WorldWideScience

Sample records for providing equitable access

  1. 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 stream_source_info Green1_2012.pdf.txt stream_content_type text/plain stream_size 6780 Content-Encoding ISO-8859-1 stream_name Green1_2012.pdf.txt Content-Type text/plain; charset=ISO-8859-1 Geographic Accessibility... - Rural 8 878 7 820 28533 Cato Ridge E - Special 45 140 6698 Craigieburn A - High 1 411 160 6698 Craigieburn B - Moderate 177 20 6698 Craigieburn C - Low 28 262 2 460 6698 Craigieburn D - Rural 25 875 10 660 6698 Craigieburn E - Special 2 203 180...

  2. EQUITABLE ACCESS TO HEALTH SERVICE IN BANYUWANGI

    Directory of Open Access Journals (Sweden)

    Lusi Herawati Sunyoto Usman Mark Zuidgeest

    2012-06-01

    as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.

  3. Universalism, universal design and equitable access to the built environment.

    Science.gov (United States)

    Imrie, Rob

    2012-01-01

    The concept of universal design (UD) has acquired global significance and become orthodoxy of what is presented as the very best of design practice. This is despite limited evaluation of the theoretical content of the concept. This article seeks to redress this shortfall in knowledge by providing a critique of the theoretical and conceptual components that underpin the principles of universal design. Commentary. The content of UD appears to be reductive and functionalist, with an appeal to discourses of technical flexibility, or the notion that the problems confronting disabled people by poorly designed built environments may be redressed by recourse to technical and management solutions. UD is characterized by its advocation of the marketization of access as the primary means to ensure the accessibility of products, including the built environment. This has the potential to reduce the "right to access" to a right to be exercised through a market presence or transaction. There is also lack of clarity about what advocates of UD understand universalism to be, as illustrated by evidence of some ambivalence towards specialist or particular design solutions. UD provides a useful, yet partial, understanding of the interrelationships between disability and design that may limit how far inequalities of access to the built environment can be overcome.

  4. Financing equitable access to antiretroviral treatment in South Africa.

    Science.gov (United States)

    Cleary, Susan; McIntyre, Di

    2010-07-02

    While South Africa spends approximately 7.4% of GDP on healthcare, only 43% of these funds are spent in the public system, which is tasked with the provision of care to the majority of the population including a large proportion of those in need of antiretroviral treatment (ART). South Africa is currently debating the introduction of a National Health Insurance (NHI) system. Because such a universal health system could mean increased public healthcare funding and improved access to human resources, it could improve the sustainability of ART provision. This paper considers the minimum resources that would be required to achieve the proposed universal health system and contrasts these with the costs of scaled up access to ART between 2010 and 2020. The costs of ART and universal coverage (UC) are assessed through multiplying unit costs, utilization and estimates of the population in need during each year of the planning cycle. Costs are from the provider's perspective reflected in real 2007 prices. The annual costs of providing ART increase from US$1 billion in 2010 to US$3.6 billion in 2020. If increases in funding to public healthcare only keep pace with projected real GDP growth, then close to 30% of these resources would be required for ART by 2020. However, an increase in the public healthcare resource envelope from 3.2% to 5%-6% of GDP would be sufficient to finance both ART and other services under a universal system (if based on a largely public sector model) and the annual costs of ART would not exceed 15% of the universal health system budget. Responding to the HIV-epidemic is one of the many challenges currently facing South Africa. Whether this response becomes a "resource for democracy" or whether it undermines social cohesiveness within poor communities and between rich and poor communities will be partially determined by the steps that are taken during the next ten years. While the introduction of a universal system will be complex, it could generate a

  5. Providing an Equitable Service to Bilingual Children in the UK: A Review

    Science.gov (United States)

    Stow, Carol; Dodd, Barbara

    2003-01-01

    Background: The UK is a multicultural, multilingual society and the majority of paediatric speech and language therapists in England have at least one bilingual child on their caseload. There are many imperatives driving the profession to provide an equitable service for bilingual children. Evidence is beginning to emerge, however, that bilingual…

  6. 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…

  7. 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

  8. Safe Delivery Posts: an intervention to provide equitable childbirth care services to vulnerable groups in Zahedan, Iran.

    Science.gov (United States)

    Moudi, Zahra; Ghazi Tabatabaie, Mahmood; Mahdi Tabatabaei, Seyed; Vedadhir, AbouAli

    2014-10-01

    Recently, there has been a shift towards alternative childbirth services to increase access to skilled care during childbirth. This study aims to assess the past 10 years of experience of the first Safe Delivery Posts (SDPs) established in Zahedan, Iran to determine the number of deliveries and the intrapartum transfer rates, and to examine the reasons why women choose to give birth at a Safe Delivery Post and not in one of the four large hospitals in Zahedan. A mixed-methods research strategy was used for this study. In the quantitative phase, an analysis was performed on the existing data that are routinely collected in the health-care sector. In the qualitative phase, a grounded theory approach was used to collect and analyse narrative data from in-depth interviews with women who had given birth to their children at the Safe Delivery Posts. Women were selected from two Safe Delivery Posts in Zahedan city in southeast Iran. Nineteen mothers who had given birth in the Safe Delivery Posts were interviewed. During the 10-year period, 22,753 low-risk women gave birth in the Safe Delivery Posts, according to the records. Of all the women who were admitted to the Safe Delivery Posts, on average 2.1% were transferred to the hospital during labour or the postpartum period. Three key categories emerged from the analysis: barriers to hospital use, opposition to home birth and finally, reasons for choosing the childbirth care provided by the SDPs. Implementing a model of midwifery care that offers the benefits of modern medical care and meets the needs of the local population is feasible and sustainable. This model of care reduces the cost of giving birth and ensures equitable access to care among vulnerable groups in Zahedan. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. 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

  10. 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.

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

    Science.gov (United States)

    Callahan, Rebecca M.; Shifrer, Dara

    2016-01-01

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

  12. On a never-ending waiting list: Toward equitable access to ...

    African Journals Online (AJOL)

    Universal access to antiretroviral (ARV) medication for HIV/AIDS is the clarion call of the WHO/UNAIDS 3 by 5 Initiative. Treatment coverage, however, remains highly uneven. This sharpens the question of who exactly is accessing ARVs and whether access is challenging inequality or reinforcing it. Issues of distributive ...

  13. 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.

  14. Universal Design for Instruction: A Matter of Equitable Access to Learning

    Science.gov (United States)

    DeVore, Simone; Stuart, Shannon; Riall, Ann

    2008-01-01

    Universal design for instruction is an inclusive teaching model that the authors advocate for responding to the diverse learning needs of students in today's postsecondary classrooms. The goal of universally designed courses is to allow all students to have available a menu of choices by which they can access curriculum content, engage in learning…

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

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

    In Mali and Burkina Faso, maternal and child mortality rates remain high. The governments of both countries are trying to increase access to and use of health care for women and children. They have adopted policies to remove financial barriers and are now piloting results-based financing, which gives financial incentives ...

  16. 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

  17. South Africa's protracted struggle for equal distribution and equitable access - still not there.

    Science.gov (United States)

    van Rensburg, Hendrik C J

    2014-05-08

    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

  18. Smart Growth and Equitable Development

    Science.gov (United States)

    This page discusses how smart growth, environmental justice, and equitable development can improve communities and provide economic, environmental, health, and social benefits to underserved communities.

  19. Accessibility of MOOCs: Understanding the Provider Perspective

    Science.gov (United States)

    Iniesto, Francisco; McAndrew, Patrick; Minocha, Shailey; Coughlan, Tim

    2016-01-01

    Massive Online Open Courses (MOOCs) have become an accepted way to make learning opportunities available at large scale and with low cost to the learner. However, only if these are made accessible will they be able to offer flexibility of learning and benefits to all, irrespective of disability. Experience in providing accessible online learning…

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

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

    In Latin America, primary health care (PHC) is often of poor quality and delivered unevenly. The region's segmented health systems make it difficult to provide equal access to services across multiple subsystems. To ensure more equitable health care and universal access to PHC in Latin America, health systems must be ...

  1. 7 CFR 1400.8 - Equitable treatment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Equitable treatment. 1400.8 Section 1400.8... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS General Provisions § 1400.8 Equitable treatment. (a... Administrator deems necessary to provide fair and equitable treatment to such person or legal entity. (b...

  2. 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

  3. 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

  4. JSTOR: Providing New Access to Old Research

    OpenAIRE

    K.M. Guthrie

    1998-01-01

    Much has transpired in a short period of time. The JSTOR database now includes well over two million pages from 47 core journals in 11 academic disciplines. Additional journal content is being digitized at a rate of approximately 100,000 pages per month. More than 250 libraries in the United States and Canada have become participating institutions, providing support for the creation, maintenance and growth of this database. Outside of North America, we have recently announced the establishmen...

  5. 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.

  6. Demonstrate provider accessibility with desktop and online services.

    Science.gov (United States)

    2001-10-01

    It's available on personal computers with a CD or through Internet access. Assess instantly the accessibility of your provider network or the most promising areas to establish a health service with new GIS tools.

  7. 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

  8. The right to water in rural Punjab: assessing equitable access to water in the context of the ongoing Punjab Rural Water Supply Proejct.

    Science.gov (United States)

    Samra, Shamsher; Crowley, Julia; Smith Fawzi, Mary C

    2011-12-15

    Although India is poised to meet its Millennium Development Goal for providing access to safe drinking water, there remains a worrying discrepancy in access between urban and rural areas. In 2006, 96% of the urban population versus 86% of the rural population obtained their drinking water from an improved water source. To increase access to potable water in rural areas, the World Bank and the state of Punjab have implemented the Punjab Rural Water Supply and Sanitation Project (PRWSS) to improve or construct water supply systems in 3,000 villages deemed to have inadequate access to clean drinking water. This study aimed to examine whether the right to water was fulfilled in six towns in rural Punjab during implementation of the PRWSS. The normative content of the right to water requires that water be of adequate quantity, safety, accessibility, affordability, and acceptability in terms of quality. While our findings suggest that the PRWSS improved water quality, they also indicate that access to water was limited due to affordability and the low socioeconomic status of some people living in the target communities. Copyright © 2011 Samra, Crowley, and Smith Fawzi. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  9. Evolving protocols for research in equitation science

    NARCIS (Netherlands)

    Pierard, M.; Hall, C.; Konig von Borstel, U.; Averis, A.; Hawson, L.; Mclean, A.; Nevison, C.; Visser, E.K.; McGreevy, P.

    2015-01-01

    Within the emerging discipline of Equitation Science, the application of consistent methodology, including robust objective measures, is required for sound scientific evaluation. This report aims to provide an evaluation of current methodology and to propose some initial guidelines for future

  10. Providing Access to Electronic Information Resources in Further Education

    Science.gov (United States)

    Banwell, Linda; Ray, Kathryn; Coulson, Graham; Urquhart, Christine; Lonsdale, Ray; Armstrong, Chris; Thomas, Rhian; Spink, Sin; Yeoman, Alison; Fenton, Roger; Rowley, Jennifer

    2004-01-01

    This article aims to provide a baseline for future studies on the provision and support for the use of digital or electronic information services (EIS) in further education. The analysis presented is based on a multi-level model of access, which encompasses access to and availability of information and communication technology (ICT) resources,…

  11. Sci-Hub provides access to nearly all scholarly literature

    OpenAIRE

    Himmelstein, Daniel S.; Romero, Ariel R.; McLaughlin, Stephen R.; Tzovaras, Bastian Greshake; Greene, Casey S.

    2017-01-01

    The website Sci-Hub provides access to scholarly literature via full text PDF downloads. The site enables users to access articles that would otherwise be paywalled. Since its creation in 2011, Sci-Hub has grown rapidly in popularity. However, until now, the extent of Sci-Hub’s coverage was unclear. As of March 2017, we find that Sci-Hub’s database contains 68.9% of all 81.6 million scholarly articles, which rises to 85.2% for those published in toll access journals. Coverage varies by discip...

  12. 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

  13. 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…

  14. 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.

  15. Internet access and investment incentives for broadband service providers

    OpenAIRE

    Baranes, Edmond; Poudou, Jean-Christophe

    2011-01-01

    This paper studies a model of the Internet broadband market as a platform in order to show how di¤erent pricing schemes from the so-called "net neutrality " can increase economic e¢ ciency by allowing more investment of access providers and enhancing consumers surplus and social welfare. We show that departing from the "net neutrality", where at rates are used, introducing termination fees can increase incentives to invest for the ISP and enhance social surplus. Keywords : Network neutrality,...

  16. Providing Internet Access to High-Resolution Mars Images

    Science.gov (United States)

    Plesea, Lucian

    2008-01-01

    The OnMars server is a computer program that provides Internet access to high-resolution Mars images, maps, and elevation data, all suitable for use in geographical information system (GIS) software for generating images, maps, and computational models of Mars. The OnMars server is an implementation of the Open Geospatial Consortium (OGC) Web Map Service (WMS) server. Unlike other Mars Internet map servers that provide Martian data using an Earth coordinate system, the OnMars WMS server supports encoding of data in Mars-specific coordinate systems. The OnMars server offers access to most of the available high-resolution Martian image and elevation data, including an 8-meter-per-pixel uncontrolled mosaic of most of the Mars Global Surveyor (MGS) Mars Observer Camera Narrow Angle (MOCNA) image collection, which is not available elsewhere. This server can generate image and map files in the tagged image file format (TIFF), Joint Photographic Experts Group (JPEG), 8- or 16-bit Portable Network Graphics (PNG), or Keyhole Markup Language (KML) format. Image control is provided by use of the OGC Style Layer Descriptor (SLD) protocol. The OnMars server also implements tiled WMS protocol and super-overlay KML for high-performance client application programs.

  17. Providing Internet Access to High-Resolution Lunar Images

    Science.gov (United States)

    Plesea, Lucian

    2008-01-01

    The OnMoon server is a computer program that provides Internet access to high-resolution Lunar images, maps, and elevation data, all suitable for use in geographical information system (GIS) software for generating images, maps, and computational models of the Moon. The OnMoon server implements the Open Geospatial Consortium (OGC) Web Map Service (WMS) server protocol and supports Moon-specific extensions. Unlike other Internet map servers that provide Lunar data using an Earth coordinate system, the OnMoon server supports encoding of data in Moon-specific coordinate systems. The OnMoon server offers access to most of the available high-resolution Lunar image and elevation data. This server can generate image and map files in the tagged image file format (TIFF) or the Joint Photographic Experts Group (JPEG), 8- or 16-bit Portable Network Graphics (PNG), or Keyhole Markup Language (KML) format. Image control is provided by use of the OGC Style Layer Descriptor (SLD) protocol. Full-precision spectral arithmetic processing is also available, by use of a custom SLD extension. This server can dynamically add shaded relief based on the Lunar elevation to any image layer. This server also implements tiled WMS protocol and super-overlay KML for high-performance client application programs.

  18. Provider barriers to family planning access in urban Kenya.

    Science.gov (United States)

    Tumlinson, Katherine; Okigbo, Chinelo C; Speizer, Ilene S

    2015-08-01

    A better understanding of the prevalence of service provider-imposed barriers to family planning can inform programs intended to increase contraceptive use. This study, based on data from urban Kenya, describes the frequency of provider self-reported restrictions related to clients' age, parity, marital status, and third-party consent, and considers the impact of facility type and training on restrictive practices. Trained data collectors interviewed 676 service providers at 273 health care facilities in five Kenyan cities. Service providers were asked questions about their background and training and were also asked about age, marital, parity, or consent requirements for providing family planning services. More than half of providers (58%) reported imposing minimum age restrictions on one or more methods. These restrictions were commonly imposed on clients seeking injectables, a popular method in urban Kenya, with large numbers refusing to offer injectables to women younger than 20 years. Forty-one percent of providers reported that they would not offer one or more methods to nulliparous women and more than one in four providers reported that they would not offer the injectable to women without at least one child. Providers at private facilities were significantly more likely to impose barriers, across all method types, and those without in-service training on family planning provision had a significantly higher prevalence of imposing parity, marital, and consent barriers across most methods. Programs need to address provider-imposed barriers that reduce access to contraceptive methods particularly among young, lower parity, and single women. Promising strategies include targeting private facility providers and increasing the prevalence of in-service training. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. The SOOS Data Portal, providing access to Southern Oceans data

    Science.gov (United States)

    Proctor, Roger; Finney, Kim; Blain, Peter; Taylor, Fiona; Newman, Louise; Meredith, Mike; Schofield, Oscar

    2013-04-01

    The Southern Ocean Observing System (SOOS) is an international initiative to enhance, coordinate and expand the strategic observations of the Southern Oceans that are required to address key scientific and societal challenges. A key component of SOOS will be the creation and maintenance of a Southern Ocean Data Portal to provide improved access to historical and ongoing data (Schofield et al., 2012, Eos, Vol. 93, No. 26, pp 241-243). The scale of this effort will require strong leveraging of existing data centres, new cyberinfrastructure development efforts, and defined data collection, quality control, and archiving procedures across the international community. The task of assembling the SOOS data portal is assigned to the SOOS Data Management Sub-Committee. The information infrastructure chosen for the SOOS data portal is based on the Australian Ocean Data Network (AODN, http://portal.aodn.org.au). The AODN infrastructure is built on open-source tools and the use of international standards ensures efficiency of data exchange and interoperability between contributing systems. OGC standard web services protocols are used for serving of data via the internet. These include Web Map Service (WMS) for visualisation, Web Feature Service (WFS) for data download, and Catalogue Service for Web (CSW) for catalogue exchange. The portal offers a number of tools to access and visualize data: - a Search link to the metadata catalogue enables search and discovery by simple text search, by geographic area, temporal extent, keyword, parameter, organisation, or by any combination of these, allowing users to gain access to further information and/or the data for download. Also, searches can be restricted to items which have either data to download, or attached map layers, or both - a Map interface for discovery and display of data, with the ability to change the style and opacity of layers, add additional data layers via OGC Web Map Services, view animated timeseries datastreams

  20. Towards an Equitable Development of Telecommunications ...

    African Journals Online (AJOL)

    Present and future equitable development of telecommunications services calls for an immediate development of an indigenous telecommunications technology capability in order to effectively and efficiently utilizes the services provided by the country's presently imported telecommunications systems while at the same time ...

  1. Engaging and staying engaged: a phenomenological study of barriers to equitable access to mental healthcare for people with severe mental disorders in a rural African setting.

    Science.gov (United States)

    Hailemariam, Maji; Fekadu, Abebaw; Prince, Martin; Hanlon, Charlotte

    2017-08-29

    In low-and middle-income countries, integration of mental health into primary care is recommended to reduce the treatment gap. In this study we explored barriers to initial and ongoing engagement of people with severe mental disorders (SMD) in rural Ethiopia after implementing integrated primary mental healthcare services. A qualitative approach was employed. In-depth interviews were conducted with 50 key informants: service users/caregivers engaged with care (n = 17), non-engagers and their caregivers (n = 10), those who had initiated treatment but disengaged and their caregivers (n = 12) and primary healthcare professionals (n = 11). Two focus group discussions were conducted with community health workers (10 per group). Thematic analysis was used. Most respondents reported improved access to care, usually equated with medication, and were motivated to remain engaged due to experienced benefits of care. However, four main barriers to engagement emerged. (1) Poverty: resulting in inability to pay for medication and undermining vital social support affected engagement for all respondents. (2) Unreliable medication supplies and lack of second line options for inadequate response or intolerable side-effects. (3) The long-term nature of the illness: expectations of cure, stigma of chronic illness, low awareness about the illness and treatment and declining social support over time. (4) The nature of SMD: difficulty conveying the person when acutely disturbed and no flexibility for proactive outreach or legal frameworks to provide care when patients lacked capacity. In those who never engaged, geographical inaccessibility was an important barrier. Alternative cultural explanations for illness were only mentioned as a barrier only by two of the respondents. Economic interventions may be needed to support ongoing engagement in care for people with SMD. Systems of care for chronic illness need to be strengthened in combination with legal frameworks

  2. Equitability, mutual information, and the maximal information coefficient.

    Science.gov (United States)

    Kinney, Justin B; Atwal, Gurinder S

    2014-03-04

    How should one quantify the strength of association between two random variables without bias for relationships of a specific form? Despite its conceptual simplicity, this notion of statistical "equitability" has yet to receive a definitive mathematical formalization. Here we argue that equitability is properly formalized by a self-consistency condition closely related to Data Processing Inequality. Mutual information, a fundamental quantity in information theory, is shown to satisfy this equitability criterion. These findings are at odds with the recent work of Reshef et al. [Reshef DN, et al. (2011) Science 334(6062):1518-1524], which proposed an alternative definition of equitability and introduced a new statistic, the "maximal information coefficient" (MIC), said to satisfy equitability in contradistinction to mutual information. These conclusions, however, were supported only with limited simulation evidence, not with mathematical arguments. Upon revisiting these claims, we prove that the mathematical definition of equitability proposed by Reshef et al. cannot be satisfied by any (nontrivial) dependence measure. We also identify artifacts in the reported simulation evidence. When these artifacts are removed, estimates of mutual information are found to be more equitable than estimates of MIC. Mutual information is also observed to have consistently higher statistical power than MIC. We conclude that estimating mutual information provides a natural (and often practical) way to equitably quantify statistical associations in large datasets.

  3. What Type of Knowledge Provides Valid Housing Standards Addressing Accessibility?

    DEFF Research Database (Denmark)

    Helle, Tina; Brandt, Åse; Iwarsson, Susanne

    Objective The overarching aim was to contribute to the advancement of the validity of the housing standards addressing accessibility. The specific aim was to explore the use of an activity-based approach to examine the validity of a set of housing standards. State of the art Housing standards...... with functional limitations and dependence on mobility devices to have access to housing design features as a means to be able to interact with the environment to perform a range of everyday activities in the dwelling. However, in a comprehensive literature review in search of scientific publications...... with a potential to inform housing standards addressing accessibility that accommodate adult people with physical functional limitations using/not using mobility devices (Helle et al., 2011), it was found that the existing knowledge: • Derived from the field of anthropometry and ergonomics • Focused on isolated...

  4. 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

  5. 48 CFR 552.238-70 - Identification of Electronic Office Equipment Providing Accessibility for the Handicapped.

    Science.gov (United States)

    2010-10-01

    ... Electronic Office Equipment Providing Accessibility for the Handicapped. 552.238-70 Section 552.238-70... Equipment Providing Accessibility for the Handicapped. As prescribed in 538.273(a)(1), insert the following clause: Identification of Electronic Office Equipment Providing Accessibility for the Handicapped (SEP...

  6. Increasing Access to Health Care Providers with Nurse Practitioner Competencies

    Science.gov (United States)

    Grace, Del Marjorie

    2014-01-01

    Emergency department visits increased from 102.8 million to 136.1 million in 2009, resulting in crowding and increased wait times, affecting U.S. hospitals' ability to provide safe, timely patient care resulting in dangerous delays and serious health problems shown by research. The purpose of this project was to determine if competencies developed…

  7. Towards a Fair and Equitable ABS Regime: Is Nagoya Leading us in the Right Direction?

    Directory of Open Access Journals (Sweden)

    Bram De Jonge

    2013-09-01

    Full Text Available A historical overview of the concept of Access and Benefit Sharing (ABS suggests that ABS is all about compensation, i.e. a benefit sharing mechanism that provides one with compensation for allowing access to one’s resources. The principles of entitlement (based on sovereign rights and desert (based on contributions may then guide a fair and equitable sharing of the resources in question. Yet, the principles of need and equity appear equally important, as it is exactly because of the inequalities and neediness in the world that the demand for benefit sharing as a compensation mechanism has evolved. Unfortunately, we have to conclude that, for several reasons, the current bilateral exchange model of the Convention on Biological Diversity (CBD can never be fair and equitable. While the Multilateral System of the International Treaty on Plant Genetic Resources for Food and Agriculture (ITPGR bypasses some of the main problems that frustrate fair and equitable benefit sharing under the CBD, it is currently being criticised for its weak benefit-sharing component. This article therefore proposes an alternative ABS regime based on the utilisation of resources instead of their exchange. One of the main advantages of such a model – apart from the fact that it does not depend on controlling the movement of plant genetic resources – is that it emphasises the responsibilities for benefit sharing on the user side. This article analyses whether the Nagoya Protocol is leading us in the right direction and, with the aforementioned principles of justice in mind, makes recommendations on how to realise a fair and equitable ABS regime.

  8. Equitable provision of social facilities for a range of settlements: guidelines and tools for integrated provision

    CSIR Research Space (South Africa)

    Green, Cheri A

    2013-09-01

    Full Text Available looks at equitable provision of social facilities for a range of settlements and offers guidelines and tools for integrated provision that incorporates the 1) development of fully provisioned quality living environments, 2) improvement of access...

  9. 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…

  10. Spectral partitioning in equitable graphs

    Science.gov (United States)

    Barucca, Paolo

    2017-06-01

    Graph partitioning problems emerge in a wide variety of complex systems, ranging from biology to finance, but can be rigorously analyzed and solved only for a few graph ensembles. Here, an ensemble of equitable graphs, i.e., random graphs with a block-regular structure, is studied, for which analytical results can be obtained. In particular, the spectral density of this ensemble is computed exactly for a modular and bipartite structure. Kesten-McKay's law for random regular graphs is found analytically to apply also for modular and bipartite structures when blocks are homogeneous. An exact solution to graph partitioning for two equal-sized communities is proposed and verified numerically, and a conjecture on the absence of an efficient recovery detectability transition in equitable graphs is suggested. A final discussion summarizes results and outlines their relevance for the solution of graph partitioning problems in other graph ensembles, in particular for the study of detectability thresholds and resolution limits in stochastic block models.

  11. 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

  12. On equitable coloring of corona of wheels

    Directory of Open Access Journals (Sweden)

    J. Vernold Vivin

    2016-10-01

    Full Text Available The notion of equitable colorability was introduced by Meyer in $1973$ \\cite{meyer}. In this paper we obtain interesting results regarding the equitable chromatic number $\\chi_{=}$ for the corona graph of a simple graph with a wheel graph $G\\circ W_n$. Some extensions into $l$-corona products are also determined.

  13. 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.

  14. The advent of equitation science.

    Science.gov (United States)

    McGreevy, Paul D

    2007-11-01

    The lengthy association of humans with horses has established traditional equestrian techniques that have served military and transport needs well. Although effective, these techniques have by-passed the research findings of modern psychologists, who developed the fundamentals of learning theory. That said, the pools of equestrian debate are far from stagnant. The latest wave of horse whisperers has offered some refinements and some novel interpretations of the motivation of horses undergoing training. Additionally, the Fédération Equestre Internationale (FEI) has introduced the concept of the 'happy equine athlete' and, in the light of the hyperflexion (Rollkür) debate, recently examined the possible effects of some novel dressage modalities on equine 'happiness'. However, many still question the welfare of the ridden horse since it is largely trained using negative reinforcement, has to respond to pressure-based signals and is seldom asked to work for positive rewards. Science holds tremendous promise for removing emotiveness from the horse-riding welfare debate by establishing how much rein tension is too much; how much contact is neutral; how contact can be measured; how discomfort can be measured; how pain can be measured; and how learned helplessness manifests in horses. These are some of the topics addressed by equitation science, an emerging discipline that combines learning theory, physics and ethology to examine the salience and efficacy of horse-training techniques.

  15. Spatial Access to Primary Care Providers in Appalachia: Evaluating Current Methodology.

    Science.gov (United States)

    Donohoe, Joseph; Marshall, Vince; Tan, Xi; Camacho, Fabian T; Anderson, Roger T; Balkrishnan, Rajesh

    2016-07-01

    The goal of this research was to examine spatial access to primary care physicians in Appalachia using both traditional access measures and the 2-step floating catchment area (2SFCA) method. Spatial access to care was compared between urban and rural regions of Appalachia. The study region included Appalachia counties of Pennsylvania, Ohio, Kentucky, and North Carolina. Primary care physicians during 2008 and total census block group populations were geocoded into GIS software. Ratios of county physicians to population, driving time to nearest primary care physician, and various 2SFCA approaches were compared. Urban areas of the study region had shorter travel times to their closest primary care physician. Provider to population ratios produced results that varied widely from one county to another because of strict geographic boundaries. The 2SFCA method produced varied results depending on the distance decay weight and variable catchment size techniques chose. 2SFCA scores showed greater access to care in urban areas of Pennsylvania, Ohio, and North Carolina. The different parameters of the 2SFCA method-distance decay weights and variable catchment sizes-have a large impact on the resulting spatial access to primary care scores. The findings of this study suggest that using a relative 2SFCA approach, the spatial access ratio method, when detailed patient travel data are unavailable. The 2SFCA method shows promise for measuring access to care in Appalachia, but more research on patient travel preferences is needed to inform implementation. © The Author(s) 2016.

  16. 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.

  17. 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.

  18. Providing Access to Unique Information Sources: A Reusable Platform for Publishing Bibliographic Databases on the Web.

    Science.gov (United States)

    Jantz, Ronald C.

    2000-01-01

    Discussion of digital library projects at Rutgers University focuses on publishing bibliographic databases on the Web to provide access to information sources not likely to be published elsewhere. Describes the reusable technology platform concept, bibliographic platform architecture, metadata approach, data entry, and managing the process.…

  19. Another Look at "SourceOECD": Providing Access to Online Publications through the Library Catalog

    Science.gov (United States)

    Ragains, Patrick

    2004-01-01

    "SourceOECD," the online/print subscription service of the Organisation for Economic Co-operation and Development, is examined. Solutions for providing access in library online catalogs are described, as are recent technical improvements to the online subscription service.

  20. Beyond the Repository: A Mixed Method Approach to Providing Access to Collections Online

    Science.gov (United States)

    Garrison, Brian Wade

    2013-01-01

    After providing access to over 100 video interviews conducted by a professor with notable entertainers and personalities from film through an institutional repository, an experiment was conducted to discover whether a larger audience could be gained by adding a subset of 32 of these videos to YouTube. The results, over 400,000 views, indicate that…

  1. The Changing Role of Community Networks in Providing Citizen Access to the Internet.

    Science.gov (United States)

    Keenan, Thomas P.; Trotter, David Mitchell

    1999-01-01

    Examines the changing role of community network associations or freenets in providing Internet access by examining the case of the Calgary Community Network Association (CCNA) in Alberta, Canada. Discusses the withdrawal of states from the telecommunications field, priorities of the Canadian government, and the role of the private sector.…

  2. 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

  3. Equitable availability of social facilities

    CSIR Research Space (South Africa)

    Green, Cheri A

    2008-11-01

    Full Text Available The South African constitution affects every citizen's access to basic services and accordingly it has become a legislative requirement for local authorities to prepare integrated development plans (IDPs), develop performance management systems...

  4. FRAMES-2.0 Software System: Providing Password Protection and Limited Access to Models and Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Whelan, Gene; Pelton, Mitch A.

    2007-08-09

    One of the most important concerns for regulatory agencies is the concept of reproducibility (i.e., reproducibility means credibility) of an assessment. One aspect of reproducibility deals with tampering of the assessment. In other words, when multiple groups are engaged in an assessment, it is important to lock down the problem that is to be solved and/or to restrict the models that are to be used to solve the problem. The objective of this effort is to provide the U.S. Nuclear Regulatory Commission (NRC) with a means to limit user access to models and to provide a mechanism to constrain the conceptual site models (CSMs) when appropriate. The purpose is to provide the user (i.e., NRC) with the ability to “lock down” the CSM (i.e., picture containing linked icons), restrict access to certain models, or both.

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

    Directory of Open Access Journals (Sweden)

    Eliana Wulandari

    Full Text Available 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.

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

    Science.gov (United States)

    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. PMID:28877174

  7. 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.

  8. Equitable benefit-sharing or self-interest?

    Energy Technology Data Exchange (ETDEWEB)

    Swiderska, Krystyna

    2010-09-15

    A legally binding protocol on access to genetic resources and benefit-sharing is to be adopted by the 193 governments that are party to the Convention on Biological Diversity in October 2010 in Nagoya, Japan. The protocol aims to ensure that the benefits derived from the use of genetic resources are shared fairly and equitably with biodiversity-rich but financially poor countries. This could help reverse the rapid loss of biodiversity and genetic resources. But unless governments make some major progress in their final negotiating session, the protocol will make little difference.

  9. 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

    2014-06-01

    Full Text Available Background: The ‘EquitAble’ project carried out content analyses of policies and collected and analysed qualitative and quantitative data concerning access to health services in Sudan, Malawi, Namibia and South Africa. Our particular concern was to address the situation of people with disabilities, although not in isolation from other marginalised or vulnerable groups.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.

  10. Subcutaneous placement of lap band port without fascial fixation provides safe and durable access.

    Science.gov (United States)

    Akkary, Ehab; Olgers, Forrest

    2014-11-01

    Laparoscopic adjustable gastric band access port has been routinely sutured to the anterior fascia of the abdominal wall using nonabsorbable sutures. We present our technique demonstrating that nonfascial fixation with using a mesh allows for a safe and durable placement of the port in the superficial subcutaneous tissue. Retrospective chart review included 102 consecutive patients who had Lap band surgery performed by single surgeon (EA) from June 2011 until April 2013. The port was sutured to a piece of polypropylene mesh and tunneled in the subcutaneous tissue away from the incision. Patients' demographics were analyzed as well as the following parameters: OR time for port placement, follow-up, port complications requiring revision, difficult access facilitated by fluoroscopy imaging, port infection, and skin erosion. The study included 102 consecutive patients (23 males and 79 females), mean age was 49 years old, mean weight was 284.7 lb, mean height was 66.2 in., and mean body mass index (BMI) was 46.3 kg/m(2). The average operative time for port placement was 4 min, mean follow-up was 12 months, port complications occurred in 2 % of the patients while fluoroscopy for difficult port access was required in 3 %. No cases of port infections or skin erosions occurred. Superficial subcutaneous placement of Lap Band Port using mesh fixation without anchoring the port to the fascia provides safe and durable access. Deep incisions to secure the port directly to the fascia might not be necessary.

  11. Contraceptive service provider imposed restrictions to contraceptive access in Urban Nigeria.

    Science.gov (United States)

    Schwandt, Hilary M; Speizer, Ilene S; Corroon, Meghan

    2017-04-17

    Health service providers can restrict access to contraceptives through their own imposed biases about method appropriateness. In this study, provider biases toward contraceptive service provision among urban Nigerian providers was assessed. Health providers working in health facilities, as well as pharmacists and patent medical vendors (PMV), in Abuja, Benin City, Ibadan, Ilorin, Kaduna, and Zaria, were surveyed in 2011 concerning their self-reported biases in service provision based on age, parity, and marital status. Minimum age bias was the most common bias while minimum parity was the least common bias reported by providers. Condoms were consistently provided with the least amount of bias, followed by provision of emergency contraception (EC), pills, injectables, and IUDs. Experience of in-service training for health facility providers was associated with decreased prevalence of marital status bias for the pill, injectable, and IUD; however, training experience did not, or had the opposite effect on, pharmacists and PMV operator's reports of service provision bias. Provider imposed eligibility barriers in urban study sites in Nigeria were pervasive - the most prevalent restriction across method and provider type was minimum age. Given the large and growing adolescent population - interventions aimed at increasing supportive provision of contraceptives to youth in this context are urgently needed. The results show that the effect of in-service training on provider biases was limited. Future efforts to address provider biases in contraceptive service provision, among all provider types, must find creative ways to address this critical barrier to increased contraceptive use.

  12. Online Professional Development for Child Care Providers: Do They Have Appropriate Access to and Comfort with the Internet?

    Directory of Open Access Journals (Sweden)

    Lindsay E. Wright

    2014-10-01

    Full Text Available With the expansion of online trainings today, Extension professionals have an opportunity to reach child care providers in more convenient ways. However, having convenient, reliable Internet access can be a barrier to online training for some child care providers, especially those with limited financial resources. This study investigated child care providers’ ability to access online training through convenient, reliable Internet access by asking 494 child care providers in Georgia about their access to and comfort with the Internet. Participants completed a brief 12-question survey that included questions about their Internet access and use for both personal and professional purposes (i.e., whether or not they have Internet access, where they have access, how often they use it, and how comfortable they feel using it. The majority of child care providers reported having Internet access (89.68% and feeling comfortable using the Internet (68.62%, and therefore, have the technological resources to participate in online professional development.

  13. Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers

    Directory of Open Access Journals (Sweden)

    Riggs Elisha

    2012-05-01

    Full Text Available Abstract Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years. Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making

  14. POPcorn: An Online Resource Providing Access to Distributed and Diverse Maize Project Data.

    Science.gov (United States)

    Cannon, Ethalinda K S; Birkett, Scott M; Braun, Bremen L; Kodavali, Sateesh; Jennewein, Douglas M; Yilmaz, Alper; Antonescu, Valentin; Antonescu, Corina; Harper, Lisa C; Gardiner, Jack M; Schaeffer, Mary L; Campbell, Darwin A; Andorf, Carson M; Andorf, Destri; Lisch, Damon; Koch, Karen E; McCarty, Donald R; Quackenbush, John; Grotewold, Erich; Lushbough, Carol M; Sen, Taner Z; Lawrence, Carolyn J

    2011-01-01

    The purpose of the online resource presented here, POPcorn (Project Portal for corn), is to enhance accessibility of maize genetic and genomic resources for plant biologists. Currently, many online locations are difficult to find, some are best searched independently, and individual project websites often degrade over time-sometimes disappearing entirely. The POPcorn site makes available (1) a centralized, web-accessible resource to search and browse descriptions of ongoing maize genomics projects, (2) a single, stand-alone tool that uses web Services and minimal data warehousing to search for sequence matches in online resources of diverse offsite projects, and (3) a set of tools that enables researchers to migrate their data to the long-term model organism database for maize genetic and genomic information: MaizeGDB. Examples demonstrating POPcorn's utility are provided herein.

  15. Equitable research: a bridge too far?

    Science.gov (United States)

    Walls, Leon

    2017-06-01

    This paper is written in response to Angela Chapman and Allan Feldman's research study, "Cultivation of science identity through authentic science in an urban high school". I utilize this forum piece to extend the call for "awakening a dialogue" that critically assesses the effectiveness of current K-12 science education research in addressing the needs of populations of color. I take the opportunity to first discuss elements of what an equitable research focus might look like. I finish by critiquing and ultimately commending the authors on the degree to which they succeed in demonstrating an equitable approach to the design and carrying out of their study.

  16. towards an equitable development of telecommunications services ...

    African Journals Online (AJOL)

    ES Obe

    1980-03-01

    Mar 1, 1980 ... Department of Electrical & Electronic Engineering. University of Nigeria, Nsukka, Nigeria. (Original manuscript received August 8, 1979 and in revised from March 20, 1980). ABSTRACT. Present and future equitable development of telecommunications services calls for an immediate development of an ...

  17. 7 CFR 760.106 - Equitable relief.

    Science.gov (United States)

    2010-01-01

    ... accordance with the FCIA (7 U.S.C. 1501-1524) or (ii) Application closing date for NAP. (b) Equitable relief will not be granted to participants in instances of: (1) A scheme or device that had the effect or intent of defeating the purposes of a program of insurance, NAP, or any other program administered under...

  18. 41 CFR 102-79.95 - Who is responsible for the costs associated with providing access to antenna sites?

    Science.gov (United States)

    2010-07-01

    ... providing access to antenna sites? The telecommunications service provider is responsible for any reasonable... support of constructing new and improving existing telecommunication infrastructures provided that such installation does not negatively impact on the Government. ...

  19. The IRIS Data Management Center: Providing Efficient Access to GSN data

    Science.gov (United States)

    Ahern, T. K.; Benson, R. B.

    2004-05-01

    The IRIS Data Management Center (DMC) in Seattle, Washington is the host of the largest seismological database of its kind in the world. The Global Seismic Network (GSN) lies at the center of the DMC holdings. The DMC relies heavily upon a petabyte mass storage system for waveform storage and Oracle for its relational data base infrastructure. During the past several years, emphasis has been placed upon the development and implementation of robust and effective technologies that allow access to the information at the IRIS DMC in a variety of ways. This talk will highlight the general structure of the IRIS DMC and the method we use to manage the gigabytes of information in Oracle as well more than 100 terabytes of time series data we have in our mass storage systems. An overview will be given of the methods through which users can access the information in our relational database systems as well as the mass storage systems in order to conduct their research using GSN and other data. A discussion of three distinctly different approaches will be presented. These include an email-based method, a web-based method as well as a multi-tier distributed computing environment we call the Data Handling Interface (DHI). The DHI is based upon Common Object Request Broker Architecture (CORBA) and provides direct connections between client applications, normally provided by IRIS, and data center servers established at several data centers within the United States. The DHI presently supports the distribution of information about seismic events, information about the seismic stations that record the time series and finally the time series (seismograms) themselves. The system is capable of transmitting seismic waveform data in real time. Waveform data and all associated metadata are available through this interface allowing direct access to information at the DMC within client applications running on a users workstation.

  20. A modified transmission tip-enhanced Raman scattering (TERS) setup provides access to opaque samples.

    Science.gov (United States)

    Deckert-Gaudig, Tanja; Richter, Marc; Knebel, Detlef; Jähnke, Torsten; Jankowski, Tilo; Stock, Erik; Deckert, Volker

    2014-01-01

    The combination of scanning probe microscopy and Raman spectroscopy enables chemical characterization of surfaces at highest spatial resolution. This so-called tip-enhanced Raman scattering (TERS) can be employed for a variety of samples where a label-free characterization or identification of constituents on the nanometer scale is pursued. Present TERS setup geometries are always a compromise for specific dedicated applications and show different advantages and disadvantages: Transmission back-reflection setups, when using immersion objectives with a high numerical aperture, intrinsically provide the highest collection efficiency but cannot be applied for opaque samples. Those samples demand upright setups, at the cost of lower collection efficiency, even though very efficient systems using a parabolic mirror for illumination and collection have been demonstrated. In this contribution it is demonstrated that the incorporation of a dichroic mirror to a transmission TERS setup provides easy access to opaque samples without further modification of the setup.

  1. [Dentistry and healthcare legislation 7. The duty to provide care: availability and accessibility].

    Science.gov (United States)

    Brands, W G; van der Ven, J M; Eijkman, M A J

    2013-12-01

    Dentists have a duty to provide care. This duty, which interestingly enough has a limited legal basis, is for the most part given form by jurisprudence. In that process, the disciplinary judge and the grievance committees pay attention especially to 2 rules of conduct and 1 regulation governing practice. In practice, it appears to be the case that rules of conduct and regulations do not always provide an unambiguous guide. The domain within which dentists operate is striking. The availability and the accessibility of dentists are not always harmonious with the personal perception of a patient. It is sometimes difficult to find a proper balance between what is a dentist is able to manage and what a patient wants.

  2. Equitable sampling of participants in biomedical research and clinical experiments

    Directory of Open Access Journals (Sweden)

    Klajn-Tatić Vesna

    2014-01-01

    Full Text Available There are several aspects of the requirement to provide for an equitable sampling of research participants. On the one hand, equitable sampling implies that the scientific research objectives shall be the cornerstone for determining the groups and individuals to be selected and included as research participants, rather than some other properties which are unrelated to research objectives (such as the subjects' vulnerability or privileges]. On the other hand, groups and individuals should not be denied the opportunity to participate in scientific research without a solid scientific justification. The concept of equitable sampling also implies that groups and individuals that have borne the risks and burden of research should enjoy some benefit from the research. The unjustified and excessive inclusion of certain groups as research participants is equally unfair and inequitable as their unjustified and excessive exclusion from research. In many cases, the excessive inclusion of some groups is often based on the administrative availability of population rather than on the scientific rationale, which is considered unacceptable. In the British and American law, the sampling of research participants has to be a reflection of the multi-cultural society, which implies taking into account the participants' ethnicity, gender, disability, age and sexual orientation in the process of planning, executing and implementing the research plan. However, literature shows that the exclusion of some groups from participation in the research is not the most important issue in sampling but whether it concurrently implies the exclusion from the benefits stemming from the research results, which would be unfair. In addressing these issues, the literature differentiates between equitable sampling in terms of benefits from a quantitative research and equitable sampling in terms of benefits from a qualitative research. Generally, sampling in the quantitative research is

  3. Access to highly active antiretroviral therapy (HAART) for injecting drug users in the WHO European Region 2002-2004

    DEFF Research Database (Denmark)

    Donoghoe, Martin C; Bollerup, Annemarie R; Lazarus, Jeff

    2007-01-01

    Providing equitable access to highly active antiretroviral treatment (HAART) to injecting drug users (IDUs) is both feasible and desirable. Given the evidence that IDUs can adhere to HAART as well as non-IDUs and the imperative to provide universal and equitable access to HIV/AIDS treatment for all...... the injecting status of those initiating HAART and the use of opioid substitution therapy among HAART patients, and discuss how HAART might be better delivered to injecting drug users. Our data adds to the evidence that IDUs in Europe have poor and inequitable access to HAART, with only a relatively small...

  4. 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.

  5. 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.

  6. 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

  7. Primary Health Care Providers' Perspectives: Facilitating Older Patients' Access to Community Support Services.

    Science.gov (United States)

    Ploeg, Jenny; Denton, Margaret; Hutchison, Brian; McAiney, Carrie; Moore, Ainsley; Brazil, Kevin; Tindale, Joseph; Wu, Amina; Lam, Annie

    2016-12-01

    The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs. Participants collaborated extensively with interprofessional colleagues within and outside their organizations to find relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to find that they relied on out-of-date resources and inefficient search strategies to find CSSs. Our findings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs.

  8. Implementation the NASA Planetary Data System PDS4 Providing Access to LADEE Data

    Science.gov (United States)

    Beebe, Reta F.; Huber , Lyle; Neakrase, Lynn; Reese, Shannon; Crichton, Daniel; Hardman, Sean; Delory, Gregory; Neese, Carol

    2014-11-01

    The NASA Planetary Data System (PDS) is responsible for archiving all planetary data acquired by robotic missions, and observational campaigns with ground/space-based observatories. PDS has moved to version 4 of its archive system. PDS4 uses XML to enhance search and retrieval capabilities. Although the efforts are system wide, the Atmospheres Node has acted as the lead node and is presenting a preliminary users interface for retrieval of LADEE data. LADEE provides the first opportunity to test out the end-to-end process of archiving data from an active mission into the new PDS4 architecture. The limited number of instruments, with simple data structures, is an ideal test of PDS4. XML uses schema (analogous to blueprints) to control the structure of the corresponding XML labels. In the case of PDS4, these schemas allow management of the labels and their content by forcing validation dictated by the underlying Information Model (IM). The use of a central IM is a vast improvement over PDS3 because of the uniformity it provides across all nodes. PDS4 has implemented a product-centric approach for archiving data and supplemental documentation. Another major change involves the Central Registry, where all products are registered and accessible to search engines. Under PDS4, documents, data, and other ancillary data are all products that are registered in the system. Together with the XML implementation, the Registry allows the search routines to be more complex and inclusive than they have been in the past. For LADEE, the PDS nodes and LADEE instrument teams worked together to identify data products that LADEE would produce. Documentation describing instruments and data products were produced by the teams and peer reviewed by PDS. XML label templates were developed by the PDS and provided to the instrument teams to integrate into their pipelines. Data from the primary mission (100 days) have been certified and harvested into the registry and are accessible through the

  9. E-health: potential benefits and challenges in providing and accessing sexual health services.

    Science.gov (United States)

    Minichiello, Victor; Rahman, Saifur; Dune, Tinashe; Scott, John; Dowsett, Gary

    2013-08-30

    E-health has become a burgeoning field in which health professionals and health consumers create and seek information. E-health refers to internet-based health care and information delivery and seeks to improve health service locally, regionally and worldwide. E-sexual health presents new opportunities to provide online sexual health services irrespective of gender, age, sexual orientation and location. The paper used the dimensions of the RE-AIM model (reach, efficacy, adoption, implementation and maintenance) as a guiding principle to discuss potentials of E-health in providing and accessing sexual health services. There are important issues in relation to utilising and providing online sexual health services. For healthcare providers, e-health can act as an opportunity to enhance their clients' sexual health care by facilitating communication with full privacy and confidentiality, reducing administrative costs and improving efficiency and flexibility as well as market sexual health services and products. Sexual health is one of the common health topics which both younger and older people explore on the internet and they increasingly prefer sexual health education to be interactive, non-discriminate and anonymous. This commentary presents and discusses the benefits of e-sexual health and provides recommendations towards addressing some of the emerging challenges. The provision of sexual health services can be enhanced through E-health technology. Doing this can empower consumers to engage with information technology to enhance their sexual health knowledge and quality of life and address some of the stigma associated with diversity in sexualities and sexual health experiences. In addition, e-sexual health may better support and enhance the relationship between consumers and their health care providers across different locations. However, a systematic and focused approach to research and the application of findings in policy and practice is required to ensure that

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. CHORUS – providing a scalable solution for public access to scholarly research

    Directory of Open Access Journals (Sweden)

    Howard Ratner

    2014-03-01

    Full Text Available CHORUS (Clearinghouse for the Open Research of the United States offers an open technology platform in response to the public access requirements of US federal funding agencies, researchers, institutions and the public. It is focused on five principal sets of functions: 'identification', 'preservation', 'discovery', 'access', and 'compliance' . CHORUS facilitates public access to peer-reviewed publications, after a determined embargo period (where applicable, for each discipline and agency. By leveraging existing tools such as CrossRef, FundRef and ORCID, CHORUS allows a greater proportion of funding to remain focused on research. CHORUS identifies articles that report on federally funded research and enables a reader to access the ‘best available version’ free of charge, via the publisher. It is a scalable solution that offers maximum efficiency for all parties by automating as much of the process as is possible. CHORUS launched in pilot phase in September 2013, and the production phase will begin in early 2014.

  15. Impact of the 'Providing Access to Continued Education' Programme on Repeat Teenage Pregnancy in the Bahamas.

    Science.gov (United States)

    Sakharkar, V P; Frankson, M A; Sakharkar, P R

    2015-05-15

    To determine the relationship of determinants such as age, ethnicity, education and sexual behaviour with repeat teenage pregnancy and to determine the impact of 'Providing Access to Continued Education' (PACE) programme in reducing repeat teenage pregnancy amongst its participants in The Bahamas. This retrospective cohort study included 397 attendees of the Adolescent Health Centre (AHC). Eighty-eight out of 139 registered participants completed the PACE programme. Data on age, ethnicity, education, sexual behaviour and repeat pregnancy in two years were analysed for descriptive statistics, and association of demographic characteristics and participation in the PACE programme with repeat pregnancy using the Chi-squared test. Mean age of participants was 16.4 ± 1.1 years; median school grade and mean grade point average (GPA) was 11 and 1.97 ± 0.7, respectively. The mean age at the first sexual activity was 14.9 ± 1.2 years. The mean age and number of sexual partners were 21 ± 4.3 years and 2 ± 1, respectively. Overall, repeat pregnancy rate was 39%: 37.4% amongst PACE registered and 31.8% amongst PACE completed mothers. No significant difference was observed in repeat pregnancy between registered and non-registered as well as those who completed the programme and those who did not. The odds ratio of 0.525 suggested that completion of the PACE programme had a moderate protective effect on reducing repeat pregnancy. Age, ethnicity, education and sexual behaviour showed no association with repeat pregnancy. The PACE programme did not reduce repeat pregnancy rate significantly. However, completion of the programme offered a moderate protection.

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

    Science.gov (United States)

    Doetter, Lorraine Frisina; Schmid, Achim

    2018-02-14

    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.

  17. 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.

  18. 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…

  19. Economic Insights into Providing Access to Improved Groundwater Sources in Remote, Low-Resource Areas

    Science.gov (United States)

    Abramson, A.; Lazarovitch, N.; Adar, E.

    2013-12-01

    Groundwater is often the most or only feasible drinking water source in remote, low-resource areas. Yet the economics of its development have not been systematically outlined. We applied CBARWI (Cost-Benefit Analysis for Remote Water Improvements), a recently developed Decision Support System, to investigate the economic, physical and management factors related to the costs and benefits of non-networked groundwater supply in remote areas. Synthetic profiles of community water services (n = 17,962), defined across 14 parameters' values and ranges relevant to remote areas, were imputed into the decision framework, and the parameter effects on economic outcomes were investigated through regression analysis (Table 1). Several approaches were included for financing the improvements, after Abramson et al, 2011: willingness-to -pay (WTP), -borrow (WTB) and -work (WTW) in community irrigation (';water-for-work'). We found that low-cost groundwater development approaches are almost 7 times more cost-effective than conventional boreholes fitted with handpumps. The costs of electric, submersible borehole pumps are comparable only when providing expanded water supplies, and off-grid communities pay significantly more for such expansions. In our model, new source construction is less cost-effective than improvement of existing wells, but necessary for expanding access to isolated households. The financing approach significantly impacts the feasibility of demand-driven cost recovery; in our investigation, benefit exceeds cost in 16, 32 and 48% of water service configurations financed by WTP, WTB and WTW, respectively. Regressions of total cost (R2 = 0.723) and net benefit under WTW (R2 = 0.829) along with analysis of output distributions indicate that parameters determining the profitability of irrigation are different from those determining costs and other measures of net benefit. These findings suggest that the cost-benefit outcomes associated with groundwater-based water

  20. 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.

  1. 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…

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

    African Journals Online (AJOL)

    Sixty-two percent (65/105) of all respondents had completed their mandatory rotation in surgery. ... The primary barriers for JDs to attending ATLS training is difficulty in accessing the course due to oversubscription, financial reasons, followed by difficulty in obtaining professional development leave due to staff shortage.

  3. Challenges in Providing End-of-Life Care for People with Intellectual Disability: Health Services Access

    Science.gov (United States)

    Wark, Stuart; Hussain, Rafat; Müller, Arne; Ryan, Peta; Parmenter, Trevor

    2017-01-01

    Background: Increasing life expectancy for people with intellectual disability is resulting in greater need for end-of-life care services. However, limited knowledge is available regarding what barriers to accessing end-of-life care support are evident, particularly comparatively across rural and metropolitan locations. Methods: Focus group…

  4. It's the Law! A Review of the Laws that Provide Americans with Access for All

    Science.gov (United States)

    Raimondo, Barbara

    2013-01-01

    The United States is more accessible to deaf and hard of hearing individuals and people with disabilities today than it was 50, 20, or even 10 years ago. A variety of laws ensures equality in the treatment of deaf and hard of hearing people. Communication barriers have been addressed, and wider opportunities are available in education, employment,…

  5. New advanced technologies to provide decentralised and secure access to medical records: case studies in oncology.

    Science.gov (United States)

    Quantin, Catherine; Coatrieux, Gouenou; Allaert, François André; Fassa, Maniane; Bourquard, Karima; Boire, Jean-Yves; de Vlieger, Paul; Maigne, Lydia; Breton, Vincent

    2009-08-07

    The main problem for health professionals and patients in accessing information is that this information is very often distributed over many medical records and locations. This problem is particularly acute in cancerology because patients may be treated for many years and undergo a variety of examinations. Recent advances in technology make it feasible to gain access to medical records anywhere and anytime, allowing the physician or the patient to gather information from an "ephemeral electronic patient record". However, this easy access to data is accompanied by the requirement for improved security (confidentiality, traceability, integrity, ...) and this issue needs to be addressed. In this paper we propose and discuss a decentralised approach based on recent advances in information sharing and protection: Grid technologies and watermarking methodologies. The potential impact of these technologies for oncology is illustrated by the examples of two experimental cases: a cancer surveillance network and a radiotherapy treatment plan. It is expected that the proposed approach will constitute the basis of a future secure "google-like" access to medical records.

  6. Migrant beer promoters' experiences accessing reproductive health care in Cambodia, Laos, Thailand, and Vietnam: lessons for planners and providers.

    Science.gov (United States)

    Webber, Gail C; Spitzer, Denise L; Somrongthong, Ratana; Dat, Truong Cong; Kounnavongsa, Somphone

    2015-03-01

    Migrant beer promoters in Cambodia, Laos, Thailand, and Vietnam were surveyed to determine their experiences in accessing reproductive health care services in the cities of Phnom Penh, Vientiane, Bangkok, and Hanoi. A total of 7 health care institutions were chosen as popular with migrant beer promoters. Staff at these institutions provided information on the institution, and 390 beer promoters were surveyed about their experiences while accessing services. There were discrepancies between findings from the staff interviews and the experiences of the beer promoters. In general, the migrant women were satisfied with the cost, location, friendliness of the health care providers, and knowledge and skills of the providers. They were less positive about confidentiality and waiting times, though many still agreed that these were not an issue. Health care planners and providers should take note of the issues affecting access to reproductive health care services for migrant women when they design and implement services. © 2012 APJPH.

  7. Comparison of adherence to chlamydia screening guidelines among Title X providers and non-Title X providers in the California Family Planning, Access, Care, and Treatment Program.

    Science.gov (United States)

    Chow, Joan M; de Bocanegra, Heike Thiel; Hulett, Denis; Park, Hye-Youn; Darney, Philip

    2012-08-01

    Annual chlamydia screening is recommended for adolescent and young adult females and targeted screening is recommended for women ≥26 years based on risk. Although screening levels have increased over time, adherence to these guidelines varies, with high levels of adherence among Title X family planning providers. However, previous studies of provider variation in screening rates have not adjusted for differences in clinic and client population characteristics. Administrative claims from the California Family Planning, Access, Care, and Treatment (Family PACT) program were used to (1) examine clinic and client sociodemographic characteristics by provider group-Title X-funded public sector, non-Title X public sector, and private sector providers, and (2) estimate age-specific screening and differences in rates by provider group during 2009. Among 833 providers, Title X providers were more likely than non-Title X public sector providers and private sector providers to serve a higher client volume, a higher proportion of clients aged ≤25 years, and a higher proportion of African American clients. Non-Title X public providers were more likely to be located in rural areas, compared with Title X grantees and private sector providers. Title X providers had the largest absolute difference in screening rates for young females vs. older females (10.9%). Unadjusted screening rates for young clients were lower among non-Title X public sector providers (54%) compared with private sector and Title X providers (64% each). After controlling for provider group, urban location, client volume, and percent African American, private sector providers had higher screening rates than Title X and non-Title X public providers. Screening rates for females were higher among private providers compared with Title X and non-Title X public providers. However, only Title X providers were more likely to adhere to screening guidelines through high screening rates for young females and low

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

    OpenAIRE

    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 Champ...

  9. 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.

  10. Laws requiring health plans to provide direct access to obstetricians and gynecologists, and use of cancer screening by women.

    Science.gov (United States)

    Baker, Laurence C; Chan, Jia

    2007-06-01

    Many states have passed legislation mandating that health plans provide direct access to obstetricians/gynecologists (hereinafter "ob/gyns") for women, limiting the ability of plans to require referrals or otherwise restrict access. One benefit of these laws may be improved preventive screening rates, but no literature has examined the relationship between ob/gyn direct access laws and use of breast cancer and cervical cancer screening. We use repeated cross-sections of privately insured women age 18-64 (Pap test) and 40-64 (mammography) from the Behavioral Risk Factor Surveillance System for 1996-2000, linked to data on the presence of ob/gyn direct access laws by state. Outcome measures are receipt of mammography and receipt of a Pap test within the past 2 years. Regression analyses are used to assess the relationship between the presence of ob/gyn direct access laws and screening, adjusting for a range of individual characteristics, fixed state characteristics, and time trends. We find no statistically significant relationships between the presence of an ob/gyn direct access law and receipt of either mammography or Pap test screening. We explore a range of alternate specifications and find none that yield clear evidence of a relationship. Laws requiring direct access to ob/gyns are not associated with large or consistent measurable impacts on use of cancer screening.

  11. An Evaluation of the Quality of Nursing Care Provided for Vascular Access in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Hamid Reza Chamanzari

    2015-10-01

    Full Text Available Introduction: Care for vascular access of patients undergoing hemodialysis is a critical issue. Inflammation and subsequent infection are the major factors which threaten patients' health and diminish effectiveness of hemodialysis. Therefore, this study aimed to evaluate the severity and incidence of inflammation of vascular access in hemodialysis patients. Materials and Methods: This cross-sectional study was conducted on 90 patients undergoing hemodialysis in Emam Reza and Montazerie Hospitals in Mashhad, June, 2014. Evaluation of inflammation severity over the course of one month (12 hemodialysis sessions was performed by means of an inflammation tool designed by the Board of Nursing. Data were analyzed using SPSS version 16, and performing descriptive and Chi-square tests.  Results:The mean and standard deviation of incidence of inflammation in the first session of hemodialysis was 3.2±1.3 cases. The mean and standard deviation of the intensity of inflammation was 12.5±4.7. Conclusion: Since inflammation of vascular access in hemodialysis patients impairs their safety and health improvement, necessary measures to reduce this complication must be taken.

  12. Giving rheumatology patients online home access to their electronic medical record (EMR): advantages, drawbacks and preconditions according to care providers.

    Science.gov (United States)

    van der Vaart, Rosalie; Drossaert, Constance H C; Taal, Erik; van de Laar, Mart A F J

    2013-09-01

    Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted. First, interviews were performed with nurses/nurse practitioners (n = 9) and rheumatologists (n = 13). Subsequently, collected responses were quantified, using a questionnaire among the interviewees. The following advantages of patient home access to the EMR were reported: (1) enhancement of patient participation in treatment, (2) increased knowledge and self-management, (3) improved patient-provider interaction, (4) increased patient safety, and (5) better communication with others. Foreseen disadvantages of the service included: (1) problems with interpretation of data, (2) extra workload, (3) a change in consultation content, and (4) disturbing the patient-provider interaction. Also, the following preconditions emerged from the data: (1) optimal security, (2) no extra record, but a patient-accessible section, (3) no access to clinical notes, and (4) a lag time on the release of lab data. Most respondents reported that data on diagnosis, medication, treatment plan and consultations could be released to patients. On releasing more complex data, such as bodily examinations, lab results and radiological images the opinions differed considerably. Providing patients home access to their medical record might be a valuable next step into patient empowerment and in service towards the patient, provided that security is optimal and content and presentation of data are carefully considered.

  13. Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh.

    Science.gov (United States)

    Chowdhury, Mahbub E; Biswas, Taposh K; Rahman, Monjur; Pasha, Kamal; Hossain, Mollah A

    2017-08-01

    To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower. Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems. © 2017 International Federation of Gynecology and Obstetrics.

  14. 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.

  15. 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...

  16. Equitable Education for All: Using a Comprehensive Instructional Model to Improve Preschool Teacher Practices

    Science.gov (United States)

    Carlson, Abby G.; Curby, Timothy W.; Brown, Chavaughn A.; Trygstad, Kelly M.; Truong, Felicia R.

    2017-01-01

    The current study evaluates the effectiveness of a comprehensive instructional model, ("Every Child Ready"), as a vehicle to provide equitable education experiences for all children by compensating for gaps in teacher knowledge. The ECR instructional model addresses several challenges facing the early childhood landscape. Specifically,…

  17. Conversion of tunneled hemodialysis catheter into HeRO device can provide immediate access for hemodialysis.

    Science.gov (United States)

    Vasquez, Julio C; DeLaRosa, Jacob; Rahim, Fahim; Rahim, Naeem

    2010-11-01

    Patients with central venous occlusion who are ''tunneled catheter dependent'' are a challenge for hemodialysis access. A relatively new option for them is the hemodialysis reliable outflow (HeRO) device that can be totally implanted subcutaneously. However, patients still require a tunneled hemodialysis catheter that is used until the HeRO device is mature, 4 to 6 weeks later. Here, we describe a conversion of an existing tunneled hemodialysis catheter into a HeRO device, which was combined with a ''self-sealing'' Flixene graft. This allowed almost immediate use of the HeRO device without the need for placement of a catheter.

  18. 20 CFR 222.34 - Relationship resulting from equitable adoption.

    Science.gov (United States)

    2010-04-01

    ... adoption. 222.34 Section 222.34 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE... equitable adoption. In many States, where a legal adoption proceeding was defective under State law or where a contemplated legal adoption was not completed, a claimant may be considered to be an equitably...

  19. Assessing equitable care for Indigenous and Afrodescendant women in Latin America.

    Science.gov (United States)

    Castro, Arachu; Savage, Virginia; Kaufman, Hannah

    2015-08-01

    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. 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. 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. 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.

  20. Revisiting the picture-superiority effect in symbolic comparisons: do pictures provide privileged access?

    Science.gov (United States)

    Amrhein, Paul C; McDaniel, Mark A; Waddill, Paula

    2002-09-01

    In 4 experiments, symbolic comparisons were investigated to test semantic-memory retrieval accounts espousing processing advantages for picture over word stimuli. In Experiment 1, participants judged pairs of animal names or pictures by responding to questions probing concrete or abstract attributes (texture or size, ferocity or intelligence). Per pair, attributes were salient or nonsalient concerning their prerated relevance to animals being compared. Distance (near or far) between attribute magnitudes was also varied. Pictures did not significantly speed responding relative to words across all other variables. Advantages were found forfar attribute magnitudes (i.e., the distance effect) and salient attributes. The distance effect was much less for salient than nonsalient concrete-attribute comparisons. These results were consistently found in additional experiments with increased statistical power to detect modality effects. Our findings argue against dual-coding and some common-code accounts of conceptual attribute processing, urging reexamination of the assumption that pictures confer privileged access to long-term knowledge.

  1. Providers of Free MOOC's Now Charge Employers for Access to Student Data

    Science.gov (United States)

    Young, Jeffrey R.

    2012-01-01

    The author describes how providers of free online courses are officially in the headhunting business, bringing in revenue by selling to employers information about high-performing students who might be a good fit for open jobs. Coursera, which works with high-profile colleges to provide massive open online courses, or MOOC's, announced its…

  2. 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.

  3. Women's access and provider practices for the case management of malaria during pregnancy: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jenny Hill

    2014-08-01

    Full Text Available 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 case management policy for malaria in pregnant women. METHODS AND FINDINGS: We searched the Malaria in Pregnancy Library, the Global Health Database, and the International Network for the Rational Use of Drugs Bibliography from 1 January 2006 to 3 April 2014, without language restriction. Data were appraised for quality and content. Frequencies of women's and healthcare providers' practices were explored using narrative synthesis and random effect meta-analysis. Barriers to women's access and providers' adherence to policy were explored by content analysis using NVivo. Determinants of women's access and providers' case management practices were extracted and compared across studies. We did not perform a meta-ethnography. Thirty-seven studies were included, conducted in Africa (30, Asia (4, Yemen (1, and Brazil (2. One- to three-quarters of women reported malaria episodes during pregnancy, of whom treatment was sought by >85%. Barriers to access among women included poor knowledge of drug safety, prohibitive costs, and self-treatment practices, used by 5%-40% of women. Determinants of women's treatment-seeking behaviour were education and previous experience of miscarriage and antenatal care. Healthcare provider reliance on clinical diagnosis and poor adherence to treatment policy, especially in first versus other trimesters (28%, 95% CI 14%-47%, versus 72%, 95% CI 39%-91%, p = 0.02, was consistently reported. Prescribing practices were driven by concerns over side effects and drug safety, patient preference, drug availability, and cost. Determinants of provider practices were access to training and facility type (public versus private. Findings were

  4. Discordant indigenous and provider frames explain challenges in improving access to arthritis care: a qualitative study using constructivist grounded theory.

    Science.gov (United States)

    Thurston, Wilfreda E; Coupal, Stephanie; Jones, C Allyson; Crowshoe, Lynden F J; Marshall, Deborah A; Homik, Joanne; Barnabe, Cheryl

    2014-06-11

    Access to health services is a determinant of population health and is known to be reduced for a variety of specialist services for Indigenous populations in Canada. With arthritis being the most common chronic condition experienced by Indigenous populations and causing high levels of disability, it is critical to resolve access disparities through an understanding of barriers and facilitators to care. The objective of this study was to inform future health services reform by investigating health care access from the perspective of Aboriginal people with arthritis and health professionals. Using constructivist grounded theory methodology we investigated Indigenous peoples' experiences in accessing arthritis care through the reports of 16 patients and 15 healthcare providers in Alberta, Canada. Semi-structured interviews were conducted between July 2012 and February 2013 and transcribed verbatim. The patient and provider data were first analyzed separately by two team members then brought together to form a framework. The framework was refined through further analysis following the multidisciplinary research team's discussions. Once the framework was developed, reports on the patient and provider data were shared with each participant group independently and participants were interviewed to assess validity of the summary. In the resulting theoretical framework Indigenous participants framed their experience with arthritis as 'toughing it out' and spoke of racism encountered in the healthcare setting as a deterrent to pursuing care. Healthcare providers were frustrated by high disease severity and missed appointments, and framed Indigenous patients as lacking 'buy-in'. Constraints imposed by complex healthcare systems contributed to tensions between Indigenous peoples and providers. Low specialist care utilization rates among Indigenous people cannot be attributed to cultural and social preferences. Further, the assumptions made by providers lead to stereotyping and

  5. 48 CFR 1837.203-70 - Providing contractors access to sensitive information.

    Science.gov (United States)

    2010-10-01

    ... submit with its proposal a preliminary analysis of possible organizational conflicts of interest that... the NASA organizational element or activity that requires specified services to be provided. (3) As... organizational conflicts of interest avoidance plan. (d) This comprehensive plan shall incorporate any previous...

  6. Nectar accessibility determines fitness, flower choice and abundance of hoverflies that provide natural pest control

    NARCIS (Netherlands)

    van Rijn, P.C.J.; Wäckers, F.L.

    2016-01-01

    1. In modern agricultural landscapes, many organisms providing ecosystem services such as pollination and natural pest control are likely constrained by shortage of nectar and/or pollen required for adult nutrition. More and more flower-rich field margin strips and other habitats are created to

  7. Providing Interactive Access to Cave Geology for All Students, Regardless of Physical Ability

    Science.gov (United States)

    Atchison, C. `; Stredney, D.; Hittle, B.; Irving, K.; Toomey, R. S., III; Lemon, N. N.; Price, A.; Kerwin, T.

    2013-12-01

    Based on an identified need to accommodate students with mobility impairments in field-based instructional experiences, this presentation will discuss current efforts to promote participation, broaden diversity, and impart a historical perspective in the geosciences through the use of an interactive virtual environment. Developed through the integration of emerging simulation technologies, this prototypical virtual environment is created from LIDAR data of the Historic Tour route of Mammoth Cave National Park. The educational objectives of the simulation focus on four primary locations within the tour route that provide evidence of the hydrologic impact on the cave and karst formation. The overall objective is to provide a rich experience of a geological field-based learning for all students, regardless of their physical abilities. Employing a virtual environment that interchangeably uses two and three-dimensional representation of geoscience content, this synthetic field-based cave and karst module will provide an opportunity to assess the effectiveness in engaging the student community, and its efficacy in the curriculum when used as an alternative representation of a traditional field experience. The expected outcome is that based on the level of interactivity, the simulated environment will provide adequate pedagogical representation for content transfer without the need for physical experience in the uncontrolled field environment. Additionally, creating such an environment will impact all able-bodied students by providing supplemental resources that can both precede a traditional field experience and allow for students to re-examine a field site long after a the field experience, in both current formal and informal educational settings.

  8. Igualdad, equidad, solidaridad Equality, equitableness and solidarity

    Directory of Open Access Journals (Sweden)

    Mariano Fernández Enguita

    2001-10-01

    Full Text Available Se propone descomponer la idea inespecífica de igualdad o, mejor, justicia distributiva, en las más específicas de igualdad estricta, equidad (acorde con la contribución o el esfuerzo, excelencia (incentivos a las aportaciones extraordinarias y solidaridad (compensación para los discapacitados. Estos son los criterios de justicia de la sociedad actual - aunque no haya acuerdo sobre como alcanzarlos - y la escuela no necesita inventar otros sino adaptarlos a su contexto. Por otra parte, se diferencia entre las desigualdades intracomunitarias - clase, género y etnia - y las intercomunitarias - entre países, entre comunidades, entre nacionales e inmigrantes.This paper suggests to decompose the unspecific idea of equality or, rather, of distributive justice, into the more specific ideas of strict equality, equitableness (according to contribution or effort, excellence (incentives for extraordinary contributions and solidarity (compensation for the disabled. These are the criteria of justice in modern society - even though there is no agreement on how to reach them. School need not make up any new ones but adapt those to its own context. Besides, a distinction is made between intracommunity - class, gender and ethnicity - and intercommunity inequalities - between countries, communities and between nationals and immigrants.

  9. E-health: potential benefits and challenges in providing and accessing sexual health services

    OpenAIRE

    Minichiello, Victor; Rahman, Saifur; Dune, Tinashe; Scott, John; Dowsett, Gary

    2013-01-01

    Background E-health has become a burgeoning field in which health professionals and health consumers create and seek information. E-health refers to internet-based health care and information delivery and seeks to improve health service locally, regionally and worldwide. E-sexual health presents new opportunities to provide online sexual health services irrespective of gender, age, sexual orientation and location. Discussion The paper used the dimensions of the RE-AIM model (reach, efficacy, ...

  10. AGRIS: providing access to agricultural research data exploiting open data on the web.

    Science.gov (United States)

    Celli, Fabrizio; Malapela, Thembani; Wegner, Karna; Subirats, Imma; Kokoliou, Elena; Keizer, Johannes

    2015-01-01

    AGRIS is the International System for Agricultural Science and Technology. It is supported by a large community of data providers, partners and users. AGRIS is a database that aggregates bibliographic data, and through this core data, related content across online information systems is retrieved by taking advantage of Semantic Web capabilities. AGRIS is a global public good and its vision is to be a responsive service to its user needs by facilitating contributions and feedback regarding the AGRIS core knowledgebase, AGRIS's future and its continuous development. Periodic AGRIS e-consultations, partner meetings and user feedback are assimilated to the development of the AGRIS application and content coverage. This paper outlines the current AGRIS technical set-up, its network of partners, data providers and users as well as how AGRIS's responsiveness to clients' needs inspires the continuous technical development of the application. The paper concludes by providing a use case of how the AGRIS stakeholder input and the subsequent AGRIS e-consultation results influence the development of the AGRIS application, knowledgebase and service delivery.

  11. Access to high-volume surgeons and the opportunity cost of performing radical prostatectomy by low-volume providers.

    Science.gov (United States)

    Barzi, Afsaneh; Klein, Eric A; Daneshmand, Siamak; Gill, Inderbir; Quinn, David I; Sadeghi, Sarmad

    2017-07-01

    Evidence suggests that redirecting surgeries to high-volume providers may be associated with better outcomes and significant societal savings. Whether such referrals are feasible remains unanswered. Medicare Provider Utilization and Payment Data, SEER 18, and US Incidence data were used to determine the geographic distribution and radical prostatectomy volume for providers. Access was defined as availability of a high-volume provider within driving distance of 100 miles. The opportunity cost was defined as the value of benefits achievable by performing the surgery by a high-volume provider that was forgone by not making a referral. The savings per referral were derived from a published Markov model for radical prostatectomy. A total of 14% of providers performed>27% of the radical prostatectomies with>30 cases per year and were designated high-volume providers. Providers with below-median volume (≤16 prostatectomies per year) performed>32% of radical prostatectomies. At least 47% of these were within a 100-mile driving distance (median = 22 miles), and therefore had access to a high-volume provider (>30 prostatectomies per year). This translated into a discounted savings of more than $24 million per year, representing the opportunity cost of not making a referral. The average volume for high- and low-volume providers was 55 and 13, respectively, resulting in an annual experience gap of 43 and a cumulative gap of 125 surgeries over 3 years. In 2014, the number of surgeons performing radical prostatectomy decreased by 5% while the number of high- and low-volume providers decreased by 25% and 11% showing a faster decline in the number of high-volume providers compared with low-volume surgeons. About half of prostatectomies performed by surgeons with below-median annual volume were within a 100-mile driving distance (median of 22 miles) of a high-volume surgeon. Such a referral may result in minimal additional costs and substantially improved outcomes. Copyright

  12. Providing access to risk prediction tools via the HL7 XML-formatted risk web service.

    Science.gov (United States)

    Chipman, Jonathan; Drohan, Brian; Blackford, Amanda; Parmigiani, Giovanni; Hughes, Kevin; Bosinoff, Phil

    2013-07-01

    Cancer risk prediction tools provide valuable information to clinicians but remain computationally challenging. Many clinics find that CaGene or HughesRiskApps fit their needs for easy- and ready-to-use software to obtain cancer risks; however, these resources may not fit all clinics' needs. The HughesRiskApps Group and BayesMendel Lab therefore developed a web service, called "Risk Service", which may be integrated into any client software to quickly obtain standardized and up-to-date risk predictions for BayesMendel tools (BRCAPRO, MMRpro, PancPRO, and MelaPRO), the Tyrer-Cuzick IBIS Breast Cancer Risk Evaluation Tool, and the Colorectal Cancer Risk Assessment Tool. Software clients that can convert their local structured data into the HL7 XML-formatted family and clinical patient history (Pedigree model) may integrate with the Risk Service. The Risk Service uses Apache Tomcat and Apache Axis2 technologies to provide an all Java web service. The software client sends HL7 XML information containing anonymized family and clinical history to a Dana-Farber Cancer Institute (DFCI) server, where it is parsed, interpreted, and processed by multiple risk tools. The Risk Service then formats the results into an HL7 style message and returns the risk predictions to the originating software client. Upon consent, users may allow DFCI to maintain the data for future research. The Risk Service implementation is exemplified through HughesRiskApps. The Risk Service broadens the availability of valuable, up-to-date cancer risk tools and allows clinics and researchers to integrate risk prediction tools into their own software interface designed for their needs. Each software package can collect risk data using its own interface, and display the results using its own interface, while using a central, up-to-date risk calculator. This allows users to choose from multiple interfaces while always getting the latest risk calculations. Consenting users contribute their data for future

  13. Partnering with community agencies to provide nursing students with cultural awareness experiences and refugee health promotion access.

    Science.gov (United States)

    Sullivan, Catherine H

    2009-09-01

    Refugees' cultural beliefs, communication barriers, and low health literacy may lead to health disparities within the Western health care system. This article describes a teaching-learning strategy emphasizing the community partnership between a baccalaureate school of nursing, an immigrant-refugee program, and a community literacy program in a rural state. Senior community health nursing students partnered with an immigrant-refugee program and a community literacy program to provide health promotion and prevention services to recently immigrated Hmong and Russian refugees. Priority health needs were identified and culturally appropriate health promotion and prevention education modules were designed and implemented by students. Students collaborated with community agencies and businesses to increase access to health resources for these vulnerable populations. Outcomes were the provision of cultural awareness experiences for nursing students and access to health care with increased knowledge of Western health care practices and beliefs for refugees.

  14. 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.

  15. delivering equitable health care in Malawi

    African Journals Online (AJOL)

    poor logistical support of services. Individuals may be discour- aged from seekinc medical care due to misdiagnosis, delays in receiving treatment and interaction with health providers“. This is clearly an inequitable situation with the majority of the popu- lation being unable to access effective health services. Inadequate ...

  16. Reasons military patients with primary care access leave an emergency department waiting room before seeing a provider.

    Science.gov (United States)

    Varney, Shawn M; Vargas, Toni E; Pitotti, Rebecca L; Bebarta, Vikhyat S

    2012-10-01

    Our objective was to assess patients' understanding of emergency department (ED) wait times and why patients may leave the waiting room before seeing a provider. Survey of patients in the ED waiting room of an urban tertiary care military hospital where civilian and military patients are treated. A total of 508/517 surveys (98%) were completed. Age ranges were 18 to 35 years (49%), 36 to 60 (31%), or older than 60 (20%). Education levels were high school (20%), some college (37%), or college graduate (39%). Of 503 respondents, 125 (25%) had left an ED waiting room before seeing a provider. The reasons included excessive wait times (91%) and family responsibilities (5%). Five hundred eight reported the factors that would motivate them to wait to see the physician (not leave without being seen [LWOBS]) were the severity of illness (64%), and if they received an update of wait times (26%); 82% (391/480) understood that severely ill patients were seen first. Patients attributed long wait times to doctors and nurses caring for other patients (292/583, 50%) and insufficient physician and nurse staffing (245, 42%). Of 802 responses for ideas to improve the wait, 34% said regular updates on estimated wait times, 21% said television shows or movies to view, 20% said books and magazines to read, and 11% said computers to access. Long wait times were the primary reason that patients left before seeing a provider, despite having ready access to care. Respondents attributed long wait times to patient volume and inadequate staffing. Regular updates on wait times and material for entertainment may improve the waiting experience and reduce LWOBS.

  17. How equitable are community health worker programmes and which programme features influence equity of community health worker services? A systematic review.

    Science.gov (United States)

    McCollum, Rosalind; Gomez, Woedem; Theobald, Sally; Taegtmeyer, Miriam

    2016-05-20

    Community health workers (CHWs) are uniquely placed to link communities with the health system, playing a role in improving the reach of health systems and bringing health services closer to hard-to-reach and marginalised groups. A systematic review was conducted to determine the extent of equity of CHW programmes and to identify intervention design factors which influence equity of health outcomes. In accordance with our published protocol, we systematically searched eight databases from 2004 to 2014 for quantitative and qualitative studies which assessed access, utilisation, quality or community empowerment following introduction of a CHW programme according to equity stratifiers (place of residence, gender, socio-economic position and disability). Thirty four papers met inclusion criteria. A thematic framework was applied and data extracted and managed, prior to charting and thematic analysis. To our knowledge this is the first systematic review that describes the extent of equity within CHW programmes and identifies CHW intervention design features which influence equity. CHW programmes were found to promote equity of access and utilisation for community health by reducing inequities relating to place of residence, gender, education and socio-economic position. CHWs can also contribute towards more equitable uptake of referrals at health facility level. There was no clear evidence for equitable quality of services provided by CHWs and limited information regarding the role of the CHW in generating community empowerment to respond to social determinants of health. Factors promoting greater equity of CHW services include recruitment of most poor community members as CHWs, close proximity of services to households, pre-existing social relationship with CHW, provision of home-based services, free service delivery, targeting of poor households, strengthened referral to facility, sensitisation and mobilisation of community. However, if CHW programmes are not well

  18. 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.

  19. 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

  20. Violation of the Morality of Resource Management and Equitable ...

    African Journals Online (AJOL)

    In this paper, I examined the ethicalmoral response to resource management as it affects principles guiding equitable distribution of power, services and burdens in a democratic system. Also examined were the consequences of unfair and unjust systems of management and distribution of power, human and natural ...

  1. 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…

  2. Andrea Passoni, Giustizia come equità e socialismo liberale

    Directory of Open Access Journals (Sweden)

    Maria Chiara Pievatolo

    2015-05-01

    Full Text Available L'articolo di Andrea Passoni, Giustizia come equità e socialismo liberale, appena pubblicato nell'archivio "Giuliano Marini", discute l’idea rawlsiana di socialismo liberale, allo scopo di dimostrare che può essere almeno parzialmente riempire di significato tramite la promozione e lo sviluppo di un’economia di mercato di tipo cooperativo.

  3. 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.

  4. Access to new medications for the treatment of drug-resistant tuberculosis: Patient, provider and community perspectives

    Directory of Open Access Journals (Sweden)

    Erica Lessem

    2015-03-01

    Full Text Available Multidrug-resistant tuberculosis (MDR-TB is on the rise, and is difficult to treat. The approval of two new drugs, bedaquiline and delamanid, and growing evidence for the use of linezolid, offer renewed hope for addressing MDR-TB. However, access to these medicines remains a significant challenge. These drugs have not been registered for TB in most settings; barriers to preapproval access persist; and high pricing and intellectual property restrictions limit access. Many unanswered research questions about optimal use of these drugs also limit access, particularly for vulnerable populations. This review outlines challenges in accessing drugs encountered from the perspective of clinicians, patients and affected communities, and offers potential solutions.

  5. Cultural transmission of tool use by Indo-Pacific bottlenose dolphins (Tursiops sp.) provides access to a novel foraging niche.

    Science.gov (United States)

    Krützen, Michael; Kreicker, Sina; MacLeod, Colin D; Learmonth, Jennifer; Kopps, Anna M; Walsham, Pamela; Allen, Simon J

    2014-06-07

    Culturally transmitted tool use has important ecological and evolutionary consequences and has been proposed as a significant driver of human evolution. Such evidence is still scarce in other animals. In cetaceans, tool use has been inferred using indirect evidence in one population of Indo-Pacific bottlenose dolphins (Tursiops sp.), where particular dolphins ('spongers') use marine sponges during foraging. To date, evidence of whether this foraging tactic actually provides access to novel food items is lacking. We used fatty acid (FA) signature analysis to identify dietary differences between spongers and non-spongers, analysing data from 11 spongers and 27 non-spongers from two different study sites. Both univariate and multivariate analyses revealed significant differences in FA profiles between spongers and non-spongers between and within study sites. Moreover, FA profiles differed significantly between spongers and non-spongers foraging within the same deep channel habitat, whereas the profiles of non-spongers from deep channel and shallow habitats at this site could not be distinguished. Our results indicate that sponge use by bottlenose dolphins is linked to significant differences in diet. It appears that cultural transmission of tool use in dolphins, as in humans, allows the exploitation of an otherwise unused niche.

  6. 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.

  7. 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

  8. 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.

  9. 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

  10. At the threshold of american personalism: providing the personal access to God’s Word in Elizabethan Bible translations

    Directory of Open Access Journals (Sweden)

    Vasyl O. Patsan

    2016-01-01

    Full Text Available The article is aimed at defining the ways to the exposure of theistic basis of personhood which were paved by the personalist philosophy founded in the USA in the late nineteenth – early twentieth centuries. Having become an initiator of historical-philosophical reconstructing the genesis of American personalism in Ukraine, the author actualizes the problem of perceiving the Scripture text by the personalistic trend sprung from the Protestant soil in North America. The article substantiates the approach to reflecting this process based upon the meta-ontology of personality expounded by patristic trinitology at the turn of Antiquity and the Middle Ages and disclosed for rational consciousness of the modern era by the personalistic mode of thinking appealed to Orthodox theology. Prepared by the previous results of the author’s elaboration of the actualized problematics (represented in his publications in Ukrainian and foreign periodical scientific editions the article focuses on the theological foundations of the personalist philosophy of the USA connecting its unsteadiness with the departure of Protestantism from Christian dogmata affirming personal principle of being, Absolute Personality of God and godlikeness of the human person uncovered by the Revelation. Correlating horizons of personalistic perception of God Breathed Book with reconstructions of the Bible topology of personhood which were performed in the Scripture translations providing the personal access to God’s Word, the author analyzes the transmission of Biblical concepts of personal being in English Scripture versions appeared during the reign of Elizabeth I (the Geneva Bible, the Bishops’ Bible, initially accepted by the Protestant denominations of North America and formed the Biblical background of personalistic thinking in the New World. The study reveals the premises of reducing the spiritual source of personality to personalized ratio in the doctrine of the classical

  11. The 3 A's of the access process to long-term care for elderly: providers experiences in a multiple case study in the Netherlands.

    Science.gov (United States)

    Schipper, Lisette; Luijkx, Katrien; Meijboom, Bert; Schols, Jos

    2015-01-01

    The access process is an important step in the care provision to independently living elderly. Still, little attention has been given to the process of access to long-term care for older clients. Access can be described by three dimensions: availability, affordability and acceptability (three A's). In this paper we address the following question: How do care providers take the three dimensions of access into account for the access process to their care and related service provision to independently living elderly? To answer this question we performed a qualitative study. We used data gathered in a multiple case study in the Netherlands. This study provides insight in the way long-term care organizations organize their access process. Not all dimensions were equally present or acknowledged by the case organizations. The dimension acceptability seems an important dimension in the access process, as shown by the efforts done in building a relationship with their clients, mainly through a strong personal relationship between client and care advisor. In that respect it is remarkable that the case organizations do not structurally evaluate their access process. Availability is compromised by practical issues and organizational choices. Affordability hardly seems an issue. Further research can reveal the underlying factors that influence the three A dimensions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Learning to teach science in contemporary and equitable ways: The successes and struggles of first-year science teachers

    Science.gov (United States)

    Bianchini, Julie A.; Johnston, Carol C.; Oram, Susannah Y.; Cavazos, Lynnette M.

    2003-05-01

    Recent studies of beginning science teachers make clear that learning to integrate contemporary nature of science descriptions and equitable instructional strategies into educational practices is a complex and challenging endeavor. In this research project, we examined the views and practices of three first-year science teachers, recent graduates of a teacher education program in California known for its attention to gender equitable and multicultural content and instruction. We explored these beginning teachers' attempts to present contemporary descriptions of the nature of science and implement equitable instructional strategies in their classrooms; we videotaped two of their curricular units and conducted individual interviews after each unit lesson. From qualitative analysis of these interviews, we developed case studies that described the ideas and practices these beginning teachers took up from their preservice experiences, as well as the reasons provided and constraints identified for science topics taught and instructional approaches used. In our discussion, we examined commonalties across beginning teachers' successes and struggles in learning to teach science in contemporary and equitable ways, as well as lessons we learned about ways to improve preservice science teacher education.

  13. Cost-Effectiveness of Access Expansion to Treatment of Hepatitis C Virus Infection Through Primary Care Providers.

    Science.gov (United States)

    Rattay, Thilo; Dumont, Ian P; Heinzow, Hauke S; Hutton, David W

    2017-12-01

    Chronic hepatitis C virus (HCV) infection is a major burden on individuals and health care systems. The Extension for Community Healthcare Outcomes (Project ECHO) enables primary care providers to deliver best-practice care for complex conditions to underserved populations. The US Congress passed the ECHO Act in late 2016, requiring the Department of Health and Human Services to investigate the model. We performed a cost-effectiveness analysis to assess diagnosis and treatment of HCV infection in a primary care patient panel with and without the implementation of Project ECHO. We used Markov models to simulate disease progression, quality of life, and life expectancy among individuals with HCV infection and for the general population. Data from the University of New Mexico's ECHO operation for HCV show an increase in treatment rates. Corresponding increases in survival, quality-adjusted life years (QALYs), costs, and resulting budget impact between ECHO and non-ECHO patients with HCV were then compared. Project ECHO increased costs and QALYs. The incremental cost-effectiveness ratio of ECHO was $10,351 per QALY compared with the status quo; >99.9% of iterations fell below the willingness-to-pay threshold of $100,000 per QALY. We were unable to confirm whether the increase in rates of treatment associated with Project ECHO were due to increased or more targeted screening, higher adherence, or access to treatment. Our sensitivity analyses show that the results are largely independent of the cause. Budget impact analysis shows payers would have to invest an additional $339.54 million over a 5-year period to increase treatment by 4446 patients, per 1 million covered lives. Using a simulated primary care patient panel, we showed that Project ECHO is a cost-effective way to find and treat patients with HCV infection at scale using existing primary care providers. This approach could substantially reduce the burden of chronic HCV infection in the United States, but high

  14. 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.

  15. 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.

  16. Species richness, equitability, and abundance of ants in disturbed landscapes

    Science.gov (United States)

    Graham, J.H.; Krzysik, A.J.; Kovacic, D.A.; Duda, J.J.; Freeman, D.C.; Emlen, J.M.; Zak, J.C.; Long, W.R.; Wallace, M.P.; Chamberlin-Graham, C.; Nutter, J.P.; Balbach, H.E.

    2009-01-01

    Ants are used as indicators of environmental change in disturbed landscapes, often without adequate understanding of their response to disturbance. Ant communities in the southeastern United States displayed a hump-backed species richness curve against an index of landscape disturbance. Forty sites at Fort Benning, in west-central Georgia, covered a spectrum of habitat disturbance (military training and fire) in upland forest. Sites disturbed by military training had fewer trees, less canopy cover, more bare ground, and warmer, more compact soils with shallower A-horizons. We sampled ground-dwelling ants with pitfall traps, and measured 15 habitat variables related to vegetation and soil. Ant species richness was greatest with a relative disturbance of 43%, but equitability was greatest with no disturbance. Ant abundance was greatest with a relative disturbance of 85%. High species richness at intermediate disturbance was associated with greater within-site spatial heterogeneity. Species richness was also associated with intermediate values of the normalized difference vegetation index (NDVI), a correlate of net primary productivity (NPP). Available NPP (the product of NDVI and the fraction of days that soil temperature exceeded 25 ??C), however, was positively correlated with species richness, though not with ant abundance. Species richness was unrelated to soil texture, total ground cover, and fire frequency. Ant species richness and equitability are potential state indicators of the soil arthropod community. Moreover, equitability can be used to monitor ecosystem change. ?? 2008 Elsevier Ltd.

  17. Equitable mitigation to achieve the Paris Agreement goals

    Science.gov (United States)

    Robiou Du Pont, Yann; Jeffery, M. Louise; Gütschow, Johannes; Rogelj, Joeri; Christoff, Peter; Meinshausen, Malte

    2017-01-01

    Benchmarks to guide countries in ratcheting-up ambition, climate finance, and support in an equitable manner are critical but not yet determined in the context of the Paris Agreement. We identify global cost-optimal mitigation scenarios consistent with the Paris Agreement goals and allocate their emissions dynamically to countries according to five equity approaches. At the national level, China's Nationally Determined Contribution (NDC) is weaker than any of the five equity approaches, India's NDC is aligned with two, and the EU's and the USA's with three. Most developing countries' conditional (Intended) NDCs (INDCs) are more ambitious than the average of the five equity approaches under the 2 °C goal. If the G8 and China adopt the average of the five approaches, the gap between conditional INDCs and 2 °C-consistent pathways could be closed. For an equitable, cost-optimal achievement of the 1.5 °C target, emissions in 2030 are 21% lower (relative to 2010) than for 2 °C for the G8 and China combined, and 39% lower for remaining countries. Equitably limiting warming to 1.5 °C rather than 2 °C requires that individual countries achieve mitigation milestones, such as peaking or reaching net-zero emissions, around a decade earlier.

  18. Health financing: Who pays for equitable health systems? | IDRC ...

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

    2012-10-24

    Oct 24, 2012 ... Countries rich and poor face difficult choices in funding quality health care for their citizens. Financing determines who can access care, what services are provided, and what costs are paid directly by users. For industrialized nations, some form of prepaid healthcare plan is the norm: their struggle today is ...

  19. Giving rheumatology patients online home access to their electronic medical record (EMR): advantages, drawbacks and preconditions according to care providers

    NARCIS (Netherlands)

    van der Vaart, R.; Drossaert, Constance H.C.; Taal, Erik; van de Laar, Mart A F J

    2013-01-01

    Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted.

  20. Providing access to research data, publications and current research information at Data Archiving and Networked Services - DANS

    NARCIS (Netherlands)

    Dijk, E.M.S.; Doorn, P.K.

    2014-01-01

    Data Archiving and Networked Services (DANS) promotes sustained access to digital research data in the Netherlands. Researchers can deposit their data through the online archiving system EASY. Via the portal NARCIS the research data are shown in context, namely in relation to publications, and other

  1. 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

    2016-05-09

    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.

  2. New National Cryo-EM Facility Provides Access to Cutting-Edge Technology for Cancer Research Community | FNLCR

    Science.gov (United States)

    Cancer researchers nationwide now have access to the latest technology in the field of cryo-electron microscopy (cryo-EM)—the study of protein structures at atomic resolution—at the Frederick National Lab for Cancer Research. The emerging technol

  3. 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

  4. Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia.

    Science.gov (United States)

    Alfaqeeh, Ghadah; Cook, Erica J; Randhawa, Gurch; Ali, Nasreen

    2017-02-02

    The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA. A questionnaire survey was carried out to identify the barriers and enablers to accessing PHCS in rural (n = 5) and urban (n = 5) areas of Riyadh province, selected on the classification of the population density of the governorates. An adapted version of the NHS National Survey Programme was administered that included 50 questions over 11 sections that assessed a wide range of factors related to respondent's access and experience of the PHCS. A total of 935 responses were obtained with 52.9% (n = 495) from urban areas and the remaining 47.1% (n = 440) from rural areas of Riyadh province. This study highlights that there are high levels of satisfaction among patients among all PHCS. In relation to differences between urban and rural respondents, the findings indicated that there were significant variations in relation to: education level, monthly income, medical investigations, receiving blood tests on time, extra opening hours, distance, cleanliness and health prevention. Core barriers for rural patients related to the distance to reach PHCS, cleanliness of the PHCS, receiving health prevention and promotion services, which should serve to improve health outcomes. This study highlighted important differences in access to and utilisation of PHCS between urban and rural populations in Riyadh province in the KSA. These findings have implications for policy and

  5. 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.

    2010-02-01

    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 far less in US dollars per unit cost on primary education than do developed countries. Increasing the unit cost of education in order to enable a government to guarantee universal primary education would take away resources from other tiers of the education system in many countries in the region. The alternative is to universalise access, despite existing budget allocation constraints, and thereby further compound the problems of poor infrastructure and limited human resource capacity that continue to compromise education quality in sub-Saharan Africa.

  6. Increasing access to sexual health care for rural and regional young people: Similarities and differences in the views of young people and service providers.

    Science.gov (United States)

    Johnston, Karen; Harvey, Caroline; Matich, Paula; Page, Priscilla; Jukka, Clare; Hollins, Jane; Larkins, Sarah

    2015-10-01

    This study aims to describe the views of sexual health service providers on access issues for young people and consider them together with the views of young people themselves. A cross-sectional mixed-methods study design involving semi-structured interviews with health service providers and an electronic survey with young people. Four towns in rural and regional Queensland, Australia. A total of 32 service providers: 9 sexual health nurses, 8 general practitioners, 6 school-based youth health nurses, 5 sexual health educators, 2 Australian Aboriginal health workers and 2 youth workers. There were 391 young people who participated in the Young People's Survey. Themes generated from interviews with service providers and quantitative data from young people addressing access to sexual and reproductive health (SRH) services for rural and regional young people. Service providers frequently identified structural barriers, confidentiality and lack of awareness of SRH services as barriers for young people seeking SRH care. Young people also reported that structural factors such as transport, cost and service operating hours were important; however, they placed greater value on personal attributes of service providers, particularly welcoming and non-judgemental attitudes. Health service policy and training focused on attitudinal qualities of individual service providers may improve access to SRH services for young people. Selective staff recruitment and professional development are important to increase sensitivity to youth issues. Promotion of non-judgemental and confidential care may also improve access for youth. © 2015 National Rural Health Alliance Inc.

  7. Water access, water scarcity, and climate change.

    Science.gov (United States)

    Mukheibir, Pierre

    2010-05-01

    This article investigates the approaches of the various discourses operating in the water sector and how they address the issues of scarcity and equitable access under projected climate change impacts. Little synergy exists between the different approaches dealing with these issues. Whilst being a sustainable development and water resources management issue, a holistic view of access, scarcity and the projected impacts of climate change is not prevalent in these discourses. The climate change discourse too does not adequately bridge the gap between these issues. The projected impacts of climate change are likely to exacerbate the problems of scarcity and equitable access unless appropriate adaptation strategies are adopted and resilience is built. The successful delivery of accessible water services under projected climate change impacts therefore lies with an extension of the adaptive water management approach to include equitable access as a key driver.

  8. Barriers to accessing ATLS provider course for junior doctors at a major university hospital in South Africa.

    Science.gov (United States)

    Odendaal, J J; Kong, V Y; Liu, T; Sartorius, B; Oosthuizen, G V; Clarke, D L

    2017-11-01

    Advanced trauma life support (ATLS) is the international standard of care and forms the basis of trauma training in South Africa. Previous local studies demonstrated a low completion rate among junior doctors (JD). This study was designed to determine the reasons and identify possible barriers of JDs to accessing the ATLS course at a major university hospital. This was a prospective study utilising a structured survey that included all JDs who were undertaking their internship training. A total of 105 JDs completed the survey. Sixty-two percent were female (65/105) and the mean age was 25 years. Forty-eight percent (50/105) of all JDs were post graduate year 1 (PGY 1) and the remaining 52% were post graduate year 2 (PGY 2) JDs. Sixty-two percent (65/105) of all respondents had completed their mandatory rotation in surgery. The reasons for non-attendance of ATLS were: unable to secure a place on course (52%), unable to afford course fee (18%), permission for attendance not granted (14%), unable to obtain study leave (10%) and lack of interest (5%). 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%, p ATLS training is difficulty in accessing the course due to oversubscription, financial reasons, followed by difficulty in obtaining professional development leave due to staff shortage. There is an urgent need to improve access to the ATLS training course for JDs in our environment.

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

    Science.gov (United States)

    Summers, Michael P; Verikios, George

    2017-02-06

    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

  10. Time to market and patient access to new oncology products in Italy: a multistep pathway from European context to regional health care providers.

    Science.gov (United States)

    Russo, P; Mennini, F S; Siviero, P D; Rasi, G

    2010-10-01

    The main purpose of this study was to identify each sequential phase followed by an oncology product, from European assessment until to patient access in each Italian region (IR). A panel of oncology products approved by the European Medicines Agency (EMA) in the period 2006-2008 was considered. The explored sequential phases included the times to market for: the EMA; pharmaceutical companies; the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA); and IRs as final providers of health care. The IR's time to market was also analyzed by a Cox regression model. The overall mean time required before patients access was 2.3 years. EMA accounted for the greater proportion of time (31.8%), followed by AIFA (28.2%). However, the duration for both pharmaceutical companies and IRs was associated with the highest variability. An oncology product authorized with a risk-sharing agreement showed an early access in the IRs. On the contrary, the introduction in IRs having a compulsory formulary was delayed. Both a high forecast of economic impact and a high oncology product price can also delay the patient access. The process before patient access to an oncology product is time and cost consuming. This study identifies the main predictors that affect the missing overlap between market and patient access in Italy.

  11. 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... Act, on a Statewide basis through: (i) Self-service; (ii) Facilitated self-help service; and (iii...

  12. 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

  13. 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.

  14. Increasing Access to Preschool: Recommendations for Reducing Barriers to Providing Full-day, Full-year Programs. Policy Brief

    Science.gov (United States)

    Miller, Kate

    2008-01-01

    More than ever before, Californians recognize that preschool provides young children with a strong start in school and life. Research confirms that effective preschool not only prepares children for kindergarten, but benefits them in the long-term. Despite the benefits, only 48% of 3- and 4-year-old children attend preschool in California. While…

  15. Why Can't Ohio Equitably Fund Public Education? Education Reform Stifling Equitable Education Funding

    Science.gov (United States)

    Simon, Carlee Escue

    2015-01-01

    Ohio has a long history of school funding inequity. This manuscript provides a brief history of Ohio education funding, the equity and adequacy concerns. Education reform efforts have been expanding while the appropriate management of the funding mechanism has been underfunded or entirely ignored. The researcher examines the negative impact of…

  16. Equitable Written Assessments for English Language Learners: How Scaffolding Helps

    Science.gov (United States)

    Siegel, Marcelle A.; Menon, Deepika; Sinha, Somnath; Promyod, Nattida; Wissehr, Cathy; Halverson, Kristy L.

    2014-10-01

    This study investigated the effects of the use of scaffolds in written classroom assessments through the voices of both native English speakers and English language learners from two middle schools. Students responded to assessment tasks in writing, by speaking aloud using think aloud protocols, and by reflecting in a post-assessment interview. The classroom assessment tasks were designed to engage students in scientific sense making and multifaceted language use, as recommended by the Next Generation Science Standards. Data analyses showed that both groups benefitted from the use of scaffolds. The findings revealed specific ways that modifications were supportive in helping students to comprehend, visualize and organize thinking, and elicit responses. This study offers a model for both sensitizing teachers and strengthening their strategies for scaffolding assessments equitably.

  17. Privately funded quality health care in India: a sustainable and equitable model.

    Science.gov (United States)

    Samandar, R; Kleefield, S; Hammel, J; Mehta, M; Crone, R

    2001-08-01

    As the cost and degree of training necessary to provide state of the art health care has increased throughout the world, the present challenge in health care is to establish institutions that are financially sound and responsive to the dynamic needs of the communities in which they exist. As public funds have diminished, the role of the private sector in estabhshing innovative health care institutions has increased. This paper reviews the case of the LV Prasad Eye Institute (LVPEI), an ophthalmologic institute in Hyderabad, India, that is financially sound and medically vital. With an annual budget of US$3 million, 180 000 patients are seen and 23 000 surgeries are performed at the Institute and its satellites each year. The Institute provides patient care at a ratio of 1:1 non-paying to paying patients through fee cross-subsidization. The Institute uses a combination of financial modalities, including donations, grants and fees to administer its non-patient care programs. Non-clinical programs of the Institute include a paramedical training program and a fellowship in ophthalmology, an internationally accredited eye bank for the preservation of corneal tissues, a rural out-reach and education program, a basic science and epidemiology program that directs health policy activities of the Institute and a rehabilitation program for patients with incurable visual deficits. To evaluate its effectiveness, LVPEI uses quality improvement measures, including patient surveys, post-operative outcomes studies and service utlization reviews. This case report of a privately-funded medical institution describes a successful model through which high-quality, equitable health care can be provided in a developing country. The LVPEI's active program of quality management, its academic commitment and programmatic relevance to the needs of its community should be modularized and replicated to establish equitable, efficient and effective health care institutions in the developing world.

  18. 20 CFR 219.40 - Evidence of relationship by equitable adoption-child.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evidence of relationship by equitable adoption-child. 219.40 Section 219.40 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE... relationship by equitable adoption—child. (a) Preferred evidence. If the claimant is a person who claims to be...

  19. A model to identify mathematics topics in MXit lingo to provide tutors quick access to supporting documentation

    Directory of Open Access Journals (Sweden)

    Laurie Butgereit

    2011-11-01

    Full Text Available Dr MathTM is a mobile, online tutoring system where learners can use MXitTM on their mobile phones to receive help with their mathematics homework from volunteer tutors. These conversations between learners and Dr Math are held in MXit lingo. MXit lingo is a heavily abbreviated, English-like language that is evolving between users of mobile phones that communicate using MXit. The Dr Math project has been running since January 2007 and uses volunteer tutors who are mostly university students who readily understand and use MXit lingo. However, due to the large number of simultaneous conversations that the tutors are often involved in and the diversity of topics discussed, it would often be beneficial to provide assistance regarding the mathematics topic to the tutors. This article explains how the μ model identifies the mathematics topic in the conversation. The model identifies appropriate mathematics topics in just over 75% of conversations in a corpus of conversations identified to be about mathematics topics in the school curriculum.

  20. 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

    2017-09-15

    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

  1. Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration.

    Science.gov (United States)

    Burkhart, Lisa; Sohn, Min-Woong; Jordan, Neil; Tarlov, Elizabeth; Gampetro, Pamela; LaVela, Sherri L

    2016-01-01

    The Veterans Health Administration piloted patient-centered care (PCC) innovations beginning in 2010 to improve patient and provider experience and environment in ambulatory care. We use secondary data to look at longitudinal trends, evaluate system redesign, and identify areas for further quality improvement. This was a retrospective, observational study using existing secondary data from multiple US Department of Veteran Affairs sources to evaluate changes in veteran and facility outcomes associated with PCC innovations at 2 innovation and matched comparison sites between FY 2008-2010 (pre-PCC innovations) and FY 2011-2012 (post-PCC innovations). Outcomes included access to primary care providers (PCPs); primary, specialty, and emergency care use; and clinical indicators for chronic disease. Longitudinal trends revealed a different story at each site. One site demonstrated better PCP access, decrease in emergency and primary care use, increase in specialty care use, and improvement in diabetic glucose control. The other site demonstrated a decrease in PCP access and primary care use, no change in specialty care use, and an increase in diastolic blood pressure in relation to the comparison site. Secondary data analysis can reveal longitudinal trends associated with system changes, thereby informing program evaluation and identifying opportunities for quality improvement.

  2. Vascular access placement in patients with chronic kidney disease Stages 4 and 5 attending an inner city nephrology clinic: a cohort study and survey of providers.

    Science.gov (United States)

    Goel, Narender; Kwon, Caroline; Zachariah, Teena P; Broker, Michael; Folkert, Vaughn W; Bauer, Carolyn; Melamed, Michal L

    2017-01-17

    The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process. The 221 patients (56% female) in the study had median age of 66 years (interquartile range (IQR), 57-75) and were followed for a median of 1.26 years (IQR 0.6-1.68). At study entry, 81%had CKD stage 4 and 19% had CKD stage 5. By the end of study, 48 patients had initiated dialysis. Thirty-four of the patients started dialysis with a catheter (1 failed and 10 maturing AVFs), 9 with an AVF and 5 with an AVG. During the study period, 61 total AV accesses were placed (54 AVF and 7 AVG). A higher urinary protein/ creatinine ratio and a lower eGFR were associated with AV access placement and dialysis initiation. A greater number of nephrology visits were associated with AV access creation but not dialysis initiation. Hospitalizations and hospitalizations with an episode of acute kidney injury (AKI) were strongly associated with dialysis initiation (odds ratio (OR) 13.0 (95% confidence interval (CI) 2.3 to 73.3, p-value = 0.004) and OR 6.6 (95% CI 1.9 to 22.8, p-value = 0.003)). More frequent nephrology clinic visits for patients with a recent hospitalization may improve rates of placement of an AV access. A hospitalization with AKI is strongly associated with the need for dialysis initiation. Nephrologists may not be referring the correct patients to get an AV access surgery.

  3. Capabilities and accessibility: a model for progress

    Directory of Open Access Journals (Sweden)

    Nick Tyler

    2011-11-01

    Full Text Available Accessibility is seen to be a core issue which relates directly to the quality of life: if a person cannot reach and use a facility then they cannot take advantage of the benefits that the facility is seeking to provide. In some cases this is about being able to take part in an activity for enjoyment, but in some it is a question of the exercise of human rights – access to healthcare, education, voting and other citizens’ rights. This paper argues that such an equitable accessibility approach requires understanding of the relationships between the capabilities that a person has and the capabilities required of them by society in order to achieve the accessibility they seek. The Capabilities Model, which has been developed at UCL is an attempt to understand this relationship and the paper sets out an approach to quantifying the capabilities in a way that allows designers and implementers of environmental construction and operation to have a more robust approach to their decisions about providing accessibility.

  4. Developing Preservice Teachers' Expertise in Equitable Assessment for English Learners

    Science.gov (United States)

    Siegel, Marcelle A.

    2014-04-01

    This study illustrated a pathway of growth that a preservice teacher might traverse when learning to use and develop equitable assessments (EA). The study is rare in that it looks at the development of preservice teachers' understanding and ability to design EA. I examined the understanding and implementation of EA of 23 secondary preservice teachers within two classes. The methods classes focused on the academic content area of science. Participants' journals, teaching philosophies, and inquiry-based science units served as data sources. Participants progressed from a simple view of EA as "fairness" to a more sophisticated view of EA, including: ways to increase fairness, the importance of challenging students, and using assessments for learning. Results also showed changes in preservice teachers' views of learners and the purpose of assessment. While understanding developed robustly, teachers' assessment plans in their units were not as strong. Teacher education programs need to place more emphasis on developing critical understanding of EA practices to meet the needs of diverse learners.

  5. “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

  6. "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.

  7. LigoDV-web: Providing easy, secure and universal access to a large distributed scientific data store for the LIGO scientific collaboration

    Science.gov (United States)

    Areeda, J. S.; Smith, J. R.; Lundgren, A. P.; Maros, E.; Macleod, D. M.; Zweizig, J.

    2017-01-01

    Gravitational-wave observatories around the world, including the Laser Interferometer Gravitational-Wave Observatory (LIGO), record a large volume of gravitational-wave output data and auxiliary data about the instruments and their environments. These data are stored at the observatory sites and distributed to computing clusters for data analysis. LigoDV-web is a web-based data viewer that provides access to data recorded at the LIGO Hanford, LIGO Livingston and GEO600 observatories, and the 40 m prototype interferometer at Caltech. The challenge addressed by this project is to provide meaningful visualizations of small data sets to anyone in the collaboration in a fast, secure and reliable manner with minimal software, hardware and training required of the end users. LigoDV-web is implemented as a Java Enterprise Application, with Shibboleth Single Sign On for authentication and authorization, and a proprietary network protocol used for data access on the back end. Collaboration members with proper credentials can request data be displayed in any of several general formats from any Internet appliance that supports a modern browser with Javascript and minimal HTML5 support, including personal computers, smartphones, and tablets. Since its inception in 2012, 634 unique users have visited the LigoDV-web website in a total of 33 , 861 sessions and generated a total of 139 , 875 plots. This infrastructure has been helpful in many analyses within the collaboration including follow-up of the data surrounding the first gravitational-wave events observed by LIGO in 2015.

  8. 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

  9. 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

    2018-01-25

    %) 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.

  10. Patients' perspectives of accessibility and digital delivery of factual content provided by official medical and surgical specialty society websites: a qualitative assessment.

    Science.gov (United States)

    Ow, Darren; Wetherell, David; Papa, Nathan; Bolton, Damien; Lawrentschuk, Nathan

    2015-03-27

    Health care websites provide a valuable resource of health information to online consumers, especially patients. Official surgical and medical society websites should be a reliable first point of contact. The primary aim of this study was to quantitatively assess medical and surgical society websites for content and highlight the essential features required for a high-quality, user-friendly society website. Twenty specialty association websites from each of the regions, Australia, UK, Canada, Europe, and the USA were selected for a total of 100 websites. Medical and surgical specialities were consistent across each region. Each website was systematically and critically analysed for content and usability. The average points scored per website was 3.2 out of 10. Of the total (N=100) websites, 12 scored at least 7 out of 10 points and 2 scored 9 out of 10. As well, 35% (35.0/100) of the websites had an information tab for patients on their respective homepages while 38% (38.0/100) had download access to patient information. A minority of the websites included different forms of multimedia such as pictures and diagrams (24.0/100, 24%) and videos (18.0/100, 18%). We found that most society websites did not meet an adequate standard for delivery of information. Half of the websites were not patient accessible, with the primary focus being for health professionals. As well, most required logins for information access. Specialty health care societies should create patient-friendly websites that would be beneficial to all online consumers.

  11. Counseling on Access to Lethal Means (CALM): An Evaluation of a Suicide Prevention Means Restriction Training Program for Mental Health Providers.

    Science.gov (United States)

    Sale, Elizabeth; Hendricks, Michelle; Weil, Virginia; Miller, Collin; Perkins, Scott; McCudden, Suzanne

    2017-11-28

    This paper evaluates the effectiveness of the Counseling on Access to Lethal Means (CALM) suicide prevention program. CALM trains mental health providers how to counsel suicidal individuals and those who support them on mean restriction during times of crisis. Pre/post/3-month follow-up assessments measured knowledge of lethal means, confidence and comfort in discussing means restriction (self-efficacy), and future intentions to counsel clients on means restriction. Change in the number of clients receiving lethal means counseling was also assessed. All constructs increased significantly at posttest. Confidence and counseling intentions were sustained at follow-up and significantly more clients received means counseling in the 3 months following the CALM training. Knowledge and comfort levels decreased at follow-up but not to pre-training levels. CALM is effective at increasing mental health professionals' comfort, knowledge, and frequency of talking about means restriction with clients. an effective means restriction training program. A template to assess clients for suicidality and lethal means access and booster sessions are recommended to further sustain effects.

  12. 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.

  13. Towards an indicator system to assess equitable management in protected areas

    DEFF Research Database (Denmark)

    Zafra Calvo, Noelia; Pascual, U.; Brockington, D.

    2017-01-01

    Aichi Target 11 (AT11), adopted by 193 Parties to the Convention on Biological Diversity (CBD) in 2010, states that protected areas (PAs) must be equitably managed by 2020. However, significant challenges remain in terms of actual implementation of equitable management in PAs. These challenges...... of social equity in protected areas: recognition, procedure and distribution. The indicators target information on social equity regarding cultural identity, statutory and customary rights, knowledge diversity; free, prior and informed consent mechanisms, full participation and transparency in decision...

  14. Addressing ethical issues in pandemic influenza planning: equitable access to scare medical resources

    NARCIS (Netherlands)

    Verweij, M.F.

    2007-01-01

    It is generally expected that sooner or later a novel influenza A virus subtype, easily transmissible from person to person, will emerge and cause pandemic disease. Humans will have little or no immunity to this virus, which could spread at least as easily as common seasonal influenza and

  15. Ensuring Equitable Access to Strong Teachers: Important Elements of an Effective State Action Plan

    Science.gov (United States)

    Metz, Rachel

    2015-01-01

    Every community has strong teachers who help their students learn to high levels. But far too often low-income students and students of color are short-changed when it comes to teacher quality. Federal law requires states to end these disparities. But states, recognizing that most hiring, compensation, and promotional decisions, not to mention…

  16. Google Scholar Retrieves Twice as Many Relevant Citations as PubMed and Provides Greater Full-Text Access for Quick, Clinical Nephrology Searches

    Directory of Open Access Journals (Sweden)

    Diana K. Wakimoto

    2014-03-01

    Full Text Available Objective – To compare recall and precision of results retrieved by searches in PubMed and Google Scholar for clinical nephrology literature. Design – Survey questionnaire, comparative. Setting – Canada. Subjects – Practicing nephrologists with average age of 48 years and who have practiced nephrology for an average of 15 years. Methods – The researchers identified 100 systematic reviews in renal therapy published between 2001 and 2009. The primary studies cited in the systematic reviews served as the reference standard for relevant articles; 1,574 unique citations were identified and used to measure recall and precision. The researchers created a unique clinical question from each of the objective statements of systematic reviews and sent one question to a random sample of practicing nephrologists to determine the search strings they would use to search for clinical literature; the researchers collected 100 usable responses. Using the search string in both Google Scholar and PubMed, the researchers analyzed the first 40 retrieved results in each for recall of relevant literature and precision. The researchers also analyzed the availability of full-text articles in each database. A pilot study to test the methodology preceded the main study. Results – Google Scholar’s recall for the first 40 records was 21.9% and PubMed was 10.9%. Each database contained 78% of the relevant literature/reference standard set from the systematic reviews. However, 15% of the articles were in neither database. Precision results were similar (7.6% for Google Scholar and 5.6% for PubMed. Google Scholar had more full-text available at 15% of articles versus 5% for PubMed. Google Scholar and PubMed had similar numbers of relevant articles when all retrieved records were analyzed, but Google Scholar still provided more access to free full-text articles. Conclusion – Google Scholar provides better recall and provides more access to full-text than Pub

  17. Measuring the impact of Hurricane Katrina on access to a personal healthcare provider: the use of the National Survey of Children's Health for an external comparison group.

    Science.gov (United States)

    Stehling-Ariza, Tasha; Park, Yoon Soo; Sury, Jonathan J; Abramson, David

    2012-04-01

    This paper examined the effect of Hurricane Katrina on children's access to personal healthcare providers and evaluated the use of propensity score methods to compare a nationally representative sample of children, as a proxy for an unexposed group, with a smaller exposed sample. 2007 data from the Gulf Coast Child and Family Health (G-CAFH) Study, a longitudinal cohort of households displaced or greatly impacted by Hurricane Katrina, were matched with 2007 National Survey of Children's Health (NSCH) data using propensity score techniques. Propensity scores were created using poverty level, household educational attainment, and race/ethnicity, with and without the addition of child age and gender. The outcome was defined as having a personal healthcare provider. Additional confounders (household structure, neighborhood safety, health and insurance status) were also examined. All covariates except gender differed significantly between the exposed (G-CAFH) and unexposed (NSCH) samples. Fewer G-CAFH children had a personal healthcare provider (65 %) compared to those from NSCH (90 %). Adjusting for all covariates, the propensity score analysis showed exposed children were 20 % less likely to have a personal healthcare provider compared to unexposed children in the US (OR = 0.80, 95 % CI 0.76, 0.84), whereas the logistic regression analysis estimated a stronger effect (OR = 0.28, 95 % CI 0.21, 0.39). Two years after Hurricane Katrina, children exposed to the storm had significantly lower odds of having a personal health care provider compared to unexposed children. Propensity score matching techniques may be useful for combining separate data samples when no clear unexposed group exists.

  18. Community-Based Participatory Research (CBPR): Towards Equitable Involvement of Community in Psychology Research.

    Science.gov (United States)

    Collins, Susan E; Clifasefi, Seema L; Stanton, Joey; Straits, Kee J E; Gil-Kashiwabara, Eleanor; Rodriguez Espinosa, Patricia; Nicasio, Andel V; Andrasik, Michele P; Hawes, Starlyn M; Miller, Kimberly A; Nelson, Lonnie A; Orfaly, Victoria E; Duran, Bonnie M; Wallerstein, Nina

    2018-01-22

    Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change. With its origins in psychology, sociology, and critical pedagogy, CBPR has become a common research approach in the fields of public health, medicine, and nursing. Although it is well aligned with psychology's ethical principles and research aims, it has not been widely implemented in psychology research. The present article introduces CBPR to a general psychology audience while considering the unique aims of and challenges in conducting psychology research. In this article, we define CBPR principles, differentiate it from a more traditional psychology research approach, retrace its historical roots, provide concrete steps for its implementation, discuss its potential benefits, and explore practical and ethical challenges for its integration into psychology research. Finally, we provide a case study of CBPR in psychology to illustrate its key constructs and implementation. In sum, CBPR is a relevant, important, and promising research framework that may guide the implementation of more effective, culturally appropriate, socially just, and sustainable community-based psychology research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  19. 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....

  20. 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.

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

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon

    2015-12-04

    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.

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

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon

    2015-01-01

    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. PMID:26690225

  3. 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

  4. 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.

  5. Role of Human Health Care Providers and Medical Treatment Facilities in Military Working Dog Care and Accessibility Difficulties with Military Working Dog Blood Products.

    Science.gov (United States)

    Giles Iii, James T

    2016-01-01

    The use of military working dogs (MWDs) in support of military operations has increased dramatically over recent years, as they have proven to be our most reliable deterrent to improvised explosive devices. Healthcare delivery for MWDs in combat presents unique challenges and requires extensive collaboration between veterinarians and human health care providers (HCPs). A successful example is the incorporation of MWD emergency care for nonveterinary HCPs into the Joint Trauma System Clinical Practice Guidelines, which has proven to be a helpful product. Additional challenges that need further solutions include MWDs as patients in human medical treatment facilities (MTFs) and the procurement of appropriate canine blood components in an operational environment. It is often necessary for MWDs to be treated as patients in human MTFs, however, there is no Department of Defense guidance to support this activity. Access to MWD blood products is limited to collection of fresh whole blood in the operational setting. Similar to humans, specific blood component therapy, such as fresh frozen plasma, is often indicated for sick or injured MWDs. Currently there is no formal system in place to deliver any blood products for MWDs or to facilitate collection in theater.

  6. [Towards a new equitable system of scientific publications].

    Science.gov (United States)

    Vizcaíno-Salazar, Gilberto

    2009-06-01

    Scientific publications are the most accessible manifestations of research activities and the main mission of public universities and academic communities. The publication legitimizes scientific activity, the authors and the institutions that they promote, but specialized publications have a very small impact on society, since a limited market have implications on their costs' increase and on their possible extinction. In this context, the Open Access initiative (OAI) promotes free access to the scientific knowledge. This movement supports the need for the free availability on Internet of scientific information, for the whole humanity, without restrictions. The modality of open access promotes actions such as stimulus, development and the claim for support for the free subsistence of publications with standards of quality that guarantee a healthy practice, with recognition by the scientific community. In the OAI, the role of the author's copyright should be to grant the control to the authors on the integrity of their work and the right to be adequately recognized and mentioned. It is necessary to emphasize that the OAI will reduce the phenomenon of "lost science", understood as those researches that are never published, taking advantage of the model of development of the Society of the Knowledge and the suitable use of the TICs (technologies of information and communication), to achieve the increment of productivity and the economic and social progress of the countries.

  7. Undocumented Immigrants and Access to Health Care: Making a Case for Policy Reform.

    Science.gov (United States)

    Edward, Jean

    2014-02-01

    The growth in undocumented immigration in the United States has garnered increasing interest in the arenas of immigration and health care policy reform. Undocumented immigrants are restricted from accessing public health and social service as a result of their immigration status. The Patient Protection and Affordability Care Act restricts undocumented immigrants from participating in state exchange insurance market places, further limiting them from accessing equitable health care services. This commentary calls for comprehensive policy reform that expands access to health care for undocumented immigrants based on an analysis of immigrant health policies and their impact on health care expenditures, public health, and the role of health care providers. The intersectional nature of immigration and health care policy emphasizes the need for nurse policymakers to advocate for comprehensive policy reform aimed at improving the health and well-being of immigrants and the nation as a whole. © The Author(s) 2014 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  8. ORIGINAL ARTICLES How equitable is the scaling up of HIV service ...

    African Journals Online (AJOL)

    Objectives. To assess the extent of inequalities in availability and utilisation of HIV services across South Africa. Design. Cross-sectional descriptive study. Setting. Three districts ... School of Public Health, University of the Western Cape. Vera Scott, MB ... The implementation of an equitable HIV service in. South Africa is a ...

  9. Low Cost Private Schooling in India: Is It Pro Poor and Equitable?

    Science.gov (United States)

    Harma, Joanna

    2011-01-01

    India has seen an explosion in low-fee private (LFP) schooling aimed at the poorer strata of society, and this once-urban phenomenon has spread in the last decade to rural areas, with implications for equity due to the level of direct costs involved. This study explores whether or not LFP schooling in rural India is pro-poor and equitable, and…

  10. Commentary: BESTTuna: Benefiting from Equitable and Sustainable Trans-boundary Tuna fisheries in the Western Pacific

    NARCIS (Netherlands)

    Bush, S.R.; Zwieten, van P.A.M.; Bailey, M.L.

    2013-01-01

    In this commentary we introduce the BESTTuna research programme which addresses the challenges of governing sustainable and equitable tuna fisheries in the Western Pacific. The research in this programme attempts to build an inter-disciplinary understanding of the complex social-ecological

  11. Education in a Diverse Society Necessitates the Implementation of an Equitable Language Policy: The Russian Experience

    Science.gov (United States)

    Sinagatullin, Ilghiz M.

    2013-01-01

    Russia's secondary school populations are becoming increasingly diverse in terms of ethnicity, culture, language, and religion. The growing diversity makes a considerable impact on the functions and goals of schools, the realization of which requires the implementation of an equitable language policy. In this article, I briefly represent Russia as…

  12. Demographic Inertia Revisited: An Immodest Proposal to Achieve Equitable Gender Representation among Faculty in Higher Education

    Science.gov (United States)

    Marschke, Robyn; Laursen, Sandra; Nielsen, Joyce McCarl; Rankin, Patricia

    2007-01-01

    Progress toward equitable gender representation among faculty in higher education has been "glacial" since the early 1970s (Glazer-Raymo, 1999; Lomperis, 1990; Trower & Chait, 2002). Women, who now make up a majority of undergraduate degree earners and approximately 46% of Ph.D. earners nationwide (National Center for Education Statistics [NCES],…

  13. Pluralism and Equitability: Multicultural Curriculum Strategies for Schools. NACCME Commissioned Research Paper No. 3.

    Science.gov (United States)

    Kalantzis, Mary; Cope, Bill

    This paper compares pluralistic and equitable approaches to sociocultural and language teaching in Australian schools. The pluralistic view of multiculturalism overemphasizes ethnic differences with the hope that appreciation and tolerance will follow. In fact, fostering feelings of difference may increase racism and cultural chauvinism. This…

  14. 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…

  15. 48 CFR 52.250-5 - SAFETY Act-Equitable Adjustment.

    Science.gov (United States)

    2010-10-01

    ... institutions of the United States. Block certification means SAFETY Act certification of a technology class... certification means a determination by DHS pursuant to 6 U.S.C. 442(d), as further delineated in 6 CFR 25.9... Act—Equitable Adjustment (FEB 2009) (a) Definitions. As used in this clause— Act of terrorism means...

  16. An Investigation of the Effectiveness of an Online Catalog in Providing Bibliographic Access to Children in a Public Library Setting. Research Report.

    Science.gov (United States)

    Edmonds, Leslie; And Others

    This study evaluated the use of an online catalog by 33 children in the fourth, sixth, and eighth grades. As a basis of comparison, the children's ability to use the card catalog was also evaluated. Touch screen terminals were used to access a CLSI catalog. A specific set of tests was developed to determine if children have the necessary…

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

    Science.gov (United States)

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

    2015-10-01

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

  18. Smart phone accessibility and mHealth use in a limited resource setting.

    Science.gov (United States)

    Garner, Shelby L; Sudia, Tanya; Rachaprolu, Spurgeon

    2017-11-20

    To determine smartphone access and use including future opportunities for mHealth and potential ethical implications among health care professionals practicing at a health care facility in Bengaluru, India. The evolution of smart phones can provide convenient, portable, and rapid access to resources for health care professionals. While mobile phone accessibility has improved in recent years in many low and middle-income countries, the use of smart phones to address health priorities remains limited in some limited resource settings. A quantitative descriptive design was used. A survey was administered in November of 2016 to nurses and physicians at a tertiary care hospital in India. All respondents had a mobile phone, and the majority owned a smart phone that was used for text messaging, email, accessing internet, and downloading apps. Participants recommended smart phone use to improve health care provider access to continuing education and to improve patient knowledge about health. Physicians had better access to mHealth resources compared with nurses. Credible, evidence-based, affordable mobile applications are needed to provide a platform for continuing health education to health professionals and patients in India and limited resource settings. Nurses need equitable access to mHealth resources to build successful mHealth initiatives. © 2017 John Wiley & Sons Australia, Ltd.

  19. 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.

  20. The role of non-dental health professionals in providing access to dental care for low-income and minority patients.

    Science.gov (United States)

    Cohen, Leonard A

    2009-07-01

    The disadvantaged suffer disproportionately from dental problems. These persons are more likely to have untreated oral health problems and associated pain, and also are more likely to forego dental treatment even when in pain. There has been increased emphasis on the potential role of physicians in alleviating oral health disparities, especially among children. In addition, many adults lacking access to traditional dental services seek care and consultation from hospital emergency departments, physicians, and pharmacists. The delivery of oral health care services by non-dental health professionals may assume increasing importance as the population continues to age and becomes more diverse. This is because, in general, the elderly and ethnic and racial minorities face significant economic barriers to accessing private dental services.

  1. Critical Race Theory and Counselor Education Pedagogy: Creating Equitable Training

    Science.gov (United States)

    Haskins, Natoya H.; Singh, Anneliese

    2015-01-01

    Infusing critical race theory, the authors discuss specific pedagogical strategies to enhance educational experiences of counselor trainees. The authors then provide an evaluative checklist to facilitate and evaluate curricular integration of critical race theory.

  2. 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.

  3. 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.

  4. 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.

  5. 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 in facility provision ?Identification of suitable location(s) for selected new facilities and assisting in the development of a integrated facility provision location plans ?Evaluation of the impact of planned project or budget requests on facility backlog... the people?s access to transport ? Road network ? the road network is used to simulate the way in which people traverse across spaces. Different types of roads also have different speeds at which traffic or a person can move on it or impedances. Using...

  6. Improvements in access to malaria treatment in Tanzania after switch to artemisinin combination therapy and the introduction of accredited drug dispensing outlets - a provider perspective

    Directory of Open Access Journals (Sweden)

    Dillip Angel

    2010-06-01

    Full Text Available Abstract Background To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO was created in Tanzania. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP to artemether-lumefantrine (ALu in 2007. Subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on access to malaria treatment was studied in rural Tanzania. Methods The study was carried out in the villages of Kilombero and Ulanga Demographic Surveillance System (DSS and in Ifakara town. Data collection consisted of: 1 yearly censuses of shops selling drugs; 2 collection of monthly data on availability of anti-malarials in public health facilities; and 3 retail audits to measure anti-malarial sales volumes in all public, mission and private outlets. The data were complemented with DSS population data. Results Between 2004 and 2008 access to malaria treatment greatly improved and the number of anti-malarial treatment doses dispensed increased by 78%. Particular improvements were observed in the availability (from 0.24 shops per 1,000 people in 2004 to 0.39 in 2008 and accessibility (from 71% of households within 5 km of a shop in 2004 to 87% in 2008 of drug shops. Despite no improvements in affordability this resulted in an increase of the market share from 49% of anti-malarial sales 2005 to 59% in 2008. The change of treatment policy from SP to ALu led to severe stock-outs of SP in health facilities in the months leading up to the introduction of ALu (only 40% months in stock, but these were compensated by the wide availability of SP in shops. After the introduction of ALu stock levels of the drug were relatively high in public health facilities (over 80% months in stock, but the drug could only be found in 30% of drug shops and in no general shops. This resulted in a low overall utilization of the drug (19% of all anti

  7. 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 ...

  8. Fair access to water | IDRC - International Development Research ...

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

    2013-03-19

    Mar 19, 2013 ... As the world observes World Water Day (March 22) and the International Year of Water Cooperation, IDRC asked researchers: How do we ensure fair and equitable access to water? The quotes below represent a range of views on this important issue. The opinions expressed reflect those of the speaker, ...

  9. Providing researchers with online access to NHLBI biospecimen collections: The results of the first six years of the NHLBI BioLINCC program.

    Science.gov (United States)

    Giffen, Carol A; Wagner, Elizabeth L; Adams, John T; Hitchcock, Denise M; Welniak, Lisbeth A; Brennan, Sean P; Carroll, Leslie E

    2017-01-01

    The National Heart, Lung, and Blood Institute (NHLBI), within the United States' National Institutes of Health (NIH), established the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) in 2008 to develop the infrastructure needed to link the contents of the NHLBI Biorepository and the NHLBI Data Repository, and to promote the utilization of these scientific resources by the broader research community. Program utilization metrics were developed to measure the impact of BioLINCC on Biorepository access by researchers, including visibility, program efficiency, user characteristics, scientific impact, and research types. Input data elements were defined and are continually populated as requests move through the process of initiation through fulfillment and publication. This paper reviews the elements of the tracking metrics which were developed for BioLINCC and reports the results for the first six on-line years of the program.

  10. 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...

  11. Validating the accuracy of GIS-based accessibility analysis in determining public primary health care demand in Metropolitan areas

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-07-01

    Full Text Available Geographical access is an important aspect of the health care planning process. GIS-based accessibility analysis is a logical method which can be applied to test the degree to which equitable access to services and facilities is obtained. The GIS...

  12. Equity in access to fortified maize flour and corn meal.

    Science.gov (United States)

    Zamora, Gerardo; De-Regil, Luz Maria

    2014-04-01

    Mass fortification of maize flour and corn meal with a single or multiple micronutrients is a public health intervention that aims to improve vitamin and mineral intake, micronutrient nutritional status, health, and development of the general population. Micronutrient malnutrition is unevenly distributed among population groups and is importantly determined by social factors, such as living conditions, socioeconomic position, gender, cultural norms, health systems, and the socioeconomic and political context in which people access food. Efforts trying to make fortified foods accessible to the population groups that most need them require acknowledgment of the role of these determinants. Using a perspective of social determinants of health, this article presents a conceptual framework to approach equity in access to fortified maize flour and corn meal, and provides nonexhaustive examples that illustrate the different levels included in the framework. Key monitoring areas and issues to consider in order to expand and guarantee a more equitable access to maize flour and corn meal are described. © 2013 New York Academy of Sciences. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  13. Equitable peer review and the national practitioner data bank

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2017-12-01

    Full Text Available No abstract available. Article truncated at 150 words. The General Accounting Office (GAO recently reported that Department of Veterans Affairs (VA did not report most physicians whose clinical care was found to be, or suspected of being, substandard to the National Practitioner Data Bank (NPDB or to state licensing boards (1. The GAO examined 5 VAMCs and found required reviews of 148 providers’ clinical care after concerns were raised from October 2013 through March 2017. Of the 148, 5 were subjected to adverse privileging actions and 4 resigned or retired while under review but before adverse actions were taken. Only 1 of these 9 was reported to the NPDB and none was reported to his or her state medical board. In response to GAO's report and in testimony to the Subcommittee on Oversight and Investigations, VA officials said the agency was taking three steps to improve reporting of providers who don't meet required standards: 1.\tReporting more clinical …

  14. The dilemma of intellectual property rights for pharmaceuticals: the tension between ensuring access of the poor to medicines and committing to international agreements.

    Science.gov (United States)

    Cohen, Jillian Clare; Illingworth, Patricia

    2003-05-01

    In this paper, we provide an overview of how the outcomes of the Uruguay Round affected the application of pharmaceutical intellectual property rights globally. Second, we explain how specific pharmaceutical policy tools can help developing states mitigate the worst effects of the TRIPS Agreement. Third, we put forward solutions that could be implemented by the World Bank to help overcome the divide between creating private incentives for research and development of innovative medicines and ensuring access of the poor to medicine. Fourth, we evaluate these solutions on the basis of utilitarian considerations and urge that equitable pricing is morally preferable to the other solutions.

  15. 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...

  16. An iron-catalysed C-C bond-forming spirocyclization cascade providing sustainable access to new 3D heterocyclic frameworks

    Science.gov (United States)

    Adams, Kirsty; Ball, Anthony K.; Birkett, James; Brown, Lee; Chappell, Ben; Gill, Duncan M.; Lo, P. K. Tony; Patmore, Nathan J.; Rice, Craig. R.; Ryan, James; Raubo, Piotr; Sweeney, Joseph B.

    2017-04-01

    Heterocyclic architectures offer powerful creative possibilities to a range of chemistry end-users. This is particularly true of heterocycles containing a high proportion of sp3-carbon atoms, which confer precise spatial definition upon chemical probes, drug substances, chiral monomers and the like. Nonetheless, simple catalytic routes to new heterocyclic cores are infrequently reported, and methods making use of biomass-accessible starting materials are also rare. Here, we demonstrate a new method allowing rapid entry to spirocyclic bis-heterocycles, in which inexpensive iron(III) catalysts mediate a highly stereoselective C-C bond-forming cyclization cascade reaction using (2-halo)aryl ethers and amines constructed using feedstock chemicals readily available from plant sources. Fe(acac)3 mediates the deiodinative cyclization of (2-halo)aryloxy furfuranyl ethers, followed by capture of the intermediate metal species by Grignard reagents, to deliver spirocycles containing two asymmetric centres. The reactions offer potential entry to key structural motifs present in bioactive natural products.

  17. An iron-catalysed C-C bond-forming spirocyclization cascade providing sustainable access to new 3D heterocyclic frameworks.

    Science.gov (United States)

    Adams, Kirsty; Ball, Anthony K; Birkett, James; Brown, Lee; Chappell, Ben; Gill, Duncan M; Lo, P K Tony; Patmore, Nathan J; Rice, Craig R; Ryan, James; Raubo, Piotr; Sweeney, Joseph B

    2017-04-01

    Heterocyclic architectures offer powerful creative possibilities to a range of chemistry end-users. This is particularly true of heterocycles containing a high proportion of sp 3 -carbon atoms, which confer precise spatial definition upon chemical probes, drug substances, chiral monomers and the like. Nonetheless, simple catalytic routes to new heterocyclic cores are infrequently reported, and methods making use of biomass-accessible starting materials are also rare. Here, we demonstrate a new method allowing rapid entry to spirocyclic bis-heterocycles, in which inexpensive iron(III) catalysts mediate a highly stereoselective C-C bond-forming cyclization cascade reaction using (2-halo)aryl ethers and amines constructed using feedstock chemicals readily available from plant sources. Fe(acac) 3 mediates the deiodinative cyclization of (2-halo)aryloxy furfuranyl ethers, followed by capture of the intermediate metal species by Grignard reagents, to deliver spirocycles containing two asymmetric centres. The reactions offer potential entry to key structural motifs present in bioactive natural products.

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

    Science.gov (United States)

    Rasella, Davide; Machado, Daiane Borges; Castellanos, Marcelo Eduardo Pfeirrer; Paim, Jairnilson; Szwarcwald, Celia Landmann; Lima, Diana; Magno, Laio; Pedrana, Leo; Medina, Maria Guadalupe; Penna, Gerson Oliveira; Barreto, Mauricio Lima

    2016-01-01

    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. 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. 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. 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. 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.

  19. Cognitive-behavioral therapy: How medical providers can increase patient and family openness and access to evidence-based multimodal therapy for pediatric migraine

    Science.gov (United States)

    Ernst, Michelle M.; O’Brien, Hope; Powers, Scott W.

    2015-01-01

    While evidence supports the recommendation for cognitive behavioral therapy (CBT) for pediatric migraine, few children actually receive this evidence-based intervention. In this article we briefly review the most recent empirical evidence supporting CBT. We then identify both provider/system-related barriers as well as patient-related barriers. Finally, we provide practical solutions to addressing these barriers in the service of facilitating children receiving optimal comprehensive management of their headaches. PMID:26198185

  20. The Role of ODL in the Advancing Access to Education for Special ...

    African Journals Online (AJOL)

    Special and vulnerable groups have a right to equitable access to all benefits that society offers. However, the situation for people with disabilities, refugees and inmates in Zimbabwe face barriers of accessibility to basic and tertiary education. Zimbabwe is a signatory to the UN Declaration Charter for Human Rights which ...

  1. 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

  2. Systematic review and evaluation of web-accessible tools for management of diabetes and related cardiovascular risk factors by patients and healthcare providers.

    Science.gov (United States)

    Yu, Catherine H; Bahniwal, Robinder; Laupacis, Andreas; Leung, Eman; Orr, Michael S; Straus, Sharon E

    2012-01-01

    To identify and evaluate the effectiveness, clinical usefulness, sustainability, and usability of web-compatible diabetes-related tools. Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, world wide web. Studies were included if they described an electronic audiovisual tool used as a means to educate patients, care givers, or clinicians about diabetes management and assessed a psychological, behavioral, or clinical outcome. Study abstraction and evaluation for clinical usefulness, sustainability, and usability were performed by two independent reviewers. Of 12,616 citations and 1541 full-text articles reviewed, 57 studies met inclusion criteria. Forty studies used experimental designs (25 randomized controlled trials, one controlled clinical trial, 14 before-after studies), and 17 used observational designs. Methodological quality and ratings for clinical usefulness and sustainability were variable, and there was a high prevalence of usability errors. Tools showed moderate but inconsistent effects on a variety of psychological and clinical outcomes including HbA1c and weight. Meta-regression of adequately reported studies (12 studies, 2731 participants) demonstrated that, although the interventions studied resulted in positive outcomes, this was not moderated by clinical usefulness nor usability. This review is limited by the number of accessible tools, exclusion of tools for mobile devices, study quality, and the use of non-validated scales. Few tools were identified that met our criteria for effectiveness, usefulness, sustainability, and usability. Priority areas include identifying strategies to minimize website attrition and enabling patients and clinicians to make informed decisions about website choice by encouraging reporting of website quality indicators.

  3. Deep mRNA sequencing of the Tritonia diomedea brain transcriptome provides access to gene homologues for neuronal excitability, synaptic transmission and peptidergic signalling.

    Directory of Open Access Journals (Sweden)

    Adriano Senatore

    Full Text Available The sea slug Tritonia diomedea (Mollusca, Gastropoda, Nudibranchia, has a simple and highly accessible nervous system, making it useful for studying neuronal and synaptic mechanisms underlying behavior. Although many important contributions have been made using Tritonia, until now, a lack of genetic information has impeded exploration at the molecular level.We performed Illumina sequencing of central nervous system mRNAs from Tritonia, generating 133.1 million 100 base pair, paired-end reads. De novo reconstruction of the RNA-Seq data yielded a total of 185,546 contigs, which partitioned into 123,154 non-redundant gene clusters (unigenes. BLAST comparison with RefSeq and Swiss-Prot protein databases, as well as mRNA data from other invertebrates (gastropod molluscs: Aplysia californica, Lymnaea stagnalis and Biomphalaria glabrata; cnidarian: Nematostella vectensis revealed that up to 76,292 unigenes in the Tritonia transcriptome have putative homologues in other databases, 18,246 of which are below a more stringent E-value cut-off of 1x10-6. In silico prediction of secreted proteins from the Tritonia transcriptome shotgun assembly (TSA produced a database of 579 unique sequences of secreted proteins, which also exhibited markedly higher expression levels compared to other genes in the TSA.Our efforts greatly expand the availability of gene sequences available for Tritonia diomedea. We were able to extract full length protein sequences for most queried genes, including those involved in electrical excitability, synaptic vesicle release and neurotransmission, thus confirming that the transcriptome will serve as a useful tool for probing the molecular correlates of behavior in this species. We also generated a neurosecretome database that will serve as a useful tool for probing peptidergic signalling systems in the Tritonia brain.

  4. GIS-based evaluation of public facility provision to achieve improved governance and equitable service delivery

    CSIR Research Space (South Africa)

    Green, Cheri A

    2009-04-01

    Full Text Available of greatest need. In tandem with the development of service provision standards, the GIS accessibility analysis enables more effective provision, management and monitoring of publicly provided facilities and services. Importantly, this technology promotes a..., management and monitoring of publicly provided facilities and services, within a transparent process. The methodology applied ensures that the backlog and provision in facilities is based on population distribution and relative shortages...

  5. AGRIS: providing access to agricultural research data exploiting open data on the web [v1; ref status: indexed, http://f1000r.es/599

    Directory of Open Access Journals (Sweden)

    Fabrizio Celli

    2015-05-01

    Full Text Available AGRIS is the International System for Agricultural Science and Technology. It is supported by a large community of data providers, partners and users. AGRIS is a database that aggregates bibliographic data, and through this core data, related content across online information systems is retrieved by taking advantage of Semantic Web capabilities. AGRIS is a global public good and its vision is to be a responsive service to its user needs by facilitating contributions and feedback regarding the AGRIS core knowledgebase, AGRIS’s future and its continuous development. Periodic AGRIS e-consultations, partner meetings and user feedback are assimilated to the development of the AGRIS application and content coverage. This paper outlines the current AGRIS technical set-up, its network of partners, data providers and users as well as how AGRIS’s responsiveness to clients’ needs inspires the continuous technical development of the application. The paper concludes by providing a use case of how the AGRIS stakeholder input and the subsequent AGRIS e-consultation results influence the development of the AGRIS application, knowledgebase and service delivery.

  6. Perceived Effect of Accessibility and Utilization of Electronic Resources on Productivity of Academic Staff in Selected Nigerian Universities

    Directory of Open Access Journals (Sweden)

    Okon E. Ani

    2015-10-01

    Full Text Available Access to information is vital for efficient research at universities. Electronic resources provide new platforms for information to aid in conducting research at universities. This study explores the perceived effect of accessibility and utilization of electronic resources on research productivity at Nigerian universities. A quantitative research approach was adopted for the study with a survey as research method. Data were collected for the study with a self-reporting questionnaire. Regression analysis in the study revealed that accessibility and use of electronic resources had a significant perceived positive effect on research productivity at the surveyed Nigerian universities. However, there was no significant perceived effect of accessibility and use of electronic resources by discipline on research productivity in the survey. In terms of gender, it was found that there was no significant perceived effect of accessibility and use of electronic resources by gender on research productivity among respondents at the surveyed Nigerian universities. Based on these findings, it is recommended that effective development of digital libraries in Nigerian universities would ameliorate the problems of accessibility and utilization of electronic resources by academic staff in research. Furthermore, the Nigerian university libraries should develop an electronic collection development policy to enhance equitable access and use of electronic resources at Nigerian universities. Policy for sustainable digitization of relevant library materials should be evolved to support digital libraries effectively for efficient accessibility and utilization of electronic resources.

  7. Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area.

    Science.gov (United States)

    Wan, Shaowei; Teichman, Peter G; Latif, David; Boyd, Jennifer; Gupta, Rahul

    2018-03-01

    To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers' beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available each day were perceived as better able to coordinate care and follow up with patients (p = .031), while teams that included clinical pharmacists were perceived as preventing medication-associated problems (p interprofessional care model as a useful strategy to improve various outcomes across different clinical settings in the context of a shortage of primary care physicians.

  8. Open Source Database and Website to Provide Free and Open Access to Inactive U.S. Patents in the Public Domain

    Directory of Open Access Journals (Sweden)

    Yuenyong Nilsiam

    2016-11-01

    Full Text Available Although theoretically the patent system is meant to bolster innovation, the current United States Patent and Trademark Office (USPTO is cumbersome and involves a significant time investment to locate inactive patents less than 20 years old. This article reports on the development of an open source database to find these public domain ideas. First, a search strategy is explained. Then the operation and use of free and open source software are detailed to meet the needs of open hardware innovators. Finally, a case study is presented to demonstrate the utility of the approach with 3-D printing. The results showed how the Free Inactive Patent Search enables users to search using plain language text to find public domain concepts and then provides a hyperlinked list of ideas that takes users to the USPTO database for the patent for more information. All of the source code to operate the search and the website are open source themselves and provided in the public domain for free. In the case study on 3-D printing the time to identify public domain patents was cut by a factor of more than 1500. This tool has the potential for accelerating the development of open hardware technologies to create high value for the public.

  9. 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.

  10. Evidence-based medicine for all: what we can learn from a programme providing free access to an online clinical resource to health workers in resource-limited settings.

    Science.gov (United States)

    Valtis, Yannis K; Rosenberg, Julie; Bhandari, Sudip; Wachter, Keri; Teichman, Marie; Beauvais, Sophie; Weintraub, Rebecca

    2016-01-01

    The rapidly changing landscape of medical knowledge and guidelines requires health professionals to have immediate access to current, reliable clinical resources. Access to evidence is instrumental in reducing diagnostic errors and generating better health outcomes. UpToDate, a leading evidence-based clinical resource is used extensively in the USA and other regions of the world and has been linked to lower mortality and length of stay in US hospitals. In 2009, the Global Health Delivery Project collaborated with UpToDate to provide free subscriptions to qualifying health workers in resource-limited settings. We evaluated the provision of UpToDate access to health workers by analysing their usage patterns. Since 2009, ∼2000 individual physicians and healthcare institutions from 116 countries have received free access to UpToDate through our programme. During 2013-2014, users logged into UpToDate ∼150 000 times; 61% of users logged in at least weekly; users in Africa were responsible for 54% of the total usage. Search patterns reflected local epidemiology with 'clinical manifestations of malaria' as the top search in Africa, and 'management of hepatitis B' as the top search in Asia. Our programme demonstrates that there are barriers to evidence-based clinical knowledge in resource-limited settings we can help remove. Some assumed barriers to its expansion (poor internet connectivity, lack of training and infrastructure) might pose less of a burden than subscription fees.

  11. Supporting Emergency Medical Care Teams with an Integrated Status Display Providing Real-Time Access to Medical Best Practices, Workflow Tracking, and Patient Data.

    Science.gov (United States)

    Wu, PoLiang; Nam, Min-Young; Choi, Jeonghwan; Kirlik, Alex; Sha, Lui; Berlin, Richard B

    2017-10-17

    The work of a hospital's medical staff is safety critical and often occurs under severe time constraints. To provide timely and effective cognitive support to medical teams working in such contexts, guidelines in the form of best practice workflows for healthcare have been developed by medical organizations. However, the high cognitive load imposed in such stressful and rapidly changing environments poses significant challenges to the medical staff or team in adhering to these workflows. In collaboration with physicians and nurses from Carle Foundation Hospital, we first studied and modeled medical team's individual responsibilities and interactions in cardiac arrest resuscitation and decomposed their overall task into a set of distinct cognitive tasks that must be specifically supported to achieve successful human-centered system design. We then developed a medical Best Practice Guidance (BPG) system for reducing medical teams' cognitive load, thus fostering real-time adherence to best practices. We evaluated the resulting system with physicians and nurses using a professional patient simulator used for medical training and certification. The evaluation results point to a reduction of cognitive load and enhanced adherence to medical best practices.

  12. Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships.

    Science.gov (United States)

    MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve

    2017-11-28

    Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

  13. Towards building equitable health systems in Sub-Saharan Africa: lessons from case studies on operational research

    Directory of Open Access Journals (Sweden)

    Tolhurst Rachel

    2009-11-01

    Full Text Available Abstract Background Published practical examples of how to bridge gaps between research, policy and practice in health systems research in Sub Saharan Africa are scarce. The aim of our study was to use a case study approach to analyse how and why different operational health research projects in Africa have contributed to health systems strengthening and promoted equity in health service provision. Methods Using case studies we have collated and analysed practical examples of operational research projects on health in Sub-Saharan Africa which demonstrate how the links between research, policy and action can be strengthened to build effective and pro-poor health systems. To ensure rigour, we selected the case studies using pre-defined criteria, mapped their characteristics systematically using a case study development framework, and analysed the research impact process of each case study using the RAPID framework for research-policy links. This process enabled analysis of common themes, successes and weaknesses. Results 3 operational research projects met our case study criteria: HIV counselling and testing services in Kenya; provision of TB services in grocery stores in Malawi; and community diagnostics for anaemia, TB and malaria in Nigeria. Political context and external influences: in each case study context there was a need for new knowledge and approaches to meet policy requirements for equitable service delivery. Collaboration between researchers and key policy players began at the inception of operational research cycles. Links: critical in these operational research projects was the development of partnerships for capacity building to support new services or new players in service delivery. Evidence: evidence was used to promote policy dialogue around equity in different ways throughout the research cycle, such as in determining the topic area and in development of indicators. Conclusion Building equitable health systems means

  14. Using peer review to distribute group work marks equitably between medical students.

    Science.gov (United States)

    Cook, Alex R; Hartman, Mikael; Luo, Nan; Sng, Judy; Fong, Ngan Phoon; Lim, Wei Yen; Chen, Mark I-Cheng; Wong, Mee Lian; Rajaraman, Natarajan; Lee, Jeannette Jen-Mai; Koh, Gerald Choon-Huat

    2017-09-20

    Although peer assessment has been used for evaluating performance of medical students and practicing doctors, it has not been studied as a method to distribute a common group work mark equitably to medical students working in large groups where tutors cannot observe all students constantly. The authors developed and evaluated a mathematical formulation whereby a common group mark could be distributed among group members using peer assessment of individual contributions to group work, maintaining inter-group variation in group work scores. This was motivated by community health projects undertaken by large groups of year four medical students at the National University of Singapore, and the new and old formulations are presented via application to 263 students in seven groups of 36 to 40 during the academic year 2012/2013. This novel formulation produced a less clustered mark distribution that rewarded students who contributed more to their team. Although collusion among some members to form a voting alliance and 'personal vendettas' were potential problems, the former was not detected and the latter had little impact on the overall grade a student received when working in a large group. The majority of students thought the new formulation was fairer. The new formulation is easy to implement and arguably awards grades more equitably in modules where group work is a major component.

  15. Equality, accessibility, and availability of physical therapy services in Israel-Perception of national directors.

    Science.gov (United States)

    Jacob, Tamar; Parag, Ayala

    2015-07-01

    To date no research has described Israeli physical therapy (PT) services to determine whether they are provided in the spirit intended by the National Health Insurance Law (NHIL). This study aimed to assess the equality, accessibility, and availability of PT services in Israel. Qualitative research was based on semi-structured, personal interviews with all national directors of PT services in Israel, followed by content analysis of the data obtained. According to the findings, PT services are provided by all Health Maintenance Organisations (HMOs) throughout Israel. In peripheral areas, access to services is limited; availability of services at most clinics is poor, a problem which is solved mainly by referring patients to PT outsourcing. The number of treatment sessions is determined by the NHIL; however, all directors agreed that the number of treatments provided should be based on a professional decision following patient evaluation and progress, rather than on administrative considerations. Inequality of service to peripheral areas could be reduced by creating cooperation between HMOs, thereby establishing clinics capable of providing services that are both accessible and equitable. In addition, the number of sessions provided to patients in the health-care basket should be reassessed, and a set of uniform criteria should be created for determining the optimal number of PT sessions. This could lead to greater uniformity in distribution of PT services provided by the HMOs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. From Access to Success: An Integrated Approach to Quality Higher Education Informed by Social Inclusion Theory and Practice

    Science.gov (United States)

    Gidley, Jennifer M.; Hampson, Gary P.; Wheeler, Leone; Bereded-Samuel, Elleni

    2010-01-01

    Equitable access, success and quality in higher education are examined from a variety of ideological perspectives. "Quality" is positioned as a complex generic concept while "access" and "success" are identified as key concepts in the social inclusion domain, supplemented by the concept of "participation."…

  17. GIS-based accessibility analysis: An approach to determine public primary health care demand in South Africa

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2013-11-01

    Full Text Available process. GIS-based accessibility analysis is a logical method which can be applied to test the degree to which equitable access is obtained. The GIS analysis is however based on the assumption of rational choice, i.e. a person will always go...

  18. 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.

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

    Science.gov (United States)

    Zaidi, Shehla; Bigdeli, Maryam; Aleem, Noureen; Rashidian, Arash

    2013-01-01

    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. 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. 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. 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.

  20. Middle School Math Acceleration and Equitable Access to Eighth-Grade Algebra: Evidence from the Wake County Public School System

    Science.gov (United States)

    Dougherty, Shaun M.; Goodman, Joshua S.; Hill, Darryl V.; Litke, Erica G.; Page, Lindsay C.

    2015-01-01

    Taking algebra by eighth grade is considered an important milestone on the pathway to college readiness. We highlight a collaboration to investigate one district's effort to increase middle school algebra course-taking. In 2010, the Wake County Public Schools began assigning middle school students to accelerated math and eighth-grade algebra based…

  1. A peripherally inserted central catheter line, inserted the day before surgery, decreases the time from induction to incision for spinal deformity surgery and safely provides central venous access during surgery: a pilot study.

    Science.gov (United States)

    Stuedemann, Anne E; Schwend, Richard M; Thomas, Valorie K; Leamon, Julia M; Lightner, Tammy S

    2018-03-01

    Pediatric patients undergoing surgery for spinal deformity may benefit from central venous access to provide intraoperative monitoring and fluid resuscitation. For pediatric surgical patients requiring central access, we hypothesized that placing a peripherally inserted central catheter (PICC) line preoperatively should decrease time from induction of anesthesia to incision and result in improved patient safety and decreased operating room charges. This was a retrospective, nonrandomized, and case comparison study. Clinical records of all children with adolescent idiopathic scoliosis or neuromuscular scoliosis treated surgically by the senior author between December 2007 and April 2012 were reviewed. Control group patients had a central venous catheter (CVC) placed by the anesthesiologist after induction of anesthesia. The trial group had a PICC placed under local anesthesia the day before surgery by an experienced vascular access team. The time from induction of anesthesia to the time for the surgical incision was determined for each study group. The CVC line placement charges were determined by the operating room time charges at $214/min. Charges saved were the mean time difference multiplied by the operating room time charge, less the charge for PICC line insertion ($1282). There were 29 neuromuscular patients, the mean age was 13 years (SD: 4 years). The mean time from induction to incision for the PICC group was 91 min [95% confidence interval (CI): 67-115 min] and for the CVC group 113 min (95% CI: 99-127 min, P=0.083). For this mean time difference of 22 min, the estimated cost savings would be $3426 per patient. There were 59 patients with adolescent idiopathic scoliosis, the mean age was 14 years (SD: 2 years). The mean time from induction to incision for the PICC group was 78 min (95% CI: 74-82 min) and for the CVC group 106 min (95% CI: 96-116  min, P≤0.001). For this mean time difference of 28 min, the estimated cost savings would

  2. Primary palliative care: the potential of primary care physicians as providers of palliative care in the community in the Eastern Mediterranean region.

    Science.gov (United States)

    Murray, S A; Osman, H

    2012-02-01

    Palliative care focuses on improving the quality of life and relieving suffering in patients with progressive chronic illnesses. Palliative care services remain very limited in the Eastern Mediterranean region although the need for them is high and increasing. The World Health Organization has identified the development of palliative care as a regional priority. This review highlights the urgent need to provide such care in the region and proposes that primary care providers in the region are well placed to provide palliative care in their communities. As palliative medicine is not established as a specialty in the region, training and support in palliative care are required to build capacity in end-of-life care and to allow all patients who would benefit from this approach access to it equitably and early in their illness.

  3. 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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    : 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......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...... quintile. In women the proportion was 23%, IRR 1.23 (1.16-1.29). An analogous pattern was seen applying education as SEP indicator and among subjects aged 65-84. CONCLUSION: The high-risk strategy to prevent CVD by initiating statin therapy seems to be inequitable, reaching primarily high-risk subjects...

  5. To reduce urban disparities in health, strengthen and enforce equitably environmental and consumer laws.

    Science.gov (United States)

    Olden, Kenneth; Ramos, Rose Marie; Freudenberg, Nicholas

    2009-11-01

    While observers agree that reducing disparities in health is an important health priority for the USA, there is little agreement and no comprehensive plan to achieve this goal. In this commentary, we make the case for reducing the disproportionate exposure to environmental and consumer hazards as a promising strategy for reducing health disparities. Exposures to environmental risks such as air pollution, lead, and hazardous wastes and to consumer products such as tobacco, alcohol, and unhealthy food have been identified as significant threats to health and important contributors to disparities in health. Strengthening the regulations that prevent exposure to these harmful substances and enforcing these rules equitably could bring benefits to the population as a whole and especially to the disenfranchised, primarily urban, populations that are most exposed. The current policy environment may present a window of opportunity for pursuing this strategy.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Morrell, Robert; Jewkes, Rachel

    2011-05-09

    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. 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. 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. 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.

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

    Science.gov (United States)

    2011-01-01

    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. PMID:21549020

  10. Measurement and analysis of inequality of opportunity in access of maternal and child health care in Togo.

    Science.gov (United States)

    Sanoussi, Yacobou

    2017-12-04

    Access to maternal and child health care in low- and middle-income countries such as Togo is characterized by significant inequalities. Most studies in the Togolese context have examined the total inequality of health and the determinants of individuals' health. Few empirical studies in Togo have focused on inequalities of opportunity in maternal and child health. To fill this gap, we estimated changes in inequality of opportunity in access to maternal and child health services between 1998 and 2013 using data from Togo Demographic and Health Surveys (DHS). We computed the Human Opportunity Index (HOI)-a measure of how individual, household, and geographic characteristics like sex and place of residence can affect individuals' access to services or goods that should be universal-using five indicators of access to healthcare and one composite indicator of access to adequate care for children. The five indicators of access were: birth in a public or private health facility; whether the child had received any vaccinations; access to prenatal care; prenatal care given by qualified staff; and having at least four antenatal visits. We then examined differences across the two years. Between 1998 and 2013, inequality of opportunities decreased for four out of six indicators. However, inequalities increased in access to antenatal care provided by qualified staff (5.9% to 12.5%) and access to adequate care (27.7% to 28.6%). Although inequality of opportunities reduced between 1998 and 2013 for some of the key maternal and child health indicators, the average coverage and access rates underscore the need for sustained efforts to ensure equitable access to primary health care for mothers and children.

  11. 41 CFR 302-11.441 - How must we determine if an employee holds equitable title interest in his/her property?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false How must we determine if an employee holds equitable title interest in his/her property? 302-11.441 Section 302-11.441 Public... interest in his/her property? To determine if an employee holds equitable title interest in his/her...

  12. Community-Based Equity Audits: A Practical Approach for Educational Leaders to Support Equitable Community-School Improvements

    Science.gov (United States)

    Green, Terrance L.

    2017-01-01

    Purpose: To equitably transform urban schools of color and the neighborhoods where they are nested requires approaches that promote community equity and foster solidarity among a range of stakeholders. However, most school-community approaches solely focus on improving school-based outcomes and leave educational leaders with little guidance for…

  13. [Validation of the equity of access of the OLMCS to health professionals in health regions of Canada].

    Science.gov (United States)

    Warnke, Jan; Bouchard, Louise

    2013-06-13

    Our research uses a regional summary indicator (IHPOLM) to measure the capacity of the health system to provide equitable access to health professionals for 2 million Official Language Minority Community (OLMC) members dispersed across 104 health regions in Canada. The summary indicator IHPOLM compares the official language minority and the official language majority potential access to health professionals. The IHPOLM indicator uses 22 professional health care occupations, representing 79% of the health care workforce in Canada, who communicate directly with their clientele for therapeutic or diagnostic purposes (Statistics Canada, 2006). The IHPOLM indicator revealed that the OLMC population is at a disadvantage in potential access to health professionals capable of providing services in the minority language when compared to the majority language population in 10 of the 13 Canadian provinces/territories. OLMC members are disadvantaged in 13 out of 14 health regions in Ontario, in 16 out of 18 in Québec and in 3 out of 7 in New Brunswick. The summary regional indicator IHPOLM identified OLMC health care access inequalities between the official language minority population and the majority language population in the health care system across the health regions in Canada. The more detailed analysis of IHPOLM for individual health occupations will further improve our knowledge of Official Language Minority Community health access inequalities.

  14. 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…

  15. Inequalities in access to medical care by income in developed countries.

    NARCIS (Netherlands)

    E.K.A. van Doorslaer (Eddy); C. Masseria (Cristina); A.H.E. Koolman (Xander)

    2006-01-01

    textabstractBACKGROUND: Most of the member countries of the Organization for Economic Cooperation and Development (OECD) aim to ensure equitable access to health care. This is often interpreted as requiring that care be available on the basis of need and not willingness or ability to pay. We sought

  16. What hinders minority ethnic access to cancer genetics services and what may help?

    Science.gov (United States)

    Allford, Anna; Qureshi, Nadeem; Barwell, Julian; Lewis, Celine; Kai, Joe

    2014-07-01

    Ethnic disparities in use of cancer genetics services raise concerns about equitable opportunity to benefit from familial cancer risk assessment, improved survival and quality of life. This paper considers available research to explore what may hinder or facilitate minority ethnic access to cancer genetics services. We sought to inform service development for people of South Asian, African or Irish origin at risk of familial breast, ovarian, colorectal and prostate cancers in the UK. Relevant studies from the UK, North America and Australasia were identified from six electronic research databases. Current evidence is limited but suggests low awareness and understanding of familial cancer risk among minority ethnic communities studied. Socio-cultural variations in beliefs, notably stigma about cancer or inherited risk of cancer, are identified. These factors may affect seeking of advice from providers and disparities in referral. Achieving effective cross-cultural communication in the complex contexts of both cancer and genetics counselling, whether between individuals and providers, when mediated by third party interpreters, or within families, pose further challenges. Some promising experience of facilitating minority ethnic access has been gained by introduction of culturally sensitive provider and counselling initiatives, and by enabling patient self-referral. However, further research to inform and assess these interventions, and others that address the range of challenges identified for cancer genetics services are needed. This should be based on a more comprehensive understanding of what happens at differing points of access and interaction at community, cancer care and genetic service levels.

  17. 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.

  18. 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

  19. Better access to mental health care and the failure of the Medicare principle of universality.

    Science.gov (United States)

    Meadows, Graham N; Enticott, Joanne C; Inder, Brett; Russell, Grant M; Gurr, Roger

    2015-03-02

    To examine whether adult use of mental health services subsidised by Medicare varies by measures of socioeconomic and geographic disadvantage in Australia. A secondary analysis of national Medicare data from 1 July 2007 to 30 June 2011 for all mental health services subsidised by Better Access to Mental Health Care (Better Access) and Medicare - providers included general practitioners, psychiatrists, clinical psychologists and mental health allied health practitioners. Service use rates followed by measurement of inequity using the concentration curve and concentration index. Increasing remoteness was consistently associated with lower service activity; eg, per 1000 population, the annual rate of use of GP items was 79 in major cities and 25 and 8 in remote and very remote areas, respectively. Apart from GP usage, higher socioeconomic disadvantage in areas was typically associated with lower usage; eg, per 1000 population per year, clinical psychologist consultations were 68, 40 and 23 in the highest, middle and lowest advantaged quintiles, respectively; and non-Better Access psychiatry items were 117, 55 and 45 in the highest, middle and lowest advantaged quintiles, respectively. Our results highlight important socioeconomic and geographical disparities associated with the use of Better Access and related Medicare services. This can inform Australia's policymakers about these priority gaps and help to stimulate targeted strategies both nationally and regionally that work towards the universal and equitable delivery of mental health care for all Australians.

  20. 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.

  1. Are green cities healthy and equitable? Unpacking the relationship between health, green space and gentrification.

    Science.gov (United States)

    Cole, Helen V S; Garcia Lamarca, Melisa; Connolly, James J T; Anguelovski, Isabelle

    2017-11-01

    While access and exposure to green spaces has been shown to be beneficial for the health of urban residents, interventions focused on augmenting such access may also catalyse gentrification processes, also known as green gentrification. Drawing from the fields of public health, urban planning and environmental justice, we argue that public health and epidemiology researchers should rely on a more dynamic model of community that accounts for the potential unintended social consequences of upstream health interventions. In our example of green gentrification, the health benefits of greening can only be fully understood relative to the social and political environments in which inequities persist. We point to two key questions regarding the health benefits of newly added green space: Who benefits in the short and long term from greening interventions in lower income or minority neighbourhoods undergoing processes of revitalisation? And, can green cities be both healthy and just? We propose the Green Gentrification and Health Equity model which provides a framework for understanding and testing whether gentrification associated with green space may modify the effect of exposure to green space on health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Validating the accuracy of GIS-based accessibility analysis in determining public primary health care demand in metropolitan areas: conference presentation

    CSIR Research Space (South Africa)

    Mokgalaka, H

    2014-07-01

    Full Text Available Accessibility analysis models the access of residents to facilities - assuming people will go to their nearest facility for service. If an analysis is done for a large area, this will show whether provision is sufficient and equitable if both...

  3. 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.

  4. Effect of provider-initiated testing and counselling and integration of ART services on access to HIV diagnosis and treatment for children in Lilongwe, Malawi: a pre- post comparison

    Directory of Open Access Journals (Sweden)

    Phiri Sam

    2009-12-01

    Full Text Available Abstract Background The HIV prevalence in Malawi is 12% and Kamuzu Central Hospital (KCH, in the capital Lilongwe, is the main provider of adult and paediatric HIV services in the central region. The Lighthouse at KCH offers opt-in HIV testing and counselling (HTC for adults and children. In June 2004, Lighthouse was the first clinic to provide free antiretroviral treatment (ART in the public sector, but few children accessed the services. In response, provider-initiated HIV testing and counselling (PITC and an ART clinic were introduced at the paediatric department at KCH in Quarter 4 (Q4 2004. Methods We analysed prospectively collected, aggregated data of quarterly reports from Q1 2003 to Q4 2006 from HTC centre registers, ART registers and clinic registrations at the ART clinics of both Lighthouse and the paediatric department. By comparing data of both facilities before (Q1 2003 to Q3 2004, and after the introduction of the services at the paediatric department (Q4 2004 to Q4 2006, we assessed the effect of this intervention on the uptake of HIV services for children at KCH. Results Overall, 3971 children were tested for HIV, 2428 HIV-infected children were registered for care and 1218 started ART. Between the two periods, the median (IQR number of children being tested, registered and starting ART per quarter rose from 101 (53-109 to 358 (318-440, 56 (50-82 to 226 (192-234 and 18 (8-23 to 139 (115-150, respectively. The median proportion of tested clients per quarter that were children rose from 3.8% (2.7-4.3 to 9.6% (8.8 to 10.0 (p = 0.0009 and the proportion of ART starters that were children rose from 6.9% (4.9-9.3 to 21.1% (19.2-24.2 (p = 0.0036. The proportion of registered children and adults starting ART each quarter increased similarly, from 26% to 53%, and 20% to 52%, respectively. Conclusions Implementation of PITC and integration of ART services within the paediatric ward are likely to be the main reasons for improved access to

  5. 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).

  6. 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'.

  7. FLORISTIC DIVERSITY AND EQUITABILITY IN FOREST FRAGMENTS USING ARTIFICIAL NEURAL NETWORKS

    Directory of Open Access Journals (Sweden)

    Christian Dias Cabacinha

    2017-01-01

    Full Text Available This study aimed to evaluate the predictive efficiency of Shannon index (H’ and Pielou Equitability index (J in forest fragments from the Brazilian Cerrado biome, from the vegetation indices and landscape metrics using artificial neural networks (ANN. Feedforward networks were used and they were trained through a back propagation error algorithm. The variables used as ANN input for simultaneous estimation of indices were: the categorical (H’ and J and the numbers related to the mean and standard deviation of vegetation indices (NDVI, SAVI, EVI, and MVI5, MVI7 and landscape metrics (AREA, GYRATE, SHAPE, CONTIG, CORE and ENN. It was generated five models of ANN from the functional relationships between numerical variables inherent to vegetation indices in two seasons, a dry season (June and a rainy season (February. The architecture of the networks was the Multilayer Perceptron (MLP, to estimate simultaneously the H’ and J: 500 using vegetation indices in the wet season (100 for each vegetation index and 500 in dry (100 for each vegetation index. The precision, accuracy and realism of biological ANN were assessed. The nets built during the rainy season and dry season that used vegetation indices MVI5 (Moisture Vegetation Index and SAVI (Soil Adjusted Vegetation Index, respectively, were more appropriate, accurate and biologically realistic to estimate both indices H’ and J. The ANN modeling demonstrated to be adequate to estimate the diversity index.

  8. Open Access: Current Status, AAS Perspectives

    Science.gov (United States)

    Marvel, Kevin B.; Biemesderfer, Chris

    Open Access, defined as the free provision of information by science publishers, is not likely to be mandated by law anytime soon in the United States. A collaborative effort, initiated by the House Science Committee, to come to some consensus within the scientific publishing enterprise has resulted in the release of the so-called "Roundtable Recommendations". These will serve as a working model moving forward on fundamental shared starting points for both publishers and authors as well as the Open Access community. The AAS' delayed open access model for publishing is flexible, supportive of our discipline and equitably distributes the cost of publishing to authors and readers. The AAS can support this flexible model because it is not dependent on journal revenues for the support of its member-focused activities.

  9. Professional Access 2013 programming

    CERN Document Server

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

    2013-01-01

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

  10. 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

  11. The Pearl of Great Price: Achieving Equitable Access to Primary and Secondary Education and Enhancing Learning in Sri Lanka. CREATE Pathways to Access. Research Monograph No. 29

    Science.gov (United States)

    Aturupane, Harsha

    2009-01-01

    The experience of public policy in Sri Lanka has had a profound impact on the thinking of the global development community in relation to the role of education in economic development. In particular, the example of Sri Lanka helped to persuade policy makers around the world that governments can successfully develop a general education system to…

  12. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Provider-Based Status of Indian Health Service and Tribal Facilities and Organizations; Costs Reporting and Provider Requirements; Agreement Termination Notices. Final rule.

    Science.gov (United States)

    2017-08-14

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey

  13. 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.

  14. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  15. 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.

  16. 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.

  17. Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

    Science.gov (United States)

    Newmann, Sara J; Rocca, Corinne H; Zakaras, Jennifer M; Onono, Maricianah; Bukusi, Elizabeth A; Grossman, Daniel; Cohen, Craig R

    2016-09-01

    This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes.

  18. 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…

  19. 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.)

  20. 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.

  1. The Ultrasonic Directional Tidal Breathing Pattern Sensor: Equitable Design Realization Based on Phase Information.

    Science.gov (United States)

    Sinharay, Arijit; Rakshit, Raj; Khasnobish, Anwesha; Chakravarty, Tapas; Ghosh, Deb; Pal, Arpan

    2017-08-11

    Pulmonary ailments are conventionally diagnosed by spirometry. The complex forceful breathing maneuver as well as the extreme cost of spirometry renders it unsuitable in many situations. This work is aimed to facilitate an emerging direction of tidal breathing-based pulmonary evaluation by designing a novel, equitable, precise and portable device for acquisition and analysis of directional tidal breathing patterns, in real time. The proposed system primarily uses an in-house designed blow pipe, 40-kHz air-coupled ultrasound transreceivers, and a radio frequency (RF) phase-gain integrated circuit (IC). Moreover, in order to achieve high sensitivity in a cost-effective design philosophy, we have exploited the phase measurement technique, instead of selecting the contemporary time-of-flight (TOF) measurement; since application of the TOF principle in tidal breathing assessments requires sub-micro to nanosecond time resolution. This approach, which depends on accurate phase measurement, contributed to enhanced sensitivity using a simple electronics design. The developed system has been calibrated using a standard 3-L calibration syringe. The parameters of this system are validated against a standard spirometer, with maximum percentage error below 16%. Further, the extracted respiratory parameters related to tidal breathing have been found to be comparable with relevant prior works. The error in detecting respiration rate only is 3.9% compared to manual evaluation. These encouraging insights reveal the definite potential of our tidal breathing pattern (TBP) prototype for measuring tidal breathing parameters in order to extend the reach of affordable healthcare in rural regions and developing areas.

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

    Science.gov (United States)

    Kevin McCluskey; Katharine B. Barker; Hazel A. Barton; Kyria Boundy-Mills; Daniel R. Brown; Jonathan A. Coddington; Kevin Cook; Philippe Desmeth; David Geiser; Jessie A. Glaeser; Stephanie Greene; Seogchan Kang; Michael W. Lomas; Ulrich Melcher; Scott E. Miller; David R. Nobles; Kristina J. Owens; Jerome H. Reichman; Manuela da Silva; John Wertz; Cale Whitworth; David Smith; Steven E. Lindow

    2017-01-01

    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...

  3. The US Culture Collection Network responding to the requirements of the Nagoya Protocol on Access and Benefit Sharing

    Science.gov (United States)

    The US Culture Collection Network held a meeting to share information about how 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 Bio...

  4. Ontology Based Access Control

    Directory of Open Access Journals (Sweden)

    Özgü CAN

    2010-02-01

    Full Text Available As computer technologies become pervasive, the need for access control mechanisms grow. The purpose of an access control is to limit the operations that a computer system user can perform. Thus, access control ensures to prevent an activity which can lead to a security breach. For the success of Semantic Web, that allows machines to share and reuse the information by using formal semantics for machines to communicate with other machines, access control mechanisms are needed. Access control mechanism indicates certain constraints which must be achieved by the user before performing an operation to provide a secure Semantic Web. In this work, unlike traditional access control mechanisms, an "Ontology Based Access Control" mechanism has been developed by using Semantic Web based policies. In this mechanism, ontologies are used to model the access control knowledge and domain knowledge is used to create policy ontologies.

  5. Access to antiretroviral treatment in developing countries: Which financing strategies are possible?

    Science.gov (United States)

    Beaulière, A; Le Maux, A; Trehin, C; Perez, F

    2010-06-01

    In low- and middle-income countries, access to combination antiretroviral therapy for all people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in need of treatment is a major public health challenge. The objective of this paper was to provide an overview of the different financing modalities of HIV/AIDS care at the microeconomic level and an analysis of their advantages and limitations. A review of the published literature using mainly the Medline and Science Direct databases for the 1990-2008 period in English and French made it possible to explore different financing strategies for the access to combination antiretroviral therapy using as case studies specific countries from different regions: Ivory Coast, Uganda, Senegal, and Rwanda for sub-Saharan Africa, Brazil and Haiti in the Latin America/Caribbean region, and Thailand for Asia. In these settings, direct payment through user fees is the most frequent financing mechanism in place for HIV/AIDS care and treatment, including combination antiretroviral therapy. Nevertheless, other mechanisms are being implemented to improve access to treatment such as community-based health insurance schemes with free care for the poor and vulnerable households and public-private partnerships. The type of financing strategy for HIV/AIDS care and treatment depends on the context. As direct payment through user fees limits access to care and does not enable program sustainability, national and donor agencies are introducing alternative strategies such as community financing systems (mutual health organizations, micro insurance, community health funds) and public-private partnerships. Finally, access to combination antiretroviral therapy has improved in resource-limited settings; however, there is a need to introduce alternative financial mechanisms to ensure long-term universal and equitable access to treatment and care, including combination antiretroviral therapy. 2010 Elsevier Masson SAS

  6. Does access to a colorectal cancer screening website and/or a nurse-managed telephone help line provided to patients by their family physician increase fecal occult blood test uptake?: A pragmatic cluster randomized controlled trial study protocol

    Directory of Open Access Journals (Sweden)

    Clouston Kathleen

    2012-05-01

    Full Text Available Abstract Background Fecal occult blood test screening in Canada is sub-optimal. Family physicians play a central role in screening and are limited by the time constraints of clinical practice. Patients face multiple barriers that further reduce completion rates. Tools that support family physicians in providing their patients with colorectal cancer information and that support uptake may prove useful. The primary objective of the study is to evaluate the efficacy of a patient decision aid (nurse-managed telephone support line and/or colorectal cancer screening website distributed by community-based family physicians, in improving colorectal cancer screening rates. Secondary objectives include evaluation of (disincentives to patient FOBT uptake and internet use among 50 to 74 year old males and females for health-related questions. Challenges faced by family physicians in engaging in collaborative partnerships with primary healthcare researchers will be documented. Methods/design A pragmatic, two-arm, randomized cluster controlled trial conducted in 22 community-based family practice clinics (36 clusters with 76 fee-for-service family physicians in Winnipeg, Manitoba, Canada. Each physician will enroll 30 patients attending their periodic health examination and at average risk for colorectal cancer. All physicians will follow their standard clinical practice for screening. Intervention group physicians will provide a fridge magnet to each patient that contains information facilitating access to the study-specific colorectal cancer screening decision aids (telephone help-line and website. The primary endpoint is patient fecal occult blood test completion rate after four months (intention to treat model. Multi-level analysis will include clinic, physician and patient level variables. Patient Personal Health Identification Numbers will be collected from those providing consent to facilitate analysis of repeat screening behavior. Secondary outcome

  7. National Archive of Marine Seismic Surveys (NAMSS): A USGS-Boem Partnership to Provide Free and Easy Access to Previously Proprietary Seismic Reflection Data on the U.S. Outer Continental Shelf

    Science.gov (United States)

    Triezenberg, P. J.; Hart, P. E.; Childs, J. R.

    2014-12-01

    The National Archive of Marine Seismic Surveys (NAMSS) was established by the USGS in 2004 in an effort to rescue marine seismic reflection profile data acquired largely by the oil exploration industry throughout the US outer continental shelf (OCS). It features a Web interface for easy on-line geographic search and download. The commercial value of these data had decreased significantly because of drilling moratoria and newer acquisition technology, and large quantities were at risk of disposal. But, the data still had tremendous value for scientific research and education purposes, and an effort was undertaken to ensure that the data were preserved and publicly available. More recently, the USGS and Bureau of Ocean Energy Management (BOEM) have developed a partnership to make similarly available a much larger quantity of 2D and 3D seismic data acquired by the U.S. government for assessment of resources in the OCS. Under Federal regulation, BOEM is required to publicly release all processed geophysical data, including seismic profiles, acquired under an exploration permit, purchased and retained by BOEM, no sooner than 25 years after issuance of the permit. Data acquired prior to 1989 are now eligible for release. Currently these data are distributed on CD or DVD, but data discovery can be tedious. Inclusion of these data within NAMSS vastly increases the amount of seismic data available for research purposes. A new NAMSS geographical interface provides easy and intuitive access to the data library. The interface utilizes OpenLayers, Mapnik, and the Django web framework. In addition, metadata capabilities have been greatly increased using a PostgresSQL/PostGIS database incorporating a community-developed ISO-compliant XML template. The NAMSS database currently contains 452 2D seismic surveys comprising 1,645,956 line km and nine 3D seismic surveys covering 9,385 square km. The 2D data holdings consist of stack, migrated and depth sections, most in SEG-Y format.

  8. Delivery of HIV care during the 2007 post-election crisis in Kenya: a case study analyzing the response of the Academic Model Providing Access to Healthcare (AMPATH) program.

    Science.gov (United States)

    Goodrich, Suzanne; Ndege, Samson; Kimaiyo, Sylvester; Some, Hosea; Wachira, Juddy; Braitstein, Paula; Sidle, John E; Sitienei, Jackline; Owino, Regina; Chesoli, Cleophas; Gichunge, Catherine; Komen, Fanice; Ojwang, Claris; Sang, Edwin; Siika, Abraham; Wools-Kaloustian, Kara

    2013-12-01

    Widespread violence followed the 2007 presidential elections in Kenya resulting in the deaths of a reported 1,133 people and the displacement of approximately 660,000 others. At the time of the crisis the United States Agency for International Development-Academic Model Providing Access to Healthcare (USAID-AMPATH) Partnership was operating 17 primary HIV clinics in western Kenya and treating 59,437 HIV positive patients (23,437 on antiretroviral therapy (ART)). This case study examines AMPATH's provision of care and maintenance of patients on ART throughout the period of disruption. This was accomplished by implementing immediate interventions including rapid information dissemination through the media, emergency hotlines and community liaisons; organization of a Crisis Response leadership team; the prompt assembly of multidisciplinary teams to address patient care, including psychological support staff (in clinics and in camps for internally displaced persons (IDP)); and the use of the AMPATH Medical Records System to identify patients on ART who had missed clinic appointments. These interventions resulted in the opening of all AMPATH clinics within five days of their scheduled post-holiday opening dates, 23,949 patient visits in January 2008 (23,259 previously scheduled), uninterrupted availability of antiretrovirals at all clinics, treatment of 1,420 HIV patients in IDP camps, distribution of basic provisions, mobilization of outreach services to locate missing AMPATH patients and delivery of psychosocial support to 300 staff members and 632 patients in IDP camps. Key lessons learned in maintaining the delivery of HIV care in a crisis situation include the importance of advance planning to develop programs that can function during a crisis, an emphasis on a rapid programmatic response, the ability of clinics to function autonomously, patient knowledge of their disease, the use of community and patient networks, addressing staff needs and developing effective

  9. Health financing reform in Uganda: How equitable is the proposed National Health Insurance scheme?

    Directory of Open Access Journals (Sweden)

    Orem Juliet

    2010-10-01

    on the distribution of accredited providers and utilisation patterns, the NHIS could worsen existing disparities in access to services, given the fee-for-service reimbursement mechanisms currently proposed. Lastly, if equity in financing and resource allocation are not explicit objectives of the NHIS, it might inadvertently worsen the existing disparities in service provision.

  10. Access to modern contraception.

    Science.gov (United States)

    Welsh, Michael J; Stanback, John; Shelton, James

    2006-06-01

    Access to modern contraception has become a recognized human right, improving the health and well-being of women, families and societies worldwide. However, contraceptive access remains uneven. Irregular contraceptive supply, limited numbers of service delivery points and specific geographic, economic, informational, psychosocial and administrative barriers (including medical barriers) undermine access in many settings. Widening the range of providers enabled to offer contraception can improve contraceptive access, particularly where resources are most scarce. International efforts to remove medical barriers include the World Health Organization's Medical Eligibility Criteria. Based on the best available evidence, these criteria provide guidance for weighing the risks and benefits of contraceptive choice among women with specific clinical conditions. Clinical job aids can also improve access. More research is needed to further elucidate the pathways for expanding contraceptive access. Further progress in removing medical barriers will depend on systems for improving provider education and promoting evidence-based contraceptive service delivery.

  11. Drought Water Rationing Necessitates an Equitable and Multidimensional Approach: Evidence from California

    Science.gov (United States)

    Ponce de Leon Barido, D.; Fildier, B.; Cucchi, K.

    2016-12-01

    less drought affected high-income communities, and that even after tight conservation standards on large consumers, high-income communities still consumed 30% more water per capita than low-income communities. We conclude with a suggested framework for how more equitable rationing could be implemented in the future.

  12. Equitable Imagery in the Preclinical Medical School Curriculum: Findings From One Medical School.

    Science.gov (United States)

    Martin, Glenna C; Kirgis, Julianne; Sid, Eric; Sabin, Janice A

    2016-07-01

    The unequal representation of women and people of color compared with men and whites in medical school textbooks has been well documented, as have health care inequities, and biases-both overt and implicit-by health care providers and in access to care. The authors investigated whether this bias exists in PowerPoint slides used in didactic material for preclinical students at one medical school. The authors analyzed 747 "decks" of slides from 33 preclinical courses in the medical school curriculum at the University of Washington School of Medicine in the years spanning 2009 to 2011. The authors coded the human images into various sex- and race-specific classifications and evaluated the distribution of images into these categories. Of the 4,033 images that could be coded by sex, 39.6% (1,595) were female and 60.5% (2,438) were male. Of the 5,230 images that could be coded by race/ethnicity, 78.4% (4,100) were white and 21.6% (1,130) were persons of color. Thus, images of whites and males predominated. The proportion of images used in didactic courses at one school of medicine is not representative of the U.S. population in terms of race or sex. The authors discuss the potential sources and impact of this bias, make a case for sex and race diversity in didactic imagery, and propose possible avenues for further research and curricular reform in an era when the population is becoming increasingly racially and ethnically diverse.

  13. 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....

  14. Wireless Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Wireless Access. Wireless connect to the Base station. Easy and Convenient access. Costlier as compared to the wired technology. Reliability challenges. We see it as a complementary technology to the DSL.

  15. Access Nets: Modeling Access to Physical Spaces

    Science.gov (United States)

    Frohardt, Robert; Chang, Bor-Yuh Evan; Sankaranarayanan, Sriram

    Electronic, software-managed mechanisms using, for example, radio-frequency identification (RFID) cards, enable great flexibility in specifying access control policies to physical spaces. For example, access rights may vary based on time of day or could differ in normal versus emergency situations. With such fine-grained control, understanding and reasoning about what a policy permits becomes surprisingly difficult requiring knowledge of permission levels, spatial layout, and time. In this paper, we present a formal modeling framework, called AccessNets, suitable for describing a combination of access permissions, physical spaces, and temporal constraints. Furthermore, we provide evidence that model checking techniques are effective in reasoning about physical access control policies. We describe our results from a tool that uses reachability analysis to validate security policies.

  16. 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

  17. Open access

    NARCIS (Netherlands)

    Valkenburg, P.M.

    2015-01-01

    Open access week Van 19 tot en met 25 oktober 2015 vond wereldwijd de Open Access Week plaats. Tijdens deze week werden er over de hele wereld evenementen georganiseerd waar open access een rol speelt. Ook in Nederland zijn er diverse symposia, workshops en debatten georganiseerd zoals het debat in

  18. Access 3

    Science.gov (United States)

    Kang, Melissa; Robards, Fiona; Sanci, Lena; Steinbeck, Katharine; Jan, Stephen; Hawke, Catherine; Kong, Marlene; Usherwood, Tim

    2017-08-07

    The integration of digital technology into everyday lives of young people has become widespread. It is not known whether and how technology influences barriers and facilitators to healthcare, and whether and how young people navigate between face-to-face and virtual healthcare. To provide new knowledge essential to policy and practice, we designed a study that would explore health system access and navigation in the digital age. The study objectives are to: (1) describe experiences of young people accessing and navigating the health system in New South Wales (NSW), Australia; (2) identify barriers and facilitators to healthcare for young people and how these vary between groups; (3) describe health system inefficiencies, particularly for young people who are marginalised; (4) provide policy-relevant knowledge translation of the research data. This mixed methods study has four parts, including: (1) a cross-sectional survey of young people (12-24 years) residing in NSW, Australia; (2) a longitudinal, qualitative study of a subsample of marginalised young people (defined as young people who: identify as Aboriginal and/or Torres Strait Islander; are experiencing homelessness; identify as sexuality and/or gender diverse; are of refugee or vulnerable migrant background; and/or live in rural or remote NSW); (3) interviews with professionals; (4) a knowledge translation forum. Ethics approvals were sought and granted. Data collection commenced in March 2016 and will continue until June 2017. This study will gather practice and policy-relevant intelligence about contemporary experiences of young people and health services, with a unique focus on five different groups of marginalised young people, documenting their experiences over time. Access 3 will explore navigation around all levels of the health system, determine whether digital technology is integrated into this, and if so how, and will translate findings into policy-relevant recommendations. © Article author(s) (or

  19. "This one will delay us": barriers to accessing health care services among persons with disabilities in Malawi.

    Science.gov (United States)

    Munthali, Alister C; Swartz, Leslie; Mannan, Hasheem; MacLachlan, Malcolm; Chilimampunga, Charles; Makupe, Cecilia

    2017-11-26

    This paper explores the barriers which people with disabilities experience in accessing health care services in Malawi. Fifty-two in-depth interviews were conducted with people with various types of disabilities. These interviews were conducted in four districts in Malawi: Blantyre and Phalombe in the Southern Region; Ntchisi in the Central Region, and Rumphi in the North. A team of trained research assistants conducted the interviews. The major challenges that people with disabilities experience include the cost of accessing health care, long distances to health facilities, lack of transport, hilly terrains and flooding of rivers during the rainy season, communication challenges with the health providers and poor attitude of health workers. Some of these challenges are not unique to people with disabilities, but constitute more of a problem among people with disabilities. There is a need to address these challenges through the expansion of the provision of assistive devices, implementing comprehensive outreach services targeting people with disabilities and strengthening the links between key component of access to quality health care. Attitudinal barriers and lack of resources remain major challenges. Implications for rehabilitation Though people with disabilities face challenges accessing health care world-wide, the challenges are greater in low-income countries. The current study in Malawi confirms this. Major challenges include costs of care, transport costs, and inaccessible facilities. Lack of health worker awareness and attitudinal barriers are major issues of concern. It is imperative, given this situation, that effort is spent in Malawi and similar contexts on dealing with issues of stigma and discrimination especially in the health care sector. It is also important to explore cost-effective ways of assisting people with disabilities accessing appropriate transport, which should be seen as part of the healthcare system. Though the cost of providing

  20. Fertility care interventions should be provided as the first line options for HIV+ serodiscordant couples who desire children in settings with affordable access to care, regardless of their fertility status

    Directory of Open Access Journals (Sweden)

    Lauren Zakarin Safier

    2017-01-01

    Conclusions: We believe that physician assisted fertility care, when affordably accessible, should be the treatment of choice over natural conception. While the preliminary data on natural conception in couples using highly active anti-retroviral therapy/pre-exposure prophylaxis/timed intercourse appears promising, we believe that this approach should be limited to patients in resource poor settings where more sophisticated measures do not exist or for patients that simply cannot afford subspecialty care. There are likely to be unknown psychological and behavioural factors impacted by promoting natural conception and diminishing the importance of safe sex practices. Additionally, it is our moral obligation to patients to offer the affordably accessible treatment interventions that pose the least known risk when considering reproductive options.

  1. Accessing the Microform Publication.

    Science.gov (United States)

    Schindler, Stan

    1985-01-01

    Characterizes types of indexing programs used by Research Publications, Inc. and describes provision of access to four major projects: "The Official Washington Post Index" (provides access to newspaper and microfilm edition); "The Eighteenth Century"; "The Declassified Documents Reference System" (ongoing fiche…

  2. Public Access Report.

    Science.gov (United States)

    Anshien, Carol M.; And Others

    A short review of the development of cable television in New York City, a brief description of wiring patterns, a history of public access, and some statistical data on public channel usage are provided in the first portion of this report. The second major part describes the Public Access Celebration, a three-day informational event held in July…

  3. 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

  4. Fertility care interventions should be provided as the first line options for HIV+ serodiscordant couples who desire children in settings with affordable access to care, regardless of their fertility status.

    Science.gov (United States)

    Zakarin Safier, Lauren; Sauer, Mark V

    2017-03-08

    With increasing life expectancy, couples with at least one partner afflicted with HIV are more commonly pursuing the opportunity to have biologic offspring. Currently, there are no universally accepted recommendations regarding first line reproductive treatments for HIV serodiscordant couples lacking a history of infertility. We strongly believe that fertility care intervention should be the first line treatment, when affordably accessible, over natural conception for HIV serodiscordant couples to achieve pregnancy in a safe and efficacious manner. In the era of highly active anti-retroviral therapy, in combination with timed intercourse and pre-exposure prophylaxis for the HIV negative partner, some members of the medical community are arguing in favour of natural conception as a means of achieving pregnancy in this patient population. In our opinion, laboratory assisted fertility methods, including intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection with semen washing should be the first line treatment recommendation for HIV serodiscordant couples desiring pregnancy for the following reasons: (1) abundance of evidence in the medical literature supporting the safety profile and efficacy of fertility care intervention in couples with HIV; paucity of data addressing safety of natural conception in comparison to fertility intervention techniques (2) unknown public health impact of promoting natural conception as a safe means of achieving pregnancy (3) ethical implications: patients should be offered the available and accessible treatment option posing the lowest possible known risk to the uninfected partner. We believe that physician assisted fertility care, when affordably accessible, should be the treatment of choice over natural conception. While the preliminary data on natural conception in couples using highly active anti-retroviral therapy/pre-exposure prophylaxis/timed intercourse appears promising, we believe that this

  5. Perspectives on the impact of stigma in leprosy: strategies to improve access to health care

    Directory of Open Access Journals (Sweden)

    Sundar Rao PSS

    2015-09-01

    Full Text Available Pamidipani SS Sundar Rao LEPRA India, Secunderabad, India Abstract: Throughout its history, leprosy has been much feared and misunderstood. Today, we have the best knowledge, expertise, therapies, and surgical and physiotherapeutic skills to virtually cure and eradicate the disease, but the continuing high levels of stigma pose insurmountable obstacles in our efforts to remove the scourges of leprosy. In this review, the medical, social, and political aspects related to the impact of stigma on leprosy are elaborated, and strategies for providing access to equitable and effective care are described. Leprosy is a biosocial disease, and experience has shown that both the medical and social dimensions must be aggressively confronted. Stigma in leprosy is based on religious, sociocultural, psychological, and demographic experience over centuries of human existence. Therefore, any attempt to eradicate or reduce stigma will require strong multifaceted approaches that will permeate psychological, social, and mental layers of the human mind and result in necessary health-seeking behaviors. What then is needed is a social multidrug therapy similar to the medical multidrug therapy, where there would be one arm for curing the medical problems of leprosy, a second arm focusing on empowering the people, especially affected persons, through appropriate education, awareness, especially for early detection and treatment, encouraging positive attitudes and perceptions, and a third arm for advocacy, attacking derogatory and discriminatory laws, enabling opportunities for persons with leprosy disabilities to be profitably employed, and providing necessary rehabilitation facilities. Health can never be adequately protected by health services without the active understanding and involvement of communities whose health is at stake. The review cautions that without a social multidisciplinary approach using community-based participatory techniques, we cannot provide

  6. Does more equitable governance lead to more equitable health care? A case study based on the implementation of health reform in Aboriginal health Australia.

    Science.gov (United States)

    Kelaher, Margaret; Sabanovic, Hana; La Brooy, Camille; Lock, Mark; Lusher, Dean; Brown, Larry

    2014-12-01

    There is growing evidence that providing increased voice to vulnerable or disenfranchised populations is important to improving health equity. In this paper we will examine the engagement of Aboriginal community members and community controlled organisations in local governance reforms associated with the Aboriginal Health National Partnership Agreements (AHNPA) in Australia and its impact on the uptake of health assessments. The sample included qualitative and quantitative responses from 188 people involved in regional governance in Aboriginal health. The study included data on the uptake of Aboriginal health assessments from July 2008 to December 2012. The study population was 83190 in 2008/9, 856986 in 2009/10, 88256 in 2010/11 and 90903 in 2011/12. Logistic regression was used to examine the relationships between organisations within forums and the regional uptake of Aboriginal health assessments. The independent variables included before and after the AHNPA, state, remoteness, level of representation from Aboriginal organisations and links between Aboriginal and mainstream organisations. The introduction of the AHNPA was associated with a shift in power from central government to regional forums. This shift has enabled Aboriginal people a much greater voice in governance. The results of the analyses show that improvements in the uptake of health assessments were associated with stronger links between Aboriginal organisations and between mainstream organisations working with Aboriginal organisations. Higher levels of community representation were also associated with improved uptake of health assessments in the AHNPA. The findings suggest that the incorporation of Aboriginal community and community controlled organisations in regional planning plays an important role in improving health equity. This study makes an important contribution to understanding the processes through which the incorporation of disadvantaged groups into governance might contribute to

  7. Open Access

    Science.gov (United States)

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder…

  8. High and equitable mass vitamin A supplementation coverage in Sierra Leone: a post-event coverage survey.

    Science.gov (United States)

    Hodges, Mary H; Sesay, Fatmata F; Kamara, Habib I; Turay, Mohamed; Koroma, Aminata S; Blankenship, Jessica L; Katcher, Heather I

    2013-08-01

    In Sierra Leone, children ages 6-59 months receive twice-yearly vitamin A supplementation (VAS) through Maternal and Child Health Week (MCHW) events. VAS coverage in 2011 was calculated using government tally sheets of vitamin A capsule distribution and outdated population projections from the 2004 census. We conducted a national post-event coverage (PEC) survey to validate coverage and inform strategies to reach universal coverage of VAS in Sierra Leone. Immediately following the November 2011 MCHW event, we conducted a national PEC survey by interviewing caregivers with children ages 6-59 months using a randomized 30X30 cluster design (N = 900). We also interviewed one health worker and one community health worker in each cluster to determine their knowledge about VAS (N = 60). VAS coverage was 91.8% among children ages 6-59 months, which was lower than the 105.1% reported through tally sheets. Coverage was high and equitable among all districts and between age groups (98.5% for infants ages 6-11 months and 90.5% for children ages 12-59 months). Major reasons for not receiving VAS were that the child was out of the area (42.4%), the household was not visited by community health workers (28.0%), and the caretaker was not aware of the event (11.9%). Twice-yearly delivery of VAS through MCHW events achieved consistently high and equitable coverage in Sierra Leone. Universal coverage may be achieved through continued focus on communication and targeted outreach to hard-to-reach areas during the MCHWs.

  9. 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, pschool organizational health and student-reported school climate (e.g., staff affiliation and student-perceived equity, γ=0.07, pschool organizational 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.

  10. 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

  11. The Open Access Divide

    Directory of Open Access Journals (Sweden)

    Jingfeng Xia

    2013-10-01

    Full Text Available This paper is an attempt to review various aspects of the open access divide regarding the difference between those academics who support free sharing of data and scholarly output and those academics who do not. It provides a structured description by adopting the Ws doctrines emphasizing such questions as who, what, when, where and why for information-gathering. Using measurable variables to define a common expression of the open access divide, this study collects aggregated data from existing open access as well as non-open access publications including journal articles and extensive reports. The definition of the open access divide is integrated into the discussion of scholarship on a larger scale.

  12. Accessing memory

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Doe Hyun; Muralimanohar, Naveen; Chang, Jichuan; Ranganthan, Parthasarathy

    2017-09-26

    A disclosed example method involves performing simultaneous data accesses on at least first and second independently selectable logical sub-ranks to access first data via a wide internal data bus in a memory device. The memory device includes a translation buffer chip, memory chips in independently selectable logical sub-ranks, a narrow external data bus to connect the translation buffer chip to a memory controller, and the wide internal data bus between the translation buffer chip and the memory chips. A data access is performed on only the first independently selectable logical sub-rank to access second data via the wide internal data bus. The example method also involves locating a first portion of the first data, a second portion of the first data, and the second data on the narrow external data bus during separate data transfers.

  13. Consolidating the social health insurance schemes in China: towards an equitable and efficient health system.

    Science.gov (United States)

    Meng, Qingyue; Fang, Hai; Liu, Xiaoyun; Yuan, Beibei; Xu, Jin

    2015-10-10

    Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health insurance schemes in fund level and benefit package. Political commitments, institutional innovations, and a feasible implementation plan are the major elements needed for success in consolidation. Achievement of universal health coverage in China needs systemic strategies including consolidation of the social health insurance schemes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Providing Contraception to Adolescents.

    Science.gov (United States)

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Historical temperature and salinity data collected from 1896-04-22 to 1961-03-26 from the World Ocean and provided by United Kingdom hydrographic office (NODC Accession 0073673)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Historical temperature and salinity data collected from 1896-04-22 to 1961-03-26 from the World Ocean. Data were digitized from cards provided by United Kingdom...

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

    Science.gov (United States)

    McCluskey, Kevin; Barker, Katharine B; Barton, Hazel A; Boundy-Mills, Kyria; Brown, Daniel R; Coddington, Jonathan A; Cook, Kevin; Desmeth, Philippe; Geiser, David; Glaeser, Jessie A; Greene, Stephanie; Kang, Seogchan; Lomas, Michael W; Melcher, Ulrich; Miller, Scott E; Nobles, David R; Owens, Kristina J; Reichman, Jerome H; da Silva, Manuela; Wertz, John; Whitworth, Cale; Smith, David

    2017-08-15

    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.

  17. 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.

  18. 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

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

    Science.gov (United States)

    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

  20. Accessible Knowledge - Knowledge on Accessibility

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette

    2015-01-01

    Although serious efforts are made internationally and nationally, it is a slow process to make our physical environment accessible. In the actual design process, architects play a major role. But what kinds of knowledge, including research-based knowledge, do practicing architects make use of when...... designing accessible environments? The answer to the question is crucially important since it affects how knowledge is distributed and how accessibility can be ensured. In order to get first-hand knowledge about the design process and the sources from which they gain knowledge, 11 qualitative interviews...... were conducted with architects with experience of designing for accessibility. The analysis draws on two theoretical distinctions. The first is research-based knowledge versus knowledge used by architects. The second is context-independent knowledge versus context-dependent knowledge. The practitioners...

  1. Open access

    CERN Document Server

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder consent, and many authors, musicians, filmmakers, and other creators who depend on royalties are understandably unwilling to give their consent. But for 350 years, scholars have written peer-reviewed journal articles for impact, not for money, and are free to consent to open access without losing revenue. In this concise introduction, Peter Suber tells us what open access is and isn't, how it benefits authors and readers of research, how we pay for it, how it avoids copyright problems, how it has moved from the periphery to the mainstream, and what its future may hold. Distilling a decade of Suber's influential writing and thinking about open access, this is the indispe...

  2. Providing Accessible Statewide Inservice Training for Practicing Professionals and Paraprofessionals Working with Infants, Toddlers, and Preschoolers Who Are Deaf or Hard of Hearing and Their Families. SKI-HI Distance Education Project, Final Report.

    Science.gov (United States)

    Barringer, Donald; Glover, Barbara; Parlin, Mary Ann; Johnson, Dorothy

    This final report discusses the outcomes of a project that developed, demonstrated, evaluated, and disseminated information about a specialized inservice training model to prepare early interventionists, special education teachers, and related service personnel to provide family-centered programming to infants, toddlers, and preschoolers who are…

  3. Healthcare Access and PrEP Continuation in San Francisco and Miami After the US PrEP Demo Project.

    Science.gov (United States)

    Doblecki-Lewis, Susanne; Liu, Albert; Feaster, Daniel; Cohen, Stephanie E; Cardenas, Gabriel; Bacon, Oliver; Andrew, Erin; Kolber, Michael A

    2017-04-15

    Pre-exposure prophylaxis (PrEP) for prevention of HIV infection has demonstrated efficacy in randomized controlled trials and in demonstration projects. For PrEP implementation to result in significant reductions in HIV incidence for men who have sex with men in the United States, sufficient access to PrEP care and continued engagement outside of demonstration projects is required. We report the results of a follow-up survey of 173 former participants from the Miami and San Francisco sites of the US PrEP Demo Project, administered 4-6 months after study completion. Survey respondents continued to frequently access medical care and had a high incidence of sexually transmitted infections after completion of the Demo Project, indicating ongoing sexual risk behavior. Interest in continuing PrEP was high with 70.8% indicating that they were "very interested" in continuing PrEP. Among respondents, 39.9% reported continuation of PrEP after completion of the Demo Project, largely through their primary care providers and frequently at low or no cost. Variability in access and engagement was seen, with participants from the San Francisco site, those with medical insurance, and those with a primary care provider at the end of the Demo Project more likely to successfully obtain PrEP medication. Two respondents reported HIV seroconversion in the period between study completion and the follow-up survey. Additional effort to increase equitable access to PrEP outside of demonstration projects is needed to realize the potential impact of this evidence-based prevention intervention.

  4. Sustaining Scientist-Community Partnerships that are Just, Equitable, and Trustworthy

    Science.gov (United States)

    Sheats, N.

    2016-12-01

    Communities of color, indigenous people, and low income communities throughout the United States are on the front lines of environmental and health impacts from polluting sources, and yet don't fully benefit from public policies that are intended to reduce or prevent those impacts. Many of the challenges faced by environmental justice communities can and should be addressed, in part, through science-based public policies. Community-relevant scientific information and equal access to this information is needed to protect people from public health and environmental hazards. Too often, however, the scientific community has failed to work collaboratively with environmental justice communities. This session will explore the challenges and opportunities faced by environmental justice advocates and scientists in working with one another. This talk will share findings from a recently-held forum, specifically discussing a formal set of principles and best practices for community-scientist partnerships to guide future collaborations between scientists and communities. When community members and scientists collaborate, they bring together unique strengths and types of knowledge that can help address our most pressing challenges, inform decision making, and develop solutions that benefit all people. The speaker will address institutional and historic barriers that hinder such collaboration, potential pitfalls to avoid, and share how institutional systems of scientific research can incorporate equity analyses into their work to ensure solutions that are truly effective.

  5. Gender equitable men's attitudes and beliefs to reduce HIV risk and ...

    African Journals Online (AJOL)

    domains on HIV related gender norms and attitudes among women and men. ... from this study may probably imply that now men are taking positive roles in issues of ..... qualitative study could provide some explanation of the reported trend.

  6. Closing the access gap for health innovations: an open licensing proposal for universities

    Directory of Open Access Journals (Sweden)

    Rajkumar Rahul

    2007-02-01

    Full Text Available Abstract Background This article centers around a proposal outlining how research universities could leverage their intellectual property to help close the access gap for health innovations in poor countries. A recent deal between Emory University, Gilead Sciences, and Royalty Pharma is used as an example to illustrate how 'equitable access licensing' could be put into practice. Discussion While the crisis of access to medicines in poor countries has multiple determinants, intellectual property protection leading to high prices is well-established as one critical element of the access gap. Given the current international political climate, systemic, government-driven reform of intellectual property protection seems unlikely in the near term. Therefore, we propose that public sector institutions, universities chief among them, adopt a modest intervention – an Equitable Access License (EAL – that works within existing trade-law and drug-development paradigms in order to proactively circumvent both national and international obstacles to generic medicine production. Our proposal has three key features: (1 it is prospective in scope, (2 it facilitates unfettered generic competition in poor countries, and (3 it centers around universities and their role in the biomedical research enterprise. Two characteristics make universities ideal agents of the type of open licensing proposal described. First, universities, because they are upstream in the development pipeline, are likely to hold rights to the key components of a wide variety of end products. Second, universities acting collectively have a strong negotiating position with respect to other players in the biomedical research arena. Finally, counterarguments are anticipated and addressed and conclusions are drawn based on how application of the Equitable Access License would have changed the effects of the licensing deal between Emory and Gilead.

  7. Access French

    CERN Document Server

    Grosz, Bernard

    2014-01-01

    Access is the major new language series designed with the needs of today's generation of students firmly in mind. Whether learning for leisure or business purposes or working towards a curriculum qualification, Access French is specially designed for adults of all ages and gives students a thorough grounding in all the skills required to understand, speak, read and write contemporary French from scratch. The coursebook consists of 10 units covering different topic areas, each of which includes Language Focus panels explaining the structures covered and a comprehensive glossary. Learning tips

  8. Exploring Determinants of Housing Prices in Beijing: An Enhanced Hedonic Regression with Open Access POI Data

    Directory of Open Access Journals (Sweden)

    Yixiong Xiao

    2017-11-01

    Full Text Available The housing market in Chinese metropolises have become inflated significantly over the last decade. In addition to an economic upturn and housing policies that have potentially fueled the real estate bubble, factors that have contributed to the spatial heterogeneity of housing prices can be dictated by the amenity value in the proximity of communities, such as accessibility to business centers and transportation hubs. In the past, scholars have employed the hedonic pricing model to quantify the amenity value in relation to structural, locational, and environmental variables. These studies, however, are limited by two methodological obstacles that are relatively difficult to overcome. The first pertains to difficulty of data collection in regions where geospatial datasets are strictly controlled and limited. The second refers to the spatial autocorrelation effect inherent in the hedonic analysis. Using Beijing, China as a case study, we addressed these two issues by (1 collecting residential housing and urban amenity data in terms of Points of Interest (POIs through web-crawling on open access platforms; and (2 eliminating the spatial autocorrelation effect using the Eigenvector Spatial Filtering (ESF method. The results showed that the effects of nearby amenities on housing prices are mixed. In other words, while proximity to certain amenities, such as convenient parking, was positively correlated with housing prices, other amenity variables, such as supermarkets, showed negative correlations. This mixed finding is further discussed in relation to community planning strategies in Beijing. This paper provides an example of employing open access datasets to analyze the determinants of housing prices. Results derived from the model can offer insights into the reasons for housing segmentation in Chinese cities, eventually helping to formulate effective urban planning strategies and equitable housing policies.

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

    African Journals Online (AJOL)

    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 ...

  10. Encouraging the Beginning of Equitable Science Teaching Practice: Collaboration Is the Key.

    Science.gov (United States)

    Bailey, Bambi L.; Scantlebury, Kathryn C.; Johnson, Ellen M.

    1999-01-01

    Discusses gender issues in science education and argues that teachers are not using appropriate teaching strategies to provide gender equity in their classrooms. Presents a study focusing on science teachers' perceptions of gender and science instruction and the cooperating teacher's role in the student teaching practicum. (Contains 46…

  11. 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.

  12. Hemodialysis access procedures

    Science.gov (United States)

    Kidney failure - chronic - dialysis access; Renal failure - chronic - dialysis access; Chronic renal insufficiency - dialysis access; Chronic kidney failure - dialysis access; Chronic renal failure - ...

  13. Access to the city

    DEFF Research Database (Denmark)

    Andreasen, Manja Hoppe; Møller-Jensen, Lasse

    2017-01-01

    by the urban transport system. The paper draws upon qualitative interviews with residents in the periphery as well as recently collected travel speed data and offers a unique combination of testimony with GIS-based modelling of overall accessibility. A central finding is the overall importance of regular......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...

  14. Influence of health rights discourses and community organizing on equitable access to health: the case of HIV, tuberculosis and cancer in Peru.

    Science.gov (United States)

    Sandoval, Clara; Cáceres, Carlos F

    2013-05-17

    The right to health is recognized as a fundamental human right. Social participation is implied in the fulfillment of health rights since Alma Ata posited its relevance for successful health programs, although a wide range of interpretations has been observed for this term. While Peruvian law recognizes community and social participation in health, it was the GFATM requirement of mixed public-civil society participation in Country Coordination Mechanisms (CCM) for proposal submission what effectively led to formal community involvement in the national response to HIV and, to a lesser extent, tuberculosis. This has not been the case, however, for other chronic diseases in Peru. This study aims to describe and compare the role of health rights discourse and community involvement in the national response to HIV, tuberculosis and cancer. Key health policy documents were identified and analyzed. In-depth interviews were conducted with stakeholders, representatives of civil society organizations (CSO), and leaders of organizations of people affected by HIV, cancer and tuberculosis. A health rights discourse, well established in the HIV field, is expanding to general health discussions and to the tuberculosis (TB) field in particular. Both HIV and TB programs have National Multisectoral Strategic Plans and recognize participation of affected communities' organizations. Similar mechanisms are non-existent for cancer or other disease-focused programs, although other affected patients are starting some organization efforts. Interviewees agreed that reaching the achievements of HIV mobilization is difficult for other diseases, since the HIV response was modeled based on a global movement with strong networks and advocacy mechanisms, eventually succeeding in the establishment of financial sources like the GFATM. Nevertheless, organizations linked to cancer and other diseases are building a National Patient Network to defend health rights. There are new efforts to promote and protect health rights in Peru, probably inspired by the achievements of organizations of people living with HIV (PLHA). The public health sector must consolidate the participation of affected communities' organizations in decision-making processes and implementation of health programs. PLHA organizations have become a key political and social actor in Peruvian public health policy.

  15. Exploring the Complexities of Group Work in Science Class: a Cautionary tale of Voice and Equitable Access to Resources for Learning

    Science.gov (United States)

    Richmond, Gail

    The interactions of 2 focus students with others in their cooperative base groups were examined as the students designed, carried out, and interpreted scientific investigations. These 2 students differed with respect to race, gender, socioeconomic status, and academic achievement. They were alike in that both maintained high levels of motivation and interaction with the scientific problems they faced. Their group interactions were not entirely positive, and the difficulties and inequities they faced are described. The data make manifest that group work is a complex process; educators must be sensitive and responsive to the subtle ways understanding can be enhanced or undermined as a result of group dynamics, which are in turn determined by individual expectations - often unfounded - of others' capacities and behaviors, and perceptions of desired group and individual outcomes. These observations also have implications for how educators help prepare prospective teachers to develop effective pedagogical strategies for teaching diverse students.

  16. 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

  17. 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.

  18. 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 h2>Backgroundh2> 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

  19. Maintaining cost-effective access to antiretroviral drug therapy through a collaborative approach to drug procurement, consensus treatment guidelines and regular audit: the experience of London HIV commissioners and providers

    Science.gov (United States)

    Gazzard, Brian; Johnson, Margaret; Sharott, Peter; Collins, Simon

    2012-01-01

    Background In the UK, meeting the £20 billion efficiency challenge in the NHS requires new approaches to protect quality and improve productivity. In London, clinicians, people living with HIV and commissioners are collaborating to reduce the cost of antiretrovirals as part of the Quality Innovation Productivity and Prevention agenda. Objectives To describe how collaboration in antiretroviral procurement in 2011/2012 aimed to significantly reduce drug acquisition costs, ensure equity of prescribing and protect the quality and experience of care and treatment for patients. Methods Greater clinical leadership and engagement and involvement of patient representatives enabled an approach to drug procurement focused on clinical outcomes at a patient and population level while reducing cost. Consensus guidelines for implementation were developed and agreed by all London lead clinicians while people living with HIV produced a patient information leaflet to explain the tender process and outcomes. A planned audit is underway at all services to monitor prescribing changes and outcomes for those on treatment. Results HIV clinicians, pharmacists and patient representatives were directly involved in this novel therapeutic tendering approach to antiretroviral drug procurement. Modelling indicates that £8–£10 million savings will be released through the process over 2 years. Conclusions Clinically led therapeutic tendering of antiretroviral drugs provides an opportunity to protect quality and improve productivity in HIV. The approach is novel in HIV in the UK, and the emergent learning has implications for quality and cost improvement in HIV spending in the UK and potentially in other countries. PMID:22345023

  20. Canadian Healthcare Practitioners’ Access to Evidence Based Information Is Inequitable. A Review of: Chatterley, T., Storie, D., Chambers, T., Buckingham, J., Shiri, A., & Dorgan, M. (2012. Health information support provided by professional associations in Canada. Health Information & Libraries Journal, 29(3, 233-241.

    Directory of Open Access Journals (Sweden)

    Maria Melssen

    2013-06-01

    Full Text Available Objective – To determine what services and resources are available to health professionals through national Canadian and Alberta based health professional associations and licensing colleges and if those resources and services are being used. Also, to assess the associations’ perceptions of what resources and services Canadian health professionals actually need and if those needs are being met, membership satisfaction with the resources and services provided, and challenges the associations have with providing resources and services.Design – Structured telephone interview.Setting – Health professional associations and licensing colleges in Canada.Subjects – 23 health professional associations: 9 Alberta-based associations and 14 national-level professional associations and licensing colleges.Methods – A librarian, communications officer, or another individual in a comparable position at each association was invited via email to participate in the study. Individuals willing to participate in the interview were emailed the interview questions in advance. Telephone interviews were conducted in July and August of 2009. For those who did not respond to the email request or who did not wish to participate in the interviews, information was collected from the association’s website.Main Results – Of the 23 contacted associations 12 agreed to be interviewed: less than 50% response rate. Data was collected from websites of seven associations that either declined to be interviewed or did not respond to the authors’ email request. Data were unavailable for four associations due to data being in members only sections of the websites. Data were analyzed both qualitatively and quantitatively.Resources and services provided by the associations and licensing colleges range from none to reference services provided by a librarian and access to licensed databases.None of the three licensing colleges or the two provincial associations interviewed

  1. Access or Quality? Why Do Families Living in Slums Choose Low-Cost Private Schools in Lagos, Nigeria?

    Science.gov (United States)

    Härmä, Joanna

    2013-01-01

    Lagos is home to 12,098 private schools catering to 57% of the state's enrolled children, from ultra-rich to relatively poor households, with many schools targeting those of lower socio-economic status. Government schools were intended to provide a just and equitable option for all; however, they have not kept pace with demand in terms of both…

  2. Sustainability, Efficiency and Equitability of Water Consumption and Pollution in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Mesfin M. Mekonnen

    2015-02-01

    Full Text Available This paper assesses the sustainability, efficiency and equity of water use in Latin America and the Caribbean (LAC by means of a geographic Water Footprint Assessment (WFA. It aims to provide understanding of water use from both a production and consumption point of view. The study identifies priority basins and areas from the perspectives of blue water scarcity, water pollution and deforestation. Wheat, fodder crops and sugarcane are identified as priority products related to blue water scarcity. The domestic sector is the priority sector regarding water pollution from nitrogen. Soybean and pasture are priority products related to deforestation. We estimate that consumptive water use in crop production could be reduced by 37% and nitrogen-related water pollution by 44% if water footprints were reduced to certain specified benchmark levels. The average WF per consumer in the region is 28% larger than the global average and varies greatly, from 912 m3/year per capita in Nicaragua to 3468 m3/year in Bolivia. Ironically, the LAC region shows significant levels of undernourishment, although there is abundant water and food production in the region and substantial use of land and water for producing export crops like soybean.

  3. Vascular Access Procedures

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Vascular Access Procedures A vascular access procedure inserts a flexible, ... the limitations of Vascular Access Procedures? What are Vascular Access Procedures? A vascular access procedure involves the insertion ...

  4. Vascular Access for Hemodialysis

    Science.gov (United States)

    ... Adequacy Eating & Nutrition for Hemodialysis Vascular Access for Hemodialysis What is a vascular access? A vascular access ... Set Up the Vascular Access Well before Starting Hemodialysis Patients should set up a vascular access well ...

  5. Challenges to access and provision of palliative care for people who are homeless: a systematic review of qualitative research.

    Science.gov (United States)

    Hudson, Briony F; Flemming, Kate; Shulman, Caroline; Candy, Bridget

    2016-12-03

    homeless is influenced by a potentially greater and more varied range of factors, on both individual and systemic levels, than providing palliative care for the housed population. Careful consideration and potentially great changes will be needed within health care systems to ensure homeless populations have equitable access to palliative care.

  6. Educational Access in India. Country Policy Brief

    Science.gov (United States)

    Online Submission, 2009

    2009-01-01

    This Policy Brief describes and explains patterns of access to schools in India. It outlines policy and legislation on access to education and provides an analysis of access, vulnerability and exclusion. The quantitative data is supported by a review of research which explains the patterns of access and exclusion. It is based on findings from the…

  7. Water Demand Management can help provide fair access to water ...

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

    Bob Stanley

    come from the socially efficient application of the revenues. WDM and fairness. When implementing water ... rights systems can be complex, with rights varying by season, purpose, and tradition. Local practice is often very ... Water is linked to a number of risks to livelihoods and to lives. For example, droughts and floods are ...

  8. XCOR AeroSpace: Providing Low Cost Access to Space

    Science.gov (United States)

    2009-02-01

    Formation flight automatically keeps troops on-target and in formation unlike WW2 drops • Capsule Troopers – Disposable capsule for 2+ people and... Capsules can carry many things besides troops – Some capsules might include fixed weapons for securing LZ 12 Extraction • Once you have rapid transport, USE...launched as a payload to target area – Lands vertically under steerable chute + retro rocket like Soyuz – Takes off vertically under rocket power to

  9. Providing clean energy and energy access through cooperatives

    CERN Document Server

    Studies, International Institute of Labour

    2013-01-01

    This publication is a collection of case studies on cooperatives in energy production, distribution and consumption as a contribution to the on-going search for ways in which the goal of sustainable Energy for All can be turned into a reality.

  10. An Equitable Approach for Compensating Municipalities of the Rio Grande Watershed for Electricity Generated by the Furnas Hydropower Plant, Brazil

    Science.gov (United States)

    Ribeiro, C. A. A. S.; Mounts, D. J.; Menezes, S. C., Jr.; Rocha, R. R. C.; Chaves, M. A.; Castro, N. L. M.; Barros, K. O.; Martins, B. F.; Gleriani, J. M.; Soares, V. P.

    2015-04-01

    In Brazil, ninety percent of total electric power comes from renewable sources, where hydropower represents 2/3 of the national energy matrix. In 2012, the new Federal Forest Code eliminated environmental protection along drainage divides and reduced the mandatory width of riparian zones, allowing for land cover change in these environmentally sensitive areas. The conversion of forestlands to agriculture will subject hydroelectric reservoirs to a growing load of sediments, shortening their useful life. In this study of the Furnas hydropower plant and its contributing basin, in the upper reaches of the Rio Grande, a re-evaluation of factors that determine the distribution of finances accrued from hydroelectric generation is recommended. Under the current policy, royalties are paid by the Furnas facility to states and municipalities in direct relation to the area of land flooded by its reservoir, whereas contributing rainfall precipitating in municipalities upstream of the lake is not considered. Currently, the 31 municipalities with lands flooded by the reservoir receive an average of R 213,107 (US 67,226) annually, while the remaining 172 municipalities in the basin receive no water royalties. In the proposed approach to redistribute these funds, each of the 203 municipalities will receive compensation determined by their contributing catchment area, averaging R32,543 (US 10,266) per year. By considering distribution of rainfall in order to equitably allocate hydroelectric royalties, a system for the payment of environmental services is conceived. Such a system intends to incent stakeholders to protect or replant native forests along drainage divides and riparian zones, in recognition of the value this vegetation has in the reduction of long term costs for hydroelectric facilities.

  11. Towards an equitable healthcare in China: evaluating the productive efficiency of community health centers in Jiangsu Province.

    Science.gov (United States)

    Zhou, Lulin; Xu, Xinglong; Antwi, Henry Asante; Wang, Linna

    2017-05-25

    While the demand for the health service keeps escalating at the grass root or rural areas of China, a substantial portion of healthcare resources remains stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, the Deepening Health Care Reform in 2012 China was intended to flush out these discrepancies and promote a more equitable and efficient distribution of health resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. We divided Jiangsu Province into 3 zones according to the level of economic and social development i.e. developed, developing, and undeveloped areas. Using a hybrid of Panel data analysis and an augmented Data Envelopment Analysis (DEA), we model human resources, capital inputs of Community Health Centers to comprehensively determine the technical and scale efficiency of community health resources in 3 zones in Jiangsu Province. We sampled data and analysed efficiency and productivity growth of 75 Community Health Centers in 13 cities of Jiangsu Province from 2011 to 2015, which shows that a significant productive growth among Community Health Centers between 2011 and 2015. Mirroring the behavior of Community Health Centers, technological progress was the underlying force for the growth and the deterioration in efficiency change was found. This can be credited partly to the Deepening Health Care Reform measures aimed at improving technology availability in health centers in sub-urban areas. The regional summary of the DEA result shows that the stage of economic development and the efficiency performance of hospital did not necessarily go hand in hand among the 3 zones of Jiangsu. The government of China in general and Jiangsu province in particular could improve the efficiency of health resources allocation by improving the community health service system, rationalizing the allocation of health

  12. Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions.

    Science.gov (United States)

    Tam, Yvonne; Huicho, Luis; Huayanay-Espinoza, Carlos A; Restrepo-Méndez, María Clara

    2016-10-04

    Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mortality impact of eliminating inequalities in coverage distribution between wealth quintiles and urban-rural residence. Our analyses quantified the remaining missed opportunities in Peru, where prioritizing scale-up of facility-based case management for all small and sick babies will be most effective in mortality reduction, compared to other evidenced-based interventions that prevent maternal and child deaths. Eliminating coverage disparities between the poorest quintiles and the richest will reduce under-five and neonatal mortality by 22.0 and 40.6 %, while eliminating coverage disparities between those living in rural and urban areas will reduce under-five and neonatal mortality by 29.3 and 45.2 %. This projected neonatal mortality reduction achieved by eliminating coverage disparities is almost comparable to that already achieved by Peru over the past decade. Although Peru has made great strides in improving child survival, further improvement in child health, especially in newborn health can be achieved if there is universal and equitable coverage of proven, quality health facility-based interventions. The magnitude of reduction in mortality will be similar to what has been achieved in the past decade. Strengthening health system to identify, understand, and direct resources to the poor and rural areas will ensure that Peru achieve the Sustainable Development Goals by 2030.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. The development and validation of the Self-Efficacy Beliefs about Equitable Science Teaching and learning instrument for prospective elementary teachers

    Science.gov (United States)

    Ritter, Jennifer M.

    1999-12-01

    The purpose of this study was to develop, validate and establish the reliability of an instrument to assess the self-efficacy beliefs of prospective elementary teachers with regards to science teaching and learning for diverse learners. The study used Bandura's theoretical framework, in that the instrument would use the self-efficacy construct to explore the beliefs of prospective elementary science teachers with regards to science teaching and learning to diverse learners: specifically the two dimensions of self-efficacy beliefs defined by Bandura (1977): personal self-efficacy and outcome expectancy. A seven step plan was designed and followed in the process of developing the instrument, which was titled the Self-Efficacy Beliefs about Equitable Science Teaching or SEBEST. Diverse learners as recognized by Science for All Americans (1989) are "those who in the past who have largely been bypassed in science and mathematics education: ethnic and language minorities and girls" (p. xviii). That definition was extended by this researcher to include children from low socioeconomic backgrounds based on the research by Gomez and Tabachnick (1992). The SEBEST was administered to 226 prospective elementary teachers at The Pennsylvania State University. Using the results from factor analyses, Coefficient Alpha, and Chi-Square a 34 item instrument was found to achieve the greatest balance across the construct validity, reliability and item balance with the content matrix. The 34 item SEBEST was found to load purely on four factors across the content matrix thus providing evidence construct validity. The Coefficient Alpha reliability for the 34 item SEBEST was .90 and .82 for the PSE sub-scale and .78 for the OE sub-scale. A Chi-Square test (X2 = 2.7 1, df = 7, p > .05) was used to confirm that the 34 items were balanced across the Personal Self-Efficacy/Outcome Expectancy and Ethnicity/LanguageMinority/Gender Socioeconomic Status/dimensions of the content matrix. Based on

  15. Developing an accessible video player

    Directory of Open Access Journals (Sweden)

    Juan José Rodríguez Soler

    2012-05-01

    Full Text Available Online Channels in financial institutions allows customers with disabilities to access services in a convenient way for them.However, one of the current challenges of this sector is to improve web accessibility and to incorporate technological resources to provide access to multimedia and video content, which has become a new form of internet communication.The present work shows in detail the strategy followed when designing and developing the new video player used by Bankinter for these purposes.

  16. Macroscopic characterisations of Web accessibility

    Science.gov (United States)

    Lopes, Rui; Carriço, Luis

    2010-12-01

    The Web Science framework poses fundamental questions on the analysis of the Web, by focusing on how microscopic properties (e.g. at the level of a Web page or Web site) emerge into macroscopic properties and phenomena. One research topic on the analysis of the Web is Web accessibility evaluation, which centres on understanding how accessible a Web page is for people with disabilities. However, when framing Web accessibility evaluation on Web Science, we have found that existing research stays at the microscopic level. This article presents an experimental study on framing Web accessibility evaluation into Web Science's goals. This study resulted in novel accessibility properties of the Web not found at microscopic levels, as well as of Web accessibility evaluation processes themselves. We observed at large scale some of the empirical knowledge on how accessibility is perceived by designers and developers, such as the disparity of interpretations of accessibility evaluation tools warnings. We also found a direct relation between accessibility quality and Web page complexity. We provide a set of guidelines for designing Web pages, education on Web accessibility, as well as on the computational limits of large-scale Web accessibility evaluations.

  17. 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.

  18. Internet Medline providers.

    Science.gov (United States)

    Vine, D L; Coady, T R

    1998-01-01

    Each database in this review has features that will appeal to some users. Each provides a credible interface to information available within the Medline database. The major differences are pricing and interface design. In this context, features that cost more and might seem trivial to the occasional searcher may actually save time and money when used by the professional. Internet Grateful Med is free, but Ms. Coady and I agree the availability of only three ANDable search fields is a major functional limitation. PubMed is also free but much more powerful. The command line interface that permits very sophisticated searches requires a commitment that casual users will find intimidating. Ms. Coady did not believe the feedback currently provided during a search was sufficient for sustained professional use. Paper Chase and Knowledge Finder are mature, modestly priced Medline search services. Paper Chase provides a menu-driven interface that is very easy to use, yet permits the user to search virtually all of Medline's data fields. Knowledge Finder emphasizes the use of natural language queries but fully supports more traditional search strategies. The impact of the tradeoff between fuzzy and Boolean strategies offered by Knowledge Finder is unclear and beyond the scope of this review. Additional software must be downloaded to use all of Knowledge Finders' features. Other providers required no software beyond the basic Internet browser, and this requirement prevented Ms. Coady from evaluating Knowledge Finder. Ovid and Silver Platter offer well-designed interfaces that simplify the construction of complex queries. These are clearly services designed for professional users. While pricing eliminates these for casual use, it should be emphasized that Medline citation access is only a portion of the service provided by these high-end vendors. Finally, we should comment that each of the vendors and government-sponsored services provided prompt and useful feedback to e

  19. Convenient Access to Professional Interpreters in the Hospital Decreases Readmission Rates and Estimated Hospital Expenditures for Patients with Limited English Proficiency

    Science.gov (United States)

    Karliner, Leah S.; Pérez-Stable, Eliseo J.; Gregorich, Steven E.

    2016-01-01

    Background Twenty-five million people in the U.S. have limited English proficiency (LEP); this growing and aging population experiences worse outcomes when hospitalized. Federal requirements that hospitals provide language access services are very challenging to implement in the fast-paced, 24-hour hospital environment. Objective Determine if increasing access to professional interpreters improves hospital outcomes for older patients with LEP Design Natural experiment on a medicine floor of an academic hospital Participants Patients age ≥50 discharged between Jan 15, 2007–Jan 15, 2010. Exposure Dual-handset interpreter telephone at every bedside July 15, 2008–Mar 14, 2009 Outcome Measures 30-day readmission, length of stay (LOS), estimated hospital expenditures Results Of 8,077 discharges, 1,963 were for LEP, and 6,114 for English-proficient (EP) patients. There was a significant decrease in observed 30-day readmission rates for the LEP group during the 8-month intervention period compared to 18 months pre-intervention (17.8% vs. 13.4%); at the same time EP readmission rates increased (16.7% vs. 19.7%); results remained significant in adjusted analyses. This improved readmission outcome for the LEP group was not maintained during the subsequent post-intervention period when the telephones became less accessible. There was no significant intervention impact on LOS in either unadjusted or adjusted analyses. After accounting for interpreter services costs, the estimated 119 readmissions averted during the intervention period were associated with estimated monthly hospital expenditure savings of $161,404. Conclusions Comprehensive language access represents an important, high value service that all medical centers should provide in order to achieve equitable, quality healthcare for vulnerable LEP populations. PMID:27579909

  20. 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.

  1. Selective access and editing in a database

    Science.gov (United States)

    Maluf, David A. (Inventor); Gawdiak, Yuri O. (Inventor)

    2010-01-01

    Method and system for providing selective access to different portions of a database by different subgroups of database users. Where N users are involved, up to 2.sup.N-1 distinguishable access subgroups in a group space can be formed, where no two access subgroups have the same members. Two or more members of a given access subgroup can edit, substantially simultaneously, a document accessible to each member.

  2. Car travel time and accessibility by bus to general practitioner services: a study using patient registers and GIS.

    Science.gov (United States)

    Lovett, Andrew; Haynes, Robin; Sünnenberg, Gisela; Gale, Susan

    2002-07-01

    Accessibility to general practitioner (GP) surgeries was investigated in a population study of East Anglia (Cambridgeshire, Norfolk and Suffolk) in the United Kingdom. Information from patient registers was combined with details of general practitioner surgery locations, road network characteristics, bus routes and community transport services, and a geographical information system (GIS) was used to calculate measures of accessibility to surgeries by public and private transport. Outcome measures included car travel times and indicators of the extent to which bus services could be used to visit GP surgeries. These variables were aggregated for wards or parishes and then compared with socio-economic characteristics of the populations living in those areas. The results indicated that only 10% of residents faced a car journey of more than 10 min to a GP. Some 13% of the population could not reach general medical services by daily bus. For 5% of the population, the car journey to the nearest surgery was longer than 10 min and there was no suitable bus service each weekday. In the remoter rural parishes, the lowest levels of personal mobility and the highest health needs indicators were found in the places with no daytime bus service each weekday and no community transport. The overall extent of accessibility problems and the existence of inverse care law effects in some rural localities have implications for the NHS, which aims to provide an equitable service to people wherever they live. The research also demonstrates the potential of patient registers and GIS as research and planning tools, though the practical difficulties of using these data sources and techniques should not be underestimated.

  3. 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.

  4. 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…

  5. Hemodialysis access -- self care

    Science.gov (United States)

    ... hemodialysis. Taking good care of your access helps make it last longer. Prevent Infection in Your Access Keep your access clean. Wash the access with soap and water every day to decrease your risk of infection. ...

  6. Internet Access and Empowerment

    Science.gov (United States)

    Masi, Christopher M; Suarez-Balcazar, Yolanda; Cassey, Margaret Z; Kinney, Leah; Piotrowski, Z Harry

    2003-01-01

    OBJECTIVE To determine whether access to health information via in-home Internet technology can positively influence empowerment among residents of a low-income urban community. DESIGN In-home Internet access and training were provided to volunteers, who, along with a comparison group, were interviewed prior to and 1 year after initiation of the program. Community-based participatory research methods were used to design and implement the intervention. SETTING A 57-block area on the West Side of Chicago. PATIENTS/PARTICIPANTS Twenty-five community residents completed all phases of the technology intervention. Thirty-five randomly selected neighbors of these residents served as the comparison group. INTERVENTIONS Members of the intervention group received Internet access via WebTV, training, technical support, and access to a community specific health-oriented web page during the course of the study. MEASUREMENTS AND MAIN RESULTS Intervention group members were similar to comparison group members in terms of empowerment at baseline. After receiving Internet access and training, empowerment related to health decision-making improved significantly in the intervention group. Similar changes did not occur in the comparison group. Affinity for and appreciation of information technology also increased in the intervention group but not in the comparison group. As a result, differences in attitudes toward technology increased between the 2 groups over time. CONCLUSIONS Using community-based participatory research methods, we found that Internet access to community-specific and general health information can lead to increased empowerment and appreciation of information technology. These benefits accrued among the intervention group but not among a random group of their neighbors. PMID:12848835

  7. 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.

    Science.gov (United States)

    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

    2014-08-05

    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 clients in Ghana and the influence of provider payment methods on incentives and behaviour. A mixed methods study involving grey and published literature reviews, as well as health management information system and primary data collection and analysis was used. Primary data collection involved in-depth interviews, observations of time spent obtaining service, prescription analysis, and exit interviews with clients. Qualitative data was analysed manually to draw out themes, commonalities, and contrasts. Quantitative data was analysed in Excel and Stata. Causal loop and cause tree diagrams were used to develop a qualitative explanatory model of provider supply incentives and behaviour related to payment method in context. There are multiple provider payment methods in the Ghanaian health system. National Health Insurance provider payment methods are the most recent additions. At the time of the study, the methods used nationwide were the Ghana Diagnostic Related Groupings payment for services and an itemized and standardized fee schedule for medicines. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear

  8. MCBS Access to Care PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MCBS 2013 Access to Care public use file (MCBS PUF) provides the first publically available MCBS file for researchers interested in the health, health care use,...

  9. 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

  10. Quantifying and explaining accessibility with application to the 2009 H1N1 vaccination campaign.

    Science.gov (United States)

    Heier Stamm, Jessica L; Serban, Nicoleta; Swann, Julie; Wortley, Pascale

    2017-03-01

    Accessibility and equity across populations are important measures in public health. This paper is specifically concerned with potential spatial accessibility, or the opportunity to receive care as moderated by geographic factors, and with horizontal equity, or fairness across populations regardless of need. Both accessibility and equity were goals of the 2009 vaccination campaign for the novel H1N1a influenza virus, including during the period when demand for vaccine exceeded supply. Distribution system design can influence equity and accessibility at the local level. We develop a general methodology that integrates optimization, game theory, and spatial statistics to measure potential spatial accessibility across a network, where we quantify spatial accessibility by travel distance and scarcity. We estimate and make inference on local (census-tract level) associations between accessibility and geographic, socioeconomic, and health care infrastructure factors to identify potential inequities in vaccine accessibility during the 2009 H1N1 vaccination campaign in the U.S. We find that there were inequities in access to vaccine at the local level and that these were associated with factors including population density and health care infrastructure. Our methodology for measuring and explaining accessibility leads to policy recommendations for federal, state, and local public health officials. The spatial-specific results inform the development of equitable distribution plans for future public health efforts.

  11. Are changes in Australian national primary healthcare policy likely to promote or impede equity of access? A narrative review.

    Science.gov (United States)

    Fisher, Matthew; Baum, Fran; Kay, Adrian; Friel, Sharon

    2017-07-01

    Significant changes have occurred in Australia's national primary healthcare (PHC) policy over the last decade, but little assessment has been made of implications for equity. This research aimed to identify key recent changes in national PHC policy and assess implications for equity of access to PHC. Academic literature was reviewed to identify issues affecting equity of access in national PHC policy, and grey literature was also reviewed to identify significant policy changes during 2005-16 with implications for equitable access. Equity implications of four areas of policy change, set against the existing Medicare system, were assessed. It was found that Medicare supports equitable access to general practice, but there is a risk of reduced equity under current policy settings. Four changes in PHC policy were selected as having particular implications for equity of access and these were assessed as follows: increased involvement of private health insurance presents risks for equity; equity implications of new models of coordinated care are unclear; and regional primary health organisations and current policy on Aboriginal and Torres Strait Islander health have potential equity benefits, but these will depend on further implementation.

  12. 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.

  13. Urban Telemedicine Enables Equity in Access to Acute Illness Care.

    Science.gov (United States)

    Ronis, Sarah D; McConnochie, Kenneth M; Wang, Hongyue; Wood, Nancy E

    2017-02-01

    Children with care for acute illness available through the Health-e-Access telemedicine model at childcare and schools were previously found to have 22% less emergency department (ED) use than counterparts without this service, but they also had 24% greater acute care use overall. We assessed the hypothesis that increased utilization reflected improved access among impoverished inner-city children to a level experienced by more affluent suburban children. This observational study compared utilization among children without and with telemedicine access, beginning in 1993, ending in 2007, and based on 84,287 child-months of billing claims-based observation. Health-e-Access Telemedicine was initiated in stepwise manner over 187 study-months among 74 access sites (childcare, schools, community centers), beginning in month 105. Children dwelled in inner city, rest-of-city Rochester, NY, or in surrounding suburbs. Rate of total acute care visits (office, ED, telemedicine) was measured as visits per 100 child-years. Observed utilization rates were adjusted in multivariate analysis for age, sex, insurance type, and season of year. When both suburban and inner-city children lacked telemedicine access, overall acute illness visits were 75% greater among suburban than inner-city children (suburban:inner-city rate ratio 1.75, p telemedicine became available to inner-city children, their overall acute visits approximated those of suburban children (suburban:inner-city rate ratio 0.80, p = 0.07), whereas acute visits among suburban children remained at least (worst-case comparison) 56% greater than inner-city children without telemedicine (rate ratio 1.56, p telemedicine to that of suburban children at baseline. Without telemedicine, however, inner-city use remained substantially less than for suburban counterparts. Health-e-Access Telemedicine redressed socioeconomic disparities in acute care access in the Rochester area, thus contributing to a more equitable community.

  14. 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...

  15. '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.

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

    Science.gov (United States)

    Hilmers, Angela; Hilmers, David C; Dave, Jayna

    2012-09-01

    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 convenience stores. Low-income neighborhoods offered greater access to food sources that promote unhealthy eating. The distribution of fast-food outlets and convenience stores differed by the racial/ethnic characteristics of the neighborhood. Further research is needed to address the limitations of current studies, identify effective policy actions to achieve environmental justice, and evaluate intervention strategies to promote lifelong healthy eating habits, optimum health, and vibrant communities.

  17. A household perspective on access to health care in the context of HIV and disability: a qualitative case study from Malawi.

    Science.gov (United States)

    Braathen, Stine Hellum; Sanudi, Lifah; Swartz, Leslie; Jürgens, Thomas; Banda, Hastings T; Eide, Arne Henning

    2016-04-01

    Equitable access to health care is a challenge in many low-income countries. The most vulnerable segments of any population face increased challenges, as their vulnerability amplifies problems of the general population. This implies a heavy burden on informal care-givers in their immediate and extended households. However, research falls short of explaining the particular challenges experienced by these individuals and households. To build an evidence base from the ground, we present a single case study to explore and understand the individual experience, to honour what is distinctive about the story, but also to use the individual story to raise questions about the larger context. We use a single qualitative case study approach to provide an in-depth, contextual and household perspective on barriers, facilitators, and consequences of care provided to persons with disability and HIV. The results from this study emphasise the burden that caring for an HIV positive and disabled family member places on an already impoverished household, and the need for support, not just for the HIV positive and disabled person, but for the entire household. Disability and HIV do not only affect the individual, but the whole household, immediate and extended. It is crucial to consider the interconnectedness of the challenges faced by an individual and a household. Issues of health (physical and mental), disability, employment, education, infrastructure (transport/terrain) and poverty are all related and interconnected, and should be addressed as a whole in order to secure equity in health.

  18. University Access, Inclusion and Social Justice

    Science.gov (United States)

    Hlalele, D.; Alexander, G.

    2012-01-01

    University access programmes inherently and inevitably provide students with a "label". Firstly, students are generally segregated and stigmatised as they are treated as a separate group that accessed university somewhat "illegitimately". Access programmes generally place more emphasis on academic development and in so doing…

  19. Freedom of the Press vs. Public Access.

    Science.gov (United States)

    Schmidt, Benno C., Jr.

    This book surveys the implications of freedom of the press for a constitutionally rooted public right of access to electronic and print media. Part one provides general perspectives on access to the media, including discussions of access in relation to the Supreme Court, to First Amendment history and theory, to current perceptions of the press,…

  20. VT Limited Access Highways

    Data.gov (United States)

    Vermont Center for Geographic Information — A limited-access road, known by various terms worldwide, including limited-access highway, dual carriageway, expressway, and partial controlled access highway, is a...

  1. Barriers to gender-equitable HIV testing: going beyond routine screening for pregnant women in Nova Scotia, Canada

    Science.gov (United States)

    2011-01-01

    Background Women and men face different gender-based health inequities in relation to HIV, including HIV testing as well as different challenges in accessing HIV care, treatment and support programs and services when testing HIV-positive. In this article, we discuss the findings of a mixed methods study exploring the various individual and structural barriers and facilitators to HIV counselling and testing experienced among a sample of adult women and men living in Nova Scotia, Canada. Methods Drawing from testing demographics, qualitative interview data and a review of existing testing policies and research, this paper focuses on understanding the gendered health inequities and their implications for HIV testing rates and behaviours in Nova Scotia. Results The findings of this research serve as the basis to further our understanding of gender as a key determinant of health in relation to HIV testing. Recognizing gender as a key determinant of health in terms of both vulnerability to HIV and access to testing, this paper explores how gender intersects with health equity issues such as access to HIV testing, stigma and discrimination, and sexual behaviours and relationships. Conclusions Drawing on the current gender and HIV literatures, in conjunction with our data, we argue that an enhanced, gender-based, context-dependent approach to HIV counselling and testing service provision is required in order to address the health equity needs of diverse groups of women and men living in various settings. Further, we argue that enhanced HIV testing efforts must be inclusive of both men and women, addressing uniquely gendered barriers to accessing HIV counselling and testing services and in the process moving beyond routine HIV testing for pregnant women. PMID:21569353

  2. Database Access Through Java Technologies

    OpenAIRE

    Nicolae MERCIOIU; Ion LUNGU

    2010-01-01

    As a high level development environment, the Java technologies offer support to the development of distributed applications, independent of the platform, providing a robust set of methods to access the databases, used to create software components on the server side, as well as on the client side. Analyzing the evolution of Java tools to access data, we notice that these tools evolved from simple methods that permitted the queries, the insertion, the update and the deletion of the data to adv...

  3. Improving access to health care amongst vulnerable populations: a qualitative study of village malaria workers in Kampot, Cambodia.

    Science.gov (United States)

    Liverani, Marco; Nguon, Chea; Sok, Ra; Kim, Daro; Nou, Panharith; Nguon, Sokhan; Yeung, Shunmay

    2017-05-08

    There is growing interest in the expansion of community health workers programmes in low- and middle-income countries as a cost-effective approach to address shortages of health professionals. However, our understanding of the reception of large-scale programmes and how to improve them remains limited, with knowledge gaps about factors that may promote or discourage equitable access to services. This paper examines the case of the Village Malaria Workers (VMW) programme in Cambodia, an extensive community-based intervention for the management of malaria cases in remote rural areas. Fieldwork was conducted in Kampot province, in six case villages characterised by different programme configuration, population size, and distance to the nearest public health facility. In these locations, in-depth interviews (n = 71) with VMWs, village authorities, and residents were conducted to identify facilitators and challenges to service utilisation. Data analysis was informed by a conceptual framework based on five domains of access to services: awareness, accessibility, accommodation, availability, and acceptability. Factors that influenced the utilisation of VMW services in our research sites include: the nature of dissemination activities and their ability to reach different population groups; the village topography and the changing road infrastructure; the involvement of VMWs in other community roles and activities; perceptions about the type of disease after the onset of symptoms; the need for comprehensive diagnosis and care; perceptions about the status of VMWs as medical providers; length of VMW appointment. This study highlights the complexity and diversity of contextual factors that may influence the uptake of a community health programme. As in other countries, continued use of lay health workers in Cambodia to deliver diagnostic and curative services has the potential for great health and economic impact. However, further consideration should be given to the

  4. NGO-provided free HIV treatment and services in Burkina Faso: scarcity, therapeutic rationality and unfair process

    Directory of Open Access Journals (Sweden)

    Ridde Valéry

    2012-03-01

    Full Text Available Abstract Until 2010, Burkina Faso was an exception to the international trend of abolishing user fees for antiretroviral treatment (ART. Patients were still expected to pay 1,500F CFA (2 Euros per month for ART. Nevertheless, many non-governmental organizations (NGOs exempted patients from payment. The objective of this study was to investigate how NGOs selected the beneficiaries of payment exemptions for government-provided ART and rationed out complementary medical and psychosocial services. For this qualitative study, we conducted 13 individual interviews and three focus group discussions (n = 13 persons with program staff in nine NGOs (4,000 patients, two NGO coordinating structures and one national program. These encounters were recorded and transcribed, and their content was thematically analyzed. The results were presented to the NGOs for feedback. Results indicate that there are no concrete guidelines for identifying patients warranting payment exemptions. Formerly, ART was scarce in Burkina Faso and the primary criterion for treatment selection was clinical. Our results suggest that this scarcity, mediated by an approach we call sociotherapeutic rationality (i.e. maximization of clinical success, may have led to inequities in the provision of free ART. This approach may be detrimental to assuring equity since the most impoverished lack resources to pay for services that maximize clinical success (e.g. viral load that would increase their chances of being selected for treatment. However, once selected into treatment, attempts were made to ration-out complementary services more equitably. This study demonstrates the risks entailed by medication scarcity, which presents NGOs and health professionals with impossible choices that run counter to the philosophy of equity in access to treatment. Amid growing concerns of an international funding retreat for ART, it is important to learn from the past in order to better manage the potentially

  5. Enstore with Chimera namespace provider

    Energy Technology Data Exchange (ETDEWEB)

    Litvintsev, Dmitry [Fermilab; Moibenko, Alexander [Fermilab; Oleynik, Gene [Fermilab; Zalokar, Michael [Fermilab

    2012-01-01

    Enstore is a mass storage system developed by Fermilab that provides distributed access and management of data stored on tapes. It uses a namespace service, PNFS, developed by DESY to provide a filesystem-like view of the stored data. PNFS is a legacy product and is being replaced by a new implementation, called Chimera, which is also developed by DESY. Chimera offers multiple advantages over PNFS in terms of performance and functionality. The Enstore client component, encp, has been modified to work with Chimera, as well as with any other namespace provider. We performed high load end-to-end acceptance test of Enstore with the Chimera namespace. This paper describes the modifications to Enstore, the test procedure and the results of the acceptance testing.

  6. Towards achieving Abuja targets: identifying and addressing barriers to access and use of insecticides treated nets among the poorest populations in Kenya

    Directory of Open Access Journals (Sweden)

    Okungu Vincent

    2010-03-01

    Full Text Available Abstract Background Ensuring that the poor and vulnerable population benefit from malaria control interventions remains a challenge for malaria endemic countries. Until recently, ownership and use of insecticides treated nets (ITNs in most countries was low and inequitable, although coverage has increased in countries where free ITN distribution is integrated into mass vaccination campaigns. In Kenya, free ITNs were distributed to children aged below five years in 2006 through two mass campaigns. High and equitable coverage were reported after the campaigns in some districts, although national level coverage remained low, suggesting that understanding barriers to access remains important. This study was conducted to explore barriers to ownership and use of ITNs among the poorest populations before and after the mass campaigns, to identify strategies for improving coverage, and to make recommendations on how increased coverage levels can be sustained. Methods The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: cross-sectional surveys (n = 708 households, 24 focus group discussions and semi-structured interviews with 70 ITN suppliers. Results Affordability was reported as a major barrier to access but non-financial barriers were also shown to be important determinants. On the demand side key barriers to access included: mismatch between the types of ITNs supplied through interventions and community preferences; perceptions and beliefs on illness causes; physical location of suppliers and; distrust in free delivery and in the distribution agencies. Key barriers on the supply side included: distance from manufacturers; limited acceptability of ITNs provided through interventions; crowding out of the commercial sector and the price. Infrastructure, information and communication played a central role in promoting or hindering access. Conclusions Significant

  7. Towards achieving Abuja targets: identifying and addressing barriers to access and use of insecticides treated nets among the poorest populations in Kenya.

    Science.gov (United States)

    Chuma, Jane; Okungu, Vincent; Ntwiga, Janet; Molyneux, Catherine

    2010-03-16

    Ensuring that the poor and vulnerable population benefit from malaria control interventions remains a challenge for malaria endemic countries. Until recently, ownership and use of insecticides treated nets (ITNs) in most countries was low and inequitable, although coverage has increased in countries where free ITN distribution is integrated into mass vaccination campaigns. In Kenya, free ITNs were distributed to children aged below five years in 2006 through two mass campaigns. High and equitable coverage were reported after the campaigns in some districts, although national level coverage remained low, suggesting that understanding barriers to access remains important. This study was conducted to explore barriers to ownership and use of ITNs among the poorest populations before and after the mass campaigns, to identify strategies for improving coverage, and to make recommendations on how increased coverage levels can be sustained. The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: cross-sectional surveys (n = 708 households), 24 focus group discussions and semi-structured interviews with 70 ITN suppliers. Affordability was reported as a major barrier to access but non-financial barriers were also shown to be important determinants. On the demand side key barriers to access included: mismatch between the types of ITNs supplied through interventions and community preferences; perceptions and beliefs on illness causes; physical location of suppliers and; distrust in free delivery and in the distribution agencies. Key barriers on the supply side included: distance from manufacturers; limited acceptability of ITNs provided through interventions; crowding out of the commercial sector and the price. Infrastructure, information and communication played a central role in promoting or hindering access. Significant resources have been directed towards addressing affordability

  8. Der Bologna-Prozess als Instrument zur Durchsetzung geschlechtergerechter Studiengänge? The Bologna Process as Instrument for the Implementation of Gender-Equitable Courses of Study?

    Directory of Open Access Journals (Sweden)

    Marco Tullney

    2007-03-01

    Full Text Available Auf der Grundlage von Expert/-inneninterviews entwickeln die Autorinnen der Studie Kriterien für geschlechtergerechte Studiengänge und analysieren den derzeitigen Stellenwert von Gender-Aspekten bei der Einführung gestufter Studiengänge. Hieraus entwickeln sie Handlungsempfehlungen zur stärkeren Integration von Inhalten der Frauen- und Geschlechterforschung sowie zur Erhöhung der Geschlechtergerechtigkeit in den neuen Studiengängen.Basing their examination on interviews with experts, the authors develop criteria for gender-equitable courses of study and analyze the current significance of gender aspects in the introduction of tiered courses of study. They then develop recommendations for taking action to better integrate the teachings of women’s and gender studies as well as to increase gender equity in the new courses of study.

  9. Therapy Provider Phase Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for...

  10. 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...

  11. CERN Access Cards and Access Authorisations

    CERN Multimedia

    2003-01-01

    From the 01/05/2003, all problems relating to access cards and refusal of access to any zone, building or experiment within CERN must be addressed to the Centrale de Surveillance des Accès (CSA building 120) on 78877 or send an e-mail to Access.Surveillance@cern.ch. The responsibles for CERN access control have put into place a procedure with the CSA, Service Enregistrement and the Technical Control Room, to make sure that all problems get resolved in a proper and timely manner.

  12. 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.

  13. ‘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

  14. ‘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.

  15. Addressing Inequities in Access to Health Products through the Use of Social Marketing, Community Mobilization, and Local Entrepreneurs in Rural Western Kenya

    Directory of Open Access Journals (Sweden)

    Julie R. Harris

    2012-01-01

    Full Text Available While social marketing can increase uptake of health products in developing countries, providing equitable access is challenging. We conducted a 2-year evaluation of uptake of WaterGuard, insecticide-treated bednets (ITNs, and micronutrient Sprinkles in Western Kenya. Sixty villages were randomly assigned to intervention and comparison groups. Following a baseline survey (BL, a multifaceted intervention comprising social marketing of these products, home visits by product vendors from a local women’s group (Safe Water and AIDS Project, or SWAP, product promotions, and modeling of water treatment and safe storage in was implemented in intervention villages. Comparison villages received only social marketing of WaterGuard and ITNs. We surveyed again at one year (FU1, implemented the intervention in comparison villages, and surveyed again at two years (FU2. At BL, 90% those reported ever purchasing a product from the vendor. WaterGuard (P=0.02 and ITNs (P=0.005 were purchased less frequently by lower-SES than higher-SES households; Sprinkles, the least expensive product, was purchased equally across all quintiles.

  16. Common Badging and Access Control System (CBACS)

    Science.gov (United States)

    Dischinger, Portia

    2005-01-01

    This slide presentation presents NASA's Common Badging and Access Control System. NASA began a Smart Card implementation in January 2004. Following site surveys, it was determined that NASA's badging and access control systems required upgrades to common infrastructure in order to provide flexibly, usability, and return on investment prior to a smart card implantation. Common Badging and Access Control System (CBACS) provides the common infrastructure from which FIPS-201 compliant processes, systems, and credentials can be developed and used.

  17. 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."

  18. 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 ...

  19. elevatr: Access Elevation Data from Various APIs

    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. ...

  20. Excluding the poor from accessing biomedical literature: a rights violation that impedes global health.

    Science.gov (United States)

    Yamey, Gavin

    2008-01-01

    Most biomedical journals charge readers a hefty access toll to read the full text version of a published research article. These tolls bring enormous profits to the traditional corporate publishing industry, but they make it impossible for most people worldwide--particularly in low and middle income countries--to access the biomedical literature. Traditional publishers also insist on owning the copyright on these articles, making it illegal for readers to freely distribute and photocopy papers, translate them, or create derivative educational works. This article argues that excluding the poor from accessing and freely using the biomedical research literature is harming global public health. Health care workers, for example, are prevented from accessing the information they need to practice effective medicine, while policymakers are prevented from accessing the essential knowledge they require to build better health care systems. The author proposes that the biomedical literature should be considered a global public good, basing his arguments upon longstanding and recent international declarations that enshrine access to scientific and medical knowledge as a human right. He presents an emerging alternative publishing model, called open access, and argues that this model is a more socially responsive and equitable approach to knowledge dissemination.

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

    Science.gov (United States)

    Mower, Allyson; Youngkin, Mary E

    2008-03-01

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

  2. Accessibility and sensory experiences

    DEFF Research Database (Denmark)

    Ryhl, Camilla

    2010-01-01

    This article introduces a new design concept; sensory accessibility. While acknowledging the importance of sensory experiences in architectural quality, as well as the importance of accommodating user needs the concept combines three equally important factors; architecture, the senses...... and accessibility. Sensory accessibility accommodates aspects of a sensory disability and describes architectural design requirements needed to ensure access to architectural experiences. In the context of architecture accessibility has become a design concept of its own. It is generally described as ensuring...... physical access to the built environment by accommodating physical disabilities. While the existing concept of accessibility ensures the physical access of everyone to a given space, sensory accessibility ensures the choice of everyone to stay and be able to participate and experience....

  3. 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

  4. 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.

  5. "Prompt and Equitable" Explained: How to Craft a Title IX Compliant Sexual Harassment Policy and Why It Matters

    Science.gov (United States)

    Block, Jason A.

    2012-01-01

    An April 2011 "Dear Colleague" letter issued by the U.S. Department of Education's Office for Civil Rights provided new guidance related to Title IX and the civil rights violation inherent in sexual harassment cases. Using the "Dear Colleague" letter as a guide, this article will provide best practice suggestions to remedy…

  6. Enteral nutrition access devices.

    Science.gov (United States)

    Kwon, Richard S; Banerjee, Subhas; Desilets, David; Diehl, David L; Farraye, Francis A; Kaul, Vivek; Mamula, Petar; Pedrosa, Marcos C; Rodriguez, Sarah A; Varadarajulu, Shyam; Song, Louis-Michel Wong Kee; Tierney, William M

    2010-08-01

    The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but, in many cases, data from randomized, controlled trials are lacking. In such situations, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the ASGE Governing Board. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2009 for articles related to endoscopy in patients requiring enteral feeding access by using the keywords "endoscopy," "percutaneous," "gastrostomy," "jejunostomy," "nasogastric," "nasoenteric," "nasojejunal," "transnasal," "feeding tube," "enteric," and "button." Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright 2010 American Society

  7. 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.

  8. Spatially balanced provision of health equipment: a cross-sectional study oriented to the identification of challenges to access promotion.

    Science.gov (United States)

    Amaral, Pedro Vasconcelos; Rocha, Thiago Augusto Hernandes; Barbosa, Allan Claudius Queiroz; Lein, Adriana; Vissoci, João Ricardo Nickenig

    2017-12-04

    Access to health services is in part defined by the spatial distribution of healthcare equipment. To ensure equity in the provision of health services, it is important to examine availability across different health care providers taking into account population demand. Given the importance of the equitable provision of health equipment, we evaluate its spatial distribution in Brazil. This study is classified as cross-sectional with an ecological design. We evaluate Brazilian data on distance to available health equipment considering: dialysis machines (385), magnetic resonance imaging (MRI) (257), hospital beds (3675) and bone densitometers (429). We define two distance thresholds (50 km and 200 km) from a municipality to the center of services provision. The balance between infrastructure capacity and potential demand was evaluated to identify a lack or surplus of health services. The distribution of dialysis equipment and bone densitometers is not balanced across Brazilian states, and unmet demand is high. With respect to MRIs, the large capacity of this equipment results in a large excess of supply. However, this characteristic alone cannot account for excesses of supply of over 700%, as is the case of the Federal District when the range is limited to 50 km. At the same time, four states in the Northeastern region of Brazil show a net excess of demand. Some regions do not meet the standard amount of supply defined by Brazilian Ministry of Health. The quantity and distribution of hospital beds are not sufficient to provide full coverage to the population. Our main focus was to evaluate the network of the provision of health equipment in Brazil, considering both private and public sectors conjointly. We take into account two main aspects of a spatially balanced health system: the regional availability of health equipment and the geographic distance between its demand and supply at the municipality level. Some regions do not meet the minimum requirement defined

  9. MAP-numa: Access Patterns Used to Characterize the NUMA Memory Access Optimization Techniques and Algorithms

    OpenAIRE

    Luo, Qiuming; Liu, Chenjian; Kong, Chang; Cai, Ye

    2012-01-01

    Part 5: Performance Modeling, Prediction, and Tuning; International audience; Some typical memory access patterns are provided and programmed in C, which can be used as benchmark to characterize the various techniques and algorithms aim to improve the performance of NUMA memory access. These access patterns, called MAP-numa (Memory Access Patterns for NUMA), currently include three classes, whose working data sets are corresponding to 1-dimension array, 2-dimension matrix and 3-dimension cube...

  10. Accessibility and inclusion informational

    Directory of Open Access Journals (Sweden)

    Mônica Sena de Souza

    2013-06-01

    Full Text Available Introduction: Discusses the role of information professionals in meeting the informational demands of people with disabilities in the information society. The librarian is crucial for the effectiveness and success in the informational inclusion of people with disabilities, considering also continuing education for their professional qualification.Objective: To provide reflections on the role of the librarian in serving users with disabilities, highlighting the need for improvement in information units, identified in the scientific literature with regard to accessibility.Methodology: Literature search, based on a review of literature in books and scientific papers, highlighting the main authors: Adams (2000, Mazzoni (2001 and Sassaki (1997, 2002, 2005.Results: The lack of informational access for people with disabilities hampers their social and political participation, hence, reduces its condition of citizenship.Conclusion: The librarian responsible for seeking continuing education, greater involvement in the events of the area and the constant search for job training, which will reflect on the best service the information needs of users with disabilities.

  11. Metropolitan Access Network

    Directory of Open Access Journals (Sweden)

    Slavko Šarić

    2003-11-01

    Full Text Available The optical fibre is the highest quality transmission mediumfor broadband services, and therefore the new access cablenetwork has to be realized to the greatest extent and as closeas possible to the subscriber by means of the optical fibre cables,in accordance with the possibilities of the telecommunicationoperator. The development of digital technology in commutations,supported by the increasingly powerful systems of processorcontrol, development of optical communications andtransport technologies in the framework of SDH concepts, arereflected on the access telecommunication networks of the urbanareas. Urban areas are the most profitable regions in telecommunications.In planning of urban optical networks the fact should betaken as a guideline that only a well-organised urban networkwill allow high quality of service provision of the leased cablesto the end points of business customers.Business customers have greater requirements for the networkreliability, flexibility and maintainability, for the sake ofundisturbed telecommunication traffic.The optical medium based technology- FITL (fiber in theloop, provides almost limitless upgrading of the system regardingthe transmission bandwidths, as well as adaptation to allthe future customers' requirements.Considering the increase in the price of installing the coppercables, the prices of electronics and optical components arecontinuously falling. The application of the optical medium isincreasing and becoming more cost-effective, and due to higherreliability of the optical transmission systems the maintenancecosts are reduced.

  12. A concepção de pobreza subjacente ao programa Bolsa Familia: rumo à construção da cidadania? (Conception of poverty underlying the Family Allowance Program: does it provide access to citizenship? Doi: 10.5212/Emancipacao.v.14i2.0008

    Directory of Open Access Journals (Sweden)

    Lucas Arcanjo Cassini

    2016-03-01

    Full Text Available Resumo: Este artigo discute a concepção de pobreza subjacente ao programa Bolsa Família nos dois governos Lula e seu continuísmo no governo Dilma. Valendose de pesquisa bibliográfica e documental, o artigo tem como objetivo verificar se esse programa, no fundamental, constitui-se em medidas compensatórias ou se traz oportunidades efetivas de acesso à cidadania. Pôde-se chegar às seguintes conclusões: na implementação do Bolsa Família, desconsidera-se a “positividade concreta” dos pobres; a pobreza não é tomada enquanto fenômeno multifacetado; o programa não contribui para que entre os pobres construam-se condições para o exercício de uma cidadania protagonista.Palavras-chave: pobreza. Programa Bolsa Família. Cidadania Abstract: This article discusses the design of poverty underlying the Family Allowance Program in two governments Lula and Dilma its continuity in government. Supported on a bibliographical and documentary research, its main purpose is to verify whether that program is essentially made up of compensatory arrangements or whether it provides real opportunities of access to citizenship. This work’s main conclusions are as follows: min the Family Allowance Program’s accomplishment, the “concrete positiveness” of the poor people is not considered; poverty isn’t faced as a multifaceted phenomenon; the program doesn’t help poor people to build conditions for the exercise of a protagonist citizenship. Keywords: poverty. Family Allowance Program. citizenship.

  13. Effective and equitable supply of gasoline to impacted areas in the aftermath of a natural disaster : final report.

    Science.gov (United States)

    2016-02-01

    The focus of this project was on supplying gasoline after a natural disaster. There were two aspects : for this work: determination of which gas stations should be provided with generators (among those that do : not have electric power) and determina...

  14. 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...

  15. Virtual Fieldwork Using Access Grid

    OpenAIRE

    Fielding, NG

    2010-01-01

    This article discusses the use of Access Grid (AG)-a form of video teleconferencing delivered over computer networks-to perform fieldwork. Interviews and group discussions were conducted with students and criminal court judges at sites remote from the fieldworker. A concept of "engagement'' was used to identify distinctive interactional features and provide a first insight into the AG as a fieldwork medium.

  16. Integrating top-down and bottom-up approaches to design a cost-effective and equitable programme of measures for adaptation of a river basin to global change

    Science.gov (United States)

    Girard, Corentin; Rinaudo, Jean-Daniel; Pulido-Velazquez, Manuel

    2016-04-01

    the implementation of cooperative game theory to define cost allocation scenarios. These results are compared with cost allocation rules based on social justice principles to provide contrasted insights into a negotiation process. The interdisciplinary framework developed in this research combines economics and water resources engineering methods, establishing a promising means of bridging the gap between bottom-up and top-down approaches and supporting the creation of cost-effective and equitable adaptation plans at the local level. The approach has been applied to the Orb river basin in Southern France. Acknowledgements The study has been partially supported by the IMPADAPT project /CGL2013-48424-C2-1-R) from the Spanish ministry MINECO (Ministerio de Economía y Competitividad) and European FEDER funds. Corentin Girard is supported by a grant from the University Lecturer Training Program (FPU12/03803) of the Ministry of Education, Culture and Sports of Spain.

  17. Design for Accessibility

    DEFF Research Database (Denmark)

    Herriott, Richard

    2012-01-01

    A report on how nine rail builder, operators and transport designers deal with design for accessibility......A report on how nine rail builder, operators and transport designers deal with design for accessibility...

  18. Physical Access Control Database -

    Data.gov (United States)

    Department of Transportation — This data set contains the personnel access card data (photo, name, activation/expiration dates, card number, and access level) as well as data about turnstiles and...

  19. Chemists, Access, Statistics

    Science.gov (United States)

    Holmes, Jon L.

    2000-06-01

    New JCE Internet Feature at JCE Online Biographical Snapshots of Famous Chemists is a new JCE Internet feature on JCE Online. Edited by Barbara Burke, this feature provides biographical information on leading chemists, especially women and minority chemists, fostering the attitude that the practitioners of chemistry are as human as those who endeavor to learn about it. Currently, the column features biographical "snapshots" of 30 chemists. Each snapshot includes keywords and bibliography and several contain links to additional online information about the chemist. More biographical snapshots will appear in future installments. In addition, a database listing over 140 women and minority chemists is being compiled and will be made available online with the snapshots in the near future. The database includes the years of birth and death, gender and ethnicity, major and minor discipline, keywords to facilitate searching, and references to additional biographical information. We welcome your input into what we think is a very worthwhile resource. If you would like to provide additional biographical snapshots, see additional chemists added to the database, or know of additional references for those that are already in the database, please contact JCE Online or the feature editor. Your feedback is welcome and appreciated. You can find Biographical Snapshots of Famous Chemists starting from the JCE Online home page-- click the Features item under JCE Internet and then the Chemist Bios item. Access JCE Online without Name and Password We have recently been swamped by libraries requesting IP-number access to JCE Online. With the great benefit IP-number authentication gives to librarians (no user names and passwords to administer) and to their patrons (no need to remember and enter valid names and passwords) this is not surprising. If you would like access to JCE Online without the need to remember and enter a user name and password, you should tell your librarian about our

  20. 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...

  1. Preferred provider organizations.

    Science.gov (United States)

    Davy, J D

    1984-05-01

    The 1980s has marked the beginning of a new alternative health care delivery system: the preferred provider organization ( PPO ). This system has developed from the health maintenance organization model and is predominant in California and Colorado. A PPO is a group of providers, usually hospitals and doctors, who agree to provide health care to subscribers for a negotiated fee that is usually discounted. Preferred provider organizations are subject to peer review and strict use controls in exchange for a consistent volume of patients and speedy turnaround on claims payments. This article describes the factors leading to the development of PPOs and the implications for occupational therapy.

  2. Exploring access to end of life care for ethnic minorities with end stage kidney disease through recruitment in action research.

    Science.gov (United States)

    Wilkinson, Emma; Randhawa, Gurch; Brown, Edwina; Da Silva Gane, Maria; Stoves, John; Warwick, Graham; Akhtar, Tahira; Magee, Regina; Sharman, Sue; Farrington, Ken

    2016-07-11

    Variation in provision of palliative care in kidney services and practitioner concerns to provide equitable access led to the development of this study which focussed on the perspectives of South Asian patients and their care providers. As people with a South Asian background experience a higher risk of Type 2 Diabetes (T2DM) and end stage kidney failure (ESKF) compared to the majority population but wait longer for a transplant, there is a need for end of life care to be accessible for this group of patients. Furthermore because non English speakers and people at end of life are often excluded from research there is a dearth of research evidence with which to inform service improvement. This paper aims to explore issues relating to the process of recruitment of patients for a research project which contribute to our understanding of access to end of life care for ethnic minority patients in the kidney setting. The study employed an action research methodology with interviews and focus groups to capture and reflect on the process of engaging with South Asian patients about end of life care. Researchers and kidney care clinicians on four NHS sites in the UK recruited South Asian patients with ESKF who were requiring end of life care to take part in individual interviews; and other clinicians who provided care to South Asian kidney patients at end of life to take part in focus groups exploring end of life care issues. In action research planning, action and evaluation are interlinked and data were analysed with emergent themes fed back to care providers through the research cycle. Reflections on the process of patient recruitment generated focus group discussions about access which were analysed thematically and reported here. Sixteen patients were recruited to interview and 45 different care providers took part in 14 focus groups across the sites. The process of recruiting patients to interview and subsequent focus group data highlighted some of the key issues

  3. Limited school drinking water access for youth

    Science.gov (United States)

    Kenney, Erica L.; Gortmaker, Steven L.; Cohen, Juliana F.W.; Rimm, Eric B.; Cradock, Angie L.

    2016-01-01

    PURPOSE Providing children and youth with safe, adequate drinking water access during school is essential for health. This study utilized objectively measured data to investigate the extent to which schools provide drinking water access that meets state and federal policies. METHODS We visited 59 middle and high schools in Massachusetts during spring 2012. Trained research assistants documented the type, location, and working condition of all water access points throughout each school building using a standard protocol. School food service directors (FSDs) completed surveys reporting water access in cafeterias. We evaluated school compliance with state plumbing codes and federal regulations and compared FSD self-reports of water access with direct observation; data were analyzed in 2014. RESULTS On average, each school had 1.5 (SD: 0.6) water sources per 75 students; 82% (SD: 20) were functioning, and fewer (70%) were both clean and functioning. Less than half of the schools met the federal Healthy Hunger Free Kids Act requirement for free water access during lunch; 18 schools (31%) provided bottled water for purchase but no free water. Slightly over half (59%) met the Massachusetts state plumbing code. FSDs overestimated free drinking water access compared to direct observation (96% FSD-reported versus 48% observed, kappa=0.07, p=0.17). CONCLUSIONS School drinking water access may be limited. In this study, many schools did not meet state or federal policies for minimum student drinking water access. School administrative staff may not accurately report water access. Public health action is needed to increase school drinking water access. IMPLICATIONS AND CONTRIBUTIONS Adolescents’ water consumption is lower than recommended. In a sample of Massachusetts middle and high schools, about half did not meet federal and state minimum drinking water access policies. Direct observation may improve assessments of drinking water access and could be integrated into routine

  4. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...

  5. Providing free autopoweroff plugs

    DEFF Research Database (Denmark)

    Jensen, Carsten Lynge; Hansen, Lars Gårn; Fjordbak, Troels

    2012-01-01

    Experimental evidence of the effect of providing households with cheap energy saving technology is sparse. We present results from a field experiment in which autopoweroff plugs were provided free of charge to randomly selected households. We use propensity score matching to find treatment effects...

  6. 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.

  7. An indicator to estimate the access to imaging services in the Costa Rican public health system.

    Science.gov (United States)

    Rosales-López, Alfonso; Ortiz-Posadas, Martha R

    2014-02-01

    The aim of this work was to develop an indicator that estimates the population's access to imaging services (IS) of health care facilities in the Costa Rican Public Health System, taking into account five aspects: (a) health care facilities infrastructure, (b) capacity of the IS according to the installed technological resources, (c) epidemiological aspects, (d) demographic aspects, and (e) location of the health facility in relation to the Capital. To achieve this, 14 variables and 7 indicators were defined. These indicators were integrated into a mathematical function which resulted in a global indicator that throws quantitative data that represents the level of access of a population to the IS in their geographic region of influence. The application of the indicator was performed in eight health facility sub-networks with defined geographical regions within the territory of Costa Rica. The level of access to the imaging service of the inhabitants of the eight sub-networks results that three of them obtained a bad access, located in east and north-central of the country; other three sub-networks obtained regular access, located in the west; and the last two who obtained a good access are located in the center of the country. The results showed that the imaging services are not equitable in each sub-network. Knowing this, it is possible to work on healthcare technology management proposals in order to strengthen the regional imaging services, contributing to decentralizing the services of the general hospitals located in the Capital.

  8. 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

  9. Towards a More Equitable and Inclusive Learning Environment in Sport Education: Results of an Action Research-Based Intervention

    Science.gov (United States)

    Farias, Cláudio; Hastie, Peter Andrew; Mesquita, Isabel

    2017-01-01

    This study was designed to examine and intervene into student behaviours to promote a democratic, inclusive and participatory focus within Sport Education. To achieve an increased understanding of and changes within student behaviours, a collaborative participatory action research methodology was applied to provide voice to students as agents of…

  10. EPA’s EnviroAtlas: Identifying Nature’s Benefits, Deficits, and Opportunities for Equitable Distribution in Populated Places#

    Science.gov (United States)

    The web-based EnviroAtlas is an easy-to-use mapping and analysis tool built by the U.S. Environmental Protection Agency and its partners to provide information, data, and research on the relationships between ecosystems, built infrastructure, and societal well-being. The tool is ...

  11. Pro Access 2010 Development

    CERN Document Server

    Collins, Mark

    2011-01-01

    Pro Access 2010 Development is a fundamental resource for developing business applications that take advantage of the features of Access 2010 and the many sources of data available to your business. In this book, you'll learn how to build database applications, create Web-based databases, develop macros and Visual Basic for Applications (VBA) tools for Access applications, integrate Access with SharePoint and other business systems, and much more. Using a practical, hands-on approach, this book will take you through all the facets of developing Access-based solutions, such as data modeling, co

  12. Access 2013 for dummies

    CERN Document Server

    Ulrich Fuller, Laurie

    2013-01-01

    The easy guide to Microsoft Access returns with updates on the latest version! Microsoft Access allows you to store, organize, view, analyze, and share data; the new Access 2013 release enables you to build even more powerful, custom database solutions that integrate with the web and enterprise data sources. Access 2013 For Dummies covers all the new features of the latest version of Accessand serves as an ideal reference, combining the latest Access features with the basics of building usable databases. You'll learn how to create an app from the Welcome screen, get support

  13. Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada’s Compassionate Care Benefit

    Directory of Open Access Journals (Sweden)

    Giesbrecht Melissa

    2012-11-01

    Full Text Available Abstract Introduction Family (i.e., unpaid caregiving has long been thought of as a ‘woman’s issue’, which ultimately results not only in gendered, but also financial and health inequities. Because of this, gender-based analyses have been prioritized in caregiving research. However, trends in current feminist scholarship demonstrate that gender intersects with other axes of difference, such as culture, socio-economic status, and geography to create diverse experiences. In this analysis we examine how formal front-line palliative care providers understand the role of such diversities in shaping Canadian family caregivers’ experiences of end-of-life care. In doing so we consider the implications of these findings for a social benefit program aimed at supporting family caregivers, namely the Compassionate Care Benefit (CCB. Methods This analysis contributes to a utilization-focused evaluation of Canada’s CCB, a social program that provides job security and limited income assistance to Canadian family caregivers who take a temporary leave from employment to provide care for a dying family member at end-of-life. Fifty semi-structured phone interviews with front-line palliative care providers from across Canada were conducted and thematic diversity analysis of the transcripts ensued. Results Findings reveal that experiences of caregiving are not homogenous and access to services and supports are not universal across Canada. Five axes of difference were commonly raised by front-line palliative care providers when discussing important differences in family caregivers’ experiences: culture, gender, geography, lifecourse stage, and material resources. Our findings reveal inequities with regard to accessing needed caregiver services and resources, including the CCB, based on these axes of difference. Conclusions We contend that without considering diversity, patterns in vulnerability and inequity are overlooked, and thus continually reinforced

  14. 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.

  15. 'Are We Not Human?' Stories of Stigma, Disability and HIV from Lusaka, Zambia and Their Implications for Access to Health Services.

    Science.gov (United States)

    Parsons, Janet A; Bond, Virginia A; Nixon, Stephanie A

    2015-01-01

    The advent of anti-retroviral therapy (ART) in Southern Africa holds the promise of shifting the experience of HIV toward that of a manageable chronic condition. However, this potential can only be realized when persons living with HIV are able to access services without barriers, which can include stigma. Our qualitative study explored experiences of persons living with disabilities (PWD) in Lusaka, Zambia who became HIV-positive (PWD/HIV+). We conducted interviews with 32 participants (21 PWD/HIV+ and 11 key informants working in the fields of HIV and/or disability). Inductive thematic analysis of interview transcripts was informed by narrative theory. Participants' accounts highlighted the central role of stigma experienced by PWD/HIV+, with stigmatizing attitudes closely linked to prevailing societal assumptions that PWD are asexual. Seeking diagnostic and treatment services for HIV was perceived as evidence of PWD being sexually active. Participants recounted that for PWD/HIV+, stigma was enacted in a variety of settings, including the queue for health services, their interactions with healthcare providers, and within their communities. Stigmatizing accounts told about PWD/HIV+ were described as having important consequences. Not only did participants recount stories of internalized stigma (with its damaging effects on self-perception), but also that negative experiences resulted in some PWD preferring to "die quietly at home" rather than being subjected to the stigmatizing gaze of others when attempting to access life-preserving ART. Participants recounted how experiences of stigma also affected their willingness to continue ART, their willingness to disclose their HIV status to others, as well as their social relations. However, participants also offered counter-stories, actively resisting stigmatizing accounts and portraying themselves as resilient and resourceful social actors. The study highlights a significant barrier to healthcare experienced by PWD

  16. Patient cost-sharing and insurance arrangements are associated with hospital readmissions after abdominal surgery: Implications for access and quality health care.

    Science.gov (United States)

    Youn, Bora; Soley-Bori, Marina; Soria-Saucedo, Rene; Ryan, Colleen M; Schneider, Jeffrey C; Haynes, Alex B; Cabral, Howard J; Kazis, Lewis E

    2016-03-01

    Readmission rates after operative procedures are used increasingly as a measure of hospital care quality. Patient access to care may influence readmission rates. The objective of this study was to determine the relationship between patient cost-sharing, insurance arrangements, and the risk of postoperative readmissions. Using the MarketScan Research Database (n = 121,002), we examined privately insured, nonelderly patients who underwent abdominal surgery in 2010. The main outcome measures were risk-adjusted unplanned readmissions within 7 days and 30 days of discharge. Odds of readmissions were compared with multivariable logistic regression models. In adjusted models, $1,284 increase in patient out-of-pocket payments during index admission (a difference of one standard deviation) was associated with 19% decrease in the odds of 7-day readmission (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.78-0.85) and 17% decrease in the odds of 30-day readmission (OR 0.83, 95% CI 0.81-0.86). Patients in the noncapitated point-of-service plans (OR 1.19, 95% CI 1.07-1.33), preferred provider organization plans (OR 1.11, 95% CI 1.03-1.19), and high-deductible plans (OR 1.12, 95% CI 1.00-1.26) were more likely to be readmitted within 30 days compared with patients in the capitated health maintenance organization and point-of-service plans. Among privately insured, nonelderly patients, increased patient cost-sharing was associated with lower odds of 7-day and 30-day readmission after abdominal surgery. Insurance arrangements also were significantly associated with postoperative readmissions. Patient cost sharing and insurance arrangements need consideration in the provision of equitable access for quality care. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

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

  18. Equity in Distribution of Health Care Resources; Assessment of Need and Access, Using Three Practical Indicators.

    Science.gov (United States)

    Omrani-Khoo, Habib; Lotfi, Farhad; Safari, Hossein; Zargar Balaye Jame, Sanaz; Moghri, Javad; Shafii, Milad

    2013-11-01

    Equitable distribution of health system resources has been a serious challenge for long ago among the health policy makers. Conducted studies have mostly ever had emphasis on equality rather than equity. In this paper we have attempted to examine both equality and equity in resources distribution. This is an applied and descriptive study in which we plotted Lorenz and concentration curves to describe graphically the distribution of hemodialysis beds and nephrologists as two complementary resources in health care in relation to hemodialysis patients. To end this, inequality and inequity were measured by calculating Gini- coefficient, concentration and Robin Hood indices. We used STATA and EXCEL software to calculate indicators. The results showed that inequality was not seen in hemodialysis beds in population level. However, distribution of nephrologists without considering population needs was accompanied with some sort of inequality. Gini- coefficient for beds and nephrologists distribution in population level was respectively 0.02 and 0.38. Hence, calculation of concentration index for distribution of hemodialysis beds and nephrologists with regard to population needs indicated that unlike beds distribution, equity gap between nephrologists distribution against patients distribution among the provinces was considerably significant again. Our results imply that although hemodialysis beds in Iran have been distributed in connection with the population need, nephrologists' distribution is not the same as hemodialysis beds one and this imbalance in complementary resources, can affect both efficiency and equitable access to services for population.

  19. Accessing timely rehabilitation services for a global aging society? Exploring the realities within Canada's universal health care system.

    Science.gov (United States)

    Landry, Michel D; Raman, Sudha; Al-Hamdan, Elham

    2010-07-01

    The proportion of older persons is increasing in developed and developing countries: this aging trend can be viewed as a two-edged sword. On the one hand, it represents remarkable successes regarding advances in health care; and on the other hand, it represents a considerable challenge for health systems to meet growing demand. A growing disequilibrium between supply and demand may be particularly challenging within publicly funding health systems that 'guarantee' services to eligible populations. Rehabilitation, including physical therapy, is a service that if provided in a timely manner, can maximize function and mobility for older persons, which may in turn optimize efficiency and effectiveness of overall health care systems. However, physical therapy services are not considered an insured service under the legislative framework of the Canadian health system, and as such, a complex public/private mix of funding and delivery has emerged. In this article, we explore the consequences of a public/private mix of physical therapy on timely access to services, and use the World Health Organization (WHO) health system performance framework to assess the extent to which the emerging system influences the goal of aggregated and equitable health. Overall, we argue that a shift to a public/private mix may not have positive influences at the population level, and that innovative approaches to deliver services would be desirable to strengthening rather than weaken the publicly funded system. We signal that strategies aimed at scaling up rehabilitation interventions are required in order to improve health outcomes in an evolving global aging society.

  20. Autism, Art, and Accessibility to Theater.

    Science.gov (United States)

    Corbett, Blythe A

    2016-12-01

    Art has the ability to entertain and educate about many vital aspects of the human experience. Recently, innovative endeavors are providing greater accessibility to theatrical productions for people with autism spectrum disorder (ASD), prompting ethical questions about how accommodations to provide access to art and culture should be made, and for whom. This article uses an attributional model of stigma to explain potential differences in knowledge, attitudes, and behavior toward people with mental illness. This social cognitive model also provides clues about how to spur social change through translational education, familiarization, and advocacy to permit greater access to art for people with disabilities. © 2016 American Medical Association. All Rights Reserved.

  1. Housing Accessibility Methodology Targeting Older People

    DEFF Research Database (Denmark)

    Helle, Tina

    activities. Barriers in the environment can limit or hinder activity performance. Therefore, older people are sensitive to the accessibility of the environment. To ensure housing accessibility, it is critical that professionals are provided with valid and reliable assessment instruments to identify...

  2. Web browser accessibility using open source software

    NARCIS (Netherlands)

    Z. Obrenovic; J.R. van Ossenbruggen (Jacco)

    2007-01-01

    htmlabstractA 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

  3. Internet Access in School Library Media Centers.

    Science.gov (United States)

    Everhart, Nancy

    1997-01-01

    Examines Internet resources available for elementary school children and discusses why Internet access should be provided through school library media centers. Highlights include appropriate Web sites, a case study, equity of access, censorship, integrating Internet resources into the curriculum, Internet usage guidelines, and identification and…

  4. 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…

  5. Access to Information and Privacy | IDRC - International ...

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

    ATIP) Coordinator is to provide information to the public on access to information and privacy matters, on behalf of IDRC, in the official language of your choice. The Access to Information Act gives Canadian citizens, permanent residents, and any ...

  6. Inclusive Design for Learning - Making Your Classroom Accessible

    Science.gov (United States)

    Speck, Angela; Ceylan, G.

    2013-06-01

    As science educators, our shared purpose of communicating and cultivating essential content and skills in all learners calls for continual re-evaluation of materials and approaches in the context of increasingly diverse classrooms. Lack of enrollment and retention of under-represented groups in science courses necessitates improvement of current science curricula design and teaching techniques in order to provide equitable educational experiences. We have developed an Inclusive Design for Learning course for STEM graduate students with the aim of improving the instructional approaches of our future STEM faculty in higher education. We will present the background and techniques used in this course and offer preliminary analysis of its first semester in action.

  7. EquiMar : Equitable Testing and Evaluation of Marine Energy Extraction Devices in Terms of Performance, Cost and Environmental Impact

    DEFF Research Database (Denmark)

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

    for economic evaluation in a small array deployment. This progression covers development Stages 3 to 4 in the 5 Stage development programme on which the EquiMar technical protocols are based. This report aims at providing a methodology for the analysis and presentation of data obtained from sea trials...... of marine energy converters, according to Annex 1 – Description of Work of the EquiMar project, where task 4.2 is defined. Some slight modifications have been made to the original structure due to re-adjustments in accordance with the on-going research....

  8. 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

  9. Single port access adrenalectomy.

    Science.gov (United States)

    Castellucci, Sean A; Curcillo, Paul G; Ginsberg, Phillip C; Saba, Salim C; Jaffe, Jamison S; Harmon, Justin D

    2008-08-01

    To report the first single port access (SPA) adrenalectomy to minimize patient discomfort through a less invasive procedure. We performed the first SPA in a 63-year-old, otherwise healthy Caucasian female who had a 4.5-cm left adrenal mass that was incidentally discovered on computed tomography scan of the abdomen and pelvis. Through a 2-cm single longitudinal supraumbilical incision extended down to the abdominal fascia, three 5-mm ports were placed through separate facial entry points, to make a triangular port arrangement. The adrenal vein was identified and ligated using hemoclips. The remainder of the dissection was done using hemocoagulation. The adrenal gland was extracted via an EndoCatch bag device by removing one 5-mm port and upsizing to a 12-mm port. We report on the first SPA adrenalectomy. Although this technology is still in its infancy, the use of a single port for surgery provides a means to provide a potentially better patient outcome with a less invasive procedure.

  10. Provider of Services File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it...

  11. The Provident Principal.

    Science.gov (United States)

    McCall, John R.

    This monograph offers leadership approaches for school principals. Discussion applies the business leadership theory of Warren Bennis and Burt Nanus to the role of the principal. Each of the booklet's three parts concludes with discussion questions. Part 1, "Visions and Values for the Provident Principal," demonstrates the importance of…

  12. What HERA may provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes [DESY, Hamburg (Germany); De Roeck, Albert [CERN, Genf (Switzerland); Bartles, Jochen [Univ. Hamburg (DE). Institut fuer Theoretische Physik II] (and others)

    2008-09-15

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. (orig.)

  13. care Providers in Ibadan

    African Journals Online (AJOL)

    Three hundred and eighty six respondents (77.7%) were aware of intermittent preventive treatment (IPT). Awareness ... Key Words: malaria in pregnancy, intermittent preventive treatment, malaria control, health care providers. Department of Obstetrics .... Auxiliary nurses do not have formal training prior to employment.

  14. Web accessibility of public universities in Andalusia

    Directory of Open Access Journals (Sweden)

    Luis Alejandro Casasola Balsells

    2017-06-01

    Full Text Available This paper describes an analysis conducted in 2015 to evaluate the accessibility of content on Andalusian public university websites. In order to determinate whether these websites are accessible, an assessment has been carried out to check conformance with the latest Web Content Accessibility Guidelines (WCAG 2.0 established by the World Wide Web Consortium (W3C. For this purpose, we have designed a methodology for analysis that combines the use of three automatic tools (eXaminator, MINHAP web accessibility tool, and TAW with a manual analysis to provide a greater reliability and validity of the results. Although the results are acceptable overall, a detailed analysis shows that more is still needed for achieving full accessibility for the entire university community. In this respect, we suggest several corrections to common accessibility errors for facilitating the design of university web portals.

  15. Open Access Monitor - DK

    DEFF Research Database (Denmark)

    Svendsen, Michael; Hansen, Lars Asger Juel; Andersen, Dorte

    2017-01-01

    Open Access Monitor - DK (OAM-DK) is a 2-year DEFF funded [DEFF.2016-0018] national project running in 2017-2018 with the aim of collecting, documenting and administrating Open Access publishing costs. OAM-DK is lead by Copenhagen University Library under the Royal Danish Library with participation...... of all Danish University Libraries. This poster presents the first results of Open Access costs related to 2015 publications at the The University of Copenhagen....

  16. Are PDF Documents Accessible?

    Directory of Open Access Journals (Sweden)

    Mireia Ribera Turró

    2008-09-01

    Full Text Available Adobe PDF is one of the most widely used formats in scientific communications and in administrative documents. In its latest versions it has incorporated structural tags and improvements that increase its level of accessibility. This article reviews the concept of accessibility in the reading of digital documents and evaluates the accessibility of PDF according to the most widely established standards.

  17. Access Data Analysis Cookbook

    CERN Document Server

    Bluttman, Ken

    2008-01-01

    This book offers practical recipes to solve a variety of common problems that users have with extracting Access data and performing calculations on it. Whether you use Access 2007 or an earlier version, this book will teach you new methods to query data, different ways to move data in and out of Access, how to calculate answers to financial and investment issues, how to jump beyond SQL by manipulating data with VBA, and more.

  18. Access control Tutorial 5

    CERN Document Server

    CERN. Geneva; Oberknapp, Bernd

    2007-01-01

    This tutorial will review current access management technologies and invite participants to discuss use cases and requirements for access management, particularly with respect to scholarly archives and their users. The presenters will describe the concepts and architecture of Federated Access Management (FAM) with reference to some large-scale federation implementations, and discuss the challenges faced particularly in Identity Management by academic institutions. The tutorial will include a practical demonstration of how FAM can be applied to an Open Archive repository.

  19. Factors Influencing Army Accessions.

    Science.gov (United States)

    1982-12-01

    fmultivariate Analyses Tables 161 Abbreviation Multivariate Analysis Variables i rAcces DODNP & DODHS (See definitions below) AFQT Armed Forces...BMA Black Military Available ColDg Associates Degree or higher DODHS DOD High School Diploma Male Accessions DODNP DOD Non-Prior Service Male Accessions...30 I Standardized Canonical Discriminant Function Coefficients (With DOD Accession Variables) • - .CentroidsDRC Marri #MHSS Unemp ArnyR DODMP DODHS

  20. Providing plastic zone extrusion

    Science.gov (United States)

    Manchiraju, Venkata Kiran; Feng, Zhili; David, Stan A.; Yu, Zhenzhen

    2017-04-11

    Plastic zone extrusion may be provided. First, a compressor may generate frictional heat in stock to place the stock in a plastic zone of the stock. Then, a conveyer may receive the stock in its plastic zone from the compressor and transport the stock in its plastic zone from the compressor. Next, a die may receive the stock in its plastic zone from the conveyer and extrude the stock to form a wire.

  1. AccessAbility @ Cleveland Public Library.

    Science.gov (United States)

    Mates, Barbara T.

    2003-01-01

    Describes several programs that were developed by staff at the Cleveland (Ohio) Public Library to be accessible to users with disabilities. Highlights include a Braille reading program; sensory garden; poetry club; book club based on talking books; wheelchair athletics; touching museum artifacts; and a mobile library for users who could not visit…

  2. 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

  3. Il federalismo in sanità: opportunità e rischi tra finanziamento, equità ed assistenza

    Directory of Open Access Journals (Sweden)

    Fabrizio Gianfrate

    2005-09-01

    Full Text Available Federalism in Italy arised beginning ’90, pushed bipartisanly from establishment in order to contrast the succesfull poll of northern league party. Being about 80% of the regions budget for healthcare, federalism had its hard impact on it. Regions can manage autonomously their healthcare organization, adding to the State financial resources own money earning from other their services or coming from local taxes, on condition that they provide the State LEA (Essential Level of Assistance. That means a high level of responsabilization for local government for reaching a higher level of efficiency in allocation of resources and organizational models of production and erogation of healthcare, beside a better ability to catch local healthcare demand. Even if now the sharing of State financial resources are agreed between all regions and Government, it’s not clear for the future wheter each region will have to procure its own finance, introducing many problems for those southern regions unable to substain theirselves. It has still to be defined wheter and how reach regions will have to transfer part of their resources to the poor ones. That means a risk of iniquity of level in healthcare provision among regions of the same country, generating possible social conflict. Therefore federalism now has from a hand the opportunity to better tail healthcare on each local demand and, on the other hand, it risks to introduce social disparity and conflicts.

  4. LAW REFORM OF SMALL AND MEDIUM ENTREPRISES (SMEs AND EQUITABLE COOPERATIVE FOR COMPETITIVENESS IMPROVEMENT IN AEC ERA

    Directory of Open Access Journals (Sweden)

    Koesrianti Koesrianti

    2017-02-01

    Full Text Available Small Medium Entreprises (SMEs and Cooperative have not received a proper law protection in facing trade liberation of ASEAN Economic Community (AEC and economic globalized world. In 2015 AEC has been established that would bring a huge change in Southeast Asia regionS and definitely will have a wide impact to business people in Indonesia. SMEs and Cooperative contribute to more than 90 percent of total Indonesian national economy. However, they are weak on investment and information technology and management skill as well as competition law among ASEAN Member States. Economic policies do not give a sufficient protection to SMEs and Cooperative. This article tries to seek solutions for SMEs problems especially their legal structure in order to enhance their competitiveness. This article argues that the government can provide legal protection by reforming SMEs economic sectors similar to the AEC’s priority sectors by which the Indonesian’ SMEs would become world class corporate.  Keywords: Cooperative, AEC, legal reform, SMEs

  5. Providing traceability for neuroimaging analyses.

    Science.gov (United States)

    McClatchey, Richard; Branson, Andrew; Anjum, Ashiq; Bloodsworth, Peter; Habib, Irfan; Munir, Kamran; Shamdasani, Jetendr; Soomro, Kamran

    2013-09-01

    With the increasingly digital nature of biomedical data and as the complexity of analyses in medical research increases, the need for accurate information capture, traceability and accessibility has become crucial to medical researchers in the pursuance of their research goals. Grid- or Cloud-based technologies, often based on so-called Service Oriented Architectures (SOA), are increasingly being seen as viable solutions for managing distributed data and algorithms in the bio-medical domain. For neuroscientific analyses, especially those centred on complex image analysis, traceability of processes and datasets is essential but up to now this has not been captured in a manner that facilitates collaborative study. Few examples exist, of deployed medical systems based on Grids that provide the traceability of research data needed to facilitate complex analyses and none have been evaluated in practice. Over the past decade, we have been working with mammographers, paediatricians and neuroscientists in three generations of projects to provide the data management and provenance services now required for 21st century medical research. This paper outlines the finding of a requirements study and a resulting system architecture for the production of services to support neuroscientific studies of biomarkers for Alzheimer's disease. The paper proposes a software infrastructure and services that provide the foundation for such support. It introduces the use of the CRISTAL software to provide provenance management as one of a number of services delivered on a SOA, deployed to manage neuroimaging projects that have been studying biomarkers for Alzheimer's disease. In the neuGRID and N4U projects a Provenance Service has been delivered that captures and reconstructs the workflow information needed to facilitate researchers in conducting neuroimaging analyses. The software enables neuroscientists to track the evolution of workflows and datasets. It also tracks the outcomes of

  6. Linear Time Algorithms to Restrict Insider Access using Multi-Policy Access Control Systems.

    Science.gov (United States)

    Mell, Peter; Shook, James; Harang, Richard; Gavrila, Serban

    2017-03-01

    An important way to limit malicious insiders from distributing sensitive information is to as tightly as possible limit their access to information. This has always been the goal of access control mechanisms, but individual approaches have been shown to be inadequate. Ensemble approaches of multiple methods instantiated simultaneously have been shown to more tightly restrict access, but approaches to do so have had limited scalability (resulting in exponential calculations in some cases). In this work, we take the Next Generation Access Control (NGAC) approach standardized by the American National Standards Institute (ANSI) and demonstrate its scalability. The existing publicly available reference implementations all use cubic algorithms and thus NGAC was widely viewed as not scalable. The primary NGAC reference implementation took, for example, several minutes to simply display the set of files accessible to a user on a moderately sized system. In our approach, we take these cubic algorithms and make them linear. We do this by reformulating the set theoretic approach of the NGAC standard into a graph theoretic approach and then apply standard graph algorithms. We thus can answer important access control decision questions (e.g., which files are available to a user and which users can access a file) using linear time graph algorithms. We also provide a default linear time mechanism to visualize and review user access rights for an ensemble of access control mechanisms. Our visualization appears to be a simple file directory hierarchy but in reality is an automatically generated structure abstracted from the underlying access control graph that works with any set of simultaneously instantiated access control policies. It also provide an implicit mechanism for symbolic linking that provides a powerful access capability. Our work thus provides the first efficient implementation of NGAC while enabling user privilege review through a novel visualization approach. This

  7. 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.

  8. [Teenagers' access to contraception in Mexico City].

    Science.gov (United States)

    Gómez-Inclán, Sofía; Durán-Arenas, Luis

    2017-01-01

    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. A qualitative study was conducted with focus groups technique in a middle and high school of Mexico City. 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. 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.

  9. Health Care Access Among Deaf People

    National Research Council Canada - National Science Library

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    .... 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...

  10. Seamless access to OER with mobile technologies

    NARCIS (Netherlands)

    Tabuenca, Bernardo

    2014-01-01

    This presentation provides insight on how ubiquitous technology can support lifelong learners facilitating access across context. The 3LHub tool is presented as suitable tool to scaffold personal learning ecologies.

  11. A model to create an efficient and equitable admission policy for patients arriving to the cardiothoracic ICU.

    Science.gov (United States)

    Yang, Muer; Fry, Michael J; Raikhelkar, Jayashree; Chin, Cynthia; Anyanwu, Anelechi; Brand, Jordan; Scurlock, Corey

    2013-02-01

    To develop queuing and simulation-based models to understand the relationship between ICU bed availability and operating room schedule to maximize the use of critical care resources and minimize case cancellation while providing equity to patients and surgeons. Retrospective analysis of 6-month unit admission data from a cohort of cardiothoracic surgical patients, to create queuing and simulation-based models of ICU bed flow. Three different admission policies (current admission policy, shortest-processing-time policy, and a dynamic policy) were then analyzed using simulation models, representing 10 yr worth of potential admissions. Important output data consisted of the "average waiting time," a proxy for unit efficiency, and the "maximum waiting time," a surrogate for patient equity. A cardiothoracic surgical ICU in a tertiary center in New York, NY. Six hundred thirty consecutive cardiothoracic surgical patients admitted to the cardiothoracic surgical ICU. None. Although the shortest-processing-time admission policy performs best in terms of unit efficiency (0.4612 days), it did so at expense of patient equity prolonging surgical waiting time by as much as 21 days. The current policy gives the greatest equity but causes inefficiency in unit bed-flow (0.5033 days). The dynamic policy performs at a level (0.4997 days) 8.3% below that of the shortest-processing-time in average waiting time; however, it balances this with greater patient equity (maximum waiting time could be shortened by 4 days compared to the current policy). Queuing theory and computer simulation can be used to model case flow through a cardiothoracic operating room and ICU. A dynamic admission policy that looks at current waiting time and expected ICU length of stay allows for increased equity between patients with only minimum losses of efficiency. This dynamic admission policy would seem to be a superior in maximizing case-flow. These results may be generalized to other surgical ICUs.

  12. Providing Compassion through Flow

    Directory of Open Access Journals (Sweden)

    Lydia Royeen

    2015-07-01

    Full Text Available Meg Kral, MS, OTR/L, CLT, is the cover artist for the Summer 2015 issue of The Open Journal of Occupational Therapy. Her untitled piece of art is an oil painting and is a re-creation of a photograph taken while on vacation. Meg is currently supervisor of outpatient services at Rush University Medical Center. She is lymphedema certified and has a specific interest in breast cancer lymphedema. Art and occupational therapy serve similar purposes for Meg: both provide a sense of flow. She values the outcomes, whether it is a piece of art or improved functional status

  13. Ysla S. Catalina & Providence

    OpenAIRE

    Diazgranados, Carlos Nicolás; Torres Carreño, Guillermo Andrés; Castell, Edmon; Moreno, Santiago; Ramirez, Natalia

    2010-01-01

    Esta Hoja de Mano pertenece a la exposición temporal "Ysla S. Catalina & Providence". Contiene un resumen histórico de las Islas de Santa Catalina y Providencia en los idiomas inglés y español y un mapa del siglo VI que lo hace más didáctico apoyado por figuras recortables. Esta muestra hace parte del proyecto IDA y VUELTA del Sistema de Patrimonio Cultural y Museos SPM que gestiona la descentralización del patrimonio cultural de la Universidad Nacional de Colombia a otras ciudades del pa...

  14. Automated Computer Access Request System

    Science.gov (United States)

    Snook, Bryan E.

    2010-01-01

    The Automated Computer Access Request (AutoCAR) system is a Web-based account provisioning application that replaces the time-consuming paper-based computer-access request process at Johnson Space Center (JSC). Auto- CAR combines rules-based and role-based functionality in one application to provide a centralized system that is easily and widely accessible. The system features a work-flow engine that facilitates request routing, a user registration directory containing contact information and user metadata, an access request submission and tracking process, and a system administrator account management component. This provides full, end-to-end disposition approval chain accountability from the moment a request is submitted. By blending both rules-based and rolebased functionality, AutoCAR has the flexibility to route requests based on a user s nationality, JSC affiliation status, and other export-control requirements, while ensuring a user s request is addressed by either a primary or backup approver. All user accounts that are tracked in AutoCAR are recorded and mapped to the native operating system schema on the target platform where user accounts reside. This allows for future extensibility for supporting creation, deletion, and account management directly on the target platforms by way of AutoCAR. The system s directory-based lookup and day-today change analysis of directory information determines personnel moves, deletions, and additions, and automatically notifies a user via e-mail to revalidate his/her account access as a result of such changes. AutoCAR is a Microsoft classic active server page (ASP) application hosted on a Microsoft Internet Information Server (IIS).

  15. Minerals, markets and open access

    OpenAIRE

    Mitchell, Clive

    2014-01-01

    Minerals, Markets and Open Access Clive Mitchell, Industrial Minerals Specialist, British Geological Survey, Nottingham, UK Email: The British Geological Survey (BGS) is a world-leading geological survey that focuses on public-good science for government and research to understand earth and environmental processes. The BGS is the UK provider of spatial and statistical minerals information, in addition it carries out research in areas such as metallogenesis, land-use im...

  16. ACCESS Pointing Control System

    Science.gov (United States)

    Brugarolas, Paul; Alexander, James; Trauger, John; Moody, Dwight; Egerman, Robert; Vallone, Phillip; Elias, Jason; Hejal, Reem; Camelo, Vanessa; Bronowicki, Allen; hide

    2010-01-01

    ACCESS (Actively-Corrected Coronograph for Exoplanet System Studies) was one of four medium-class exoplanet concepts selected for the NASA Astrophysics Strategic Mission Concept Study (ASMCS) program in 2008/2009. The ACCESS study evaluated four major coronograph concepts under a common space observatory. This paper describes the high precision pointing control system (PCS) baselined for this observatory.

  17. Market Access and Welfare

    DEFF Research Database (Denmark)

    Raimondos-Møller, Pascalis; Woodland, Alan D.

    2015-01-01

    Well known tariff reform rules that are guaranteed to increase welfare will not necessarily increase market access, while rules that are guaranteed to increase market access will not necessarily increase welfare. The present paper proposes a new set of tariff reforms that can achieve both objecti...

  18. The accessible city

    NARCIS (Netherlands)

    Woestenburg, A.K.

    2017-01-01

    An accessible urban environment is crucial for a healthy, dynamic and economically vibrant city. It will not come as a surprise to anyone to learn that accessibility is a growing problem for many cities. In recent decades, the number of inhabitants has risen considerably, while economic activity has

  19. Self-Access Systems.

    Science.gov (United States)

    Miller, Lindsay; Rogerson-Revell, Pamela

    1993-01-01

    Four self-access centers (SAC) are described, as well as their rationale, human resources, and end users. A framework for establishing a SAC is proposed; an informed decision about the type of self-access system, based on the rationale of the institution and the human resources available, will ensure a system suited to end users. (Contains 13…

  20. Comparing Information Access Approaches.

    Science.gov (United States)

    Chalmers, Matthew

    1999-01-01

    Presents a broad view of information access, drawing from philosophy and semiology in constructing a framework for comparative discussion that is used to examine the information representations that underlie four approaches to information access--information retrieval, workflow, collaborative filtering, and the path model. Contains 32 references.…