WorldWideScience

Sample records for providing equitable access

  1. 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.

  2. Can ICTs contribute to the efficiency and provide equitable access to the health care system in Sub-Saharan Africa? The Mali experience.

    Science.gov (United States)

    Bagayoko, C O; Anne, A; Fieschi, M; Geissbuhler, A

    2011-01-01

    The aim of this study is to demonstrate from actual projects that ICT can contribute to the balance of health systems in developing countries and to equitable access to human resources and quality health care service. Our study is focused on two essential elements which are: i) Capacity building and support of health professionals, especially those in isolated areas using telemedicine tools; ii) Strengthening of hospital information systems by taking advantage of full potential offered by open-source software. Our research was performed on the activities carried out in Mali and in part through the RAFT (Réseau en Afrique Francophone pour la Télémédecine) Network. We focused mainly on the activities of e-learning, telemedicine, and hospital information systems. These include the use of platforms that work with low Internet connection bandwidth. With regard to information systems, our strategy is mainly focused on the improvement and implementation of open-source tools. Several telemedicine application projects were reviewed including continuing online medical education and the support of isolated health professionals through the usage of innovative tools. This review covers the RAFT project for continuing medical education in French-speaking Africa, the tele-radiology project in Mali, the "EQUI-ResHuS" project for equal access to health over ICT in Mali, The "Pact-e.Santé" project for community health workers in Mali. We also detailed a large-scale experience of an open-source hospital information system implemented in Mali: "Cinz@n". We report on successful experiences in the field of telemedicine and on the evaluation by the end-users of the Cinz@n project, a pilot hospital information system in Mali. These reflect the potential of healthcare-ICT for Sub-Saharan African countries.

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

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

    Home · What we do ... This project will contribute to increasing equitable access to health services for the poor by strengthening the ... The project will also look at the impact of results-based financing on health providers' motivation and ...

  4. Iranian women and care providers' perceptions of equitable prenatal care: A qualitative study.

    Science.gov (United States)

    Gheibizadeh, Mahin; Abedi, Heidar Ali; Mohammadi, Easa; Abedi, Parvin

    2016-06-01

    Equity as a basic human right builds the foundation of all areas of primary healthcare, especially prenatal care. However, it is unclear how pregnant women and their care providers perceive the equitable prenatal care. This study aimed to explore Iranian women's and care providers' perceptions of equitable prenatal care. In this study, a qualitative approach was used. Individual in-depth unstructured interviews were conducted with a purposeful sample of pregnant women and their care providers. Data were analyzed using inductive content analysis method. A total of 10 pregnant women and 10 prenatal care providers recruited from six urban health centers across Ahvaz, a south western city in Iran, were participated in the study. The study was approved by the Ethics Committee affiliated to Ahvaz Jundishapur University of Medical Sciences. The ethical principles of voluntary participation, confidentiality, and anonymity were considered. Analysis of participants' interviews resulted in seven themes: guideline-based care, time-saving care, nondiscriminatory care, privacy-respecting care, affordable comprehensive care, effective client-provider relationships, and caregivers' competency. The findings explain the broader and less discussed dimensions of equitable care that are valuable information for the realization of equity in care. Understanding and focusing on these dimensions will help health policy-makers in designing more equitable healthcare services for pregnant women. © The Author(s) 2015.

  5. 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…

  6. Equitable access to spectrum in further development of the Geneva 2006 frequency plan

    Science.gov (United States)

    Philipp, J.

    2011-12-01

    Since the frequency plan of the Regional Radiocommunication Conference Geneva 2006 has come into force, many attempts have been made towards its enhancement. The preliminary results, however, seem not to be compliant with elementary principles of distribution justice. Therefore, the planning principles which lead to the observed imbalance will be scrutinized. Furthermore it will be shown that the utilization of spectrum can be advanced in a balanced way when the same (necessary) condition for "equitable access", which has been used by a group of middle European countries for the construction of the original frequency plan, is applied to plan refinements as well. The necessary condition mentioned consists simply in the parity of the number of coverages (constituted of disjoint allotments) configured in the plan for each country. In order to be able to plan enhancements, the concept of coverage number has to be generalized to the case of incomplete coverages of potentially overlapping allotments. The computation of coverage numbers is straightforward and renders the concept of coverage number parity a useful tool to be applied as a necessary condition in testing a frequency plan variant for equitable access.

  7. The Purpose of the Cataloging for Matters of Equitable Access: Spanish-Language Cataloging and "Everyday" Approaches of Non-Native English Speakers

    Science.gov (United States)

    Adamich, Tom

    2009-01-01

    While teacher-librarians embrace the concept of equitable access when they select "multicultural" materials to include in their collections, plan special programs, and teach lessons on a variety of topics, what do they do to make equitable access a part of their online catalogs? Have they achieved (or nearly achieved) a consistent level of…

  8. 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

  9. Examining Deaf Students' Equitable Access to Science vis-a-vis Contemporary Pedagogical Practices

    Science.gov (United States)

    Ross, Annemarie D.

    As a Deaf individual, it is important to ensure the growth of the Deaf community as science-literate members of society. While many predecessors have contributed to the body of research in Deaf pedagogy, there is still much to be done in safeguarding Deaf learners' equitable access to science education. One area of concern is in narrowing the statistically significant gap in Climate Change knowledge between Deaf students' and Hearing students' at the Rochester Institute of Technology. It is within this topic that the writing-to-learn-science framework is practiced and Deaf students in the Laboratory Science Technology program at the National Technical Institute for the Deaf participate in a study to assess whether or not the use of writing-to-learn-science strategies help them become better scientists, writers and learners. In this study, the social constructivist framework (Vygotsky, 1987) is used to study the impact of the use of the Berland and Reiser (2009) argumentation framework, so that they write-to-learn-science through the steps of sense-making, articulation and persuasion.

  10. Equitable access to health insurance for socially excluded children? The case of the National Health Insurance Scheme (NHIS) in Ghana.

    Science.gov (United States)

    Williams, Gemma A; Parmar, Divya; Dkhimi, Fahdi; Asante, Felix; Arhinful, Daniel; Mladovsky, Philipa

    2017-08-01

    To help reduce child mortality and reach universal health coverage, Ghana extended free membership of the National Health Insurance Scheme (NHIS) to children (under-18s) in 2008. However, despite the introduction of premium waivers, a substantial proportion of children remain uninsured. Thus far, few studies have explored why enrolment of children in NHIS may remain low, despite the absence of significant financial barriers to membership. In this paper we therefore look beyond economic explanations of access to health insurance to explore additional wider determinants of enrolment in the NHIS. In particular, we investigate whether social exclusion, as measured through a sociocultural, political and economic lens, can explain poor enrolment rates of children. Data were collected from a cross-sectional survey of 4050 representative households conducted in Ghana in 2012. Household indices were created to measure sociocultural, political and economic exclusion, and logistic regressions were conducted to study determinants of enrolment at the individual and household levels. Our results indicate that socioculturally, economically and politically excluded children are less likely to enrol in the NHIS. Furthermore, households excluded in all dimensions were more likely to be non-enrolled or partially-enrolled (i.e. not all children enrolled within the household) than fully-enrolled. These results suggest that equity in access for socially excluded children has not yet been achieved. Efforts should be taken to improve coverage by removing the remaining small, annually renewable registration fee, implementing and publicising the new clause that de-links premium waivers from parental membership, establishing additional scheme administrative offices in remote areas, holding regular registration sessions in schools and conducting outreach sessions and providing registration support to female guardians of children. Ensuring equitable access to NHIS will contribute substantially

  11. 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

  12. Equitable access to comprehensive surgical care: the potential of indigenous private philanthropy in low-income settings.

    Science.gov (United States)

    Samad, Lubna; Iqbal, Mehreen; Tariq, Ahson; Shahzad, Wasif; Khan, Aamir J

    2015-01-01

    Equitable access to surgical care is necessary for improving global health. We report on the performance, financial sustainability, and policy impact of a free-of-cost multispecialty surgical delivery program in Karachi, Pakistan built upon local private philanthropy. We evaluated trends in surgical service delivery, expenditures, and philanthropic donations from Indus Hospital's first 5 years of operation (2007-2012), projected these over the hospital's current expansion phase, compared these to publicly accessible records of other philanthropic hospitals providing surgical care, and documented the government's evolving policies toward this model. Between 2007 and 2012, Indus Hospital treated 40,012 in-patients free of cost, 33,606 (84 %) of them for surgical procedures. Surgical procedures increased fivefold to 9,478 during 2011-2012 from 1,838 during 2007-2008. Bed occupancy increased to 91 % from 65 % over the same period. External surgical missions accounted for less than 0.5 % of patients served. Ninety-eight percent (98 %) of all philanthropic donations--totaling USD 26.6 million over 2007-2012--were locally generated. Zakat (obligatory annual religious alms in the Islamic faith) constituted 34 % of all donations, followed by unrestricted funds (24 %) and donations-in-kind (24 %), buildings (12 %), grants (5 %), and return on investments (1 %). Overall, donations received between 2007 and 2012 increased sevenfold, with Zakat increasing 12-fold. During 2013-2014, the Government of Pakistan provided land lease and annual operational grants totaling USD 9 million. Local philanthropy can sustain and grow the provision of free, high-quality surgical care in low-income settings, and encourage the development of hybrid government-philanthropic models of surgical care.

  13. 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.

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

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

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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Hannah Kuper

    2016-07-01

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

  17. 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

  18. Browsing for the Best Internet Access Provider?

    Science.gov (United States)

    Weil, Marty

    1996-01-01

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

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

    Science.gov (United States)

    Ritchie, A; Sowter, B

    2000-01-01

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

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

    CSIR Research Space (South Africa)

    Green, Cheri A

    2012-10-01

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

  1. Practice variation in the Dutch long-term care and the role of supply-sensitive care: Is access to the Dutch long-term care equitable?

    Science.gov (United States)

    Duell, Daisy; Koolman, Xander; Portrait, France

    2017-12-01

    Universal access and generous coverage are important goals of the Dutch long-term care (LTC) system. It is a legal requirement that everyone eligible for LTC should be able to receive it. Institutional care (IC) made up for 90% of Dutch LTC spending. To investigate whether access to IC is as equitable as the Dutch government aspires, we explored practice variation in entitlements to IC across Dutch regions. We used a unique dataset that included all individual applications for Dutch LTC in January 2010-December 2013 (N = 3,373,358). This dataset enabled an accurate identification of the need for care. We examined the local variation in the probability of being granted long-term IC and in the intensity of the care granted given that individuals have applied for LTC. We also investigated whether the variation observed was related to differences in the local availability of care facilities. Although our analyses indicated the presence of some practice variation, its magnitude was very small by national and international standards (up to 3%). Only a minor part of the practice variation could be accounted for by local supply differences in care facilities. Overall, we conclude that, unlike many other developed countries, the Dutch system ensured equitable access to long-term IC. © 2017 The Authors. Health Economics Published by John Wiley & Sons Ltd.

  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. Virtual Library: Providing Accessible Online Resources.

    Science.gov (United States)

    Kelly, Rob

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    N. Tyler

    2017-07-01

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

  5. 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

  6. 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.

  7. Strategies for gender-equitable HIV services in rural India

    Science.gov (United States)

    Sinha, Gita; Peters, David H; Bollinger, Robert C

    2009-01-01

    The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system. PMID:19244284

  8. 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

  9. Equitable Colorings Of Corona Multiproducts Of Graphs

    Directory of Open Access Journals (Sweden)

    Furmánczyk Hanna

    2017-11-01

    Full Text Available A graph is equitably k-colorable if its vertices can be partitioned into k independent sets in such a way that the numbers of vertices in any two sets differ by at most one. The smallest k for which such a coloring exists is known as the equitable chromatic number of G and denoted by =(G. It is known that the problem of computation of =(G is NP-hard in general and remains so for corona graphs. In this paper we consider the same model of coloring in the case of corona multiproducts of graphs. In particular, we obtain some results regarding the equitable chromatic number for the l-corona product G ◦l H, where G is an equitably 3- or 4-colorable graph and H is an r-partite graph, a cycle or a complete graph. Our proofs are mostly constructive in that they lead to polynomial algorithms for equitable coloring of such graph products provided that there is given an equitable coloring of G. Moreover, we confirm the Equitable Coloring Conjecture for corona products of such graphs. This paper extends the results from [H. Furmánczyk, K. Kaliraj, M. Kubale and V.J. Vivin, Equitable coloring of corona products of graphs, Adv. Appl. Discrete Math. 11 (2013 103–120].

  10. 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

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

    International Nuclear Information System (INIS)

    Miura, Yasushi

    2001-01-01

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

  12. 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…

  13. Providing Access to Library Automation Systems for Students with Disabilities.

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2016-01-01

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

  15. 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.

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

    Science.gov (United States)

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

    2018-03-01

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

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

    DEFF Research Database (Denmark)

    Helle, Tina; Brandt, Åse; Iwarsson, Susanne

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

  18. 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 ...

  19. 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...... who need it, here we examine whether IDUs in the 52 countries in the WHO European Region have equitable access to HAART and whether that access has changed over time between 2002 and 2004. We consider regional and country differences in IDU HAART access; examine preliminary data regarding...

  20. Equitable availability of social facilities

    CSIR Research Space (South Africa)

    Green, Cheri A

    2008-11-01

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

  1. 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

  2. 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…

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

    Science.gov (United States)

    Lewis, Morgan V.

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

  4. 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

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

    Science.gov (United States)

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

    2017-02-01

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

  6. Is health care financing in Uganda equitable?

    Science.gov (United States)

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

    2009-10-01

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

  7. 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.

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

    Science.gov (United States)

    Paladini, D.; Mello, A. B.

    2016-07-01

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

  9. Efficient and equitable HIV prevention: A case study of male circumcision in South Africa

    Directory of Open Access Journals (Sweden)

    Verguet Stéphane

    2013-01-01

    Full Text Available Abstract Background We determine efficient, equitable and mixed efficient-equitable allocations of a male circumcision (MC intervention reducing female to male HIV transmission in South Africa (SA, as a case study of an efficiency-equity framework for resource allocation in HIV prevention. Methods We present a mathematical model developed with epidemiological and cost data from the nine provinces of SA. The hypothetical one-year-long MC intervention with a budget of US$ 10 million targeted adult men 15–49 years of age in SA. The intervention was evaluated according to two criteria: an efficiency criterion, which focused on maximizing the number of HIV infections averted by the intervention, and an equity criterion (defined geographically, which focused on maximizing the chance that each male adult individual had access to the intervention regardless of his province. Results A purely efficient intervention would prevent 4,008 HIV infections over a year. In the meantime, a purely equitable intervention would avert 3,198 infections, which represents a 20% reduction in infection outcome as compared to the purely efficient scenario. A half efficient-half equitable scenario would prevent 3,749 infections, that is, a 6% reduction in infection outcome as compared to the purely efficient scenario. Conclusions This paper provides a framework for resource allocation in the health sector which incorporates a simple equity metric in addition to efficiency. In the specific context of SA with a MC intervention for the prevention of HIV, incorporation of geographical equity only slightly reduces the overall efficiency of the intervention.

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

    Science.gov (United States)

    Gamble, Brandon E.; Lambros, Katina M.

    2014-01-01

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

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

    OpenAIRE

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

    2017-01-01

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

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

    CERN Document Server

    Kumar, Suhasini L

    2006-01-01

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

  13. 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.

  14. 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.

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

    DuBois, Phyllis A.; Schubert, Jane G.

    1986-01-01

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

  17. 34 CFR 364.37 - What access to records must be provided?

    Science.gov (United States)

    2010-07-01

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

  18. 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

  19. Equitable Prices of Single-Source Drugs in Thailand.

    Science.gov (United States)

    Ngorsuraches, Surachat; Chaiyakan, Kanokkan

    2015-08-01

    In Thailand, total drug expenditure has grown rapidly. Recently, the Thai government has addressed the issue of drug pricing, but the prices of single-source drugs remain a major challenge. To examine equitable prices of single-source drugs in Thailand. A total of 98 single-source and high-expenditure drugs were examined. Unit prices from the Drug and Medical Supplies Information Center (DMSIC) and National Average Drug Acquisition Cost (NADAC) were used to represent drug prices at the provider level in Thailand and the U.S., respectively. Data for measuring drug affordability, e.g., dose and poverty line, were obtained from Micromedex online and the National Statistical Office (NSO). The U.S. drug prices were adjusted by the Human Development Index (HDI) to be equitable prices for Thailand. Purchasing Power Parity (PPP) was used to convert US currency into Thai baht. All prices in this study were based on the year 2012. Catastrophic, Impoverishment, and WHO/Health Action International (HAI) approaches were used to determine Thai citizens' ability to afford the study drugs. Finally, uncertainty analyses were conducted. From all study drugs, 55 single-source drugs were priced higher than their equitable prices, ranging from 0.38 to 422.36% higher. Among these, 28 items were antineoplastic drugs. The prices of drugs outside the National List of Essential Medicines (NLEM), as well as the country's newer drugs, tended to be higher than their calculated equitable prices. The majority of drugs in Thailand priced higher than equitable prices were unaffordable for most Thai citizens. The uncertainty analyses revealed that almost all results were relatively robust. Most single-source drug prices in Thailand were higher than their equitable prices, and were likely to be unaffordable to Thai citizens.

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

    Science.gov (United States)

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

    2018-07-01

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

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

    Science.gov (United States)

    Zolnikov, Tara Rava; Blodgett-Salafia, Elizabeth

    2017-03-01

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

  2. 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.

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

    Science.gov (United States)

    2014-01-01

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

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

    Science.gov (United States)

    Long, Genia; Mortimer, Richard; Sanzenbacher, Geoffrey

    2014-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  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. 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.

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

    Science.gov (United States)

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

    2011-04-01

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

  11. 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.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

    2011-01-01

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

  15. An Introduction to Web Accessibility, Web Standards, and Web Standards Makers

    Science.gov (United States)

    McHale, Nina

    2011-01-01

    Librarians and libraries have long been committed to providing equitable access to information. In the past decade and a half, the growth of the Internet and the rapid increase in the number of online library resources and tools have added a new dimension to this core duty of the profession: ensuring accessibility of online resources to users with…

  16. 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

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

    Evans, Marsha Ann Johnson

    2012-01-01

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

  19. 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.

  20. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Theoharis, George; Haddix, Marcelle

    2011-01-01

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

  3. 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.

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

    Science.gov (United States)

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

    2003-12-01

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

  5. 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.

  6. RNM and CRITER projects: providing access to environmental radioactivity measurements during crisis and in peacetime

    Energy Technology Data Exchange (ETDEWEB)

    Leprieur, F.; Couvez, C.; Manificat, G. [Institut de radioprotection et de surete nucleaire (France)

    2014-07-01

    The multiplicity of actors and sources of information makes it difficult to centralize environmental radioactivity measurements and to provide access to experts and policy makers, but also to the general public. In the event of a radiological accident, many additional measures will also be carried out in the field by those involved in crisis management. In order to answer this problem, two projects were launched by IRSN with the aim of developing tools to centralize information on environmental radioactivity in normal situation (RNM project: National network of radioactive measurements) and during radiological crisis (CRITER project: Crisis and field). The RNM's mission is to contribute to the estimation of doses from ionizing radiation to which people are exposed and to inform the public. In order to achieve this goal, this network collects and makes available to the public the results of measurements of environmental radioactivity obtained in a normal situation by the French stakeholders. More than 18,000 measurements are transmitted each month by all producers to the RNM. After more than 4 years of operation, the database contains nearly 1,200,000 results. The opening in 2010 of the public web site (www.mesure-radioactivite.fr) was also a major step forward toward transparency and information. In case of radiological emergency, IRSN's mission is to centralize and process at the national level, in a database, all the results of measurements or analysis by all stakeholders throughout the crisis, in order to precisely determine the radiological situation of the environment, before, during and after the event. The project CRITER therefore involves the collection of all possible data from all potential sources, transmission, organization, and the publication of the measurements in crisis or post-accident situation. The emergency nature of the situation requires a transmission in near real-time data, facilitated by the development of automatic sensors. For

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

    Science.gov (United States)

    MacCall, Steven L

    2006-01-01

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

  8. 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.

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

    Science.gov (United States)

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

    2016-07-01

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

  10. 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

  11. 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…

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

    Science.gov (United States)

    Renn, Kristen A.

    2017-01-01

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

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

    Science.gov (United States)

    Lechuga, Vicente M.

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

  14. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Designing equitable antiretroviral allocation strategies in resource-constrained countries.

    Directory of Open Access Journals (Sweden)

    David P Wilson

    2005-02-01

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

  17. Equitable access: Remote and rural communities 'transport needs'

    OpenAIRE

    White, Peter

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-11-01

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

  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. Free access to INIS database provides a gateway to nuclear energy research results

    International Nuclear Information System (INIS)

    Tolonen, E.; Malmgren, M.

    2009-01-01

    Free access to INIS database was opened to all the Internet users around the world on May, 2009. The article reviews the history of INIS (the International Nuclear Information System), data aquisition process, database content and search possibilities. INIS is focused on the worldwide literature of the peaceful uses of nuclear energy and the database is produced in close collaboration with the IEA/ETDE World Energy Base (ETDEWEB), a database focusing on all aspects of energy. Nuclear Science Abstracts database (NSA), which is a comprehensive collection of international nuclear science and technology literature for the period 1948 through 1976, is also briefly discussed in the article. In Finland, the recently formed Aalto University is responsible for collecting and disseminating information (literature) and for the preparation of input to the INIS and IEA/ETDE Databases on the national level

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  3. 42 CFR 433.127 - Termination of FFP for failure to provide access to claims processing and information retrieval...

    Science.gov (United States)

    2010-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Lorraine Frisina Doetter

    2018-02-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  6. Human capital flight challenges within an equitable health system.

    Science.gov (United States)

    Udonwa, N E

    2007-01-01

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

  7. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Science.gov (United States)

    2010-10-01

    ..., widespread fires, discharge of toxic gases, widespread power failures, industrial explosions, civil disorders... of programming providing emergency information. (a) Definitions. (1) For purposes of this section, the definitions in §§ 79.1 and 79.3 apply. (2) Emergency information. Information, about a current...

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

    NARCIS (Netherlands)

    van Rijn, Paul C. J.; Wäckers, Felix L.

    2016-01-01

    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

  9. 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

  10. 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.

  11. 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.

  12. Providing cleaner energy access in Indonesia through the megaproject of kerosene conversion to LPG

    International Nuclear Information System (INIS)

    Budya, Hanung; Yasir Arofat, Muhammad

    2011-01-01

    In 2007 Indonesia undertook a massive energy program to convert its primary cooking fuel from kerosene to LPG in more than 50 million households. This megaproject, to be completed in late 2011, provided an improved household cooking fuel, with its associated benefits in user costs, cleanliness, convenience, and environment, and reduced the government's huge subsidy for petroleum fuels. Presented from the perspective of Pertamina, Indonesia's sole NOC, and the program implementer, this paper describes the background of the fuels situation, the planning stages, including the preparatory analytical work, targeted market surveys and tests, and the subsequent building of the financial, technical, and institutional models for carrying out the program on an expeditious schedule. It presents the project's major execution steps, results of the program to date, and the unique institutional roles of each party, including the activities and benefits for the government, Pertamina, the public, the industry, and the crucial agents in the fuel supply chains. Finally there is a retrospective policy analysis and a discussion of key factors and challenges in the execution of Indonesia's largest-ever energy initiative to provide improved cooking fuel.

  13. 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

  14. Accessibility

    DEFF Research Database (Denmark)

    Brooks, Anthony Lewis

    2017-01-01

    This contribution is timely as it addresses accessibility in regards system hardware and software aligned with introduction of the Twenty-First Century Communications and Video Accessibility Act (CVAA) and adjoined game industry waiver that comes into force January 2017. This is an act created...... by the USA Federal Communications Commission (FCC) to increase the access of persons with disabilities to modern communications, and for other purposes. The act impacts advanced communications services and products including text messaging; e-mail; instant messaging; video communications; browsers; game...... platforms; and games software. However, the CVAA has no legal status in the EU. This text succinctly introduces and questions implications, impact, and wider adoption. By presenting the full CVAA and game industry waiver the text targets to motivate discussions and further publications on the subject...

  15. Reaching out to the forgotten: providing access to medical care for the homeless in Italy.

    Science.gov (United States)

    De Maio, Gianfranco; Van den Bergh, Rafael; Garelli, Silvia; Maccagno, Barbara; Raddi, Freja; Stefanizzi, Alice; Regazzo, Costantina; Zachariah, Rony

    2014-06-01

    A program for outpatient and intermediate inpatient care for the homeless was pioneered by the humanitarian organization Médecins Sans Frontières (MSF) in Milan, Italy, during the winter of 2012-2013. We aimed to document the characteristics and clinical management of inpatients and outpatients seen during this program. A clinic providing outpatient and intermediate inpatient care (24 bed capacity) was set up in an existing homeless hostel. Patients were admitted for post-hospitalization intermediate care or for illnesses not requiring secondary care. This study was a retrospective audit of the routine program data. Four hundred and fifty four individuals presented for outpatient care and 123 patients were admitted to inpatient intermediary care. On average one outpatient consultation was conducted per patient per month, most for acute respiratory tract infections (39.8%; 522/1311). Eleven percent of all outpatients suffered from an underlying chronic condition and 2.98% (38/1311) needed referral to emergency services or secondary care facilities. Most inpatients were ill patients referred through public reception centers (72.3%; 89/123), while 27.6% (34/123) were post-hospitalization patients requiring intermediate care. Out of all inpatients, 41.4% (51/123) required more than 1 week of care and 6.5% (8/123) needed counter-referral to secondary care. The observed service usage, morbidity patterns, relatively long lengths of stay, high referral completion and need for counter-referrals, all reflect the important gap-filling role played by an intermediate care facility for this vulnerable population. We recommend that in similar contexts, medical non-governmental organizations (NGOs) focus on the setup of inpatient intermediary care services; while outpatient services are covered by the public health system. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

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

    Science.gov (United States)

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

    2017-06-29

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

  17. 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.

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

    Science.gov (United States)

    Qian, Wen-Jian

    2015-01-01

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

  19. Assessing equitable care for indigenous and afrodescendant women in Latin America

    Directory of Open Access Journals (Sweden)

    Arachu Castro

    2015-08-01

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

  20. Voluntary program promotes equitable and expedited remediation of contaminated properties

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-31

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

  1. 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.

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

    Science.gov (United States)

    Trexler, M.

    2017-12-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  4. 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.

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

    Science.gov (United States)

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-11-05

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

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

    Science.gov (United States)

    1999-01-01

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

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

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

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

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

    Directory of Open Access Journals (Sweden)

    Edward G. Lyon

    2013-07-01

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

  10. 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.

  11. Direct and indirect patient costs of dermatology clinic visits and their impact on access to care and provider preference.

    Science.gov (United States)

    Rothstein, Brooke E; Gonzalez, Jessica; Cunningham, Kiera; Saraiya, Ami; Dornelles, Adriana C; Nguyen, Bichchau M

    2017-12-01

    The direct and indirect costs of dermatology clinic visits are infrequently quantified. Indirect costs, such as the time spent traveling to and from appointments and the value of lost earnings from time away from work, are substantial costs that often are not included in economic analyses but may pose barriers to receiving care. Due to the national shortage of dermatologists, patients may have to wait longer for appointments or travel further to see dermatologists outside of their local community, resulting in high time and travel costs for patients. Patients' lost time and earnings comprise the opportunity cost of obtaining care. A monetary value for this opportunity cost can be calculated by multiplying a patient's hourly wage by the number of hours that the patient dedicated to attending the dermatology appointment. Using a single institution survey, this study quantified the direct and indirect patient costs, including opportunity costs and time burden, associated with dermatology clinic visits to better appreciate the impact of these factors on health care access and dermatologic provider preference.

  12. 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.

    2014-01-01

    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. PMID:24759862

  13. Tradeoff between User Quality-Of-Experience and Service Provider Profit in 5G Cloud Radio Access Network

    Directory of Open Access Journals (Sweden)

    Mahbuba Afrin

    2017-11-01

    Full Text Available In recent years, the Cloud Radio Access Network (CRAN has become a promising solution for increasing network capacity in terms of high data rates and low latencies for fifth-generation (5G cellular networks. In CRAN, the traditional base stations (BSs are decoupled into remote radio heads (RRHs and base band units (BBUs that are respectively responsible for radio and baseband functionalities. The RRHs are geographically proximated whereas the the BBUs are pooled in a centralized cloud named BBU pool. This virtualized architecture facilitates the system to offer high computation and communication loads from the impetuous rise of mobile devices and applications. Heterogeneous service requests from the devices to different RRHs are now sent to the BBUs to process centrally. Meeting the baseband processing of heterogeneous requests while keeping their Quality-of-Service (QoS requirements with the limited computational resources as well as enhancing service provider profit is a challenging multi-constraint problem. In this work, a multi-objective non-linear programming solution to the Quality-of-Experience (QoE and Profit-aware Resource Allocation problem is developed which makes a trade-off in between the two. Two computationally viable scheduling algorithms, named First Fit Satisfaction and First Fit Profit algorithms, are developed to focus on maximization of user QoE and profit, respectively, while keeping the minimum requirement level for the other one. The simulation environment is built on a relevant simulation toolkit. The experimental results demonstrate that the proposed system outperforms state-of-the-art works well across the requests QoS, average waiting time, user QoE, and service provider profit.

  14. 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

  15. 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.

  16. 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

  17. Universal access, cost recovery, and payment services

    OpenAIRE

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

    2005-01-01

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

  18. Equitable Financial Evaluation Method for Public-Private Partnership Projects

    Institute of Scientific and Technical Information of China (English)

    KE Yongjian; LIU Xinping; WANG Shouqing

    2008-01-01

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

  19. 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

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

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

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

  1. 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.

  2. 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.

  3. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  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.

    2010-01-01

    Budgetary capacity that would allow for the public funding of the provision of universal access to primary education is lacking in many sub-Saharan economies. National revenues significantly lag behind the overall economic productivity measure of GDP. Analysis of data derived from UNESCO and UNDP for 2004 shows that governments in the region spend…

  6. 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

  7. 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…

  8. 20 CFR 222.34 - Relationship resulting from equitable adoption.

    Science.gov (United States)

    2010-04-01

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

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

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

    Sarah Ssali

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

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

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

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

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

    African Journals Online (AJOL)

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

  12. 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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  15. 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.

  16. Curriculum Designed for an Equitable Pedagogy

    Science.gov (United States)

    Cullen, Roxanne; Hill, Reinhold R.

    2013-01-01

    Rather than viewing curriculum as linear, a post-modern, learner-centered curriculum design is a spiral or recursive curriculum. Post-modernism provides a much less stable foundation upon which to build a model of student learning, a model that recognizes and even celebrates individual difference and one that is supported by research on how people…

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

    Science.gov (United States)

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

    2014-01-01

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

  18. 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

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

    Science.gov (United States)

    Fair, Cynthia D; Berk, Meredith

    2018-02-01

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

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

    Science.gov (United States)

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

    2001-12-01

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

  1. 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.

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

    Science.gov (United States)

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

    2014-10-01

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

  3. 20 CFR 652.207 - How does a State meet the requirement for universal access to services provided under the Act?

    Science.gov (United States)

    2010-04-01

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

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

    OpenAIRE

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

    2014-01-01

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

  5. 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

  6. 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.

  7. IMPEDIMENTS TO WOMEN’S EQUITABLE EMPLOYMENT: GLOBAL SCENARIO

    OpenAIRE

    Farida Faisal

    2011-01-01

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

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

    Science.gov (United States)

    Shaefer, H Luke; Miller, Matthew

    2011-08-01

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

  9. Would it provide Free Education?

    Indian Academy of Sciences (India)

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

  10. Oceanographic Data in Europe: Minimal Effort for Data Providers, Maximal Ease of Use and Access for Data Users

    Science.gov (United States)

    De Bruin, T.

    2017-12-01

    SeaDataCloud/SeaDataNet (SDC/SDN) is both a consortium and a data infrastructure as well as a (series of) European oceanographic data management project(s), allowing data providers to store data at a data centre of their choice (usually a type of National Oceanographic Data Center), while exposing and making the data available for download via a chain of interconnected data portals at local, regional, pan-European and global levels. SDC/SDN as an infrastructure connects over 100 data centers from 35 countries in and around Europe. The infrastructure has been operational since early 2009 and provides the user an overview of all available data as well as the possibility to download the data in an uniform format. This presentation will give a short introduction to the SDC/SDN infrastructure and describe how its development was based on sound data management principles. The emphasis will be on how the system is interconnected with other, non-discipline specific (metadata) portals such as the Group of Earth Observations System of Systems (GEOSS), allowing oceanographic data stored at a local level in a data centre to be exposed at a global level to a wide audience from various disciplines.

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

    Directory of Open Access Journals (Sweden)

    Laura Otero-Garcia

    2013-11-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-11-08

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

  14. 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.

  15. The SARA Consortium: Providing Undergraduate Access to a 0.9-m Telescope at Kitt Peak National Observatory

    Science.gov (United States)

    Wood, M. A.

    2003-12-01

    The Southeastern Research for Astronomy (SARA) operates a 0.9-m telescope at Kitt Peak National Observatory (KPNO). The member institutions are Florida Institute of Technology, East Tennessee State University, Florida International University, The University of Georgia at Athens, Valdosta State University, and Clemson University. The NSF awarded the KPNO #1 0.9-m telescope to the SARA Consortium in 1990. We built a new facility and began routine on-site observations in 1995. We began routine remote observations in 1999 using VNC to export the telescope and CCD control screens, and a web-cam in the dome to provide critical visual feedback on the status of the telescope and dome. The mission of the SARA Consortium is to foster astronomical research and education in the Southeastern United States. Although only two of the member institutions have no graduate programs, all six have a strong emphasis on undergraduate research and education. By pooling our resources, we are able to operate a research-grade facility that none of the individual schools could manage by itself, and in the process we can offer our undergraduate students the opportunity to assist in our research projects as well as to complete their own independent research projects using a facility at a premier site. The SARA Consortium also hosts a NSF REU Summer Intern Program in Astronomy, in which we support 11-12 students that work one-on-one with a SARA faculty mentor. Most of these interns are selected from primarily undergraduate institutions, and have not had significant previous research experience. As part of the program, interns and mentors travel to KPNO for a 4-5 night observing run at the telescope. The SARA NSF REU Program is funded through NSF grant AST-0097616.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  17. Implementation of accessible tourism concept at museums in Jakarta

    Science.gov (United States)

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

    2018-03-01

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

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

    Science.gov (United States)

    Summers, Michael P; Verikios, George

    2018-02-01

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

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

    Science.gov (United States)

    Glenngård, Anna H; Anell, Anders

    2018-01-01

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

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

    OpenAIRE

    Xiaobin Li

    2010-01-01

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

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

    OpenAIRE

    Byrd, Hugh

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  4. High Rates of Access to Health Care, Disclosure of Sexuality and Gender Identity to Providers Among House and Ball Community Members in New York City.

    Science.gov (United States)

    Cahill, Sean; Trieweiler, Sarah; Guidry, John; Rash, Nelisa; Stamper, Layla; Conron, Kerith; Turcotte, Nicole; Gratch, Ilana; Lowery, Paige

    2018-01-01

    The House and Ball community is an important cultural manifestation of resiliency for Black and Latino gay and bisexual men and transgender women. Participants at the August 2013 House of Latex Ball in New York City were surveyed about insurance coverage, health care access, experiences in health care, and housing instability. The sample (n = 367) was 58% Black/African American and 20% Hispanic/Latino, with a mean age of 31. Fifty-five percent were gay and bisexual men. Although only 6% identified as transgender, nearly one half were gender nonconforming. Strong majorities had health insurance, were in regular medical care, and were "out" to their providers. Some were unstably housed and had recently exchanged sex for shelter or money. High rates of health care access and disclosure indicate resiliency and agency. Unstable housing and income insecurity may be structural drivers of vulnerability for this population to HIV infection and other health risks.

  5. 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.

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Đundić Petar

    2014-01-01

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

  8. Barriers to Maori sole mothers’ primary health care access

    Directory of Open Access Journals (Sweden)

    Lee R

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Elsje Scheffler

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Mac MacLachlan

    2014-10-01

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

  11. 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

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

  14. 20 CFR 222.57 - When an equitably adopted child is dependent.

    Science.gov (United States)

    2010-04-01

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

  15. 30 CFR 285.540 - How will MMS equitably distribute revenues to States?

    Science.gov (United States)

    2010-07-01

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

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Paul O Ouma, MSc

    2018-03-01

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

  18. RCSB PDB Mobile: iOS and Android mobile apps to provide data access and visualization to the RCSB Protein Data Bank.

    Science.gov (United States)

    Quinn, Gregory B; Bi, Chunxiao; Christie, Cole H; Pang, Kyle; Prlić, Andreas; Nakane, Takanori; Zardecki, Christine; Voigt, Maria; Berman, Helen M; Bourne, Philip E; Rose, Peter W

    2015-01-01

    The Research Collaboratory for Structural Bioinformatics Protein Data Bank (RCSB PDB) resource provides tools for query, analysis and visualization of the 3D structures in the PDB archive. As the mobile Web is starting to surpass desktop and laptop usage, scientists and educators are beginning to integrate mobile devices into their research and teaching. In response, we have developed the RCSB PDB Mobile app for the iOS and Android mobile platforms to enable fast and convenient access to RCSB PDB data and services. Using the app, users from the general public to expert researchers can quickly search and visualize biomolecules, and add personal annotations via the RCSB PDB's integrated MyPDB service. RCSB PDB Mobile is freely available from the Apple App Store and Google Play (http://www.rcsb.org). © The Author 2014. Published by Oxford University Press.

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

    Science.gov (United States)

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

    2009-12-29

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

  20. JISC Open Access Briefing Paper

    OpenAIRE

    Swan, Alma

    2005-01-01

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

  1. Integrated social facility location planning for decision support: Accessibility studies provide support to facility location and integration of social service provision

    CSIR Research Space (South Africa)

    Green, Cheri A

    2012-09-01

    Full Text Available for two or more facilities to create an integrated plan for development Step 6 Costing of development plan Case Study Access norms and thresholds guidelines in accessibility analysis Appropriate norms/provision guidelines facilitate both service... access norms and threshold standards ?Test the relationship between service demand and the supply (service capacity) of the facility provision points within a defined catchment area ?Promote the ?right?sizing? of facilities relative to the demand...

  2. "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.

  3. “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

  4. Accessibility, Availability, and Potential Benefits of Psycho-Oncology Services: The Perspective of Community-Based Physicians Providing Cancer Survivorship Care.

    Science.gov (United States)

    Zimmermann-Schlegel, Verena; Hartmann, Mechthild; Sklenarova, Halina; Herzog, Wolfgang; Haun, Markus W

    2017-06-01

    As persons of trust, community-based physicians providing survivorship care (e.g., general practitioners [GPs]) often serve as the primary contacts for cancer survivors disclosing distress. From the perspective of physicians providing survivorship care for cancer patients, this study explores (a) the accessibility, availability, and potential benefits of psycho-oncology services; (b) whether physicians themselves provide psychosocial support; and (c) predictors for impeded referrals of survivors to services. In a cross-sectional survey, all GPs and community-based specialists in a defined region were interviewed. In addition to descriptive analyses, categorical data were investigated by applying chi-square tests. Predictors for impeded referrals were explored through logistic regression. Of 683 responding physicians, the vast majority stated that survivors benefit from psycho-oncology services (96.8%), but the physicians also articulated that insufficient coverage of psycho-oncology services (90.9%) was often accompanied by impeded referrals (77.7%). A substantial proportion (14.9%) of physicians did not offer any psychosocial support. The odds of physicians in rural areas reporting impeded referrals were 1.91 times greater than the odds of physicians in large urban areas making a similar report (95% confidence interval [1.07, 3.40]). Most community-based physicians providing survivorship care regard psycho-oncology services as highly beneficial. However, a large number of physicians report tremendous difficulty referring patients. Focusing on those physicians not providing any psychosocial support, health policy approaches should specifically (a) raise awareness of the role of physicians as persons of trust for survivors, (b) highlight the effectiveness of psycho-oncology services, and (c) encourage a proactive attitude toward the assessment of unmet needs and the initiation of comprehensive care. Community-based physicians providing survivorship care for cancer

  5. Evaluating Admission Practices as Potential Barriers to Creating Equitable Access to Undergraduate Engineering Education

    Science.gov (United States)

    Myers, Beth Ann

    2016-01-01

    To create a more competitive and creative engineering workforce, breakthroughs in how we attract and educate more diverse engineers are mandated. Despite a programmatic focus on increasing the representation of women and minorities in engineering during the last few decades, no single solution has been identified and is probably not realistic. But…

  6. Pattern of electroconvulsive therapy use in Spain: Proposals for an optimal practice and equitable access.

    Science.gov (United States)

    Sanz-Fuentenebro, Javier; Vera, Ignacio; Verdura, Ernesto; Urretavizcaya, Mikel; Martínez-Amorós, Erika; Soria, Virginia; Bernardo, Miquel

    The main aims of our study were to estimate the current rates and pattern of electroconvulsive therapy (ECT) use in Spain, as well as exploring the causes that may be limiting its use in our country. A cross-sectional survey was conducted covering every psychiatric unit in Spain as of 31 December 2012. More than half (54.9%) of the psychiatric units applied ECT at a rate of 0.66 patients per 10,000 inhabitants. There are wide variations with regard to ECT application rates between the different autonomous communities (0.00-1.39) and provinces (0.00-3.90). ECT was prescribed to a mean of 25.5 patients per hospital that used the technique and 4.5 in referral centre (P=.000), but wide differences were reported in the number of patients who were prescribed ECT from hospital to hospital. Although the percentage of psychiatric units applying ECT in our country is among the highest in the world, the ECT application rate in Spain is among the lowest within western countries. Large differences in ECT use have been reported across the various autonomous communities, provinces and hospitals. Thus, health planning strategies need to be implemented, as well as promoting training in ECT among health professionals, if these differences in ECT use are to be reduced. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. 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

  8. 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

  9. Effect of a comprehensive programme to provide universal access to care for sputum-smear-positive multidrug-resistant tuberculosis in China: a before-and-after study.

    Science.gov (United States)

    Li, Renzhong; Ruan, Yunzhou; Sun, Qiang; Wang, Xiexiu; Chen, Mingting; Zhang, Hui; Zhao, Yanlin; Zhao, Jin; Chen, Cheng; Xu, Caihong; Su, Wei; Pang, Yu; Cheng, Jun; Chi, Junying; Wang, Qian; Fu, Yunting; Huan, Shitong; Wang, Lixia; Wang, Yu; Chin, Daniel P

    2015-04-01

    China has a quarter of all patients with multidrug-resistant tuberculosis (MDRTB) worldwide, but less than 5% are in quality treatment programmes. In a before-and-after study we aimed to assess the effect of a comprehensive programme to provide universal access to diagnosis, treatment, and follow-up for MDRTB in four Chinese cities (population 18 million). We designated city-level hospitals in each city to diagnose and treat MDRTB. All patients with smear-positive pulmonary tuberculosis diagnosed in Center for Disease Control (CDC) clinics and hospitals were tested for MDRTB with molecular and conventional drug susceptibility tests. Patients were treated with a 24 month treatment package for MDRTB based on WHO guidelines. Outpatients were referred to the CDC for directly observed therapy. We capped total treatment package cost at US$4644. Insurance reimbursement and project subsidies limited patients' expenses to 10% of charges for services within the package. We compared data from a 12 month programme period (2011) to those from a retrospective survey of all patients with MDRTB diagnosed in the same cities during a baseline period (2006-09). 243 patients were diagnosed with MDRTB or rifampicin-resistant tuberculosis during the 12 month programme period compared with 92 patients (equivalent to 24 per year) during the baseline period. 172 (71%) of 243 individuals were enrolled in the programme. Time from specimen collection for resistance testing to treatment initiation decreased by 90% (from median 139 days [IQR 69-207] to 14 days [10-21]), the proportion of patients who started on appropriate drug regimen increased 2·7 times (from nine [35%] of 26 patients treated to 166 [97%] of 172), and follow-up by the CDC after initial hospitalisation increased 24 times (from one [4%] of 23 patients to 163 [99%] of 164 patients). 6 months after starting treatment, the proportion of patients remaining on treatment increased ten times (from two [8%] of 26 patients to 137 [80

  10. Carbon emissions and an equitable emission reduction criterion

    International Nuclear Information System (INIS)

    Golomb, Dan

    1999-01-01

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

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

    National Research Council Canada - National Science Library

    1997-01-01

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

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

    African Journals Online (AJOL)

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

  13. Transmission access raises unresolved economic issues

    International Nuclear Information System (INIS)

    Happ, H.H.

    1994-01-01

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

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

    OpenAIRE

    Parks, Louisa; Morgera, Elisa

    2015-01-01

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

  15. 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....

  16. 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.

  17. The current situation of human resources for health in the province of Cabinda in Angola: is it a limitation to provide universal access to healthcare?

    Science.gov (United States)

    Macaia, Damas; Lapão, Luís Velez

    2017-12-28

    significant HRH management efforts contributing to this result. Whereas HRH are financed by the State General Budget, the majority of health facilities are still dependent on the Provincial Health Secretariat budget. The study provides a broader view of the current HRH situation in Cabinda Province. Geographical imbalances and other issues with impact in delivering universal access to healthcare are highlighted.

  18. High Availability Applications for NOMADS at the NOAA Web Operations Center Aimed at Providing Reliable Real Time Access to Operational Model Data

    Science.gov (United States)

    Alpert, J. C.; Rutledge, G.; Wang, J.; Freeman, P.; Kang, C. Y.

    2009-05-01

    The NOAA Operational Modeling Archive Distribution System (NOMADS) is now delivering high availability services as part of NOAA's official real time data dissemination at its Web Operations Center (WOC). The WOC is a web service used by all organizational units in NOAA and acts as a data repository where public information can be posted to a secure and scalable content server. A goal is to foster collaborations among the research and education communities, value added retailers, and public access for science and development efforts aimed at advancing modeling and GEO-related tasks. The services used to access the operational model data output are the Open-source Project for a Network Data Access Protocol (OPeNDAP), implemented with the Grid Analysis and Display System (GrADS) Data Server (GDS), and applications for slicing, dicing and area sub-setting the large matrix of real time model data holdings. This approach insures an efficient use of computer resources because users transmit/receive only the data necessary for their tasks including metadata. Data sets served in this way with a high availability server offer vast possibilities for the creation of new products for value added retailers and the scientific community. New applications to access data and observations for verification of gridded model output, and progress toward integration with access to conventional and non-conventional observations will be discussed. We will demonstrate how users can use NOMADS services to repackage area subsets either using repackaging of GRIB2 files, or values selected by ensemble component, (forecast) time, vertical levels, global horizontal location, and by variable, virtually a 6- Dimensional analysis services across the internet.

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

    Directory of Open Access Journals (Sweden)

    Blanca Fraijo-Sing

    2013-02-01

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

  20. Increasing Equitable Care for Youth through Coordinated School Health

    Science.gov (United States)

    Sanetti, Lisa M. Hagermoser

    2017-01-01

    Nearly a quarter of the students in the U.S. education system have a chronic health condition, disability, or special healthcare need. Students living in poverty and those at risk for or with disabilities have higher rates of health issues and encounter more barriers to accessing appropriate health care than their peers. The reciprocal influences…

  1. 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.

  2. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  4. 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.

  5. Towards equitable solutions to siting and noise problems in windfarms

    International Nuclear Information System (INIS)

    Larke, C.; Woodbridge, A.; Hayes, M.

    1991-01-01

    For windfarming to be a successful long-term business, it is essential that wind developments are good neighbours, and good neighbours do not keep you awake at night. Very low rural ambients of 20-32 dB(A) at turbine cut-in windspeeds and for half the time at operating windspeeds ambients below about 40 dB(A) show a large potential problem. The settlement patterns necessitate a target of 400m distance with no noise nuisance to maintain accessibility to over 2 GW of windsites in Western Britain. At least one manufacturer has produced a turbine meeting this requirement. (author)

  6. Concurrent use of data base and graphics computer workstations to provide graphic access to large, complex data bases for robotics control of nuclear surveillance and maintenance

    International Nuclear Information System (INIS)

    Dalton, G.R.; Tulenko, J.S.; Zhou, X.

    1990-01-01

    The University of Florida is part of a multiuniversity research effort, sponsored by the US Department of Energy which is under way to develop and deploy an advanced semi-autonomous robotic system for use in nuclear power stations. This paper reports on the development of the computer tools necessary to gain convenient graphic access to the intelligence implicit in a large complex data base such as that in a nuclear reactor plant. This program is integrated as a man/machine interface within the larger context of the total computerized robotic planning and control system. The portion of the project described here addresses the connection between the three-dimensional displays on an interactive graphic workstation and a data-base computer running a large data-base server program. Programming the two computers to work together to accept graphic queries and return answers on the graphic workstation is a key part of the interactive capability developed

  7. 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.

  8. 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...

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

    Science.gov (United States)

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

    2011-01-01

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

  10. Designing equitable workplace dietary interventions: perceptions of intervention deliverers.

    Science.gov (United States)

    Smith, Sarah A; Visram, Shelina; O'Malley, Claire; Summerbell, Carolyn; Araujo-Soares, Vera; Hillier-Brown, Frances; Lake, Amelia A

    2017-10-16

    Workplaces are a good setting for interventions that aim to support workers in achieving a healthier diet and body weight. However, little is known about the factors that impact on the feasibility and implementation of these interventions, and how these might vary by type of workplace and type of worker. The aim of this study was to explore the views of those involved in commissioning and delivering the Better Health at Work Award, an established and evidence-based workplace health improvement programme. One-to-one semi-structured interviews were conducted with 11 individuals in North East England who had some level of responsibility for delivering workplace dietary interventions. Interviews were transcribed verbatim and analysed using thematic framework analysis. A number of factors were felt to promote the feasibility and implementation of interventions. These included interventions that were cost-neutral (to employee and employer), unstructured, involved colleagues for support, took place at lunchtimes, and were well-advertised and communicated via a variety of media. Offering incentives, not necessarily monetary, was perceived to increase recruitment rates. Factors that militate against feasibility and implementation of interventions included worksites that were large in size and remote, working patterns including shifts and working outside of normal working hours that were not conducive to workers being able to access intervention sessions, workplaces without appropriate provision for healthy food on site, and a lack of support from management. Intervention deliverers perceived that workplace dietary interventions should be equally and easily accessible (in terms of cost and timing of sessions) for all staff, regardless of their job role. Additional effort should be taken to ensure those staff working outside normal working hours, and those working off-site, can easily engage with any intervention, to avoid the risk of intervention-generated inequalities (IGIs).

  11. 34 CFR 200.65 - Determining equitable participation of teachers and families of participating private school...

    Science.gov (United States)

    2010-07-01

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

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

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2000-01-01

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

  13. 12 CFR 614.4590 - Equitable treatment of OFIs and Farm Credit System associations.

    Science.gov (United States)

    2010-01-01

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

  14. 48 CFR 52.250-5 - SAFETY Act-Equitable Adjustment.

    Science.gov (United States)

    2010-10-01

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

  15. Finding pathways to more equitable and meaningful public-scientist partnerships

    Science.gov (United States)

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

    2016-01-01

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

  16. 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…

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

    Science.gov (United States)

    Kenton, David

    1984-01-01

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

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

    Science.gov (United States)

    Dai, David Yun

    2015-01-01

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

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

    Science.gov (United States)

    Wager, Anita A.

    2014-01-01

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

  20. 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.

  1. 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.

  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. 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 ...

  4. Advancing primary care to promote equitable health: implications for China

    Directory of Open Access Journals (Sweden)

    Hung Li-Mei

    2012-01-01

    Full Text Available Abstract China is a country with vast regional differences and uneven economic development, which have led to widening gaps between the rich and poor in terms of access to healthcare, quality of care, and health outcomes. China's healthcare reform efforts must be tailored to the needs and resources of each region and community. Building and strengthening primary care within the Chinese health care system is one way to effectively address health challenges. This paper begins by outlining the concept of primary care, including key definitions and measurements. Next, results from a number of studies will demonstrate that primary care characteristics are associated with savings in medical costs, improvements in health outcomes and reductions in health disparities. This paper concludes with recommendations for China on successfully incorporating a primary care model into its national health policy, including bolstering the primary care workforce, addressing medical financing structures, recognizing the importance of evidence-based medicine, and looking to case studies from countries that have successfully implemented health reform.

  5. 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.

  6. 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.

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

    African Journals Online (AJOL)

    Building a healthy and wealthy society that can give hope to all depends greatly on a moral structure that provides the enabling atmosphere for effective resource management and distribution. Therefore, the foundation of true development does not lie strictly on scientific knowledge, technology, socio-political and economic ...

  8. 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 care model as a useful strategy to improve various outcomes across different clinical settings in the context of a shortage of primary care physicians.

  9. 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

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

    Science.gov (United States)

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

  11. 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.

  12. Equitable service provision for inclusive education and effective early intervention.

    Science.gov (United States)

    Wicks, K M

    1998-01-01

    This paper illustrates one model of providing an integrated paediatric speech and language therapy service which attempts to meet the demands of both inclusive education and effective early intervention. A move has been made from location-oriented therapy provision to offering children and their families equal opportunities to have appropriate intervention according to need. The model incorporates the philosophy of inclusive education and supports the development of current specialist educational establishments into resource bases of expertise for children with special needs in mainstream schools.

  13. What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

    Science.gov (United States)

    Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

    2016-01-01

    Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

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

    Directory of Open Access Journals (Sweden)

    Tumo Charles Maloka

    2016-05-01

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

  15. What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

    Science.gov (United States)

    Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

    2016-06-23

    This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    1992-01-01

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

  18. 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...

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

    Directory of Open Access Journals (Sweden)

    Davide Rasella

    2016-02-01

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

  20. 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.

  1. 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.

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

    Science.gov (United States)

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

    2013-03-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marco Dall'Aglio

    2017-01-01

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

  5. Culturally Diverse and Underserved Populations of Gifted Students in the United States and in Taiwan: Equitable Access to Gifted Education

    Science.gov (United States)

    Ho, Ya-Ting

    2014-01-01

    There is a continuing increase in the African American and Hispanic student populations in public schools. The students who are invited to gifted programs are overwhelmingly White. This is the situation in schools in the United States and also in Taiwan. Misunderstanding or unawareness of culture difference among educators might contribute to…

  6. 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…

  7. Disentangling Chile's Authoritarian Neoliberalism and Its Effects: The Downfall of Public Higher Education and Its Implications for Equitable Access

    Science.gov (United States)

    Pitton, Viviana

    2007-01-01

    In recent decades, neoliberal reforms have spread across Latin America. Despite different accounts showing the adverse social impact of these reforms, what seems lacking are historical analyses of why and how neoliberal policies occurred in this region. For instance, there are only rare accounts of how dictatorships in the 1970s prepared the…

  8. 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

  9. Credential Service Provider (CSP)

    Data.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Sarah Spencer

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

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

    Science.gov (United States)

    Spencer, Sarah; Meer, Talia

    2017-01-01

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

  12. 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…

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

    Science.gov (United States)

    Jaques, Thomas F.

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

  14. Broadband Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Broadband Access. Worldwide market for broadband access $30 Billion! Over 200 million broadband subscribers worldwide! Various Competing Broadband access. Digital Subscriber line; Wireless; Optical Fiber.

  15. 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

  16. 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

  17. 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

  18. 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

  19. Accessing Electronic Journals.

    Science.gov (United States)

    McKay, Sharon Cline

    1999-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  1. 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.

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

    Science.gov (United States)

    Hanning, Brian W T

    2005-02-01

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

  3. 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.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Paul S. Reichler

    2013-06-01

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

  6. 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.

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

    Science.gov (United States)

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

    2018-04-02

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

  8. 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.

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

    Science.gov (United States)

    Karlberg, H I; Brinkmo, B-M

    2009-03-01

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

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

    Science.gov (United States)

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

    2004-10-01

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

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

    Science.gov (United States)

    Shihua, Peng; Rihui, Tan

    2009-01-01

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

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

    Science.gov (United States)

    Laner, Stephen; And Others

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

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

    Science.gov (United States)

    Jaaskelainen, Kristal; Deneen, Musetta

    2018-01-01

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

  14. 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.

  15. 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…

  16. 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.

  17. 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...

  18. 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.

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

    Science.gov (United States)

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

    2017-08-01

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

  20. 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

  1. 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.

  2. 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

  3. 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.

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

    Science.gov (United States)

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

    2013-02-01

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

  5. 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

  6. 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....

  7. 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'.

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

    Science.gov (United States)

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

    2011-08-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  10. 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).

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Yehua Dennis Wei

    2016-08-01

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

  14. 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

  15. Paradigm for Distributive & Procedural Justice in Equitable Apportionment of Transboundary Ganges Waters Under Changing Climate & Landuse

    Science.gov (United States)

    Tyagi, H.; Gosain, A. K.; Khosa, R.; Anand, J.

    2015-12-01

    Rivers have no regard for human demarcated boundaries. Besides, ever increasing demand-supply gap & vested riparian interests, fuel transboundary water conflicts. For resolving such disputes, appropriation doctrines advocating equity & fairness have received endorsement in the Helsinki Rules-1966 & UN Convention-1997. Thus, current study proposes the principle of equitable apportionment for sharing Ganges waters as it balances the interests & deservedness of all stakeholders, namely, India & its 11 states, Bangladesh, Nepal, & China. The study endeavors to derive a reasonable share of each co-basin state by operationalizing the vague concepts of fairness & equity through an objective & quantitative framework encompassing proportionality & egalitarianism for distributive & procedural justice. Equal weightage factors reflecting hydrology, geography & water use potential are chosen for fair share computation, wherein each contender ranks these factors to maximize his entitlement. If cumulative claims exceed the water availability, each claimant puts forth next ranked factor & this process continues till the claims match availability. Due to inter-annual variability in few factors, scenarios for Rabi & Kharif seasons are considered apart from cases for maximum, upper quartile, median, lower quartile & minimum. Possibility of spatial homogeneity & heterogeneity in factors is also recognized. Sometimes lack of technical information hinders transboundary dispute resolution via legal mechanisms. Hence, the study also attempts to bridge this gap between law & technology through GIS-based SWAT hydrologic model by estimating the Ganges water yield, & consequent share of each riparian for range of flows incorporating e-flows as well, under present & future climate & landuse scenarios. 82% of India's territory lies within interstate rivers, & therefore this research is very pertinent as it can facilitate the decision makers in effective interstate water conflict resolution.

  16. 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.

  17. Paying for and receiving benefits from health services in South Africa: is the health system equitable?

    Science.gov (United States)

    Ataguba, John E; McIntyre, Di

    2012-03-01

    There is a global challenge for health systems to ensure equity in both the delivery and financing of health care. However, many African countries still do not have equitable health systems. Traditionally, equity in the delivery and the financing of health care are assessed separately, in what may be termed 'partial' analyses. The current debate on countries moving toward universal health systems, however, requires a holistic understanding of equity in both the delivery and the financing of health care. The number of studies combining these aspects to date is limited, especially in Africa. An assessment of overall health system equity involves assessing health care financing in relation to the principles of contributing to financing according to ability to pay and benefiting from health services according to need for care. Currently South Africa is considering major health systems restructuring toward a universal system. This paper examines together, for both the public and the private sectors, equity in the delivery and financing of health care in South Africa. Using nationally representative datasets and standard methodologies for assessing progressivity in health care financing and benefit incidence, this paper reports an overall progressive financing system but a pro-rich distribution of health care benefits. The progressive financing system is driven mainly by progressive private medical schemes that cover a small portion of the population, mainly the rich. The distribution of health care benefits is not only pro-rich, but also not in line with the need for health care; richer groups receive a far greater share of service benefits within both public and private sectors despite having a relatively lower share of the ill-health burden. The importance of the findings for the design of a universal health system is discussed.

  18. A Holistic Framework for Deriving Equitable Apportionments and Resolving Conflicts in Transboundary Watercourses

    Science.gov (United States)

    Tyagi, H.; Gosain, A. K.; Khosa, R.

    2017-12-01

    Climate uncertainty & perpetually rising freshwater demands have emerged as the biggest threat to global water security. Consequently, water disputes have become more frequent & intense. If such conflicts remain unresolved for long, eventually they may cause severe socio-political damage to the riparians. The present study develops a comprehensive framework for conflict resolution & equitable allocation in transboundary Ganges watercourse with 4 stakeholder nations: China (Tibet), Nepal, India & Bangladesh. Scientific spatio-temporal information can be of great help in transboundary dispute resolution. Hence, this study employs a GIS-based semi-distributed SWAT hydrologic model for estimating water balance at different scales within the basin for present & future climate, landuse, storage & water use efficiency scenarios. The study analyses pertinent provisions of the Indian Constitution & examines the rulings of Indian water tribunals. It also critically compares various water dispute resolution mechanisms & doctrines on the barometer of equity & fairness to arrive at a procedurally & distributionally just water apportionment policy. The study makes use of Methods of Apportionments, Operations Research & Bankruptcy Rules to operationalize the chosen doctrine by devising an objective & quantifiable formulae for water allocation amongst the co-basin states for a range of flows. Furthermore, Game Theoretic and multi-optimization techniques have been used to rank the appropriateness of the above mentioned methods according to aggregate satisfaction/resentment of the stakeholders computed by equating their respective water claims with actual water shares obtained by them under different methods. Moreover, several Social Choice Theory methods have been employed to rate the performance of water allotment methods in a socio-political setting. The developed framework can thus be of great help for decision makers in effective water conflict resolution as transboundary

  19. The role of academic health centres in building equitable health systems: a systematic review protocol

    Science.gov (United States)

    Edelman, Alexandra; Taylor, Judy; Ovseiko, Pavel V; Topp, Stephanie M

    2017-01-01

    Introduction Academic health centres (AHCs) are complex organisations often defined by their ‘tripartite’ mission: to achieve high standards of clinical care, undertake clinical and laboratory research and educate health professionals. In the last decade, AHCs have moved away from what was a dominant focus on high impact (clinical) interventions for individuals, towards a more population-oriented paradigm requiring networked institutions and responsiveness to a range of issues including distribution of health outcomes and health determinants. Reflective of this paradigm shift is a growing interest in the role of AHCs in addressing health disparities and improving health system equity. This protocol outlines a systematic review that seeks to synthesise and critically appraise the current state of evidence on the role of AHCs in contributing to equitable health systems locally and globally. Methods and analysis Electronic searches will be conducted on a pilot list of bibliographic databases, including Google Scholar, Scopus, MEDLINE, PsycInfo, CINAHL, ERIC, ProQuest Dissertations & Theses, Cochrane Library, Evidence Based Medicine Reviews, Campbell Library and A+ Education, from 1 January 2000 to 31 December 2016. Apart from studies reporting clinical interventions or trials, all types of published peer-reviewed and grey literature will be included in the review. The single screening method will be employed in selecting studies, with two additional reviewers consulted where allocation is unclear. Quality and relevance appraisal utilising Joanna Briggs Institute critical appraisal tools will follow data extraction to a preprepared template. Thematic synthesis will be undertaken to develop descriptive themes and inform analysis. Ethics and dissemination As the review is focused on the analysis of secondary data, it does not require ethics approval. The results of the study will be disseminated through articles in peer-reviewed journals and trade publications as

  20. 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.)

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

    Science.gov (United States)

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

    2014-03-01

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

  2. 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…

  3. Open access

    African Journals Online (AJOL)

    Prof. Dennis Ocholla

    The argument that access to information is an instrumental and individual as well as ... and Dean School of Information Studies, University of Wisconsin, Milwaukee, USA. ... to scholarly publications and can be in any digital format, including text, movies and ... language barriers, censorship, lack of access to the Internet and ...

  4. 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.

  5. KAUST Open Access policy

    KAUST Repository

    Baessa, Mohamed A.

    2017-01-01

    The library plays a critical role in facilitating open access for their researchers, from managing a repository to providing support and information on the OA publication process to their authors. Janis Tyhurst and Dr Imad

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

    Science.gov (United States)

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

    2006-05-01

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

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

    African Journals Online (AJOL)

    included the provision of voluntary counselling and testing. (VCT), prevention of .... to travel up to 150 km to the nearest regional hospital, while in. Engcobo access to .... deteriorating relationship between staff and clients. Other studies15.

  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 The Government Programme of Action (Outcome 12) requires government departments to develop geographic access norms and to set targets for reducing the distances people have to travel to reach services, where this is appropriate. This presentation...

  9. 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 .0 – smart, sustainable, integrative. Strategies, concepts and technologies for planning the urban future The South African constitution requires that every citizen be granted access to basic services. It is therefore a legal requirement that all... eradication 8 REAL CORP 2009: Cities 3.0 – smart, sustainable, integrative. Strategies, concepts and technologies for planning the urban future 6 EVALUATION OF THE SERVICE ACCESS PLANNING APPLICATION 6.1 Usefulness of the results...

  10. 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.

  11. Access Contested

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

    Transforming Global Information and Communication Markets: The Political Economy of ... 8 Control and Resistance: Attacks on Burmese Opposition Media 153 ...... “Reluctant Gatekeepers: Corporate Ethics on a Filtered Internet,” in Access ...

  12. Accessing memory

    Science.gov (United States)

    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. Forbidden Access

    CERN Multimedia

    C. Colloca TS/FM

    2004-01-01

    TS/FM group informs you that, for the replacement of the door of the main entrance at bldg. 500, the access will be closed to the public between 19 and 30 July 2004. Access to the Main Building complex will be assured at any time through both of the side doors and from bldg. 64. For more information, please contact 73273. C. Colloca TS/FM

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

    Science.gov (United States)

    Hyndman, J C; Holman, C D

    2001-12-01

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

  15. 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

  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. 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...

  18. Vascular Access in Children

    International Nuclear Information System (INIS)

    Krishnamurthy, Ganesh; Keller, Marc S.

    2011-01-01

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

  19. 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...

  20. Private health insurance and access to healthcare.

    Science.gov (United States)

    Duggal, Ravi

    2011-01-01

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

  1. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.

    2006-01-01

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

  2. EPICS: Channel Access security design

    International Nuclear Information System (INIS)

    Kraimer, M.; Hill, J.

    1994-05-01

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

  3. 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

  4. 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

  5. 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...

  6. Provider-patient interaction in rural Cameroon--how it relates to the patient's understanding of diagnosis and prescribed drugs, the patient's concept of illness, and access to therapy.

    Science.gov (United States)

    Labhardt, Niklaus Daniel; Schiess, Kaspar; Manga, Engelbert; Langewitz, Wolf

    2009-08-01

    This cross-sectional survey examines the relation between provider-patient interaction and several patient-outcomes in a rural health district in Cameroon. We used structured patient interviews and the Roter Interaction Analysis System (RIAS) for analysis of audio-recorded consultations. Data from 130 primary care consultations with 13 health-care providers were analysed. 51% of patients correctly named their diagnoses after the consultation; in 47% of prescribed drugs patients explained correctly the purpose. Patients' ability to recall diagnoses was related to the extent of clarity a provider used in mentioning it during consultation (recall rates: 87.5% if mentioned explicitly, 56.7% if mentioned indirectly and 19.2% if not mentioned at all; pbuy prescribed drugs, discussion about financial issues was very rare during consultations. Providers issued financial questions in 32%, patients in 21% of consultations. This study shows that provider-patient interaction in primary health care in a rural Cameroon district deserves more attention. It might improve the patients' knowledge about their health condition and support them in beneficial health behaviour. Our findings should encourage providers to give more medical explanation, to discuss patients' health beliefs in a non-judgmental manner, and to consider financial issues more carefully.

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

    Science.gov (United States)

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

    2018-02-22

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

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

    Science.gov (United States)

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

    2018-01-01

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

  9. Gaining Access.

    Science.gov (United States)

    Wand, Sean; Thermos, Adam C.

    1998-01-01

    Explains the issues to consider before a college decides to purchase a card-access system. The benefits of automation, questions involving implementation, the criteria for technology selection, what typical card technology involves, privacy concerns, and the placement of card readers are discussed. (GR)

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

    Directory of Open Access Journals (Sweden)

    Louw Johann

    2010-11-01

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

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

    Science.gov (United States)

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

    2018-02-20

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

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

    Directory of Open Access Journals (Sweden)

    Jing Sun

    2018-02-01

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

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

    Science.gov (United States)

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

    2009-11-01

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

  14. 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

    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-making......, access to justice, accountability over decisions, distribution of conservation burdens, and sharing of conservation benefits. The proposed indicator system is a first step in advancing an approach to facilitate our understanding of how the different dimensions of social equity are denied or recognized...

  15. A national evaluation of workplace-based assessment tools (WPBAs) in foundation dental training: a UK study. Effective and useful but do they provide an equitable training experience?

    Science.gov (United States)

    Kirton, J A; Palmer, N O A; Grieveson, B; Balmer, M C

    2013-03-01

    A questionnaire study was undertaken with trainers and trainees from 12 deaneries in England and Northern Ireland in June 2010 to evaluate workplace-based assessments (WPBAs) in foundation training. From the sample consisting of 741 trainers and 643 foundation trainees, experience of WPBAs was positive overall, playing an important role in trainees' learning during foundation training and building confidence. However, there is a need for comprehensive training in the WPBA tools used to ensure their efficacy.

  16. Access to the city

    DEFF Research Database (Denmark)

    Andreasen, Manja Hoppe; Møller-Jensen, Lasse

    2017-01-01

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

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

    Science.gov (United States)

    Senier, Laura; Kearney, Matthew; Orne, Jason

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

  18. 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.

  19. 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

  20. : 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

  1. Optical Access Networks

    Science.gov (United States)

    Zheng, Jun; Ansari, Nirwan

    2005-01-01

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

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

    Science.gov (United States)

    Kindig, David A; Milstein, Bobby

    2018-04-01

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

  3. How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees

    Science.gov (United States)

    Razum, Oliver; Wenner, Judith; Bozorgmehr, Kayvan

    2017-01-01

    Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis – not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens’ right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call "globalization within." Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof. PMID:28812828

  4. Sometimes, economic arguments provide better conditions for achieving energy efficiency in transport (A remarkable new market based approach on Commuter Mobility Management makes accessibility and energy efficiency go hand in hand)

    International Nuclear Information System (INIS)

    Elburg, Henk van

    2003-01-01

    Commuter Mobility Management (CMM) is broadly regarded as one of the most potential instruments to reduce the negative effects of mass commuting on the environment and energy demand. Until now, only 4% of private enterprise implemented CMM in the Netherlands. Business community turned out to be very reluctant in embracing CMM as a workable method. National employers' federations, representing more than 90% of employment in private sector, pictured CMM as a laborious and not effective instrument. Novem realised that the real issue was not so much about the practicability of the instrument, but more about the environmental and energy related arguments being used by the government. Novem took the initiative and invited the employers federations to participate in a unique project: the development of a Standard Set of CMM-incentives. In this project, environmental and energy related arguments were tactically avoided. The target scenario was to convince business community strictly with economic arguments. The project showed remarkable results. The influential employers' federations became more co-operative and accepted a 'Standard Set of incentives'. While not emphasising it, the 'hidden' positive effect on energy conservation is still substantial: 5% reduction of single occupant vehicle-trips during rush hours, each 'switcher' saving an average of 7,200 single occupant car kilometres each year. By 2010 this could nation wide result in a reduction of approximately 3PJ, about 4,3% of all energy used by private car travel in mass commuting. This explains the title: 'Sometimes, economic arguments provide better conditions for achieving energy efficiency in transport'

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

    Tenenbaum, Evelyn M

    2018-03-01

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

  7. 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

  8. The 1.5 kilowatt society: Towards a sustainable, equitable, and habitable world

    International Nuclear Information System (INIS)

    Duerr, H.P.

    1998-01-01

    Numerous tremblings around the globe painfully signal that the end of the Cold War has not carried mankind to the envisaged less troubled political and economical waters. The defects of the present industrial civilization present mankind today with a formidable challenge to fulfil successfully and simultaneously to reconcile three incompatible requirements: ecological sustainability; social sustainability; individual sustainability; energy resources, their abundance, accessibility and if scarce possible substitutions, or in case of renewable resources possibilities of their regeneration; environmentally and socially tolerable deposition of the non-recycled remnants of non-renewable fuels (safe removal of radioactive wastes in case of nuclear energy, and the release of carbondioxide in case of fossil fuels without climatic changes); appropriate limitation of local and global primary energy conversion because of the negative side effects of human energy applications, and in view of limited robustness of the earth's ecosystem

  9. 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.

  10. 17 CFR 270.18f-2 - Fair and equitable treatment for holders of each class or series of stock of series investment...

    Science.gov (United States)

    2010-04-01

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

  11. Providing information and guidance on water and soil management

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-01

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

  12. 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.

  13. Framework development for providing accessibility to qualitative spatial calculi

    OpenAIRE

    Jan, Sahib

    2011-01-01

    Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies. Qualitative spatial reasoning deals with knowledge about an infinite spatial domain using a finite set of qualitative relations without using numerical computation. Qualitative knowledge is relative knowledge where we obtain the knowledge on the basis of comparison of features with in the object domain rather then using some external scales. Reasoning is an inte...

  14. 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.

  15. Equity for open-access journal publishing.

    Directory of Open Access Journals (Sweden)

    Stuart M Shieber

    2009-08-01

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

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

    Science.gov (United States)

    Yaogo, Maurice

    2017-07-12

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

  17. Gene therapy for spinomuscular atrophy: a biomedical advance, a missed opportunity for more equitable drug pricing.

    Science.gov (United States)

    Friedmann, T

    2017-09-01

    An experimental approach for gene therapy of spinomuscular atrophy has been reported to prevent development of the neuromuscular features of this lethal and previously untreatable disorder. The approach involves treatment of patients suffering from SMN1-associated infantile form of the disease with a splice-switching antisense oligonucleotide (ASO) that corrects aberrant splicing of the nearly identical SMN2 gene to allow the generation of functional SMN protein, thereby mitigating the development of the disease. This technique represents the first apparently effective therapy for spinal muscular atrophy (SMA) and an important documentation for ASO technology for therapy of neurodegenerative disease. These results with one form of SMA are likely to be relevant for similar applications to other SMA types and are likely to inspire application to a number of other intractable neurodegenerative diseases such as Huntington's disease, amyotrophic lateral sclerosis and possibly even the extremely common Parkinson's and Alzheimer's diseases and others. Nevertheless, the scientific and medical importance of this advance is marred by a pricing policy by the corporate sponsors that may complicate accessibility of the drug for some desperate patients.

  18. 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.

  19. Effective and equitable supply of gasoline to impacted areas in the aftermath of a natural disaster.

    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...

  20. Access control system operation

    International Nuclear Information System (INIS)

    Barnes, L.D.

    1981-06-01

    An automated method for the control and monitoring of personnel movement throughout the site was developed under contract to the Department of Energy by Allied-General Nuclear Services (AGNS) at the Barnwell Nuclear Fuel Plant (BNFP). These automated features provide strict enforcement of personnel access policy without routine patrol officer involvement. Identification methods include identification by employee ID number, identification by voice verification and identification by physical security officer verification. The ability to grant each level of access authority is distributed over the organization to prevent any single individual at any level in the organization from being capable of issuing an authorization for entry into sensitive areas. Each access event is recorded. As access events occur, the inventory of both the entered and the exited control area is updated so that a current inventory is always available for display. The system has been operated since 1979 in a development mode and many revisions have been implemented in hardware and software as areas were added to the system. Recent changes have involved the installation of backup systems and other features required to achieve a high reliability. The access control system and recent operating experience are described

  1. 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.

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

    Science.gov (United States)

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

    2017-06-22

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

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

    Directory of Open Access Journals (Sweden)

    Judith Bray

    2016-01-01

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

  4. The Duke Elder lecture: the challenge of equitable eye care in Pakistan.

    Science.gov (United States)

    Khan, M D

    2011-04-01

    Pakistan, like many other developing countries, is caught in the vicious cycle of poverty, illiteracy, violence, and disease. Right from its inception, it has been facing serious challenges of fast growing population, longevity, unemployment, wars, floods, double burden of diseases including blindness, as well as earthquakes, insurgencies, and political instability. Despite such challenges, the country has managed to reduce the burden of blindness from 1.78% in 1987-88 to 0.9% in 2003.This paper will highlight the methods used to achieve such a difficult goal. The country used the report of the World Health Organization (WHO) temporary consultant as the initial tool for advocacy to obtain political and professional commitment. Results from the first National Blindness Survey 1987-1990 were used as baseline for development of the programme. Under the Ministry of Health, national and provincial committees with respective coordinators were constituted. To ensure access and equity, the national programme was developed on the basis of district comprehensive eye care services. The concept was carefully tested in a laboratory and then piloted in a real district before it was rolled over to the country. Strong national institutes for human resource development, research and development, and service delivery were established. A strong network of high-quality national institutes was set up and run by powerful national non-governmental organizations. The second National Blindness Survey evaluated the achievements of the programme in 2001-2003. National prevalence of blindness was reduced by 100% by improving the uptake of services at the district level, especially by females.

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

    Science.gov (United States)

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

    2015-06-09

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

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

    Science.gov (United States)

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

    2017-09-13

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

  7. Editorial: Next Generation Access Networks

    Science.gov (United States)

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

    2015-12-01

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

  8. 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.

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

    Science.gov (United States)

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

    2012-12-01

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

  10. Moving from Separate, to Equal, to Equitable Schooling: Revisiting School Desegregation Policies

    Science.gov (United States)

    McPherson, Ezella

    2011-01-01

    For over a century after the 1896 "Plessy v. Ferguson" decision, researchers have been grappling with how to effectively implement educational reform policies to provide students with an equal education in American schools. This literature review examines previous school desegregation cases and school desegregation plans to investigate…

  11. Sustainability, efficiency and equitability of water consumption and pollution in Latin America and the Caribbean

    NARCIS (Netherlands)

    Mekonnen, Mesfin; Pahlow, Markus; Martinez-Aldaya, Maite; Zarate, E.; Hoekstra, Arjen Ysbert

    2015-01-01

    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

  12. Integrating neurocritical care approaches into neonatology: should all infants be treated equitably?

    Science.gov (United States)

    Mann, P C; Gospe, S M; Steinman, K J; Wilfond, B S

    2015-12-01

    To improve the neurologic outcomes for infants with brain injury, neonatal providers are increasingly implementing neurocritical care approaches into clinical practice. Term infants with brain injury have been principal beneficiaries of neurologically-integrated care models to date, as evidenced by the widespread adoption of therapeutic hypothermia protocols for hypoxic-ischemic encephalopathy. Innovative therapeutic and diagnostic support for very low birth weight infants with brain injury has lagged behind. Given that concern for significant future neurodevelopmental impairment can lead to decisions to withdraw life supportive care at any gestational age, providing families with accurate prognostic information is essential for all infants. Current variable application of multidisciplinary neurocritical care approaches to infants at different gestational ages may be ethically problematic and reflect distinct perceptions of brain injury for infants born extremely premature.

  13. Holistic approaches to e-learning accessibility

    OpenAIRE

    Phipps, Lawrie; Kelly, Brian

    2006-01-01

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

  14. 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…

  15. Overview of UNEP's CDM activities. Enhancing a more equitable regional distribution of CDM project activities

    Energy Technology Data Exchange (ETDEWEB)

    2007-12-15

    More than thirty months after the entry into force of the Kyoto Protocol, CDM transactions continue to gain momentum. By November 2007, 2,647 CDM projects are in the CDM pipeline. Of these, 827 are registered projects, and a further 154 are inthe registration process. The CDM Executive Board (CDM EB) has issued more than 82 million Certified Emissions Reductions (CER). In terms of number of projects by type of technology, renewables CDM projects are the leading type with 62% of the pipeline. However, N{sub 2}O, HFC and PFC projects have the biggest share (34%) of CERs expected to be generated by end of first commitment period. At the same time, more and more renewables and other non-industrial gases projects are going into the pipeline increasing their share of emissions reductions to be achieved. Geographically, the distribution of CDM projects has so far not been very equitable. A limited number of countries including China, India, Brazil and Mexico have captured the largest share of the global CDM project portfolio. Specific regions in the developing world, namely Sub-Saharan Africa, have been largely bypassed by the CDM market and are struggling to attract a decent number of CDM projects. In fact, of the total 2,647 projects, only 33 projects are in Sub-Saharan Africa where 21 of these are actually in South Africa, making the distribution even more skewed. (au)

  16. Perspectives of Community Co-Researchers About Group Dynamics and Equitable Partnership Within a Community-Academic Research Team.

    Science.gov (United States)

    Vaughn, Lisa M; Jacquez, Farrah; Zhen-Duan, Jenny

    2018-04-01

    Equitable partnership processes and group dynamics, including individual, relational, and structural factors, have been identified as key ingredients to successful community-based participatory research partnerships. The purpose of this qualitative study was to investigate the key aspects of group dynamics and partnership from the perspectives of community members serving as co-researchers. Semistructured, in-depth interviews were conducted with 15 Latino immigrant co-researchers from an intervention project with Latinos Unidos por la Salud (LU-Salud), a community research team composed of Latino immigrant community members and academic investigators working in a health research partnership. A deductive framework approach guided the interview process and qualitative data analysis. The LU-Salud co-researchers described relationships, personal growth, beliefs/identity motivation (individual dynamics), coexistence (relational dynamics), diversity, and power/resource sharing (structural dynamics) as key foundational aspects of the community-academic partnership. Building on existing CBPR and team science frameworks, these findings demonstrate that group dynamics and partnership processes are fundamental drivers of individual-level motivation and meaning making, which ultimately sustain efforts of community partners to engage with the research team and also contribute to the achievement of intended research outcomes.

  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. 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.

  19. 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,...

  20. Distributive justice in American healthcare: institutions, power, and the equitable care of patients.

    Science.gov (United States)

    Putsch, Robert W; Pololi, Linda

    2004-09-01

    The authors argue that the American healthcare system has developed in a fashion that permits and may support ongoing, widespread inequities based on poverty, race, gender, and ethnicity. Institutional structures also contribute to this problem. Analysis is based on (1) discussions of a group of experts convened by the Office of Minority Health, US Department of Health and Human Services at a conference to address healthcare disparities; and (2) review of documentation and scientific literature focused on health, health-related news, language, healthcare financing, and the law. Institutional factors contributing to inequity include the cost and financing of American healthcare, healthcare insurance principles such as mutual aid versus actuarial fairness, and institutional power. Additional causes for inequity are bias in decision making by healthcare practitioners, clinical training environments linked to abuse of patients and coworkers, healthcare provider ethnicity, and politics. Recommendations include establishment of core attributes of trust, relationship and advocacy in health systems; universal healthcare; and insurance systems based on mutual aid. In addition, monitoring of equity in health services and the development of a set of ethical principles to guide systems change and rule setting would provide a foundation for distributive justice in healthcare. Additionally, training centers should model the behaviors they seek to foster and be accountable to the communities they serve.

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

    Science.gov (United States)

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

    2018-03-27

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

  2. Joint Scheduling Optimization of Virtual Power Plants and Equitable Profit Distribution Using Shapely Value Theory

    Directory of Open Access Journals (Sweden)

    Zhong-fu Tan

    2018-01-01

    Full Text Available The installation capacity of wind and solar photovoltaic power is continually increasing, which makes renewable energy grid connection and power generation an important link of China’s power structure optimization. A virtual power plant (VPP is an important way to help distributed energy resource grid connection and promote renewable energy industry development. To study the economic scheduling problem of various distributed energy resources and the profit distribution problem of VPP alliance, this study builds a separate operation scheduling model for individual VPP and a joint operation scheduling model for VPP alliance, as well as the profit distribution model. The case study verifies the feasibility and effectiveness of the proposed model. The sensitivity analysis provides information about VPP decision-making in accordance with the policy environment development trend.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Gabriella Bordin

    2015-09-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

  6. 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.

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

    Science.gov (United States)

    Kurt, Serhat

    2017-12-08

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

  8. Direct access to INIS

    International Nuclear Information System (INIS)

    Zheludev, I.S.; Romanenko, A.G.

    1981-01-01

    Librarians, researchers, and information specialists throughout the world now have the opportunity for direct access to coverage of almost 95% of the world's literature dealing with the peaceful uses of atomic energy and nuclear science. This opportunity has been provided by the International Nuclear Information System (INIS) of the IAEA. INIS, with the voluntary collaboration of more than 60 of the Agency's Member States, maintains a comprehensive, computer-resident data-base, containing the bibliographic details plus informative abstracts of the bulk of the world's literature on nuclear science and technology. Since this data-base is growing at a rate of 75,000 items per year, and already contains more than 500,000 items, it is obviously important to be able to search this collection conveniently and efficiently. The usefulness of this ability is enhanced when other data-bases on related subjects are made available on an information network. During the early 1970s, on-line interrogation of large bibliographic data-bases became the accepted method for searching this type of information resource. Direct interaction between the searcher and the data-base provides quick feed-back resulting in improved literature listings for launching research and development projects. On-line access enables organizations which cannot store a large data-base on their own computer to expand the information resources at their command. Because of these advantages, INIS undertook to extend to interested Member States on-line access to its data-base in Vienna

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  10. Counseling Received by Adolescents Undergoing Voluntary Medical Male Circumcision: Moving Toward Age-Equitable Comprehensive Human Immunodeficiency Virus Prevention Measures.

    Science.gov (United States)

    Kaufman, Michelle R; Patel, Eshan U; Dam, Kim H; Packman, Zoe R; Van Lith, Lynn M; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

    2018-04-03

    The minimum package of voluntary medical male circumcision (VMMC) services, as defined by the World Health Organization, includes human immunodeficiency virus (HIV) testing, HIV prevention counseling, screening/treatment for sexually transmitted infections, condom promotion, and the VMMC procedure. The current study aimed to assess whether adolescents received these key elements. Quantitative surveys were conducted among male adolescents aged 10-19 years (n = 1293) seeking VMMC in South Africa, Tanzania, and Zimbabwe. We used a summative index score of 8 self-reported binary items to measure receipt of important elements of the World Health Organization-recommended HIV minimum package and the US President's Emergency Plan for AIDS Relief VMMC recommendations. Counseling sessions were observed for a subset of adolescents (n = 44). To evaluate factors associated with counseling content, we used Poisson regression models with generalized estimating equations and robust variance estimation. Although counseling included VMMC benefits, little attention was paid to risks, including how to identify complications, what to do if they arise, and why avoiding sex and masturbation could prevent complications. Overall, older adolescents (aged 15-19 years) reported receiving more items in the recommended minimum package than younger adolescents (aged 10-14 years; adjusted β, 0.17; 95% confidence interval [CI], .12-.21; P benefits or uptake of HIV testing. These self-reported findings were confirmed during counseling observations. Moving toward age-equitable HIV prevention services during adolescent VMMC likely requires standardizing counseling content, as there are significant age differences in HIV prevention content received by adolescents.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Yvonne Tam

    2016-10-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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. 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

  14. 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.

  15. Five Steps to an Accessible Classroom Website

    Science.gov (United States)

    Amundson, Linda

    2009-01-01

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

  16. Accessibility issues with long-term disabilities.

    Science.gov (United States)

    Sebring-Cale, Nancy J

    2008-06-01

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

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

    Science.gov (United States)

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

    2011-09-01

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

  18. 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

  19. Accessibility and sensory experiences

    DEFF Research Database (Denmark)

    Ryhl, Camilla

    2010-01-01

    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....

  20. Optical Subsystems for Next Generation Access Networks

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2003-06-01

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

  2. Wireless Multi Hop Access Networks and Protocols

    OpenAIRE

    Nilsson Plymoth, Anders

    2007-01-01

    As more and more applications and services in our society now depend on the Internet, it is important that dynamically deployed wireless multi hop networks are able to gain access to the Internet and other infrastructure networks and services. This thesis proposes and evaluates solutions for providing multi hop Internet Access. It investigates how ad hoc networks can be combined with wireless and mesh networks in order to create wireless multi hop access networks. When several access points t...

  3. Patient choice of providers in a preferred provider organization.

    Science.gov (United States)

    Wouters, A V; Hester, J

    1988-03-01

    This article is an analysis of patient choice of providers by the employees of the Security Pacific Bank of California and their dependents who have access to the Med Network Preferred Provider Organization (PPO). The empirical results show that not only is the PPO used by individuals who require relatively little medical care (as measured by predicted office visit charges) but that the PPO is most intensively used for low-risk services such as treatment for minor illness and preventive care. Also, the most likely Security Pacific Health Care beneficiary to use a PPO provider is a recently hired employee who lives in the south urban region, has a relatively low income, does not have supplemental insurance coverage, and is without previous attachments to non-PPO primary care providers. In order to maximize their ability to reduce plan paid benefits, insurers who contract with PPOs should focus on increasing PPO utilization among poorer health risks.

  4. Parents' and healthcare providers perspectives about hospitalised ...

    African Journals Online (AJOL)

    Parents' and healthcare providers perspectives about hospitalised children being visited by other ... Log in or Register to get access to full text downloads. ... children should be visited by other children has been accorded minimal attention.

  5. Biometrics: Accessibility challenge or opportunity?

    Science.gov (United States)

    Blanco-Gonzalo, Ramon; Lunerti, Chiara; Sanchez-Reillo, Raul; Guest, Richard Michael

    2018-01-01

    Biometric recognition is currently implemented in several authentication contexts, most recently in mobile devices where it is expected to complement or even replace traditional authentication modalities such as PIN (Personal Identification Number) or passwords. The assumed convenience characteristics of biometrics are transparency, reliability and ease-of-use, however, the question of whether biometric recognition is as intuitive and straightforward to use is open to debate. Can biometric systems make some tasks easier for people with accessibility concerns? To investigate this question, an accessibility evaluation of a mobile app was conducted where test subjects withdraw money from a fictitious ATM (Automated Teller Machine) scenario. The biometric authentication mechanisms used include face, voice, and fingerprint. Furthermore, we employed traditional modalities of PIN and pattern in order to check if biometric recognition is indeed a real improvement. The trial test subjects within this work were people with real-life accessibility concerns. A group of people without accessibility concerns also participated, providing a baseline performance. Experimental results are presented concerning performance, HCI (Human-Computer Interaction) and accessibility, grouped according to category of accessibility concern. Our results reveal links between individual modalities and user category establishing guidelines for future accessible biometric products.

  6. Biometrics: Accessibility challenge or opportunity?

    Science.gov (United States)

    Lunerti, Chiara; Sanchez-Reillo, Raul; Guest, Richard Michael

    2018-01-01

    Biometric recognition is currently implemented in several authentication contexts, most recently in mobile devices where it is expected to complement or even replace traditional authentication modalities such as PIN (Personal Identification Number) or passwords. The assumed convenience characteristics of biometrics are transparency, reliability and ease-of-use, however, the question of whether biometric recognition is as intuitive and straightforward to use is open to debate. Can biometric systems make some tasks easier for people with accessibility concerns? To investigate this question, an accessibility evaluation of a mobile app was conducted where test subjects withdraw money from a fictitious ATM (Automated Teller Machine) scenario. The biometric authentication mechanisms used include face, voice, and fingerprint. Furthermore, we employed traditional modalities of PIN and pattern in order to check if biometric recognition is indeed a real improvement. The trial test subjects within this work were people with real-life accessibility concerns. A group of people without accessibility concerns also participated, providing a baseline performance. Experimental results are presented concerning performance, HCI (Human-Computer Interaction) and accessibility, grouped according to category of accessibility concern. Our results reveal links between individual modalities and user category establishing guidelines for future accessible biometric products. PMID:29565989

  7. Biometrics: Accessibility challenge or opportunity?

    Directory of Open Access Journals (Sweden)

    Ramon Blanco-Gonzalo

    Full Text Available Biometric recognition is currently implemented in several authentication contexts, most recently in mobile devices where it is expected to complement or even replace traditional authentication modalities such as PIN (Personal Identification Number or passwords. The assumed convenience characteristics of biometrics are transparency, reliability and ease-of-use, however, the question of whether biometric recognition is as intuitive and straightforward to use is open to debate. Can biometric systems make some tasks easier for people with accessibility concerns? To investigate this question, an accessibility evaluation of a mobile app was conducted where test subjects withdraw money from a fictitious ATM (Automated Teller Machine scenario. The biometric authentication mechanisms used include face, voice, and fingerprint. Furthermore, we employed traditional modalities of PIN and pattern in order to check if biometric recognition is indeed a real improvement. The trial test subjects within this work were people with real-life accessibility concerns. A group of people without accessibility concerns also participated, providing a baseline performance. Experimental results are presented concerning performance, HCI (Human-Computer Interaction and accessibility, grouped according to category of accessibility concern. Our results reveal links between individual modalities and user category establishing guidelines for future accessible biometric products.

  8. Using the Five Domains Model to Assess the Adverse Impacts of Husbandry, Veterinary, and Equitation Interventions on Horse Welfare

    Science.gov (United States)

    McGreevy, Paul; Berger, Jeannine; de Brauwere, Nic; Doherty, Orla; Harrison, Anna; Fiedler, Julie; Jones, Claudia; McDonnell, Sue; McLean, Andrew; Nakonechny, Lindsay; Preshaw, Liane; Tzioumis, Vicky; Webster, John; Wolfensohn, Sarah; Yeates, James; Jones, Bidda

    2018-01-01

    Simple Summary Using an adaptation of the domain-based welfare assessment model, a panel of horse welfare professionals (with professional expertise in psychology, equitation science, veterinary science, education, welfare, equestrian coaching, advocacy, and community engagement) assessed the perceived harms, if any, resulting from 116 interventions that are commonly applied to horses. Scores for Domain 5 (the integrated mental impact) gathered after extensive discussion during a four-day workshop aligned well with overall impact scores assigned by the same panellists individually before the workshop, although some rankings changed after workshop participation. Domain 4 (Behaviour) had the strongest association with Domain 5, whilst Domain 1 (Nutrition) had the weakest association with Domain 5, implying that the panellists considered commonly applied nutritional interventions to have less of a bearing on subjective mental state than commonly applied behavioural restrictions. The workshop defined each intervention, and stated assumptions around each, resulting in a set of exemplar procedures that could be used in future equine welfare assessments. Abstract The aim of this study was to conduct a series of paper-based exercises in order to assess the negative (adverse) welfare impacts, if any, of common interventions on domestic horses across a broad range of different contexts of equine care and training. An international panel (with professional expertise in psychology, equitation science, veterinary science, education, welfare, equestrian coaching, advocacy, and community engagement; n = 16) met over a four-day period to define and assess these interventions, using an adaptation of the domain-based assessment model. The interventions were considered within 14 contexts: C1 Weaning; C2 Diet; C3 Housing; C4 Foundation training; C5 Ill-health and veterinary interventions (chiefly medical); C6 Ill-health and veterinary interventions (chiefly surgical); C7 Elective

  9. Positioning Your Library in an Open-Access Environment

    Science.gov (United States)

    Bhatt, Anjana H.

    2010-01-01

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

  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. 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."

  12. Enstore with Chimera namespace provider

    International Nuclear Information System (INIS)

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

    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.

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

    Science.gov (United States)

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

    2018-03-05

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

  14. Using the Five Domains Model to Assess the Adverse Impacts of Husbandry, Veterinary, and Equitation Interventions on Horse Welfare.

    Science.gov (United States)

    McGreevy, Paul; Berger, Jeannine; de Brauwere, Nic; Doherty, Orla; Harrison, Anna; Fiedler, Julie; Jones, Claudia; McDonnell, Sue; McLean, Andrew; Nakonechny, Lindsay; Nicol, Christine; Preshaw, Liane; Thomson, Peter; Tzioumis, Vicky; Webster, John; Wolfensohn, Sarah; Yeates, James; Jones, Bidda

    2018-03-18

    The aim of this study was to conduct a series of paper-based exercises in order to assess the negative (adverse) welfare impacts, if any, of common interventions on domestic horses across a broad range of different contexts of equine care and training. An international panel (with professional expertise in psychology, equitation science, veterinary science, education, welfare, equestrian coaching, advocacy, and community engagement; n = 16) met over a four-day period to define and assess these interventions, using an adaptation of the domain-based assessment model. The interventions were considered within 14 contexts: C1 Weaning; C2 Diet; C3 Housing; C4 Foundation training; C5 Ill-health and veterinary interventions (chiefly medical); C6 Ill-health and veterinary interventions (chiefly surgical); C7 Elective procedures; C8 Care procedures; C9 Restraint for management procedures; C10 Road transport; C11 Activity-competition; C12 Activity-work; C13 Activity-breeding females; and C14 Activity-breeding males. Scores on a 1-10 scale for Domain 5 (the mental domain) gathered during the workshop were compared with overall impact scores on a 1-10 scale assigned by the same panellists individually before the workshop. The most severe (median and interquartile range, IQR) impacts within each context were identified during the workshop as: C1 abrupt, individual weaning (10 IQR 1); C2 feeding 100% low-energy concentrate (8 IQR 2.5); C3 indoor tie stalls with no social contact (9 IQR 1.5); C4 both (i) dropping horse with ropes (9 IQR 0.5) and forced flexion (9 IQR 0.5); C5 long-term curative medical treatments (8 IQR 3); C6 major deep intracavity surgery (8.5 IQR 1); C7 castration without veterinary supervision (10 IQR 1); C8 both (i) tongue ties (8 IQR 2.5) and (ii) restrictive nosebands (8 IQR 2.5); C9 ear twitch (8 IQR 1); C10 both (i) individual transport (7.00 IQR 1.5) and group transport with unfamiliar companions (7 IQR 1.5); C11 both (i) jumps racing (8 IQR 2.5) and

  15. Using the Five Domains Model to Assess the Adverse Impacts of Husbandry, Veterinary, and Equitation Interventions on Horse Welfare

    Directory of Open Access Journals (Sweden)

    Paul McGreevy

    2018-03-01

    Full Text Available The aim of this study was to conduct a series of paper-based exercises in order to assess the negative (adverse welfare impacts, if any, of common interventions on domestic horses across a broad range of different contexts of equine care and training. An international panel (with professional expertise in psychology, equitation science, veterinary science, education, welfare, equestrian coaching, advocacy, and community engagement; n = 16 met over a four-day period to define and assess these interventions, using an adaptation of the domain-based assessment model. The interventions were considered within 14 contexts: C1 Weaning; C2 Diet; C3 Housing; C4 Foundation training; C5 Ill-health and veterinary interventions (chiefly medical; C6 Ill-health and veterinary interventions (chiefly surgical; C7 Elective procedures; C8 Care procedures; C9 Restraint for management procedures; C10 Road transport; C11 Activity—competition; C12 Activity—work; C13 Activity—breeding females; and C14 Activity—breeding males. Scores on a 1–10 scale for Domain 5 (the mental domain gathered during the workshop were compared with overall impact scores on a 1–10 scale assigned by the same panellists individually before the workshop. The most severe (median and interquartile range, IQR impacts within each context were identified during the workshop as: C1 abrupt, individual weaning (10 IQR 1; C2 feeding 100% low-energy concentrate (8 IQR 2.5; C3 indoor tie stalls with no social contact (9 IQR 1.5; C4 both (i dropping horse with ropes (9 IQR 0.5 and forced flexion (9 IQR 0.5; C5 long-term curative medical treatments (8 IQR 3; C6 major deep intracavity surgery (8.5 IQR 1; C7 castration without veterinary supervision (10 IQR 1; C8 both (i tongue ties (8 IQR 2.5 and (ii restrictive nosebands (8 IQR 2.5; C9 ear twitch (8 IQR 1; C10 both (i individual transport (7.00 IQR 1.5 and group transport with unfamiliar companions (7 IQR 1.5; C11 both (i jumps racing (8 IQR 2

  16. 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.

  17. 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.

  18. '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.

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

    Directory of Open Access Journals (Sweden)

    Bruno Bauer

    2016-12-01

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

  20. Overview: Routes to Open Access

    OpenAIRE

    Tullney, Marco; van Wezenbeek, Wilma

    2017-01-01

    Slides of an overview presentation given at a CESAER workshop on Open Access, February 2nd, 2017, in Brussels Cover major routes to more open access as discussed in the Task Force Open Science of CESAER: (national) open access strategies open access mandates open access incentives open access awareness open access publishing open access infrastructure

  1. 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...

  2. 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...

  3. Information on Open Access

    African Journals Online (AJOL)

    Open Access (OA), defined most simply, means free full text online. There are over 130 Open Access journals hosted on the AJOL website. You can find a full list of these journals here: OA journals on AJOL ...

  4. 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...

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

    Science.gov (United States)

    Fredericks, Suzanne

    2015-07-01

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

  6. Access Customized Forms

    OpenAIRE

    Cosma Emil; Jeflea Victor

    2010-01-01

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

  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. 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

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

    Science.gov (United States)

    Ridde, Valéry; Somé, Paul Andre; Pirkle, Catherine M

    2012-03-06

    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 inequitable consequences

  10. 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

  11. Open access and beyond

    Directory of Open Access Journals (Sweden)

    Das Chhaya

    2006-09-01

    Full Text Available Abstract Uncensored exchange of scientific results hastens progress. Open Access does not stop at the removal of price and permission barriers; still, censorship and reading disabilities, to name a few, hamper access to information. Here, we invite the scientific community and the public to discuss new methods to distribute, store and manage literature in order to achieve unfettered access to literature.

  12. Arts Accessibility for the Deaf.

    Science.gov (United States)

    Bergman, Eugene

    The booklet provides information and resources for cultural organizations and institutions interested in making the arts accessible to deaf citizens. Preliminary information includes a discussion of deafness in America and the deaf in the history of the arts and notes that the era of silent films was the golden age of cinema. Listed are 36…

  13. Lightweight methodology to improve web accessibility

    CSIR Research Space (South Africa)

    Greeff, M

    2009-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-10-01

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

  15. Evolving trade policy and the Trans-Pacific Partnership Agreement: does it threaten Vietnam's access to medicine and its progress towards scaling up HIV prevention, treatment and care?

    Science.gov (United States)

    Linh, Nguyen Nhat; Huong, Nguyen Thanh; Thuy, Hua Thanh

    2015-01-01

    The Trans-Pacific Partnership Agreement (TPP) has undergone 18 rounds of secretive negotiation between the USA and 11 Asia-Pacific countries. Aiming at a free trade area, this multilateral trade proposal covers all aspects of commercial relations among the countries involved. Despite some anticipated positive impacts in trade, specific articles in this proposal's intellectual property and transparency chapters might negatively impact access to medicine, in general, and to antiretroviral (ARV) drugs, in particular, in Vietnam. Drawing on a desk review and qualitative in-depth interviews with 20 key informants from government, academia, hospitals and civil society, we analyse various provisions of the proposal being negotiated leaked after the 14th round of negotiations in September 2012. Findings suggest that the TPP could lead to increased monopoly protection and could limit technological advancements within the local pharmaceutical manufacturing industry, resulting in higher medicine prices in Vietnam. This outcome would have a significant impact on Vietnam's ability to achieve goals for HIV prevention, treatment and care, and create barriers to universal health-care coverage. This research provides unique evidence for Vietnam to advocate for more equitable pharmaceutical provisions in and to raise awareness of the implications of the TPP among the pharmaceutical stakeholder community in Vietnam.

  16. 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

  17. 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

  18. Accessing and disclosing protected resources

    DEFF Research Database (Denmark)

    Olesen, Henning; Khajuria, Samant

    2014-01-01

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

  19. Accessibility of antiretroviral therapy in Ghana: convenience of access.

    Science.gov (United States)

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

    2012-01-01

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

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

    OpenAIRE

    Møinichen, Jørgen

    2014-01-01

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

  1. How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees Comment on "Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis".

    Science.gov (United States)

    Razum, Oliver; Wenner, Judith; Bozorgmehr, Kayvan

    2016-10-17

    Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis - not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens' right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call "globalization within." Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  2. 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...

  3. 34 CFR 21.1 - Equal Access to Justice Act.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Equal Access to Justice Act. 21.1 Section 21.1 Education Office of the Secretary, Department of Education EQUAL ACCESS TO JUSTICE General § 21.1 Equal Access to Justice Act. (a) The Equal Access to Justice Act (the Act) provides for the award of fees and...

  4. 78 FR 10166 - Access Interpreting; Transfer of Data

    Science.gov (United States)

    2013-02-13

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

  5. The Access Pricing Problem: A Synthesis.

    OpenAIRE

    Armstrong, Mark; Doyle, Chris; Vickers, John

    1996-01-01

    The Baumol-Willig efficient component pricing rule states that it is efficient to set the price of access to an essential facility equal to the direct cost of access plus the opportunity cost to the integrated access provider. The authors analyze the relevant notion of 'opportunity cost' under various assumptions about demand and supply conditions, including product differentiation, bypass, and substitution possibilities, which all reduce opportunity cost compared to the benchmark case. They ...

  6. 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

  7. The Café Femenino Peru story : evaluating the potential of a for-profit gender equitable value chain

    OpenAIRE

    Shah, Kanira; Bjørndal, Trond

    2016-01-01

    The focus of this paper is on evaluating how Café Femenino Peru, an organically grown coffee produced by women, is successful in promoting gender equity, while being a for-profit business. Using the ‘pro-poor perspective’ of Porter’s value chain analysis as its primary methodology, this research identifies links and dynamics in the value chain of Café Femenino Peru but with a gender lens perspective. Results reveal that the combined increases in income and the increased access to assista...

  8. Remote access to mathematical software

    International Nuclear Information System (INIS)

    Dolan, E.; Hovland, P.; More, J.; Norris, B.; Smith, B.

    2001-01-01

    The network-oriented application services paradigm is becoming increasingly common for scientific computing. The popularity of this approach can be attributed to the numerous advantages to both user and developer provided by network-enabled mathematical software. The burden of installing and maintaining complex systems is lifted from the user, while enabling developers to provide frequent updates without disrupting service. Access to software with similar functionality can be unified under the same interface. Remote servers can utilize potentially more powerful computing resources than may be available locally. We discuss some of the application services developed by the Mathematics and Computer Science Division at Argonne National Laboratory, including the Network Enabled Optimization System (NEOS) Server and the Automatic Differentiation of C (ADIC) Server, as well as preliminary work on Web access to the Portable Extensible Toolkit for Scientific Computing (PETSc). We also provide a brief survey of related work

  9. Accessing and disclosing protected resources

    DEFF Research Database (Denmark)

    Olesen, Henning; Khajuria, Samant

    2015-01-01

    Today, data is money. Whether it is private users' personal data or confidential data and assets belonging to service providers, all parties have a strong need to protect their resources when interacting with each other, i.e. for access control and authorization measures to be deployed. Enabling...... advanced user controlled privacy is essential to realize the visions of 5G applications and services. For service providers and enterprises resources are usually well safeguarded, while private users are often missing the tools and the know-how to protect their own data and preserve their privacy. The user...... the framework of User Managed Access (UMA), can enable users to understand the value of their protected resources and possibly give them control of how their data will be used by service providers....

  10. Medical service provider networks.

    Science.gov (United States)

    Mougeot, Michel; Naegelen, Florence

    2018-05-17

    In many countries, health insurers or health plans choose to contract either with any willing providers or with preferred providers. We compare these mechanisms when two medical services are imperfect substitutes in demand and are supplied by two different firms. In both cases, the reimbursement is higher when patients select the in-network provider(s). We show that these mechanisms yield lower prices, lower providers' and insurer's profits, and lower expense than in the uniform-reimbursement case. Whatever the degree of product differentiation, a not-for-profit insurer should prefer selective contracting and select a reimbursement such that the out-of-pocket expense is null. Although all providers join the network under any-willing-provider contracting in the absence of third-party payment, an asymmetric equilibrium may exist when this billing arrangement is implemented. Copyright © 2018 John Wiley & Sons, Ltd.

  11. 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.

  12. Migrants' access to healthcare

    DEFF Research Database (Denmark)

    Norredam, Marie

    2011-01-01

    There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare...... according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why...... are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV). The thesis builds on different methodological approaches using both register-based retrospective cohort design, cross-sectional design and survey methods. Two different measures of access were...

  13. 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.

  14. Strategic Accessibility Competition

    OpenAIRE

    Bacchiega, Emanuele; Randon, Emanuela; Zirulia, Lorenzo

    2010-01-01

    We analyze the effect of competition in market-accessibility enhancement among quality-differentiated firms. Firms are located in regions with different ex-ante transport costs to reach the final market. We characterize the equilibrium of the two-stage game in which firms first invest to improve market accessibility and then compete in prices. Efforts in accessibility improvement crucially depend on the interplay between the willingness to pay for the quality premium of the median consumer an...

  15. 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.

  16. 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....

  17. 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.

  18. ‘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

  19. ‘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.

  20. Open access in the critical care environment.

    Science.gov (United States)

    South, Tabitha; Adair, Brigette

    2014-12-01

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

  1. Examining data access and use in science

    Energy Technology Data Exchange (ETDEWEB)

    Yan, E.; Zhao, M.

    2016-07-01

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

  2. Development of Disruptive Open Access Journals

    Science.gov (United States)

    Anderson, Terry; McConkey, Brigette

    2009-01-01

    Open access (OA) publication has emerged, with disruptive effects, as a major outlet for scholarly publication. OA publication is usually associated with on-line distribution and provides access to scholarly publications to anyone, anywhere--regardless of their ability to pay subscription fees or their association with an educational institution.…

  3. Librarians and Libraries Supporting Open Access Publishing

    Science.gov (United States)

    Richard, Jennifer; Koufogiannakis, Denise; Ryan, Pam

    2009-01-01

    As new models of scholarly communication emerge, librarians and libraries have responded by developing and supporting new methods of storing and providing access to information and by creating new publishing support services. This article will examine the roles of libraries and librarians in developing and supporting open access publishing…

  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. Open Access to Mexican Academic Production

    Science.gov (United States)

    Adame, Silvia I.; Llorens, Luis

    2016-01-01

    This paper presents a description of the metadata harvester software development. This system provides access to reliable and quality educational resources, shared by Mexican Universities through their repositories, to anyone with Internet Access. We present the conceptual and contextual framework, followed by the technical basis, the results and…

  6. National Radiobiology Archives Distributed Access user's manual

    International Nuclear Information System (INIS)

    Watson, C.; Smith, S.; Prather, J.

    1991-11-01

    This User's Manual describes installation and use of the National Radiobiology Archives (NRA) Distributed Access package. The package consists of a distributed subset of information representative of the NRA databases and database access software which provide an introduction to the scope and style of the NRA Information Systems

  7. Open-Access Electronic Textbooks: An Overview

    Science.gov (United States)

    Ovadia, Steven

    2011-01-01

    Given the challenging economic climate in the United States, many academics are looking to open-access electronic textbooks as a way to provide students with traditional textbook content at a more financially advantageous price. Open access refers to "the free and widely available information throughout the World Wide Web. Once an article's…

  8. Deaf New Zealand Sign Language users' access to healthcare.

    Science.gov (United States)

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

    2017-12-01

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

  9. Demystifying Open Access

    International Nuclear Information System (INIS)

    Mele, Salvatore

    2007-01-01

    The tenets of Open Access are to grant anyone, anywhere and anytime free access to the results of scientific research. HEP spearheaded the Open Access dissemination of scientific results with the mass mailing of preprints in the pre-WWW era and with the launch of the arXiv preprint system at the dawn of the '90s. The HEP community is now ready for a further push to Open Access while retaining all the advantages of the peer-review system and, at the same time, bring the spiralling cost of journal subscriptions under control. I will present a possible plan for the conversion to Open Access of HEP peer-reviewed journals, through a consortium of HEP funding agencies, laboratories and libraries: SCOAP3 (Sponsoring Consortium for Open Access Publishing in Particle Physics). SCOAP3 will engage with scientific publishers towards building a sustainable model for Open Access publishing, which is as transparent as possible for HEP authors. The current system in which journals income comes from subscription fees is replaced with a scheme where SCOAP3 compensates publishers for the costs incurred to organise the peer-review service and give Open Access to the final version of articles. SCOAP3 will be funded by all countries active in HEP under a 'fair share' scenario, according to their production of HEP articles. In this talk I will present a short overview of the history of Open Access in HEP, the details of the SCOAP3 model and the outlook for its implementation.

  10. Web Accessibility and Guidelines

    Science.gov (United States)

    Harper, Simon; Yesilada, Yeliz

    Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

  11. 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.

  12. 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

  13. 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

  14. 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...

  15. Holistic approaches to e-learning accessibility

    Directory of Open Access Journals (Sweden)

    Lawrie Phipps

    2006-12-01

    Full Text Available The importance of accessibility to digital e-learning resources is widely acknowledged. The World Wide Web Consortium Web Accessibility Initiative has played a leading role in promoting the importance of accessibility and developing guidelines that can help when developing accessible web resources. The accessibility of e-learning resources provides additional challenges. While it is important to consider the technical and resource related aspects of e-learning when designing and developing resources for students with disabilities, there is a need to consider pedagogic and contextual issues as well. A holistic framework is therefore proposed and described, which in addition to accessibility issues takes into account learner needs, learning outcomes, local factors, infrastructure, usability and quality assurance. The practical application and implementation of this framework is discussed and illustrated through the use of examples and case studies.

  16. 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.

  17. Accessibility of public services

    NARCIS (Netherlands)

    Poort, J.P.; Groot, I.; Kok, L.; de Graaf, D.; Hof, B.J.F.

    2005-01-01

    The accessibility of certain products and services to all people, irrespective of their income, age, health and geographical location is considered to be of great social importance. Think for instance of health care, education, electricity, and sanitation. Accessibility can be secured in a variety

  18. 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...

  19. Standards and Access.

    Science.gov (United States)

    Fox, Tom

    1993-01-01

    Argues that easy claims about the relationship between language mastery and academic or economic access (made by both conservative commentators on education and mainstream writing teachers) are false and obscure real social and political boundaries, such as racism, sexism, elitism, and homophobia, that really do prevent access. (SR)

  20. 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