information System (INIS)

Golomb, Dan

1999-01-01

In 1995 the world-wide carbon emissions reached 5.8 billion metric tonnes per year (GTC/y). The Kyoto protocol calls for a reduction of carbon emissions from the developed countries (Annex I countries) of 6-8% below 1990 levels on the average, and unspecified commitments for the less developed (non-Annex I) countries. It is doubtful that the Kyoto agreement will be ratified by some parliaments, especially the USA Congress. Furthermore, it is shown that if the non-Annex I countries will not curtail their carbon emissions drastically, the global emissions will soar to huge levels by the middle of the next century. An equitable emission criterion is proposed which may lead to a sustainable rate of growth of carbon emissions, and be acceptable to all countries of the world. The criterion links the rate of growth of carbon emissions to the rate of growth of the Gross Domestic Product (GDP). A target criterion is proposed R = 0.15 KgC/SGDP, which is the current average for western European countries and Japan. This allows for both the growth of the GDP and carbon emissions. However, to reach the target in a reasonable time, the countries for which R≤ 0.3 would be allowed a carbon emission growth rate of 1%./y, and countries for which R≥ 0.3, 0.75%/y. It is shown that by 2050 the world-wide carbon emissions would reach about 10 GTC/y, which is about 3 times less than the Kyoto agreement would allow. (Author)

The Dilemma of Inclusion: Is Full Inclusion Ethical? An Examination of the Culture of Special Education within a Semi-Rural Pre-K to Sixth Grade Elementary School District

Science.gov (United States)

Press, Kandie A.

2010-01-01

At its core the political push for full inclusion models of special education delivery derives from the belief that inclusion provides equal access, equitable distribution of resources and increased social opportunity to children. This study focused upon the evolution of special education programming within a pre-K to sixth grade elementary school…

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

Science.gov (United States)

2011-01-01

The U.S. National Academy of Engineering (NAE) recently published a document presenting "Grand Challenges for Engineering". This list was proposed by leading engineers and scientists from around the world at the request of the U.S. National Science Foundation (NSF). Fourteen topics were selected for these grand challenges, and at least seven can be addressed using the tools and methods of biological engineering. Here we describe how biological engineers can address the challenge of providing access to clean drinking water. This issue must be addressed in part by removing or inactivating microbial and chemical contaminants in order to properly deliver water safe for human consumption. Despite many advances in technologies this challenge is expanding due to increased pressure on fresh water supplies and to new opportunities for growth of potentially pathogenic organisms. PMID:21453515

Exploring barriers to and enablers of adequate healthcare for Indigenous Australian prisoners with cancer: a scoping review drawing on evidence from Australia, Canada and the United States.

Science.gov (United States)

Olds, Jessica; Reilly, Rachel; Yerrell, Paul; Stajic, Janet; Micklem, Jasmine; Morey, Kim; Brown, Alex

International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group. This scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation. Eight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons' concern with security versus the need for timely access to medical care. Findings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians' over-burden of cancer mortality and over-representation in the prison system, further research is needed to

Digital Scholarship and Open Access

Science.gov (United States)

Losoff, Barbara; Pence, Harry E.

2010-01-01

Open access publications provide scholars with unrestricted access to the "conversation" that is the basis for the advancement of knowledge. The large number of open access journals, archives, and depositories already in existence demonstrates the technical and economic viability of providing unrestricted access to the literature that is the…

The perspectives of structurally vulnerable people who use drugs on volunteer stipends and work experiences provided through a drug user organization: Opportunities and limitations.

Science.gov (United States)

Bardwell, Geoff; Anderson, Solanna; Richardson, Lindsey; Bird, Lorna; Lampkin, Hugh; Small, Will; McNeil, Ryan

2018-03-01

While drug user organizations (DUO) have received public health attention as a means to potentially reduce the harms associated with drug use, there is a lack of research on the compensation and structural forces that promote or inhibit participation in DUO. Against the backdrop of structural vulnerability experienced by people who use drugs (PWUD), we examined the impact of monetary 'volunteer stipends' provided through a DUO and explore their role in providing low-threshold employment opportunities and shaping participation in DUO. Participants were purposively sampled to reflect a range of perspectives and experiences volunteering at Vancouver Area Network of Drug Users (VANDU) and receiving stipends. Semi-structured qualitative interviews were conducted with 23 members of VANDU. Interview transcripts were coded in Atlas.ti 7 for key a priori themes and emergent categories from the data and analyzed thematically. Stipends provided participants with symbolic and material recognition of the time, effort, and expertise they contribute to the organization, and functioned to facilitate ongoing participation. Payments that rewarded, skills, labour and drug-related knowledge reduced participant's perception of stigma against PWUD. Paid work in VANDU further provided participants with non-material benefits commonly attributed to regular employment, including social connections and a sense of purpose. Participants also identified the low level of pay as a limitation of VANDU's paid participation program. The daily demands of survival (accessing shelter, food, and drugs) posed more complex structural vulnerabilities to participate in VANDU, as small stipends were not sufficient to address these needs. Low threshold employment opportunities within DUO may provide significant individual and public health benefits. However, these benefits are constrained by the small size of stipends. Therefore, to ensure better inclusion of PWUD, our findings recommend the development and

The determinants of long-term care utilization and equity of access to care among older adults in Dong-Ku of Incheon Metropolitan city, South Korea.

Science.gov (United States)

Park, J M

2005-01-01

Under the current health care system, around three percent of the elderly remain uninsured. Based on the 2003 Dong-Ku Health Status Survey and the Aday and Andersen Access Framework, the present study examined the social and behavioral determinants of long-term care utilization and the extent to which equity in the use of long-term care services for the elderly has been achieved. The results indicate that universal health insurance system has not yielded a fully equitable distribution of services. Type of coverage and resource availability do not remain predictors of long-term care utilization. The data suggest that a universal health insurance system exists in South Korea with significant access problems for the population without insurance. Access differences also arise from obstacles in expanding the scope and level of plan benefits due to financial disparity among insurers. Health policy reforms must continue to concentrate on extending insurance coverage to the uninsured and establishing long-term insurance system for the elderly.

Combining DRGs and per diem payments in the private sector: the Equitable Payment Model.

Science.gov (United States)

Hanning, Brian W T

2005-02-01

The many types of payment models used in the Australian private sector are reviewed. Their features are compared and contrasted to those desirable in an optimal private sector payment model. The EPM(TM) (Equitable Payment Model) is discussed and its consistency with the desirable features of an optimal private sector payment model outlined. These include being based on a robust classification system, nationally benchmarked length of stay (LOS) results, nationally benchmarked relative cost and encouraging continual improvement in efficiency to the benefit of both health funds and private hospitals. The advantages in the context of the private sector of EPM(TM) being a per diem model, albeit very different to current per diem models, are discussed. The advantages of EPM(TM) for hospitals and health funds are outlined.

Recomposing consumption: defining necessities for sustainable and equitable well-being

Science.gov (United States)

Gough, Ian

2017-05-01

This paper focuses on consumption in the affluent world and the resulting level, composition and distribution of consumption-based emissions. It argues that public policy should foster the recomposition of consumption, while not disadvantaging poorer groups in the population. To combine these two imperatives entails making a distinction between goods and services that are necessary for a basic level of well-being, and those that are surplus to this requirement. The argument proceeds in six stages. First, the paper outlines a theory of universal need, as an alternative conception of well-being to consumer preference satisfaction. Second, it proposes a dual strategy methodology for identifying need satisfiers or necessities in a given social context. Then, it applies this methodology to identify a minimum bundle of necessary consumption items in the UK and speculates how it might be used to identify a maximum bundle for sustainable consumption. The next part looks at corporate barriers and structural obstacles in the path of sustainable consumption. The following part reveals a further problem: mitigation policies can result in perverse distributional outcomes when operating in contexts of great inequality. The final section suggests four ecosocial public policies that would simultaneously advance sustainable and equitable consumption in rich nations. This article is part of the themed issue 'Material demand reduction'.

Transportation Limitation Access to the Small Islands (Case Study: Banggai Laut Regency)

Science.gov (United States)

Sunarti, S.

2018-02-01

Indonesia is as an archipelago and maritime country, the large number of Islands owned and scattered in all directions makes a challenge for the Government in equitable development. Development in Indonesia has not been spread evenly and tends to focus on the big island, while the smaller islands are still far behind and lack of government attention. One of them is the lack of infrastructure especially the access to the small islands. Among the small islands in Indonesia with minimal maritime infrastructure or transportation is Banggai Laut Regency, Central Sulawesi Province. This Regency is a new regency that separate itself from its previous regency that is Banggai Kepulauan Regency in about 4 years ago. For the development of the Banggai Laut Regency, access to reach that regency is quite difficult. Therefore, the aim of this research is to find infrastructure development strategy to support the development of Banggai Laut Regency. The research method used was the concurrent model mixed method. Data collection method was done with primary data through field observation and interview, secondary data through literature and document review. Analytical techniques used are qualitative descriptive and Map Overlay techniques using GIS to describe the characteristics of study areas and spatial relationships between islands. The results of this research conclude that the Banggai Laut Regency requires infrastructure development particularly maritime transportation to enhance accessibility of the community headed to Banggi Laut Regency or headed to another island from the Banggai Laut Regency.

'If she is a good woman …' and 'to be a real man …': gender, risk and access to HIV services among key populations in Tajikistan.

Science.gov (United States)

King, Elizabeth J; Maksymenko, Kateryna M; Almodovar-Diaz, Yadira; Johnson, Sarah

2016-01-01

The HIV epidemic continues to grow in Tajikistan, especially among people who inject drugs, sex workers, men who have sex with men and incarcerated populations. Despite their susceptibility to HIV, members of these groups do not always have access to HIV prevention, testing and treatment. The purpose of this study was to identify and understand the gender constraints in accessing HIV services for key populations in Tajikistan. Using focus-group discussions and key-informant interviews the assessment team collected information from members of key populations and those who work with them. Several themes emerged from the data, including: low levels of HIV knowledge, gender constraints to condom use and safer drug use, gender constraints limit HIV testing opportunities, gender-based violence, stigma and discrimination, and the lack of female spaces in the HIV response. The results of this study show that there are well-defined gender norms in Tajikistan, and these gender norms influence key populations' access to HIV services. Addressing these gender constraints may offer opportunities for more equitable access to HIV services in Tajikistan.

National Measures on Access to Genetic Resources and Benefit Sharing – The Case of the Philippines

Directory of Open Access Journals (Sweden)

Aphrodite Smagadi

2005-06-01

Full Text Available The objective of the Convention on Biological Diversity stipulated at the United Nations Conference on Environment and Development (Rio de Janeiro, 1992 was not merely to promote the conservation and sustainable use of biological resources, but to ensure the fair and equitable sharing of benefits arising from their utilisation. The Convention stresses the sovereignty that signatory states exert over the biological wealth within their jurisdiction and calls on them to enact national legislation that will contribute to fleshing out the provisions on access to genetic resources and benefit sharing. The Philippines was the first country to enact such legislation and has thus accrued a decade of experience in this field. The first and much-analysed access and benefit sharing instrument enacted by the Government of the Philippines, was Executive Order 247 of 1995. However, due to problems experienced during the implementation of the Order, draft guidelines based on the 2001 Implementing Rules to the Wildlife Act have been drafted and are expected to correct the failures of the previous law. This article takes the example of the Philippines to assess the extent to which laws regulating the access and benefit sharing of biological resources can be effective in any country.

Lost and Found: Music Activities Delivered by Primary Classroom Generalists

Science.gov (United States)

King, Fiona

2015-01-01

Primary classroom teachers can play a vital role in the music education of primary school students, providing a basis for lifelong learning in music and the arts. Research shows that not all Victorian primary school students have equitable access to music education and that the role of the classroom teacher becomes valuable in supplying or…

A Qualitative Study of Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Malawi.

Science.gov (United States)

White, Sian; Kuper, Hannah; Itimu-Phiri, Ambumulire; Holm, Rochelle; Biran, Adam

2016-01-01

Globally, millions of people lack access to improved water, sanitation and hygiene (WASH). Disabled people, disadvantaged both physically and socially, are likely to be among those facing the greatest inequities in WASH access. This study explores the WASH priorities of disabled people and uses the social model of disability and the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to look at the relationships between impairments, contextual factors and barriers to WASH access. 36 disabled people and 15 carers from urban and rural Malawi were purposively selected through key informants. The study employed a range of qualitative methods including interviews, emotion mapping, free-listing of priorities, ranking, photo voice, observation and WASH demonstrations. A thematic analysis was conducted using nVivo 10. WASH access affected all participants and comprised almost a third of the challenges of daily living identified by disabled people. Participants reported 50 barriers which related to water and sanitation access, personal and hand hygiene, social attitudes and participation in WASH programs. No two individuals reported facing the same set of barriers. This study found that being female, being from an urban area and having limited wealth and education were likely to increase the number and intensity of the barriers faced by an individual. The social model proved useful for classifying the majority of barriers. However, this model was weaker when applied to individuals who were more seriously disabled by their body function. This study found that body function limitations such as incontinence, pain and an inability to communicate WASH needs are in and of themselves significant barriers to adequate WASH access. Understanding these access barriers is important for the WASH sector at a time when there is a global push for equitable access.

Benchmarking of refinery CO2 emissions. The CWT methodology provides a way forward

Energy Technology Data Exchange (ETDEWEB)

Larive, J.F. [CONCAWE, Brussels (Belgium)

2009-10-01

The EU Greenhouse Gas Emissions Trading Scheme foresees a number of mechanisms for distributing emission allowances amongst market players. For those economic sectors exposed to international competition, a portion of the required allowances will be distributed free of charge. In order to do this in an equitable manner, the amount of free allowances will be based on a sectoral benchmark representing best practice in the sector. In cooperation with Solomon Associates, CONCAWE has developed the so-called Complexity Weighted Tonne (CWT) methodology which provides a common and balanced basis for comparing the performance of refineries.

Accessibility of antiretroviral therapy in Ghana: convenience of access.

Science.gov (United States)

Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

2012-01-01

The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify

Accessing Electronic Journals.

Science.gov (United States)

McKay, Sharon Cline

1999-01-01

Discusses issues librarians need to consider when providing access to electronic journals. Topics include gateways; index and abstract services; validation and pay-per-view; title selection; integration with OPACs (online public access catalogs)or Web sites; paper availability; ownership versus access; usage restrictions; and services offered…

20 CFR 652.207 - How does a State meet the requirement for universal access to services provided under the Act?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How does a State meet the requirement for universal access to services provided under the Act? 652.207 Section 652.207 Employees' Benefits EMPLOYMENT... exercising this discretion, a State must meet the Act's requirements. (b) These requirements are: (1) Labor...

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.

Fishing Access Areas

Data.gov (United States)

Vermont Center for Geographic Information — The Vermont Fish & Wildlife Department maintains developed fishing access areas. These sites provide public access to waters in Vermont for shore fishing...

Evolution of Network Access Points (NAPs and agreements among Internet Service Providers (ISPs in South America

Directory of Open Access Journals (Sweden)

Fernando Beltrán

2006-05-01

Full Text Available Este artículo presenta los aspectos principales del desarrollo histórico y de asuntos actuales en el mercado suramericano de acceso a Internet: los acuerdos de interconexión para el intercambio de tráfico local y regional en Suramérica, los incentivos que tienen los proveedores de acceso a Internet para mantener o modificar la naturaleza de los acuerdos y los métodos de recuperación de costos en los puntos de intercambio de tráfico. El artículo también identifica algunas amenazas a la estabilidad de los puntos de intercambio de tráfico y las ilustra con dos casos. / This paper presents the main aspects of the historical development and the current issues at stake in the South American Internet access market: the interconnection schemes for the exchange of local and regional traffic in the South American region, the incentives Internet access providers have for keeping or modifying the nature of the agreements, and the cost recovery methods at the traffic exchange points. Some threats to the stability of the scheme for domestic traffic exchange adopted throughout the region are also identified and subsequently illustrated with country-cases.

Perspectives on providing good access to dental services for elderly people: patient selection, dentists' responsibility and budget management.

Science.gov (United States)

Grytten, Jostein; Holst, Dorthe

2013-06-01

To suggest a model for organizing and financing dental services for elderly people so that they have good access to services. There are few studies on how dental services for elderly people should be organized and financed. This is surprising if we take into consideration the fact that the proportion of elderly people is growing faster than any other group in the population, and that elderly people have more dental diseases and poorer access to dental services than the rest of the adult population. In several countries, dental services are characterized by private providers who often operate in a market with competition and free price-setting. Private dentists have no community responsibility, and they are free to choose which patients they treat. Literature review and critical reasoning. In order to avoid patient selection, a patient list system for elderly people is recommended, with per capita remuneration for the patients that the dentist is given responsibility for. The patient list system means that the dentist assumes responsibility for a well-defined list of elderly people. Our model will lead to greater security in the dentist/patient relationship, and patients with great treatment needs will be ensured access to dental services. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Frontline health workers as brokers: provider perceptions, experiences and mitigating strategies to improve access to essential medicines in South Africa.

Science.gov (United States)

Magadzire, Bvudzai Priscilla; Budden, Ashwin; Ward, Kim; Jeffery, Roger; Sanders, David

2014-11-05

Front-line health providers have a unique role as brokers (patient advocates) between the health system and patients in ensuring access to medicines (ATM). ATM is a fundamental component of health systems. This paper examines in a South African context supply- and demand- ATM barriers from the provider perspective using a five dimensional framework: availability (fit between existing resources and clients' needs); accessibility (fit between physical location of healthcare and location of clients); accommodation (fit between the organisation of services and clients' practical circumstances); acceptability (fit between clients' and providers' mutual expectations and appropriateness of care) and affordability (fit between cost of care and ability to pay). This cross-sectional, qualitative study uses semi-structured interviews with nurses, pharmacy personnel and doctors. Thirty-six providers were purposively recruited from six public sector Community Health Centres in two districts in the Eastern Cape Province representing both rural and urban settings. Content analysis combined structured coding and grounded theory approaches. Finally, the five dimensional framework was applied to illustrate the interconnected facets of the issue. Factors perceived to affect ATM were identified. Availability of medicines was hampered by logistical bottlenecks in the medicines supply chain; poor public transport networks affected accessibility. Organization of disease programmes meshed poorly with the needs of patients with comorbidities and circular migrants who move between provinces searching for economic opportunities, proximity to services such as social grants and shopping centres influenced where patients obtain medicines. Acceptability was affected by, for example, HIV related stigma leading patients to seek distant services. Travel costs exacerbated by the interplay of several ATM barriers influenced affordability. Providers play a brokerage role by adopting flexible

Assessing internet access and use in a medically underserved population: implications for providing enhanced health information services.

Science.gov (United States)

Zach, Lisl; Dalrymple, Prudence W; Rogers, Michelle L; Williver-Farr, Heather

2012-03-01

The relationship between health information seeking, patient engagement and health literacy is not well understood. This is especially true in medically underserved populations, which are often viewed as having limited access to health information. To improve communication between an urban health centre and the community it serves, a team of library and information science researchers undertook an assessment of patients' level and methods of access to and use of the Internet. Data were collected in 53 face-to-face anonymous interviews with patients at the centre. Interviews were tape-recorded for referential accuracy, and data were analysed to identify patterns of access and use. Seventy-two percentage of study participants reported having access to the Internet through either computers or cell phones. Barriers to Internet access were predominantly lack of equipment or training rather than lack of interest. Only 21% of those with Internet access reported using the Internet to look for health information. The findings suggest that lack of access to the Internet in itself is not the primary barrier to seeking health information in this population and that the digital divide exists not at the level of information access but rather at the level of information use. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Open Access @ DTU

DEFF Research Database (Denmark)

Ekstrøm, Jeannette

Open Access is high on the agenda in Denmark and internationally. Denmark has announced a national strategy for Open Access that aims to achieve Open Access to 80% in 2017 and 100% in 2022 to peer review research articles. All public Danish funders as well as H2020 requires that all peer review...... articles that is an outcome of their funding will be Open Access. Uploading your full texts (your final author manuscript after review ) to DTU Orbit is a fundamental part of providing Open Access to your research. We are here to answer all your questions with regards to Open Access and related topics...... such as copyright, DTU Orbit, Open Access journals, APCs, Vouchers etc....

Recomposing consumption: defining necessities for sustainable and equitable well-being.

Science.gov (United States)

Gough, Ian

2017-06-13

This paper focuses on consumption in the affluent world and the resulting level, composition and distribution of consumption-based emissions. It argues that public policy should foster the recomposition of consumption, while not disadvantaging poorer groups in the population. To combine these two imperatives entails making a distinction between goods and services that are necessary for a basic level of well-being, and those that are surplus to this requirement. The argument proceeds in six stages. First, the paper outlines a theory of universal need, as an alternative conception of well-being to consumer preference satisfaction. Second, it proposes a dual strategy methodology for identifying need satisfiers or necessities in a given social context. Then, it applies this methodology to identify a minimum bundle of necessary consumption items in the UK and speculates how it might be used to identify a maximum bundle for sustainable consumption. The next part looks at corporate barriers and structural obstacles in the path of sustainable consumption. The following part reveals a further problem: mitigation policies can result in perverse distributional outcomes when operating in contexts of great inequality. The final section suggests four ecosocial public policies that would simultaneously advance sustainable and equitable consumption in rich nations.This article is part of the themed issue 'Material demand reduction'. © 2017 The Author(s).

Producing More Actionable Science Isn't the Problem; It's Providing Decision-Makers with Access to Right Actionable Knowledge

Science.gov (United States)

Trexler, M.

2017-12-01

Policy-makers today have almost infinite climate-relevant scientific and other information available to them. The problem for climate change decision-making isn't missing science or inadequate knowledge of climate risks; the problem is that the "right" climate change actionable knowledge isn't getting to the right decision-maker, or is getting there too early or too late to effectively influence her decision-making. Actionable knowledge is not one-size-fit-all, and for a given decision-maker might involve scientific, economic, or risk-based information. Simply producing more and more information as we are today is not the solution, and actually makes it harder for individual decision-makers to access "their" actionable knowledge. The Climatographers began building the Climate Web five years ago to test the hypothesis that a knowledge management system could help navigate the gap between infinite information and individual actionable knowledge. Today the Climate Web's more than 1,500 index terms allow instant access to almost any climate change topic. It is a curated public-access knowledgebase of more than 1,000 books, 2,000 videos, 15,000 reports and articles, 25,000 news stories, and 3,000 websites. But it is also much more, linking together tens of thousands of individually extracted ideas and graphics, and providing Deep Dives into more than 100 key topics from changing probability distributions of extreme events to climate communications best practices to cognitive dissonance in climate change decision-making. The public-access Climate Web is uniquely able to support cross-silo learning, collaboration, and actionable knowledge dissemination. The presentation will use the Climate Web to demonstrate why knowledge management should be seen as a critical component of science and policy-making collaborations.

The Challenges of Living with Inflammatory Bowel Disease: Summary of a Summit on Patient and Healthcare Provider Perspectives

Directory of Open Access Journals (Sweden)

Judith Bray

2016-01-01

Full Text Available Canada has one of the highest rates of inflammatory bowel disease (IBD and the disease represents a significant health, social, and economic burden. There is currently no cure for IBD, although earlier diagnosis and new therapies have improved the overall health outcomes and quality of life for patients. Crohn’s and Colitis Canada is Canada’s only national, volunteer-based charity dedicated to finding cures for IBD and improving the lives of those affected, through research, education, patient programs, advocacy, and increased awareness. On April 30, 2015, Crohn’s and Colitis Canada hosted the “Patient and Healthcare Professional Summit on the Burden of Disease in IBD” to obtain a deeper understanding of the unmet needs of IBD patients and their caregivers. Through personal vignettes, patients articulated a pressing need to increase understanding of the challenges faced by people suffering from IBD among both health care professionals and the general public, develop best practices for navigating life transitions and addressing the unique challenges faced by children with IBD, and provide equitable access to appropriate, effective, and affordable treatments. The recommendations that emerged from the summit will inform about efforts to increase public awareness, inform about advocacy strategies, and contribute to the development of research priorities.

Inequalities in Educational Access in Mexico: A Study with Graduates Students of a High Performance Technical High School

Directory of Open Access Journals (Sweden)

Fernando Pérez-Santiago

2016-09-01

Full Text Available Access to the higher education system in Mexico has been characterized by educational inequalities explained by social and reproductionist currents. The phenomenon occurs in graduate students with a high school diploma and coming from different contexts (social, cultural, economic, institutional and academic ones that create a process of transition far away from equal opportunities. Therefore, the differences due to cultural diversity do not generate equitable access to higher education institutions. The aim of this study was to identify the social, cultural and academic factors affecting the access to or the abandonment of the academic education of students with expectations of entering the higher education system. The research was based on the results obtained from forty technicians who studied at a vocational high school with high academic performance in Mexico, and were supposed to enter the higher level. It was an exploratory descriptive investigation with qualitative approach, using two multiple-choice item questionnaires whose results were analyzed interpretively. The sampling was non-probability, with the technique of “snowball” and “convenience”. The results showed that the level of parents’ schooling, social relations, and academic career of graduates were decisive to enter the higher education; so it can be concluded that the students’ origin generate inequality in educational achievement.

Remote nursing certified practice: viewing nursing and nurse practitioner practice through a social justice lens.

Science.gov (United States)

Tarlier, Denise S; Browne, Annette J

2011-06-01

Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.

Deregulation, Distrust, and Democracy: State and Local Action to Ensure Equitable Access to Healthy, Sustainably Produced Food.

Science.gov (United States)

Wiley, Lindsay F

2015-01-01

Environmental, public health, alternative food, and food justice advocates are working together to achieve incremental agricultural subsidy and nutrition assistance reforms that increase access to fresh fruits and vegetables. When it comes to targeting food and beverage products for increased regulation and decreased consumption, however, the priorities of various food reform movements diverge. This article argues that foundational legal issues, including preemption of state and local authority to protect the public's health and welfare, increasing First Amendment protection for commercial speech, and eroding judicial deference to legislative policy judgments, present a more promising avenue for collaboration across movements than discrete food reform priorities around issues like sugary drinks, genetic modification, or organics. Using the Vermont Genetically Modified Organism (GMO) Labeling Act litigation, the Kauai GMO Cultivation Ordinance litigation, the New York City Sugary Drinks Portion Rule litigation, and the Cleveland Trans Fat Ban litigation as case studies, I discuss the foundational legal challenges faced by diverse food reformers, even when their discrete reform priorities diverge. I also 'explore the broader implications of cooperation among groups that respond differently to the "irrationalities" (from the public health perspective) or "values" (from the environmental and alternative food perspective) that permeate public risk perception for democratic governance in the face of scientific uncertainty.

A Balanced Investment Portfolio For Equitable Health And Well-Being Is An Imperative, And Within Reach.

Science.gov (United States)

Kindig, David A; Milstein, Bobby

2018-04-01

Health investments, defined as formal expenditures to either produce or care for health, in the US are extremely inefficient and have yet to unlock the country's full potential for equitable health and well-being. A major reason for such poor performance is that the US health investment portfolio is out of balance, with too much spent on certain aspects of health care and not enough spent to ensure social, economic, and environmental conditions that are vital to maintaining health and well-being. This commentary summarizes the evidence for this assertion, along with the opportunities and challenges involved in rebalancing investments in ways that would improve overall population health, reduce health gaps, and help build a culture of health for all Americans.

Tablet based simulation provides a new solution to accessing laparoscopic skills training.

Science.gov (United States)

Bahsoun, Ali Nehme; Malik, Mohsan Munir; Ahmed, Kamran; El-Hage, Oussama; Jaye, Peter; Dasgupta, Prokar

2013-01-01

Access to facilities that allow trainees to develop their laparoscopic skills is very limited in the hospital environment and courses can be very expensive. We set out to build an inexpensive yet effective trainer to allow laparoscopic skill acquisition in the home or classroom environment based on using a tablet as a replacement for the laparoscopic stack and camera. The cavity in which to train was made from a cardboard box; we left the sides and back open to allow for natural light to fill the cavity. An iPad 2 (Apple Inc.) was placed over the box to act as our camera and monitor. We provided 10 experienced laparoscopic surgeons with the task of passing a suture needle through 3 hoops; then they filled in a questionnaire to assess Face (training capacity) and Content (performance) validity. On a 5-point Likert scale, the tablet-based laparoscopic trainer scored a mean 4.2 for training capacity (hand eye coordination, development, and maintenance of lap skills) and for performance (graphics, video, and lighting quality) it scored a mean 4.1. The iPad 2-based laparoscopic trainer was successfully validated for training. It allows students and trainees to practice at their own pace and for inexpensive training on the go. Future "app-"based skills are planned. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Pediatric vascular access

International Nuclear Information System (INIS)

Donaldson, James S.

2006-01-01

Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

The DEDUCE Guided Query tool: providing simplified access to clinical data for research and quality improvement.

Science.gov (United States)

Horvath, Monica M; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

2011-04-01

In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction--the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a Guided Query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion. Copyright © 2010 Elsevier Inc. All rights reserved.

Great expectations. Can international emissions trading deliver an equitable climate regime?

International Nuclear Information System (INIS)

Baumert, Kevin A.; Perkaus, James F.; Kete, Nancy

2003-01-01

Climate change equity debates tend to focus on achieving a fair and global 'allocation' of emission rights among countries. Allocation proposals typically envision, if implicitly, two purposes for international emissions trading. First, trading is expected to serve as a cost-effective means of promoting compliance with emissions targets. Second, trading is posited as a means to generate financial transfers, typically from industrialized to transitioning and developing countries. This article investigates the common assumption that international emissions trading will effectively serve both of these purposes. We conclude that the two purposes might not be mutually supportive, and that efforts to use international emissions trading as a financial transfer mechanism may potentially undermine cost-effectiveness goals. International emissions trading on a global scale would create new risks in terms of both cost-effectiveness and environmental performance, some of which will be challenging to manage. In particular, uncertainties over market prices and trading eligibility, coupled with the costs of participation, may together be the Achilles heel of some allocation proposals that entail large financial transfers from industrialized to developing countries. Any proposal for an 'equitable' allocation of emission allowances, we conclude, must be cognizant of the risks and costs implied by a reliance on international emissions trading. We offer some suggestions to this end

Building Trust-Based Sustainable Networks

Science.gov (United States)

2013-06-05

entities to build sustainable networks with limited resources or misbehaving entities by learning from the lessons in the social sciences. We discuss...their individuality); and ■ Misbehaving nodes in terms of environmental, economic, and social perspectives. The sustainable network concerns...equitable access to particular services which are otherwise abused by misbehaving or malicious users. Such approaches provide a fair and

Ontological Possibilities: Rhizoanalytic Explorations of Community Food Work in Central Appalachia

Science.gov (United States)

D'Adamo-Damery, Philip C.

2014-01-01

In the United States, the community food movement has been put forward as a potential solution for a global food system that fails to provide just and equitable access to nutritious food. This claim has been subject to the criticism of a variety of scholars and activists, some of whom contend that the alternative food movement is complicit in the…

Evaluation of the role of access providers. Discussion of Dutch Pirate Bay case law and introducing principles on directness, effectiveness, costs, relevance, and time

NARCIS (Netherlands)

Lodder, A.R.; van der Meulen, N.S.

2013-01-01

Internet service providers (ISPs) play a pivotal role in contemporary society because they provide access to the Internet. The primary task of ISPs – to blindly transfer information across the network – has recently come under pressure, as has their status as neutral third parties. Both the public

Costing human rights and community support interventions as a part of universal access to HIV treatment and care in a Southern African setting.

Science.gov (United States)

Jones, Louisa; Akugizibwe, Paula; Clayton, Michaela; Amon, Joseph J; Sabin, Miriam Lewis; Bennett, Rod; Stegling, Christine; Baggaley, Rachel; Kahn, James G; Holmes, Charles B; Garg, Navneet; Obermeyer, Carla Makhlouf; Mack, Christina DeFilippo; Williams, Phoebe; Smyth, Caoimhe; Vitoria, Marco; Crowley, Siobhan; Williams, Brian; McClure, Craig; Granich, Reuben; Hirnschall, Gottfried

2011-09-01

Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, 'Know Your Rights' information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall programmes

Costing Human Rights and Community Support Interventions as a Part of Universal Access to HIV Treatment and Care in a Southern African Setting

Science.gov (United States)

Jones, Louisa; Akugizibwe, Paula; Clayton, Michaela; Amon, Joseph J; Sabin, Miriam Lewis; Bennett, Rod; Stegling, Christine; Baggaley, Rachel; Kahn, James G; Holmes, Charles B; Garg, Navneet; Obermeyer, Carla Makhlouf; Mack, Christina DeFilippo; Williams, Phoebe; Smyth, Caoimhe; Vitoria, Marco; Crowley, Siobhan; Williams, Brian; McClure, Craig; Granich, Reuben; Hirnschall, Gottfried

2011-01-01

Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, ‘Know Your Rights’ information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall

Do Women Have a Choice? Care Providers' and Decision Makers' Perspectives on Barriers to Access of Health Services for Birth after a Previous Cesarean.

Science.gov (United States)

Munro, Sarah; Kornelsen, Jude; Corbett, Kitty; Wilcox, Elizabeth; Bansback, Nick; Janssen, Patricia

2017-06-01

Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean. In-depth, semi-structured interviews were conducted with family physicians, midwives, obstetricians, nurses, anesthetists, and health service decision makers recruited from three rural and two urban Canadian communities. Constructivist grounded theory informed iterative data collection and analysis. Analysis of interviews (n = 35) revealed that the factors influencing decisions resulted from interactions between the clinical, organizational, and policy levels of the health care system. Physicians acted as information providers of clinical risks and benefits, with limited discussion of patient preferences. Decision makers serving large hospitals revealed concerns related to liability and patient safety. These stemmed from competing access to surgical resources. To facilitate women's increased access to planned VBAC, it is necessary to address the barriers perceived by care providers and decision makers. Strategies to mitigate concerns include initiating decision support immediately after the primary cesarean, addressing the social risks that influence women's preferences, and managing perceptions of patient and litigation risks through shared decision making. © 2016 Wiley Periodicals, Inc.

Equity of access to primary care among older adults in Incheon, South Korea.

Science.gov (United States)

Park, Ju Moon

2012-11-01

The present study examines the extent to which equity in the use of physician services for the elderly has been achieved in Incheon, Korea. It is based on the Aday and Andersen Access Framework. The results indicate that a universal health insurance system has not yielded a fully equitable distribution of services. The limitation of benefit coverage as well as high out-of-pocket payment can be a barrier to health care utilization, which results in inequity and differential medical care utilization between subgroups of older adults. Health policy reforms in South Korea must continue to concentrate on extending insurance coverage to the uninsured and establishing a financially separate insurance system for poor older adults. In addition, further research is needed to identify the nonfinancial barriers that persist for certain demographic subgroups, that is, those 80 years and older, men, those who lack a social network, and those who have no religion.

Promoting an equitable and supportive school climate in high schools: the role of school organizational health and staff burnout.

Science.gov (United States)

Bottiani, Jessika H; Bradshaw, Catherine P; Mendelson, Tamar

2014-12-01

In response to persistent racial disparities in academic and behavioral outcomes between Black and White students, equitable school climate has drawn attention as a potential target for school reform. This study examined differences in Black and White students' experiences of school climate and explored whether indicators of school organizational health and staff burnout moderated differences in students' school experiences by race. Utilizing hierarchical linear modeling with a sample of 18,397 Black students (n=6228) and White students (n=12,169) and 2391 school staff in 53 schools, we found a consistent pattern of racial inequalities, such that Black students reported less positive experiences than White students across three indicators of school climate (caring γ=-0.08, porganizational health and student-reported school climate (e.g., staff affiliation and student-perceived equity, γ=0.07, porganizational health indicators were more strongly associated with positive perceptions of school climate among White students than Black students, translating into greater racial disparities in perceived school climate at schools with greater organizational health (e.g., supportive leadership by race on student-perceived engagement, γ=-0.03, p=.042). We also found negative associations between staff-reported burnout and students' experience of equity, such that the racial gap was smaller in schools with high ratings of burnout (γ=0.04, p=.002). These findings have implications for educators and education researchers interested in promoting school social contexts that equitably support student engagement and success. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Process measures or patient reported experience measures (PREMs) for comparing performance across providers? A study of measures related to access and continuity in Swedish primary care.

Science.gov (United States)

Glenngård, Anna H; Anell, Anders

2018-01-01

Aim To study (a) the covariation between patient reported experience measures (PREMs) and registered process measures of access and continuity when ranking providers in a primary care setting, and (b) whether registered process measures or PREMs provided more or less information about potential linkages between levels of access and continuity and explaining variables. Access and continuity are important objectives in primary care. They can be measured through registered process measures or PREMs. These measures do not necessarily converge in terms of outcomes. Patient views are affected by factors not necessarily reflecting quality of services. Results from surveys are often uncertain due to low response rates, particularly in vulnerable groups. The quality of process measures, on the other hand, may be influenced by registration practices and are often more easy to manipulate. With increased transparency and use of quality measures for management and governance purposes, knowledge about the pros and cons of using different measures to assess the performance across providers are important. Four regression models were developed with registered process measures and PREMs of access and continuity as dependent variables. Independent variables were characteristics of providers as well as geographical location and degree of competition facing providers. Data were taken from two large Swedish county councils. Findings Although ranking of providers is sensitive to the measure used, the results suggest that providers performing well with respect to one measure also tended to perform well with respect to the other. As process measures are easier and quicker to collect they may be looked upon as the preferred option. PREMs were better than process measures when exploring factors that contributed to variation in performance across providers in our study; however, if the purpose of comparison is continuous learning and development of services, a combination of PREMs and

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.

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.

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

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

Deaf New Zealand Sign Language users' access to healthcare.

Science.gov (United States)

Witko, Joanne; Boyles, Pauline; Smiler, Kirsten; McKee, Rachel

2017-12-01

The research described was undertaken as part of a Sub-Regional Disability Strategy 2017-2022 across the Wairarapa, Hutt Valley and Capital and Coast District Health Boards (DHBs). The aim was to investigate deaf New Zealand Sign Language (NZSL) users' quality of access to health services. Findings have formed the basis for developing a 'NZSL plan' for DHBs in the Wellington sub-region. Qualitative data was collected from 56 deaf participants and family members about their experiences of healthcare services via focus group, individual interviews and online survey, which were thematically analysed. Contextual perspective was gained from 57 healthcare professionals at five meetings. Two professionals were interviewed, and 65 staff responded to an online survey. A deaf steering group co-designed the framework and methods, and validated findings. Key issues reported across the health system include: inconsistent interpreter provision; lack of informed consent for treatment via communication in NZSL; limited access to general health information in NZSL and the reduced ability of deaf patients to understand and comply with treatment options. This problematic communication with NZSL users echoes international evidence and other documented local evidence for patients with limited English proficiency. Deaf NZSL users face multiple barriers to equitable healthcare, stemming from linguistic and educational factors and inaccessible service delivery. These need to be addressed through policy and training for healthcare personnel that enable effective systemic responses to NZSL users. Deaf participants emphasise that recognition of their identity as members of a language community is central to improving their healthcare experiences.

Access 2013 bible

CERN Document Server

Alexander, Michael

2013-01-01

A comprehensive reference to the updated and new features of Access 2013 As the world's most popular database management tool, Access enables you to organize, present, analyze, and share data as well as build powerful database solutions. However, databases can be complex. That's why you need the expert guidance in this comprehensive reference. Access 2013 Bible helps you gain a solid understanding of database purpose, construction, and application so that whether you're new to Access or looking to upgrade to the 2013 version, this well-rounded resource provides you with a th

Mobile and Accessible Learning for MOOCs

Science.gov (United States)

Sharples, Mike; Kloos, Carlos Delgado; Dimitriadis, Yannis; Garlatti, Serge; Specht, Marcus

2015-01-01

Many modern web-based systems provide a "responsive" design that allows material and services to be accessed on mobile and desktop devices, with the aim of providing "ubiquitous access." Besides offering access to learning materials such as podcasts and videos across multiple locations, mobile, wearable and ubiquitous…

The Others: Equitable Access, International Students, and the Community College

Science.gov (United States)

Viggiano, Tiffany; López Damián, Ariadna I.; Morales Vázquez, Evelyn; Levin, John S.

2018-01-01

This qualitative investigation explains the ways in which community college decision makers justify the inclusion of international students at three community colleges in the United States. We identify and explain the ways in which decision makers rationalize institutional policy--particularly recruitment strategies and motivations--related to…

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

Directory of Open Access Journals (Sweden)

Grogan Samuel

2016-07-01

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

Moving toward a universally accessible web: Web accessibility and education.

Science.gov (United States)

Kurt, Serhat

2017-12-08

The World Wide Web is an extremely powerful source of information, inspiration, ideas, and opportunities. As such, it has become an integral part of daily life for a great majority of people. Yet, for a significant number of others, the internet offers only limited value due to the existence of barriers which make accessing the Web difficult, if not impossible. This article illustrates some of the reasons that achieving equality of access to the online world of education is so critical, explores the current status of Web accessibility, discusses evaluative tools and methods that can help identify accessibility issues in educational websites, and provides practical recommendations and guidelines for resolving some of the obstacles that currently hinder the achievability of the goal of universal Web access.

Accessing patient-centered care using the advanced access model.

Science.gov (United States)

Tantau, Catherine

2009-01-01

Waits and delays for healthcare are legendary. These delays are not only frustrating and potentially hazardous for patients and providers but also represent significant cost to office practices. The traditional medical model that defines urgent care versus routine care is a vain and futile attempt to sort demand. This approach is at constant odds with patients' definition of urgency. Trusting patients to determine when and how they want to access care makes sense from a customer service perspective. If approached systematically using the principles of Advanced Access, patient demand patterns can be tracked to forecast demand. These demand patterns become the template for deploying the resources necessary to meet patients' needs. Although not a simple journey, the transformation to Advanced Access provides an entree to patient-centered care where patients can say, "I get exactly the care I want and need, when I want and need it."

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

KAUST Repository

Belli, Roberto; Hoefler, Torsten

2015-01-01

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

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.

Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US.

Directory of Open Access Journals (Sweden)

Kristen Underhill

Full Text Available Pre-exposure prophylaxis (PrEP is a promising strategy for HIV prevention among men who have sex with men (MSM and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men's healthcare and HIV testing experiences to inform PrEP implementation.We conducted 8 focus groups (n = 38 in 2012 and 56 in-depth qualitative interviews in 2013-14 with male sex workers (MSWs (n = 31 and other MSM (n = 25 in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers.MSWs primarily accessed care in emergency rooms (ERs, substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings.PrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations.

Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US.

Science.gov (United States)

Underhill, Kristen; Morrow, Kathleen M; Colleran, Christopher M; Holcomb, Richard; Operario, Don; Calabrese, Sarah K; Galárraga, Omar; Mayer, Kenneth H

2014-01-01

Pre-exposure prophylaxis (PrEP) is a promising strategy for HIV prevention among men who have sex with men (MSM) and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men's healthcare and HIV testing experiences to inform PrEP implementation. We conducted 8 focus groups (n = 38) in 2012 and 56 in-depth qualitative interviews in 2013-14 with male sex workers (MSWs) (n = 31) and other MSM (n = 25) in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers. MSWs primarily accessed care in emergency rooms (ERs), substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings. PrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations.

Physical Science Informatics: Providing Open Science Access to Microheater Array Boiling Experiment Data

Science.gov (United States)

McQuillen, John; Green, Robert D.; Henrie, Ben; Miller, Teresa; Chiaramonte, Fran

2014-01-01

The Physical Science Informatics (PSI) system is the next step in this an effort to make NASA sponsored flight data available to the scientific and engineering community, along with the general public. The experimental data, from six overall disciplines, Combustion Science, Fluid Physics, Complex Fluids, Fundamental Physics, and Materials Science, will present some unique challenges. Besides data in textual or numerical format, large portions of both the raw and analyzed data for many of these experiments are digital images and video, requiring large data storage requirements. In addition, the accessible data will include experiment design and engineering data (including applicable drawings), any analytical or numerical models, publications, reports, and patents, and any commercial products developed as a result of the research. This objective of paper includes the following: Present the preliminary layout (Figure 2) of MABE data within the PSI database. Obtain feedback on the layout. Present the procedure to obtain access to this database.

Gender Dimensions Framework Application

OpenAIRE

Rubin, D.

2011-01-01

This is a presentation of the The Gender Dimensions Framework (GDF). The GDF was developed to provide guidance to USAID staff and partner organizations for working with USAID projects looking at promoting equitable opportunities in agricultural value chains. The GDF contemplates four dimensions: access to and control over key productive assets (tangible and intangible); beliefs and perceptions; practices and participation, and legal frameworks. CCRA-7 (Gendered Knowledge)

Experiencing 'pathologized presence and normalized absence'; understanding health related experiences and access to health care among Iraqi and Somali asylum seekers, refugees and persons without legal status.

Science.gov (United States)

Fang, Mei Lan; Sixsmith, Judith; Lawthom, Rebecca; Mountian, Ilana; Shahrin, Afifa

2015-09-19

Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities. For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status. The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. Macro- and micro-level intersections of accustomed societal

Improving access to oral health care services among underserved populations in the U.S.: is there a role for mid-level dental providers?

Science.gov (United States)

Shaefer, H Luke; Miller, Matthew

2011-08-01

Nearly one-third of U.S. citizens lack access to basic preventive and primary oral health care services, which is primarily the result of the high costs of care and the uneven geographic distribution of dental providers. This article examines the case for and against one possible solution to address these barriers to oral health care: the introduction of a mid-level dental provider (MDP) position within the dental field.

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

Science.gov (United States)

Senier, Laura; Kearney, Matthew; Orne, Jason

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

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.

Optical Subsystems for Next Generation Access Networks

DEFF Research Database (Denmark)

Lazaro, J.A; Polo, V.; Schrenk, B.

2011-01-01

Recent optical technologies are providing higher flexibility to next generation access networks: on the one hand, providing progressive FTTx and specifically FTTH deployment, progressively shortening the copper access network; on the other hand, also opening fixed-mobile convergence solutions...... in next generation PON architectures. It is provided an overview of the optical subsystems developed for the implementation of the proposed NG-Access Networks....

A randomized trial comparing two intraosseous access devices in intrahospital healthcare providers with a focus on retention of knowledge, skill, and self-efficacy.

Science.gov (United States)

Derikx, H J G M; Gerritse, B M; Gans, R; van der Meer, N J M

2014-10-01

Intraosseous access is recommended in vitally compromised patients if an intravenous access cannot be easily obtained. Intraosseous infusion can be initiated by various healthcare providers. Currently, there are two mechanical intraosseous devices approved by the U.S. Food and Drug Administration (FDA) for use in adults and children. A comparison is made in this study of the theoretical and practical performance by anesthesiologists and registered nurses of anesthesia (RNAs) in the use of the battery-powered device (device A) versus the spring-loaded needle device (device B). This study entailed a 12-month follow-up of knowledge, skill retention, and self-efficacy measured by standardized testing. A prospective randomized trial was performed, initially comparing 15 anesthesiologists and 15 RNAs, both on using the two types of intraosseous devices. A structured lecture and skill station was given with the educational aids provided by the respective manufacturers. Individual knowledge and practical skills were tested at 0, 3, and 12 months after the initial course. There was no statistical significant difference in the retention of theoretical knowledge between RNAs and anesthesiologists on all testing occasions. However, the self-efficacy of the anesthesiologists is significantly higher (p intraosseous access has been disproven, as anesthesiologists were as successful as RNAs. However, the low self-efficacy of RNAs in the use of intraosseous devices could diminish the chance of them actually using one.

Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

Directory of Open Access Journals (Sweden)

Michael Schuckers

2017-01-01

Full Text Available The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks” can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics department, or part of a learning commons, or a stand-alone center. There are hundreds of these centers in the U.S. The new handbook, which is the outgrowth of a 2013 NSF-sponsored, national workshop attended by 23 QMaSC directors from all quarters of the U.S., is available open access on the USF Scholar Commons and in hard copy from Amazon.com. This editorial by the handbook’s editors provides background and overview of the 20 detailed chapters on center leadership and management; community interactions; staffing, hiring and training; center assessment; and starting a center; and then a collection of ten case studies from research universities, four-year state colleges, liberal arts colleges, and a community college. The editorial ends by pointing out the need and potential benefits of a professional organization for QMaSC directors.

Lightweight methodology to improve web accessibility

CSIR Research Space (South Africa)

Greeff, M

2009-10-01

Full Text Available to improve score. Colour Contrast Fujitsu ColorSelector [9] Each colour combination has to be selected manually. Didn’t identify colour contrast problems that were highlighted by the other two tools. JuicyStudio Colour Contrast Analyser Firefox..., but this is not tested by AccessKeys AccessColor. However, AccessKeys AccessColor provides a link to the specific line in the code where the problem occurs. This is not provided by JuicyStudio Colour Contrast Analyser. According to these two tools, many colour...

The Net Neutrality Debate: Analysis of economic implications of net neutrality on internet service providers, content providers and internet users

OpenAIRE

Møinichen, Jørgen

2014-01-01

This thesis studies the economic implications of a transition from a neutral to a non-neutral network. A mathematical model with an end to end ecosystem is developed, which includes a backbone internet service provider that provides connectivity for the content providers. The model also includes internet users that pay an access internet service provider for connectivity to interact with the content providers, advertisers that pay the content providers, and access internet service providers t...

Maternal and neonatal implementation for equitable systems. A study design paper.

Science.gov (United States)

Ekirapa-Kiracho, Elizabeth; Tetui, Moses; Bua, John; Muhumuza Kananura, Rornald; Waiswa, Peter; Makumbi, Fred; Atuyambe, Lynn; Ajeani, Judith; George, Asha; Mutebi, Aloysuis; Kakaire, Ayub; Namazzi, Gertrude; Paina, Ligia; Namusoke Kiwanuka, Suzanne

2017-08-01

Evidence on effective ways of improving maternal and neonatal health outcomes is widely available. The challenge that most low-income countries grapple with is implementation at scale and sustainability. The study aimed at improving access to quality maternal and neonatal health services in a sustainable manner by using a participatory action research approach.  The  study consisted of a quasi-experimental design, with a participatory action research approach to implementation in three rural districts (Pallisa, Kibuku and Kamuli) in Eastern Uganda. The intervention had two main components; namely, community empowerment for comprehensive birth preparedness, and health provider and management capacity-building. We collected data using both quantitative and qualitative methods using household and facility-level structured surveys, record reviews, key informant interviews and focus group discussions. We purposively selected the participants for the qualitative data collection, while for the surveys we interviewed all eligible participants in the sampled households and health facilities. Descriptive statistics were used to describe the data, while the difference in difference analysis was used to measure the effect of the intervention. Qualitative data were analysed using thematic analysis. This study was implemented to generate evidence on how to increase access to quality maternal and newborn health services in a sustainable manner using a multisectoral participatory  approach.

Optical Access Networks

Science.gov (United States)

Zheng, Jun; Ansari, Nirwan

2005-06-01

Call for Papers: Optical Access Networks With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access networks have been receiving tremendous attention from both academia and industry. A large number of research activities have been carried out or

Access to childhood immunisation services and its determinants among recent and settled migrants in Delhi, India.

Science.gov (United States)

Kusuma, Y S; Kaushal, S; Sundari, A B; Babu, B V

2018-03-27

Childhood immunisation is one of the important public health interventions, and poor migrants are vulnerable to forego these services. The objective of the study is to understand the access of childhood immunisation services to the socio-economically disadvantaged migrants and the determinants of full immunisation uptake up to the age of 1 year. In a cross-sectional survey, 458 migrant households with a child aged up to 2 years were identified. Data on sociodemographics, migration history, receipt of various vaccines and maternal healthcare services were collected through interviewer-administered pretested questionnaires. Multiple logistic regression analysis was performed to identify the determinants of full immunisation status. Childhood immunisation coverage rates were low as only 31% of recent-migrant children and 53% of settled-migrant children were fully immunised against seven vaccine-preventable diseases (VPDs) by 12 months of age. Lack of awareness of the immunisation schedule and location of health facilities, mobility, illness of the child, fear of vaccines and side-effects were the main reasons for incomplete or no immunisation. Mother's educational attainment, TV viewership, hospital birth and receipt of information on childhood immunisation from the health workers during postnatal visits increased chances of getting the child fully immunised against seven VPDs by 1 year of age. The migrants, particularly the recent migrants, are at the risk of foregoing immunisation services because of livelihood insecurity, mobility and non-familiarity of services in the new urban environment. There is a need to deliver services with a focus on recent migrants. Investing in education and socio-economic development and providing secured livelihoods and equitable services are important to improve and sustain access to healthcare services in the long run. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality: An application of Equitable Impact Sensitive Tool (EQUIST) in five low- and middle-income countries.

Science.gov (United States)

Waters, Donald; Theodoratou, Evropi; Campbell, Harry; Rudan, Igor; Chopra, Mickey

2012-12-01

The aim of this study was to populate the Equitable Impact Sensitive Tool (EQUIST) framework with all necessary data and conduct the first implementation of EQUIST in studying cost-effectiveness of community case management of childhood pneumonia in 5 low- and middle-income countries with relation to equity impact. Wealth quintile-specific data were gathered or modelled for all contributory determinants of the EQUIST framework, namely: under-five mortality rate, cost of intervention, intervention effectiveness, current coverage of intervention and relative disease distribution. These were then combined statistically to calculate the final outcome of the EQUIST model for community case management of childhood pneumonia: US$ per life saved, in several different approaches to scaling-up. The current 'mainstream' approach to scaling-up of interventions is never the most cost-effective. Community-case management appears to strongly support an 'equity-promoting' approach to scaling-up, displaying the highest levels of cost-effectiveness in interventions targeted at the poorest quintile of each study country, although absolute cost differences vary by context. The relationship between cost-effectiveness and equity impact is complex, with many determinants to consider. One important way to increase intervention cost-effectiveness in poorer quintiles is to improve the efficiency and quality of delivery. More data are needed in all areas to increase the accuracy of EQUIST-based estimates.

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

Science.gov (United States)

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

2015-01-01

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

Equitable fund allocation, an economical approach for sustainable waste load allocation.

Science.gov (United States)

Ashtiani, Elham Feizi; Niksokhan, Mohammad Hossein; Jamshidi, Shervin

2015-08-01

This research aims to study a novel approach for waste load allocation (WLA) to meet environmental, economical, and equity objectives, simultaneously. For this purpose, based on a simulation-optimization model developed for Haraz River in north of Iran, the waste loads are allocated according to discharge permit market. The non-dominated solutions are initially achieved through multiobjective particle swarm optimization (MOPSO). Here, the violation of environmental standards based on dissolved oxygen (DO) versus biochemical oxidation demand (BOD) removal costs is minimized to find economical total maximum daily loads (TMDLs). This can save 41% in total abatement costs in comparison with the conventional command and control policy. The BOD discharge permit market then increases the revenues to 45%. This framework ensures that the environmental limits are fulfilled but the inequity index is rather high (about 4.65). For instance, the discharge permit buyer may not be satisfied about the equity of WLA. Consequently, it is recommended that a third party or institution should be in charge of reallocating the funds. It means that the polluters which gain benefits by unfair discharges should pay taxes (or funds) to compensate the losses of other polluters. This intends to reduce the costs below the required values of the lowest inequity index condition. These compensations of equitable fund allocation (EFA) may help to reduce the dissatisfactions and develop WLA policies. It is concluded that EFA in integration with water quality trading (WQT) is a promising approach to meet the objectives.

Vascular access in pediatric patients in the emergency department: types of access, indications, and complications [digest].

Science.gov (United States)

Whitney, Rachel; Langhan, Melissa; Pade, Kathryn H

2017-06-22

Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

KAUST Open Access policy

KAUST Repository

Baessa, Mohamed A.

2017-03-07

The transition to open access (OA) is being driven by funders, libraries, researchers and publishers around the world, and is having an impact on us all. It is inevitable that different countries, organisations and disciplines are moving at different rates towards an OA model, and it is this that we will focus on in this session. Drawing on experiences from across Europe and the Middle East we will provide perspectives from both a global publisher and institutions based in the region. Taylor & Francis take a flexible, evidence-based approach to open access, providing a choice of publication routes for our authors, and a choice of agreements for our library customers. Carolyn will outline some of the open access developments, opportunities and challenges at Taylor & Francis. The library plays a critical role in facilitating open access for their researchers, from managing a repository to providing support and information on the OA publication process to their authors. Janis Tyhurst and Dr Imad Bachir will each give an overview of how this is being managed by their institution. There will be an opportunity for questions and discussion with the panel.

Positioning Your Library in an Open-Access Environment

Science.gov (United States)

Bhatt, Anjana H.

2010-01-01

This paper is a summary of the project that the author completed at Florida Gulf Coast University (FGCU) library for providing online access to 80 open access E-journals and digital collections. Although FGCU uses SerialsSolutions products to establish online access, any one can provide access to these collections as they are free for all. Paper…

Barriers and facilitators of access to maternal services for women with disabilities: scoping review protocol.

Science.gov (United States)

Mheta, Doreen; Mashamba-Thompson, Tivani P

2017-05-16

The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.

The relationship between healthcare services and the political economy with reference to the Jamaican experience.

Science.gov (United States)

Maharaj, S R

2010-12-01

The availability of and equitable access to, health services have challenged healthcare providers with a greater degree of urgency since the end of World War II. Prior to that time, concepts such as equity and social justice were just that, concepts but no real attempts were ever made to operationalize them. Goods and services were still produced and distributed based on market forces, that is, one's ability and willingness to pay for something. Health in that context was a service, some say a commodity, to be bought and sold, hence its availability was not necessarily commensurate with its accessibility.

The ANÌMO Decalogue for a Slow Medicine care: the general recommendations of the nurses of internal medicine for a sober, respectful and equitable care

Directory of Open Access Journals (Sweden)

Gabriella Bordin

2015-09-01

Full Text Available Following the lead of Slow Medicine, the Association of Nurses of Internal Medicine (ANÌMO saw the opportunity to build, through an analysis of the professional practice, an alliance between health professionals and citizens in order to support and facilitate informed choices. From this revision emerged The Decalogue, a document which summarizes the fundamental pillars of the slow nursing to guarantee a sober respectful and equitable care during the hospitalization.

Open Access Publishing - Strengths and Strategies

Science.gov (United States)

Rasmussen, Martin

2010-05-01

The journal crisis and the demand for free accessibility to the results of publicly funded research were the main drivers of the Open Access movement since the late 1990's. Besides many academic institutions that support the different ways of Open Access publishing, there is a growing number of publishing houses that are specialized on this new access and business model of scholarly literature. The lecture provides an overview of the different kinds of Open Access publishing, discusses the variety of underlying business models, names the advantages and potentials for researches and the public, and overcomes some objections against Open Access. Besides the increased visibility and information supply, the topic of copyrights and exploitation rights will be discussed. Furthermore, it is a central aim of the presentation to show that Open Access does not only support full peer-review, but also provides the potential for even enhanced quality assurance. The financing of business models based on open accessible literature is another important part to be outlined in the lecture.

Assistive technology pricing in Australia: is it efficient and equitable?

Science.gov (United States)

Summers, Michael P; Verikios, George

2018-02-01

Objective To examine available systematically collected evidence regarding prices for assistive technology (AT; e.g. disability aids and equipment) in Australia with other comparable countries. Issues of appropriate AT pricing are coming to the fore as a consequence of efforts to move to consumer-centric purchasing decisions with the National Disability Insurance Scheme (NDIS) and also in the recent aged care reforms. Methods We identified and present three sets of AT price comparisons. Two comparisons were based solely on the lowest prices advertised on the internet, and one comparison examined recommended retail prices. Variables essential to ensuring accurate comparisons, as well as significant supply-chain issues were also examined and considered in the analyses. Results The first internet-only price comparison found that overall AT prices were 38% higher in Australia compared to other countries, but did not factor in shipping and other related costs that are essential to include given that most AT is imported. The second internet-only price comparison found that overall Australian prices were 24% lower when shipping and related costs were included. The recommended retail price comparisons found that Australian prices were between 14% and 27% lower. Prices for internet-only retailers (those with no bricks-and-mortar presence) are consistently lower for all products than those sold by retailers with actual shop-fronts. Further, there is no evidence of suppliers earning supranormal profits in Australia. Conclusions The results indicate that AT prices in Australia are efficient and equitable, with no significant indicators of market failure which would require government intervention. Efforts to reduce prices through the excessive use of large-scale government procurement programs are likely to reduce diversity and innovation in AT and raise AT prices over time. Open markets and competition with centralised tracking of purchases and providers to minimise possible

EPICS: Channel Access security design

International Nuclear Information System (INIS)

Kraimer, M.; Hill, J.

1994-05-01

This document presents the design for implementing the requirements specified in: EPICS -- Channel Access Security -- functional requirements, Ned. D. Arnold, 03/09/92. Use of the access security system is described along with a summary of the functional requirements. The programmer's interface is given. Security protocol is described and finally aids for reading the access security code are provided

ICSU and the Challanges of Data and Information Management for International Science

Directory of Open Access Journals (Sweden)

Peter Fox

2013-01-01

Full Text Available The International Council for Science (ICSU vision explicitly recognises the value of data and information to science and particularly emphasises the urgent requirement for universal and equitable access to high quality scientific data and information. A universal public domain for scientific data and information will be transformative for both science and society. Over the last several years, two ad-hoc ICSU committees, the Strategic Committee on Information and Data (SCID and the Strategic Coordinating Committee on Information and Data (SCCID, produced key reports that make 5 and 14 recommendations respectively aimed at improving universal and equitable access to data and information for science and providing direction for key international scientific bodies, such as the Committee on Data for Science and Technology (CODATA as well as a newly ratified (by ICSU in 2008 formation of the World Data System. This contribution outlines the framing context for both committees based on the changed world scene for scientific data conduct in the 21st century. We include details on the relevant recommendations and important consequences for the worldwide community of data providers and consumers, ultimately leading to a conclusion, and avenues for advancement that must be carried to the many thousands of data scientists world-wide.

Holistic approaches to e-learning accessibility

OpenAIRE

Phipps, Lawrie; Kelly, Brian

2006-01-01

The importance of accessibility to digital e-learning resources is widely acknowledged. The World Wide Web Consortium Web Accessibility Initiative has played a leading role in promoting the importance of accessibility and developing guidelines that can help when developing accessible web resources. The accessibility of e-learning resources provides additional challenges. While it is important to consider the technical and resource related aspects of e-learning when designing and developing re...

Inequities in accessibility to and utilisation of maternal health services in Ghana after user-fee exemption: a descriptive study.

Science.gov (United States)

Ganle, John K; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

2014-11-01

Inequities in accessibility to, and utilisation of maternal healthcare services impede progress towards attainment of the maternal health-related Millennium Development Goals. The objective of this study is to examine the extent to which maternal health services are utilised in Ghana, and whether inequities in accessibility to and utilization of services have been eliminated following the implementation of a user-fee exemption policy, that aims to reduce financial barriers to access, reduce inequities in access, and improve access to and use of birthing services. We analyzed data from the 2007 Ghana Maternal Health Survey for inequities in access to and utilization of maternal health services. In measuring the inequities, frequency tables and cross-tabulations were used to compare rates of service utilization by region, residence and selected socio-demographic variables. Findings show marginal increases in accessibility to and utilisation of skilled antenatal, delivery and postnatal care services following the policy implementation (2003-2007). However, large gradients of inequities exist between geographic regions, urban and rural areas, and different socio-demographic, religious and ethnic groupings. More urban women (40%) than rural, 53% more women in the highest wealth quintile than women in the lowest, 38% more women in the best performing region (Central Region) than the worst (Upper East Region), and 48% more women with at least secondary education than those with no formal education, accessed and used all components of skilled maternal health services in the five years preceding the survey. Our findings raise questions about the potential equity and distributional benefits of Ghana's user-fee exemption policy, and the role of non-financial barriers or considerations. Exempting user-fees for maternal health services is a promising policy option for improving access to maternal health care, but might be insufficient on its own to secure equitable access to

Equity for open-access journal publishing.

Directory of Open Access Journals (Sweden)

Stuart M Shieber

2009-08-01

Full Text Available Open-access journals, which provide access to their scholarly articles freely and without limitations, are at a systematic disadvantage relative to traditional closed-access journal publishing and its subscription-based business model. A simple, cost-effective remedy to this inequity could put open-access publishing on a path to become a sustainable, efficient system.

[Access to health care in Dakar (Senegal): frequency, type of provider, and non-communicable chronic diseases].

Science.gov (United States)

Duboz, P; Gueye, L; Boetsch, G; Macia, E

2015-01-01

(1) To describe access to health care in the population of Dakar; (2) to analyze the influence of socioeconomic and demographic characteristics on access to health care; (3) and to describe the fraction of consultations accounted for by chronic non-communicable diseases. These data come from a 2009 survey of 600 individuals aged 20 years and over. Socioeconomic and demographic characteristics and information about access to health care were collected. Chi-square tests and binary logistic regressions were used for the statistical analyses. Men, people with no schooling, and poor people were underrepresented among users of health care services. Moreover, the majority of Dakar residents who sought health care during the year preceding the survey went to see a doctor (as opposed to a traditional healer, pharmacist, nurse, midwife, or dentist). Finally, chronic diseases accounted for the smallest fraction of reasons for medical consultations; they were mentioned most often by those aged 50 years or older who consult more than 5 times a year. Dakar residents have an access to health care similar to that of people in other African countries, but this conclusion hides major inequalities. Moreover, at the same time that Senegal is undergoing an epidemiological transition, chronic non-communicable diseases are not a major reason for consultations. The epidemiological projections made for Africa for the next 15 years indicate that the development of strategies to avert the development of these diseases in Senegal must be a priority objective.

Trade in health services in the ASEAN region.

Science.gov (United States)

Arunanondchai, Jutamas; Fink, Carsten

2006-12-01

Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.

'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.

Swaps and Chains and Vouchers, Oh My!: Evaluating How Saving More Lives Impacts the Equitable Allocation of Live Donor Kidneys.

Science.gov (United States)

Tenenbaum, Evelyn M

2018-03-01

Live kidney donation involves a delicate balance between saving the most lives possible and maintaining a transplant system that is fair to the many thousands of patients on the transplant waiting list. Federal law and regulations require that kidney allocation be equitable, but the pressure to save patients subject to ever-lengthening waiting times for a transplant has been swinging the balance toward optimizing utility at the expense of justice. This article traces the progression of innovations created to make optimum use of a patient's own live donors. It starts with the simplest - direct donation by family members - and ends with voucher donations, a very recent and unique innovation because the donor can donate 20 or more years before the intended recipient is expected to need a kidney. In return for the donation, the intended recipient receives a voucher that can be redeemed for a live kidney when it is needed. Other innovations that are discussed include kidney exchanges and list paired donation, which are used to facilitate donor swaps when donor/recipient pairs have incompatible blood types. The discussion of each new innovation shows how the equity issues build on each other and how, with each new innovation, it becomes progressively harder to find an acceptable balance between utility and justice. The article culminates with an analysis of two recent allocation methods that have the potential to save many additional lives, but also affirmatively harm some patients on the deceased donor waiting list by increasing their waiting time for a life-saving kidney. The article concludes that saving additional lives does not justify harming patients on the waiting list unless that harm can be minimized. It also proposes solutions to minimize the harm so these new innovations can equitably perform their intended function of stimulating additional transplants and extending the lives of many transplant patients.

Optical Access Networks

Science.gov (United States)

Zheng, Jun; Ansari, Nirwan

2005-01-01

Call for Papers: Optical Access Networks Guest Editors Jun Zheng, University of Ottawa Nirwan Ansari, New Jersey Institute of Technology Submission Deadline: 1 June 2005 Background With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access networks

Replacing the Ethernet access mechanism with the real-time access mechanism of Twentenet

NARCIS (Netherlands)

Pras, Aiko

1989-01-01

The way in which a Local Area Network access mechanism (Medium Access Control protocol) designed for a specific type of physical service can be used on top of another type of physical service is discussed using a particular example. In the example, an Ethernet physical layer is used to provide

Checklist "Open Access Policies": Analysis of the Open Access Policies of Public Universities in Austria

Directory of Open Access Journals (Sweden)

Bruno Bauer

2016-12-01

Full Text Available This checklist provides an overview of the Open Access policies implemented at Austrian universities and extramural research institutions. Furthermore, the polices adopted at nine public universities are analyzed and the respective text modules are categorized thematically. The second part of the checklist presents measures for the promotion of Open Access following the implementation of an Open Access policy.

Why equity in health and in access to health care are elusive: Insights from Canada and South Africa.

Science.gov (United States)

Benatar, Solomon; Sullivan, Terrence; Brown, Adalsteinn

2017-12-04

Health and access to health care vary strikingly across the globe, and debates about this have been pervasive and controversial. Some comparative data in Canada and South Africa illustrate the complexity of achieving greater equity anywhere, even in a wealthy country like Canada. Potential bi-directional lessons relevant both to local and global public health are identified. Both countries should consider the implications of lost opportunity costs associated with lack of explicit resource allocation policies. While National Health Insurance is attractive politically, Canada's example cannot be fully emulated in South Africa. Short- and medium-term attempts to improve equity in middle-income countries should focus on equitable access to insurance to cover primary health care and on making more use of nurse practitioners and community health workers. In the longer-term, attention is needed to the economic and political power structures that influence health and health care and that ignore the social and societal determinants of sustainable good health locally and globally. This long-term vision of health is needed globally to achieve improvements in individual and population health in a century characterised by limits to economic growth, widening disparities, continuing conflict and migration on a large scale and multiple adverse impacts of climate change.

The Economic and Social Benefits and the Barriers of Providing People with Disabilities Accessible Clean Water and Sanitation

Directory of Open Access Journals (Sweden)

Gregor Wolbring

2012-11-01

Full Text Available Resolution A/HRC/RES/16/2 adopted by the UN Human Rights Council on 8 April 2011 declared access to safe drinking water and sanitation a human right. However many people around the globe including people with disabilities do not have access to safe drinking water, hygiene or sanitation facilities. Inaccessibility of clean water sources, hygiene and sanitation facilities negatively impacts among others health, education, the ability to work, and the ability to partake in social activities. This paper looks at the benefits of, and access barriers to, clean water and sanitation for people with disabilities.

Developing a Holistic Approach for E-Learning Accessibility

Directory of Open Access Journals (Sweden)

Brian Kelly

2004-10-01

Full Text Available The importance of accessibility to digital resources is now widely acknowledged. The W3C WAI has played a significant role in promoting the importance of accessibility and developing a framework for accessible Web resources. The accessibility of e-learning provides additional challenges that may not be faced when providing access to other Web resources. The authors argue that there is a need for a more sophisticated model for addressing e-learning accessibility which takes into account the usability of e-learning, pedagogic issues and student learning styles in addition to technical and resource issues. The authors expand on these issues and propose a holistic model for the development of accessible e-learning resources.

elevatr: Access Elevation Data from Various APIs | Science ...

Science.gov (United States)

Several web services are available that provide access to elevation data. This package provides access to several of those services and returns elevation data either as a SpatialPointsDataFrame from point elevation services or as a raster object from raster elevation services. Currently, the package supports access to the Mapzen Elevation Service, Mapzen Terrain Service, and the USGS Elevation Point Query Service. The R language for statistical computing is increasingly used for spatial data analysis . This R package, elevatr, is in response to this and provides access to elevation data from various sources directly in R. The impact of `elevatr` is that it will 1) facilitate spatial analysis in R by providing access to foundational dataset for many types of analyses (e.g. hydrology, limnology) 2) open up a new set of users and uses for APIs widely used outside of R, and 3) provide an excellent example federal open source development as promoted by the Federal Source Code Policy (https://sourcecode.cio.gov/).

BIOREACTOR WITH LID FOR EASY ACCESS TO INCUBATION CAVITY

DEFF Research Database (Denmark)

2012-01-01

There is provided a bioreactor which is provided with a lid (13) that facilitates access to the incubation cavity. Specifically the end wall of the incubation cavity is constituted by the lid (13) so that removal of the cap renders the incubation cavity fully accessible.......There is provided a bioreactor which is provided with a lid (13) that facilitates access to the incubation cavity. Specifically the end wall of the incubation cavity is constituted by the lid (13) so that removal of the cap renders the incubation cavity fully accessible....

Robotics and telecommunication systems to provide better access to ultrasound expertise in the OR.

Science.gov (United States)

Angelini, L; Papaspyropoulos, V

2000-01-01

Surgery has begun to evolve as a result of the intense use of technological innovations. The result of this is better services for patients and enormous opportunities for the producers of biomedical instruments. The surgeon and the technologist are fast becoming allies in applying the latest developments of robotics, image treatment, simulation, sensors and telecommunications to surgery, in particular to the emerging field of minimally-invasive surgery. Ultrasonography is at present utilised both for diagnostic and therapeutic purposes in various fields. Intraoperative US examination can be of primary importance, especially when dealing with space-occupying lesions. The widening use of minimally-invasive surgery has furthered the development of US for use during this type of surgery. The success of a US examination requires not only a correct execution of the procedure, but also a correct interpretation of the images. We describe two projects that combine robotics and telecommunication systems to provide better access to US expertise in the operating room. The Midstep project has as its object the realisation of two robotic arms, one for the distant control of the US probe during laparoscopic surgery and the second to perform tele-interventional US. The second project, part of the Strategic CNR Project-'Robotics in Surgery', involves the realisation of a common platform for tracking and targeting surgical instruments in video-assisted surgery.

Die funksies van die distrikgemeenskapsverpleegkundige

OpenAIRE

2014-01-01

M.Cur. A single comprehensive, equitable and integrated National Health System must be created for South Afiica (ANC, 1994:19). This will be achieved by the ANC's commitment too promotion ofhealth through prevention and education. The Primary Health Care approach is the tenet for the restructuring ofthe health system. To be able to create a Health System which is single, comprehensive, equitable and integrated the system should be accessible, effective, acceptable, affordable and just. Com...

Health access livelihood framework reveals potential barriers in the control of schistosomiasis in the Dongting Lake area of Hunan Province, China.

Directory of Open Access Journals (Sweden)

Julie Balen

Full Text Available Access to health care is a major requirement in improving health and fostering socioeconomic development. In the People's Republic of China (P.R. China, considerable changes have occurred in the social, economic, and health systems with a shift from a centrally planned to a socialist market economy. This brought about great benefits and new challenges, particularly for vertical disease control programs, including schistosomiasis. We explored systemic barriers in access to equitable and effective control of schistosomiasis.Between August 2002 and February 2003, 66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the Dongting Lake area, Hunan Province. Additionally, 79 patients with advanced schistosomiasis japonica were interviewed. The health access livelihood framework was utilized to examine availability, accessibility, affordability, adequacy, and acceptability of schistosomiasis-related health care.We found sufficient availability of infrastructure and human resources at most control stations. Many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas, however, with poor accessibility to disease-specific knowledge and specialized health services. Moreover, none of the patients interviewed had any form of health insurance, resulting in high out-of-pocket expenditure or unaffordable care. Reports on the adequacy and acceptability of care were mixed.There is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings, as well as to reduce diagnostic and treatment costs. Further studies are needed to gain a multi-layered, in-depth understanding of remaining barriers, so that the ultimate goal of schistosomiasis elimination in P.R. China can be reached.

Democratizing Energy Access in a Marketized World: The Cases of Costa Rica and Nicaragua

Science.gov (United States)

Colbert, M'Lisa Lee

This thesis explores the experiences, motivations and the imaginary of people who seek to democratize access to energy. Through a survey of the energy democracy movement in Europe and North America and a case study of two participatory and democratically oriented electricity providers in Central America, this thesis examines the differences and similarities between democratizing energy in the Global North and Global South in the context of marketization and the global push to transition to renewable energy. The forces of an expanding global energy economy are increasingly influencing the way that we can access and consume energy in our lives. Local interactions cannot be understood by an isolated analysis without considering the larger structural conditions that implicate them. Today, we are witnessing a global push to transition our energy resources from fossil fuels to renewables due to the emergency of climate change. For the most part, this transition preoccupies itself with changing the technological instruments that source us the energy. Yet few changes are targeting transition from growth focused market-based economic models. Energy Democracy is one new imaginary that people are rallying around to help realize alternatives to drive more equitable and sustainable post-carbon futures. This thesis finds that there are unfounded normative assumptions being made about groups organizing around energy democracy that is causing scatter in the movement. There is an aggressive strand of energy democracy that readily accepts for-profit schemes and risks turning energy democracy into just another space for capital accumulation in the energy sector. This thesis presents two important suggestions for reconciling these problems. Firstly, to look beyond moving the term itself and prioritize connecting on the basis of the underlying principles that define the term. This will ultimately create more meaningful solidarity in the future, and a more grounded and unified movement

Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis.

Science.gov (United States)

Ouma, Paul O; Maina, Joseph; Thuranira, Pamela N; Macharia, Peter M; Alegana, Victor A; English, Mike; Okiro, Emelda A; Snow, Robert W

2018-03-01

%) women of child bearing age are located more than 2-h travel time from the nearest hospital. Marked differences were observed within and between countries, ranging from less than 25% of the population within 2-h travel time of a public hospital in South Sudan to more than 90% in Nigeria, Kenya, Cape Verde, Swaziland, South Africa, Burundi, Comoros, São Tomé and Príncipe, and Zanzibar. Only 16 countries reached the international benchmark of more than 80% of their populations living within a 2-h travel time of the nearest hospital. Physical access to emergency hospital care provided by the public sector in Africa remains poor and varies substantially within and between countries. Innovative targeting of emergency care services is necessary to reduce these inequities. This study provides the first spatial census of public hospital services in Africa. Wellcome Trust and the UK Department for International Development. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Accessible Geoscience - Digital Fieldwork

Science.gov (United States)

Meara, Rhian

2017-04-01

Accessible Geoscience is a developing field of pedagogic research aimed at widening participation in Geography, Earth and Environmental Science (GEES) subjects. These subjects are often less commonly associated with disabilities, ethnic minorities, low income socio-economic groups and females. While advancements and improvements have been made in the inclusivity of these subject areas in recent years, access and participation of disabled students remains low. While universities are legally obligated to provide reasonable adjustments to ensure accessibility, the assumed incompatibility of GEES subjects and disability often deters students from applying to study these courses at a university level. Instead of making reasonable adjustments if and when they are needed, universities should be aiming to develop teaching materials, spaces and opportunities which are accessible to all, which in turn will allow all groups to participate in the GEES subjects. With this in mind, the Swansea Geography Department wish to enhance the accessibility of our undergraduate degree by developing digital field work opportunities. In the first instance, we intend to digitise three afternoon excursions which are run as part of a 1st year undergraduate module. Each of the field trips will be digitized into English- and Welsh-medium formats. In addition, each field trip will be digitized into British Sign Language (BSL) to allow for accessibility for D/deaf and hard of hearing students. Subtitles will also be made available in each version. While the main focus of this work is to provide accessible fieldwork opportunities for students with disabilities, this work also has additional benefits. Students within the Geography Department will be able to revisit the field trips, to revise and complete associated coursework. The use of digitized field work should not replace opportunities for real field work, but its use by the full cohort of students will begin to "normalize" accessible field

Credential Service Provider (CSP)

Data.gov (United States)

Department of Veterans Affairs — Provides a VA operated Level 1 and Level 2 credential for individuals who require access to VA applications, yet cannot obtain a credential from another VA accepted...

Accessing and disclosing protected resources

DEFF Research Database (Denmark)

Olesen, Henning; Khajuria, Samant

2014-01-01

TODAY, DATA IS MONEY. Whether it is private users’ personal data or confidential data and assets belonging to service providers, all parties have a strong need to protect their resources when interacting with each other, i.e. for access control and authorization. For service providers and enterpr......TODAY, DATA IS MONEY. Whether it is private users’ personal data or confidential data and assets belonging to service providers, all parties have a strong need to protect their resources when interacting with each other, i.e. for access control and authorization. For service providers...... and enterprises resources are usually well safeguarded, while private users are often missing the tools and the know-how to protect their own data and preserve their privacy. The user’s personal data have become an economic asset, not necessarily to the owners of these data, but to the service providers, whose...... business mod- els often includes the use of these data. In this paper we focus on the user – service provider interaction and discuss how recent technological progress, in particular the framework of User Managed Access (UMA), can enable users to understand the value of their protected resources...

Access 2010 for dummies

CERN Document Server

Ulrich Fuller, Laurie

2010-01-01

A friendly, step-by-step guide to the Microsoft Office database application Access may be the least understood and most challenging application in the Microsoft Office suite. This guide is designed to help anyone who lacks experience in creating and managing a database learn to use Access 2010 quickly and easily. In the classic For Dummies tradition, the book provides an education in Access, the interface, and the architecture of a database. It explains the process of building a database, linking information, sharing data, generating reports, and much more.As the Micr

OGIS Access System

Data.gov (United States)

National Archives and Records Administration — The OGIS Access System (OAS) provides case management, stakeholder collaboration, and public communications activities including a web presence via a web portal.

Inequities in access to and use of drinking water services in Latin America and the Caribbean.

Science.gov (United States)

Soares, Luiz Carlos Rangel; Griesinger, Marilena O; Dachs, J Norberto W; Bittner, Marta A; Tavares, Sonia

2002-01-01

To identify and evaluate inequities in access to drinking water services as reflected in household per capita expenditure on water, and to determine what proportion of household expenditures is spent on water in 11 countries of Latin America and the Caribbean. Using data from multi-purpose household surveys (such as the Living Standards Measurement Survey Study) conducted in 11 countries from 1995 to 1999, the availability of drinking water as well as total and per capita household expenditures on drinking water were analyzed in light of socioeconomic parameters, such as urban vs. rural setting, household income, type and regularity of water supply service, time spent obtaining water in homes not served by running water, and type of water-purifying treatment, if any. Access to drinking water as well as total and per capita household expenditures on drinking water show an association with household income, economic conditions of the household, and location. The access of the rural population to drinking water services is much more restricted than that of the urban population for groups having similar income. The proportion of families having a household water supply system is comparable in the higher-income rural population and the lower-income urban population. Families without a household water supply system spend a considerable amount of time getting water. For poorer families, this implies additional costs. Low-income families that lack a household water supply spend as much money on water as do families with better income. Access to household water disinfection methods is very limited among poor families due to its relatively high cost, which results in poorer drinking water quality in the lower-income population. Multi-purpose household surveys conducted from the consumer's point of view are important tools for research on equity and health, especially when studying unequal access to, use of, and expenditures on drinking water. It is recommended that countries

49 CFR 238.114 - Rescue access windows.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Rescue access windows. 238.114 Section 238.114... § 238.114 Rescue access windows. (a) Number and location. Except as provided in paragraph (a)(1)(ii) of... rescue access windows. At least one rescue access window shall be located in each side of the car...

Open access in the critical care environment.

Science.gov (United States)

South, Tabitha; Adair, Brigette

2014-12-01

Open access has become an important topic in critical care over the last 3 years. In the past, critical care had restricted access and set visitation guidelines to protect patients. This article provides a review of the literature related to open access in the critical care environment, including the impact on patients, families, and health care providers. The ultimate goal is to provide care centered on patients and families and to create a healing environment to ensure safe passage of patients through their hospital stays. This outcome could lead to increased patient/family satisfaction. Copyright © 2014 Elsevier Inc. All rights reserved.

A Systematic Scheme for Multiple Access in Ethernet Passive Optical Access Networks

Science.gov (United States)

Ma, Maode; Zhu, Yongqing; Hiang Cheng, Tee

2005-11-01

While backbone networks have experienced substantial changes in the last decade, access networks have not changed much. Recently, passive optical networks (PONs) seem to be ready for commercial deployment as access networks, due to the maturity of a number of enabling technologies. Among the PON technologies, Ethernet PON (EPON) standardized by the IEEE 802.3ah Ethernet in the First Mile (EFM) Task Force is the most attractive one because of its high speed, low cost, familiarity, interoperability, and low overhead. In this paper, we consider the issue of upstream channel sharing in the EPONs. We propose a novel multiple-access control scheme to provide bandwidth-guaranteed service for high-demand customers, while providing best effort service to low-demand customers according to the service level agreement (SLA). The analytical and simulation results prove that the proposed scheme performs best in what it is designed to do compared to another well-known scheme that has not considered providing differentiated services. With business customers preferring premium services with guaranteed bandwidth and residential users preferring low-cost best effort services, our scheme could benefit both groups of subscribers, as well as the operators.

‘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

‘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.

Ethical, legal, and social implications of incorporating genomic information into electronic health records.

Science.gov (United States)

Hazin, Ribhi; Brothers, Kyle B; Malin, Bradley A; Koenig, Barbara A; Sanderson, Saskia C; Rothstein, Mark A; Williams, Marc S; Clayton, Ellen W; Kullo, Iftikhar J

2013-10-01

The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk.

Fixed Access Network Sharing

Science.gov (United States)

Cornaglia, Bruno; Young, Gavin; Marchetta, Antonio

2015-12-01

Fixed broadband network deployments are moving inexorably to the use of Next Generation Access (NGA) technologies and architectures. These NGA deployments involve building fiber infrastructure increasingly closer to the customer in order to increase the proportion of fiber on the customer's access connection (Fibre-To-The-Home/Building/Door/Cabinet… i.e. FTTx). This increases the speed of services that can be sold and will be increasingly required to meet the demands of new generations of video services as we evolve from HDTV to "Ultra-HD TV" with 4k and 8k lines of video resolution. However, building fiber access networks is a costly endeavor. It requires significant capital in order to cover any significant geographic coverage. Hence many companies are forming partnerships and joint-ventures in order to share the NGA network construction costs. One form of such a partnership involves two companies agreeing to each build to cover a certain geographic area and then "cross-selling" NGA products to each other in order to access customers within their partner's footprint (NGA coverage area). This is tantamount to a bi-lateral wholesale partnership. The concept of Fixed Access Network Sharing (FANS) is to address the possibility of sharing infrastructure with a high degree of flexibility for all network operators involved. By providing greater configuration control over the NGA network infrastructure, the service provider has a greater ability to define the network and hence to define their product capabilities at the active layer. This gives the service provider partners greater product development autonomy plus the ability to differentiate from each other at the active network layer.

Accessibility issues with long-term disabilities.

Science.gov (United States)

Sebring-Cale, Nancy J

2008-06-01

Home modifications for barrier-free accessibility will assist the physically challenged populations by increasing their independence. By providing an accessible environment, an individual can become more independent and require less assistance for functional activities, such as kitchen appliance access, door widening, open floor plan, elevated electric outlets, roll-under sinks, roll-in showers and MobiLife elevating wheelchair.

Access to the city

DEFF Research Database (Denmark)

Andreasen, Manja Hoppe; Møller-Jensen, Lasse

2017-01-01

This paper is concerned with access to the city for urban residents living in the periphery of Dar es Salaam, Tanzania. The paper presents an analysis of the mobility practices of residents and investigates the mobility constraints they experience in relation to the limited accessibility provided...... mobility and access to the city for residents in the periphery. Regular mobility is an ingrained part of residents' livelihood strategies. The majority of households rely on one or more members regularly travelling to central parts of the city in relation to their livelihood activities. The analysis...... by road and traffic conditions and highlights how accessibility problems of peripheral settlements are not easily understood separately from the general dysfunctions of the overall mobility system of city....

Shaping Public Health Education, Research, and Policy in the Arab ...

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

Shaping Public Health Education, Research, and Policy in the Arab World. While the Arab World has enjoyed substantial economic progress, there has been little improvement in ensuring equitable access to health care. In most countries, the majority of people have limited access to basic health services. These are ...

Cross-country variation in medicines use; a pharmaceutical system perspective

NARCIS (Netherlands)

Hoebert, J.M.

2013-01-01

Access to effective and affordable medicines (medical care) is considered an equitable right for all (European) citizens. Ensuring access to medical care is a challenge for governments and health care systems across the world. Choices need to be made about which medicine can be used and in what

Distribution and Utilization of Health Facilities in Calabar Metropolis ...

African Journals Online (AJOL)

The level of accessibility increases with increasing utilization. Distance was a barrier to the utilization of health facilities due to the uneven distribution of health facilities and the inability of patients to overcome economic distance. Greater investment by government in the health sector would guarantee more equitable access ...

Physical, Social, and Political Inequities Constraining Girls' Menstrual Management at Schools in Informal Settlements of Nairobi, Kenya.

Science.gov (United States)

Girod, Candace; Ellis, Anna; Andes, Karen L; Freeman, Matthew C; Caruso, Bethany A

2017-12-01

Access to adequate water and sanitation is limited in informal settlements, contributing to girls' challenges managing menstruation at school, especially when they cannot access materials to absorb menstrual blood and appropriate facilities for hygiene. This study documents differences between girls' experience of menstruation at public schools (where the Kenyan government provides menstrual pads) and private schools (where pads are not provided) in two informal settlements of Nairobi, Kenya. Results showed that supply chains to public schools were not reliable, and equitable pad provision was not assured. Girls in private schools struggled to access pads because they were not provided. Sanitation facilities were physically available, but Muslim girls were unable to practice ablution due to the design of toilets in our study schools. Girls experienced fear and anxiety due to harassment from male peers and had incomplete information about menstruation from teachers. Findings suggest that practitioners and policy-makers should acknowledge the diversity of school populations and monitor programs to ensure efforts do not contribute to inequity.

College Access and Success for Students Experiencing Homelessness: A Toolkit for Educators and Service Providers

Science.gov (United States)

Dukes, Christina

2013-01-01

This toolkit serves as a comprehensive resource on the issue of higher education access and success for homeless students, including information on understanding homeless students, assisting homeless students in choosing a school, helping homeless students pay for application-related expenses, assisting homeless students in finding financial aid…

Access to dialysis services: A systematic mapping review based on geographical information systems.

Science.gov (United States)

Hoseini, Benyamin; Bagheri, Nasser; Kiani, Behzad; Azizi, Amirabbas; Tabesh, Hamed; Tara, Mahmood

2018-05-07

Equitable access to healthcare services constitutes one of the leading priorities of healthcare provision and access to dialysis services (ADS) has an essential impact on patients depending on renal dialysis. The many existing GIS-based ADS evaluations include various spatial and non-spatial factors affecting ADS. We systematically mapped and reviewed the available literature with reference to this area identifying gaps in current GIS-based ADS measurements and developing recommendations for future studies. A threestep, systematic mapping review of the available GIS-related evidence in PubMed, Embase, Web of science, Scopus, Science Direct and IEEE Xplore was performed in May 2016 and the information collected updated October 2017 by two independent selection processes. The quality of the studies was assessed using an informal, mixed-approach scoring system. Out of 1119 literature references identified, 36 were identified and used for final review after removal of duplicates, study screenings and applying inclusion/exclusion criteria. Given the contents of the selected studies, three study groups were identified and 41 factors with potential effects on ADS determined. These studies mainly addressed the potential and/or spatial aspects of ADS. Our systematic mapping review of the evidence revealed that current GIS-based measures of ADS tend to calculate potential ADS instead of a realized one. It was also noted that listed factors affecting ADS were mainly nonspatial bringing forth the hypothesis that designing an integrated ADS index could possibly produce better ADS score than those currently advocated. Some primary and secondary research suggestions are made and a list of recommendations offered.

Access to dialysis services: A systematic mapping review based on geographical information systems

Directory of Open Access Journals (Sweden)

Benyamin Hoseini

2018-05-01

Full Text Available Equitable access to healthcare services constitutes one of the leading priorities of healthcare provision and access to dialysis services (ADS has an essential impact on patients depending on renal dialysis. The many existing GIS-based ADS evaluations include various spatial and non-spatial factors affecting ADS. We systematically mapped and reviewed the available literature with reference to this area identifying gaps in current GIS-based ADS measurements and developing recommendations for future studies. A threestep, systematic mapping review of the available GIS-related evidence in PubMed, Embase, Web of science, Scopus, Science Direct and IEEE Xplore was performed in May 2016 and the information collected updated October 2017 by two independent selection processes. The quality of the studies was assessed using an informal, mixed-approach scoring system. Out of 1119 literature references identified, 36 were identified and used for final review after removal of duplicates, study screenings and applying inclusion/exclusion criteria. Given the contents of the selected studies, three study groups were identified and 41 factors with potential effects on ADS determined. These studies mainly addressed the potential and/or spatial aspects of ADS. Our systematic mapping review of the evidence revealed that current GIS-based measures of ADS tend to calculate potential ADS instead of a realized one. It was also noted that listed factors affecting ADS were mainly nonspatial bringing forth the hypothesis that designing an integrated ADS index could possibly produce better ADS score than those currently advocated. Some primary and secondary research suggestions are made and a list of recommendations offered.

The rise and fall of dental therapy in Canada: a policy analysis and assessment of equity of access to oral health care for Inuit and First Nations communities.

Science.gov (United States)

Leck, Victoria; Randall, Glen E

2017-07-20

Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities. A policy analysis of the rise and fall of the dental therapy profession in Canada was conducted using historical and policy documents. The analysis is framed within Kingdon's agenda-setting framework and considers why dental therapy was originally pursued as an option to ensure equitable access to oral health care for Inuit and First Nations communities and why this policy has now been abandoned with the closure of Canada's last dental therapy training school. The closure of the last dental therapy program in Canada has the potential to further reduce access to dental care in some Inuit and First Nations communities. Overlaps between federal and provincial jurisdiction have contributed to the absence of a coordinated policy approach to address the equity gap in access to dental care which will exacerbate the inequalities in comparison to the general population. The analysis suggests that while a technically feasible policy solution is available there continues to be no politically acceptable solution and thus it remains unlikely that a window of opportunity for policy change will open any time soon. In the absence of federal government leadership, the most viable option forward may be incremental policy change. Provincial governments could expand the scope of practice for

78 FR 10166 - Access Interpreting; Transfer of Data

Science.gov (United States)

2013-02-13

... regulations. Access Interpreting has been awarded a contract to perform work for OPP, and access to this information will enable Access Interpreting to fulfill the obligations of the contract. DATES: Access.... Contractor Requirements Under Contract No. EP10H000109, this contract is to provide the Environmental...

Health service access and utilization among Syrian refugees in Jordan.

Science.gov (United States)

Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Burnham, Gilbert

2016-07-14

health equity for refugees. Dependence of refugees on the public facilities for primary and specialist care has placed a great burden on the Jordanian health system. To improve accessibility and affordability of health services in an equitable manner for both refugees and Jordanian host communities, strategies that should be considered going forward include shifting resources for non-communicable diseases and other traditional hospital services to the primary level and creating strong health promotion programs emphasizing prevention and self-care are strategies.

Integrating Attributes into Role-Based Access Control

DEFF Research Database (Denmark)

Mahmood Rajpoot, Qasim; Jensen, Christian D.; Krishnan, Ram

2015-01-01

of research recently. We propose an access control model that combines the two models in a novel way in order to unify their benefits. Our approach provides a fine-grained access control mechanism that takes into account the current contextual information while making the access control decisions....

Support for a tax increase to provide unrestricted access to an Alzheimer's disease medication: a survey of the general public in Canada.

Science.gov (United States)

Oremus, Mark; Tarride, Jean-Eric; Clayton, Natasha; Raina, Parminder

2009-12-29

Public drug insurance plans provide limited reimbursement for Alzheimer's disease (AD) medications in many jurisdictions, including Canada and the United Kingdom. This study was conducted to assess Canadians' level of support for an increase in annual personal income taxes to fund a public program of unrestricted access to AD medications. A telephone survey was administered to a national sample of 500 adult Canadians. The survey contained four scenarios describing a hypothetical, new AD medication. Descriptions varied across scenarios: the medication was alternatively described as being capable of treating the symptoms of cognitive decline or of halting the progression of cognitive decline, with either no probability of adverse effects or a 30% probability of primarily gastrointestinal adverse effects. After each scenario, participants were asked whether they would support a tax increase to provide unrestricted access to the drug. Participants who responded affirmatively were asked whether they would pay an additional $75, $150, or $225 per annum in taxes. Multivariable logistic regression analysis was conducted to examine the determinants of support for a tax increase. Eighty percent of participants supported a tax increase for at least one scenario. Support was highest (67%) for the most favourable scenario (halt progression - no adverse effects) and lowest (49%) for the least favourable scenario (symptom treatment - 30% chance of adverse effects). The odds of supporting a tax increase under at least one scenario were approximately 55% less for participants who attached higher ratings to their health state under the assumption that they had moderate AD and almost five times greater if participants thought family members or friends would somewhat or strongly approve of their decision to support a tax increase. A majority of participants would pay an additional $150 per annum in taxes, regardless of scenario. Less than 50% would pay $225. Four out of five persons

HIV testing and care in Burkina Faso, Kenya, Malawi and Uganda: ethics on the ground

Directory of Open Access Journals (Sweden)

Obermeyer Carla Makhlouf

2013-01-01

Full Text Available Abstract Background The ethical discourse about HIV testing has undergone a profound transformation in recent years. The greater availability of antiretroviral therapy (ART has led to a global scaling up of HIV testing and counseling as a gateway to prevention, treatment and care. In response, critics raised important ethical questions, including: How do different testing policies and practices undermine or strengthen informed consent and medical confidentiality? How well do different modalities of testing provide benefits that outweigh risks of harm? To what degree do current testing policies and programs provide equitable access to HIV services? And finally, what lessons have been learned from the field about how to improve the delivery of HIV services to achieve public health objectives and protections for human rights? This article reviews the empirical evidence that has emerged to answer these questions, from four sub-Saharan African countries, namely: Burkina Faso, Kenya, Malawi and Uganda. Discussion Expanding access to treatment and prevention in these four countries has made the biomedical benefits of HIV testing increasingly clear. But serious challenges remain with regard to protecting human rights, informed consent and ensuring linkages to care. Policy makers and practitioners are grappling with difficult ethical issues, including how to protect confidentiality, how to strengthen linkages to care, and how to provide equitable access to services, especially for most at risk populations, including men who have sex with men. Summary The most salient policy questions about HIV testing in these countries no longer address whether to scale up routine PITC (and other strategies, but how. Instead, individuals, health care providers and policy makers are struggling with a host of difficult ethical questions about how to protect rights, maximize benefits, and mitigate risks in the face of resource scarcity.

Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

Science.gov (United States)

Hussey, Peter S.; Ringel, Jeanne S.; Ahluwalia, Sangeeta; Price, Rebecca Anhang; Buttorff, Christine; Concannon, Thomas W.; Lovejoy, Susan L.; Martsolf, Grant R.; Rudin, Robert S.; Schultz, Dana; Sloss, Elizabeth M.; Watkins, Katherine E.; Waxman, Daniel; Bauman, Melissa; Briscombe, Brian; Broyles, James R.; Burns, Rachel M.; Chen, Emily K.; DeSantis, Amy Soo Jin; Ecola, Liisa; Fischer, Shira H.; Friedberg, Mark W.; Gidengil, Courtney A.; Ginsburg, Paul B.; Gulden, Timothy; Gutierrez, Carlos Ignacio; Hirshman, Samuel; Huang, Christina Y.; Kandrack, Ryan; Kress, Amii; Leuschner, Kristin J.; MacCarthy, Sarah; Maksabedian, Ervant J.; Mann, Sean; Matthews, Luke Joseph; May, Linnea Warren; Mishra, Nishtha; Miyashiro, Lisa; Muchow, Ashley N.; Nelson, Jason; Naranjo, Diana; O'Hanlon, Claire E.; Pillemer, Francesca; Predmore, Zachary; Ross, Rachel; Ruder, Teague; Rutter, Carolyn M.; Uscher-Pines, Lori; Vaiana, Mary E.; Vesely, Joseph V.; Hosek, Susan D.; Farmer, Carrie M.

2016-01-01

Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth. PMID:28083424

Open Access to essential health care information

Directory of Open Access Journals (Sweden)

Pandey Manoj

2004-12-01

Full Text Available Abstract Open Access publishing is a valuable resource for the synthesis and distribution of essential health care information. This article discusses the potential benefits of Open Access, specifically in terms of Low and Middle Income (LAMI countries in which there is currently a lack of informed health care providers – mainly a consequence of poor availability to information. We propose that without copyright restrictions, Open Access facilitates distribution of the most relevant research and health care information. Furthermore, we suggest that the technology and infrastructure that has been put in place for Open Access could be used to publish download-able manuals, guides or basic handbooks created by healthcare providers in LAMI countries.

Questioning the efficacy of 'gold' open access to published articles.

Science.gov (United States)

Fredericks, Suzanne

2015-07-01

To question the efficacy of 'gold' open access to published articles. Open access is unrestricted access to academic, theoretical and research literature that is scholarly and peer-reviewed. Two models of open access exist: 'gold' and 'green'. Gold open access provides everyone with access to articles during all stages of publication, with processing charges paid by the author(s). Green open access involves placing an already published article into a repository to provide unrestricted access, with processing charges incurred by the publisher. This is a discussion paper. An exploration of the relative benefits and drawbacks of the 'gold' and 'green' open access systems. Green open access is a more economic and efficient means of granting open access to scholarly literature but a large number of researchers select gold open access journals as their first choices for manuscript submissions. This paper questions the efficacy of gold open access models and presents an examination of green open access models to encourage nurse researchers to consider this approach. In the current academic environment, with increased pressures to publish and low funding success rates, it is difficult to understand why gold open access still exists. Green open access enhances the visibility of an academic's work, as increased downloads of articles tend to lead to increased citations. Green open access is the cheaper option, as well as the most beneficial choice, for universities that want to provide unrestricted access to all literature at minimal risk.

Access Agent Improving The Performance Of Access Control Lists

Directory of Open Access Journals (Sweden)

Thelis R. S.

2015-08-01

Full Text Available The main focus of the proposed research is maintaining the security of a network. Extranet is a popular network among most of the organizations where network access is provided to a selected group of outliers. Limiting access to an extranet can be carried out using Access Control Lists ACLs method. However handling the workload of ACLs is an onerous task for the router. The purpose of the proposed research is to improve the performance and to solidify the security of the ACLs used in a small organization. Using a high performance computer as a dedicated device to share and handle the router workload is suggested in order to increase the performance of the router when handling ACLs. Methods of detecting and directing sensitive data is also discussed in this paper. A framework is provided to help increase the efficiency of the ACLs in an organization network using the above mentioned procedures thus helping the organizations ACLs performance to be improved to be more secure and the system to perform faster. Inbuilt methods of Windows platform or Software for open source platforms can be used to make a computer function as a router. Extended ACL features allow the determining of the type of packets flowing through the router. Combining these mechanisms allows the ACLs to be improved and perform in a more efficient manner.

Five Steps to an Accessible Classroom Website

Science.gov (United States)

Amundson, Linda

2009-01-01

When teachers or technology coordinators publish a website, they are providing a product for a diverse group of people. That's why website design should follow accessibility guidelines. Websites should be accessible to those with visual, hearing, movement, cognitive, and speech disabilities. Good design means greater accessibility for all. This…

Principles of wireless access and localization

CERN Document Server

Pahlavan, Kaveh

2013-01-01

A comprehensive, encompassing and accessible text examining a wide range of key Wireless Networking and Localization technologies This book provides a unified treatment of issues related to all wireless access and wireless localization techniques.  The book reflects principles of design and deployment of infrastructure for wireless access and localization for wide, local, and personal networking.   Description of wireless access methods includes design and deployment of traditional TDMA and CDMA technologies and emerging Long Term Evolution (LTE) techniques for wide area cellular networks, the

The Role of Women's Colleges and Universities in Providing Access to Postsecondary Education

Science.gov (United States)

Renn, Kristen A.

2017-01-01

Based on a qualitative, comparative, multiple case study of the contributions and status of 21st century women's colleges and universities, this article analyzes the topic of women's access to postsecondary education in ten nations. Despite decreasing numbers of women-only institutions in some regions (e.g., North America), the sector is growing…

Water footprints as an indicator for the equitable utilization of shared water resources. (Case study: Egypt and Ethiopia shared water resources in Nile Basin)

Science.gov (United States)

Sallam, Osama M.

2014-12-01

The question of "equity." is a vague and relative term in any event, criteria for equity are particularly difficult to determine in water conflicts, where international water law is ambiguous and often contradictory, and no mechanism exists to enforce principles which are agreed-upon. The aim of this study is using the water footprints as a concept to be an indicator or a measuring tool for the Equitable Utilization of shared water resources. Herein Egypt and Ethiopia water resources conflicts in Nile River Basin were selected as a case study. To achieve this study; water footprints, international virtual water flows and water footprint of national consumption of Egypt and Ethiopia has been analyzed. In this study, some indictors of equitable utilization has been gained for example; Egypt water footprint per capita is 1385 CM/yr/cap while in Ethiopia is 1167 CM/yr/cap, Egypt water footprint related to the national consumption is 95.15 BCM/yr, while in Ethiopia is 77.63 BCM/yr, and the external water footprints of Egypt is 28.5%, while in Ethiopia is 2.3% of the national consumption water footprint. The most important conclusion of this study is; natural, social, environmental and economical aspects should be taken into account when considering the water footprints as an effective measurable tool to assess the equable utilization of shared water resources, moreover the water footprints should be calculated using a real data and there is a necessity to establishing a global water footprints benchmarks for commodities as a reference.

Education and the Work Force.

Science.gov (United States)

Lakebrink, Joan M.

1986-01-01

Asserts that a liberal education and supervised work experience are important to the flexibility needed in the modern workplace. Encourages equitable access to education and employment for all groups. (CH)

The role of decentralized systems in providing universal electricity access in Sub-Saharan Africa – A model-based approach

NARCIS (Netherlands)

Dagnachew, Anteneh G.; Lucas, Paul L.|info:eu-repo/dai/nl/272607444; Hof, Andries F.|info:eu-repo/dai/nl/240412397; Gernaat, David E.H.J.|info:eu-repo/dai/nl/372664636; de Boer, Harmen Sytze; van Vuuren, Detlef P.|info:eu-repo/dai/nl/11522016X

2017-01-01

Poverty and lack of access to electricity are highly correlated. In Sub-Saharan Africa, one of the poorest regions in the world, two in every three people have no access to electricity. This paper describes a purpose designed model to explore and project the development in the Sub-Saharan African

Editorial: Next Generation Access Networks

Science.gov (United States)

Ruffini, Marco; Cincotti, Gabriella; Pizzinat, Anna; Vetter, Peter

2015-12-01

Over the past decade we have seen an increasing number of operators deploying Fibre-to-the-home (FTTH) solutions in access networks, in order to provide home users with a much needed network access upgrade, to support higher peak rates, higher sustained rates and a better and more uniform broadband coverage of the territory.

Homeless in Galilee

Directory of Open Access Journals (Sweden)

Robert L. Brawley

2011-04-01

Full Text Available This article has located Jesus’ saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic covenant traditions and the prophetic hope expressed especially in Isaiah, Ezekiel and Psalm 37, Jesus proclaimed God’s kingdom as God’s rule over heaven and earth, which implicates restoration of equitable access to the resources of the earth. The Lord’s Prayer, presumptions about the water of Jacob’s well in John 4 and the parable of the unjust steward in Luke 16 are used to demonstrate understandings of violations of equitable access according to Abrahamic covenant traditions and the hope for the restoration thereof.

"Pushing" physical activity, and justice.

Science.gov (United States)

García, Robert; Bracho, America; Cantero, Patricia; Glenn, Beth A

2009-10-01

There has been an increasing realization of the need for environmental interventions to increase physical activity levels in the population. Although promising, the impact of these strategies in reducing obesity-related disparities will be limited by the presence of inequities in the distribution of activity-related resources in the community. Advocacy efforts are critically needed to ensure that all communities benefit from environmental strategies being implemented. This paper describes two activist community-based organizations in Southern California, The City Project and Latino Health Access, and their successful efforts to mandate equitable access to public resources critical for reducing obesity-related disparities. Principles for equitable development of public land are also presented as well as lessons learned that can inform future advocacy efforts.

Access Control of Web- and Java-Based Applications

Science.gov (United States)

Tso, Kam S.; Pajevski, Michael J.

2013-01-01

Cybersecurity has become a great concern as threats of service interruption, unauthorized access, stealing and altering of information, and spreading of viruses have become more prevalent and serious. Application layer access control of applications is a critical component in the overall security solution that also includes encryption, firewalls, virtual private networks, antivirus, and intrusion detection. An access control solution, based on an open-source access manager augmented with custom software components, was developed to provide protection to both Web-based and Javabased client and server applications. The DISA Security Service (DISA-SS) provides common access control capabilities for AMMOS software applications through a set of application programming interfaces (APIs) and network- accessible security services for authentication, single sign-on, authorization checking, and authorization policy management. The OpenAM access management technology designed for Web applications can be extended to meet the needs of Java thick clients and stand alone servers that are commonly used in the JPL AMMOS environment. The DISA-SS reusable components have greatly reduced the effort for each AMMOS subsystem to develop its own access control strategy. The novelty of this work is that it leverages an open-source access management product that was designed for Webbased applications to provide access control for Java thick clients and Java standalone servers. Thick clients and standalone servers are still commonly used in businesses and government, especially for applications that require rich graphical user interfaces and high-performance visualization that cannot be met by thin clients running on Web browsers

Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis

Directory of Open Access Journals (Sweden)

Paul O Ouma, MSc

2018-03-01

 282 013 (29·0% people and 64 495 526 (28·2% women of child bearing age are located more than 2-h travel time from the nearest hospital. Marked differences were observed within and between countries, ranging from less than 25% of the population within 2-h travel time of a public hospital in South Sudan to more than 90% in Nigeria, Kenya, Cape Verde, Swaziland, South Africa, Burundi, Comoros, São Tomé and Príncipe, and Zanzibar. Only 16 countries reached the international benchmark of more than 80% of their populations living within a 2-h travel time of the nearest hospital. Interpretation: Physical access to emergency hospital care provided by the public sector in Africa remains poor and varies substantially within and between countries. Innovative targeting of emergency care services is necessary to reduce these inequities. This study provides the first spatial census of public hospital services in Africa. Funding: Wellcome Trust and the UK Department for International Development.

A re-conceptualization of access for 21st century healthcare.

Science.gov (United States)

Fortney, John C; Burgess, James F; Bosworth, Hayden B; Booth, Brenda M; Kaboli, Peter J

2011-11-01

Many e-health technologies are available to promote virtual patient-provider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital "encounterless" utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access.

Melinda - A custom search engine that provides access to locally-developed content using the HL7 Infobutton standard.

Science.gov (United States)

Wan, Yik-Ki J; Staes, Catherine J

2016-01-01

Healthcare organizations use care pathways to standardize care, but once developed, adoption rates often remain low. One challenge for usage concerns clinicians' difficulty in accessing guidance when it is most needed. Although the HL7 'Infobutton Standard' allows clinicians easier access to external references, access to locally-developed resources often requires clinicians to deviate from their normal electronic health record (EHR) workflow to use another application. To address this gap between internal and external resources, we reviewed the literature and existing practices at the University of Utah Health Care. We identify the requirements to meet the needs of a healthcare enterprise and clinicians, describe the design and development of a prototype to aggregate both internal and external resources from within or outside the EHR, and evaluated strengths and limitations of the prototype. The system is functional but not implemented in a live EHR environment. We suggest next steps and enhancements.

Next generation sequencing provides rapid access to the genome of Puccinia striiformis f. sp. tritici, the causal agent of wheat stripe rust.

Directory of Open Access Journals (Sweden)

Dario Cantu

Full Text Available BACKGROUND: The wheat stripe rust fungus (Puccinia striiformis f. sp. tritici, PST is responsible for significant yield losses in wheat production worldwide. In spite of its economic importance, the PST genomic sequence is not currently available. Fortunately Next Generation Sequencing (NGS has radically improved sequencing speed and efficiency with a great reduction in costs compared to traditional sequencing technologies. We used Illumina sequencing to rapidly access the genomic sequence of the highly virulent PST race 130 (PST-130. METHODOLOGY/PRINCIPAL FINDINGS: We obtained nearly 80 million high quality paired-end reads (>50x coverage that were assembled into 29,178 contigs (64.8 Mb, which provide an estimated coverage of at least 88% of the PST genes and are available through GenBank. Extensive micro-synteny with the Puccinia graminis f. sp. tritici (PGTG genome and high sequence similarity with annotated PGTG genes support the quality of the PST-130 contigs. We characterized the transposable elements present in the PST-130 contigs and using an ab initio gene prediction program we identified and tentatively annotated 22,815 putative coding sequences. We provide examples on the use of comparative approaches to improve gene annotation for both PST and PGTG and to identify candidate effectors. Finally, the assembled contigs provided an inventory of PST repetitive elements, which were annotated and deposited in Repbase. CONCLUSIONS/SIGNIFICANCE: The assembly of the PST-130 genome and the predicted proteins provide useful resources to rapidly identify and clone PST genes and their regulatory regions. Although the automatic gene prediction has limitations, we show that a comparative genomics approach using multiple rust species can greatly improve the quality of gene annotation in these species. The PST-130 sequence will also be useful for comparative studies within PST as more races are sequenced. This study illustrates the power of NGS for

The Mission Accessibility of Near-Earth Asteroids

Science.gov (United States)

Barbee, Brent W.; Abell, P. A.; Adamo, D. R.; Mazanek, D. D.; Johnson, L. N.; Yeomans, D. K.; Chodas, P. W.; Chamberlin, A. B.; Benner, L. A. M.; Taylor, P.;

Antenatal and obstetric care in Afghanistan--a qualitative study among health care receivers and health care providers.

Science.gov (United States)

Rahmani, Zuhal; Brekke, Mette

2013-05-06

Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled "the worst country in which to be a mom" in Save the Children's World's Mothers' Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi's phenomenological analysis. Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care

The ATS Web Page Provides "Tool Boxes" for: Access Opportunities, Performance, Interfaces, Volume, Environments, "Wish List" Entry and Educational Outreach

Science.gov (United States)

1999-01-01

This viewgraph presentation gives an overview of the Access to Space website, including information on the 'tool boxes' available on the website for access opportunities, performance, interfaces, volume, environments, 'wish list' entry, and educational outreach.

Revitalising primary healthcare requires an equitable global economic system - now more than ever.

Science.gov (United States)

Sanders, David; Baum, Fran E; Benos, Alexis; Legge, David

2011-08-01

The promised revitalisation of primary healthcare (PHC) is happening at a time when the contradictions and unfairness of the global economic system have become clear, suggesting that the current system is unsustainable. In the past two decades, one of the most significant impediments to the implementation of comprehensive PHC has been neoliberal economic policies and their imposition globally. This article questions what will be required for PHC to flourish. PHC incorporates five key principles: equitable provision of services, comprehensive care, intersectoral action, community involvement and appropriate technology. This article considers intersectoral action and comprehensiveness and their potential to be implemented in the current global environment. It highlights the constraints to intersectoral action through a case study of nutrition in the context of globalisation of the food chain. It also explores the challenges to implementing a comprehensive approach to health that are posed by neoliberal health sector reforms and donor practices. The paper concludes that even well-designed health systems based on PHC have little influence over the broader economic forces that shape their operation and their ability to improve health. Reforming these economic forces will require greater regulation of the national and global economic environment to emphasise people's health rather than private profit, and action to address climate change. Revitalisation of PHC and progress towards health equity are unlikely without strong regulation of the market. The further development and strengthening of social movements for health will be key to successful advocacy action.

Attributes Enhanced Role-Based Access Control Model

DEFF Research Database (Denmark)

Mahmood Rajpoot, Qasim; Jensen, Christian D.; Krishnan, Ram

2015-01-01

as an important area of research. In this paper, we propose an access control model that combines the two models in a novel way in order to unify their benefits. Our approach provides a fine-grained access control mechanism that not only takes contextual information into account while making the access control...... decisions but is also suitable for applications where access to resources is controlled by exploiting contents of the resources in the policy....

Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

Science.gov (United States)

Soekarjo, Damayanti; Zehner, Elizabeth

2011-10-01

It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

Gambling accessibility: a scale to measure gambler preferences.

Science.gov (United States)

Moore, Susan M; Thomas, Anna C; Kyrios, Michael; Bates, Glen; Meredyth, Denise

2011-03-01

Geographic closeness of gambling venues is not the only aspect of accessibility likely to affect gambling frequency. Perceived accessibility of gambling venues may include other features such as convenience (e.g., opening hours) or "atmosphere". The aim of the current study was to develop a multidimensional measure of gamblers' perceptions of accessibility, and present evidence for its reliability and validity. We surveyed 303 gamblers with 43 items developed to measure different dimensions of accessibility. Factor analysis of the items produced a two factor solution. The first, Social Accessibility related to the level at which gambling venues were enjoyed because they were social places, provided varying entertainment options and had a pleasant atmosphere. The second factor, Accessible Retreat related to the degree to which venues were enjoyed because they were geographically and temporally available and provided a familiar and anonymous retreat with few interruptions or distractions. Both factors, developed as reliable subscales of the new Gambling Access Scale, demonstrated construct validity through their correlations with other gambling-related measures. Social Accessibility was moderately related to gambling frequency and amount spent, but not to problem gambling, while, as hypothesised, Accessible Retreat was associated with stronger urges to gamble and gambling problems.

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

Science.gov (United States)

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

2003-12-01

Modern laptop computers, and personal computers, can provide capabilities that are, in many ways, comparable to workstations or departmental servers. However, this doesn't mean we should run all computations on our local computers. We have identified several situations in which it preferable to implement our seismological application programs in a distributed, server-based, computing model. In this model, application programs on the user's laptop, or local computer, invoke programs that run on an organizational server, and the results are returned to the invoking system. Situations in which a server-based architecture may be preferred include: (a) a program is written in a language, or written for an operating environment, that is unsupported on the local computer, (b) software libraries or utilities required to execute a program are not available on the users computer, (c) a computational program is physically too large, or computationally too expensive, to run on a users computer, (d) a user community wants to enforce a consistent method of performing a computation by standardizing on a single implementation of a program, and (e) the computational program may require current information, that is not available to all client computers. Until recently, distributed, server-based, computational capabilities were implemented using client/server architectures. In these architectures, client programs were often written in the same language, and they executed in the same computing environment, as the servers. Recently, a new distributed computational model, called Web Services, has been developed. Web Services are based on Internet standards such as XML, SOAP, WDSL, and UDDI. Web Services offer the promise of platform, and language, independent distributed computing. To investigate this new computational model, and to provide useful services to the SCEC Community, we have implemented several computational and utility programs using a Web Service architecture. We have

Access 2013 all-in-one for dummies

CERN Document Server

Barrows, Alison; Taylor, Allen G

2013-01-01

Get started with the new Access 2013 with this impressive all-in-one reference! Microsoft Access allows you to store, organize, view, analyze, and share data; the new release enables you to build even more powerful, custom database solutions that integrate with the web and enterprise data sources. This compilation of nine indispensible minibooks is exactly what you need to get up to speed on the latest changes to Access. This easy-to-understand resource provides both new and experienced Access users with invaluable advice for connecting Access to SQL Server, manipulating data local

Open Access and ORCID poster presentation

DEFF Research Database (Denmark)

Elbæk, Mikael Karstensen; Ekstrøm, Jeannette

2014-01-01

and related topics such as copyright, DTU Orbit, Open Access journals, APCs, Vouchers etc. ORCID ORCID – Open Research & Contributor ID – is an internationally recognized and widely used researcher-ID. ORCID makes it easy to reuse your data across disciplines, publishers and databases – all you need to do......Open Access Open Access is high on the agenda in Denmark and internationally. Denmark has announced a national strategy for Open Access that aims to achieve Open Access to 80% in 2017 and 100% in 2022 to peer review research articles. All public Danish funders as well as H2020 requires that all...... peer review articles that is an outcome of their funding will be Open Access. Uploading your full texts (your final author manuscript after review ) to DTU Orbit is a fundamental part of providing Open Access to your research. We are here to answer all your questions with regards to Open Access...

Achieving open access to conservation science.

Science.gov (United States)

Fuller, Richard A; Lee, Jasmine R; Watson, James E M

2014-12-01

Conservation science is a crisis discipline in which the results of scientific enquiry must be made available quickly to those implementing management. We assessed the extent to which scientific research published since the year 2000 in 20 conservation science journals is publicly available. Of the 19,207 papers published, 1,667 (8.68%) are freely downloadable from an official repository. Moreover, only 938 papers (4.88%) meet the standard definition of open access in which material can be freely reused providing attribution to the authors is given. This compares poorly with a comparable set of 20 evolutionary biology journals, where 31.93% of papers are freely downloadable and 7.49% are open access. Seventeen of the 20 conservation journals offer an open access option, but fewer than 5% of the papers are available through open access. The cost of accessing the full body of conservation science runs into tens of thousands of dollars per year for institutional subscribers, and many conservation practitioners cannot access pay-per-view science through their workplace. However, important initiatives such as Research4Life are making science available to organizations in developing countries. We urge authors of conservation science to pay for open access on a per-article basis or to choose publication in open access journals, taking care to ensure the license allows reuse for any purpose providing attribution is given. Currently, it would cost $51 million to make all conservation science published since 2000 freely available by paying the open access fees currently levied to authors. Publishers of conservation journals might consider more cost effective models for open access and conservation-oriented organizations running journals could consider a broader range of options for open access to nonmembers such as sponsorship of open access via membership fees. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for

Family planning dialogue: Identifying the key determinants of young ...

African Journals Online (AJOL)

ANBR

planning information and services for sexually active young women – in ... towards ensuring the equitable distribution of resources and accessible basic services. 99 ...... denial and disengagement affecting intergenerational dialogue in many ...

Sociodemographic disparities in the utilization of proton therapy for prostate cancer at an urban academic center

Directory of Open Access Journals (Sweden)

Kristina D. Woodhouse, MD

2017-04-01

Conclusion: Sociodemographic disparities exist in PT use for prostate cancer at an urban academic institution. Further investigation of potential barriers to access is warranted to ensure equitable distribution across all demographic groups.

CameraCast: flexible access to remote video sensors

Science.gov (United States)

Kong, Jiantao; Ganev, Ivan; Schwan, Karsten; Widener, Patrick

2007-01-01

New applications like remote surveillance and online environmental or traffic monitoring are making it increasingly important to provide flexible and protected access to remote video sensor devices. Current systems use application-level codes like web-based solutions to provide such access. This requires adherence to user-level APIs provided by such services, access to remote video information through given application-specific service and server topologies, and that the data being captured and distributed is manipulated by third party service codes. CameraCast is a simple, easily used system-level solution to remote video access. It provides a logical device API so that an application can identically operate on local vs. remote video sensor devices, using its own service and server topologies. In addition, the application can take advantage of API enhancements to protect remote video information, using a capability-based model for differential data protection that offers fine grain control over the information made available to specific codes or machines, thereby limiting their ability to violate privacy or security constraints. Experimental evaluations of CameraCast show that the performance of accessing remote video information approximates that of accesses to local devices, given sufficient networking resources. High performance is also attained when protection restrictions are enforced, due to an efficient kernel-level realization of differential data protection.

The Access Pricing Problem: A Synthesis.

OpenAIRE

Armstrong, Mark; Doyle, Chris; Vickers, John

1996-01-01

The Baumol-Willig efficient component pricing rule states that it is efficient to set the price of access to an essential facility equal to the direct cost of access plus the opportunity cost to the integrated access provider. The authors analyze the relevant notion of 'opportunity cost' under various assumptions about demand and supply conditions, including product differentiation, bypass, and substitution possibilities, which all reduce opportunity cost compared to the benchmark case. They ...

Internet-accessible real-time weather information system

Digital Repository Service at National Institute of Oceanography (India)

Desai, R.G.P.; Joseph, A.; Desa, E.; Mehra, P.; Desa, E.; Gouveia, A.D.

An internet-accessible real-time weather information system has been developed. This system provides real-time accessibility to weather information from a multitude of spatially distributed weather stations. The Internet connectivity also offers...

Teenagers’ access to contraception in Mexico City

Directory of Open Access Journals (Sweden)

Sofía Gómez-Inclán

2017-05-01

Full Text Available Objective. To study and understand the phenomenon of access to contraceptive methods in Mexican teenages, through the use of the Levesque model, which allows for the observation of both the system and the system and the user´s participation in the access process. Materials and methods. A qualitative study was conducted with focus groups technique in a middle and high school of Mexico City. Results. The perception of ability to access to health care is limited, teenagers do not know the mechanisms of care or supply of contraceptive methods. Prejudices of service providers provoke a negative reaction. The family is a source of information for adolescents to make decisions. Conclusions. The model allowed the assessment of access to contraceptive methods in teenagers. It were identified dif­ferent aspects that act as barriers to access and may inform health care providers about this population in their sexual and reproductive health.

Wireless Multi Hop Access Networks and Protocols

OpenAIRE

Nilsson Plymoth, Anders

2007-01-01

As more and more applications and services in our society now depend on the Internet, it is important that dynamically deployed wireless multi hop networks are able to gain access to the Internet and other infrastructure networks and services. This thesis proposes and evaluates solutions for providing multi hop Internet Access. It investigates how ad hoc networks can be combined with wireless and mesh networks in order to create wireless multi hop access networks. When several access points t...

Accessibility Guidelines for Astronomy and Astrophysics Meetings

Science.gov (United States)

Monkiewicz, Jacqueline; Murphy, Nicholas; Diaz-Merced, Wanda Liz; Aarnio, Alicia; Knierman, Karen; AAS Working Group for Accessibility and Disability

2018-01-01

Attendance at meetings and conferences is a critical component of an astronomer's professional life, providing opportunities for presenting one's work, staying current in the field, career networking, and scientific collaboration. Exclusion from these gatherings due to lack of accessibility and accommodation failure is a reality for disabled astronomers, and contributes substantially to low levels of representation in the senior-most levels of the field. We present a preview of the AAS Working Group for Accessibility and Disability's best practice recommendations for meetings accessibility. Applying the principles of universal access and barrier-free design, we model a paradigm of anticipating and removing accessibility barriers in advance, rather than putting the burden of requesting accommodation solely on disabled astronomers and students. We cite several professional and nonprofessional societies identified as meetings accessibility exemplars, and model our guidelines on their best practices. We establish standards for accessibility budgeting, venue choice, publication of policies online, designating point persons, and identifying barriers. We make recommendations for oral and poster presentations, event registration, receptions and banquets, excursions, and other typical conference activities. For meetings which are constrained by fixed budgets and venue choice, we identify a number of low cost/high reward accessibility steps which might still have a large beneficial impact. We likewise provide adapted recommendations for low budget meetings. THIS IS A POSTER LOCATED IN THE AAS BOOTH

ASAView: Database and tool for solvent accessibility representation in proteins

Directory of Open Access Journals (Sweden)

Fawareh Hamed

2004-05-01

Full Text Available Abstract Background Accessible surface area (ASA or solvent accessibility of amino acids in a protein has important implications. Knowledge of surface residues helps in locating potential candidates of active sites. Therefore, a method to quickly see the surface residues in a two dimensional model would help to immediately understand the population of amino acid residues on the surface and in the inner core of the proteins. Results ASAView is an algorithm, an application and a database of schematic representations of solvent accessibility of amino acid residues within proteins. A characteristic two-dimensional spiral plot of solvent accessibility provides a convenient graphical view of residues in terms of their exposed surface areas. In addition, sequential plots in the form of bar charts are also provided. Online plots of the proteins included in the entire Protein Data Bank (PDB, are provided for the entire protein as well as their chains separately. Conclusions These graphical plots of solvent accessibility are likely to provide a quick view of the overall topological distribution of residues in proteins. Chain-wise computation of solvent accessibility is also provided.

Exploring Intra-Urban Accessibility and Impacts of Pollution Policies with an Agent-Based Simulation Platform: GaMiroD

Directory of Open Access Journals (Sweden)

Pierre Fosset

2016-01-01

Full Text Available In this work we address the issue of sustainable cities by focusing on one of their very central components: daily mobility. Indeed, if cities can be interpreted as spatial organizations allowing social interactions, the number of daily movements needed to reach this goal is continuously increasing. Therefore, improving urban accessibility merely results in increasing traffic and its negative externalities (congestion, accidents, pollution, noise, etc., while eventually reducing the quality of life of people in the city. This is why several urban-transport policies are implemented in order to reduce individual mobility impacts while maintaining equitable access to the city. This challenge is however non-trivial and therefore we propose to investigate this issue from the complex systems point of view. The real spatial-temporal urban accessibility of citizens cannot be approximated just by focusing on space and implies taking into account the space-time activity patterns of individuals, in a more dynamic way. Thus, given the importance of local interactions in such a perspective, an agent based approach seems to be a relevant solution. This kind of individual based and “interactionist” approach allows us to explore the possible impact of individual behaviors on the overall dynamics of the city but also the possible impact of global measures on individual behaviors. In this paper, we give an overview of the Miro Project and then focus on the GaMiroD model design from real data analysis to model exploration tuned by transportation-oriented scenarios. Among them, we start with the the impact of a LEZ (Low Emission Zone in the city center.

Open Access to Mexican Academic Production

Science.gov (United States)

Adame, Silvia I.; Llorens, Luis

2016-01-01

This paper presents a description of the metadata harvester software development. This system provides access to reliable and quality educational resources, shared by Mexican Universities through their repositories, to anyone with Internet Access. We present the conceptual and contextual framework, followed by the technical basis, the results and…

Access control within military C4ISR systems

Science.gov (United States)

Maschino, Mike

2003-07-01

Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance (C4ISR) tactical battlefield systems must provide the right information and resources to the right individuals at the right time. At the same time, the C4ISR system must enforce access controls to prevent the wrong individuals from obtaining sensitive information, or consuming scarce resources. Because lives, missions and property depend upon them, these access control mechanisms must be effective, reliable, efficient and flexible. The mechanisms employed must suit the nature of the items that are to be protected, as well as the varieties of access policies that must be enforced, and the types of access that will be made to these items. Some access control technologies are inherently centralized, while others are suitable for distributed implementation. The C4ISR architect must select from among the available technologies a combination of mechanisms that eases the burden of policy administration, but is inherently survivable, accurate, resource efficient, and which provides low latency. This paper explores various alternative access enforcement mechanisms, and assesses their effectiveness in managing policy-driven access control within the battlespace.

Marine biotechnologies and synthetic biology, new issues for a fair and equitable profit-sharing commercial use.

Science.gov (United States)

Bloch, Jean-François; Tardieu-Guigues, Elisabeth

2014-10-01

The sea will be a source of economic development in the next years. Today the research works in marine biotechnologies supply new products and processes. The introduction in the laboratories of a new technology, synthesis biology, is going to increase the possibilities of creation of new products. Exploitation of product stemming from marine biodiversity has to be made with regard to various rights among which industrial property law, maritime law and the Convention on BioDiversity. All participants involved in the promotion of research in marine biotechnology must address the fair and equitable sharing of any commercial exploitation. Carrying out work involving synthetic biology has increased the number of unanswered questions about how operators should manage in order to avoid any threat of being sued for infringements of IP rights or for alleged bio-piracy. This paper, by no means exhaustive in the field, analyzes some of the issues raised on the modification to the landscape in marine biotechnology by the advent of synthetic biology. Such issues indicate how important the collaboration between researchers, industrialists, lawyers is for allowing proper use of marine biotech. Copyright © 2014 Elsevier B.V. All rights reserved.

Patient choice of providers in a preferred provider organization.

Science.gov (United States)

Wouters, A V; Hester, J

1988-03-01

This article is an analysis of patient choice of providers by the employees of the Security Pacific Bank of California and their dependents who have access to the Med Network Preferred Provider Organization (PPO). The empirical results show that not only is the PPO used by individuals who require relatively little medical care (as measured by predicted office visit charges) but that the PPO is most intensively used for low-risk services such as treatment for minor illness and preventive care. Also, the most likely Security Pacific Health Care beneficiary to use a PPO provider is a recently hired employee who lives in the south urban region, has a relatively low income, does not have supplemental insurance coverage, and is without previous attachments to non-PPO primary care providers. In order to maximize their ability to reduce plan paid benefits, insurers who contract with PPOs should focus on increasing PPO utilization among poorer health risks.

Increasing Equitable Care for Youth through Coordinated School Health

Science.gov (United States)

Sanetti, Lisa M. Hagermoser

2017-01-01

Nearly a quarter of the students in the U.S. education system have a chronic health condition, disability, or special healthcare need. Students living in poverty and those at risk for or with disabilities have higher rates of health issues and encounter more barriers to accessing appropriate health care than their peers. The reciprocal influences…

Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

Science.gov (United States)

Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

2017-10-01

Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

Biometrics: Accessibility challenge or opportunity?

Science.gov (United States)

Blanco-Gonzalo, Ramon; Lunerti, Chiara; Sanchez-Reillo, Raul; Guest, Richard Michael

2018-01-01

Biometric recognition is currently implemented in several authentication contexts, most recently in mobile devices where it is expected to complement or even replace traditional authentication modalities such as PIN (Personal Identification Number) or passwords. The assumed convenience characteristics of biometrics are transparency, reliability and ease-of-use, however, the question of whether biometric recognition is as intuitive and straightforward to use is open to debate. Can biometric systems make some tasks easier for people with accessibility concerns? To investigate this question, an accessibility evaluation of a mobile app was conducted where test subjects withdraw money from a fictitious ATM (Automated Teller Machine) scenario. The biometric authentication mechanisms used include face, voice, and fingerprint. Furthermore, we employed traditional modalities of PIN and pattern in order to check if biometric recognition is indeed a real improvement. The trial test subjects within this work were people with real-life accessibility concerns. A group of people without accessibility concerns also participated, providing a baseline performance. Experimental results are presented concerning performance, HCI (Human-Computer Interaction) and accessibility, grouped according to category of accessibility concern. Our results reveal links between individual modalities and user category establishing guidelines for future accessible biometric products.

Biometrics: Accessibility challenge or opportunity?

Science.gov (United States)

Lunerti, Chiara; Sanchez-Reillo, Raul; Guest, Richard Michael

2018-01-01

Biometric recognition is currently implemented in several authentication contexts, most recently in mobile devices where it is expected to complement or even replace traditional authentication modalities such as PIN (Personal Identification Number) or passwords. The assumed convenience characteristics of biometrics are transparency, reliability and ease-of-use, however, the question of whether biometric recognition is as intuitive and straightforward to use is open to debate. Can biometric systems make some tasks easier for people with accessibility concerns? To investigate this question, an accessibility evaluation of a mobile app was conducted where test subjects withdraw money from a fictitious ATM (Automated Teller Machine) scenario. The biometric authentication mechanisms used include face, voice, and fingerprint. Furthermore, we employed traditional modalities of PIN and pattern in order to check if biometric recognition is indeed a real improvement. The trial test subjects within this work were people with real-life accessibility concerns. A group of people without accessibility concerns also participated, providing a baseline performance. Experimental results are presented concerning performance, HCI (Human-Computer Interaction) and accessibility, grouped according to category of accessibility concern. Our results reveal links between individual modalities and user category establishing guidelines for future accessible biometric products. PMID:29565989

Holistic approaches to e-learning accessibility

Directory of Open Access Journals (Sweden)

Lawrie Phipps

2006-12-01

Full Text Available The importance of accessibility to digital e-learning resources is widely acknowledged. The World Wide Web Consortium Web Accessibility Initiative has played a leading role in promoting the importance of accessibility and developing guidelines that can help when developing accessible web resources. The accessibility of e-learning resources provides additional challenges. While it is important to consider the technical and resource related aspects of e-learning when designing and developing resources for students with disabilities, there is a need to consider pedagogic and contextual issues as well. A holistic framework is therefore proposed and described, which in addition to accessibility issues takes into account learner needs, learning outcomes, local factors, infrastructure, usability and quality assurance. The practical application and implementation of this framework is discussed and illustrated through the use of examples and case studies.

Tracking progress towards equitable child survival in a Nicaraguan community: neonatal mortality challenges to meet the MDG 4

Directory of Open Access Journals (Sweden)

Persson Lars-Åke

2011-06-01

Full Text Available Abstract Background Nicaragua has made progress in the reduction of the under-five mortality since 1980s. Data for the national trends indicate that this poor Central American country is on track to reach the Millennium Development Goal-4 by 2015. Despite this progress, neonatal mortality has not showed same progress. The aim of this study is to analyse trends and social differentials in neonatal and under-five mortality in a Nicaraguan community from 1970 to 2005. Methods Two linked community-based reproductive surveys in 1993 and 2002 followed by a health and demographic surveillance system providing information on all births and child deaths in urban and rural areas of León municipality, Nicaragua. A total of 49 972 live births were registered. Results A rapid reduction in under-five mortality was observed during the late 1970s (from 103 deaths/1000 live births and the 1980s, followed by a gradual decline to the level of 23 deaths/1000 live births in 2005. This community is on track for the Millennium Development Goal 4 for improved child survival. However, neonatal mortality increased lately in spite of a good coverage of skilled assistance at delivery. After some years in the 1990s with a very small gap in neonatal survival between children of mothers of different educational levels this divide is increasing. Conclusions After the reduction of high under-five mortality that coincided with improved equity in survival in this Nicaraguan community, the current challenge is the neonatal mortality where questions of an equitable perinatal care of good quality must be addressed.

Inequities in access to and use of drinking water services in Latin America and the Caribbean

Directory of Open Access Journals (Sweden)

Soares Luiz Carlos Rangel

2002-01-01

Full Text Available Objective. To identify and evaluate inequities in access to drinking water services as reflected in household per capita expenditure on water, and to determine what proportion of household expenditures is spent on water in 11 countries of Latin America and the Caribbean. Methods. Using data from multi-purpose household surveys (such as the Living Standards Measurement Survey Study conducted in 11 countries from 1995 to 1999, the availability of drinking water as well as total and per capita household expenditures on drinking water were analyzed in light of socioeconomic parameters, such as urban vs. rural setting, household income, type and regularity of water supply service, time spent obtaining water in homes not served by running water, and type of water-purifying treatment, if any. Results. Access to drinking water as well as total and per capita household expenditures on drinking water show an association with household income, economic conditions of the household, and location. The access of the rural population to drinking water services is much more restricted than that of the urban population for groups having similar income. The proportion of families having a household water supply system is comparable in the higher-income rural population and the lower-income urban population. Families without a household water supply system spend a considerable amount of time getting water. For poorer families, this implies additional costs. Low-income families that lack a household water supply spend as much money on water as do families with better income. Access to household water disinfection methods is very limited among poor families due to its relatively high cost, which results in poorer drinking water quality in the lower-income population. Conclusions. Multi-purpose household surveys conducted from the consumer's point of view are important tools for research on equity and health, especially when studying unequal access to, use of, and

Evolving trade policy and the Trans-Pacific Partnership Agreement: does it threaten Vietnam's access to medicine and its progress towards scaling up HIV prevention, treatment and care?

Science.gov (United States)

Linh, Nguyen Nhat; Huong, Nguyen Thanh; Thuy, Hua Thanh

2015-01-01

The Trans-Pacific Partnership Agreement (TPP) has undergone 18 rounds of secretive negotiation between the USA and 11 Asia-Pacific countries. Aiming at a free trade area, this multilateral trade proposal covers all aspects of commercial relations among the countries involved. Despite some anticipated positive impacts in trade, specific articles in this proposal's intellectual property and transparency chapters might negatively impact access to medicine, in general, and to antiretroviral (ARV) drugs, in particular, in Vietnam. Drawing on a desk review and qualitative in-depth interviews with 20 key informants from government, academia, hospitals and civil society, we analyse various provisions of the proposal being negotiated leaked after the 14th round of negotiations in September 2012. Findings suggest that the TPP could lead to increased monopoly protection and could limit technological advancements within the local pharmaceutical manufacturing industry, resulting in higher medicine prices in Vietnam. This outcome would have a significant impact on Vietnam's ability to achieve goals for HIV prevention, treatment and care, and create barriers to universal health-care coverage. This research provides unique evidence for Vietnam to advocate for more equitable pharmaceutical provisions in and to raise awareness of the implications of the TPP among the pharmaceutical stakeholder community in Vietnam.

Development of Disruptive Open Access Journals

Science.gov (United States)

Anderson, Terry; McConkey, Brigette

2009-01-01

Open access (OA) publication has emerged, with disruptive effects, as a major outlet for scholarly publication. OA publication is usually associated with on-line distribution and provides access to scholarly publications to anyone, anywhere--regardless of their ability to pay subscription fees or their association with an educational institution.…

14-EEASA-Vol 22.indd

African Journals Online (AJOL)

jenny

2006-02-22

Feb 22, 2006 ... into the construction, conceptualisation and implementation of the curriculum. .... defining development pathways that are not water or energy intensive. ... equitable access to an effective education while at the same time ...

Integrated social facility location planning for decision support: Accessibility studies provide support to facility location and integration of social service provision

CSIR Research Space (South Africa)

Green, Cheri A

2012-09-01

Full Text Available for two or more facilities to create an integrated plan for development Step 6 Costing of development plan Case Study Access norms and thresholds guidelines in accessibility analysis Appropriate norms/provision guidelines facilitate both service... access norms and threshold standards ?Test the relationship between service demand and the supply (service capacity) of the facility provision points within a defined catchment area ?Promote the ?right?sizing? of facilities relative to the demand...

Fire, Aim… Ready? Alberta's Big Bang Approach to Healthcare Disintegration.

Science.gov (United States)

Donaldson, Cam

2010-08-01

Alberta's abolition in 2008 of its health regions and the creation of Alberta Health Services (AHS) was a bold move, but the reasons for the change remain hazy. The stated goals were to "help make Alberta's … system more effective and efficient" and to "provide equitable access to health services and long-term sustainability." Data show, however, that Alberta's health regions were already performing well on these goals relative to other provinces, and where changes have since occurred, they cannot necessarily be attributed to AHS.

Workshop AccessibleTV "Accessible User Interfaces for Future TV Applications"

Science.gov (United States)

Hahn, Volker; Hamisu, Pascal; Jung, Christopher; Heinrich, Gregor; Duarte, Carlos; Langdon, Pat

Approximately half of the elderly people over 55 suffer from some type of typically mild visual, auditory, motor or cognitive impairment. For them interaction, especially with PCs and other complex devices is sometimes challenging, although accessible ICT applications could make much of a difference for their living quality. Basically they have the potential to enable or simplify participation and inclusion in their surrounding private and professional communities. However, the availability of accessible user interfaces being capable to adapt to the specific needs and requirements of users with individual impairments is very limited. Although there are a number of APIs [1, 2, 3, 4] available for various platforms that allow developers to provide accessibility features within their applications, today none of them provides features for the automatic adaptation of multimodal interfaces being capable to automatically fit the individual requirements of users with different kinds of impairments. Moreover, the provision of accessible user interfaces is still expensive and risky for application developers, as they need special experience and effort for user tests. Today many implementations simply neglect the needs of elderly people, thus locking out a large portion of their potential users. The workshop is organized as part of the dissemination activity for the European-funded project GUIDE "Gentle user interfaces for elderly people", which aims to address this situation with a comprehensive approach for the realization of multimodal user interfaces being capable to adapt to the needs of users with different kinds of mild impairments. As application platform, GUIDE will mainly target TVs and Set-Top Boxes, such as the emerging Connected-TV or WebTV platforms, as they have the potential to address the needs of the elderly users with applications such as for home automation, communication or continuing education.

Rural adolescents' access to adolescent friendly health services.

Science.gov (United States)

Secor-Turner, Molly A; Randall, Brandy A; Brennan, Alison L; Anderson, Melinda K; Gross, Dean A

2014-01-01

The purpose of this study was to assess rural North Dakota adolescents' experiences in accessing adolescent-friendly health services and to examine the relationship between rural adolescents' communication with health care providers and risk behaviors. Data are from the Rural Adolescent Health Survey (RAHS), an anonymous survey of 14- to 19-year-olds (n = 322) attending secondary schools in four frontier counties of North Dakota. Descriptive statistics were used to assess participants' access to adolescent-friendly health services characterized as accessible, acceptable, and appropriate. Logistic regressions were used to examine whether participant-reported risk behaviors predicted communication with health care providers about individual health risk behaviors. Rural adolescents reported high access to acceptable primary health care services but low levels of effective health care services. Participant report of engaging in high-risk behaviors was associated with having received information from health care providers about the leading causes of morbidity and mortality. These findings reveal missed opportunities for primary care providers in rural settings to provide fundamental health promotion to adolescents. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Provider role attitudes, marital satisfaction, role overload, and housework: a dyadic approach.

Science.gov (United States)

Helms, Heather M; Walls, Jill K; Crouter, Ann C; McHale, Susan M

2010-10-01

Treating the marital dyad as the unit of analysis, this study examined the within-couple patterning of 272 dual-earner spouses' provider role attitudes and their longitudinal associations with marital satisfaction, role overload, and the division of housework. Based on the congruence of husbands' and wives' provider role attitudes, couples were classified into one of four types: (a) main-secondary, (b) coprovider, (c) ambivalent coprovider, and (d) mismatched couples. Nearly half of all spouses differed in their attitudes about breadwinning. A series of mixed model ANCOVAs revealed significant between- and within-couple differences in human capital characteristics, spouses' perceptions of marital satisfaction and role overload, and the division of housework across 3 years of measurement. Coprovider couples reported higher levels of marital satisfaction and a more equitable division of housework than the other couple groups. Wives in the ambivalent coprovider couples' group reported higher levels of role overload than their husbands to a greater extent than was found in the other couple groups. As the first study to adopt a dyadic approach that considers the meanings that both spouses in dual-earner couples ascribe to paid employment, these findings advance understanding of how dual-earner spouses' provider role attitudes serve as contexts for marital quality, behavior, and role-related stress.

Access Structures in a Standard Translation Dictionary | Louw ...

African Journals Online (AJOL)

The access structure is the primary guide structure in the central texts of any standard translation dictionary. The metalexicographical term "guide structures" refers to the set of structures that provides a framework within which the accessibility and availability of information types in the dictionary can be evaluated. The access ...

Tactical resource allocation and elective patient admission planning in care processes.

Science.gov (United States)

Hulshof, Peter J H; Boucherie, Richard J; Hans, Erwin W; Hurink, Johann L

2013-06-01

Tactical planning of resources in hospitals concerns elective patient admission planning and the intermediate term allocation of resource capacities. Its main objectives are to achieve equitable access for patients, to meet production targets/to serve the strategically agreed number of patients, and to use resources efficiently. This paper proposes a method to develop a tactical resource allocation and elective patient admission plan. These tactical plans allocate available resources to various care processes and determine the selection of patients to be served that are at a particular stage of their care process. Our method is developed in a Mixed Integer Linear Programming (MILP) framework and copes with multiple resources, multiple time periods and multiple patient groups with various uncertain treatment paths through the hospital, thereby integrating decision making for a chain of hospital resources. Computational results indicate that our method leads to a more equitable distribution of resources and provides control of patient access times, the number of patients served and the fraction of allocated resource capacity. Our approach is generic, as the base MILP and the solution approach allow for including various extensions to both the objective criteria and the constraints. Consequently, the proposed method is applicable in various settings of tactical hospital management.

Open-Access Electronic Textbooks: An Overview

Science.gov (United States)

Ovadia, Steven

2011-01-01

Given the challenging economic climate in the United States, many academics are looking to open-access electronic textbooks as a way to provide students with traditional textbook content at a more financially advantageous price. Open access refers to "the free and widely available information throughout the World Wide Web. Once an article's…

Online Access Patterns and Students

Directory of Open Access Journals (Sweden)

Nasir Butrous

2011-04-01

Full Text Available The paper follows accessing patterns of five cohorts of postgraduate students enrolled in a core unit within a master of business administration (MBA program. The unit is designed to provide numerous opportunities for student participation in Discussion Boards using Blackboard technology. Discussion Boards create numerous opportunities for interaction amongst online learners to share and exchange their experiences, creating a sense of a virtual community. Relationships between accessing patterns for each week of the semester for each student are explored in relation to their performance using course statistics generated by the Blackboard technology. Close examination of the significant differences in access patterns to the course window and its components of communication, content, and student areas reveal middle of the semester (week 7 as the common critical point that differentiates high achieving students from low achieving students. Identifying critical points provides the faculty staff member an opportunity to introduce intervention strategies in order to improve the learning experience of all the students.

Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016.

Science.gov (United States)

Farrer, Louise M; Walker, Jennie; Harrison, Christopher; Banfield, Michelle

2018-01-01

General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.

Access control system operation

International Nuclear Information System (INIS)

Barnes, L.D.

1981-06-01

An automated method for the control and monitoring of personnel movement throughout the site was developed under contract to the Department of Energy by Allied-General Nuclear Services (AGNS) at the Barnwell Nuclear Fuel Plant (BNFP). These automated features provide strict enforcement of personnel access policy without routine patrol officer involvement. Identification methods include identification by employee ID number, identification by voice verification and identification by physical security officer verification. The ability to grant each level of access authority is distributed over the organization to prevent any single individual at any level in the organization from being capable of issuing an authorization for entry into sensitive areas. Each access event is recorded. As access events occur, the inventory of both the entered and the exited control area is updated so that a current inventory is always available for display. The system has been operated since 1979 in a development mode and many revisions have been implemented in hardware and software as areas were added to the system. Recent changes have involved the installation of backup systems and other features required to achieve a high reliability. The access control system and recent operating experience are described

The experiences of high intensity therapists delivering cognitive behavioural therapy to people with intellectual disabilities.

Science.gov (United States)

Marwood, Hayley; Chinn, Deborah; Gannon, Kenneth; Scior, Katrina

2018-01-01

People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness for people with ID, when delivered within IAPT, is unclear. Ten high-intensity therapists took part in semi-structured interviews, analysed using thematic analysis, regarding their experiences of delivering CBT to people with ID in IAPT. The rigidity of the IAPT model appears to offer a poor fit with the needs of people with ID. Therapists appeared uncertain about how to modify CBT and highlighted training and service development needs. Findings suggest barriers to accessing IAPT largely remain unaddressed where people with ID are concerned. Services may need to reconsider what constitutes appropriate reasonable adjustments to ensure equitable access. © 2017 John Wiley & Sons Ltd.

Support to the CGIAR Program on Aquaculture | IDRC - International ...

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

... promoting equitable access to markets by poor and vulnerable households; ... control of resources; improving policies and institutional structures in support of ... to announce that the first call for applications for the new Early Career Women.

Publications | Page 87 | IDRC - International Development Research ...

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

Results 861 - 870 of 7331 ... Using social network analysis to profile organised crime (restricted access) ... and to maximize delivery of equitable economic benefits of research. ... and Child Care (MHCC) & Micro, Small, and Medium Enterprises ...

Accessing and disclosing protected resources

DEFF Research Database (Denmark)

Olesen, Henning; Khajuria, Samant

2015-01-01

Today, data is money. Whether it is private users' personal data or confidential data and assets belonging to service providers, all parties have a strong need to protect their resources when interacting with each other, i.e. for access control and authorization measures to be deployed. Enabling...... advanced user controlled privacy is essential to realize the visions of 5G applications and services. For service providers and enterprises resources are usually well safeguarded, while private users are often missing the tools and the know-how to protect their own data and preserve their privacy. The user...... the framework of User Managed Access (UMA), can enable users to understand the value of their protected resources and possibly give them control of how their data will be used by service providers....

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

Public Access for Teaching Genomics, Proteomics, and Bioinformatics

Science.gov (United States)

Campbell, A. Malcolm

2003-01-01

When the human genome project was conceived, its leaders wanted all researchers to have equal access to the data and associated research tools. Their vision of equal access provides an unprecedented teaching opportunity. Teachers and students have free access to the same databases that researchers are using. Furthermore, the recent movement to…

Health Care Access Among Deaf People.

Science.gov (United States)

Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

2016-01-01

Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Efficient Access Control in Multimedia Social Networks

Science.gov (United States)

Sachan, Amit; Emmanuel, Sabu

Multimedia social networks (MMSNs) have provided a convenient way to share multimedia contents such as images, videos, blogs, etc. Contents shared by a person can be easily accessed by anybody else over the Internet. However, due to various privacy, security, and legal concerns people often want to selectively share the contents only with their friends, family, colleagues, etc. Access control mechanisms play an important role in this situation. With access control mechanisms one can decide the persons who can access a shared content and who cannot. But continuously growing content uploads and accesses, fine grained access control requirements (e.g. different access control parameters for different parts in a picture), and specific access control requirements for multimedia contents can make the time complexity of access control to be very large. So, it is important to study an efficient access control mechanism suitable for MMSNs. In this chapter we present an efficient bit-vector transform based access control mechanism for MMSNs. The proposed approach is also compatible with other requirements of MMSNs, such as access rights modification, content deletion, etc. Mathematical analysis and experimental results show the effectiveness and efficiency of our proposed approach.

KAUST Open Access policy

KAUST Repository

Baessa, Mohamed A.

2017-01-01

The library plays a critical role in facilitating open access for their researchers, from managing a repository to providing support and information on the OA publication process to their authors. Janis Tyhurst and Dr Imad

34 CFR 21.1 - Equal Access to Justice Act.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Equal Access to Justice Act. 21.1 Section 21.1 Education Office of the Secretary, Department of Education EQUAL ACCESS TO JUSTICE General § 21.1 Equal Access to Justice Act. (a) The Equal Access to Justice Act (the Act) provides for the award of fees and...

Biometrics: Accessibility challenge or opportunity?

Directory of Open Access Journals (Sweden)

Ramon Blanco-Gonzalo

Full Text Available Biometric recognition is currently implemented in several authentication contexts, most recently in mobile devices where it is expected to complement or even replace traditional authentication modalities such as PIN (Personal Identification Number or passwords. The assumed convenience characteristics of biometrics are transparency, reliability and ease-of-use, however, the question of whether biometric recognition is as intuitive and straightforward to use is open to debate. Can biometric systems make some tasks easier for people with accessibility concerns? To investigate this question, an accessibility evaluation of a mobile app was conducted where test subjects withdraw money from a fictitious ATM (Automated Teller Machine scenario. The biometric authentication mechanisms used include face, voice, and fingerprint. Furthermore, we employed traditional modalities of PIN and pattern in order to check if biometric recognition is indeed a real improvement. The trial test subjects within this work were people with real-life accessibility concerns. A group of people without accessibility concerns also participated, providing a baseline performance. Experimental results are presented concerning performance, HCI (Human-Computer Interaction and accessibility, grouped according to category of accessibility concern. Our results reveal links between individual modalities and user category establishing guidelines for future accessible biometric products.

Public Funding and Budgetary Challenges to Providing Universal Access to Primary Education in Sub-Saharan Africa

Science.gov (United States)

Omwami, Edith Mukudi; Keller, Edmond J.

2010-01-01

Budgetary capacity that would allow for the public funding of the provision of universal access to primary education is lacking in many sub-Saharan economies. National revenues significantly lag behind the overall economic productivity measure of GDP. Analysis of data derived from UNESCO and UNDP for 2004 shows that governments in the region spend…

New funding opportunity for gender equality and climate change ...

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

2018-03-08

Mar 8, 2018 ... What we do · Funding · Resources · About IDRC ... Energy security: Research projects that explore socially equitable access to innovative, clean, and renewable energy services and to energy-based technologies; and ...

University access for social justice: a capabilities perspective

Directory of Open Access Journals (Sweden)

Merridy Wilson-Strydom

2011-01-01

Full Text Available The closely related, but often contradictory, issues of increasing access to university and improving students' chances of success in their university studies have been and continue to be an important research focus within higher education studies and policy in South Africa and beyond. More recently, the challenge of underpreparedness of students entering university has gained prominence as universities struggle to increase their throughput rates. It can be argued that increasing access, without increasing chances of success, is becoming a new form of social exclusion within higher education. Thispaperproposes that approaching issues of access from a capabilities perspective (as developed by Amartya Sen provides a means of fostering access for social justice and countering access that leads to social exclusion. As such, this is a theoretical paper building on existing work on the capabilities approach within education to argue that the notion of capabilities provides a useful theoretical and conceptual framework for understanding the complexities of meaningful access to university in a deeply divided society like South Africa.

Web accessibility and open source software.

Science.gov (United States)

Obrenović, Zeljko

2009-07-01

A Web browser provides a uniform user interface to different types of information. Making this interface universally accessible and more interactive is a long-term goal still far from being achieved. Universally accessible browsers require novel interaction modalities and additional functionalities, for which existing browsers tend to provide only partial solutions. Although functionality for Web accessibility can be found as open source and free software components, their reuse and integration is complex because they were developed in diverse implementation environments, following standards and conventions incompatible with the Web. To address these problems, we have started several activities that aim at exploiting the potential of open-source software for Web accessibility. The first of these activities is the development of Adaptable Multi-Interface COmmunicator (AMICO):WEB, an infrastructure that facilitates efficient reuse and integration of open source software components into the Web environment. The main contribution of AMICO:WEB is in enabling the syntactic and semantic interoperability between Web extension mechanisms and a variety of integration mechanisms used by open source and free software components. Its design is based on our experiences in solving practical problems where we have used open source components to improve accessibility of rich media Web applications. The second of our activities involves improving education, where we have used our platform to teach students how to build advanced accessibility solutions from diverse open-source software. We are also partially involved in the recently started Eclipse projects called Accessibility Tools Framework (ACTF), the aim of which is development of extensible infrastructure, upon which developers can build a variety of utilities that help to evaluate and enhance the accessibility of applications and content for people with disabilities. In this article we briefly report on these activities.

Public Interest in Accessing the INIS Collection

International Nuclear Information System (INIS)

Savić, Dobrica

2016-01-01

Since its creation in 1970, the International Nuclear Information System (INIS) has collected and provided access to more than 3.8 million bibliographic references to publications, documents, technical reports, non‐copyrighted documentation, and other grey literature, as well as over a million full texts. Overall, there are 800 GB of data in the INIS repository. Public interest in accessing this collection has been remarkable. This year alone, there were more than one million sessions and almost two million page views. During the same period, there were 1.6 million full text document downloads. The INIS collection consists of seven types of literature – computer media, patents, books, reports, journal articles, miscellaneous and audio‐visuals. This paper provides an overview of the INIS collection subject coverage, and the distribution of different types of grey literature. It also provides INIS repository access statistics based on Google Analytics and other Web search data pertaining to public interest in accessing these different types of literature and the uniqueness of the collection. As one of the world's largest collections of published information on the peaceful uses of nuclear science and technology, INIS represents an extraordinary example of world cooperation. 154 INIS members share and allow access to their valuable nuclear information resources, preserving them for future generations and offering a freely available nuclear knowledge repository. (author)

Health Care Access among Deaf People

Science.gov (United States)

Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

2016-01-01

Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

Facilitators of prenatal care access in rural Appalachia.

Science.gov (United States)

Phillippi, Julia C; Myers, Carole R; Schorn, Mavis N

2014-12-01

There are many providers and models of prenatal care, some more effective than others. However, quantitative research alone cannot determine the reasons beneficial models of care improve health outcomes. Perspectives of women receiving care from effective clinics can provide valuable insight. We surveyed 29 women receiving care at a rural, Appalachian birth center in the United States with low rates of preterm birth. Semi-structured interviews and demographic questionnaires were analyzed using conventional qualitative content analysis of manifest content. Insurance was the most common facilitator of prenatal access. Beneficial characteristics of the provider and clinic included: personalized care, unrushed visits, varied appointment times, short waits, and choice in the type and location of care. There is a connection between compassionate and personalized care and positive birth outcomes. Women were willing to overcome barriers to access care that met their needs. To facilitate access to prenatal care and decrease health disparities, healthcare planners, and policy makers need to ensure all women can afford to access prenatal care and allow women a choice in their care provider. Clinic administrators should create a welcoming clinic environment with minimal wait time. Unrushed, woman-centered prenatal visits can increase access to and motivation for care and are easily integrated into prenatal care with minimal cost. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Random access procedures and radio access network (RAN) overload control in standard and advanced long-term evolution (LTE and LTE-A) networks

DEFF Research Database (Denmark)

Kiilerich Pratas, Nuno; Thomsen, Henning; Popovski, Petar

2015-01-01

In this chapter, we describe and discuss the current LTE random access procedure and the Radio Access Network Load Control solution within LTE/LTE-A. We provide an overview of the several considered load control solutions and give a detailed description of the standardized Extended Access Class B...

Access control and personal identification systems

CERN Document Server

Bowers, Dan M

1988-01-01

Access Control and Personal Identification Systems provides an education in the field of access control and personal identification systems, which is essential in selecting the appropriate equipment, dealing intelligently with vendors in purchases of the equipment, and integrating the equipment into a total effective system. Access control devices and systems comprise an important part of almost every security system, but are seldom the sole source of security. In order for the goals of the total system to be met, the other portions of the security system must also be well planned and executed

A plan for transmission access and pricing

International Nuclear Information System (INIS)

Oldak, M.

1990-01-01

The National Rural Electric Cooperative Association (NRECA) believes that while access to the interconnected transmission system (grid) is necessary to provide the most efficient and economical development and use of the bulk power supply system, the grid cannot be unconditionally opened. Additionally, access should be provided only under reasonable terms, conditions, and cost-based compensation, within a framework of joint planning and coordinated operations. NRECA describes here its transmission policy, a coordinated planning and utilization model (CPU)

Does Access Trump Ownership? Exploring Consumer Acceptance of Access-Based Consumption in the Case of Smartphones

Directory of Open Access Journals (Sweden)

Flora Poppelaars

2018-06-01

Full Text Available Value creation in a circular economy is based on products being returned after use. In the case of smartphones, most are never returned and tend to be kept in drawers. Smartphone access services (e.g., leasing or upgrade have been experimented with in the Netherlands but have been largely unsuccessful. This study explores the reasons why consumers rejected these access-based smartphone services and is one of the very few to address this topic. The findings are compared with the case of car access services, which are socially better accepted, to identify potential areas for improvement. The qualitative study consists of in-depth interviews with consumers (n = 18 who either adopted and used a smartphone or car access service, or had considered a new smartphone or car but did not choose access-based consumption. The findings of this small-scale study suggest that the main reasons for the rejection of smartphone access services are a lack of awareness, misunderstanding of terms and conditions, and unsatisfactory compensation for their sacrifice of not owning. Smartphone access providers could thus clearly communicate customers’ rights and responsibilities, offer an excellent service experience (especially during repair by taking over the burdens of ownership, and stimulate the societal logic shift from ownership to access.

Free access to INIS database provides a gateway to nuclear energy research results

International Nuclear Information System (INIS)

Tolonen, E.; Malmgren, M.

2009-01-01

Free access to INIS database was opened to all the Internet users around the world on May, 2009. The article reviews the history of INIS (the International Nuclear Information System), data aquisition process, database content and search possibilities. INIS is focused on the worldwide literature of the peaceful uses of nuclear energy and the database is produced in close collaboration with the IEA/ETDE World Energy Base (ETDEWEB), a database focusing on all aspects of energy. Nuclear Science Abstracts database (NSA), which is a comprehensive collection of international nuclear science and technology literature for the period 1948 through 1976, is also briefly discussed in the article. In Finland, the recently formed Aalto University is responsible for collecting and disseminating information (literature) and for the preparation of input to the INIS and IEA/ETDE Databases on the national level

1 Integrating reproductive and child health and HIV services in ...

African Journals Online (AJOL)